Neglected Tropical Diseases go largely unnoticed, but the new road map for (NTDs) 2021–2030 is vitally important in accelerating action towards ending these preventable and treatable diseases.

The World Health Organization’s new road map for neglected tropical diseases (NTDs) 2021–2030 is a turning point in our fight against NTDs. It provides us with a clear route forward and the opportunities to effectively control and eliminate these debilitating diseases.   On World Health Day 2021, dedicated to the theme of building a healthier, fairer world, it’s important to remember how NTDs, which are deeply linked to unhealthy environments, and unequal social and economic conditions, also perpetuate long-term cycles of suffering and poverty. 

Although NTDs continue to go largely unnoticed, they comprise a group of 20 diseases and disease groups that affect more than 1.5 billion people worldwide, with a third living in Africa. NTDs occur predominantly in the poorest communities with little or no access to healthcare systems. These diseases often cause severe disfigurement and other long-term disabilities that hinder education, economic growth and overall development. 

I have seen first-hand the disability and suffering these diseases inflict, and I know only too well their devastating impact on communities already struggling with poverty. The new road map is vitally important in accelerating action towards ending these preventable and treatable diseases. The Global Summit on Malaria and NTDs in Kigali, Rwanda in June 2021 is an opportune moment to support this activity. 

Global leaders will meet during the Commonwealth Heads of Government Meeting to discuss our next steps in the battle against NTDs and to help build momentum into the next decade. The road map is central to our upcoming work and has firmly placed NTDs in the global spotlight. It is essential that we take this opportunity to raise awareness and capitalise on increased momentum.

With 600 million people in Africa requiring treatment for NTDs every year, too many vulnerable people continue to suffer from these treatable and preventable diseases. NTDs have been the subject of less research than other diseases – this has meant that new treatments have developed more slowly. And it is estimated that just 0.6% of global healthcare funding is earmarked for the control of NTDs. This lack of investment is one of the greatest obstacles we face in the fight against NTDs. 

NTD Road Map To Address Critical Gaps Across Multiple Diseases

To ensure sustainable progress is achieved, countries should take the lead in controlling these diseases and the conditions that cause them. In March 2020, the African Union Commission held its first experts’ meeting on NTDs to advocate for prioritising the fight against NTD levels through the allocation of sufficient resources to strengthen national programmes. The meeting revised the African Union Continental Framework for NTDs (2021–2030) and the Common African Position on NTDs. Once endorsed, these documents aim to provide guidance to Member States on fighting NTDs on the continent. The African Union Commission, in collaboration with its Member States, called for accelerated efforts towards the elimination of NTDs in the wake of WHO’s new road map.

The road map is designed to address critical gaps across multiple diseases by integrating and mainstreaming approaches and actions within national health systems, and across sectors. By setting clear targets and milestones, it also provides opportunities to evaluate, assess and adjust programmatic actions as needed over the next decade. Its 4 overarching global targets for 2030 are:

  • reduce the number of people requiring treatment for NTDs by 90%;
  • eliminate at least 1 NTD in at least 100 countries;
  • eradicate 2 diseases (dracunculiasis and yaws); and
  • reduce the disability-adjusted life years related to NTDs by 75%.

Furthermore, the road map will track a set of disease-specific targets and 10 cross-cutting targets, including: a reduction by more than 75% in the number of deaths from vector-borne NTDs; and the promotion of full access to basic water supply, sanitation and hygiene in areas endemic for NTDs. 

Not Enough Progress On Eliminating NTD

The new road map for neglected tropical diseases (NTDs) 2021–2030 will address critical gaps across multiple diseases.

The global NTD community has made great progress in recent years, eliminating at least 1 NTD in 42 countries, including Togo and Ghana. With the right approach and funding, we can achieve even greater progress in the coming years. By combining increased investment with stronger accountability and intensified collaboration across sectors, as called for in the new road map, I believe we will go from strength to strength as we unite to combat NTDs.

The COVID-19 pandemic has taught us that rapid progress is possible when we come together in partnership and solidarity. The new NTD road map will help ensure that the global health community is engaged in our mission to eliminate NTDs and to raise the funding needed to control, eliminate and eradicate these diseases. Investment in NTDs is not only vital for those directly affected but also one of the most cost-effective investments in public health – treatment for the top 5 NTDs costs less than US$ 0.50 per person. 

Now is the time to stimulate our efforts and sharpen our focus: I encourage all policymakers, donors, political leaders and private sector organizations to embrace the new road map. It will provide guidance, momentum and enthusiasm to our global community. 

World Health Day 2021 focuses on building a fairer, healthier world. We cannot achieve this without tackling NTDs. With the direction provided by the road map, I believe we can mobilise the resources needed to strengthen our health systems, to treat and prevent these diseases of poverty, and, ultimately, to end NTDs once and for all.

  • Dr Mwelecele Ntuli Malecela is the Director, Department of Control of Neglected Tropical Diseases, World Health Organization (WHO)

 

One in three COVID-19 survivors received a neurological or psychiatric diagnosis within 6 months of infection with the virus.

A new study published by the journal Lancet Psychiatry estimates that one in three COVID-19 survivors received a neurological or psychiatric diagnosis within six months of infection with the SARS-CoV-2 virus. 

The study, conducted with researchers from both the United States and United Kingdom, analyzed the electronic health records of 236,379 COVID-19 patients primarily from the US, also comparing them to 105,579 patients diagnosed with the flu and 236,038 patients diagnosed with any respiratory tract infection (including flu). 

Overall, it was estimated that 34% of patients were diagnosed with a neurological or psychiatric disorder in the first six months after after a COVID diagnosis – with some 13% having a first-time ever diagnosis. Results also showed that the risks were greatest in, but not limited to, those with severe COVID-19.

Professor Paul Harrison, University of Oxford, lead author of study

Professor Paul Harrison, lead author of the study, from the University of Oxford, said: “These are real-world data from a large number of patients. They confirm the high rates of psychiatric diagnoses after COVID-19, and show that serious disorders affecting the nervous system (such as stroke and dementia) occur too. While the latter are much rarer, they are significant, especially in those who had severe COVID-19.”

And while countries around the world are now focused on vaccine rollouts, in hopes of achieving herd immunity, the study underlines how effects of COVID-19 will be felt for much longer, said Dr Jonathan Rogers, who was not involved in the study, from University College London (UCL), UK, in a separate comment on the study.

“Sadly, many of the disorders identified in this study tend to be chronic or recurrent, so we can anticipate that the impact of COVID-19 could be with us for many years.”

Neurological and Mental Health Risk Increase Following COVID-19, When Compared to Flu or Respiratory Tract Infections, Says Study 

Additionally, neurological and psychiatrist outcomes were more frequent in COVID-19 patients than those patients who had suffered from the flu or respiratory tract infections –  suggesting the specific impact of COVID-19, the researchers found. 

After taking into account underlying health characteristics, such as age, sex, ethnicity, and existing health conditions, there was overall a 44% greater risk of neurological and mental health diagnoses after COVID-19 than after flu, and a 16% greater risk after COVID-19 than with other respiratory tract infections.

Ischaemic Stroke and Hemorrhage Risks Also Elevated
Associations between COVID-19 and ischemic stroke and intracranial hemorrhage is “concerning”

The risk of ischemic stroke and intracranial hemorrhage was elevated after COVID-19, with incidence of stroke increasing almost one in ten in patients with delirium (encephalopathy). Substance use disorders and insomnia were also more common. 

The study authors called the associations between COVID-19 and brain diseases and psychiatric disorders “concerning”, with additional research needed on disease severity and development. 

“We now need to see what happens beyond six months. The study cannot reveal the mechanisms involved, but does point to the need for urgent research to identify these, with a view to preventing or treating them,” Dr Max Taquet, a co-author of the study, from the University of Oxford, said.

The results also point to a substantial impact on health systems and social care networks, given the potentially chronic nature of many of these conditions, added Harrison.

“Health care systems need to be resourced to deal with the anticipated need, both within primary and secondary care services,”  he advised. 

Will Mental Health Or Neurological Conditions Predominate Over Time?  
COVID-19
Patients who received a psychiatric or neurological diagnoses 6 months after COVID-19

In the wake of these findings, health experts also questioned if the severe, chronic, and less common mental health conditions linked to these findings will manifest more as neurological disorders or common mental disorders over time. 

While this study found that anxiety (17%) and mood disorders (14%) were the most common diagnoses, diagnosis of stroke and dementia were more common in patients who required hospitalization (83%), and even more so in those who required intensive treatment (46%) and in those with delirium (encephalopathy) during COVID-19 infection (62%). 

Writing in a linked comment to the study, Rogers, found the link with encephalopathy [delirium caused by a brain disease typically caused by infection, tumor or stroke] “important, even if the underlying mechanism turns out to be indirect.” 

But Rogers issued a note of caution about the apparent connections between encephalopathy and COVID-19, citing difficulties in distinguishing between psychotic disorders and delirium. 

On the one hand, the average age of patients with first-onset mental health disorders (53 years old) was on average much greater than those in the general population, where onset usually occurs in early adulthood. But, in some cases, however, that psychosis may have been exacerbated by pre-existing conditions unknown to the health-care provider, he argued. 

However, Rogers added that the study has important implications pointing “us towards the future, in both its methods and implications. 

“Researchers need to be able to observe and anticipate the neurological and psychiatric outcomes of future emerging health threats by use of massive, international, real-world clinical data,” Rogers added, calling on countries with public health-care systems to “enable truly comprehensive national data to be available for research.” 

Image Credits: AMSA/Flickr, Flickr: Florey Institute of Neuroscience & Mental Health.

Azerbaijan’s President Ilham Aliyev

Some of the world’s smallest countries joined the World Health Organization (WHO) to appeal for equitable access to COVID-19 vaccines on the eve of World Health Day – as the pipeline of global vaccine supplies to low- and middle-income countries risk drying up for the coming few months. 

Barbados Prime Minister Mia Amor Mottley told the WHO press briefing on Tuesday that her country was simply too small to negotiate with large pharmaceutical companies, while Namibian President Hage Geingob said that his country had only received small donations of vaccines from China and Russia.

“The bald reality is that our market size is simply too small to command the attention of global pharmaceutical companies, or indeed other suppliers of goods,” said Mottley, who added that her country had received its first delivery of COVAX vaccines just today – but only enough to cover 3% of its population.

“We’ve not had access, even when we are prepared to pay,” said Mottley, who also expressed concern for the health of Tom Rowley, Prime Minister of Trinidad and Tobago who had been diagnosed with COVID-19 earlier in the day, a mere hours before he had been due to be vaccinated.

WHO Director-General Dr Tedros Adhanom Ghebreyesus made a five-point global call to action ahead of World Health Day on Wednesday, calling for:

  • Accelerated equitable access to COVID-19 technologies between and within countries;
  • Investment in primary health care;
  • Prioritizing health and social protection;
  • Building safe, healthy and inclusive neighbourhoods;
  • Strengthening data and health information systems.

“At the start of the year, I made a call for every country to start vaccinating health workers and older people in the first 100 days of 2021. This week [10 April] will mark the 100th day, and 190 countries and economies have now started vaccinations.”

Even so, he added that although COVAX has delivered 36 million vaccine doses to 286 countries and economies, “equitable distribution remains the major barrier to ending the acute stage of this pandemic” – with supplies running dry after initial deliveries are completed.

“It is a travesty that health workers and most at-risk groups remain completely unvaccinated” in some countries, the WHO DG said. “We need to invest in equitable production and access to COVID-19 rapid tests, oxygen treatments and vaccines, between and within countries.”  

Azerbaijan’s President Ilham Aliyev, speaking via a recorded video, said that his country had co-sponsored the resolution adopted in the March session of the UN Human Rights Council calling for “equitable, affordable, timely, and universal access for all countries” to COVID-19 vaccines. 

Access to ‘Concessionary Capital’ to Address Pandemic Impact

Appealing for more investment in primary healthcare, Tedros said that the pandemic has “exposed the fragility of our health systems”.

“At least half of the world’s population still lacks access to essential services, and out-of-pocket expenses on health drive almost 100 million people into poverty each year,” he said.

In the past year, the pandemic is estimated to have driven between 119 and 124 million more people into extreme poverty, according to the WHO.

Mottley, who chairs the development committee of the World Bank and the International Monetary Fund, said she would propose to the committee at its meeting this week that it needed to use “different criteria” to determine how countries get access to “serious concessional capital” to stave off the pandemic and its long-lasting consequences.

President Carlos Andrés Alvarado Quesada of Costa Rica also appealed for “multilateral organisations” to provide financing for poorer countries to address the medium and long-term effects of the pandemic. 

“Today, developed economies have managed to achieve special packages to help their countries to overcome the effects of COVID-19 but that’s not something that poorer countries can do,” said Quesada, appealing for “debt forgiveness” and long-term financing at zero or low rates.

“There is no magic bullet. and there is no magic recipe,” concluded Mottley. “The answer is simply for us to work together to get that fairer world and for there to be a level of global moral leadership, recognising that the singular pursuit of individual countries will not rid the world of the major problems because human beings cannot be contained behind boundaries easily in this globally interdependent world.”

Risk-benefit for AstraZeneca Still ‘Positive’ But More Data Expected in Next Day

Rogerio Pinto de Sa Gaspar, the WHO’s Director of Regulation and Prequalification

On a related matter, WHO’s Director of medicines Regulation and Prequalification, told the media briefing that it expected to have more data about possible linkages between the AstraZeneca vaccine and rare “thrombolytic events” in the next few days.

However, Rogerio Pinto de Sa Gaspar, stressed that “at the present moment, and under the assessment that we have from the data submitted up to yesterday, we are confident that the benefit-risk assessment for the vaccine is largely still positive.”

The European Medicines Agency (EMA) was meeting again Tuesday and Wednesday over  the issue, as was the United Kingdom’s Health Products Regulatory Authority following a decision by Germany last week to suspend the vaccine’s use among people under the age of 60 – after further rare blood clot events occurred.

 WHO’s own Global Advisory Committee on vaccine safety was due to meet on Wednesday, said De Sa Gaspar amind the ongoing controversy about the vaccine.

European Medicines Agency Meeting is Viewing All Data

The WHO also has observers at the EMA meeting, which is assessing “the core clinical data that was submitted by AstraZeneca”.

Describing the events as “rare”, De Sa Gaspar said there was “no evidence that the benefit-risk assessment for the vaccine needs to be changed, and we know from the data coming from countries like the UK and others, that the benefits are really important in terms of reduction of the mortality of populations that are being vaccinated”. 

He added that the WHO expected to have “a fresh conclusive assessment from our experts” by Wednesday or Thursday.

 “There’s no link for the moment between the vaccine and thrombolytic events with thrombocytopenia, but of course it’s under evaluation, and we wait for some feedback from those communities in the coming days and coming hours just to give a full assessment,”  asserted De Sa Gaspar.

“WHO is relying heavily on the national pharmacovigilance systems, but also on the assessment committees from national regulatory authorities, and also from regional regulatory authorities like the EMA,” he said.

Mariangela Simão, WHO’s Assistant Director-General, added that data was being assessed from all regions of the world: “Millions and millions of AstraZeneca doses have been distributed and used in Latin America, Africa, India and other countries in Asia so we are very actively proactively collecting data from different national regulatory authorities,” said Simão. “We are also in touch with AstraZeneca, as AstraZeneca has an obligation to monitor the safety data and report to the WHO.”

‘Let’s Not Speculate’ About Serum Institute of India Vaccine Supplies to COVAX 

Dr Bruce Aylward

Related to the vaccine shortage issue, Bruce Aylward, Tedros’ special advisor and the WHO’s lead on COVAX, dismissed a reporter’s question about the possibility that the Serum Institute of India (SII) might delay vaccine deliveries to COVAX until as late as June – well beyond the April suspension date announced by Gavi, The Vaccine Alliance late last month.  SII suspended its exports abroad after being asked by the Indian government to redirect its production to the domestic Indian market – which is seeing a surge in coronavirus cases. 

“Let’s not speculate on what’s going to happen in terms of future deliveries from any of the companies that we’re working with,” said Aylward.

“Right now, every country we talk to, every company, is trying to make sure that they prioritise COVAX and that we get the vaccines that we need. Obviously, if we have an interruption with any one of our suppliers for a short time, a month or so, we can find ways to manage as best we can, but if it prolongs for longer, that would be a challenge.”

Aylward added that some additional supplies from SII had come through in the past few days to enable “which are important to all countries being able to start vaccination by the end of the 100-day period”.

Aylward also stressed that the vaccine supply situation was “fluid” and COVAX also had deals with other pharma manufacturers, most notably Johnson and Johnson and Novavax, which are due to come online in the coming weeks and months.

 

Ugandan private health providers have been given the green light to import and distribute their own COVID-19 vaccines.

In what may be a first for the African continent, the Ugandan government has decided to allow private sector health providers to import and distribute their own COVID-19 vaccines amidst strict regulations – in an effort to expedite the country’s vaccination drive, which is caught in the crosswinds of vaccine supply shortages plaguing the entire region and low-income countries more generally.

The Ugandan decision comes just after the Kenyan government decided last week not to allow the private importation of vaccines –  due largely to fears of fake vaccines swamping markets.

The immediate future of vaccine roll-outs in African countries remains uncertain in the wake of India’s recent decision to suspend for the immediate future, its bulk supplies of AstraZeneca vaccines, produced by the Serum Institute of India (SII), to low-income countries in Africa, Asia and the Americas.  Those countries are largely  dependent on vaccine deliveries arranged through the WHO co-sponsored COVAX facility.   Meanwhile, South Africa and Nigeria have also made strategic decisions to shift away from further bilateral purchases of the AstraZeneca vaccine in favour of the Johnson and Johnson jab – which will nonetheless take longer to deliver.

In an effort to expedite the vaccination drive, the Ugandan Ministry of Health last week outlined the rules whereby the private sector will be able to participate in the  COVID-19 vaccine supply chain, including an accreditation process which will require them to source the vaccine, detail the quantities to be imported and the cold chain capacity of the provider.

Providers will  be required to import only those vaccines that have received an “Emergency Use Listing” from the World Health Organization as well as being cleared by the national drug regulator, the Uganda National Drug Authority.

Uganda has thus far vaccinated 80,836 people since vaccinations commenced on 10 March.  The country received a first tranche of 864,000 doses of the AstraZeneca COVID-19 vaccine on 5 March from the COVAX facility – out of a total expected COVAX supply of about 3.5 million doses that was supposed to be delivered over the course of 2021.  But as with many African countries, COVAX vaccine deliveries for April, May and possibly even beyond, are now in jeopardy due to the suspension of Indian exports – as SII redirects its vaccine production to domestic use in India, which is seeing a surge of COVID cases.  

“A list of facilities will be provided and a Memorandum of Understanding will be  signed spelling out the modalities of the collaboration,” said Jane Ruth Aceng, the Minister of Health, regarding the private procurement arrangements. She added that the vaccines authorized for import to private sector health service providers, would have to be administered by that same health care provider – and could not be resold again. The ultimate goal, said Aceng, was to protect the consumer.

Ugandan Health Minister Jane Ruth Aceng

Safety of Citizens is Paramount

Alfred Driwale, the programme manager of Uganda National Expanded Programme on Immunisation echoed Aceng’s sentiments: “One of the roles of the government is to protect the public so we want to know most importantly the source of the vaccine. The safety of the people is paramount”.

The private sector represents half of all health services delivered in Uganda.  But up until the pandemic, private health care providers have not been deeply involved in mass immunisation programmes. In Uganda, over 90% of immunisations are administered free of charge by the public health system, which receives support from GAVI, The Vaccine Alliance.   

The Private sector will also be required to import the vaccines through the National Medical Stores which is the national agency for the storage, importation and distribution of all drugs in Uganda. This will ensure that the maintenance of the cold chain and viability of the vaccines, officials said.

“If the private sector will help us to acquire COVID-19 vaccines it is good and we have created rules to have order ” said Driwale. He said a few private players have approached the Ministry of Health, but none have qualified yet.

High Demand, Low Supply Opens Market for Fake Vaccines

However, allowing the private sector to participate in the COVID-19 supply chain at a time when demand outweighs supply, opens the market to fake vaccines and exploitation and abuse, Gideon Badagawa, the Executive Director of the Private Sector Foundation-Uganda told Health Policy Watch. Badagawa said he is against complete liberalisation of the COVID-19 vaccines for the private sector in Uganda  and said the government should remain in control to maintain standards and enable the private sector to follow specifications. 

In cases where private sector health services are authorized, participation should be in a ‘phased manner’ – allowing only those who meet the government specifications to participate. In the case of COVID vaccines, he said, only about 10 health sector entities would have the capacity.  “They can allow just a few players initially because the COVID-19 vaccines are delicate and not everybody can participate in the market,” said Badagawa, adding that: “If we import in partnership with the government it will enable us to follow the specifications that are required”.

Grace Kiwanuka, Executive Director of the Uganda HealthCare Federation had mixed reactions to the decision. “It is a right step to mobilise domestic resources and it helps us to achieve herd immunity which would be difficult if only left for the government,” she said. But on the other hand, she warned that Uganda is an open economy – and privatizing the vaccine market opens the way for profiteers to substitute saline and glucose solutions for genuine vaccines.

For just those reasons, Uganda’s neighbory, Kenya, on Friday said that it would ban the “ importation, distribution and administration of vaccines, until such time there is greater transparency and accountability in the entire process”.  The Kenyan government’s ban comes amid fears that counterfeit inoculations may otherwise infiltrate the market.  

WHO Risk communication and Infection Prevention and Control teams provide massive community sensitization on COVID-19 vaccinations

South Africa’s Medical Aid Giant Ready To Help With Vaccinations

Meanwhile, frustration over the slow pace of vaccination in South Africa also saw the health services giant, Discovery Health, announce plans last week to vaccinate up to 550, 000 of its high risk members within weeks of vaccines becoming available, through a partnership with the South Africa government.  In the case of South Africa, however, the supplies would still be procured by the government, and then distributed by Discovery Health. 

The private medical aid company said it plans to vaccinate up to 50, 000 of its members a day. 

Discovery Health CEO Adrian Gore said the company would be establishing  20 large-scale vaccination sites and plans to vaccinate three million adult beneficiaries, beginning on May 1.

Gore  said Discovery would not be importing any vaccines, but that it was ready to vaccinate its members in high volumes when the supply of vaccines became available from the South African government’s health department.

“Our segmentation approach is aligned with the national prioritisation framework, as guided by the ministerial advisory committee. Simply, this means that we know exactly who should receive the vaccine first, and we will communicate quickly with our scheme members to confirm their place in the roll-out, contingent on vaccine supply,” Gore explained.

“This would help realise meaningful health and economic outcomes, and avoid many preventable Covid-related deaths,” he said, adding that those who qualify to receive the vaccine, will be contacted by the medical aid.

Abacus pharma Limited , one of the companies hoping to participate in the COVID-19 vaccine supply chain in East Africa, said collaborating with the government would help expedite the COVID-19 vaccination drive.

“Opening up the vaccines to the private sector will help accelerate the process of providing protection as long as it is done in a thoughtful manner and in line with regulatory requirements,” said Rajaram Sankaran, Group Chief Executive Officer & Director on Board at Abacus Pharma (Africa) 

“We would be glad to collaborate with the government such that we complement their efforts and not duplicate. Such public-private partnerships would be more sustainable in the long run,” Sankaran told Health Policy Watch. 

Image Credits: ABC7 News.

A new survey shows that the use of family planning services in Kenya increased from 56% in 2019 to 61% despite curfews and lockdowns.

Kenya’s family planning services experienced a 5% increase in the uptake of modern contraceptives at the height of the COVID-19 pandemic last year, possibly contributing to a decline in unwanted pregnancies in the country, a new survey has shown.

The survey, conducted by Performance Monitoring for Action (PMA), shows that the use of family planning services increased from 56% in 2019 to 61% in 2020 in married women and from 40% to 46% in all women, despite curfews and lockdowns.

The PMA generates surveys of key health indicators in nine countries in Africa and Asia, whose open-resource data is available for research, programme planning and policymaking. 

The increased use of contraceptives is likely to have contributed to the decline of unintended pregnancies over the same period from 42% to 37%. 

The survey – done between November and December last year in 11 counties (Nairobi, Kilifi, Nandi, Nyamira, Kiambu, Bungoma, Siaya, Kericho, Kitui, Kakamega and West Pokot) – also found that unmarried women prefer short-acting methods, while their married counterparts chose longer-acting methods.

The most popular method for unmarried women were male condoms (29%), injectables and implants (both at 26%). The married women, on the other hand, preferred injectables (39%) and implants (37%).

Family Planning is an Essential Service 

Albert Ndwiga, the National Family Planning Program manager in the Ministry of Health, said family planning was an essential service and that the country “had to come up with guidelines quickly to ensure continued care in public health facilities during the pandemic”.

Family planning services are offered free of charge in public health facilities in Kenya. The guidelines were formulated in April last year, giving directives to facilities on how to protect the client and the service provider.

The government is now collaborating with the private sector, which supplies over a quarter of Kenyans (28%) with their family planning methods and commodities. 

“Some may choose to get services from the private sector because of the convenience it offers to them, therefore reducing the burden on government-owned facilities,” Ndwiga said, adding that the health ministry has formulated a “total market approach” as a result. 

The ministry has also actively engaged with communities “because issues around culture and religious beliefs have for a long time affected the uptake of family planning,” observes Josephine Kinyua, the director of Delivering Equitable and Sustainable Increases in Family Planning (DESIP) in Kenya, a program funded by the UK.

The DESIP program is implemented in 19 counties where the modern method contraceptive prevalence rate is less than 45%.

Commodity Financing and Economic Empowerment

Ndwiga said family planning was going to be included as one of the government’s four key agendas, of which universal health coverage is a key component. The agendas include food security, affordable housing, manufacturing and affordable healthcare for all.

Kenya’s government has committed to financing 100% of family planning commodities by 2023, and Ndwiga said they were now able to use health insurance to fund family planning.

Linking family planning with economic empowerment has contributed to increased uptake, according to Kinyua, who said some counties were now introducing bills geared towards funding maternal and child health alongside family planning.

“This will ensure that later, even if the programme is no longer there, some funding will be available to support maternal and child health,” she said.

However, cutting back on family planning commodities wastage would also go a long way towards saving money. This could be achieved by improving the quality of family planning services.

Ndwiga said an example of preventing wastage would be if a mother is counseled properly so that if she chooses to have a long-term contraceptive method, she will not change her mind after two months to have it removed.

“Because if that implant is meant to last for five years, but is removed after only two months, you lose four years and 10 months that it could have been used,” he says.

Data is Important to Inform Policies and Programs

Contraceptive use is known to be one of the determinants that influence fertility, according to Dr Anne Akonyo, senior lecturer and director of population studies at the University of Nairobi.

“It is one of the greatest inhibitors of fertility when used properly,” she explains.

Professor Peter Gichangi, the lead investigator of the PMA, says that the data collected should not just be used to inform programmes, policies and scientific publications, but as data sets that can be used for different purposes.

The data presented also posed some questions that need further investigating such as stock-outs for Intrauterine Devices (IUDs), which increased from 7% in 2019 to 11% in 2020.

Image Credits: iStock.

A “human error” at a Johnson & Johnson production facility caused millions of doses of its COVID-19 vaccine to be spoiled and unusable.

A mix-up with vaccine ingredients at a production site in Baltimore, Maryland, which is manufacturing both the Johnson & Johnson and AstraZeneca COVID-19 vaccines, has led to the contamination of 15 million J&J doses, which risks delaying national and global deliveries of the recently-approved vaccine. 

The pharma company, which is producing the world’s first single dose COVID-19 vaccine, announced Wednesday that a batch of doses failed its “rigorous quality control” standards. The doses were manufactured at a facility run by Emergent BioSolutions, which has production deals with both J&J and AstraZeneca.

Federal officials have described the issue as human error, as workers at the plant reportedly confused components for the two vaccines in late February. It took several days for the mistake to be recognised, ruining a batch of millions of doses.

The Emergent Bayview Facility in Baltimore has not yet, in fact, been authorised by the US Food and Drug Administration (FDA) to manufacture the J&J drug substance, but is currently under review for Emergency Use Authorization. 

The authorization has been held up by the FDA’s investigation into the site’s lapse in quality control.  

J&J will send experts in manufacturing, technical operations, and quality monitoring to supervise and support activity at the facility and gain more control over the manufacturing processes to avoid another public hiccup in production.

The production of Johnson & Johnson’s one-shot COVID-19 vaccine, delivered through an inactivated adenovirus.
Potential Delays in Vaccine Shipments

J&J stressed, however, that the error won’t impact its upcoming delivery to the US of 11 million doses, forecasted to arrive this week from a manufacturing site in the Netherlands. However, the company had been expected to deliver 24 million more doses to US destinations from the Baltimore site in April.

Although J&J officials said that they intend to remain on schedule with deliveries, US health officials said that they anticipate fluctuations in the vaccine delivery timetable, saying it could still take weeks to get the facility up to regulatory standards.

The US has ordered a total of 100 million doses from J&J, which are to be shipped by the end of June.

As of Thursday, approximately 7.8 million J&J doses were delivered and 3.4 million doses administered, according to the US Centers for Disease Control and Prevention.

The J&J vaccine has widely been regarded as essential to speed up vaccination campaigns globally due to the fact it is a one-jab vaccine as well as its logistical advantages: it can be stored for at least three months at temperatures of 2-8°C and can be transported using existing cold chain technologies and standard vaccine distribution channels.

“Changing the trajectory of the pandemic will require mass vaccination to create herd immunity, and a single-dose regimen with fast onset of protection and ease of delivery and storage provides a potential solution to reaching as many people as possible,” said Mathai Mammen, Global Head of Research and Development at Janssen Pharmaceuticals – a Belgian pharma company owned by J&J and responsible for developing the vaccine – in a press release published in late February.

J&J expects to deliver one billion doses globally by the end of 2021, including some 400 million doses to African Union member states beginning in the third quarter of 2021. An agreement is also underway between J&J and Gavi, the Vaccine Alliance to provide 500 million doses to the WHO co-sponsored global COVAX Facility through 2022. The facility is trying to ensure more equitable distribution vaccines to low- and middle-income coutnries.  

However, insofar as J&J has already faced previous manufacturing delays in January, it remains to be seen if J&J will succeed in scaling up production to meet its commitments. 

CDC Warns – US Facing Fourth Wave of COVID-19 In ‘Critical Moment’ for Pandemic

Meanwhile, the US could be facing an imminent fourth wave in the pandemic, with COVID-19 cases increasing in 25 states, and an average of 64,000 new cases reported daily over the past week, officials from the US Centers for Disease Control warned. The rise in cases coincides with multiple states loosening COVID restrictions on social distancing and other measures.

Cases have increased by 12% from last week, accompanied by higher hospitalisation and death rates, with a seven day average of deaths at 940 per day. 

“This is a critical moment in our fight against the pandemic. As we see increases in cases, we can’t afford to let our guard down,” said Dr Rochelle Walensky, Director of the CDC, at a White House press briefing of the COVID-19 Response Team.  

“We need to keep taking the mitigation measures, like wearing a mask and social distancing, as we continue to get more and more Americans vaccinated every single day,” Walensky added, speaking at a White House press briefing on Wednesday. 

The B.1.1.7 variant, first identified in the United Kingdom, is responsible for 26% of the SARS-CoV2 variants circulating across the US, and it is the predominant strain in at least five regions of the country. 

“We do know it’s more transmissible – somewhere between 50 and 70 percent more transmissible than the wild-type strain,” said Walensky. “So to the extent that people are not practising those standard mitigation strategies, we do think that more infections will result because of B.1.1.7.”

At the same time, however, several states have begun abandoning mask mandates and allowing for more social gatherings, which may provide an opportunity for the virus to spread as well as to mutatey, developing new deadly variants. 

“The failure to take this virus seriously [is] precisely what got us in this mess in the first place [and] risks more cases and more deaths,” said President Joe Biden at a press conference on Monday.

Joe Biden, US President, delivering his presidential remarks on COVID-19 response and vaccinations on Monday.

BIden pledged that the US will continue scaling up its vaccination campaign, setting the goal of having a vaccination site within five miles of every American by 19 April.

“We are in a ‘life-and-death race’ against the virus. We are facing an accelerating threat,” said Andy Slavitt, Acting Administrator of the Centers for Medicare and Medicaid Services, at the White House press briefing on Wednesday.

This will simultaneously require continued adherence to public health measuring and the improvement of vaccine access nationally.

Image Credits: Johnson & Johnson, Johnson & Johnson, C-Span.

Community health worker distributes ivermectin – the mainstay treatment against onchocercisasis (river blindness) – for the past several decades.

A recent trial of ivermectin, a mainstay treatment for the parasitic disease onchocerciasis for the past three decades, has failed to show significant impacts against COVID-19, a new study,  published in JAMA, reports. The study by a group of researchers in Cali, Colombia found that the use of the antiparitic drug, typically used to treat onchocersiasis  (river blindness) endemic to West Africa, did not not significantly shorten the durationof COVID symptoms in patients with mild disease.

The study of some 400 people found that those trated with the drug had a resolution of symptoms in 10 days, on average, as compared to 12 days – but the two day difference was not deemed statistically significant. “Further trials of ivermectin as a treatment against COVID-19 are, however, still underway. The ANTICOV Consortium, for example, is considering adding ivermectin – in combination with another drug – as an additional arm of its ANTICOV series of clinical trials underway in Africa.  The clinical trials, coordinated by DNDi, are testing the efficacy of different drugs as a potential treatment against mild to moderate cases of COVID-19.”

In light of the inconclusive evidence, WHO, meanwhile, has issued a recommendation that use of ivermectin be limited to clinical trials, until more data is available. This recommendation, which applies to patients with COVID-19 of any disease severity, is now part of WHO’s guidelines on COVID-19 treatments.

Ivermectin is a broad spectrum anti-parasitic agent, included in WHO essential medicines list, and a mainstay of treatment against river blindness for the past four decades or more. Following the breakthrough discovery of efficacy in trials conducted by WHO in the 1970s, it was put into widespread use in West Africa, where river blindness is endemic, under programmes of preventative, mass community administration of the drug once a year.  Only in the past several years has a new treatment for river blindness, moxidectin emerged, which shows promise of even greater efficacy against onchocerciasis. Ivermectin is also used for the tratment of scabies, strongyloidiasis and other diseases caused by soil transmitted helminthiasis.

Ivermectin is traditionally used against onchocerciasis and scabies

The current WHO guidance on ivermectin was issued following a review of the evidence by an international panel of experts. The group reviewed pooled data from 16 randomized controlled trials (total enrolled 2407), including both inpatients and outpatients with COVID-19. They determined that the evidence on whether ivermectin reduces mortality, need for mechanical ventilation, need for hospital admission and time to clinical improvement in COVID-19 patients is of “very low certainty,” due to the small sizes and methodological limitations of available trial data, including small number of events. The panel did not look at the use of ivermectin to prevent COVID-19, which is outside of scope of the current guidelines.  Other WHO recommendations on COVID-19 treatments include:

  • Strong recommendation for the use systemic corticosteroids (e.g. dexemethesone) for severe or critically ill COVID-19 patients; with a conditional recommendation against their use in patients with mild/moderate COVID-19;
  • Conditional recommendation for the use of low dose anticoagulants in hospitalized patients (this recommendation is part of the clinical management guidelines). We suggest the use of low dose anticoagulants rather than higher doses, unless otherwise indicated;
  • Conditional recommendation against administering remdesivir in addition to usual care;
  • Strong recommendation against the use of hydroxychloroquine or chloroquine for treatment of COVID-19 of any severity;
  • Strong recommendation against administering lopinavir/ritonavir for treatment of COVID-19 of any severity.

Updated on 6 April 2020. 

Image Credits: Mectizan Donation Programme, Sarang.

The debate around technology transfer is proving to be critical in addressing shortages in the production of vaccines. We wanted to know from developing country manufacturers on the challenges they face in making vaccines for COVID-19. Geneva Health Files brings you an interview with Abdul Muktadir, Chairman and Managing Director of the Dhaka-based company Incepta Pharmaceuticals Limited.

Established in 1999, Incepta specialises in biosimilars and vaccines, employing nearly 10,000 people and producing about 1000 different medicines and vaccines – including oral cholera vaccines, vaccines for influenza, measles, rubella, and Hepatitis B. Incepta exports to 67 countries across the world, has 3 manufacturing sites, and 17 factories and research facilities.

Geneva Health Files (GHF): What, according to you, are the real impediments for technology transfer in the process of production of vaccines in the developing world? 

Abdul Muktadir (AM): The innovator companies are preoccupied with the supply commitments to the governments from which they have taken advance payment. They have successfully transferred the technology to all the Contract Research Organizations (CROs) so the technical difficulties that are often referred to may not be a big impediment. The innovator companies are at ease working within their comfort zone and do not want to deal with unknown companies.

This is the real barrier that the innovator companies do not feel comfortable working with many companies from the developing world.

Abdul Muktadir, an industrial pharmacist by training, who is Chairman & Managing Director for Incepta Pharmaceuticals Limited

GHF: In policy debates in Geneva, developed countries argue that intellectual property has not been a barrier for the production of vaccines. What are your thoughts on this? 

AM:  In the current context, the IP right is not the impediment as the companies from the developing world would act either as a CRO or as a license holder. The innovator companies should utilize as many manufacturing bases as possible and then increase their production. In this case there is no issue of IP violation.  

GHF: It has also been argued that developing country manufacturers may not have the skills and equipment to engage in technology transfer. What are your views on the expertise and manufacturing capacities in the developing world?

AM: There are several technological platforms for production of currently approved COVID-19 vaccines, and for each platform there are differences in upstream and downstream processes. The vaccine manufacturing is not very widely distributed but the companies that manufacture vaccines – they understand the process fairly well.

So, the capacity and expertise are available with the manufacturers of the developing world – otherwise Serum Institute and other Indian manufacturers would have faced difficulties. The equipment might require some re-tooling to accommodate the new process but certainly it is possible. 

GHF: As a developing country manufacturer, what in your view is a preferred way for technology transfer: non-exclusive licensing or bilateral arrangements? And why?

AM: Here, the primary objective is to increase the volume of production. My argument is: if a company can deliver 1 billion doses a year then we should try to increase that capacity to 4 billion using the same principle. No company was prepared to deliver 1 billion doses a year, but the companies are doing this now. The task of manufacturing should be distributed based on the capability of each manufacturing partner.

The best way should be to mass manufacture antigen [vaccine active ingredient] bulk in a few places and then the antigen could be distributed for fill/finish wherever the capacity is available. 

We are referring to any licensed Covid-19 vaccine such as Moderna, Pfizer, Astrazeneca, Johnson & Johnson. If we receive the active bulk ingredient, we have the capacity to fill and finish.

This way we can involve many companies in many different countries. This would also eliminate impediments on cross border transportation. We observe now that most of the manufacturing countries are putting barriers in previously agreed supply commitments. 

The above process would involve both non-exclusive licensing and bi-lateral arrangements. We can avoid non-exclusive licencing if the innovator company can make the agreements through multi-party contract manufacturing. In such a case the technology transfer requirement would be as per the requirement of each task. If the bulk antigen can be produced in a few places then the requirement of tech transfer would be very minimal, and the innovator company’s technology can remain very well guarded.

The current technology of manufacturing the COVID-19 vaccine is probably known to many vaccine companies, including companies from the developing world like ours. The biggest challenge in introducing a new vaccine is to successfully conduct an efficacious clinical trial and this remains the main barrier for a new vaccine. So, our best option would be to manufacture the already-approved vaccines on a massive scale and provide them fair reward for their innovation.

GHF: Can you share specific details on your operations in Bangladesh in terms of capacity for technology transfer? What would be the easiest vaccines to produce and what are the potential areas for improvements in your manufacturing plants?

Incepta Pharmaceuticals has full-scale vaccine manufacturing facilities – including antigen production lines, bioreactors, and fill-and-finish capacity.

AM: We have full-scale vaccine and biosimilar manufacturing facilities. We can manufacture bulk antigen using almost all technology platforms. 

We have the bulk antigen production facilities which could be utilized to adapt almost all technology platforms (e.g. mRNA, DNA, adenoviral & insect/baculoviral etc ) available for COVID-19 vaccine. 

For example, we have developed a meningococcal polysaccharide subunit vaccine (ACYW135), hepatitis B sub-unit vaccine (VLP based), and whole cell oral cholera vaccine from our own bulk, and obtained licensure for these vaccines in Bangladesh. Moreover, a cell culture-derived rabies vaccine that we developed is in a clinical trial now. A pre-clinical study for typhoid conjugate vaccine is on-going. In addition, we have more vaccines in the pipelines.

Depending on a particular process we have to re-tool the facility to accommodate the manufacturing of a new vaccine. Once we have a process in hand, then we would know the extent of re-tooling requirements. Once the facility is ready then we have to optimize the manufacturing process and it requires some time.

For us the easiest COVID vaccine technologies  would be the protein subunit vaccines [such as the one produced by Novavax] and mRNA vaccines [such as those produced by Pfizer/BioNTech and Moderna]. We would also be able to manufacture adenovirus vaccines.

We have the bulk antigen production facilities which could be used to adapt technology related to mRNA vaccines and protein subunit vaccines for COVID-19. 

We have a 500L bioreactor which could be used to produce insect cells/baculovirus based protein sub-unit vaccines like the one from Novavax. 

At the moment, we have a licensed protein sub-unit vaccine for hepatitis B which we developed using the yeast technology platform. 

If we have access to mRNA technology, we believe we can easily adapt this technology. We have all the reactors and purification tools required for mRNA vaccine production.

If we get the antigen then the production can start immediately, as we have two and a half production lines sitting idle. In one line we can handle multiple dose vials, and with 20 doses a vial, we can deliver about 500 million doses a year. If we re-tool the other two lines for larger, multiple vial capability then we would be able to deliver another 600 million doses. But this would require a lead time for the supply of tools from machine manufacturers, and this may require a lead time of 6-8 months. But we now have one line fully ready to deliver about 500 million doses a year in multiple dose vials (the lines we have are suitable to fill any type of vaccine).

At the moment we don’t have any deals with any innovators.

Priti Patnaik is the founding editor of Geneva Health Files – a reporting initiative that tracks power and politics in global health. This interview is a part of a series under a collaboration arrangement between Geneva Health Files and Health Policy Watch.

Image Credits: Incepta.

Dr. Tedros Adhanom Ghebreyesus, WHO Director General, at the press briefing on Thursday.

The World Health Organization (WHO) is hopeful that all healthcare workers can be vaccinated by mid-April, but the clock is ticking away, leaving rich countries only nine days to donate surplus COVID-19 vaccines to the global COVAX facility – which has run out of doses at a crucial time.

So far, the WHO has not received any donations since it called on countries last week to donate surplus doses they have accumulated, said Dr. Tedros Adhanom Ghebreyesus at a press conference on Thursday. 

“Last week, I made an urgent request to countries with surplus vaccines that have WHO emergency use listings to share 10 million doses with COVAX,” said Dr. Tedros. “This challenge has been heard, but we’re yet to receive commitments for those. I’m still hopeful that some forward looking and enlightened leaders will step up.”

COVAX Facing “Serious Challenges” 

Although the global COVAX facility has already delivered 35 million doses to more than 78 countries across the globe, it is facing “serious” shortfalls in doses – mainly because of India’s recent move to halt vaccine exports to the rest of the world as it attempts to fend off an outbreak that has grown to some 70,000 cases a day from only 15,000 since early March – an increase in cases by a factor of four in just a month. 

Despite the WHO’s call on rich countries and vaccine manufacturers to donate surplus vaccine doses last week, a whopping 100 countries still lack adequate access to vaccines, said Turkey’s Health Minister Fahrettin Koca, who also spoke at the press conference. Of those, two dozen countries that have signed up to the WHO co-sponsored COVAX initiative are ready to begin vaccinating healthcare workers – but they lack the supplies to begin before the 100th day of 2021 – the target date WHO had said for vaccine campaigns to start everywhere in the world. These include Cameroon, Haiti, Congo, Burkina Faso, Niger, Vanuatu, Papua New Guinea, Kyrgyzstan, the Dominican Republic and Mauritania, among others. 

“I know this is a challenging time for many countries as cases and hospitalization are spiking, but conversely, it’s when cases are spiking that it’s the most important time to share vaccines equitably and protect our workers, and at-risk communities,” Dr Tedros said.

Going forward, the concerning gaps in equity “could be addressed” by increasing local and regional vaccine production capacity and by moving forward on the intellectual property waiver spearheaded by South Africa and India, said the WHO Director General. 

“I think we should be able to produce vaccines everywhere, all over the world without intellectual property rights being a problem,” added Koca. “So that’s why I think we need to be taking concrete steps about this issue.”

Turkish Health Minister Fahrettin Koca at the press briefing on Thursday.

Turkey Announces Digital Platform To Commemorate Healthcare Workers

Meanwhile, in celebration of the International Year of Health and Care Workers, Koca announced the creation of a digital platform to tell the stories of the heroic and essential work carried out by healthcare workers since the pandemic began. The platform will be run in collaboration with WHO. 

“The whole of humanity is grateful to you right now,” said Koka. “[Your] stories need to be told in the common language of humanity. For this purpose, as a first step, we are working on creating a digital platform with WHO, to serve as a memorial dedicated to health and care workers.”

Since the start of the pandemic, millions of healthcare workers have been infected with the coronavirus and thousands have died. Those that have survived are struggling with a range of mental health issues, including heightened stress, anxiety, depression, insomnia, and exhaustion. 

That toll, said Dr Tedros, has been far too great – but it can be reversed by strengthening the capacity of the healthcare workforce, improving salaries, and ensuring healthcare workers are equipped with adequate personal protective equipment so they can do their job safely and effectively. 

“Far too many health and care workers have died in the pandemic,” he said. “As we work to end the pandemic and recover together….We must ensure that they are trained, protected, and supported to do their job safely and effectively.”

Image Credits: Our World In Data, WHO.

A man with symptoms of the deadly NTD African trypanosomiasis (sleeping sickness), is examined by Dr Victor Kande in the Democratic Republic of Congo (DRC). Kande was principle investigator for clinical trials of fexinidazole, the first oral sleeping sickness treatment approved by the European Medicines Agency (EMA) in 2018. Developed by DNDi, it is being rolled out in  DRC.

Global health experts expressed their frustration with the lack of research and attention towards neglected tropical diseases (NTDs) and vulnerable populations, calling for health systems to address NTDs in a more sustainable and holistic way.

Speaking at the launch of a new strategic plan for the Geneva-based Drugs for Neglected Diseases initiative (DNDi) on Tuesday, DNDi Executive Director Bernard Pécoul said greater emphasis should be placed on expanding access and developing treatments for patients in low- and middle-income countries (LMICs) affected by neglected tropical diseases (NTDs), as well as neglected viral diseases like HIV/AIDS, and also pandemic-prone and climate-sensitive diseases.

“Treatments were abandoned for years or decades because they fell outside commercial markets,” said Pécoul, at the launch of the plan that charters an eight-year journey to 2028, aiming to deliver 15 – 18 additional treatments, in addition to eight already developed, for a total of 25 new or improved, and highly effective, NTD treatments. 

“The frustration is where the idea was born – from the experience of humanitarian doctors, frustrated, while treating patients with vaccines that were ineffective, unsafe, or unaffordable, or never developed at all because the research and development was abandoned,” Pecoul added, speaking of his own experience in the past working with Medecins Sans Frontieres (MSF). 

DNDi, a WHO-supported organization of private and public sector actors, has committed to five strategic imperatives for the next eight-years: to deliver new treatments and expand access for neglected patients of NTDs and related viral diseases; join with public health leaders and Research and Development (R&D) stakeholders in low- and middle-income countries to advance sustainable health systems; contribute to building a proactive agenda for maternal, child health, and gender-responsive R&D; champion open science and transparency; and leverage new technologies to accelerate R&D. 

“It is our hope that we will identify safe, effective, and affordable medicines to help countries fight the health and social burden put on them by COVID-19. While all global attention is focused on development and purchase of COVID-19 vaccines, we should not forget about treatment and diagnostics,” said Marie-Paule Kieny, Director of Research, INSERM and DNDi Board Chair, at the Tuesday DNDi launch.

Challenging The Status Quo

DNDi
DNDi’s Strategic Plan launch event panel: clockwise: Patricia Amira, moderator; Dr Somya Swaminathan; Dr Marie-Paule Kieny; Dr Jeremy Farrar; Dr Bernard Pecoul; Dr Berhards Ogutu

Also appearing at the event, Jeremy Farrar, director of the Wellcome Trust. also expressed frustration with the ‘status quo’ that has defined R&D for global health, and called for more attention to be brought to three areas that would ‘define the 21st century’ – neglected and infectious disease, climate change, and mental health. 

“These three things are going to define our time – which have a focus on youth, and which have an inequitable impact on societies around the world. [DNDi is committed to] not just doing the science, but making sure that science is shared equally with everybody in the world,” he said. 

Over the next decade, DNDi will work to accelerate sustainable disease elimination in diseases with existing treatments, such as sleeping sickness and Chagas disease, and increase access to lifesaving and safer treatments for HIV and leishmaniasis. 

DNDi –  founded in  2003 to discover, develop, and deliver safe, effective, and affordable treatments for neglected and marginalized patients –  will also work with leaders and institutions in LMICs to bolster research capacity and generate more sustainable production and supply of NTD treatments. 

The initiative has grown into a network of over 200 partner institutions, and has so far delivered eight new treatments for people with sleeping sickness, visceral leishmaniasis, Chagas disease, HIV, and malaria.  

Clinical Trials for Mild COVID Cases Launching in 13 African Countries

Africa launches largest COVID clinical trial

COVID-19 has highlighted the need to prioritize and finance research in LMICs, as well as government preparedness to ensure both transparency and equitable access.  

In addition to working on NTDs and viral illnesses, DNDi will also address unmet medical needs, utilizing its ‘dynamic portfolio’ approach to explore new interventions in diseases with clear R&D gaps, including snakebite, dengue fever, schistosomiasis, and pandemic-prone diseases. 

At the start of the strategic planning period, DNDi also is coordinating ANTICOV – the largest African-led clinical trial testing for mild-to-moderate COVID-19. 

The ANTICOV platform  deals with the outpatient population, which is the majority of people with COVID, and is trying to answer the question of how to treat people to prevent them from getting ill and needing hospitalization, said Dr Soumya Swaminathan,  WHO Chief Scientist.

Carried out by a group of 26 prominent African and global R&D organizations in 13 countries, ANTICOV will simultaneously test and adjust treatments for COVID-19, and identify new treatments, fast-tracking research for patients and health systems in resource-limited settings. 

Swaminathan said that the high costs of the COVID-19 pandemic should not come at the expense of cutting or reducing budgets for NTDs, saying that the ‘collaborative science’ seen over the past year as proof that knowledge could be shared openly and freely. 

“Because of this vision, and the collective mission to solve the problem of COVID and develop new tools, it is possible to [share knowledge more widely].”

Though DNDi is primarily focused on R&D, the organization will also identify gaps in access to care, and build the partnerships needed to overcome them, laying the groundwork for more affordable care.  

Said Swaminathan: “When there’s a new technology, which can make a big impact, especially when it’s related to health and disease, it should be considered a global public good, and be made available to people who need it, regardless of their ability to pay.”

Image Credits: DNDi, DNDi, ClimateWed/Twitter.