Michael Osterholm – a leading member of the United States President’s coronavirus transition team – has said he is “convinced” by data indicating the UK COVID-19 variant is more deadly, even as United Kingdom officials downplay the limited and “uncertain” evidence.

Meanwhile, Moderna announced today that it will “test an additional booster dose of its COVID-19 Vaccine (mRNA-1273)” to see whether it can further increase neutralizing antibodies against emerging strains “beyond the existing primary vaccination series”.

Late on Friday evening, UK Prime Minister Boris Johnson announced that the SARS-CoV-2 variant, also known as B.1.1.7, “may be associated with a higher degree of mortality”: potentially by up to 30%.

But the government’s chief scientific adviser, Sir Patrick Vallance, was quick to flag that the current data available – published by Nervtag, a government advisory committee – was “not yet strong”.

The report concluded there was “a realistic possibility” that infection with B.1.1.7 “is associated with an increased risk of death”.

Vallance noted: “There’s a lot of uncertainty around these numbers and we need more work to get a precise handle on it, but it obviously is a concern that this has an increase in mortality as well as an increase in transmissibility.”

The variant, which was first detected in September 2020, was previously understood to be around 30-70% more transmissible than the Wuhan strain.

Vallance explained that around 10 in 1,000 men in their 60s infected with the Wuhan strain would be expected to die with the virus. “With the new variant,” he said, “for 1,000 people infected, roughly 13 or 14 people might be expected to die.”

Despite this, Michael Osterholm – epidemiologist and a member of President Joe Biden’s coronavirus transition team – has said he is “convinced” that B.1.1.7 is deadlier after reviewing the UK report.

Osterholm, who has also reviewed other unpublished data, said: “The data is mounting — and some of it I can’t share — that clearly supports that B.1.1.7 is causing more severe illness and increased death.”

The US Centers for Disease Control and Prevention (CDC) has begun reviewing the data, it confirmed to CNN on Saturday: “The CDC has reached out to UK officials and is reviewing their new mortality data associated with variant B.1.1.7.”

The Nervtag report collected data from three independent analyses, led by University of Exeter, Imperial College London, and London School of Hygiene & Tropical Medicine.

Moderna Latest To Claim Vaccine Effective Against Key Variants

Moderna’s clinical development manufacturing facility in MA, USA.

Given this uncertainty, questions have naturally been directed toward those organizations developing COVID-19 vaccines, notably as to whether these candidates can protect against these variants.

As of Monday morning, Moderna — whose mRNA vaccine has so far been approved for emergency use in at least 10 blocs including the UK, the US and the European Union — has claimed its candidate appears to retain its efficacy against the B.1.1.7 and South Africa-identified (B.1.351) variants.

In the study, which is yet to be peer-reviewed, researchers looked at blood samples from eight participants who had previously received the recommended two doses during Phase 1 trials.

In the case of the B.1.1.7 variant, they reported the mutated virus posed no significant impact on titers: a means for measuring the amount of antibodies in a blood sample.

Tests on B.1.351 showed a “six-fold reduction in neutralizing titers” although “neutralizing titer levels with B.1.351 remain above levels that are expected to be protective”, according to the company media release. But the sample size is surprisingly low, with only eight participants and the study is based on an in-house, un-peer reviewed study,

Last week, Pfizer made a similar claim after testing only 16 blood samples: a startlingly low number given the number of participants involved in their clinical trials. Critics had said Pfizer had been overly optimistic in its interpretation of the data.

Meanwhile, Moderna is also “advancing an emerging variant booster candidate (mRNA-1273.351) against the B.1.351 variant first identified in South Africa”.

It aims to test the candidate in preclinical studies and a Phase 1 study in the US “to evaluate the immunological benefit of boosting with strain-specific spike proteins” and “expects that its mRNA-based booster vaccine will be able to further boost neutralizing titers in combination with all of the leading vaccine candidates”.

Image Credits: Moderna.

Vaccine
The economic cost to the world’s advanced economies in the absence of global vaccine access could be up to US$5 trillion, a report has found, compared to the $38 billion cost of funding WHO’s ACT Accelerator.

Wealthy countries that pursue ‘vaccine nationalism’ when their trading partners don’t have access to the COVID-19 vaccine will pay a far higher economic price than if they invest in ensuring all countries have access to vaccines, according to a comprehensive economic modelling study released today by the World Health Organization (WHO).

The study, commissioned by the International Chamber of Commerce (ICC) Research Foundation, projects that the economic cost to the world’s advanced economies in the absence of global vaccine access could be up to US$5 trillion.

In contrast, the entire cost of funding the Access to COVID-19 Tools (ACT) Accelerator, the WHO-led global platform to ensure equitable access to COVID-19 vaccines, tests and treatments, is $38 billion.

“Strikingly, a $27.2 billion investment on the part of advanced economies – the current funding shortfall to fully capitalize the ACT Accelerator and its vaccine pillar COVAX – is capable of generating returns as high as 166x the investment,” according to the ICC.

The researchers looked at the production and trade networks of 65 countries across 35 sectors, modelling three different vaccine access and lockdown scenarios. They concluded that the global loss to GDP if vaccines are not widely available “is higher than the cost of manufacturing and distributing vaccines globally”.

“Our estimates suggest that up to 49 percent of the global economic costs of the pandemic in 2021 are borne by the advanced economies even if they achieve universal vaccination in their own countries,” states the report, which was produced by the Centre for Economic Policy Research.

The study explains that the advanced economies are “tightly connected to unvaccinated trading partners which consist of a large number of emerging markets and developing economies”.

“Thus, the devastating economic conditions in these countries under the ongoing pandemic can cause a non-negligible drag on the advanced economies as well,” according to the study.

Demand for goods would fall in countries badly affected, and their production capacity would be weakened, thus affecting their ability to supply goods and materials needed by advanced economies.

Ṣebnem Kalemli-Özcan, Professor of Economics and Finance at the University of Maryland and an author of the report, said: “No economy can fully recover until we have global equitable access to vaccines, therapeutics and diagnostics. The path we are on leads to less growth, more deaths, and a longer economic recovery.”

Dr Tedros Adhanom Ghebreyesus, WHO Director General.

Meanwhile, WHO Director General Dr Tedros Adhanom Ghebreyesus said that “this research shows a potentially catastrophic economic failure”.

“The progress made by the ACT Accelerator shows solidarity in beating this virus. The longer we wait to provide vaccines, tests, and treatments to all countries, the faster the virus will take hold, the potential for more variants will emerge, the greater the chance today’s vaccines could become ineffective, and the harder it will be for all countries to recover. Truly, no-one is safe until everyone is safe.”

ICC Secretary General John WH Denton added that the research shows that  “ensuring equitable access to COVID-19 tests, treatments and vaccines is not only the right thing to do – to do otherwise is economically irresponsible. International business needs a fully funded ACT Accelerator”.

“This is not an act of charity. This is economic common sense,” said Denton. “If you want to ensure a durable recovery in your economies, you need to step up and actually pay up.”

Countries with open economies stand to lose the most, particularly Belgium, France, Germany, the Netherlands, Norway, Switzerland, the United Kingdom and the US, “who might lose up to 3.9% of their GDPs”.

“No economy is an island,” the report concluded, paraphrasing the John Donne poem. “The economic losses of the pandemic can only be mitigated through a multilateral coordination ensuring the equitable access of vaccines, tests and therapeutics.”

COVAX Deal With Pfizer Is Small But ‘Opens the Door’

Meanwhile, WHO Special Advisor Dr Bruce Aylward defended a small 40 million COVAX deal reached with Pfizer, which had been announced on Friday. The European Union has reserved 600 million doses, with the US securing 200 million.

Alyward said the small number was “a start”, but that the Pfizer vaccine was already recommended by WHO “so this could be launched very, very rapidly and earlier possibly than some of the other products”.

45 out of 50 of the countries rolling out COVID-19 vaccines are using the Pfizer vaccine.

“45 out of 50 of the countries rolling out vaccines are using the Pfizer vaccine,” said Aylward. “Even with a relatively small number of doses …  it was clear that we could make a real difference in protecting some of the most highly exposed, highly at risk health care workers, particularly in some of the [low- and middle-income countries (LMICs)] that the facility serves.

“The other big advantage by putting the framework agreement in place, is that we can then open the door to donations in a much more potentially seamless manner with other countries that currently have contracts with and substantial quantities of the Pfizer vaccine.”

Rapid COVID Tests Ensured For LMICs As Costs Halved

Fragile health systems, remote or decentralised populations, and reliance on global provision in LMICs have created obtrusive barriers to achieving mass rapid testing for SARS-CoV-2.

However, more than 250 million antigen-detecting rapid diagnostic tests (Ag RDTs) will be made available to LMICs for approximately US$2.50 each following a July 2020 call for interest.

The open call for Expressions of Interest (EOI) was launched by Unitaid — a WHO partner — and global nonprofit Foundation for Innovative New Diagnostics (FIND), on behalf of the ACT-Accelerator: WHO’s platform for providing equitable COVID medicines and treatments

Up to 120 million tests will be produced by Premier Medical Corporation, India, in 2021, with a further 130 million tests secured through other, unannounced agreements.

The ACT-Accelerator has estimated that 500 million COVID tests will be needed in LMICs over the next 12 months, with three-quarters necessarily deployed via primary health care.

Image Credits: WHO Afro region, WHO, Pfizer.

Activism against Gender-Based Violence at the National University of Lao, Dong Dok campus. During the pandemic, violence against women had increased by 25% as early as April in countries with formal reporting systems in place.

WHO needs to focus more work on limiting gender-based violence, increase its programmatic emphasis on healthy diets and lifestyles, and contribute to renewed momentum on climate action, said WHO member states at Friday’s Executive Board session.

The member states were reviewing the WHO Director General’s report on “social determinants of health” – in light of the added health impacts of the ongoing global COVID-19 pandemic.

Social determinants of health is a broad umbrella term referring to a range of socio-economic and environmental drivers that can help prevent diseases from ever occurring – or conversely accelerate more disease if neglected. They range from poverty, which can foster more communal violence and addictions, to unhealthy diets leading to malnutrition and obesity, or air pollution that contributes to the development of cardiovascular and respiratory diseases as well as cancers.

COVID-19’s Gender Gap

Amid mounting evidence that the social and economic toll of the COVID-19 pandemic is to being disproportionately paid by women, member states flagged WHO’s need to do more to assist countries’ attempts to limit gender-based violence and discrimination, WHO member states suggested.

A delegate from Kenya highlighted “increased teenage pregnancies, gender-based violence and substance abuse” as results of pandemic related lock-downs and economic stagnation. He called on WHO for an inter-agency plan to support its Member States, as they struggle to mitigate the “severe social shocks of the pandemic”.

A United Nations report, published as early in the pandemic, highlighted that “many women are being forced to ‘lock down’ at home with their abusers” even as support services typically available for victims continue to be “disrupted or made inaccessible”.

That same report flagged that violence against women had increased by 25% in countries with formal reporting systems in place.

Beyond gender-based abuse, the pandemic-related gender impacts also are evident in the greater difficulties when have had accessing healthcare. And the pandemic has exacerbated pre-existing employment inequalities, member states reflected.

“Gender is a key social determinant of health given the impact of gender roles, norms and behaviours, on how people access health services and information,” a delegate from the United Kingdom said. Similarly, gender also determines how health systems respond to individual patients.

With regards to the pandemic, as such, the WHO report staed that the Organization is developing advocacy and engaging with other UN agencies and actors on “on human rights-based approaches” to gender and COVID-19- although it didn’t provide further details.

The report also notes that internally at WHO: “The Gender, Equity and Human Rights team at headquarters and the regional office network are spearheading efforts to mainstream gender issues across the Organization.” In other comments this past week to the EB, Dr Tedros Adhanom Ghebreyesus has noted that while WHO has gender parity among the ranks os its senior management – but male professionals still well outnumber women in certain WHO regional  and country offices – with the most imbalance in the African region.

Diet and Nutrition

During the board meeting, the UK also flagged diet and nutrition as key social determinants: topics scarcely mentioned in the WHO report.

“Healthy diets and malnutrition are an important element of determinants of health,” the delegate said.  “Action is needed to address unhealthy diets and malnutrition in all its forms.”

The WHO report refers to nutrition only vaguely, listing “food insecurity” alongside “poor-quality housing … insecure employment, and poorly regulated care for the elderly” as “examples of social determinants with devastating impacts on individuals and communities affected by COVID-19”.  However, a growing body of evidence, including other recent WHO reports, point to the double burden many low-and middle-income countries are now seeing from undernutrition and malnutrition- the latter related to an over reliance of fast-urbanizing communities on fast or processed foods, cheap starches, and sugar-  and fat-heavy diets.

Despite arguments that addressing diet would help to improve health outcomes and prevent future pandemics, the WHO report on social determinants of health scarcely mentioned nutrition.

Those forms of malnutrition – leading to micronutrient deficiencies as well as to obesity –  are responsible for a significant portion of the Global Burden of Disease, the UK delegate said.  He reminded the EB that “obesity has shown to significantly increase the severity of COVID-19”.

Meaningfully addressing poor diet, the UK argued, would help to improve health outcomes and enter future pandemics better prepared.

The Climate Crisis & Biodiversity

In the decade before the pandemic, awareness of the health impacts of climate change and loss of biological diversity were growing global health concerns, including at WHO. But the sudden and overwhelming emergence of SARS-CoV-2, however, has meant climate-related health policy has mostly been left to stagnate, some delegates observed.

Pedestrians in Bangladesh cover their faces to keep from breathing in dust and smog. Despite significant advancements before the pandemic, environmental health has largely taken a back seat in policymaking.

While there have been a few significant steps made since the first COVID-19 death — such as the UN including climate measures on its Human Development Report, or the UK registering the first death due to air pollution — there is evidence that the pandemic has led national health ministers to push  environmental health risks to the background of their agendas.

This is despite the fact that environmental risks, notably from air pollution, also contribute directly to more chronic cardiovascular and respiratory health conditions, and thus more COVID-related deaths.

The WHO report acknowledges this, indirectly, stating that “increasing urbanization and climate change risk [as] entrenching existing inequalities and further widening the gap in health outcomes”.

However, delegates noted that more attention needs to be given to the routes by which climate change, biodiversity loss and urbanization are contributing to ill health during the pandemic – as well as increasing future pandemic risks.

In the case of SARS-CoV2, for instance, while the exact route by which the virus reached Wuhan and its seafood market where the first human clusters of infection appeared, most scientists agree that the virus hails from a bat coronavirus that leaped the species barrier. In the past, that has happened when wild animals are hunted, captured, caged, transported and sold alive in crowded urban food markets across Asia.

Similar leaps of animal diseases to humans have led to the rise of Ebola and HIV in Africa, where the capture and consumption of  wild animals as “bushmeat” is a traditional practice that became even more common in conditions of conflict and food insecurity, where wildlife areas also are more vulnerable to poaching and plunder by black marketeers.

“The [COVID-19] crisis we are facing is not only a health crisis, but also a social and economic crisis,” the Austrian delegate told the board. But, vitally, she added that “it cannot be fully understood without considering the ongoing ecological crisis.”

“The poorest and most vulnerable have been disproportionately hit,” she said, “and further action to foster health equity and moving beyond the health sector is urgently needed.”

This was also underlined by the UK delegate, who stated it “will also welcome more attention on to the impact of climate change both on people’s health and on national health systems”.

Image Credits: DANHO/Daniel Hodgso, Sven Petersen/Flickr, Rashed Shumon.

Manufacturing Pfizer/BioNTech’s COVID-19 vaccine

Pfizer/BioNTech will join the WHO-co-sponsored COVAX vaccine facility, providing up to 40 million vaccines at cost to the Facility for use in low-income countries around the world – in what signals a breakthrough for the facility that only a week ago appeared to be teetering on the verse of irrelevance – as more low- and middle-income countries raced to sign bilateral contracts with pharma manufacturers for vaccine supplies.   

The joint announcement by Pfizer CEO Albert Bourla and WHO’s Dr Tedros Adhanom Ghebreyesus at a WHO press conference on Friday evening puts a bookend on a week of good-news developments for the WHO and its global health partners in COVAX – following on from moves by the new US administration of President Joe Biden to rejoin WHO and join the COVAX facility as well. 

Albert Bourla, CEO Pfizer, announces vaccine procurement deal with COVAX, Friday 22 January 2021

Psychological Turning Point For COVAX

While 40 million doses is still a relatively a small initial amount, to begin with, it is also psychologically important to COVAX.  It makes a statement that the even the most expensive, cutting edge mRNA vaccine technologies will be a part of the global vaccine pool made available to low and middle-income countries  – which has already stocked up pre-orders for 2 billion doses of cheaper, and more conventional COVID vaccines.  Together with the AstraZeneca vaccine, the commitment by Pfizer also ensures that at least some vaccine supplies will be ready to roll out almost immediately; other vaccines in the COVAX portfolio include products by Johnson & Johnson, Novavax and Sanofi – which are still in Phase 3 trials and thus haven’t yet been approved by any regulatory agency.   

The Pfizer move is also important because it provides a signal to other vaccine developers that COVAX has a broad base of industry support. This now leaves Moderna, the other producer of an already-approved mRNA vaccine, as the COVAX “outsider”. Moderna was among the first pharma companies to declare that it would not enforce its patent rights on its vaccine technology during the pandemic. But it has not signed a contract with COVAX – yet.   

“Pfizer and BioNTech have reached an advance purchase agreement with the COVAX facility for up to 40 million initial doses of our COVAX vaccine,” said Bourla, in annoucing the agreement at the WHO briefing. “We expect that the first doses will be delivered in the first quarter of this year, once we finalize agreements with UNICEF … we are coordinating procurement to support the delivery of these vaccines.

UNICEF is mounting the COVAX logistics effort on the back of its enormous existing global infrastructure in transport, logistics and cold chain management – which distributes and administers childhood vaccines worldwide every year.  GAVI, The Vaccine Alliance, and the other key  COVAX partner, is mediating the contractual arrangements with vaccine manufacturers as well as COVAX members, including 92 low-income  countries that regularly receive vaccines free or at preferential prices through a donor supported “Advance Market Commitment” scheme. 

WHO Director General Dr Tedros Adhanom Ghebreyesus announces COVAX vaccine procurement deal with Pfizer/BioNTech Friday 22 January

“Since the very beginning of our vaccine development program Pfizer and BioNTech have been firmly committed to working toward equitable and affordable access of COVID-19 vaccines for people around the world,” added Bourla. “We fully support, and we are in alignment with the guiding principles of the COVAX facility

“GAVI’s coordination of the COVAX Advanced Market Commitment that supports the participation of 92, lower-middle and low-income economies, is an important tool that will help ensure developing countries have the same access to vaccines as the rest of the world,” said Bourla. “And we will provide the vaccine coverage for these countries, not for profit,” said Bourla.” 

Bourla said that the doses would “support COVAX efforts to vaccinate healthcare works at high risk of exposure, and other vulnerable communities.” 

He added, “this is just one step in our commitment to support developing countries. As we work to deliver these doses, we are also bringing resources and expertise that will help to strengthen the global health infrastructure, building on our recent innovations in packaging and cold chain requirements, and ensuring that solid systems are in place. 

“Establishing the infrastructure needed to deliver breakthrough mRNA vaccine in ow income countries will not also will not only help us fight the pandemic, but make us more prepared for the next pandemic,” Bourla said. “We believe that this is a collective responsibility that calls for highly coordinated and collaborative actions by public and private stakeholders.”

COVAX Deals with Pfizer and AstraZeneca Mean Facility is Ready To Rollout Supplies 
Pfizer COVID-19 vaccine delivery – in ultra-cold chain storage in special containers designed by the company.

Some 150 million doses of the AstraZeneca vaccine will also be available in the first quarter of 2021, said Dr Tedros, speaking at the press briefing.  Those doses are primed and ready to go, pending only WHO review and approval of the safety and efficacy of the AstraZeneca vaccine and its production facilities at the Serum Institute in India and in the Republic of Korea. 

“Together, these announcements mean COVAX could begin delivering doses in February, provided that we can finalize a supply agreement for the Pfizer biotech vaccine and emergency use listing for the AstraZeneca Oxford vaccine,” he said.  

“This agreement also opens the door for countries who are willing to share doses of the Pfizer BioNTech vaccine, to donate doses to COVAX and support rapid rollout,” the WHO Director General said.  A handful of high income countries have purchased or pre-ordered even more COVID19 vaccine doses than they have people to immunize – with Canada topping the list with pre-orders or purchases of multiple  vaccines per capita. 

UNICEF’s Executive Director Henrietta Fore, said that her organization was in the process of securing logistics and supply chain arrangements for the new contract with Pfizer/BioNTech as well as for others in the COVAX pipeline. Those are arrangements will be particularly sensitive because the Pfizer vaccine requires -70C storage conditions – although innovative new packaging developed by the company can help keep the vaccine cold for at leat a week without an electricity supply.  

“In the coming weeks UNICEF will begin transporting vaccines, together with syringes and safety boxes to countries around the world. And we are working with airlines and freight and logistics providers to ensure safe and timely delivery,” said Fore at the briefing.

“UNICEF and our partners are working with governments around the clock to ensure that countries are ready to receive the vaccines that there is appropriate cold chain equipment in place, and that health workers are trained to dispense them,” said Fore, adding that UNICEF is also playing a lead role in efforts to foster trust in the vaccine, tracking and addressing vaccine misinformation.”

United States Expected to Play Critical Role in COVAX Global Vaccine Rollout

The fact that the United States has rejoined WHO and is also playing an active role in COVAX, will also help ensure the kind of global solidarity needed to ensure success in the vaccine rollout effort, said Bourla and all three agency heads at the briefing.

“Last year, we saw a truly unique human ingenuity at work to successfully develop effective and safe vaccines in record time. This year, we turn to the biggest logistical challenge the world has ever seen. And we need all hands on deck,” said Fore. “With that in mind,  I join everyone to say how pleased I am that the United States is has joined the COVAX facility, and confident that with its expertise and resources, the United States will give this global effort, and UNICEF’s role in it, a major boost.” Her comments referred to the leading role the US has played as a funder and supporter of the UN agency whose main mission is the children’s and adolescent health in the world’s poorest countries.

Tedros, for his part, said he spoke with Vice-President Kamala Harris by phone on what was her first full day in office: “The United States has long played a vital role in global health. The US was a founding member of WHO, and has been a leader in the fight against many diseases from smallpox to polio, and malaria to HIV. The US contributes an enormous amount to global health, but it also benefits from WHO’s work on a range of both infectious and non communicable diseases,” he added, noting that a healthier, safer world is a healthier, safer America.”

Added Bourla, whose company is headquartered in the United States: “I couldn’t avoid the temptation to say that I’m very glad this press conference is happening the day that the United States is rejoining the WHO organization. I think it is a symbolic great day for us.

Global Vaccine Capacity Increasing 
Seth Berkley, CEO GAVI, The Vaccine Alliance

Seth Berkley, CEO of GAVI, said that with the rapid approval of new vaccines, the world could be positioned to roll out as much as 6 or 7 million vaccine doses in 2021. 

While Dr Tedros said that the COVAX was on track to rollout out at least 2 billion doses this year, Berkley said that the number could rise to 2.3 billion doses  – “with the right level of funding in place”

“This would equate to close to 1.8 billion doses for the 92 lower income counties in the COVAX advanced market commitment, or AMC,” said Berkley.  “That’s enough to protect about  27% of the population in those low and lower-middle income countries, which is in excess of the initial tartlets we laid out to protect those at highest risks. And we have the prospect of more doses to come through other deals and sharing principles that we announced in December.”

While initial deliveries “will be small, but they will grow quickly,” Berkley promised.  

Pfizer, for its park had initially only projected the production of 1.3 billion vaccine doses this year, but that has now increased to 2 billion Bourla said, adding that he feels “confident” about that projection.  

Reduce Virus Transmission to Preserve Vaccine Efficiency But Decision on 2021 Olympics Is Japan’s – WHO Says
WHO’s Katherine O’Brien speaking at press briefing 22 January

In a wide-ranging press briefing that covered a week packed with the WHO Executive Board meeting, WHO’s Executive Director of Health Emergencies, Mike Ryan, said that the higher rate of serious COVID19 cases now being observed in the United Kingdom doesn’t necesarily mean that the mutated SARSCoV virus variants are necessarily more deadly/.  More infectious also generate more serious hospital cases, overloading hospitals and reducing their response capacity, he pointed out.  So the dynamics of health system response have to be looked at in addition to the dynamics of the infections as such.

Katherine O’Brien, WHO’s director of Immunization, Vaccines and Biologicals, underlined that as vaccine rollouts get underway, it is more important than ever for societies to use social distancing and other measures to rein in the virus.

“The risk of virus variants relative to vacccines is even greater when transmission is very high in communities – because of the possiblility of additional [resistant]  variants emerging under the pressure of vaccines,” she explaining, stressing “the importance of really crushing transmission.”

In terms of queries over whether it would be safe to hold the 2021 Olympics, which the Japanese government is still planning to host this July – even though public opinion is more negative, Ryan said that WHO would provide advice about risk management of mass gatherings – but it doesn’t provide advice on whether to hold a mass gathering or not.  He added: “we all hope for the Olympics but we all recognize that everyone is a little afraid as we enter the new year with some uncertainties. I believe the Japanese overnment will always act in the best interest, and according to the will of its people.”

Investigation of SARS-CoV2 Virus Origins Will “Follow the Science”

With regards to Beijing’s recent media campaign suggesting that the virus may have originated somewhere other than China – just as a WHO-led team begins work in Wuhan to look for virus tracks in the city where the first clusters of infection were reported, Ryan said that it was mistaken to “start any process where the conclusions are at the start, and then we look for the evidence to support them – we’re dealing with a lot of that in the last few days.”

But Ryan declined to say whether the international team of independent experts would visit the Wuhan Virology Institute that had been conducting research into coronaviruses before the pandemic began.

There has been some speculation that the virus could have escaped accidentally from the facility. Leading experts have noted that the virus that caused the pandemic shares 96% of its genetic makeup with coronavirus variants that circulate naturally among bat populations living in caves in Yunnan Province, about 1800 kilometers southwest of Wuhan near the borders of Laos and Myanmar. But there has been no suggestion that the team would visit the Yunnan cave region either – an area in Yunnan’s Tongguan district, from which roving BBC media team was recently barred.

In terms of where the quest for the virus origins might lead, Ryan added that, “all hypotheses are on the table, and it is definitely to early to come to a conclusion, this is a big jigsaw puzzle, you’re entitled to your opinion… but that doesn’t make you right. So let’s step back and follow the science.

“Our WHO team on the ground are having a good experience working with our Chinese colleagues, working through the data; the data will lead us to the next phase, where we need to go next to look at the origins of the SARS-CoV2 virus.”

Image Credits: Flickr – Province of British Columbia, Pfizer, Flickr – Province of British Columbia.

Ethiopia led the appeal to WHO for support to develop “national policies and evidence-based comprehensive strategies and plans of action for local production”. [Pictured, Professor of Vaccinology, Shabir Madhi of Wits University leading the first Covid-19 vaccine trial in Africa, July.]
Ten African countries, supported by China, have appealed to the World Health Organization (WHO) to support increased local production of medicines, vaccines and other health products – to improve their access and drive down prices, according to a draft resolution presented to WHO’s Executive Board Friday.

Ethiopia, supported by nine other African countries – eSwatini, Ghana, Kenya, Namibia, Rwanda, South Africa, Sudan, Togo and Zimbabwe – led the appeal to WHO for support to develop “national policies and evidence-based comprehensive strategies and plans of action for local production”.

The resolution brings to the fore a key issue that emerged in the first months of the pandemic when the globalized and highly concentrated global supply chains for critical medicines were interrupted – leaving both high and low income countries in the lurch. Anchoring more manufacturing in a wider range of countries would help address similar future risks – while also bolstering technology transfer and economic development in low- and middle- income countries, advocates of the proposal say.

The intervention came as the executive board discussed WHO report on expanding access to effective treatments for cancers and rare and orphan diseases, the prices of which are usually unaffordable for low and middle-income countries. WHO points to high prices preventing 72% of African countries from providing hepatitis B vaccinations despite the high prevalence of this disease.

Speaking at the EB session, WHO Director-General Dr Tedros Adhanom Ghebreyesus praised Ethiopia, his home country, for its initiative and leadership in championing the resolution. Ethiopia has worked hard to establish its own pharmaceutical industry, offering various incentives to the pharmaceutical industry over a number of years to establish local manufacturing businesses.

COVID Pandemic Highlighted Need To Expand Manufacturing Capacity

“The COVID-19 pandemic has shown the great need to strengthen and expand global manufacturing capacity to timely meet global health demands for priority COVID-19 products to combat the pandemic,” Dr Tedros told the board meeting.

“Local production can play a critical role in expanding global manufacturing capacity and achieve equitable access to COVID-19 vaccines, therapeutics and medical devices and equipment,” added Tedros, stressing that this was “of particular importance to address equitable access”.

“WHO is committed to working with member states and partners from the public and private sector for strengthening and scaling up local production, promoting technology transfer and reducing barriers to quality assured safe, effective, and affordable medicines and other health products,” said Tedros.

Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

Also thanking Ethiopia, Dr Mariângela Simão, WHO’s Assistant Director-General for Drug Access, said that the pandemic had highlighted that “we live in a world where there is a concentration of production in some countries”, and there was a need to “diversify and increase manufacturing capacity in different locations in the world”.

She also thanked Costa Rica for championing the COVID-19 Technology Access Pool (C-TAP), an initiative set up to promote sharing intellectual property and scientific knowledge to address the pandemic.

 

However, according to Simão only 40 member states support C-TAP, which highlights how hard it has been to get countries to share information.

Earlier today, renowned medicine access activist and academic Ellen ‘t Hoen of Medicines, Law & Policy, released an article saying that the “elephant in the room” at the WHO executive board meeting was that “most pharmaceutical companies refuse to share the know-how and technology needed to produce vaccines on a large scale”.

“Despite the fine words of European leaders who, just under a year ago, promised that no one could ‘own the vaccine’, C-TAP is empty. Forty one countries officially support C-TAP in words but few with action. This failure cannot be bought off with donations to the COVAX facility. COVAX after all, also needs the success of C-TAP to be able to buy affordable vaccines on a large scale,” said t’ Hoen.

Health Access International and the People’s Vaccine alliance also expressed unhappiness with C-TAP’s functioning in a letter delivered to the board meeting today. In it, they asked for “clarification of the strategy for C-TAP, who is providing political leadership, and who is providing the necessary technical leadership with regards practical issues for the transfer of know-how and technology for manufacturing” and also called for “bi-weekly public briefings to report on the progress of C-TAP”.

WHO Working for Access To Medicines With Other Agencies

Simão says that WHO implementing its roadmap to improve access to medicines on a number of fronts, including through a “tripartite collaboration” on intellectual property (IP) with the World Intellectual Property Organisation (WIPO) and the World Trade Organisation (WTO), and through initiatives with a range of UN agencies on IP, technology transfer and voluntary licenses.

Indonesia, which invested in the rapid expansion in its pharmaceutical industry, said told the board meeting that “expanding equitable access needs to be supported by transparency of market for medicine, vaccines, other health products”. It added that the prices of medicines and medical devices were available online.

Meanwhile, Bangladesh said that high cost meant that treatments for cancer and other rare diseases “is still limited in our country”, and urged WHO to both support local production and make available “clear and equitable pricing” for these diseases.

Mariângela Simão, Assistant Director General of WHO Access to Medicines and Health Products.

Colombia reported that it had saved itself R18-million since last March by controlling the prices of “approximately 2,513 commercial medicines and 279 active ingredients”.

Even high-income Norway reported that “unreasonably high prices on new medicines threaten sustainability of our health budgets and our ability to provide universal health coverage”.

“Industry demands for confidential prices contribute to our struggle to explain access decisions to the public,” added the Norwegian delegate. “Without transparency, it is challenging to justify to the public why we accept the production of some new medicines. while rejecting others.”

Norway expressed support for the WHO’s report on increased transparency on the prices of health technology, which combines earlier proposals by South Africa and Peru.

“However, to achieve more transparency, we need to collaborate, both with our national health authorities international organizations, and other stakeholders. We cannot do this alone,” stressed Norway.

Japan stressed that “incentives to develop new therapeutic tools” had to be maintained, urging “dialogue with relevant stakeholders, including stakeholders in industry, such as the International Federation of Pharmaceutical Manufacturers & Associations (IFMPA).

Image Credits: Wits University, WHO.

The meeting of the 148th session of the WHO Exeuctive Board.

Reform and diversification of the World Health Organization’s (WHO) funding model is vital if the global health body is to avoid repeating the consequences of the US’s withdrawal in April 2020, member states have said during WHO’s Executive Board meetings.

The global COVID-19 pandemic has magnified the “open secret” within the field of global health that WHO has long suffered from disproportionate expectations and resources, Singapore said Wednesday, during the 148th EB session.

“Stable funding will be required for adequacy, predictability and stability they have been lacking in WHO’s budget for some time now,” the EB representative said.

It is no coincidence that such a reference to predictability and stability was made on the same that the new US President Joe Biden’s inauguration: a day that also marked the first step in the country’s return to the global health organization.

In April, former President Donald Trump announced that the US was to immediately suspend its WHO funding, followed in July by his announcement that the country would withdraw from the Organization entirely.

Trump’s decision highlighted the delicate nature of the Organization’s resource base, which relies heavily on voluntary donations from member states as well as from other charities. At the time Trump gave notice, the US was the biggest single donor to WHO, providing US$400 million in 2019, and accounting for around 15% of its annual budget.

And it was as Biden made his way to the Capitol for his inauguration, on 20 January, that the WHO Executive Board members were examining the future of the body’s financing.

Top contributors to WHO’s Budget (2018) – The United States has historically been the largest contributor overall.

“It is timely to initiate a discussion on sustainable financing for the WHO, to take a comprehensive look at its functions, work, and associated costs,” the representative from Canada noted.

Furthering the point that there is a growing gap between what Member States expect from WHO and what resources are currently available to meet those expectations, he added:

“The challenges arising from the current funding model are evident in the persistent pockets of poverty across various technical areas as well as in the chronic underfunding of particular WHO functions including core science and normative work, emergency preparedness and enabling functions such as internal oversight.”

The US’ decision to rejoin the body, and pay up on its contributions, as Biden’s newly appointed Chief Medical Advisor Anthony Fauci promised to do on Thursday (see related HPW story)  is clearly a positive step towards restabilizing WHO’s finances, EB members said. But that doesn’t solve the long-term problems of the Organization, which include an overreliance on a few key member states, as well as on voluntary contributions, which may vary year to year, instead of fixed member state assessments.

Other budget challenges include the need to improve staffing and resources at country level – which are at the core of WHO’s work with governments and Ministries of Health.

The committee also noted that improving geographical representation among WHO staff should be considered through the lens of member states geographical representation— and not that of WHO regions.

Also, although WHO Director General Dr Tedros Adhanom Ghebreyesus has trumpeted the fact that his senior staff has reached gender parity – in lower levels of the Organization and particularly in countries and regional offices, men still well outnumber women professionals, the EB committee members noted, saying that more steps be taken towards the goal of gender parity at all levels, especially among heads of country offices.

Image Credits: WHO, WHO .

Major fire at Serum Institute Vaccine Complex in Pune, India

Five people have died in a major fire at the Serum Institute’s manufacturing facility, charged with producing India’s supply of the Oxford/AstraZeneca vaccine –  just days after the country’s national vaccine campaign got underway.

Serum Institute Chief Executive Adar Poonawalla was quick to say that the fire at its main complex in Pune, would not affect its delivery of some one bilion doses of vaccines in 2021.

“I would like to reassure all governments & the public that there would be no loss of COVISHIELD production due to multiple production buildings that I had kept in reserve to deal with such contingencies,” Poonawalla said. ‘COVISHIELD’ is the branded name for the AstraZeneca vaccine being produced by the Serum Institute in India. The fire would mean delays in launching new products, he added however.

Even so, the huge billows of smoke pouring out of the buildng plainly visible on social media led observers to wonder if that optimistic forecast would hold up.  Along with supplying India’s domestic market, the Serum Institute has major contracts with other low- and middle-income countries in Africa and South-East Asia, as well as with the WHO co-sponsored COVAX global procurement facility – which has promised to start rolling out vaccines to countries worldwide in the first quarter of 2021.

The fire could have been caused by an electrical fault, according to government officials. India media reported that the fire had broken out in a part of the complex that was under construction.

 

The Serum Institute is producing approximately 50 million doses of COVISHIELD a month across multiple facilities in India: a number it plans to up to 100 million.

Additionally, the manufacturer is set to produce up to 50 million doses of the US’ Novavax candidate from April, if the vaccine, now in Phase 3 trials, is approved.

India began its COVID immunization campaign over the weekend, but the rollout saw lower turnout than expected with only around 50% of people registered to be vaccinated receiving their dose. Additionally, there is a lot of hesitancy among its health workforce.

Serum Institute vaccines figure heavily in the distribution timeline for the WHO co-sponsored COVAX facility’s commitment to distriute some 2 billion vaccine doses in 2021 (Gavi, 7 January 2021).

Image Credits: Twitter via https://en.gaonconnection.com/, WHO.

A small study of 50 blood samples from people previously infected with SARS-CoV-2 found that 90% had reduced immune response to the 501Y.V2 variant and almost half did not recognise it at all.

CAPE TOWN – Scientists are concerned that antibodies that could detect SARS-CoV-2 in South Africa’s first wave will be less effective against a virus variant that first emerged here and is known as 501Y.V2.  What’s worse, they still don’t know if brand new COVID-19 vaccines will work against the variant – which is deemed to be 50% more transmissible than ones prevailing until now.

The uncertainty contrasts sharply with the more optimistic profile of vaccine efficacy against British variants that have spread widely across the world.

A small study of 50 blood samples from people previously infected with SARS-CoV-2 found that 90% had reduced immune response to the 501Y.V2 variant and almost half did not recognise it at all, South African scientists told reporters at a scientific briefing this week.

They stressed that there was no evidence yet that a vaccine would not be effective against the variant, but acknowledged that the lack of antibody sensitivity, known as ‘immune escape’, among people who had already recovered from COVID-19 in the first wave could suggest they might be vulnerable to re-infection with the new variant.

Professor Penny Moore, research chair of Virus-Dynamics at the University of the Witwatersrand and the National Institute of Communicable Diseases, conducted the research on blood samples of 50 people who had been previously infected.

While there was a concern that the new variant could drive reinfections, “the data at this point does not point in that direction” says Professor Salim Abdool Karim.

Given that vaccines are also based on triggering similar antibody responses, they might also be less effective. But while the immune escape was “concerning”, Moore stressed that the dynamics of antibodies triggered by vaccines also could be different than natural antibody response.

“What we are doing now is taking blood from those people who mounted a response to the vaccine during vaccine trials and we are testing those antibodies against the viruses,” said Moore.

“That will give us a sense of whether the new variant is less sensitive to the antibodies that various vaccines elicit. But again, there are lots of caveats, because there are many vaccines, they all behave in a different way, and they all tickle the immune system to produce antibodies in a different way.”

‘Tweaking’ Vaccines a Possibility – But World May be Constantly Dealing with More & More Variants

Moore said that while it might be possible to “tweak” existing vaccines, slightly adjusting them to deal with the new variant, a new strategy might be necessary: “There is potential to do this [tweak the design] for some of the vaccines but in the future I think we will be consistently dealing with more and more of these variants.

“So we might need to be a little bit cleverer in how we design vaccines and look for other parts of the virus that cannot change so effectively and try to design vaccines to target these.”

‘Don’t Call It South African Variant’
Salim Abdool Karim
Prof Salim Abdool Karim, co-chair of the South African Health Minister’s advisory committee

Professor Salim Abdool Karim, co-chair of the South African health minister’s advisory committee on COVID-19, who led the briefing, appealed for the variant to be called by its scientific name, 501Y.V2, and “not the South African variant” just as COVID-19 “is not called the China virus”.

Variants have been identified in many parts of the world including the UK and Brazil, all with mutations to the spike protein that binds to the human cells.

Abdool Karim reported that the 501Y.V2 variant has 23 mutations including a 20% rotation in the spike protein which enables it to bind more strongly to human cells. Mathematical modelling predicts that it is 50% more infectious than its predecessor but not more severe.

In the Western Cape province, it took 107 days for 100,000 cases to develop, whereas in the second wave, it took only 54 days. However, hospitalisations for both waves were similar, indicating that the variant was not more severe.

Reinfection and The Variant

While there was a concern that the new variant could drive reinfections, Abdool Karim said “the data at this point does not point in that direction”.

Dr Koleka Mlisana, Executive Manager of Research at the National Health Laboratory Service (NHLS), said that an analysis of over 1.1 million positive tests found that by 6 January, there had been about 4000 reinfections.

“We have not seen a marked increase in reinfections since the variant, but bear in mind, we’re only talking about a month’s data so far, so this is an area that we need to look very closely,” said Mlisana.

Although national statistics are not yet available, the latest data for KwaZulu-Natal province found that the variant was present in 59 of the 61 genome sequences analysed.

501Y.V2 Variant Raises More Concern than UK-Identified Variant

While the variant identified in the United Kingdom has received a great deal of attention for driving a big surge of infections there, across Europe and elsewhere, scientists have been even more concerned about the 501Y.V2 – which makes more significant changes in the protein structure of the characteristic coronavirus spike, which new vaccines are targeting.

Pfizer/BioNTech has already published a number of studies on the variant identified in the UK late last year, (known as B.1.1.7).  One such pre-print study claimed the antibodies in the blood of vaccinated people still recognize the variant.  However, that study has already been hammered by online reviewers saying that the study sizes are far too small (16), and Pfizer’s interpretation of the data was overly optimistic.

Some Pharma Companies Already Preparing For Next Stage Variant Vaccines

While scientists try to assess the impacts of variants on existing vaccines, some pharma companies are already gearing up for a second generation of vaccine development to address them.

One example is the startup biotech firm, Gritstone Oncology, which will begin human testing for a “backstop” vaccine in the event that mutant strains do evade the current range of vaccines, STAT has reported.

Preclinical work on the vaccine was supported by the Bill and Melinda Gates Foundation. Though no data is publicly available yet, its Phase 1 clinical trial is due to begin shortly.

The firm’s CEO Andrew Allen told the outlet that “we all hope that this will not be necessary” and that he thinks “it’s prudent to have it developed as a backstop”.

It should also be noted, however, that if a virus variant were to escape the immune response generated by existing vaccines, updating the tool would take only a matter of months.

Image Credits: National Institute of Allergy and Infectious Diseases, NIH, Twitter: @WHO.

Researchers have reported pausing many or all of their late-stage trials due to the COVID-19 pandemic. This is likely to have a knock-on effect.

The demands of fighting the COVID-19 pandemic are draining resources from global health research and development (R&D) programs and disrupting clinical trials and other work, presenting a potential post-pandemic scenario of a world more vulnerable to a host of infectious threats.

That’s what our organization, the Global Health Technologies Coalition (GHTC), learned after conducting extensive, candid conversations at the end of 2020 with global health researchers around the world from both the public and private sectors. We reached out to them to understand how the fight against COVID-19, an effort that has often relied on their expertise and innovations, may be imperiling science to reduce the burden of many other infectious pathogens. That includes malaria, tuberculosis, HIV/AIDS and a broad spectrum of neglected tropical diseases.

Their reports revealed an urgent need to bring together the global health research community and our allies—in government, industry and international institutions—to avoid lasting damage to hard-fought progress and prevent further delays in delivering new advances.

Everyone understands that right now, COVID-19 must be the focus. We spoke with many researchers who were proud to see their capabilities contributing to developing better diagnostics, vaccines and new treatments. But they also were keenly aware of the toll it was taking on any work not related to the pandemic.

Scientists, speaking confidentially in order to provide a frank assessment, talked about staffing and funding being shifted to focus on pandemic-related work—and with no clear indication on when non-COVID-19 work would resume, or if diverted funding would be restored.

Meanwhile, clinical trials—the most costly and complex aspect of developing new health interventions—have been hit especially hard by pandemic-related shutdowns. Nearly every interviewee involved in clinical trials, many of which are located in low- and middle-income countries, reported significant issues, including trials being delayed indefinitely. The biggest disruptions have involved phase 3 trials. That’s understandable, as these trials are logistically complex and typically require managing thousands of participants. But reaching Phase 3 means a project is tantalizingly close to delivering a new breakthrough, which makes interruptions at this stage particularly devastating.

Researchers reported pausing many or all of their late-stage trials. One clinical trial administrator reported that where a trial was already underway, numerous trial participants were not showing up for essential follow-up visits at the clinic due to fears of contracting COVID-19. Virtual follow-ups were proving challenging in many cases, in part due to infrastructure barriers in low-resource settings—such as the need for many people to regularly purchase new SIM cards for their phones, which changes their phone number. Virtual visits are also not an option for trials that require in-person follow-up to collect samples.

Outside of clinical trial disruptions, scientists noted a number of discrete challenges. For example, there were reports of work stymied because laboratory reagents or personal protective equipment (PPE) were needed for pandemic response. Operational expenses have increased significantly for many projects, due to issues like higher shipping costs and additional resources needed for safety.

The cumulative effect of so many obstacles is presenting staggering challenges for global health researchers. But there is a way to recover from these setbacks—and avoid a situation where we emerge from the battle against one deadly disease less prepared to fight off many others.

First, we must work with our partners in the public and private sector to ensure scientists are given the resources and flexibility to recover from their pandemic-related problems and restart their work. Second, we must emphasize that decades of investments in global health R&D generated new insights and alliances that have played a big role in speeding the development of COVID-19 interventions. The fast pace of that work, especially around vaccines, demonstrates that, with greater funding, the field is poised to produce rapid progress in fighting many other infectious diseases.

In fact, we did hear a measure of optimism among some of the researchers we interviewed that the harsh experience of the pandemic—and the fact that scientists are leading the effort to end it— could create a new era in which investments in global health R&D become an enduring political priority.

But another scenario is one in which disruptions caused by the pandemic are compounded by long-term funding problems. Global health R&D funding always has been a hard sell and the economic impact of the pandemic is likely to constrain spending in both the public and private sector for years to come. It will require a concerted effort by our community to ensure global health R&D quickly regains lost ground and, equally important, that we can capitalize on opportunities revealed by pandemic-related advances to accelerate work on a number of diseases.

Jamie Bay Nishi is director of the Global Health Technologies Coalition (GHTC), a coalition of 30 nonprofit organizations, academic institutions, and aligned businesses advancing policies to accelerate the creation of new drugs, vaccines, diagnostics, and other tools that bring healthy lives within reach for all people. For more on this topic, read the GHTC’s full synthesis of the interviews: Pain Points and Potential: How COVID-19 is Reshaping Global Health R&D.

Image Credits: Dato Koridze /STUDIO for TB Alliance.

Dr Anthony Fauci, Chief Medical Advisor to new US President Joe Biden addresses the WHO Executive Board Thursday, 21 January, the morning after Biden’s inauguration..

In a brief, but historic speech Thursday morning before WHO’s Executive Board, President Joe Biden’s Chief Medical Advisor, Dr Anthony Fauci, reversed course on four years erratic and often hostile approaches to the World Health Organization and global health – which had alienated and bewildered friends and allies worldwide. . 

As one of the first acts of the new president, inaugurated only yesterday, the United States was rejoining the WHO and joining the global COVAX facility and Act Accelerator, WHO’s platforms for ensuring global access to medicines and vaccines, Fauuci announced. The United States will also cease its “drawdown” of seconded US personnel and honor outstanding financial commitments, which the previous administration had failed to pay. 

“The Biden administration also intends to be fully engaged in advancing global health, supporting global health security, and the global health security agenda and building a healthier future for all people,” Fauci told the EB’s Thursday morning seession. 

“The United States will work with the WHO and member states to counter the erosion of major gains in global health, that we have achieved through decades of research collaboration and investments in health and health security including in HIV AIDS. Food Security malaria and epidemic preparedness,” said Fauci, citing the longstanding involvement of the US in the WHO from its foundational days in 1948.  

Fauci’s announcement also carried a personal flair, describing his own longtime involvement with WHO and addressing WHO Director General Dr Tedros Adhanom Ghebreyesus as “my dear friend”:

 “I also know firsthand the work of WHO, with whom I am engaged in a collaborative manner. Touching all aspects of global health. Over the past four decades. And as such, I am honored to announce that the United States will remain a member of the World Health Organization,” Fauci said. 

“Yesterday, President Biden signed letters retracting, the previous administration’s announcement to withdraw from the organization. And those letters have been transmitted to the Secretary General of the United Nations, and to you. Dr. Tedros, my dear friend. also reflected the close working relationships he has maintained over the years with WHO.”

New Policy for Reproductive Health Rights 

Notably, Fauci also said the new Biden Administration, politically bolstered by a Democratic-controlled Congress, would revoke the 1980-s era “Mexico City Policy”, despised by gender and reproductive health rights advocates around the world.  The 1984 policy of the Reagan-era, which Donald Trump had reinstated and expanded, banned US aid to any foreign NGOS that might be seen as providing any form of abortion assistance.  

During the Trump period, the United States abstained from, or opposed, countless WHO and UN resolutions that even indirectly referred to women’s “reproductive health rights” – including a clause in a milestone COVID-19 pandemic response resolution, adopted by the World Health Assesmbly in May.  

“It will be our policy to support women’s and girls, sexual and reproductive health and reproductive rights in the United States, as well as globally,” Fauci declared.  

From Trump Administrations’ Bitter Attacks to Thanks 

Fauci’s remarks were also noteworthy for their dramatic U-Turn  in tone from the harsh Trump Administration attacks on WHO seen over the spring and summer, 

Rather, Fauci praised the Organization, saying, “I joined my fellow representatives in thanking the World Health Organization for its role in leading the global public health response to this pandemic under trying circumstances. 

“This organization has rallied the scientific and research and development community to accelerate vaccines therapies and diagnostics, conducted regular, streamed press briefings that authoritatively track, global developments, providing millions of vital supplies from lab reagents to protective gear to healthcare workers in dozens of countries, and relentlessly worked with nations in their fight against COVID-19.”

But Fauci also said that the US was committed to WHO reform as well as getting to the truth behind the pandemic’s viral sources, saying, “we are committed to transparency, including those events surrounding the early days of the pandemic. It is imperative that we learn and build upon important lessons about how future events can be averted. 

“The international investigation must be robust and clear. And we look forward to evaluating it.” 

A stronger system of global health pandemic alert and preparedness will be another US priority, Fauci said, saying that the US would work “to strengthen and reform the WHO and improve mechanisms responding to health emergencies, build health security and expand pandemic preparedness: 

“”We will seek an improved shared system for early warning and rapid response to emerging biological threats. We will support it scientifically robust and ethically sound collaborative science research and research capacity building, as well  as the rapid pace of research results pathogen samples and data are essential to research progress.”” 

WHO Executive Board Members Welcome US Statements
Martin Essono Ndoutoumou, Ministry of Health delegate to the EB, Gabon, welcomes the US statement on behalf of the Africa group of states

Fauci’s comments were welcomed by traditional US allies in the WHO wall-to-wall, including the United Kingdom, The European Union, Norway, Finland and Israel; and in the Western Pacific, Australia, Japan, and New Zealand.

Germany called it “a great day for multilateralism and for WHO.” 

Added Austria’s EB delegate, Clements Auer. “This is good news for all of us who regard multilaterlisim as an indispensible strength and not a weakness in our work.”

The African bloc, Pacific small island states, and Latin American countries such as Argentina, Chile and Brazil, also issued positive statements. 

“We’ve heard on a number of occasions that the only way of overcoming this and other international health emergencies. In the future, is by pooling our efforts,” said Chile. “We’ve underscored the fundamental leadership role of the WHO. And so the renewed commitment of the United States of this organization is important. They’ve also renewed their commitment to multilateralism.

Russia was loudly silent. But China sounded a cautiously positive note.  

“China has noted the statement made by the US. China reiterates that we firmly advocate multilateralism and we wisupport the WHO to truly play aa scientificy, fair and professional guidance frole in global public heatlh. China welcomes any work that contributes to global solidarity to fight the virus,” said China’s EB delegate.  

This is despite the increased level of anti-US rhetoric coming from Beijing.  That rhetoric has pushed conspiracy theories that regard the new mRNA vaccines developed by European and North American pharma companies such as Pfizer and Moderna as dangerous to older people and part of a US military plot.

China has also launched a propaganda campaign that aims to  muddy the waters around the origins of the SARS-CoV-2 virus, just as a WHO-led independent research team visits Wuhan to search for the elusive trail of how the virus, from a family of coronaviruses that circulates among bats in southwestern China, first infected humans in the city of 10 million.  But official Chinese media and spokespeople are now saying that researchers should look in Southeast Asia or Europe – and one China Foreign Ministry spokeswoman speaking a recent media briefing pointed the finger at a US army base.

“My Friend -“My Brother” – Tedros and Fauci Exchange Warm Words
Dr Tedros Adhanom Ghebreyesus, WHO Director General, welcoming Fauci and the United States back into the WHO “family”.

Against that background, US moves to not only rejoin WHO but also play an active leadership role the global health scene – without provoking uneecessary hostility and tension as the Trump Administration was prone to doing, will certainly be welcomed by WHO. And the enthusiastic WHO response was plainly evident in the reception Fauci received on Thursday. 

Calling Fauci “my brother,” the Director General said, “This is a good day for WHO and a good day for Global Health.”

He hearkened back to the historically strong role the United States has played in the global organization. 

“The United States, its global role is very very crucial. …. we must work together as one family, to ensure vaccination of health workers and either high risk group is underway in all countries within the first 100 days of 2021 with your commitment. We’re one step closer. 

“Since WHO’s founding in 1948. The United States has played a vital role in global health, and the American people have made enormous contributions to the health of the world’s people. We look forward to continuing this partnership. As I know all member states, do we have a lot of work to do.”

US Move to Rejoin WHO Will Help Expedite Global Vaccine Rollout  – WHO’s Regional Director For Africa

The fact that the United States has now committed to join the global vaccine facility, COVAX, which aims to roll out vaccine doses to countries worldwide, is “extremely significant”, Dr Matshidiso Moeti, WHO Regional Director for Africa told Health Policy Watch this afternoon.

“For WHO and for global health, I would say this is indeed a very important and very significant development,” Dr Moeti said, adding, “The US has been one of the biggest partners supporting some major health development actions in Africa – and if we are working with them as the member state of WHO, I believe it facilitates even this bilateral support.”

The honeymoon between WHO staff – and their US counterparts in the incoming Biden administration – was also plainly evident in the back and forth banter on the Twitter channels, in the hours following the Fauci speech.

“Effective leadership is the ultimate ‘vaccine’ against coronavirus,” tweeted WHO special advisor Peter Singer, a Canadian, in a post that featured emojis of the US and UN side by side with hands grasped in thanks.

Replied Colin McIff, Biden’s new Deputy Director of Global Affairs at the Department of Health and Human Services: “Amen brother, we are so much stronger together!”

– Paul Adepoju in Ibadan, Nigeria, contributed to this story

Image Credits: WHO.