Boys play on a beach in Kiribati, one of the Pacific island states most threatened by rising sea levels due to climate change.

Climate activists have high hopes that at this week’s Leaders Summit on Climate, hosted by US President Joe Biden with forty other heads of state, climate change will be framed as a health issue that is exacerbating the risk of future pandemics, as well as causing seven million deaths a year right now as a result of air pollution and reducing already fragile crop yields critical to nutrition and food security.  

Climate activists are pinning these hopes on the Biden administration’s recent appointment of two well-known advocates of the health card in climate change negotiations – John Kerry, the U.S. Special Presidential Envoy for Climate, and Gina MacCarthy, the White House climate advisor. 

“At the Leaders’ Climate Summit, I think we’ll see the US framing their climate commitments at least in part in terms of health,” said the head of Global Climate and Health Alliance Jenny Miller, in an interview with Health Policy Watch. “The US Climate Advisor Gina McCarthy is very knowledgeable about the health impacts of climate change and the health benefits of climate solutions.” 

Even during the Trump years, Kerry was pounding the pavement of climate meetings and interacting with health advocates. Pictured here with WHO’s former Assistant Director General Flavia Bustreo at the 2019 Madrid climate conference of parties (COP 25) – the last in-person meeting before the COVID pandemic.

Indeed, Gina McCarthy has been a regular on the podium of numerous health and climate events, dating back at least to the 2014 UN Climate Summit, when she headed the work of the US Environmental Protection Agency, under the Obama Administration. Kerry, US Secretary of State in the Obama Administration who led the US team negotiating the 2015 Paris Climate Accord, remained active on the climate issue in the dark days of Trump’s climate denial policies, including meetings with climate and health advocates. Last week, just ahead of the climate summit, Kerry shuttled to Shanghai for the first meeting by a senior Biden Administration figure with Chinese officials, and President Xi Jinping later confirmed he would attend the virtual summit meeting. 

Health, however, is not formally on next week’s agenda, and there is concern that a more traditional positioning of climate action as a solution that benefits economies and businesses could detract from a strong health case, Miller warned.

“While I do think that health may come up during the Summit, it’s not actually on the official agenda,” she said, adding. “If you’re talking about climate change and you’re not talking about the impact on people, you’re missing the boat.”

“At the Summit, I’m concerned that with a more narrow focus on economies, businesses, and on new technologies, rather than on making sure the solutions we pursue really deliver benefits for people, we won’t actually get those health benefits we could see,” she said. She added that a stronger representation of health ministers in future climate conferences, such as the UN COP 26, due to be hosted by the United Kingdom in Glasgow at the end of 2021, could help position climate change as an opportunity to improve health.

Climate change has increased droughts and water scarcity, reducing crop productivity and pastureland; increased food insecurity; and driven local conflicts and migration in Africa’s Sahel and beyond.

Still, a handful of countries have begun to draw more explicit links between climate change and health in their policies, such as Canada, which recently put health front and centre in its climate adaptation plan. In the United Kingdom, meanwhile, the National Health Service recently committed to carbon neutrality by 2040. And in Latin America, countries such as Argentina are moving to integrate health into their national climate commitments, made under the 2015 Paris Agreement.

But “most” countries still have a long way to go, Miller notes, emphasizing the urgent need for bolder commitments across the board. In even the more health-and-climate conscious countries, carbon emissions have continued to increase in past years, she noted.

Concretely, the White House Summit aims to firm up a stronger consensus among the world’s largest greenhouse gas emitters, including the US and China, to limit the earth’s warming to no more than 1.5 C. In one hopeful sign, other leading state actors on the climate front, including India, the United Kingdom and Russia, have also confirmed their attendance. And while the final list of attendees hasn’t been published, it is expected that most other countries among the 40 invitees from Europe, Latin America, Africa, The Middle East, and Asia will follow suit.

Ahead of the summit, the United States and China released a historic joint statement, calling on countries to raise their level of ambition in fighting climate change, and cooperate on reaching carbon neutrality.

At the Summit, the White House has already said that the Biden administration will unveil an “ambitious 2030 emissions target” for the US, as well, to move towards the 1.5 °C goal, reversing four years of inaction under the former administration of Donald Trump, who backed out of the Paris climate agreement, bolstered the fossil fuel industry and relaxed regulations on climate and environmental pollution. Not coincidentally, Thursday’s opening session, 22 April, also coincides with the annual celebration of Earth Day.

Climate Change Is A Health Issue 
Maria Neira, WHO WHO Director of Environment, Climate Change and Health

Given that seven million people a year die from air pollution every year – mainly from the burning of fossil fuels – it makes sense to position climate change as a health issue, emphasized Maria Neira, WHO’s director of environment, climate change and health, who has previously said that “fossil fuels are literally killing us”. That framing, she argues, can help accelerate action on the climate front.

“If you care about your lungs, you better care about climate change,” she said. “If we want to speed up action on the climate front, the most powerful argument is about health.” 

Tackling the causes of climate change, she stressed, has “enormous” health benefits, because the same dirty fuels that cause pollution in households, cities and rural areas also contribute one way or another to climate change. So curbing air pollution can both rapidly reduce some of the key climate change drivers, as well as reducing risks of cardiovascular, respiratory diseases and cancers, she pointed out.

In the wake of the COVID-19 pandemic, too, it is becoming increasingly clear that cllimate change has seeded the “ideal” conditions for more frequent and more devastating pandemics – increasing human encroachment on wilderness areas, leading to the release of new pathogens that previously circulated only among animal species in the wild. 

 “Today, up to 75% of all emerging diseases come from animals,” warned teenage climate activist Greta Thunberg earlier this week at a WHO press conference. “And as we are cutting down forests and destroying habitats. We are creating the ideal conditions for diseases to spill over from one animal to another, and then to us,” she said, adding: “We can no longer separate the health crisis from the ecological crisis, and we cannot separate, separate the ecological crisis from the climate crisis. It’s all interlinked, in many ways.”

Polluting Industries Must Pay The Real Price For Carbon Emissions 

Looking ahead to the COP26 climate conference in Glasgow, planned to take place 1-12 November, climate advocates must ensure that polluting industries pay a “serious” price for the carbon they are releasing into the atmosphere, added former spokesperson for the Paris Agreement of 2015, Nick Nuttall, who is co-hosting the Exponential Climate Action Summit-Financing the Race to Zero on Thursday as well. The event brings together thought leaders from the private sector, labour unions and civil society to talk about ways in which climate action can be accelerated, while creating more jobs and global development payoffs. 

“We need a proper price on pollution to make sure that people who continue to pollute like oil companies, and like heavy industries, actually have to pay a serious price for the carbon that they’re putting out into the atmosphere – as a way of generating finance for those that are doing the right thing,” said Nuttall, in an interview with Health Policy Watch. 

The income generated from pricing carbon, he added, would both encourage dirty industries to quickly reduce their emissions and help generate the working capital to support national and regional governments and cities that are working towards reducing their emissions.

There also needs to be a “clear message from people that have pensions and have investments in pension funds that we will no longer tolerate investment in those pensions in the shares and the stocks of companies that are causing harm to our planet,” he said, noting that some of the public motivation for that kind of divestment will come from growing public awareness about the health impacts of climate change. 

He said that the last three years have finally seen the finance sector tipping into “real action” on investments into more low-carbon and greener development. “Now it needs to achieve the required velocity to first halve emissions by 2030 and then net zero by 2050.”

Ultimately, the financial arguments are also linked to the health card as well: “We need to address climate change to protect human health, and this won’t happen if we don’t finance the transition, and fast… to protect our ecosystems [needed for health], and breathable, productive cities.” 

Image Credits: UNDP, WHO, Flavia Bustreo , Flickr – EU Civil Protection and Humanitarian Aid, Maria Neira.

There is a “possible link” between the Johnson & Johnson COVID-19 vaccine and very rare cases of blood clots, but the benefits of the single-dose vaccine outweigh the risks, the European Medicines Agency (EMA) has announced.

In a statement released on Tuesday, the EMA safety committee said that the rare, but serious blood clot disorders, should be listed as “very rare side effects” of the vaccine. The EMA statement followed a similar decision with respect to the AstraZeneca vaccine, just two weeks ago. 

The European regulator had reviewed eight reports of “serious cases of unusual blood clots associated with low levels of blood platelets”, one of which was fatal – among seven million who received the jab in the United States. 

No cases of deaths associated with the J&J vaccine have so far been reported in the European Union, said EMA executive director Emer Cooke – but vaccine administration on the continent is also far less advanced.

Along with Europe, South Africa and the US had also announced a pause in J&J vaccinations over the blood clot reports in response to reports of a rare cerebral blood clot disorder that combines clots with low blood platelets (CVST).  Since then, vaccines in South Africa have resumed, but in the US, they remain on hold.  

Announcing its decision, the EMA said the risks associated with the virus itself are still higher than the vaccine.

“Covid-19 is associated with a risk of hospitalisation and death,” it said. “The reported combination of blood clots and low blood platelets is very rare, and the overall benefits of [the Johnson & Johnson] Covid-19 vaccine in preventing Covid-19 outweigh the risks of side effects.”

European Commission President Ursula von der Leyen welcomed “the announcement on the safety of the Johnson & Johnson vaccine”.

“This is good news for the roll-out of vaccination campaigns across the EU,” she tweeted.

Johnson & Johnson Rare Blood Clotting Cases

The cases of clotting in the US “occurred in people under 60 years of age within three weeks after vaccination, the majority in women”, the EMA regulator said in its statement. 

“One plausible explanation for the combination of blood clots and low blood platelets is an immune response, leading to a condition similar to one seen sometimes in patients treated with heparin called heparin induced thrombocytopenia, HIT,” it said. Heparin is a blood thinner given to people with clotting disorders.

The EMA said healthcare workers and those who have received the vaccine should be aware of potential symptoms of these rare blood clots. They include shortness of breath, chest pain, leg swelling, abdominal pain, headache, blurred vision or tiny blood spots under the skin.

The early intervention of a specialist can change the outcome for the patient, Cooke said.

‘Similarities’ with AstraZeneca

Emer Cooke, EMA Executive Director.

The cases reported with  J&J’s vaccine were similar to the rare blood clot cases linked to the AstraZeneca vaccine, EMA also noted.

Earlier this month, the EMA made the same recommendation for the Covid-19 vaccine produced by Oxford-AstraZeneca.

That recommendation, made on 7 April, came after 86 people, out of 25 million Europeans who had received the jab, developed the unusual blood clots. Germany has since halted administration of the vaccine to people under the age of 60, the UK has ceased giving the vaccine to people under age 30, and Denmark has halted it altogether. 

Both vaccines use a disabled, or inactive adenovirus vector [viruses that typically cause colds or flu-like symptoms] to deliver a double stranded DNA containing the genetic instructions for part of the SARS-CoV2 characteristic spike protein. That stimulates the body’s immune system to develop antibodies to the virus.

However, Sabine Straus, chairperson of EMA’s evaluation committee of risks and pharmacovigilance (PRAC) noted there were differences between both vaccines since Johnson & Johnson’s vaccine uses an inactivated human adenovirus as the “vector” to deliver the spike protein DNA, while AstraZeneca’s is chimpanzee-based. Both vaccines also target a different part of the SARS-CoV2’s spike proteins, she said.

Considering that the Russian-made Sputnik-V vaccine also uses adenovirus vectors to deliver its jab (in this case different ones for first and second jabs), the EU regulator will “pay close attention” to the issue of rare blood clots as it reviews the vaccine, she added.

According to the latest available data, a total of 287 cases of unusual blood clots have been  reported following the administration of the AstraZeneca vaccine; 25 in the case of the Pfizer-BioNTech vaccine and 5 for the Moderna vaccine, the EMA officials told reporters.

The first-ever informal meeting between civil society groups, WHO officials and WHO member states was held on Tuesday ahead of the formal 74th   World Health Assembly, 24 May-1 June. 

The World Health Organization (WHO) and member states have an obligation to listen to stakeholders in a “sympathetic and respectful manner” as non-state actors (NSAs) play critical roles in supporting global health work generally – and more immediately addressing COVID-19 and its impacts on communities.

That call was made by Mara Burr, director of multilateral relations at the United States Department of Health and Human Services/Global Affairs, during a first-ever informal meeting between civil society groups, WHO officials and WHO member states ahead of the formal 74th   World Health Assembly, 24 May-1 June. 

While civil society groups have expressed fears that novel format of a separate forum for more detailed discussions between NGOs and member states could also undermine their standing at the formal WHA – the presence of some leading WHO donors and member states, such as the United States, Germany and France – in at least some of the sessions  – seemed to indicate that countries are taking the new model seriously.   

“WHO needs to ensure it has the ability to engage directly with non state actors, including civil society and the private sector… who can make strong contributions that is vital to any type of success against the pandemic,” said Burr on Tuesday, the first day of the 3-day virtual meeting, adding that it is “critically” important to ensure the participation of so-called “non-state actors” (NSAs) in WHO governing bodies and that such participation be in a “transparent and accountable manner, with an open door” to allow input from all stakeholders, including the private sector.

She underlined how the COVID-19 pandemic has demonstrated the critical role NSA’s and the private sector play, in everything ranging from addressing pandemic fallout at the community level to the development of vaccines and supply chains. 

Mara Burr, director of multilateral relations at the United States Department of Health and Human Services/Global Affairs.

“We all know that the COVID 19 pandemic has worsened inequalities and threatens decades of hard won gains in childhood vaccination coverage, fighting HIV, tuberculosis, malaria, malnutrition, maternal and child mortality sexual and reproductive health and rights, property, and much more.NSAs have played critical roles, not just in addressing the direct effects of COVID-19, but also in focusing on the secondary impacts in communities across the globe.”

Other actors, however, said that they would have liked to have seen greater member state presence – and in all of the sessions – rather than only in two half day sessions – out of the three full days. Although most of the sessions during the three day event are being broadcast publicly, WHO also said it had no list of what civil society and private sector groups, as well as member states, actually had attended the informal sessions.  

WHO Reforms, Finance And Other Key Issues Raised

However, in the session on public health emergencies, preparedness and response, in which Member States also were invited on Tuesday, the opening day, leading countries such as US took the opportunity to air preliminary views on the more controversial issues that will come before the full World Health Assembly (WHA) when it meets in just a month’s time. 

Those include a proposed “Pandemic treaty” that could strengthen the legal mandates around emergency response; a more sustainable system for WHO finance; vaccine production, distribution and equity; and series of independent reviews both into the functioning of WHO’s own health emergency system, the broader global pandemic response of member states and the functionality of the international health emergency system during the crisis – with recommendations for reform.  

“It is very important that member states have the ability to review those reports, in a way that allows us to really digest the information and discuss with member states the way forward,” Burr said.  

“I think we are a bit concerned that there are proposals that are presupposing a path forward without allowing the member states to actually have a discussion and determine what path makes the most sense.”

With respect to new resolutions and political instruments such as a treaty, however, her remarks seemed to express some hesitations.  

“There are there just not enough hours in the day to negotiate several different instruments at the same time,” she said. “And so we want to make sure the path we choose is the best way forward, based on the overwhelming consensus of the member states. We are analyzing everything. We appreciate all of the inputs, but I think it’s time for us to carefully consider these recommendations before we decide on a way forward.”

NGOs Play Key Role in WHO’s Work

During opening remarks earlier in the day, WHO director general Dr Tedros Adhanom Ghebreyesus said the organisation valued the “longstanding and fruitful collaboration” it shared with NSAs in official relations.

“Nongovernmental organizations have been working with WHO since its creation, and continue to play a key role, especially on technical collaboration. Philanthropic foundations have long been strong supporters of WHO’s work, said Tedros, highlighting the support given for the COVID-19 Solidarity Response Fund. In a conciliatory remarks clearly aimed at pharma industry leaders, whom he has repeatedly slammed over past months, Tedros added that “international business associations also provide a vital link between the private sector and WHO in finding common ground in public health goals”. 

Future Emergency Response: Needs Stronger Political Commitment From All 

Jaouad Mahjour, WHO acting Regional Director for the Eastern Mediterranean

Jaouad Mahjour, WHO acting Regional Director for the Eastern Mediterranean, said engagement with all NSAs is integral to moving forward on a new global framework for pandemic preparedness and response at the WHA and beyond. 

That includes a proposed treaty on pandemic preparedness and response, which gained the support of some 25 global leaders in an open letter launching the WHO initiative just last month.

“The aim would be to garner higher local political commitment to ensure and interconnect the global system to prevent predictable response to epidemic and pandemics,” Mahjour said.

There is currently a group of countries, including the United Kingdom, Germany, France, Indonesia, Kenya, Rwanda, and South Africa, co-sponsoring a draft decision on the treaty at the WHA. The decision would mandate WHO to create an intergovernmental working group to start working through the treaty specifics. 

Mahjour stated that civil society’s role in supporting such a treaty would be “most important”: 

“We know that community readiness and resilience are essential for effective all hazard approach.”

“But we’re hoping that we go out from this pandemic with strong political commitment, that will protect the world in the future and also the best legacy to our new and future generation.”

Added Gaudenz Silberschmidt, WHO director for health and multilateral partnerships, who moderated portions of the meeting:  “It’s also a call for all of you. It won’t happen on its own. It’s also your intervention and your support which will make a difference.”

The Importance of Maintaining Essential Health Services 

At the Tuesday session, WHO referred to the importance of maintaining essential health services – pointing to the role that civil society can plan in supporting that. 

The WHO has produced operational guidance to maintain essential health services, determining which services are the ones that “absolutely need to be maintained,” said Sylvie Briand, Director of the Global Infectious Hazard Preparedness Department.

Sylvie Briand, Director of the Global Infectious Hazard Preparedness Department.

The document recommends practical actions that countries can take at national, subregional, and local levels to reorganize and safely maintain access to high-quality, essential services in the pandemic context. 

Essential services include support for chronic diseases such as diabetes, HIV, and reproductive health, and also services that reduce suffering are “extremely important,” Briand added. 

Many countries find their health system capacities have been reduced by 50%, leaving their hospitals unable to provide support, noted Altaf Musani, director of health emergency interventions.  The global health workforce currently is suffering from brain drain in many countries, and a displacement of the essential health workforce does not enable refresher training for essential care; lack of accessibility of services in fragile, conflict, and vulnerable settings.

“Access is something that has to be negotiated. Access is something that often gets reduced,” said Musani.

Supporting Youth During Emergencies 

Civil society groups also  emphasized the importance of supporting youth during COVID-19, and also during future health emergencies. 

“You cannot do proper community engagement without the youth. It is really important in public health emergencies to include all segments of the population,” said Dr Ibrahima Soce Fall, Assistant Director General, Emergency Response.

Claire Beck, Director Humanitarian health nutrition and WASH, pointed out that health services, especially during humanitarian crises and pandemics, focus on certain life-saving issues for mothers and childrens, but there are more health needs that also need to be addressed as well. “Services are not youth-friendly, she said, “[They] are not open to meet the needs of youth during an emergency – reproductive health needs and listening to concerns they have.”

“It is important that the WHO not only look at the training of health workers in dealing with disease but training them to have a sympathetic and youth-friendly way of working with youth.”

But traditional health practitioners also have an important role to play during this pandemic, said Briand.

“First, they have the trust of the population, [making them] good communication channels]. If they are properly informed and they have the right message, they can help the community to protect themselves. They have a role to play in health as well.” 

Upcoming Sessions 

While Tuesday’s sessions were focused on COVID-19 response and health emergencies more generally, Wednesday and Thursday sessions will trace the steps of the wider range of issues that will also be addressed in May’s formal World Health Assembly.

Those will include sessions on the other two “pillars” of the WHO’s current strategic plan, including: one billion more people getting access to universal health coverage and one billion more people enjoying better health and well being.  

As part of that, civil society, WHO officials and (in some sessions) member state representatives will look at initiatives to address interpersonal violence; expand access to medicines, vaccines and treatment for rare diseases, and increase transparency around medicines markets; address health workforce issues; and create a framework for more sustainable finance for WHO.

Image Credits: WHO.

Encouraged by how fast vaccines have been developed for COVID-19, tuberculosis advocates launched a “TB vaccine roadmap” on Tuesday and aim to use lessons from the pandemic to jumpstart the quest for a TB vaccine.

The purpose of the roadmap, said Frank Cobelens of the Amsterdam Institute for Global Health and Development, is to provide “key actionable priorities” to develop affordable vaccines for use in low and middle income countries.

TB vaccine research and development (R&D) needs to focus on “diversifying the vaccine pipeline, accelerating clinical development, and ensuring public health impact,” he added.

But Willem Hanekom, head of the African Health Research Institute, warned that implementation of the roadmap was key, pointing out that a similar “TB blueprint” had been published 10 years ago.

“We need to establish COVID-19 as a global crisis,” said Hanekom, adding that TB deaths in India, Indonesia and South Africa exceeded COVID-19 deaths.

He also called for more investment in TB, pointing to $78.6-billion spent on R&D for COVID-19 vaccines whereas $1-billion is spent annually on TB vaccine development.

Rethinking and Repurposing

Delivering the keynote address at the TB Vaccine Conference, South Africa’s Professor Helen Rees said that COVID-19 had taught researchers the importance of “rethinking and repurposing”.

“Everyone is rethinking how we have traditionally done clinical trials,” said Rees. “What do we do to bridge from the pre-clinical to clinical development phases that is innovative and much stronger than what we already have?

“What biomarkers can be used to support and accelerate decisions? When we move from phase two to phase three trials, what kind of trial designs and very innovative, adaptive and seamless designs can be  introduced?” she asked.

The HIV field was looking at the development of mRNA vaccines “backwards”, to see whether the same approach could be applied to HIV, added Rees, who chairs the SA Health Products Regulatory Authority (SAHPRA).

She also said drugs were also being repurposed for COVID-19 and this was also the case for TB.

“We’ve been doing a lot of rethinking about [the TB vaccine] BCG, and there have been a number of trials, for example, in adolescents, seeing whether the use of a BCG booster will have an impact on disease outcome for TB. 

“There have also been trials looking at different timing of offering BCG to newborns. So this is taking an existing technology and saying, can we adapt it and do something different with it and get a better outcome?”

Studies were also looking into whether BCG could be “repurposed” for COVID-19. 

“Can we use the BCG vaccine phenomenon that is known to induce both humoral and adaptive immunity, that it has this nonspecific immune response that can be used to boost the immune system?” she asked.

Affordability and Access

Rees added that the COVID-19 pandemic had highlighted issues of “access and affordability”, reminding the conference that the Coalition for Epidemic Preparedness Innovation (CEPI) had been set up in 2017 as a public health innovation and funding mechanism in response to  Ebola “to enable equitable access of these vaccines for affected populations during outbreaks”. 

“CEPI has definitely been thrown into the forefront in terms of COVID,” said Rees, who chairs the initiative’s scientific advisory committee.

“Vaccine innovation and introduction is something that COVID has just revolutionised. The timeline between identification of a vaccine and registration was under a year – unprecedented,” said Rees. 

“If there are good things to come out of COVID-19, one of them is to say how important vaccines are in terms of control and elimination of diseases.

“If we want to eliminate TB, we desperately need better vaccines and the clock is ticking.”

 

Image Credits: Socios en Salud .

DELHI – In a twin bid to get ahead of a surging COVID-19 epidemic, the Indian government said that it will make “advance payments” totally some US$ 550 million to domestic COVID-19 vaccine makers – as well as opening up the market to private sector import and sales of other approved COVID-19 vaccines. 

Under the plan, the Serum Institute of India, which is producing the AstraZeneca vaccine (Covishield) will be given an advance of Rs 300 billion rupees (US $400 million) and Bharat Biotech, the Hyderabad-based company producing an India-made vaccine, called Covaxin, will receive a 150 billion rupees ($US 200 million) advance.  

At the same time, domestic vaccine manufacturers will be able to sell up to 50% of the vaccines that they produce on the private market – to further incentivize the production ramp-up, the government said.  

And imported vaccines by other manufacturers can also be imported and sold privately – after the government fast-tracks emergency approval.  

Finally, the Indian government said it would change its vaccine eligibility policy – allowing for all adults to be vaccinated as of Monday – as another measure to accelerate vaccinations. 

India has a population of 1.38 billion, including about 966 million adults over the age of 18 – but so far only about 127 million vaccine doses have been administered – with only about 17 million people receiving two doses.  And until this week, only  health workers, essential workers, and people over the age of 45 had been allowed to get the vaccinations. 

Incentive to Vaccine Makers – Private Market Sales 

As per the new policy, the Indian government said that domestic vaccine makers may supply up to 50% of their doses for India to the open market or to individual state governments within India. Half the doses will be earmarked for the Central Indian government. 

Foreign-manufactured vaccines, including those approved by United States and European regulatory agencies (as well as the recently Indian-approved Sputnik) may also be allowed to be sold in the private market. Both the vaccine makers and private hospitals can fix their prices for the doses sold in the open market – apparently without government controls, although they must be reported transparently. 

The Indian government said that the liberalized pricing policies have been made to incentivise vaccine-makers and boost vaccine production as well as imports. The government press release said that this policy “would augment vaccine production as well as availability, incentivising vaccine manufacturers to rapidly ramp up their production as well as attract new vaccine manufacturers, domestic and international.”

Just a couple of weeks ago, the Serum Institute’s Adar Poonawala had lamented in an interview given to NDTV that the company was unable to  make “super-profits” via exports – and the consequent lack of capital was hampering the capacity of the institute to scale up its production. He clarified that he was making profits selling vaccines (about 2 dollars per dose) to the Indian government, but the profit margin was not big enough. The Serum Institute had earlier sold the vaccine doses to the Uganda government for three times more than European Union.

R Ramakumar, a professor at the Centre for Study of Developing Economies in Tata Institute of Social Sciences, Mumbai questioned this move in an editorial for Scroll.in and said that this policy will drive up the price of vaccines “excluding millions of (Indian) people from voluntarily coming forward to take the vaccine.”

On Wednesday, just after getting permission to sell vaccines on the private market, the Serum Institute posted the new prices that it would charge for the AstraZeneca vaccine – equal to about US$ 8 a dose in private hospitals and US $5 a dose for Indian state government facilities. In comparison, the central government will still pay the original price of $US 2 per dose.

The vaccine price hikes prompted an immediate backlash from social and health advocates on social media.

“This is unacceptable” said one comment. The Centre [central government] must buy vaccines and distribute in a transparent, equitable manner free to states.  For 70 years India always had a free, universal vaccine programme.”

“Is the Serum Institute setting vaccine policy now?” tweeted Malini Aisola, co-convenor of All India Drug Action Network (AIDAN). She noted that SI had set the price without even engaging in a procurement process with the State governments.

Serum Institute CEO Warns Again That Supplies To COVAX Will Be Delayed 

Poonawala said that he will be able to renew vaccine supplies to COVAX by June or July,  provided he is able to ramp up production. SII had sought funds from the Indian government to increase its monthly capacity from up to 65 million currently to more than 100 million doses per month. 

He attributed the delay in ramping up the production due to the massive fire at Serum Institute’s facility in Pune and the sudden increase in demand by India owing to a massive surge of cases. At the time of the fire, Poonawala had earlier claimed that the damaged unit was a brand new facility which was to be used for future production of BCG and Rotavirus vaccine.

In order to provide the new support for domestic vaccine production, the Indian Finance Ministry offered credit to the two Indian manufacturing companies without the usual guarantee requirements, the Indian Express reported. 

India is currently seeing more than 200,000  COVID-19 cases per day. Many cities of the country have experienced stock outs of vaccines. In addition to halting COVAX supplies, the Indian government has also delayed bilateral vaccine exports to other countries, on account of the shortfall of vaccines in India.

Delay in Supply to COVAX

As of Monday, some 38.7  million doses had been distributed through the COVAX facility, said senior WHO advisor Bruce Aylward in a press conference Monday evening. These were mostly sourced from India’s Serum Institute in February and March before the current infection surge – although he acknowledged continuing uncertainty about when SII exports through COVAX could fully resume.

But, Serum Institute’s Poonawala said that their company is giving its entire capacity of production to India. 

“It has been difficult to explain to other countries that for a temporary period of two months we need to prioritise the needs of India over contractual obligations,” Poonawala told CNBC-TV-18 in the first week of April.

“The severe and sheer burden in cases in India, demands that we service the needs of our nation first. At least for two months and then we review the situation going forward,” Poonawala said.

Poonawala had also sought lifting of embargo of raw material exports from the US, including filters and cell culture media which are relevant for the COVID-19 vaccines. 

Poonawala explained to CNBC that while these materials do not affect the production of Covishield, they would affect the production of the vaccine Covovax which SII developed jointly with  the American company Novavax. He said that Covovax is being produced at 50% capacity for stockpiling from April- May in case the ban on raw materials is not lifted.

Public Health Experts Critique COVAX

Indian public health experts, however, have criticised both the Indian government, and international agencies for not anticipating vaccine shortages of this kind.  – leading to stock outs in several parts of India and a shortfall of doses promised to other developing countries that were reliant on Serum Institute’s stocks of the AstraZeneca vaccine. 

Rohit Malpani, a public health consultant based in Paris said that there is always a risk inherent to the structuring of the international vaccine market in such a way that a large proportion  of the vaccines destined for low and middle income countries, provided by COVAX or bilaterally,  come  from India.

“There was always a possibility or risk that eventually India would in itself require vaccines from its domestic production.” said Malpani, who also represents non-governmental organisations on the Board of Unitaid.

High income governments have felt the pinch as well. The UK government bought 5 million Covishield (the locally produced AstraZeneca vaccine) doses in the first week of March. However, the Serum Institute could not supply 5 million more after the Indian government delayed SII exports. The UK government then claimed that their vaccine roll out had been hampered as a result – although Indian observers said this is unjustified insofar as the UK has so far managed to vaccinate some 30% of its eligible population. The Canadian government also  bought about 5 million doses from Serum Institute early March. 

“The COVAX initiative did not anticipate that companies would go to the highest bidder [to sell vaccines]. They expected countries to share the vaccines. This has turned out wrong,” said Malpani. 

In an op-ed in The Guardian, access to medicine Indian activists Achal Prabhala and Leena Menghaney blamed the production shortage firstly on the decision of Oxford University to reneg on an earlier commitment to keep their vaccine technology as open-source, and sign over exclusive rights to AstraZeneca, “acting on advice from the Gates Foundation.”   

“Oxford University should have stuck to its plans of allowing anyone, anywhere, to make its vaccine. AstraZeneca and Covax should have licensed as many manufacturers in as many countries as they could to make enough vaccines for the world,” the op-ed by Prabhala and Menghaney stated.

In a recent interview, a senior Gates official denied that charge – saying that while the Foundation had assisted Oxford in finding a suitable pharma partner to scale up R&D – it had not intervened on the details of the license that Oxford signed with AstraZeneca.  

Malpani said that the international agencies need to think about what changes can be put in place to ensure that we do not have similar problems of inequitable distribution of vaccines again in the future.

He said, “If we do not make changes in the way the market is structured, how vaccines are produced..if we do not learn from these problems then criticism is very much warranted.”

–Updated 21 April 2021

An advertisement in favour of a tax on sugary drinks run in South Africa as part of a campaign by advocacy group Health Living Alliance (HEALA)

CAPE TOWN – South Africans are consuming fewer sugary drinks since their government introduced a tax on these in 2018 – but powerful multinational food and beverage companies are inhibiting neighbouring countries from following suit, according to research published on Tuesday.

South Africa was the first African country to impose a tax of approximately 10% on the sugar in sweetened soft drinks in an attempt to curb rising obesity and related diseases including diabetes and hypertension.

Last week, the Lancet published a four-year study that looked at the sugar consumption of 113,000 South African households and found per capita daily sugar consumption dropped from 16.25g before the tax was announced to 10.63g in the year after the tax was implemented.

But research published on Tuesday by the Global Health Action on seven other countries in southern and east Africa found that the path to introducing a similar tax is being blocked by industries.

There was little information in the seven countries about citizens’ consumption of sugary drinks, taxes or the industry itself, yet sub-Saharan Africa has been identified as a “growth market” for soft drinks, according to the research.

Sugary Drinks are ‘Vectors of Disease’

Professor Karen Hofman

“Obesity and its related diseases are escalating like a tidal wave across the continent of Africa,” said Professor Karen Hofman, director of Wits University’s Centre for Health Economics and Decision Science (known as Priceless). 

“It is fueled by colonisers in the guise of the processed food and beverage industry, and their associates in the advertising and marketing industries, who see our continent as a final growth market and who, for many decades have ensured that even our children are brainwashed to buy the products, because it will make them feel cool,” Hofman told the virtual launch of the research

She described ultra processed food and beverages as “vectors of disease” available at local supermarkets and transmitting “diabetes, cancer, and high blood pressure”.

Although a number of the seven countries – Botswana, Namibia, Zambia, Uganda, Kenya, Rwanda and Tanzania – do tax soft drinks, none target the sugar content or do so for health reasons.

Uganda has a general excise tax on soft drinks but despite NCDs now accounting for one-third of the country’s deaths, there is “limited recognition” of the link between sugary drinks and NCDs, according to the Uganda research.

“The soft drink industry has been influential in framing the taxation debate, and the Ministry of Finance previously reduced taxation of sugar-sweetened beverages,” according to the report.

Tension Between Economic and Health Considerations

In 2018, the Ugandan Finance Ministry proposed to cut the tax on non-alcoholic drinks from 13% to 10% – apparently because investment from Coca-Cola was contingent on this. After objections from the health ministry, the tax was reduced by to 12%, but the agreed plan of action is to gradually reduce the tax to 10%. 

After the tax was cut, Coca-Cola Uganda’s CEO is quoted as saying: “This $15 million investment was made on a promise of reducing taxes (on soft drinks), from 13% excise duty to 12% in the 2018/19 financial year, and we are glad it was implemented. This is confirmation that a favorable tax regime can attract more investment for the industry.”

While taxing sugary drinks in Kenya “has been identified as an effective mechanism to address nutrition-related non-communicable diseases”, the country is not yet committed to this.

“Government has competing roles: advocating for industrial growth, such as sugar and food processing industries to foster economic development, yet wanting to control nutrition-related non-communicable diseases,” according to the report.

An unnamed representative from the Kenyan Ministry of Health told researchers that “the Kenya Association of Manufacturers come out guns blazing whenever any of the clients is subjected to scrutiny in terms of ‘we need to tax ‘or ‘what is the health of this product’.” 

Another health official conceded that “unfortunately there’s a lot of industry interference with policy” on taxing sugary drinks, and that  it was not simply a decision about health but  [“an industrialisation issue and also a manufacturing practice issue … an industry like that, of course, has a lot of policy interference because they have big money they can compete with us.” 

Proliferation of Unhealthy Food

Botswana and Zambia appear better prepared and more interested in taxing sugary drinks, according to research presented at the launch.

However, said Zambian researcher Mulenga Mukanu, “The priority of most African governments is towards economic growth, as evidenced by policies that encourage the growth of industries that produce unhealthy commodities like sugar-sweetened beverages. This context should not be ignored.”  

Researcher Safura Abdool Karim said the growing problem of NCDs in sub-Saharan Africa “is partly due to the nutrition transition and proliferation of unhealthy foods across the continent, coupled with a lack of regulation and a lack of enforcement of existing policies”. 

But Abdool Karim concluded: “There are a number of cost-effective population-level interventions that can be implemented, particularly in low and middle-income countries, including regulating food labels, regulating marketing to children, and adopting taxes on sugary beverages.”

South Africa succeeded in introducing a tax, she added, because it based its campaign on robust local evidence, key policy-makers had political will, there was support from civil society advocacy organisations and “industry interference was neutralised”.

 

Image Credits: Kerry Cullinan, Healthy Living Alliance.

The EU has announced a €100 million fund that prioritises humanitarian settings and capacity building of national health authorities in Africa.

The European Union (EU) today pledged €100 million towards a humanitarian fund that will assist with COVID-19 vaccine roll-out in Africa.

The initiative was announced today at a press briefing addressed by Dr John Nkengasong, Director of the Africa CDC and Janez Lenarčič, European Commissioner for Crisis Management.

According to the EU, the new fund will support two complementary dimensions of the vaccination campaigns in Africa. A quarter of the fund will support the roll-out of the vaccination campaigns in African countries. It will also support capacity building of national health authorities and health care workers and will also support the management of information and vaccination coordination platforms.

“It will also address critical logistical gaps, including equipment. This implementation at country and continental level will ensure better and independent monitoring of the roll-out of the COVID-19 vaccination campaigns across Africa, supporting Africa CDC’s ongoing work. From a long-term perspective, it would also seek to reinforce national health systems’ resilience to address future epidemic outbreaks,” the EU said in a statement.

A second tranche of €65 million is set aside to support the roll-out of vaccination campaigns in specific humanitarian settings, notably in conflict and hard-to-reach areas, implemented through needs-specific activities, in close cooperation with various EU humanitarian partners. A further €10 million in reserve will be allocated to any of the two tracks as needed.

Continuous Support for Africa

Africa’s public health stakeholders have repeatedly decried vaccine nationalism of several rich countries including some in Europe that have an oversupply of COVID-19 vaccines for their citizens while groups at most risk in several African countries are yet to get vaccine doses.

But Lenarčič noted that the EU has continued to support Africa and is doing a lot to expand and ensure equitable access to COVID-19 vaccine doses in Africa through the COVAX Facility and several other bilateral and unilateral actions. “Almost half of what is produced in the EU is exported,” he said.

According to him, the EU believes and supports a global approach towards tackling the COVID-19 pandemic.

“The EU has demonstrated its solidarity in many respects with regard to this pandemic, including through its financial contribution to the COVAX facility, and through export of vaccines produced in the EU. Together(with Africa CDC), we will be able to assist members of the African Union in rolling out their vaccination campaigns. This is part of what we see as a global approach,” Lenarčič said.

The EU has not always agreed with the Africa CDC on how best to approach poor access to COVID-19 vaccines in Africa. It opposed calls for intellectual property rights for COVID-19 vaccines to be waived so that more vaccine producers, including some in Africa, are able to be involved in mass production so that sufficient doses are available across the world.

Fund Allocation

John Nkenkasong, Director of the Africa Centres for Disease Control.

Nkenkasong told Health Policy Watch that while the estimate of what each African country will receive through the initiative is not yet available, there are broad indications of the kinds of efforts the fund can support in AU member states.

“The fund is not to get vaccines and distribute them to countries; it is to first aid countries to set up vaccination centres, and the roll-outs mechanism. The breakdown of exactly how much will go to each country is not an issue that we can put on the table now; it will be based on their strategic plans,” he told HPW.

He said every African country now has a vaccination plan and to disburse the fund will require engaging the countries, look at the interface between Africa CDC’s discussions with them, where they are with their vaccination plans and needs they still have.

“Some countries are very capable of doing their own things and they may not need this kind of support. However, some countries would need tremendous support to get to where they have to be, and then the specificity of this program is very important—the humanitarian component is extremely valuable because it has to be tailored to meet those goals of the targeted nature of the funds,” he added.

Image Credits: European Union.

Some studies have suggested that administration to travelers of a rapid COVID test upon arrival may be just as effective as lengthy quarantine requirements, to control the import of COVID-19 cases.

After months of stalemate, WHO looks set to update its guidance on managing COVID-19 infections in the context of international travel – but proof of vaccination should not be required as a condition of entry to any country, emphasized WHO’s International Health Emergency Committee.

This was among the wide-ranging recommendations issued on Monday by the International Health Regulations Emergency Committee, which first declared that the COVID-19 outbreak constituted an International Public Health Emergency (PHEIC), in January of 2020.

That advice seemed to clash head-on with the political winds in many countries, and the travel industry, regarding the adoption of vaccine certificates to reopen travel while containing virus spread and variants. Groups ranging from the International Air Transport Association to the European Commission have proposed the creation of a digital COVID vaccine/recovery certificate to facilitate safer international travel.

The statement also follows months in which WHO has resisted taking a stance in favor of now widely used measures such as pre-flight or post-flight COVID testing  – even though this is now widely practiced around the world – from Europe and North America, to Africa and Asia.

In a press release issued after its seventh meeting on the COVID pandemic, the Committee said that WHO should indeed: “update the WHO December 2020 risk-based guidance for reducing SARS-CoV-2 transmission related to international travel (by air, land, and sea) based on current science and best practices that include clear recommendations for testing approaches and traveler quarantine duration, as appropriate.”

It added that the updated travel guidance should “take into consideration COVID-19 vaccination roll out, immunity conferred by past infection, risk settings, movements of migrants, temporary workers, and purpose of travel (non-essential versus essential),” the Committee stated.

But in an explicit message to member states, the Committee added: “Do not require proof of vaccination as a condition of entry, given the limited (although growing) evidence about the performance of vaccines in reducing transmission and the persistent inequity in the global vaccine distribution. States Parties are strongly encouraged to acknowledge the potential for requirements of proof of vaccination to deepen inequities and promote differential freedom of movement.”

Strict COVID-related controls in travel and COVID testing at airports helped ‘bend the curve’ of the outbreak,in some countries, experts say. But WHO has so far not provided guidance.  
Other Advice – Control Food Safety in Wild Animal Markets to Reduce Pathogen Spillover to Humans

In other recommendations, the Committee also advised WHO and member states to proceed with rapid implementation of recommendations that have emerged from the international expert committee investigating the origins of the SARS-CoV2 virus, including new WHO guidance to temporarily suspend the sales of wild mammals in the so-called “wet animal markets”, where wild animals are held in captivity, and slaughtered on site for customers in many Asian and African cities.

The WHO international expert committee had said that infected wild mammals that were slaughered and sold in Wuhan wet markets were one “very likely” pathway for the introduction of the SARS-CoV2 virus into the city – although other scientists have charged that the theory the virus escaped from a Wuhan virology laboratory investigating coronaviruses should not be discounted either.

According to the Emergency Committee recommendations, WHO should:

  • Encourage research into the genetic evolution of the SARS-CoV-2 virus.
  • Promote One Health approaches to better understand and reduce the risk of spill-over of emerging infections from animal to human populations and from humans to animals, including from domestic animals.
  • Work with partners to develop and disseminate joint risk-based guidance for regulation of wet markets and farms to reduce transmission of novel pathogens from humans to animals and vice-versa.

The Committee also urged WHO to continue its appeals to “global solidarity efforts to increase equitable access to COVID-19 vaccines and ancillary supplies by supporting the COVAX Facility and engaging in technology transfer, where feasible.”  And it said that WHO and member states should strengthen its epidemiological and virologic surveillance as part of a comprehensive strategy to control the development of COVID-19 variants, including member state’s sharing of variant gene sequences and meta-data with WHO and on publicly available platforms.

 

Image Credits: Wikimedia Commons: Nemo.

New COVID-19  cases climbed again globally last week for the eighth week in a row – while only 1% of the 100 million vaccine doses administered last week were in low- and middle-income countries – said senior WHO officials on Monday, citing two key barometers of pandemic policies.

Meanwhile, speaking at a WHO press conference ahead of this week’s planned White House Climate Summit, the teenage climate activist Greta Thunberg called upon global leaders to ensure that front line health workers and other high-risk groups in low- and middle-income countries are vaccinated more rapidly – saying it was morally unacceptable that younger people in affluent countries should be able to access the vaccine ahead of high-risk groups elsewhere.

“We have the tools we need to correct this great imbalance that exists around the world today in the fight against COVID-19, just with the climate crisis, Thunberg said. “Those who are the most vulnerable need to be prioritized in global problems require global solutions… But so far, on average, one in four people in high-income countries have received the coronavirus vaccine, compared with just one in 500 in low and middle-income countries,” she said.

Thunberg, whose foundation announced a 100,000 Euro donation to the WHO co-sponsored COVAX initiative, added: “It is completely unethical that high-income countries are vaccinating young and healthy people, if that happens at the expense of people in risk groups, and on the front lines in low- and middle-income countries.”

Regarding the upcoming climate summit, the pandemic has highlighted how health and climate are inextricably intertwined with deforestation and environmental degradation that causes climate change and the spillover of animal-borne diseases into human populations, Thunberg stressed.

“In the future, we will most likely experience more frequent and more devastating pandemics unless we drastically changed the way our ways and the way we treat nature,” she said.

“Today, up to 75% of all emerging diseases come from animals. As we are cutting down forests and destroying habitats, we are creating the ideal conditions for diseases to spill over from one animal to another, and then to us. And we can no longer separate the health crisis from the ecological crisis, and we cannot separate the ecological crisis from the climate crisis. It’s all interlinked.”

Youth Climate Activist Greta Thunberg speaking at WHO press conference

COVID Infections Also Increasing Among Younger People at ‘Alarming’ Rate 

Meanwhile, COVID cases were increasing among younger people aged 25-29 at an “alarming rate” Tedros said, possibly as a result of the propagation of more transmissible SARS-CoV2 variants as well as increased social mixing among younger adults. That mixing, added WHO COVID-19 lead Maria Van Kerkhove, is not only due to more socializing and pandemic fatigue, but also for work and religious reasons following the Easter holidays and Ramadan.

More than 5.2 million new cases were reported just last week, the largest so far, and the world also topped the record of 3 million deaths.  “It took nine months to reach 1 million [deaths], four months to reach 2 million and just 3 months to reach 3 million deaths. Big numbers can make us numb. But each one of these lives lost is a tragedy for families, communities and nations,” Tedros said.

COVAX Facility Facing Immediate Supply Problems Related to India Case Surge

WHO’s Bruce Aylward

The COVAX facility had, as of Monday, distributed just over 38.7 million vaccine doses in low- and middle-income countries, noted WHO senior advisor Bruce Aylward.

“The whole vaccine supply situation remains precarious, and the challenge still because of such competing demands for these doses remains a very difficult one to manage,” said Aylward.

The surge in COVAX cases in India has put constraints on COVAX access to vaccines produced by the Serum Institute of India (SII) – one of the main COVAX vaccine suppliers to date, he explained For the time being, SII has had to redirect much of its recent production to domestic cases. COVAX remains short on donations of other alternative vaccines, as well as funds to make strategic purchases.

“It all it all comes back again also to the COVAX facility having the resources it needs so that it can put the contracts in place, upfront to make sure the supplies are there, not just the supplies in terms of the vaccines, but… syringes and the other supplies, including … cold chain equipment, and sometimes very specialized cold chain equipment to get these products to people,” said Aylward.

While the African Union and the World Trade Organization last week held major conferences on the topic of expanding vaccine manufacturing in the short term the focus needs to be on the redistribution of doses being produced right now, Aylward stressed.

“The challenge is how we’re actually using the doses that are being made.  Last week, while those conferences were taking place, 100 million more doses of vaccines were administered around the world. And the issue is where they’re being administered – because … 99 million doses of vaccines last week went into high, upper middle income and some lower-middle-income countries but only 1% went to the lowest income countries.”

Aylward and other WHO officials lauded recent gestures by countries such as Sweden and Norway to donate excess vaccines that they don’t plan to use – urging other high-income countries that are currently hoarding vaccines to follow suit.

“If we have a lot more weeks, where 99% of the vaccines go to a set of countries that already have most of the vaccine, we’re not going to get out of this crisis as rapidly and efficiently and with as least, you know lives lost as possible,” Aylward noted.

Meanwhile, WHO’s Chief Scientist Soumya Swaminathan said that there remains considerable global vaccine “fill and finish” capacity that has not yet been harnessed by pharma producers capable of making larger quantities of active vaccine ingredients.  She said that a new COVID Vaccine Manufacturing Task Force, co-sponsored by WHO, COVAX, and other partners, is looking at opportunities to quickly address bottlenecks and ramp up the production of more vaccine supplies.

WHO Chief Scientist Soumya Swaminathan

“We know that there is a lot of unused fill and finish capacity globally, and therefore we need manufacturers who have the capacity to make a bulk [active vaccine ingredient] product, to link them with existing fill and finish capacities in facilities around the world,” Swaminathan said.

The Task Force is trying to help link suppliers of critical vaccine ingredients and raw materials to manufacturers, and ensure that export bans “don’t interfere with the process of vaccine manufacturing”. A longer-term goal would be to actually build more manufacturing capacity, particularly in low- and middle-income countries through technology transfer arrangements, she added.

In a thinly veiled appeal to Moderna and Pfizer, Swaminathan said that WHO is calling upon “owners of technology, particularly mRNA technology, to come forward to work with us, to share that technology, that know-how, and experience with recipient companies that will be selected according to a set of criteria that we are developing, and that will ensure not only supplies for this pandemic, but will also help with future regional health security for regions which currently do not have any vaccine manufacturing capacity.  And this obviously can be extended to vaccines for many other infectious diseases.”

On Friday, WHO issued a call for expressions of interest from small and mid-sized pharma firms, as well as from “owners of technology and intellectual property rights” to mRNA vaccines –  to support the creation of a COVID-19 mRNA vaccine technology transfer hubs, particularly in low- and middle-income countries.

“The intention is for these hubs to enable the establishment of production process at an industrial or semi-industrial level permitting training and provision of all necessary standard operating procedures for production and quality control. It is essential that the technology used is either free of intellectual property constraints in LMICs, or that such rights are made available to the technology hub and the future recipients of the technology through non-exclusive licenses to produce, export and distribute the COVID-19 vaccine in LMICs, including through the COVAX facility,” stated the WHO call.

It added that it was seeking expressions of interest from:

  1. Small/middle-sized (public or private) manufacturers of medical products (drugs, vaccines or drug substances) preferably, but not exclusively, in LMICs, which could host a COVID-19 mRNA hub and:
    • Assemble the technology up to good manufacturing practices-grade pilot lots for clinical trials;
    • Transfer the appropriate know-how and technology to existing or new manufacturers in LMICs to enable them to develop and produce COVID-19 mRNA vaccines;
  2. Owners (public or private) of technology and/or intellectual property rights. These may be academic institutions, pharmaceutical companies, non-governmental organizations, or any other entity willing to contribute these to a technology transfer hub, under the auspices of WHO, to enable the production of mRNA-based COVID-19 vaccines in LMICs.

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Africa, Ghana

Six weeks after receiving 1.7 million doses of the AstraZeneca COVID-19 vaccine from COVAX, the Democratic Republic of Congo (DRC) finally started to vaccinate people on Monday.

The delay followed concerns about the safety of the vaccine amid reports about possible links between the vaccine and blood clotting.

In a bid to build public confidence, Health Minister Eteni Longondo became one of the first people to receive the vaccine at Kinshasa University’s medical school. The European Union’s Ambassador to the DRC, Jean-Marc Chataigner, and UN Humanitarian Affairs Coordinator David McLachlan-Karr were also vaccinated.

The rollout was initially due to start on 15 March.

Interior Minister Gilbert Kankonde said last week that the country’s medical experts were satisfied that the vaccine posed no danger to citizens.

“The vaccination will be voluntary and priority will be given to healthcare personnel, vulnerable people, those with chronic illnesses and all those who are greatly exposed while carrying out their work,” Kankonde said.

The country of more than 80 million people has received 1.7 million doses of AstraZeneca through COVAX, a World Health Organization-backed effort to procure and distribute inoculations to poor countries. In addition, India has also donated 50,000 doses to the country.

The vast central African country has officially registered 28,956 cases of COVID-19, with 745 deaths, since the start of the pandemic last year.

Kankonde added that the country would also ease its curfew, currently between 9pm to 5am, to 10pm – 4am in provinces with low caseloads.

According to official statistics, the 80-million strong country has only recorded 28,665 infections and 745 deaths.

In early April, UN peacekeepers from the Southern Sector at Democratic Republic of Congo received their first dose of COVID-19 vaccine from a donation from the Indian government. Other UN agency staff members are expected to start being vaccinated from today.

 

Image Credits: WHO.