A smoke-free poster at a bus stop in Yunnan

Eight campaigns and initiatives aimed at encouraging people to quit smoking were launched this week by Vital Strategies and partners to mark World No Tobacco Day on 31 May 2021. 

Tobacco use is the single greatest source of preventable death and disease worldwide – responsible for eight million deaths each year and the theme of this year’s World No Tobacco Day was “commit to quit.” 

José Luis Castro, President and CEO of Vital Strategies

“Now is the time for bold, comprehensive action on tobacco. COVID-19’s tragic toll has fuelled vulnerabilities from decades of under-investment and inattention to prevention and preparedness, including more than a billion people more susceptible to illness because of current tobacco use,” said Jose Luis Castro, President and CEO of Vital Strategies, in a statement. 

Vital Strategies’ World No Tobacco Day campaigns support policies to discourage and reduce smoking, and to keep the industry out of tobacco control legislation, reaching millions around the world. 

India – “When You Quit” Campaign

Vital Strategies and WHO India launched the campaign, “When You Quit” on national radio stations and on digital television platforms, and disseminated a communications toolkit with social media resources to communicate the harms of tobacco use. 

Indonesia – New Smoke-Free Laws 

In Bandung, Indonesia, Mayor H Oded Muhammad Danial unveiled a new smoke-free law that prohibits smoking in seven types of public spaces. Bandung, with its smoke-free law, was part of the many cities that participated in the Partnership for Healthy Cities global network supported by Bloomberg Philanthropies in partnership with WHO and Vital Strategies.   

Philippines – Running to Quit

The Philippines Department of Health and Vital launched a virtual ‘Smoke-Free Challenge’, where participants competed in virtual distance-based activities, such as running, walking, and swimming, promoting health activities. 

China – Promotion of Smoke-Free Policies 

Vital Strategies promoted smoke-free policies in China with two public service announcements, “Cigarettes are Eating Your Baby Alive” and “Smoke-Free Family”, reaching more than one million people through an online event organized with the National Health Commission. 

Vital also worked with the Yunnan Health Education Center and Health Education Association to provide posters on the importance of smoke-free policies for 200,000 posters bulletin boards across the province. Other cities in China also launched social and mass-media campaigns. 

Ukraine – Tobacco Use and Risks From COVID-19

“A Doctor’s Warning” is a new media campaign on tobacco use and COVID-19 launched in Ukraine, in partnership with the Public Health Center of the Ministry of Health and the NGO Life Advocacy Center. The campaign featured a testimonial from a prominent doctor on how smoking increases the risk of COVID-19. 

Vietnam and Bangladesh – Protecting Loved Ones From Secondhand Smoke

In Vietnam, “Quit Smoking to Protect Your Loved Ones,” recounts the story of Le Thi Tinh, who developed lung cancer after regular exposure to secondhand smoke in her home. The campaign is run on national television channels and on the Smoke-Free Vietnam Facebook page through June.  

In Bangladesh, the government aired the public service announcement, “Smoke-Free” homes for six weeks on the state-owned television channel, Bangladesh Television. The messaging focused on the importance of quitting smoking to protect loved ones from secondhand smoke, and was supplemented by posts to the Facebook page, Stop Tobacco Bangladesh. 

Brazil – Ending Electronic Nicotine Delivery Systems 

The Brazilian Medical Association and Cancer Foundation launched a social media campaign focused on the importance of banning ENDS in Brazil and pushing back against industry efforts to overturn it. 

The Facebook live launch event of “Quit Smoking to Protect Your Loved Ones” in Vietnam

Stopping Tobacco Industry Interference in National Policy

Castro urged governments to enact policies that support healthier choices for all, especially through the use of effective tobacco control laws, such as the WHO’s Framework Convention on Tobacco Control (FCTC). 

“For our healthiest future, we must act to shape our society and our environment to support health,” he said, adding that this includes contending with persuasive marketing from the tobacco industry and the influence of the industry on government policies. 

The Global Tobacco Industry Interference Index 2020, released by STOP (Stopping Tobacco Organizations and Products), also showed that the tobacco industry has been using the pandemic to promote itself through donations of necessary goods, in order to gain a foothold in tobacco policies of national governments.  

Pakistan health authorities continue in their struggle to implement the FCTC, though the treaty was signed in 2004. In addition, tobacco control activists fear that the government has given in to industry pressure to close down its only government body addressing tobacco consumption, the Tobacco Control Cell (TCC). 

Meanwhile, the Kenyan government, earlier this year, had issued a directive requiring the tobacco industry to register all nicotine products as tobacco products. 

The Kenya Tobacco Control Alliance (KETCA) had also called on the government to act fast, as tobacco use is a bigger epidemic than COVID-19, and requested the Ministry of Health to tighten tobacco control regulations. 

“Tobacco use continues to kill at least 9,000 Kenyans every year. This is three times the total number of Kenyans killed by Covid-19 in the last one year. By Sunday, May 30, 2021, Covid-19 had killed 3,157 Kenyans,” said Joel Gitali, chairman of the KETCA.

 

 

Image Credits: Vital Strategies, Vital Strategies.

European Commission President Ursula von der Leyen suggests that the EU’s counter-proposal to the TRIPS waiver offers “concrete short and medium term solutions to ensure universal access at affordable prices”.

Humanitarian organisation Médecins Sans Frontières (MSF) has criticised the European Union’s (EU) opposition to the TRIPS waiver, labelling its counter-proposal published on Friday as a “manoeuvre” to replace a concrete legal solution to COVID-19 vaccine manufacturing.

Ahead of next week’s TRIPS council meeting scheduled for 8-9 June, Senior Legal and Policy Advisor at MSF’s Access Campaign, Yuanqiong Hu, said the EU’s counter proposal not only ignored critical corrections needed to overcome the shortcomings of existing rules, but also failed to address access to a sustainable supply of tests and other life saving devices beyond vaccines and therapeutics.

The EU has consistently opposed India and South Africa’s proposal at the World Trade Organization (WTO) to temporarily waive certain intellectual property rules under the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS Agreement), a measure that would expand access to lifesaving vaccines and other health products. 

Their entrenched position comes despite growing support for the TRIPS waiver – including an indication by the US that it was willing to move to text-based negotiations on the proposal.

On Friday, the EU published its proposal to WTO members for a multilateral trade action plan to expand the production of COVID-19 vaccines and treatments, and ensure universal and fair access. 

The EU remains adamant that, while it is open to discussing options that could help end the pandemic, the TRIPS waiver is not the solution. 

“(The EU) is not convinced that this would provide the best immediate response to reach the objective of the widest and timely distribution of COVID-19 vaccines that the world urgently needs” the body said in a statement.

Key to the new proposal is a need for voluntary licences to facilitate the expansion of production and sharing of expertise. 

“Where voluntary cooperation fails, compulsory licences, whereby a government grants a targeted licence allowing a willing producer to make a vaccine without the consent of a patent holder, are a legitimate tool in the context of a pandemic,” states the proposal.

EU Proposal Fails to Extend Beyond Vaccines

Highlighting the EU’s counter-proposal, European Commission Executive Vice-President and Commissioner for Trade, Valdis Dombrovskis, warned against “complacency” as the world continues to fight the COVID-19 pandemic. One of the main problems currently, is the lack of sufficient manufacturing capacity to rapidly produce the required quantities of COVID-19 vaccines. 

“We need to urgently concentrate on proposals that accelerate the equitable distribution of COVID-19 vaccines worldwide, said Dombrovskis, adding that: “In this respect, a strong multilateral trade response could deliver a huge boost in the fight against COVID-19.”

“The objective must be to ensure that any available and adequate manufacturing capacity anywhere in the world is used for the COVID-19 vaccines production.”

MSF’s Hu however called out the EU’s resistance to the TRIPS waiver, pointing out that its reference to compulsory licensing is already permitted in the current provisions and practices of the TRIPS Agreement.

“The EU’s counter-proposal to the TRIPS waiver is a manoeuvre to push for voluntary actions of pharmaceutical corporations as a solution to replace a concrete legal solution backed by more than 100 countries,” said Hu.

According to Hu, MSF’s analysis has found that compulsory licenses alone would not be enough to achieve urgent access to lifesaving COVID-19 medical tools, even for the EU itself, during the pandemic.   

Importantly, said Hu, the EU counter-proposal only applies to patent barriers and fails to address intellectual property (IP) barriers that need to be waived when countries and manufacturers seek to scale up the manufacturing and supply of COVID-19 vaccines, medicines and other health technologies. 

“It also fails to mention the need to ensure access to a sustainable supply of tests and other life saving devices beyond vaccines and therapeutics,” said Hu.

“Concrete Short and Medium Solution” to Vaccine Manufacturing

However, EC President Ursula von der Leyen said the EU’s counter-proposal offers “concrete short and medium term solutions to ensure universal access at affordable prices”.

“Beyond the current crisis, it is important to ensure global preparedness for future pandemics: diversifying manufacturing so that it is not centralised only in a handful of countries and strengthening the resilience of the healthcare infrastructure in least developed countries,” said von der Leyen.

The EU’s proposal is based on trade facilitation and disciplines on export restrictions, support for the expansion of production, and clarifying and simplifying the use of compulsory licences during crisis times”.

Elements of the proposal include limiting the use of export restrictions for vaccine-producing countries and keeping supply chains open and uninterrupted; calling on governments to encourage and support vaccine manufacturers and developers to expand production and ensure the affordable supply of vaccines to low- and middle-income countries. 

“Such actions could include licensing agreements, the sharing of expertise, tiered pricing including non-profit sales to low-income countries, contract manufacturing and new investments in manufacturing facilities in developing countries,” states the proposal.

Image Credits: R Santos/HP Watch.

Ultra-processed food is a staple diet for Mexican 10-year-old Ricky and his mother, Alicia.

UK farmers use half the antibiotics they did in 2014; Mexico has reduced stunting by 6% in the last 30 years, and Pakistan is offering conditional cash transfers to poor families to improve their nutrition. 

These examples of how countries are trying to fix broken food systems were offered at Friday’s Healthy Food Systems dialogue, co-hosted by the World Health Organization (WHO), EAT, and the Global Alliance for the Future of Food.

Opening Friday’s dialogue, WHO Director-General Dr Tedros Adhanom Ghebreyesus said that “we need a new food systems narrative that embraces the interconnectedness of humans, animals, and the planet that sustains us”. 

The dialogue marked the start of a week-long series of global conversations in preparation for the United Nations (UN) Food Systems Summit in September and the civil society “pre-summit” next month.

UN Secretary-General Antonio Guterres has called the summit to address how to build healthier, more sustainable and equitable food systems to achieve the Sustainable Development Goals (SDGs) by 2030.

Tedros told the dialogue that the  WHO proposes a new food system based on five major pathways:

“First, unhealthy diets, and food insecurity, with impacts including overweight and obesity, undernutrition, micronutrient deficiencies and diet-related non-communicable diseases,” he said.

“Second, zoonotic pathogens and antimicrobial resistance which impacts farm ranged and wild-caught animals. 

“Third, unsafe and adulterated foods, including those containing hazards such as pathogens, chemicals and toxicants. 

“Fourth, environmental contamination and degradation through pollution of soil, air and water resources and fifth, occupational hazards, including harm to physical and mental health, suffered by workers in the food system,” said Tedros.

New Food System Narrative is Needed

Dr Agnes Kalibata, UN Special Envoy to the Food Systems Summit

Francesco Branca, WHO’s Director Nutrition and Food Safety, said that the Food Summit provides an opportunity “to develop a new food system narrative centred around upholding human, ecological and animal health using a One Health approach”.

“Current narratives do not always recognise these interconnections and could miss the opportunity of a radical food system transformation, building on the pandemic recovery process,” he added.

Dr Agnes Kalibata, UN Special Envoy to the Food Systems Summit, said that although “we thought our food systems have been designed to provide us with food”, instead we were faced with obesity, hunger, malnutrition and biodiversity loss.

She added that food system dialogues had been taking place all over the world and over 2,500 proposals to fix the broken system had already been put forward.

“I hope that we don’t squander the opportunity that the Food System Summit is giving us to pivot our food system into something that works for all of us,” said Kalibata.

“We have a lot of inequity in our systems. So we need our food system to work for us from a health perspective and from a food perspective.”

Mexico Struggles with Stunting and Obesity

Juan Rivera, Director General of Mexico’s National Institute of Public Health

Juan Rivera, Director General of Mexico’s National Institute of Public Health, outlined a major problem facing many developing countries – the seemingly paradoxical problems of stunting and obesity.

“Stunting dropped in the last three decades from 20% to 14%. And I think that what worked was a combination of nutrition-sensitive actions, such as the provision of nutritional supplements and nutrition education, along with the access to health care of children under five targeted to the poorest population, and conditional cash transfers to incentivise the utilisation of those services,” said Rivera.

“On the other hand, during the same period, we experienced a huge increase in overweight and obesity in Mexico,” he added. 

“In adults, we went from 35% to 70% overweight and obesity and in adolescents from 11% to 40%,” which had made Mexico vulnerable to severe illness and death from COVID-19,” said Rivera. Mexico has one of the highest obesity rates in the world.

“In the last seven years, we have implemented measures to limit the availability and accessibility of unhealthy foods and beverages through taxes, limiting availability to children through school regulations, restraining advertising of unhealthy food for children and adolescents and providing simple and clear information to consumers, and trying to reduce food processing through front of packet warning labels to reduce the intake of unhealthy ultra-processed food,” said Rivera.

Johanna Ralston, Chief Executive of the World Obesity Federation, said that “90% of deaths due to COVID are occurring in countries with high rates of obesity which tells us that probably COVID is the second predictor after age of poor outcomes”.

“COVID-19 highlighted the extremes about all that’s broken in our food systems,”  added Ralston, who said that obesity was “particularly exacerbated by consumption of ultra-processed foods and unhealthy beverages”.

G7 Commits to Addressing AMR 

Dame Sally Davies, the UK’s Special Envoy on AMR

Dame Sally Davies, the UK’s Special Envoy on Antimicrobial Resistance (AMR) reported on a glimmer of hope on addressing AMR.

“Through a collaborative and multi-sectoral voluntary approach to antibiotic stewardship in livestock production, antibiotic sales for food-producing animals in the UK has halved since 2014. This makes the UK one of the lowest users of antibiotics in agriculture, amongst those countries, with a significant livestock farming industry,” said Davies.

She was also encouraged by the commitment by climate and environment ministers at last week’s G7 meeting to reduce the inappropriate use of antimicrobials and to make the manufacturing of antibiotics more friendly for the environment.

“Our dependence on antimicrobials has become so excessive that our systems are now unsustainable and our treatments are becoming less effective,” warned Davies.

“This silent pandemic is on the rise. And if we don’t get our act together, it could kill 10 million people each year by 2050. 

“You see antimicrobials being used for food-producing animals to promote rapid growth for a faster route to market. That increases the prevalence of antibiotic-resistant bacteria in animals, potentially untreatable infections. This approach is short-term and risks the sustainability of our food systems.”

Well-being of Animals and People is Connected

Philip Lymbery, CEO of Compassion in World Farming, said that one lesson that could be learned from COVID-19 “is the well-being of people, animals and the planet are all interconnected”.

“COVID has been linked to the ill-treatment of wildlife. A source of both past and future pandemics is industrial animal agriculture or factory farming,” said Lymbery. “Keeping thousands of animals caged, crammed and confined is inherently unhealthy, producing the perfect breeding ground for disease,” he added, pointing out that swine flu from factory farms had killed about half a million people worldwide. 

“Industrial agriculture is not only the biggest causes of animal cruelty on the planet. It is also a major driver of deforestation, decline in the world’s wildlife and a consumer of more than two thirds of the world’s antibiotics.”

Hundreds of local, national and international events are being convened to discuss food system transformation, with those involved in food policy urging a global adoption of a “One Health” approach –  upholding human, ecological, and animal health – before the next pandemic.

 

ends

Image Credits: The American Society for the Prevention of Cruelty to Animals, UNICEF.

Africa CDC Director Dr John Nkengasong is optimistic that the WHO’s approval of two Chinese-made COVID-19 vaccines and its inclusion in the COVAX facilty will help expedite Africa’s vaccination programmes.

A deal is in the works for the global COVAX vaccine facility to procure two Chinese-made COVID-19 vaccines recently approved by the World Health Organization for emergency use – greatly expanding vaccine choices for low- and middle income countries, Africa Centers for Disease Control Director John Nkengasong, told Health Policy Watch on Thursday.

“The good news is that the Chinese vaccines that have just been provided with the emergency use authorization by WHO, will also be engaging with COVAX so that they can make available their vaccines to the COVAX facility,”  Nkengasong said at a press briefing. 

The addition of those options to COVAX will help expedite Africa’s vaccination programmes and put the continent on track towards achieving herd immunity, he said. 

“I think that will improve our ability and diversify our options,” he added.  

Last week, WHO’s expert committee said it would approve the two-dose Sinovac COVID-19 vaccine for its “emergency use listing”. That made it the eighth vaccine to receive WHO approval and followed on from WHO’s approval of the Chinese Sinopharm vaccine on 7 May.

The COVAX facility, which is supplying vaccines to over 100 low and middle income countries, has been desperately short of vaccines since it’s main supplier, the Serum Institute of India, redirected all of its production to domestic use following a huge domestic surge in infections that began in April. 

“We can only be optimistic and hopeful that the new vaccines that have been approved will actually also help us increase the uptake of vaccines on the continent,” Nkengasong said. “I believe they will improve our abilities and diversify our options to access vaccines which up to now were extremely constrained with the crisis that India went through.”

Unlike the next-generation mRNA vaccines, both the Sinopharm and SinoVac vaccines are based upon a conventional vaccine delivery platform – using an inactivated SARS-CoV2 virus to stimulate immunity. 

The vaccines can be stored at normal fridge temperatures, making them  easier to roll out in resource limited settings in various African countries. This in contrast to the mRNA vaccines by Pfizer/BioNTech and Moderna, which need to be stored at freezer conditions or below, creating major logistical problems, especially in rural areas.

Countries shouldn’t rule out use of the mRNA vaccines or others that require stricter cold chain storage conditions  – but rather be selective about where they are used, Nkengasong stressed. 

“I would encourage countries to look at things through their vaccine plans and not ‘excuse’ any vaccine but make it part of the vaccination strategy and implementation plan,” Nkengasong said.

“Sputnik Light” Single dose Vaccine Also Being Rolled Out  

Adding yet another vaccine to the array is a new Russian single dose COVID-19 vaccine that was just approved by the first African country. On Wednesday, Mauritius granted emergency use authorization to the “Sputnik Light vaccine, which also may be rolled out soon in India.  

Sputnik Light is in fact simply the first dose of the two-dose Sputnik V vaccine; its developers claim that the first dose alone achieves an efficacy rate of 79.5 %, as compared to 91.6% for the original two dose regime. 

A technologically more advanced vaccine than its Chinese counterparts, Sputnik V used the SARS-CoV-2’s DNA instructions for building the distinctive coronavirus spike protein as a vehicle for stimulating the body’s immunity. That DNA is delivered in an inactivated  adenoviruses, a kind of virus that causes colds. 

If the efficacy data reported so far by Sputnik’s developers, the Russian Direct Investment Fund (RDIF) is validated by WHO or another independent regulatory authority, that would make Sputnik Light as efficient – or even more so, than the two Chinese vaccines, and comparable with the efficacy of the single dose Johnson & Johnson vaccine, which is being deployed in South Africa.  So far, however, neither the European Medicines Agency nor WHO have approved the vaccine for emergency use. 

However, according to latest WHO update on its reviews of Covid-19 vaccines, the Organization’s review of the original Sputnik V two-dose vaccine is still lagging far behind its Chinese counterparts.  Additional clinical and non-clinical data are still to be provided by RDIF, and manufacturing facility inspections are pending for June.  As for the Sputnik Light, no dossier has even yet been submtited to WHO for review.

COVAX Deliveries Resuming 

Another bright spot on the horizon, said Nkengasong, is the fact that the first donations of vaccines by rich countries are reaching more African countries now. There are, however, indications, that COVID-19 vaccination in Africa could soon be back on track with three African countries receiving doses of Oxford-AstraZeneca and Pfizer vaccines via COVAX.

A major boost for Africa is the announcement of United States President Joe Biden on Thusday tht his country would share 80 million surplus US COVID-19 vaccine doses with other countries in need by the end of June – approximately 5 million would go to Africa.

On May 27, Rwanda received 247,000 doses of AstraZeneca vaccine from the COVAX facility and this included 117,600 doses donated by France. 

“With these doses, Rwanda will be able to resume its vaccination campaign and fully immunize those who previously received the first dose of the vaccine,” Nkengasong said.

Rwanda received 100,600 additional doses of the Pfizer vaccine from COVAX on June 1, while  Burkina Faso received 115,200 doses of the AstraZeneca vaccine from the COVAX facility on Monday. Two days later, on Wednesday, Burkina Faso launched its national COVID-19 vaccination campaign. Togo also received about 100,000 doses of the Pfizer vaccine.

WHO Warning – Southern and Eastern African Countries Experiencing a Surge 

Dr Matshidiso Moeti, director of WHO’s Africa Regional Office.

But doses are quickly running dry in many African countries, WHO also said on Thursday, noting that  nearly 20 African countries have used up more than two-thirds of their doses.

And at the same time that new vaccine approvals and COVAX procurement deals may hearken light at the end of the COVID-19 tunnel, southern and eastern African countries are witnessing COVID-19 resurgence, underlining the need for an urgent boost in critical care capacity to prevent health facilities from being overwhelmed.

“Weak observance of preventive measures, increased population movement and interaction as well as the arrival of winter in southern Africa have heightened the risk of COVID-19 resurgence in many countries,” said Dr Matshidiso Moeti, director of WHO’s Africa Regional Office, in another press briefing.

Over just the last two weeks, the continent had recorded a 20% increase in COVID-19 cases compared to a fortnight ago. The pandemic is also trending upwards in 14 countries and in the past week alone, eight countries witnessed an abrupt rise of over 30% in cases,  said Moeti.

While Africa’s reported infection rates throughout the pandemic have generally been lower than almost any other region of the world,  African public health officials have been nervously eyeing the India experience, where historically low rates were followed by an extraordinary surge in cases. At the peak, infection rates approached 400,000 cases a day, creating unprecedented demands on health systems and in particular on oxygen supplies. 

If a similar scenario were to play out in African countries with even weaker health systems, the results would be nightmarish – particularly in light of the fact that African countries have even less access to vaccines than India, which is manufacturing two vaccines in the country. As a result,  any trend of rising cases is a cause of concern.   

“South Africa is reporting a sustained increase in cases, while Uganda saw a 131% week-on-week rise last week, with infection clusters in schools, rising cases among health workers and isolation centres and intensive care units filling up. Angola and Namibia are also experiencing a resurgence in cases,” Moeti said.

Of the 53.5 million COVID-19 vaccine doses delivered so far to 50 African Region member states, 38.1 million doses have been administered, according to Africa CDC.

So far, only 0.54% of the African population has been fully vaccinated, although that represents  an increase of 0.8% compared to the previous week. WHO and CDC officials said. 

Five countries are leading vaccine rollouts on the continent (Morocco – 14 million doses, Egypt – 2.4 million doses, Nigeria – 2 million doses, Ethiopia – 1.8 million doses, and Zimbabwe – 1 million doses). Five African Union member states – Tanzania, Saharawi Republic, Eritrea, Chad and Burundi – are yet to commence vaccine rollouts at all. 

Some  29 countries are now reporting the presence of the more infectious B.1.1.7 variant, originally reported in the UK, while 26 countries are reporting the B.1.351 variant, originally reported in South Africa. 

In light of all of those factors, Moeti warned that the threat of a third wave in the continent “is real and rising”, adding that the priority now is to swiftly :get vaccines into the arms of Africans at high risk of falling seriously ill and dying of COVID-19”.

“Many African hospitals and clinics are still far from ready to cope with a huge rise in critically-ill patients. We must better equip our hospitals and medical staff to avert the worst effects of a  runaway surge,” said Moeti. “Treatment is the last line of defence against this virus and we cannot let it be breached.”

Image Credits: Paul Adepoju.

White House Press Secretary Jen Psaki at briefing Thursday on the US COVID vaccine- sharing plans

United States President Joe Biden on Thusday unveiled a detailed strategy for sharing 80 million surplus US COVID-19 vaccine doses with other countries in need by the end of June.

A detailed allocation plan for the first 25 million of those vaccine doses calls for sharing 75%  through the WHO-cosponsored COVAX global vaccine facility – while some 25% of doses would be shared bilaterally “for immediate needs and to help with surges around the world.”

The latter group of countries, receiving some six million doses, would include Canada, Mexico, the Republic of Korea and COVID-struck India, as well as the Israeli-occupied West Bank and Hamas-controlled Gaza, according to a detailed statement published this afternoon by The White House.

“Twenty-five million doses will be going out as soon as we can logistically get them out the door,” said White House Press Secretary Jen Psaki, in a briefing on the strategy shortly after the announcement.  She called it a “historic, herculean effort, to get these doses to all of the communities and countries that we committed them to” – before their expiry dates.

She said that all doses being shared would be drawn from US FDA approved stocks – meaning either vaccines produced by Moderna, Pfizer or Johnson & Johnson’s one-dose vaccine – although she provided no details on the exact mix.

US Allies & Countries Embroiled In Regional Conflicts Also Get Some Vaccine Doses

A more detailed fact sheet  also noted that some of the six milion doses to be shared directly would go to a shortlist of countries embroiled in, or bordering on regional conflict zones or natural disaster areas, including: ” West Bank and Gaza, Ukraine, Kosovo, Haiti, Georgia, Egypt, Jordan, Iraq, and Yemen, as well as for United Nations frontline workers.”

Although 19 million doses would be shared with COVAX – in line with recent White House pledges to support the global vaccine sharing plan – Biden’s statement also earmarked specifically where it wants COVAX to distribute those doses. The designations follow in line with a trend whereby donor countries have been sharing spare doses with the COVAX facility – while also prioritizing regional neighbours or allies.

In the case of the US COVAX donations, the detailed rundown of priorities include:

  • Approximately 6 million for South and Central America to the following countries: Brazil, Argentina, Colombia, Costa Rica, Peru, Ecuador, Paraguay, Bolivia, Guatemala, El Salvador, Honduras, Panama, Haiti, and other Caribbean Community (CARICOM) countries, as well as the Dominican Republic.
  • Approximately 7 million for Asia to the following countries and entities:  India, Nepal, Bangladesh, Pakistan, Sri Lanka, Afghanistan, Maldives, Malaysia, Philippines, Vietnam, Indonesia, Thailand, Laos, Papua New Guinea, Taiwan, and the Pacific Islands.
  • Approximately 5 million for Africa to be shared with countries that will be selected in coordination with the African Union.

White House Denies Geopolitical Considerations In Vaccine Priorties

Even so,  a White House statement denied that geopolitical considerations had played a role in its prioritization, with the caveat that, “We are sharing these doses not to secure favors or extract concessions. We are sharing these vaccines to save lives and to lead the world in bringing an end to the pandemic…”

Rather, the statements said that the priortization of doses was meant to favour “countries in urgent need” as well as countries with “vaccine readiness plans that prioritize individuals at highest risk of severe disease and those working to help care for them, like health care workers.”

While not a new commitment, the detailed plan follows upon a pledge made by Biden in May to “share 80 million doses of our vaccine supply with the world.”

The Biden announcement also follows on the heels of a major COVAX donor event on Monday, that raised US $2.4 billion more for the facility, as well as new announcements from Belgium, Denmark, Japan, Spain and Sweden to share a total of 54 million vaccines.

In it, the President also reaffirmed US commitments to funding for COVAX  as well as US support for a temporary waiver on intellectual property associated with COVID vaccine manufacture:

“Already the United States has committed $4 billion to support COVAX, and we have launched partnerships to boost global capacity to manufacture more vaccines,” said the statement. “My administration supports efforts to temporarily waive intellectual property rights for COVID-19 vaccines because, over time, we need more companies producing life-saving doses of proven vaccines that are shared equitably….

Other measures being pursued include: “working with U.S. manufacturers to increase vaccine production for the rest of the world, and helping more countries expand their own capacity to produce vaccines including through support for global supply chains.

“This vaccine strategy is a vital component of our overall global strategy to lead the world in the fight to defeat COVID-19, including emergency public health assistance and aid to stop the spread and building global public health capacity and readiness to beat not just this pandemic, but the next one.

“As long as this pandemic is raging anywhere in the world, the American people will still be vulnerable. And the United States is committed to bringing the same urgency to international vaccination efforts that we have demonstrated at home.”

Image Credits: C-Span.

unaids
UNAIDS Executive Director Winnie Byanyima

Despite the disruptions of the COVID pandemic, dozens of countries have met or exceeded the ambitious targets set by the UN General Assembly towards a goal of ending AIDS by 2030, with evidence indicating that targets were not just aspirational but achievable, according to a new report by UNAIDS.

The report, released today, shows that countries with progressive laws and policies and strong and inclusive health systems have had the best outcomes against HIV. 

In these countries, people living with and affected by HIV are more likely to have access to effective HIV services, which include HIV testing, pre-exposure prophylaxis (medicine to prevent HIV), harm reduction, and multi month supplies of HIV treatment.

“High-performing countries have provided paths for others to follow,” said UNAIDS Executive Director Winnie Byanyima.

“Their adequate funding, genuine community engagement, rights-based and multisectoral approaches and the use of scientific evidence to guide focused strategies have reversed their epidemics and saved lives. These elements are invaluable for pandemic preparedness and responses against HIV, COVID-19, and many other diseases.” 

Globally, the report shows that the number of people on treatment has more than tripled since 2010, with 27.4 million of the 37.6 million people, 75% of those living with HIV were on treatment. This roll-out of quality, affordable treatment is estimated to have averted 16.2 million deaths since 2000. 

COVID-19 Still Sets Back Progress In Some Countries  

Quarraisha Abdool Karim, Associate Scientific Director of CAPRISA

However, despite those bright spots, some countries and regions are off-track, with previous gains in eliminating AIDS being reversed due to COVID-19, conflicts, and humanitarian emergencies.  Particular problem areas that need more focus exist in eastern Europe, central Asia and parts of Sub-Saharan Africa, she said. 

“Our progress towards ending AIDS is further threatened by COVID-19,” said Byanyima during a launch of the report.

“In the last year, the trend is in the wrong direction. Countries with punitive laws that do not take a rights-based approach to health punish, ignore, stigmatize, and leave key populations on the margins and out of reach of HIV services.” 

“Our gains over the last year are something that we might lose because of COVID-19,” said Maximina Jokonya, Y+ Global HER Voice Fund Coordinator. 

To get sub-Saharan Africa back on track to meet the 2030 targets for HIV/AIDS will require expanding high impact treatment and prevent for key populations – adolescent girls and young women, and young men, said Quarraisha Abdool Karim, Associate Scientific Director of the Centre for the AIDS Programme of Research in South Africa (CAPRISA).

“We need to ensure the sustainability of an HIV response [that breaks down] social and structural barriers.”

“We have seen how community services and leadership enable us to reach affected communities with essential services under the most difficult circumstances.”

Young People as Decision-Makers and Experts in HIV/AIDS

A man uses the HIV self-test and waits a few minutes for his results.

In the fight against HIV/AIDS, Jokonya emphasized the need for countries and decision-makers to not forget the voices and rights of young people, a group often left behind in these important discussions.

“Are we making sure their voices are being heard, their priorities are being put in place, and they’re also involved in key decision making processes to make sure they have access to services?” 

Though ideas are sought out from young people, they are often not involved in program design or implementation.

However, Jokonya pointed out that since young people are the ones experiencing HIV/AIDS, they are the experts when it comes to their health. 

“We need policies that speak to young people themselves in their diversity.” 

These policies give an opportunity not only to integrate HIV services into health more broadly, but also to integrate other aspects of health that are also neglected, such as sexual and reproductive health, and mental health.  

“We are saying no to tokenism, we are saying no to manipulation. We want meaningful and ethical engagement with people being able to participate and have a voice.” 

Gender Inequality in HIV/AIDS Policy

Six out of seven new HIV infections in the sub-Saharan African region are from adolescent girls aged 15 – 19 years

Women are continually left behind in HIV/AIDS policy, especially in sub-Saharan Africa, with six out of seven new HIV infections from adolescent girls 15 – 19 years of age and 4500 adolescent girls and young women newly infected every week in the region. 

AIDS is also the leading cause of death in adult women aged 15 to 49 years old. 

According to Karim, the root cause of this lies in gender inequality.

“[Gender inequality] underpins harmful gender norms that restrict women’s access to HIV and sexual reproductive health services. It’s exacerbated by a parallel pandemic of gender-based violence and limited agency and decision making power.”

Globally, only 55% of adult women have the agency and autonomy to say no to sex, decide on the use of contraception, and decide on their own healthcare.

Girls are least likely to complete second education, leading to missed opportunities for the provision of comprehensive sexual health education that can shift toxic gender norms for both young boys and young girls. 

Law and Policy – Determines Access to HIV Treatment 

Community Health Workers attend a training session on HIV accompaniment in Kirehe, Rwanda.

The growing gap between and within countries on HIV/AIDS elimination is driven very significantly by law and policy, said Matthew Kavanagh, Director of Global Health Policy and Politics Initiative at Georgetown University’s O’Neill Institute. 

“Law is a determinant of health. Law structures inequality; policy drives success and failure in the pandemic response.” 

Countries that criminalized gay men and other men who have sex with men, sex workers, and people who inject drugs saw significantly less sucess in the 90-90-90 targets. 

The 90-90-90 targets, agreed by the United Nations General Assembly in 2016, call for the vast majority of people living with HIV to be tested, start treatment and reduce HIV within their bodies to undetectable levels by 2020. 

HIV Policy Lab data shows that only 21 countries in the world have fully adopted national policies aligned with WHO recommendations for treating, preventing, and managing HIV/AIDS. 82 countries have policies that restrict access to PrEP and are not aligned with the WHO. 

Policy alignment remains uneven and contradictory, with only some people eligible in certain countries – for example, gay men, but not young women or sex workers, may have access to PrEP.  

Kavanagh called the differences in law and policy ‘substantial’, that criminalization is associated with factors that drive HIV infections across the whole population. 

He also added that alongside criminal laws and rights laws, laws on access to science are also impact access to treating HIV.

“It’s critical that in the next five years there’s a sharp focus on building law and policy environments that enable us to get back on track to defeat HIV.” 

UNAIDS Urges Action in Upcoming UN General Assembly Meeting on AIDS 

United Nations General Assembly hall in New York City

With the upcoming UN General Assembly holding its fifth high-level session on HIV and AIDS on 8-10 June, Byanyima called on governments to commit to taking a people-centered, rights-based approach to HIV, and to work with policy reform, to engage and support communities and to end inequalities.

“We need to build on this momentum to drive forward political will and commitment to end AIDS. We need commitment for better technologies and treatments for a vaccine, and for a cure to get the world back on track.”

Image Credits: ©PSI-Dogsontherunphotography, UNAIDS, Cecille Joan Avila / Partners In Health, Patrick Gruban.

Staff Association President Catherine Kororei Corsini

Shortcomings and failures in the World Health Organization’s internal justice system  –  laid bare during revelations of sexual abuse and exploitation in DR Congo –  require more systematic reform to make the system transparent, fair and equitable, the head of WHO’s Staff Association told WHO’s Executive Board governing body on Wednesday.  

“Delays in responding to allegations of wrongdoings still affect the work environment of too many WHO personnel,”  said Staff Association President Catherine Kororei Corsini, delivering both oral remarks and a written statement to the EB. 

While the DRC cases have received wide media attention, broader issues need to be resolved, she noted. Among those, she said that the Organization had yet to “revise and share its investigation policy, and to establish time targets and indicators for monitoring investigations.” 

“We need an internal justice system that is well functional and able to deliver in a timely manner. We need a system that all staff have confidence in. We have on several occasions said that justice delayed is indeed justice denied.” 

In a written statement that went further, the Staff Association added that staff members who feel that they have been wrongly accused remain on an “unequal footing” with the organization – when forced to take on expensive appeals of their cases beyond WHO internal channels – to the broader UN tribunal, of the International Labour Organization (ILOTA).  

“Today, many staff members are not able to exercise their right to an appeal process because they cannot afford the legal fees,” statement by Staff Associations representing some 9000 people employed in WHO’s global organization as well as UNAIDs. “Staff members who feel they are victims of wrong-doing by the Organization are in a disadvantaged situation vis-à-vis the Organization in terms of means for the defence of their case. In particular, staff members must personally spend considerable amounts of money from their salaries or savings to pay for a lawyer. 

“That is the case even when they benefit from the limited insurance coverage provided by the staff associations, a benefit that staff in regions do not have. Some staff are even obliged to take out a private financial loan to be able to afford the appeal process. The staff member is thus on an unequal footing with the Organization in the face of litigation.

“We need an internal justice system that is well functional and able to deliver in a timely manner. We need a system that all staff have confidence in. We have on several occasions said that justice delayed is indeed justice denied.” 

Comments Follow Reports of Sexual Abuse Scandals in DR Congo

A series of media reports have recently come to light about extensive sexual abuse scandals in DR Congo

The comments came on the heels of a lengthy discussion by WHO member states at last week’s World Health Assembly about a series of recent media reports  of extensive sexual abuse and exploitation of Congolese women by WHO aid workers supporting DRC response to the 2018-2021 Ebola epidemic. 

Coinciding with those debates, some 54 member states and the European Union signed a joint statement voicing concerns over the allegations of sexual exploitation and abuse – and even more critically – the possibility that “WHO management knew” – but failed to report about some allegations or even acted to “suppress the cases.”  

“We expressed alarm at the suggestions in the media that WHO management knew of reported cases of sexual exploitation and abuse, and sexual harassment and had failed to report them, as required by UN and WHO protocol, as well as at allegations that WHO staff acted to suppress the cases,” said the joint statement. 

 

In remarks to the EB, the Staff Association President expressed the dismay of WHO staff over the reports and the way in which they had first been publicized by the media, but also pointed to the wider gaps and shortcomings this  had revealed in the internal justice system:    

“When misconduct on the part of members of the WHO workforce goes unaddressed. And this is not dealt with swiftly, transparently and rapidly, the reputation of the organization is damaged,” she noted in her presentation, which called for the implementation of a long-delayed  “360 degree” performance review system to address current shortcomings. 

Added the written statement: “With the required resources in place, like funding, Human Resources tracking and accountability systems, etc, incidents such as this would have been rapidly investigated, and more importantly, support would have been provided immediately to the women and children affected.”  

The statement laid out a six point plan for: “a more transparent and global approach” to WHO’s internal justice system; “fair and adequate access to justice mechanisms”; more “solutions-oriented” WHO administrative management of appeals; as well as more “transparent global reporting” and a “review of reporting lines” for review and judgment of staff cases. 

WHO Steps Addressing on Internal Justice 

In his remarks before the Executive Board, WHO Director General Dr Tedros Adhanom Ghebreyesus noted that he had created an open door policy in the Director General’s Office – where staff issues and complaints could also be aired with him directly during designated hours. He said he was encouraging managers at other levels of the organization to do the same thing.

“Frequent dialogue helps to address issues,” he said. 

He added that WHO is beginning to pilot a 350 degree performance system – which has received broad endorsement from WHO member states at the EB meeting. 

Although he noted that there remain disagreements with staff about where those pilots should begin – with senior management – or with more rank-and-file staff , “we will continue the discussion and finalize as soon as possible.”  

Tedros also said that WHO’s Internal Oversight Services (IOS) department, which manages the first two steps of internal justice review, is receiving extra funds to clear its backlog of cases. 

“They have now designed a proposal to address the backlogs and focus on the fresh investigations that they need to do. We will continue to support them. The support we gave them this year is based on their proposal, we haven’t even reduced any penny from what they proposed to have in order to close the backlogs,” the Director General said.  “As the president said, justice delayed is justice denied.”

Tackling Sexual Abuse & Exploitation 

who
Dr Tedros addressed WHO staff today at the organisation’s 149th Executive Board meeting

Speaking last week at the WHA as well as a special strategic meeting on the Assembly’s margins,  Tedros also announced a series of new initiatives to tackle sexual harassment at all levels of the WHO. 

This effort involves the creation of an Independent Commission, based in Goma, DRC, supported by a “mass of inspectors” to prioritise investigations in at least eight countries.

“We have decided to adopt new ways of doing it by appointing an independent commission. And also, by letting the Independent Commission to hire an external firm  to investigate. 

“Doing things the same way again and again will not get us a different result. That’s why we’re doing it differently so we can get a different result with regard to identifying perpetrators and also identifying the systemic problems,”  Tedros said.

The sex-for-jobs scandal has been focused in the Democratic Republic of Congo (DRC), where dozens of workers alleged abuse by WHO employees during their work as responders in the 2018-2021 Ebola outbreak. One nursing assistant had charged that a WHO doctor offered her a double salary in exchange for sex, one of multiple misconduct cases WHO allegedly knew about but failed to act on.

Independent Commission Inquiry Interrupted by Volcanic Explosion 

Goma residents flee city night of 22 May after volcanic eruption

 

However, the work of the Goma-based Independent Commission had only just begun when it was interrupted. 

The Commission’s contractor Justice Rapid Response (JRR) began its field investigations in Goma on 3 May.   Then on 22 May, the eruption of the Mount Nyiragongo volcano nearby, followed by constant earthquakes and tremors in the region, led to the suspension of activities. The ongoing risks of further eruptions, earthquakes, and the possible release of dangerous methane gas buried in adjacent Lake Kivu, has since led to the displacement of some 400,000 people, creating a massive humanitarian emergency.

“As you can imagine, the situation on the ground is very challenging starting from the security problems that exist in North Kivu, with disruptions to the Goma area caused by the volcanic eruption over the past week,” the WHO DG said last week. 

Over 50 Member States Express Concerns About Sexual Abuse & Exploitation In WHO

Stephanie Psaki, Senior Advisor on Human Rights and Gender Equity, HHS Office of Global Affairs, speaks out on sexual abuse issues at World Health Assembly

Speaking at the Assembly, Stephanie Psaki, Senior Advisor on Human Rights and Gender Equity in the US Office of Global Affairs, Department of Health and Human Services, said that member states needed to hold WHO to the highest standards of protection from sexual exploitation and abuse.

“We must work together to ensure that perpetrators face the full measure of accountability for sexual exploitation, harassment  and abuse of authority,” she said.

“Regular collaborative attention to these issues, especially in terms of ensuring locally appropriate prevention and risk mitigation measures, is necessary for decisively responding to these issues. We look forward to making tangible progress on this issue so accountability and healing can begin,” she concluded.

The focus of future inquiries should not be limited to DRC, noted Ghana’s delegate to the WHA, Iddrisu Yakubu.

“Moral grandstanding and tactic attempts to associate the problem with a particular WHO country or region, by fixating on a media report from a particular country while ignoring similar reports from other regions will not solve the problem of sexual exploitation and abuse, which as we all know, is a real danger in many countries and organizations. The WHO needs our support to address what is essentially a structural problem afflicting many of our own national institutions,” he said.

Image Credits: WHO, WHO, @GuerchomNdebo, WHO .

The United States representative to the Executive Board on Wednesday – speaks out sharply about Syrian and Belarus health and human rights violations.  

United States charges against Syria and Belarus for human rights abuses, including reference to a “ruthless Assad regime”, were a major theme at Wednesday’s World Health Organization (WHO) Executive Board meeting – in what may also be a signal by Washington to Russia ahead of a high profile “Geneva Summit” that the US is going to take a harder tact on human rights.    

US President Joe Biden and Russia’s Valdimir Putin are set to meet on June 16 in Geneva for the first time since Biden became president.  The meeting follows four years in which US President Donald Trump was perceived by many critics as often courting Putin’s favor while sidestepping divisive issues such as the human rights record of Russia and its proxies.  

The US statements may also be a signal to WHO member states – that if the global health forum is going to remain a place where Taiwan is sidelined and politically-charged debates on health conditions in the Occupied Palestinian Territories regularly take place – then Washington will have its say on issues that concern it, as well. 

Last week the Israeli-Palestinian conflict took centre stage for a full day at the World Health Assembly gathering of all 194 WHO member states during a debate on a WHA resolution decrying “Health conditions in the occupied Palestinian territory, including east Jerusalem and the occupied Syrian Golan”. The prolonged discussion drew protests not only from the US delegate, but also from the United Kingdom and other allies that noted the WHA accords no comparable amount of attention to health conditions specific to other conflict zones and humanitarian settings.  

Election of New Executive Board Members 

The debate over Syria and Belarus occurred as both countries were elected to represent their respective regions in the WHO Governing Board  – the 34-member state steering committee that is supposed to guide and watchdog the activities of WHO at close range. 

Palestine and Taiwan excepting, member states usually try to avoid direct attacks on other members. They even more rarely criticize the selections of countries from other regions to the governing body, per se.  But in today’s session, the criticism was sharp and repeated – beginning with protests by the United States, as an outgoing EB member concluding its own three-year term.   

“We know that members of the Executive Board are expected to uphold universal values and human rights. Unfortunately, we have grave concerns that the governments of two new board members, Belarus and Syria do not share these values as demonstrated by their respective human rights violations and abuses against their own citizens – as overwhelmingly condemned by the international community,” said the US representative to the EB in a statement. 

Added the US, “In particular, we know Syria’s track record of conducting chemical weapons attacks, harming civilians and striking medical facilities, as well as first responders. The United States takes this opportunity to reinforce the expectations of members of the Executive Board, and call on the governments of both Belarus and and Syria to respect human rights. We also call on Syria to allow for the unimpeded access of life saving humanitarian aid, including medical supplies, regardless of where those in need are located.”

Syria and Belarus Reply 

Syria decries “politicization” of WHO forum.

The US comments brought swift and sharp replies from Syria and Belarus, also supported by Russia – which accused the United States of, in Syria’s words, “politicization of the WHO”    

Protesting the allegations of chemical weapons use and bombings of health facilities, Syria’s representative accused the US of “an effort to destabilize our countries by supporting terrorism, as well as aggression and occupation…. That destroy the quality of life in our countries.”

As the language became even more heated, Syrian charged that the US allegations of chemical weapons use by Damascus were “part of fake news campaigns that have no justification,” adding that “the United States actually creates humanitarian crises by pillaging human and economic resources, supporting militias and terrorist groups.”

The debate would better be consigned to the UN Human Rights Council, Belarus added, saying: “When we think about the flagrant violations of human rights in the US, we’re thinking about things like racism, violation of the right to peaceful process. We have seen also that millions of people in the United States are deprived of their right to medical care in many cases. I do hope that in the future such discussion will be held only in the Human Rights Council – and not here at the Executive Board –  and we would hope that a similar approach would be taken by other countries, our partners here within the WHO Executive Board.” 

US Comes Back Again 

Belarus lashes back at US record on racism and civil rights.

At the EB’s afternoon session, however, the United States came back to the Syrian issue again – focusing, in particular, on the destruction of health facilities by the “ruthless Assad regime”. 

The comments were a clear reference to the pattern of Syrian bombings and artillery fire aimed at hospitals and clinics located in areas held by Kurdish or other opposition forces – although the opposition groups were not cited by name.  

“We condemn in the strongest terms the repeated attacks impacting health and other civilian facilities throughout the conflict in Syria,” said the US.   

“We do believe issues raised by my government are within the purview of the UN. In fact, the evidence compiled by the UN’s Board of Inquiry clearly supports what we have known throughout this conflict:  the ruthless Assad regime and its allies have destroyed, hospitals, schools, and civilian infrastructure. 

In addition, Washington added, the US sanctions against the Syrian regime, “generally do not target provision of humanitarian goods including medicine, medical supplies and food to Syria. 

“The Syrian sanctions program provides authorizations, exemptions and general licenses for humanitarian aid and medical supplies to reach the Syrian people, including US-funded humanitarian aid to regime-held areas. 

“The regime is the one obstructing the access to humanitarian and medical assistance to all Syrians in need.” 

As for Belarus, the United States said the government had a demonstrated record of “human rights violations condemned by the international community; in particular the regime continues to deploy mass detentions, police brutality, and other abuses against peaceful protesters journalists and other members of civil society.”

In one note of irony, Turkey sided with the United States with regards to its criticism of Syria.  Said the Turkish representative attending the EB meeting as an observer: “Turkey would like to note its concern that in light of the Syrian regime’s record in targeting civilian healthcare facilities and health workers, its representation at the board is regrettable.”

gavi
Left to Right, clockwise – Olly Cann, Michael Froman, Seth Berkley, Marie-Ange Saraka-Yao

The WHO-sponsored COVAX facility raised another US $2.4 billion on Wednesday from donors to fund more COVID vaccines for low- and middle-income countries – exceeding their total funding target and bringing the total pledged to the COVAX AMC to US $9.6 billion, following a GAVI COVAX AMC Summit “One World Protected” virtual event.

But the 54 million donations in vaccines that were also offered by rich countries at the event – still fall far short of the 1 billion doses that WHO and other global health leaders say are needed by 1 September to fill immediate needs for fighting the pandemic.

The summit, hosted by the government of Japan and Gavi, the Vaccine Alliance, garnered donations from nearly 40 governments, the private sector, and foundations.

The donations will enable COVAX to secure 1.8 billion fully subsidized doses of COVID-19 vaccines for delivery to LMICs participating in the COVAX facility.

The vaccines, to be delivered in 2021 and early 2022, will protect almost 30% of the adult population against COVID-19 in these 91 participating countries. 

“Thanks to all our donors, we can now protect not only healthcare workers, the elderly and other vulnerable people but broader sections of the population, increasing our chances further of bringing the pandemic under control,” said Gavi Board Chair Jose Manuel Barroso. 

Donations Bring Hope in Overcoming COVID-19

Japan’s Prime Minister Suga Yoshihide

Gavi has received tremendous support in particular from Japan, which has pledged US $800 million at the summit, making their total contribution to the COVAX AMC US $1 billion. 

“Delivering more vaccines through the Gavi COVAX AMC Facility is the key to overcoming this pandemic. Today’s summit has brought hope to the world in both overcoming COVID-19 and building back better,” said Japan’s Prime Minister Suga Yoshihide.

The United States, which hosted the launch of the Gavi COVAX AMC Investment Opportunity in April, reaffirmed its support as a Gavi partner on Wednesday, committing US $4 billion for procurement and delivery of COVID-19 vaccines.    

The European Investment Bank (EIB) has also stepped up to support African Union countries with EUR 300 million financing to access vaccines via COVAX. 

According to Marie-Ange Saraka-Yao, Gavi Managing Director of Resource Mobilization and Private Partnerships, Gavi is working with the EIB to leverage access to domestic resources for vaccine doses.

“The key here is that financial innovation needs to continue,” said Saraka-Yao. 

Dose Sharing Boosted, but More Vaccines Needed To Prevent Deadly Mutations

The first shipment of vaccine doses by the international COVAX facility reached Ghana in February

Alongside financial pledges, first dose sharing donations were announced by Belgium, Denmark, and Japan, as well as additional pledges from Spain and Sweden, boosting short-term supplies by over 54 million vaccine doses.  

However, Gavi remains “deeply concerned about the short-term disruptions we face,” said Gavi CEO Seth Berkley, citing the second wave in India that has deeply impacted early secured supply and consumed all of the country’s production, leading to a shortfall of 190 million doses. 

“We need all countries that have doses to share a portion of them with COVAX now, so that we can get them into the hands of those who are most at risk of the virus and help prevent the emergence of more deadly mutants,” said Gavi CEO Seth Berkley. 

The WHO had appealed for vaccine donations last month in the midst of the shortfall, with manufacturers that have reached agreements with the facility – Moderna, Novavax, and Johnson and Johnson, only able to deliver later in the year or in 2022. 

Bilateral Agreements May Undermine Equitable Access

Gavi also addressed the potential that bilateral agreements for donations may undermine COVAX. 

“If we want to get equitable access, the problem is that if countries are picking their favorites, there will be countries that will not be the favorites,” said Berkley. 

“Despite a massive effort to scale up and produce billions of vaccine doses, COVID-19 vaccines currently are not reaching all priority populations worldwide,” said Director General of the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) Thomas Cueni, during the summit. 

Gavi does not take into account bilateral donations, so one of the advantages of going through COVAX, is that [doses] can be adjusted to be part of equitable allocation, added Berkley.   

Gavi is currently looking for doses from manufacturers with long shelf-lives and are pre-qualified for use. 

“Speed is the critical issue here and that’s why we’re trying to have a systematic process,” said Berkley, noting the difficulties of getting vaccines without a complex regulatory mechanism.  

Private Sector Crucial in Running Biggest Immunisation Campaign

The private sector is crucial to COVAX’s vaccination campaign.

In addition to government and foundation donors, Gavi emphasized the importance of its private sector partnerships in mobilizing resources towards vaccine equity.  

“The private sector really is in Gavi’s DNA. Of course, there’s funding, there’s reserving, there’s building capacity, but there’s also the process of vaccinating, and then we need the expertise of the private sector,” said Saraka-Yao. 

“This will be critical in running the largest immunization campaign ever.”

Mastercard, alongside existing partners such as Google.org, the Visa Foundation, has increased their financial donations. 

The company has pledged US $28 million in a new commitment.  

“We’re not a pharmaceutical company but it’s obvious to us that we thrive when economies around the world thrive, and our business is healthier when people are healthier,” said Vice Chairman and President of Mastercard Michael Froman. 

Image Credits: WHO, Gavi, Jose Manuel Barroso/Twitter, WHO Ghana, Eric Fiegl-Ding/Twitter.

Humans can typically be exposed to bird flu at live poultry markets like this one in Xining, China.

The World Health Organization(WHO) is working with Chinese authorities to assess the circumstances around the first documented case of human infection with a rare strain bird flu known as H10N3.

This is after a 41-year-old man in China’s eastern province of Jiangsu, located northwest of Shanghai, tested positive for H10N3 on May 28 – a month after he was hospitalised in an intensive care unit on 28 April.

The China’s National Health Commission (NHC) alerted WHO on Tuesday of the detection of human infection with avian influenza. No other cases of human infection with H10N3 have been reported globally, it added.

The Chinese authorities, however, provided no details on how the man was infected.

Although this is the first case of infection with the H10N3 strain, other bird flu strains have been found to have high mortality rates in humans – thus the heightened concerns over human infection with any new strain of the virus.

While there are instances of human-to-human infection with other deadly bird flu strains, they have been rare.

“WHO, through the Global Influenza Surveillance and Response System (GISRS) continuously monitors influenza viruses, including those with pandemic potential, and conducts risk assessments,” WHO said in response to a query from Health Policy Watch.

The Chinese NHC said it has instructed Jiangsu Province to carry out prevention and control measures in accordance with relevant plans, and that it has organised expert risk assessments.

“Experts assessed that the whole gene analysis of the virus showed that the H 10 N 3 virus was of avian origin and did not have the ability to effectively infect humans, the NHC asserted. 

No human cases of H10N3 have been reported globally , and the H10N3 virus among poultry is low pathogenic to poultry.

No Published WHO Alert So Far

While acknowledging China’s report, WHO said that it had not yet posted any information about the incident on its website.

However, in its response, WHO stressed that it was not merely relying on reports from Chinese authorities, but was also using its International Health Regulations (IHR) and the Epidemic Intelligence from Open Sources (EIOS) to monitor and investigate the matter.

“Under the IHR, there is the possibility for WHO to take into account reports from sources other than notifications or consultations,” said WHO.

It said the GISRS, through its various surveillance, monitoring and alert systems,  is in place to protect people from the threat of influenza.

The Chinese man is now in a stable condition and he is ready to be discharged.  Emergency surveillance of the local population found no other cases, the Chinese reports stated.

Avian influenza Type A viruses infect the respiratory and gastrointestinal tracts of birds and have been found in more than 100 different species of wild birds around the world, according to the U.S. Centers for Disease Control and Prevention (CDC).

While these viruses don’t normally infect humans, birds can shed virus in their saliva, mucous and faeces, the CDC says. Human infections can occur if enough virus gets into a person’s eyes, nose, or mouth.

Experts suggest that the public should avoid contact with sick or dead poultry , try to avoid direct contact with live birds, pay attention to food hygiene , and improve self-protection awareness. It urged the public to seek medical help if they experience flu-like symptoms and respiratory problems.

Symptoms of avian influenza A virus infections can be accompanied by nausea, abdominal pain, diarrhoea, vomiting and severe respiratory illness, according to the CDC. 

Image Credits: Wikimedia Commons.