Eight Hundred Women Die Every Day During Pregnancy or Childbirth 23/02/2023 Stefan Anderson In 2020, a woman died every two minutes from pregnancy or childbirth. By the time you finish reading this article, at least two women will have died from complications in pregnancy or childbirth. In the next 24 hours, another 798 will lose their lives. Nearly all of these women will be from low-and lower middle-income countries, and nearly all of their deaths will have been preventable. These are the jarring findings of a new multi-agency UN report tracking deaths related to pregnancy and childbirth from 2000 to 2020 published on Thursday. The report paints a vivid picture of the dangers faced by women who lack access to the basic but life-saving health services for preventing maternal deaths that most of the world has benefited from for decades. Yet instead of showing progress, the report reveals an alarming new development: nearly all regions of the world have witnessed an increase or stagnation in maternal deaths since 2016. The consequences for women’s health if this global backsliding continues, the report’s authors warned, will be severe. “We need to reverse the declines that we’re seeing in maternal mortality reductions,” said Dr Jenny Cresswell, lead author of the report. “This is a very important issue with very substantial inequities by country and within countries, which is unacceptable given that the majority of maternal deaths are due to preventable causes.” In 2020, an estimated 287,000 women died of complications during pregnancy or childbirth – one every two minutes. For every woman who died, between 15 to 30 more paid for their survival with life-altering disabilities. And for every mother who does not make it past childbirth, a newborn is left at higher risk of dying as well. “The persistent gender norms that deprioritize the health of women and girls must be addressed,” said Dr Tedros Adhanom Ghebreyesus, WHO’s Director-General at a media briefing on Tuesday. “While pregnancy should be a time of immense hope and a positive experience for all women, it is tragically still a shockingly dangerous experience for millions around the world who lack access to high quality, respectful health care,” he added. “Childbirth should be a time of life, not death.” A story of inequality Maternal mortality ratio estimates by country 2020. Maternal death rates tell a story of deep global inequalities. An astonishing 70% of global maternal deaths in 2020 — over 200,000 — occurred in sub-Saharan Africa, where girls aged 15 face a one in 40 chance of dying from pregnancy-related complications. Central and Southern Asia arrive in a distant second, accounting for 17% of the global death toll. Globally, nearly 95% of all maternal deaths occur in low- and lower middle-income countries. Meanwhile, 73 countries, mostly in Europe, Latin America and the Caribbean, recorded less than 20 maternal deaths in 2020. The sub-Saharan death rate is 136 times higher than in Australia and New Zealand, the region with the lowest maternal mortality rate documented in the report. Between countries on the statistical extremes, inequalities are staggering. In Chad, the country with the highest rate of maternal mortality, a 15-year-old girl has a one in 15 chance of dying of maternal causes in her lifetime. If that same girl lived in Belarus, the highest performing country analyzed in the report, she would be 4,000 times less likely to succumb to pregnancy related causes. The stark contrast between the world’s best and worst performing countries highlight deep divisions within countries and regions that get lost in the averages of global statistics. While regional disparities are heavily influenced by relative development levels and the impacts of prolonged conflict and climate change, national disparities run along the rural-urban divide that defines health access in developing countries, where limited health workforces and facilities are concentrated in cities due to their relative wealth and high population densities. Remote populations out of reach of their country’s central power grid also suffer from reduced levels of care in the facilities at their disposal due to a lack of access to electricity. Paired with overstretched health systems lacking in critical medicines and essential medical supplies, the absence of electricity to power even barebones medical setups limits doctors’ abilities to provide life-saving care during childbirth, or operate incubators if a child is successfully delivered. One billion people in low- and middle-income countries do not have access to health facilities with reliable electricity, and South Asia and sub-Saharan Africa – the two regions with the highest maternal death rates – also have the lowest rates of healthcare facilities with reliable electricity. “No mother should have to fear for her life while bringing a baby into the world,” said UNICEF Executive Director Cathering Russell. “Equity in healthcare gives every mother, no matter who they are or where they are, a fair chance at a safe delivery and a healthy future with their family.” Progress is possible, but the world is backsliding Global reductions in maternal mortality rate by five-year time period, 2000-2020. The 287,000 maternal deaths seen in 2020 is more than a third lower than the 446,000 documented at the turn of the millennium. From 2020 to 2015, all global regions achieved significant reductions in maternal mortality. But since 2016, the year the UN’s Sustainable Development Goals (SDGs) came into effect, this era of progress has flatlined. The SDG target for maternal mortality is to reduce deaths to 70 per 100,000 live births by 2030. The report found that for the world to reach this goal, an unprecedented reduction of 11.6% per year will be needed from 2021 to 2030. From 2000 to 2020, the average annual drop in maternal mortality was just 2.1% – a fifth of the rate needed to hit the SDG. Based on available data, the optimistic scenario outlined in the report projects the world will miss the SDG by more than double. The business-as-usual scenario, meanwhile, has the world arriving at a rate over three times the SDG target. Africa faces an even taller task: the continent needs to reduce maternal deaths by a staggering 86% to reach the rate set out in the SDG target. Australia and New Zealand, and Central and South Asia were the only two regions to make significant progress since 2016, reducing maternal mortality by 34.6% and 15.7% respectively. Half of global pregnancies are unplanned Distributions of contraceptive users by method and region, 2019. / UNFPA Nearly half of all pregnancies around the world, totalling 121 million annually, are unintended. According to the UN Population Fund (UNFPA), an estimated 257 million women wishing to avoid pregnancy lack access to safe, modern family planning methods like contraception and abortion. In a report published in March 2022, UNFPA found that in 47 countries, about 40% of sexually active women were not using any contraceptive methods to avoid pregnancy, while nearly a quarter of all women are not able to say no to sex. “For the women affected, the most life-altering reproductive choice – whether or not to become pregnant – is no choice at all,” UNFPA Executive Director Dr Natalia Kanem said. “The staggering number of unintended pregnancies represents a global failure to uphold women and girls’ basic human rights.” At a press conference with reporters on Tuesday, WHO officials said the ability to make autonomous decisions regarding reproductive health, including the choice of having children and the timing of childbirth, is crucial for women to plan and space their pregnancies and safeguard their well-being. A lack of access to the necessary care and medical resources leads many women to turn to unsafe abortions, which account for 45% of all abortions performed every year. These hospitalize about 7 million women a year globally and cause 5 to 13 percent of all maternal deaths – one of its leading causes. Pregnant women from marginalized communities with limited access to essential maternity care are at increased risk due to inequalities related to income, education, race or ethnicity, the report added. Nearly a third of women do not even have half of the recommended eight antenatal checks during their pregnancy, or receive any postnatal care. “We have the tools, knowledge and resources to end preventable maternal deaths,” Kanem said. “What we need now is the political will.” Crisis and instability drive maternal deaths When disaster strikes, contraception and maternal health are often treated as secondary concerns. Women and children are the first to suffer security and health consequences from war, conflict and instability. Amid the chaos, maternal health services are no longer considered essential, with dire consequences for women living in conflict zones. In the world’s nine most unstable countries on the Fragile States Index – Chad, Yemen, South Sudan, Somalia, Syria, Democratic Republic of Congo, Central African Republic, and Afghanistan – women die from pregnancy or childbirth at a rate more than double the world average. “It is telling and discouraging that the five countries with the highest maternal mortality (Afghanistan, Central African Republic, Chad, Somalia, and South Sudan) are all experiencing or recovering from conflict,” WHO said. This has knock on effects on the health outcomes of their potential children, too. Of the 54 countries on track to miss the SDG for child mortality, half are considered fragile or in conflict. Humanitarian crises push contraception down the priority list due to the increased urgency of finding food, shelter, safety, water, and other life or death necessities made scarce in times of crisis. International aid also prioritizes these essentials, meaning maternal health assistance is often an afterthought. Experts say changing this paradigm could save thousands of lives. “Delivery doesn’t wait. Whether it’s an earthquake or whether it’s COVID,” said Dr Anshu Banerjee, Assistant Director General for Universal Health Coverage at WHO. “[Maternal health services] need to be part of the core package for any intervention in a humanitarian setting.” If the world continues on its current trajectory, an estimated one million women will die preventable deaths by 2030. Image Credits: UN, UN, UNFPA, UNDP. WHO Stands Firm On Using Masks to Combat COVID-19 22/02/2023 Megha Kaveri Dr Maria van Kerkhove, WHO’s Covid-19 technical lead. The World Health Organization (WHO) has reiterated its firm recommendation that wearing masks is an effective method to prevent the spread of COVID-19 in a media briefing on Wednesday. Dr Maria Van Kerkhove, WHO’s technical lead for COVID-19, said that coronavirus is still in circulation and wearing appropriate face masks is one of the ways to prevent the spread of the virus. “I reiterate that the use of masks continues to be part of our strategy to reduce the spread. We have a strategy that is based on vaccinations, on distancing as much as possible as we go about our lives, wearing of well-fitting masks when we’re around others, and particularly on public transportation and certainly among health workers.” In January 2023, Cochrane published a comprehensive analysis of 78 randomized controlled trials (RCTs) conducted in several countries over a period of time, including six RCTs conducted during COVID-19 pandemic, concluded that wearing face masks “makes little or no difference to the outcome of influenza‐like illness (ILI)/COVID-19 like illness compared to not wearing masks”. The study said that there is uncertainty about the effects of face masks. “The pooled results of RCTs did not show a clear reduction in respiratory viral infection with the use of medical/surgical masks. There were no clear differences between the use of medical/surgical masks compared with N95/P2 respirators in healthcare workers when used in routine care to reduce respiratory viral infection.” “There was a systematic review that was published that was looking at randomized controlled trials,” Van Kerkhove said, adding that as an organization, the WHO looks at all available evidence on the issue. “We continue to look at all available evidence that is provided to us, that is published through this pandemic as well as looking at other studies of other respiratory diseases, including flu, influenza-like illness, acute respiratory infections and severe acute respiratory infections,” she added. “Masks remain one of the recommendations that we have because we know that they are effective at preventing some of the transmission. They’re not perfect and that’s why we have a comprehensive strategy, a layered approach of many different types of interventions,” stressed Van Kerkhove. Working around sanctions on Syria The WHO also told the media briefing that it is making the best possible use of the pause in sanctions against Syria to ensure that aid reaches the people who have been affected by the earthquake. Around 47,100 people were killed in the devastating earthquake that struck Syria and parts of Turkiyë on 6 February. Several countries including the US have imposed sanctions on Syria in an attempt to pressurise the regime of Bashar al-Assad to stop killing civilians. However, sanctions have been relaxed to enable aid to reach those affected by the earthquake. Explaining that the WHO is working with other UN partners to procure and mobilize medical equipment and supplies, Dr Abdi Rahaman Mahamud said that the relief work is moving in the right direction. In response to the global mobilization of help to Syria and Turkiyë, the US government released a compliance document on Tuesday for those willing to mobilize aid. Increasingly Brutal Attacks on Civilians by Islamist Rebels Take Toll on Mental Health in DR Congo 22/02/2023 Claude Muhindo Sengenya via The New Humanitarian The town of Beni in the DRC has been the scene of a number of ADF massacres. “We have never experienced such killings,” says an aid work as local health centres struggle to help survivors deal with mental health problems in the aftermath of increasingly brutal attacks by the Islamic rebel group, Allied Democratic Forces. Of the more than 100 armed groups active in DRC’s eastern provinces, one of the oldest and most violent is the Allied Democratic Forces (ADF), a militant movement of Ugandan origins that has pledged allegiance to the so-called Islamic State (IS). With the spotlight on the M23 – which is backed by Rwanda and has seized large chunks of territory in the east – The New Humanitarian spent time speaking with survivors of ADF atrocities and health workers addressing the conflict’s fallout. “I have been supporting displaced people of different wars for 20 years… [but] the ADF massacres have become serious and we have never experienced such killings,” said Marie-Jeanne Masika, who works for a local NGO helping conflict victims. Interviewees said recent measures taken to combat the ADF – from a joint Uganda-DRC military intervention to the introduction of martial law – have failed to improve security for civilians. Instead, the militants have expanded geographically, carrying out massacres, abductions, and bombings in urban areas that have struck targets including a government building, a cinema, and a church in recent months. Those affected by the long-running violence – which centres on North Kivu and Ituri provinces – raised warnings of a rising mental health toll. Yet local health workers said there is an absence of support for those needing psychosocial services. “Today, we must no longer reduce humanitarian assistance to the sole distribution of provisions… to victims,” said Masika. “A big problem also remains psychosocial care to avoid having mental illnesses in the future.” ‘We are in so much pain’ The ADF was formed in 1995 after members fled to DRC amid military pressure in Uganda. It has its roots in the repression of Ugandan Muslims, though its complex history and modus operandi is obscured by narratives that focus solely on its Islamist orientation. Military operations, including by UN peacekeepers, are frequently launched against the group. Yet they often result in ADF reprisal attacks designed to punish civilians who support the army and pressure the government to end offensives. Recent ADF raids have sought to undermine support for Uganda’s operations. That mission – which may be guided by economic interests rather than security concerns – was launched after IS claimed a triple suicide bombing in Kampala in late 2021. A meeting of displaced people who had fled recent ADF massacres healed at a cathedral in Butembo, a town in North Kivu, earlier this month, highlighted the suffering caused by the conflict. Kavugho Sikiliza, 42, said she had lost four of her relatives, including her son and daughter-in-law, in an ADF attack in Bashu chiefdom – in the North Kivu territory of Beni – last September. “We suffer so much. We have abandoned our fields and we no longer find anything to eat,” Kavugho said. “Today, we are spending the night in the bush; we have orphans who are struggling to [eat].” Next to Kavugho sat Yoha Nyasavo Bibiche. Six months ago, she saw her son killed by ADF rebels in Mungamba, in Ituri province. She is now living in Butembo but was recently forced out of her house there because she couldn’t afford rent. “As we were about to harvest, the ADF attacked the village and stabbed my son, who is dead,” said Bibiche. “We no longer have a home. Eating, dressing – it has become a headache.” Mental health toll The cumulative impact of attacks – which have killed thousands over the past decade – has led to serious mental health challenges, according to survivors and medical staff from three psychiatric centres in Beni and Butembo. Esdras Pika, a psychologist at a health centre in Butembo, said his clinic treats survivors of ADF killings, kidnap victims, and farmers and traders struggling to cope with the loss of their livelihoods. “Before 2015, the reasons that led patients to be admitted to mental healthcare here were often drug abuse [and] cases of romantic disappointment,” Pika said. “But today, most of the patients who come to us are victims of insecurity.” Kakule Kisonia, from Beni territory, said his brother went to the local Muyisa psychiatric centre after witnessing a recent ADF attack that cost the lives of his wife, sister, and two of his children. Kisonia said his brother’s behaviour changed after the attack. “Every night he shouted: Ba Nalu! Ba Nalu! [a reference to the ADF in Swahili],” Kisonia said. “Each time a neighbour came, he shouted that it was the ADF, and did not hesitate to take either a wooden stick or a machete to attack the visitors.” More support is needed Medical staff from the health centres said they receive around 30 patients per month who are victims of ADF attacks. Yet the staff said their clinics receive no support from the state or from aid organisations, and that patients must self-finance their treatment. “Most of the victims are in a state of serious vulnerability, but we too are private, unsubsidised structures,” said Pika from the Butembo clinic. “We have to buy the drugs, pay the state taxes, and pay our nursing staff. We have no choice.” Marie-Jeanne Masika, the local NGO worker, said some displaced families have come to her organisation presenting bills of more than $300 issued by health centres for psychiatric support. “It is too much for the victims, who have lost everything in the attacks, and these kinds of bills trouble them rather than relieve them,” said Masika, whose organisation is called Social Integration for the Promotion of the Needy (ISPRON). Mumbere Nyerere, an ADF victim who is receiving therapy, said paying for care represents a “big difficulty”. “I am the father of the family. Those who finance my care are my parents, older than me. It is I who should assist them,” Nyerere said. As attacks continue, Masika called for the government to subsidise clinics providing mental health support and said occupational therapy should be rolled out in villages to “tackle the problem at the base”. Georges Machokuona, a psychosocial worker in Butembo, said livelihood support is needed too: “Once they have returned home, most of those cured are faced with challenges… linked to survival, which led some to fall ill again.” This story was originally published by The New Humanitarian, which puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Image Credits: Robert Flummerfelt/ TNH, The New Humanitarian. Ukraine Gets New Emergency Funds for HIV and TB Programmes 21/02/2023 Kerry Cullinan Alliance Global’s Andrii C shelters in the NGO’s basement in Lviv and waits for air raid sirens to finish. The organisation is helping to get treatment to people living with HIV. On the eve of the first anniversary of Russia’s invasion of Ukraine, the Global Fund to Fight AIDS, Tuberculosis and Malaria has approved an additional $10.32 million in emergency funding to maintain essential HIV and tuberculosis (TB) services in Ukraine. The funds are earmarked for HIV and TB treatment, prevention and care, including for internally displaced persons and hard-to-reach communities. Since the start of the war, more than 13.5 million people have been internally displaced or forced to flee to neighbouring countries as refugees. “If displaced people don’t get the medicines they need, there is a high risk that they will actually die because of the lack of therapy,” said Dmytro Sherembei, head of 100% LIFE, a Global Fund-supported nongovernmental organization delivering HIV medications in war-affected Ukraine. In the past year, the Global Fund has allocated $25.32 million in emergency funds in addition to $119.48 million allocated to Ukraine to support the fight against HIV and TB in the country over the 2021-2023 period. Ukraine has the second-largest HIV epidemic in Eastern Europe and Central Asia, and a high burden of TB, including drug-resistant TB, according to the Global Fund in a statement on Tuesday. “Both HIV and TB require long-term treatment to reduce the risk of transmission and both diseases have the best outcome with early diagnosis. As people escape the fighting, they often lose access to health care and their medications. HIV and TB prevention and diagnosis services have also been significantly disrupted.” Needs more desperate “As the war rages on, the needs in the country are getting more severe and urgent,” said Peter Sands, the Global Fund’s Executive Director. “Damage and destruction to water, electricity and sanitation facilities, health facilities, as well as road and residential infrastructure continue to be reported across multiple areas throughout the country. The additional emergency funding that we are unlocking today is intended to support the government in filling the significant financing gaps across critical HIV and TB interventions. We will continue to monitor the situation closely.” The World Health Organization (WHO) reports that over 1,200 health facilities in the country have been attacked, and 170 of these facilities have been destroyed, leaving healthcare workers and patients displaced, injured or dead. “It’s been a year since the Russian Federation’s invasion of Ukraine, and today, the fighting and deadly missile strikes continue, bringing more destruction and devastating impact in several oblasts of the country,” said Minister of Health of Ukraine Viktor Liashko. “Despite the crisis and challenges, Ukraine’s HIV and TB programs sustained operations. The Global Fund’s investments through the emergency funding, on top of the ongoing grant, have proven invaluable, especially as health facilities have been damaged or destroyed and people continue to be displaced, causing them to lose access to health care, including treatment for HIV and TB.” Over the last 20 years, Ukraine has been a champion in maintaining long-term and innovative HIV and TB programs, according to the Global Fund. More than 100 community-based and community-led organizations have been delivering HIV and TB services to vulnerable people. Image Credits: Global Fund. Scientists Launch R&D Plan to Develop Broad Vaccine for Coronaviruses 21/02/2023 Kerry Cullinan SARS-Co-V2. Fifty influential scientists have developed a coronavirus vaccines research and development (R&D) roadmap aimed at developing broadly protective vaccines to combat fast-evolving coronaviruses threatening humans. “The COVID-19 pandemic marks the third time in just 20 years that a coronavirus has emerged to cause a public health crisis,” said Professor Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP). “Rather than waiting for a fourth coronavirus to emerge — or for the arrival of an especially dangerous SARS-CoV-2 variant — we must act now to develop better, longer-lasting and more broadly protective vaccines,” added Osterholm, whose centre spearheaded the development of the roadmap that was unveiled on Tuesday. CIDRAP unveils roadmap for advancing better coronavirus vaccines The roadmap provides a detailed a strategy to develop broadly protective vaccines—suitable for wide use—to tackle future #COVID19 variants and other worrisome coronaviruseshttps://t.co/yfv7nb5Jnq pic.twitter.com/mQBonJneZc — CIDRAP (@CIDRAP) February 21, 2023 The roadmap sets out steps to accelerate the development of broadly effective coronavirus vaccines capable of preventing severe disease and death that are suitable for all regions worldwide. New SARS-CoV-2 variants pose the most immediate threat and could evolve until they evade the protection of current vaccines. But the bigger fear is the emergence of a super-coronavirus that has the transmissibility of SARSCoV-2 combined with the deadliness of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). MERS-CoV spilled over from camels to humans in 2012 and kills about a third of the people it infects. To head off such a threat, the roadmap proposes a number of approaches. One could involve a stepwise process, starting with vaccines to protect against SARS-CoV-2 variants. As knowledge about coronaviruses expands, it may be possible to develop vaccines that are capable of protecting against multiple types of coronaviruses, including those likely to spill over from animals to humans in the future. “It is critical that we start now to develop vaccines that are future-ready for coronaviruses circulating in animals now, that might infect humans and cause pandemics in the future as SARS-CoV-3 and beyond,” said Professor Linfa Wang, executive director of Singapore’s Programme for Research in Epidemic Preparedness and Response (PREPARE). Wang, who was part of the team that developed the roadmap, also said that the work was daunting: “The coronavirus diversity in bats is so great that we even don’t know how much we really know about them.” Five work areas The roadmap proposes five areas of work: Virology: learning more about the global distribution of coronaviruses circulating in animal reservoirs that have the potential to spill over to humans. Immunology: learning more about human immunology to expand the breadth and durability of immune protection from vaccines and natural infection. This includes a better understanding of mucosal immunity, which may unlock new strategies to block infection such as nasal sprays. Vaccinology: identifying key preferred product characteristics for vaccines, including new technologies and identifying the best methods to assess vaccine efficacy. Animal and human infection models for vaccine research: expanding the range of suitable animal models, which is a key barrier to developing broadly protective coronavirus vaccines. Policy and financing: reinvigorating and sustaining a high level of political commitment and long-term investment in vaccine R&D and manufacturing to ensure the successful development and global distribution of broadly protective coronavirus vaccines. While praising the current COVID-19 vaccines, Wellcome Trust’s Dr Charlie Weller, said the roadmap would research “new ways to deliver vaccines, such as skin patches or intranasal vaccines – and maybe even vaccines that could block transmission”. Constant mutation “Coronaviruses such as SARS-CoV-2 are constantly mutating. With every infection, there is an interplay among host characteristics, past infection, and vaccination – each exerting further pressures on the virus to evolve and acquire further reproductive and fitness advantages,” wrote Dr Margaret Hamburg, former Food and Drug Administration (FDA) commissioner, and Dr Gregory Poland, from the Mayo Clinic’s Vaccine Research Group in the US in a commentary published in the journal, Vaccine. “As a consequence, we are chasing continually evolving viral opponents, leaving the global community in a reactive rather than proactive position in regard to vaccines, therapeutics, and public health policies.” They warn that the global community cannot afford “to play reactive catch up continuously, chasing the latest variant”, or expect people to get vaccinated several times a year. However, Hamburg and Poland added that the roadmap also needs “a governance or administrative structure” to better coordinate vaccine R&D and track progress –and accountability – on the goals and milestones that will further facilitate and accelerate this process. They point to the “siloed” activities by governments, industry and researchers, and how the roadmap can “build bridges between these various sectors” to reduce barriers and duplication, and improve efficiencies. Image Credits: Johnson&Johnson. Natural Immunity Against COVID-19 ‘At Least’ On Par With Vaccination in Preventing Death 21/02/2023 Stefan Anderson Natural immunity provides strong protection against severe illness from COVID-19, but obtaining it carries its own set of risks. New research published in The Lancet suggests that individuals who have previously been infected with COVID-19 have an 88% lower risk of hospitalization or death than those who have not. The study is the most comprehensive review of data on natural immunity to date, covering data from 65 studies across 19 countries published since January 2021. The analysis found that the strength and 10-month duration of protection conferred by natural immunity against severe illness is “at least” on par with that provided by two doses of Moderna and Pfizer-BioNtech’s mRNA vaccines. The study’s authors said the data suggests natural immunity in people recently infected with COVID-19 should be recognised by policymakers but warned against using their findings to undermine the importance of vaccination due to the risks associated with the first infection. “Vaccination is the safest way to acquire immunity, whereas acquiring natural immunity must be weighed against the risks of severe illness and death associated with the initial infection,” lead author Dr Stephen Lim of the University of Washington’s School of Medicine. Researchers also cautioned that differences between the infectious properties of COVID-19 variants mean protection levels can vary. Infection by pre-Omicron variants, for example, yielded substantially lower natural immunity protection against reinfection by the now dominant Omicron BA.1 variant, with just 36% protection remaining after the 10-month window. Nevertheless, protection against hospitalization and death remained high at 88%. “The weaker cross-variant immunity with the Omicron variant and its sub-lineages reflects the mutations they have that make them escape built-up immunity more easily than other variants,” report co-author Dr Hasan Nassereldine of the University of Washington’s School of Medicine said. “The limited data we have on natural immunity protection from the Omicron variant and its sub-lineages underscores the importance of continued assessment, particularly since they are estimated to have infected 46% of the global population between November 2021 and June 2022.” The analysis excluded studies examining “hybrid immunity” (the combination of immune responses from vaccination and natural infection) as well as data relating to Omicron XBB and its sub-lineages. The authors encouraged further research to fill the gaps in the study. Europeans Don’t Exercise Enough – And Policy-Makers Should Do More to Encourage Them 17/02/2023 Kerry Cullinan A third of Europeans don’t meet the World Health Organization’s (WHO) guidelines for physical activity – but if they did, this would avert over 10 000 premature deaths, almost four million cases of cardiovascular disease, three and a half million cases of depression and nearly a million cases of type two diabetes by 2050. This is according to a report launched on Friday by the WHO Europe and the Organisation for Economic Co-operation and Development (OECD), which urges policy-makers to adopt strategies to increase people’s physical activity. The findings are based on a recent Eurobarometer survey conducted for the European Commission which found that 45% of the respondents report that they never exercise or play sport, an increase of 6% since 2009. People in Finland (71%), Luxembourg (63%), the Netherlands (60%), and Denmark and Sweden (both 59%) were the most likely to exercise, while people in Portugal, Greece and Poland were least likely to exercise. “We find that it’s worse among women, with some countries having almost half of all adult women not meeting the WHO recommended guidelines on physical activity,” OECD health policy analyst Sabine Vuik told the launch on Friday. Meanwhile, less than a quarter of people who consider themselves to be working class exercise at least once a week, and over half of all adults surveyed said that they exercised less frequently since the COVID-19 pandemic. Recommended activity The WHO recommends that everyone does at least 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity every week. “This could be a half-hour run twice a week, running about 10 kilometres per hour, but it doesn’t need to be formal exercise. It can also be walking the dog every day for half an hour,” added Vuik. OECD health analyst Sabine Vuik “Our analysis shows that larger countries such as Germany, France and Italy can save more than €1 billion every year if everyone were to meet the physical activity guidelines. And across the EU, we could save €8 billion every year in healthcare expenditure if everyone meets the minimum recommended guidelines.” WHO Europe regional director Dr Hans Kluge, said that the report “provides evidence that investing in policies that promote physical activity not only improves individual well-being and population health, but also pays economic dividends”. “Every €1 invested in physical activity generates an almost two-fold return of €1.7 in economic benefits. We need to communicate the benefits of being active, not just the physical benefits, but the benefits to mental health, the environment and society in the WHO European Region, and we need to make sure that our systems can and will sustain these changes – as real, long-term transformation,” added Kluge, who is an avid cyclist and cycles to work and back daily. The report calls on policymakers to step up the policy response to increase physical activity in schools, in urban and transport design and in healthcare settings and workplaces. Since 2015, some EU countries have adopted policies to improve access to physical activity. For example, Finland adopted a resolution to promote active modes of transportation, Austria builds up co-operation between sports clubs and primary schools and Bulgaria develops a programme to help people whose jobs involve sitting for long periods. Investing in #PhysicalActivity improves individual and population health, while returning 1.7 EUR in economic benefits for every 1 EUR invested. New WHO/@OECD report funded by the #EU shares great ideas for policy makers to consider.👇https://t.co/Ri3xynx9bv@EU_Commission pic.twitter.com/A28qBknwiQ — WHO/Europe (@WHO_Europe) February 17, 2023 Lack of Test Kits for Marburg Virus Hamper Africa’s Response to Outbreak 16/02/2023 Paul Adepoju Dr Ahmed Ogwell Ouma, Acting Director of the Africa Centres for Disease Control. The Africa Centres for Disease Control and Prevention (Africa CDC) is closely monitoring Equatorial Guinea’s first-ever Marburg virus disease outbreak, Africa CDC acting director Dr Ahmed Ogwell Ouma told a media briefing on Thursday “One big challenge we have are test kits and we are working around the clock to try and get test kits to Equatorial Guinea and also to Cameroon and Gabon, to ensure that we have a very short turnaround time for samples being tested in the laboratory,” Ouma added. So far, one case has been confirmed and nine deaths have been reported, while there are 16 suspected cases in quarantine, and another 15 contacts are under observation. All cases have occurred in the province of Kie Ntem in the country’s western region. Ouma added that a key priority is to limit the spread of the virus, as well as monitor neighbouring countries such as Cameroon and Gabon for potential cross-border spillover. As reported by Health Policy Watch, on Tuesday, the WHO received updates from five vaccine developers who have been working on candidate vaccines. The WHO plans to convene a working group to prioritize existing vaccine candidates, with an eye to seeing if clinical trials for any of the vaccines can be launched in real time, particularly if the outbreak expands. Diphtheria, cholera, mpox, Lassa fever, and measles are some of the other health emergencies that African countries are also grappling with, alongside COVID-19, and Ouma, a Kenyan epidemiologist, said that his center is currently monitoring up to nine different public health events. Nigeria reported over 600 new cases of diphtheria and several African countries reported cases of cholera, including Malawi, where three-quarters of the continent’s cases have been reported. The continent has documented over 12 million cases of COVID-19 and 256,705 deaths, a case fatality rate of 2.1%, which is double the global average, Ouma told the media. While the number of new cases and deaths have decreased over the past several weeks, he emphasized the importance of continuing to encourage vaccination efforts and targeted campaigns to reach more people. “The general trend on the continent now is quite flat with the indications that we may be seeing further decreases in numbers and also in deaths,” Ouma told journalists. Ouma noted that Africa CDC is working with governments and health organizations to provide technical assistance and medical countermeasures as needed for these and other health emergencies. He added that the organization is also continuing to promote vaccination efforts and targeted campaigns to help prevent the spread of infectious diseases. Draft Pandemic Accord Neglects Prevention, Particularly ‘Zoonotic Spillover’ 15/02/2023 Kerry Cullinan INB co-chair Roland Driece The draft pandemic accord needs more emphasis on preventing pandemics at their source – where animal pathogens “spill over” to people – according to a number of organisations participating in a consultation on the document’s “zero draft” on Wednesday. Negotiations between World Health Organization (WHO) member states on the draft are due to begin at the fourth meeting of the Intergovernmental Negotiating Body (INB), scheduled to take place from 27 February to 3 March. However, Wednesday’s meeting gave WHO’s civil society stakeholders an opportunity to comment on the draft ahead of that meeting. Only member states will take part in the actual treaty negotiations, which are likely to start behind closed doors on the second day of the month-end meeting (called INB 4), INB co-chair Roland Driece told the meeting. INB 4 and the following INB5 meeting from 3 to 6 April would be approached as “one big meeting”, he added. While the start of the meeting would be open to all stakeholders, “as soon as member states tell us that they accept the zero draft as the zero draft, we will move into negotiation mode, and that means that only member states can be present,” said Driece. “So that’s why it’s so important that you tell us and member states now what you feel and think about this zero draft.” He added that he thought that the INB Bureau had done “a pretty decent job [of synthesizing stakeholders’ inputs]” but “this is an important moment for you all to share whether or not you share my optimism about that and tell us what you think is important”. Prevent ‘zoonotic spillover’ – environmental and animal health groups Across large swathes of Asia and Africa, wholesale markets often sell wild animals captured or bred for food consumption, and which may harbor dangerous viruses. Many scientists believe that SARS-CoV2 was transmitted to humans via live, wild animals, caged for slaughter in Wuhan’s wet market. An unprecedented number of organisations spoke about how the draft needs to pay more attention to pandemic prevention at the source; this means addressing the social, environmental and food safety factors that lead to the spillover of pathogens from wild animal populations into human communities. These drivers range from deforestation which has prompted animal populations like bats, which harbor a range of deadly pathogens from SARS-COV to Marburg, to move closer to human habitats; to wild animal trafficking and trade, both legal and illicit; as well as industrial production, sale and slaugher of wild animal species. The Wildlife Conservation Society recommended that the accord commit governments to “identifying and prioritising actions to prevent pathogen spillover in the first place” by prioritising tougher regulations on “markets and trade chains and wildlife domestic and international trade”. “We have extensive experience and expertise with habitat degredation, deforestation, forest degradation, wildlife trade and wildlife markets,” said the WCS representative. “And this isn’t about illegal trade, its about any live trade, particularly for food but also for other purposes, birds and mammals. We look forward to working with member states and the INB to ensure that first and foremost there are commitments by governments to avoid the spillover in the first place. And we do know how to do that, from a biodiversity perspective and in terms of markets.” The World Wildlife Fund (WWF) appealed for the “list of drivers of pathogen emergence risks to be expanded to include not just deforestation, but ecosystem loss, fragmentation and degradation”. “Deforestation alone omits many of the potentially important pandemic frontiers and ignores the role of fragmentation and degradation in increasing proximity between humans and wildlife,” said the WWF. Meanwhile, the World Organisation of Animal Health (WOAH) called for the inclusion of the full definition of “One Health” in the treaty. Its delegate also questioned why preparedness and response were stressed whereas “preventive actions targeting activities and places that increase the risk of zoonotic spillover” were not. Pointing to a lack of expertise to address zoonotic spillover, the Action for Animal Health Coalition said that member states needed to invest in increasing the animal health workforce. Equity obligations Oxfam’s Piotr Kolczynski, who also represented the People’s Vaccine Alliance. Meanwhile, Oxfam, also representing the People’s Vaccine Alliance, said that “the accord’s language must oblige governments to take specific actions to ensure equity; otherwise it would be very difficult to implement this”. The current zero draft also assumes that “critical public health interventions are based on the willingness of pharmaceutical companies to engage in voluntary mechanisms” but “these have proved to be largely insufficient during the current and previous pandemics,” said Piotr Kolczynski, of Oxfam and PVA. For this reason, it added, “the accord must require governments to invest in research and development and manufacturing capacities and to condition public funding on the sharing of technologies, knowledge and intellectual property with developers and manufacturers in the South”. In reference to the accord’s proposal that 20% of pandemic-related goods be allocated to the WHO for distribution, Oxfam stated that “equitable allocation of medical countermeasures cannot be achieved by reserving a 20% of production for 80% of the world’s population”. Medecins sans Frontieres (MSF), meanwhile, asked for a legal definition of “pandemic”, and “explicit reference to governments complying with international humanitarian law obligations in the context of pandemic preparedness, prevention and response”. It also demanded stronger language in relation to commitments to protect “humanitarian populations of concerns” and healthcare workers during pandemics. Private sector is a ‘critical partner’ IFPMA’s Grega Kumer, Deputy Director of Government Relations. “The private sector should be seen as a critical partner in preparedness, response and recovery, and should have a seat at the table,” stated Grega Kumer, Deputy Director of Government Relations at the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA). However, it warned that some of the accord’s proposals “would jeopardise our capacity to efficiently prepare for the next pandemic.” Key concerns it cited included proposals for a waiver on intellectual property rights (IP) for health products during a pandemic, as well as proposals that would “be “transactionally linking access to pathogens and sharing of benefits”. It also urged the INB to “avoid unnecessary overlaps and duplications including other multilateral organisations mandate and expertise such as WTO and WIPO”. While there were over 200 participants online, a handful of member states were also on hand to listen in person at WHO’s Geneva Headquarters to the inputs as they prepare for INB4, when the real negotiations begin for the accord that is due to be presented by May 2024 to the World Health Assembly. Image Credits: Peter Griffin/Public Domain Pictures. Mpox To Remain A Public Health Emergency of International Concern Says WHO 15/02/2023 Megha Kaveri Dr Tedros Adhanom Ghebreyesus speaking at the media briefing on Wednesday. The World Health Organization (WHO) declared on Wednesday that Mpox will continue to remain a Public Health Emergency of International Concern (PHEIC). The decision to continue with the status quo on Mpox was based on the recommendations made by an Mpox Emergency Committee, whose findings were published on the same day. “The emergency committee for the global outbreak of Mpox met to assess whether, in its view, the outbreak remains a public health emergency of international concern. The committee has advised me that, in its view, Mpox remains a global health emergency, and I have accepted that advice,” Dr Tedros Adhanom Ghebreyesus, director-general of the WHO, said at a press briefing on Wednesday. In its report, the Mpox committee, which met on 9 February, acknowledged the progress made in reducing the virus transmission and the sharp decline of reported cases. However, it also expressed concerns that “a few countries continued to see a sustained incidence of illness” while in other countries it’s likely that more cases are occuring under the radar. “More than 30 countries continue to report cases, and the possible underdetection and under-reporting of confirmed cases in some regions is concerning. Particularly in countries where animal-human transmission of Mpox has been reported before,” Tedros pointed out. In its report, the expert committee also expressed concerns about the possible resurgence of cases due to the expected resumption of LGBTQ social events and other mass gathering events; lack of access to vaccines and testing capacities in many lower-income countries; and the recurring zoonotic transmission in Africa. It added that “not all countries are receiving the support they need or have structures or systems to respond to mpox, including inadequate support for marginalized groups; and general fatigue among supporting agencies.” Returning from Syrian scenes of devastation Tedros spoke at the briefing shortly after returning to Geneva from a visit to earthquake affected areas in Syria. The 7.8 magnitude earthquake that hit Syria and Türkiye last week is now estimated to have killed over 41,000 people. I've never in my life seen the level of destruction as I did on the road from Aleppo to Damascus. Skeletons of houses. Almost no people in sight. Over a decade of war has taken an unimaginable toll. Syrians need our support now and in years to come to rebuild their lives. pic.twitter.com/Ym2zmDixdw — Tedros Adhanom Ghebreyesus (@DrTedros) February 14, 2023 Describing the damage caused to Aleppo and Damascus first due to the war, and now by the earthquake, Tedros said “I saw the destruction of entire communities, the unspeakable suffering of people, and the courage and determination of survivors and responders. As we drove from Aleppo to Damascus, I saw the legacy of conflict, with town after town destroyed and abandoned. Survivors are now facing freezing conditions without adequate shelter, heating, food, clean water, or medical care.” While two more cross-border points between Türkiye and Syria have been opened, Tedros said he had had asked Syrian president Bashar al-Assad to open still more crossings so that relief could reach people in need more rapidly. Humanitarian aid groups charge that the Syrian president has “weaponized aid” channeling available supplies to government controlled areas – while most of western Syria where the earthquake hit, is controlled by Kurdish and other Syrian anti-government militias. “WHO remains committed to supporting all people in the Syrian Arab Republic now and in the days, weeks, months, and years ahead,” Tedros added. The WHO has launched an appeal for $43 million to support its response in Syria and Türkiye and expects the amount to double by this weekend. Meanwhile, UN Secretary General Antonio Guterres called upon countries to fully fund a $397 million earthquake fund for Syria, in particular, which lacks resources to mount its own response. Marburg disease – ramping up diagnostics and clinical trial possibilities Touching back on the Marburg Virus Disease (MVD) outbreak in Equatorial Guinea, which has claimed nine lives, Tedros said that the WHO is working with the country’s health authorities to ramp up their diagnostic capacity. “So far, no confirmed cases have been reported in Cameroon and or Gabon,” he added, referring to the two countries that, along with Liberia, border Equatorial Guinea. “We’re also supporting the governments of Cameroon and Gabon to prepare to rapidly detect, isolate, and provide care for any suspected cases.” Following up on the Marburg Virus Vaccine Consortium (MARVAC)’s meeting on Tuesday, Tedros said that WHO is trying to accelerate talks on possibile clinical trials for Marburg virus diseaes vaccine candidates. But he reiterated that any decision on the trials of vaccines and therapeutics for Marburg needs to be taken by researchers and the national authorities of Equatorial Guinea. “In the meantime, WHO is convening the vaccine prioritization committee to identify which vaccine candidates should be evaluated first and prepare for potential trials. WHO is also discussing with the ministry of health, the possibility of providing access to experimental therapeutics as part of a clinical trial,” he said. Posts navigation Older postsNewer posts
WHO Stands Firm On Using Masks to Combat COVID-19 22/02/2023 Megha Kaveri Dr Maria van Kerkhove, WHO’s Covid-19 technical lead. The World Health Organization (WHO) has reiterated its firm recommendation that wearing masks is an effective method to prevent the spread of COVID-19 in a media briefing on Wednesday. Dr Maria Van Kerkhove, WHO’s technical lead for COVID-19, said that coronavirus is still in circulation and wearing appropriate face masks is one of the ways to prevent the spread of the virus. “I reiterate that the use of masks continues to be part of our strategy to reduce the spread. We have a strategy that is based on vaccinations, on distancing as much as possible as we go about our lives, wearing of well-fitting masks when we’re around others, and particularly on public transportation and certainly among health workers.” In January 2023, Cochrane published a comprehensive analysis of 78 randomized controlled trials (RCTs) conducted in several countries over a period of time, including six RCTs conducted during COVID-19 pandemic, concluded that wearing face masks “makes little or no difference to the outcome of influenza‐like illness (ILI)/COVID-19 like illness compared to not wearing masks”. The study said that there is uncertainty about the effects of face masks. “The pooled results of RCTs did not show a clear reduction in respiratory viral infection with the use of medical/surgical masks. There were no clear differences between the use of medical/surgical masks compared with N95/P2 respirators in healthcare workers when used in routine care to reduce respiratory viral infection.” “There was a systematic review that was published that was looking at randomized controlled trials,” Van Kerkhove said, adding that as an organization, the WHO looks at all available evidence on the issue. “We continue to look at all available evidence that is provided to us, that is published through this pandemic as well as looking at other studies of other respiratory diseases, including flu, influenza-like illness, acute respiratory infections and severe acute respiratory infections,” she added. “Masks remain one of the recommendations that we have because we know that they are effective at preventing some of the transmission. They’re not perfect and that’s why we have a comprehensive strategy, a layered approach of many different types of interventions,” stressed Van Kerkhove. Working around sanctions on Syria The WHO also told the media briefing that it is making the best possible use of the pause in sanctions against Syria to ensure that aid reaches the people who have been affected by the earthquake. Around 47,100 people were killed in the devastating earthquake that struck Syria and parts of Turkiyë on 6 February. Several countries including the US have imposed sanctions on Syria in an attempt to pressurise the regime of Bashar al-Assad to stop killing civilians. However, sanctions have been relaxed to enable aid to reach those affected by the earthquake. Explaining that the WHO is working with other UN partners to procure and mobilize medical equipment and supplies, Dr Abdi Rahaman Mahamud said that the relief work is moving in the right direction. In response to the global mobilization of help to Syria and Turkiyë, the US government released a compliance document on Tuesday for those willing to mobilize aid. Increasingly Brutal Attacks on Civilians by Islamist Rebels Take Toll on Mental Health in DR Congo 22/02/2023 Claude Muhindo Sengenya via The New Humanitarian The town of Beni in the DRC has been the scene of a number of ADF massacres. “We have never experienced such killings,” says an aid work as local health centres struggle to help survivors deal with mental health problems in the aftermath of increasingly brutal attacks by the Islamic rebel group, Allied Democratic Forces. Of the more than 100 armed groups active in DRC’s eastern provinces, one of the oldest and most violent is the Allied Democratic Forces (ADF), a militant movement of Ugandan origins that has pledged allegiance to the so-called Islamic State (IS). With the spotlight on the M23 – which is backed by Rwanda and has seized large chunks of territory in the east – The New Humanitarian spent time speaking with survivors of ADF atrocities and health workers addressing the conflict’s fallout. “I have been supporting displaced people of different wars for 20 years… [but] the ADF massacres have become serious and we have never experienced such killings,” said Marie-Jeanne Masika, who works for a local NGO helping conflict victims. Interviewees said recent measures taken to combat the ADF – from a joint Uganda-DRC military intervention to the introduction of martial law – have failed to improve security for civilians. Instead, the militants have expanded geographically, carrying out massacres, abductions, and bombings in urban areas that have struck targets including a government building, a cinema, and a church in recent months. Those affected by the long-running violence – which centres on North Kivu and Ituri provinces – raised warnings of a rising mental health toll. Yet local health workers said there is an absence of support for those needing psychosocial services. “Today, we must no longer reduce humanitarian assistance to the sole distribution of provisions… to victims,” said Masika. “A big problem also remains psychosocial care to avoid having mental illnesses in the future.” ‘We are in so much pain’ The ADF was formed in 1995 after members fled to DRC amid military pressure in Uganda. It has its roots in the repression of Ugandan Muslims, though its complex history and modus operandi is obscured by narratives that focus solely on its Islamist orientation. Military operations, including by UN peacekeepers, are frequently launched against the group. Yet they often result in ADF reprisal attacks designed to punish civilians who support the army and pressure the government to end offensives. Recent ADF raids have sought to undermine support for Uganda’s operations. That mission – which may be guided by economic interests rather than security concerns – was launched after IS claimed a triple suicide bombing in Kampala in late 2021. A meeting of displaced people who had fled recent ADF massacres healed at a cathedral in Butembo, a town in North Kivu, earlier this month, highlighted the suffering caused by the conflict. Kavugho Sikiliza, 42, said she had lost four of her relatives, including her son and daughter-in-law, in an ADF attack in Bashu chiefdom – in the North Kivu territory of Beni – last September. “We suffer so much. We have abandoned our fields and we no longer find anything to eat,” Kavugho said. “Today, we are spending the night in the bush; we have orphans who are struggling to [eat].” Next to Kavugho sat Yoha Nyasavo Bibiche. Six months ago, she saw her son killed by ADF rebels in Mungamba, in Ituri province. She is now living in Butembo but was recently forced out of her house there because she couldn’t afford rent. “As we were about to harvest, the ADF attacked the village and stabbed my son, who is dead,” said Bibiche. “We no longer have a home. Eating, dressing – it has become a headache.” Mental health toll The cumulative impact of attacks – which have killed thousands over the past decade – has led to serious mental health challenges, according to survivors and medical staff from three psychiatric centres in Beni and Butembo. Esdras Pika, a psychologist at a health centre in Butembo, said his clinic treats survivors of ADF killings, kidnap victims, and farmers and traders struggling to cope with the loss of their livelihoods. “Before 2015, the reasons that led patients to be admitted to mental healthcare here were often drug abuse [and] cases of romantic disappointment,” Pika said. “But today, most of the patients who come to us are victims of insecurity.” Kakule Kisonia, from Beni territory, said his brother went to the local Muyisa psychiatric centre after witnessing a recent ADF attack that cost the lives of his wife, sister, and two of his children. Kisonia said his brother’s behaviour changed after the attack. “Every night he shouted: Ba Nalu! Ba Nalu! [a reference to the ADF in Swahili],” Kisonia said. “Each time a neighbour came, he shouted that it was the ADF, and did not hesitate to take either a wooden stick or a machete to attack the visitors.” More support is needed Medical staff from the health centres said they receive around 30 patients per month who are victims of ADF attacks. Yet the staff said their clinics receive no support from the state or from aid organisations, and that patients must self-finance their treatment. “Most of the victims are in a state of serious vulnerability, but we too are private, unsubsidised structures,” said Pika from the Butembo clinic. “We have to buy the drugs, pay the state taxes, and pay our nursing staff. We have no choice.” Marie-Jeanne Masika, the local NGO worker, said some displaced families have come to her organisation presenting bills of more than $300 issued by health centres for psychiatric support. “It is too much for the victims, who have lost everything in the attacks, and these kinds of bills trouble them rather than relieve them,” said Masika, whose organisation is called Social Integration for the Promotion of the Needy (ISPRON). Mumbere Nyerere, an ADF victim who is receiving therapy, said paying for care represents a “big difficulty”. “I am the father of the family. Those who finance my care are my parents, older than me. It is I who should assist them,” Nyerere said. As attacks continue, Masika called for the government to subsidise clinics providing mental health support and said occupational therapy should be rolled out in villages to “tackle the problem at the base”. Georges Machokuona, a psychosocial worker in Butembo, said livelihood support is needed too: “Once they have returned home, most of those cured are faced with challenges… linked to survival, which led some to fall ill again.” This story was originally published by The New Humanitarian, which puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Image Credits: Robert Flummerfelt/ TNH, The New Humanitarian. Ukraine Gets New Emergency Funds for HIV and TB Programmes 21/02/2023 Kerry Cullinan Alliance Global’s Andrii C shelters in the NGO’s basement in Lviv and waits for air raid sirens to finish. The organisation is helping to get treatment to people living with HIV. On the eve of the first anniversary of Russia’s invasion of Ukraine, the Global Fund to Fight AIDS, Tuberculosis and Malaria has approved an additional $10.32 million in emergency funding to maintain essential HIV and tuberculosis (TB) services in Ukraine. The funds are earmarked for HIV and TB treatment, prevention and care, including for internally displaced persons and hard-to-reach communities. Since the start of the war, more than 13.5 million people have been internally displaced or forced to flee to neighbouring countries as refugees. “If displaced people don’t get the medicines they need, there is a high risk that they will actually die because of the lack of therapy,” said Dmytro Sherembei, head of 100% LIFE, a Global Fund-supported nongovernmental organization delivering HIV medications in war-affected Ukraine. In the past year, the Global Fund has allocated $25.32 million in emergency funds in addition to $119.48 million allocated to Ukraine to support the fight against HIV and TB in the country over the 2021-2023 period. Ukraine has the second-largest HIV epidemic in Eastern Europe and Central Asia, and a high burden of TB, including drug-resistant TB, according to the Global Fund in a statement on Tuesday. “Both HIV and TB require long-term treatment to reduce the risk of transmission and both diseases have the best outcome with early diagnosis. As people escape the fighting, they often lose access to health care and their medications. HIV and TB prevention and diagnosis services have also been significantly disrupted.” Needs more desperate “As the war rages on, the needs in the country are getting more severe and urgent,” said Peter Sands, the Global Fund’s Executive Director. “Damage and destruction to water, electricity and sanitation facilities, health facilities, as well as road and residential infrastructure continue to be reported across multiple areas throughout the country. The additional emergency funding that we are unlocking today is intended to support the government in filling the significant financing gaps across critical HIV and TB interventions. We will continue to monitor the situation closely.” The World Health Organization (WHO) reports that over 1,200 health facilities in the country have been attacked, and 170 of these facilities have been destroyed, leaving healthcare workers and patients displaced, injured or dead. “It’s been a year since the Russian Federation’s invasion of Ukraine, and today, the fighting and deadly missile strikes continue, bringing more destruction and devastating impact in several oblasts of the country,” said Minister of Health of Ukraine Viktor Liashko. “Despite the crisis and challenges, Ukraine’s HIV and TB programs sustained operations. The Global Fund’s investments through the emergency funding, on top of the ongoing grant, have proven invaluable, especially as health facilities have been damaged or destroyed and people continue to be displaced, causing them to lose access to health care, including treatment for HIV and TB.” Over the last 20 years, Ukraine has been a champion in maintaining long-term and innovative HIV and TB programs, according to the Global Fund. More than 100 community-based and community-led organizations have been delivering HIV and TB services to vulnerable people. Image Credits: Global Fund. Scientists Launch R&D Plan to Develop Broad Vaccine for Coronaviruses 21/02/2023 Kerry Cullinan SARS-Co-V2. Fifty influential scientists have developed a coronavirus vaccines research and development (R&D) roadmap aimed at developing broadly protective vaccines to combat fast-evolving coronaviruses threatening humans. “The COVID-19 pandemic marks the third time in just 20 years that a coronavirus has emerged to cause a public health crisis,” said Professor Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP). “Rather than waiting for a fourth coronavirus to emerge — or for the arrival of an especially dangerous SARS-CoV-2 variant — we must act now to develop better, longer-lasting and more broadly protective vaccines,” added Osterholm, whose centre spearheaded the development of the roadmap that was unveiled on Tuesday. CIDRAP unveils roadmap for advancing better coronavirus vaccines The roadmap provides a detailed a strategy to develop broadly protective vaccines—suitable for wide use—to tackle future #COVID19 variants and other worrisome coronaviruseshttps://t.co/yfv7nb5Jnq pic.twitter.com/mQBonJneZc — CIDRAP (@CIDRAP) February 21, 2023 The roadmap sets out steps to accelerate the development of broadly effective coronavirus vaccines capable of preventing severe disease and death that are suitable for all regions worldwide. New SARS-CoV-2 variants pose the most immediate threat and could evolve until they evade the protection of current vaccines. But the bigger fear is the emergence of a super-coronavirus that has the transmissibility of SARSCoV-2 combined with the deadliness of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). MERS-CoV spilled over from camels to humans in 2012 and kills about a third of the people it infects. To head off such a threat, the roadmap proposes a number of approaches. One could involve a stepwise process, starting with vaccines to protect against SARS-CoV-2 variants. As knowledge about coronaviruses expands, it may be possible to develop vaccines that are capable of protecting against multiple types of coronaviruses, including those likely to spill over from animals to humans in the future. “It is critical that we start now to develop vaccines that are future-ready for coronaviruses circulating in animals now, that might infect humans and cause pandemics in the future as SARS-CoV-3 and beyond,” said Professor Linfa Wang, executive director of Singapore’s Programme for Research in Epidemic Preparedness and Response (PREPARE). Wang, who was part of the team that developed the roadmap, also said that the work was daunting: “The coronavirus diversity in bats is so great that we even don’t know how much we really know about them.” Five work areas The roadmap proposes five areas of work: Virology: learning more about the global distribution of coronaviruses circulating in animal reservoirs that have the potential to spill over to humans. Immunology: learning more about human immunology to expand the breadth and durability of immune protection from vaccines and natural infection. This includes a better understanding of mucosal immunity, which may unlock new strategies to block infection such as nasal sprays. Vaccinology: identifying key preferred product characteristics for vaccines, including new technologies and identifying the best methods to assess vaccine efficacy. Animal and human infection models for vaccine research: expanding the range of suitable animal models, which is a key barrier to developing broadly protective coronavirus vaccines. Policy and financing: reinvigorating and sustaining a high level of political commitment and long-term investment in vaccine R&D and manufacturing to ensure the successful development and global distribution of broadly protective coronavirus vaccines. While praising the current COVID-19 vaccines, Wellcome Trust’s Dr Charlie Weller, said the roadmap would research “new ways to deliver vaccines, such as skin patches or intranasal vaccines – and maybe even vaccines that could block transmission”. Constant mutation “Coronaviruses such as SARS-CoV-2 are constantly mutating. With every infection, there is an interplay among host characteristics, past infection, and vaccination – each exerting further pressures on the virus to evolve and acquire further reproductive and fitness advantages,” wrote Dr Margaret Hamburg, former Food and Drug Administration (FDA) commissioner, and Dr Gregory Poland, from the Mayo Clinic’s Vaccine Research Group in the US in a commentary published in the journal, Vaccine. “As a consequence, we are chasing continually evolving viral opponents, leaving the global community in a reactive rather than proactive position in regard to vaccines, therapeutics, and public health policies.” They warn that the global community cannot afford “to play reactive catch up continuously, chasing the latest variant”, or expect people to get vaccinated several times a year. However, Hamburg and Poland added that the roadmap also needs “a governance or administrative structure” to better coordinate vaccine R&D and track progress –and accountability – on the goals and milestones that will further facilitate and accelerate this process. They point to the “siloed” activities by governments, industry and researchers, and how the roadmap can “build bridges between these various sectors” to reduce barriers and duplication, and improve efficiencies. Image Credits: Johnson&Johnson. Natural Immunity Against COVID-19 ‘At Least’ On Par With Vaccination in Preventing Death 21/02/2023 Stefan Anderson Natural immunity provides strong protection against severe illness from COVID-19, but obtaining it carries its own set of risks. New research published in The Lancet suggests that individuals who have previously been infected with COVID-19 have an 88% lower risk of hospitalization or death than those who have not. The study is the most comprehensive review of data on natural immunity to date, covering data from 65 studies across 19 countries published since January 2021. The analysis found that the strength and 10-month duration of protection conferred by natural immunity against severe illness is “at least” on par with that provided by two doses of Moderna and Pfizer-BioNtech’s mRNA vaccines. The study’s authors said the data suggests natural immunity in people recently infected with COVID-19 should be recognised by policymakers but warned against using their findings to undermine the importance of vaccination due to the risks associated with the first infection. “Vaccination is the safest way to acquire immunity, whereas acquiring natural immunity must be weighed against the risks of severe illness and death associated with the initial infection,” lead author Dr Stephen Lim of the University of Washington’s School of Medicine. Researchers also cautioned that differences between the infectious properties of COVID-19 variants mean protection levels can vary. Infection by pre-Omicron variants, for example, yielded substantially lower natural immunity protection against reinfection by the now dominant Omicron BA.1 variant, with just 36% protection remaining after the 10-month window. Nevertheless, protection against hospitalization and death remained high at 88%. “The weaker cross-variant immunity with the Omicron variant and its sub-lineages reflects the mutations they have that make them escape built-up immunity more easily than other variants,” report co-author Dr Hasan Nassereldine of the University of Washington’s School of Medicine said. “The limited data we have on natural immunity protection from the Omicron variant and its sub-lineages underscores the importance of continued assessment, particularly since they are estimated to have infected 46% of the global population between November 2021 and June 2022.” The analysis excluded studies examining “hybrid immunity” (the combination of immune responses from vaccination and natural infection) as well as data relating to Omicron XBB and its sub-lineages. The authors encouraged further research to fill the gaps in the study. Europeans Don’t Exercise Enough – And Policy-Makers Should Do More to Encourage Them 17/02/2023 Kerry Cullinan A third of Europeans don’t meet the World Health Organization’s (WHO) guidelines for physical activity – but if they did, this would avert over 10 000 premature deaths, almost four million cases of cardiovascular disease, three and a half million cases of depression and nearly a million cases of type two diabetes by 2050. This is according to a report launched on Friday by the WHO Europe and the Organisation for Economic Co-operation and Development (OECD), which urges policy-makers to adopt strategies to increase people’s physical activity. The findings are based on a recent Eurobarometer survey conducted for the European Commission which found that 45% of the respondents report that they never exercise or play sport, an increase of 6% since 2009. People in Finland (71%), Luxembourg (63%), the Netherlands (60%), and Denmark and Sweden (both 59%) were the most likely to exercise, while people in Portugal, Greece and Poland were least likely to exercise. “We find that it’s worse among women, with some countries having almost half of all adult women not meeting the WHO recommended guidelines on physical activity,” OECD health policy analyst Sabine Vuik told the launch on Friday. Meanwhile, less than a quarter of people who consider themselves to be working class exercise at least once a week, and over half of all adults surveyed said that they exercised less frequently since the COVID-19 pandemic. Recommended activity The WHO recommends that everyone does at least 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity every week. “This could be a half-hour run twice a week, running about 10 kilometres per hour, but it doesn’t need to be formal exercise. It can also be walking the dog every day for half an hour,” added Vuik. OECD health analyst Sabine Vuik “Our analysis shows that larger countries such as Germany, France and Italy can save more than €1 billion every year if everyone were to meet the physical activity guidelines. And across the EU, we could save €8 billion every year in healthcare expenditure if everyone meets the minimum recommended guidelines.” WHO Europe regional director Dr Hans Kluge, said that the report “provides evidence that investing in policies that promote physical activity not only improves individual well-being and population health, but also pays economic dividends”. “Every €1 invested in physical activity generates an almost two-fold return of €1.7 in economic benefits. We need to communicate the benefits of being active, not just the physical benefits, but the benefits to mental health, the environment and society in the WHO European Region, and we need to make sure that our systems can and will sustain these changes – as real, long-term transformation,” added Kluge, who is an avid cyclist and cycles to work and back daily. The report calls on policymakers to step up the policy response to increase physical activity in schools, in urban and transport design and in healthcare settings and workplaces. Since 2015, some EU countries have adopted policies to improve access to physical activity. For example, Finland adopted a resolution to promote active modes of transportation, Austria builds up co-operation between sports clubs and primary schools and Bulgaria develops a programme to help people whose jobs involve sitting for long periods. Investing in #PhysicalActivity improves individual and population health, while returning 1.7 EUR in economic benefits for every 1 EUR invested. New WHO/@OECD report funded by the #EU shares great ideas for policy makers to consider.👇https://t.co/Ri3xynx9bv@EU_Commission pic.twitter.com/A28qBknwiQ — WHO/Europe (@WHO_Europe) February 17, 2023 Lack of Test Kits for Marburg Virus Hamper Africa’s Response to Outbreak 16/02/2023 Paul Adepoju Dr Ahmed Ogwell Ouma, Acting Director of the Africa Centres for Disease Control. The Africa Centres for Disease Control and Prevention (Africa CDC) is closely monitoring Equatorial Guinea’s first-ever Marburg virus disease outbreak, Africa CDC acting director Dr Ahmed Ogwell Ouma told a media briefing on Thursday “One big challenge we have are test kits and we are working around the clock to try and get test kits to Equatorial Guinea and also to Cameroon and Gabon, to ensure that we have a very short turnaround time for samples being tested in the laboratory,” Ouma added. So far, one case has been confirmed and nine deaths have been reported, while there are 16 suspected cases in quarantine, and another 15 contacts are under observation. All cases have occurred in the province of Kie Ntem in the country’s western region. Ouma added that a key priority is to limit the spread of the virus, as well as monitor neighbouring countries such as Cameroon and Gabon for potential cross-border spillover. As reported by Health Policy Watch, on Tuesday, the WHO received updates from five vaccine developers who have been working on candidate vaccines. The WHO plans to convene a working group to prioritize existing vaccine candidates, with an eye to seeing if clinical trials for any of the vaccines can be launched in real time, particularly if the outbreak expands. Diphtheria, cholera, mpox, Lassa fever, and measles are some of the other health emergencies that African countries are also grappling with, alongside COVID-19, and Ouma, a Kenyan epidemiologist, said that his center is currently monitoring up to nine different public health events. Nigeria reported over 600 new cases of diphtheria and several African countries reported cases of cholera, including Malawi, where three-quarters of the continent’s cases have been reported. The continent has documented over 12 million cases of COVID-19 and 256,705 deaths, a case fatality rate of 2.1%, which is double the global average, Ouma told the media. While the number of new cases and deaths have decreased over the past several weeks, he emphasized the importance of continuing to encourage vaccination efforts and targeted campaigns to reach more people. “The general trend on the continent now is quite flat with the indications that we may be seeing further decreases in numbers and also in deaths,” Ouma told journalists. Ouma noted that Africa CDC is working with governments and health organizations to provide technical assistance and medical countermeasures as needed for these and other health emergencies. He added that the organization is also continuing to promote vaccination efforts and targeted campaigns to help prevent the spread of infectious diseases. Draft Pandemic Accord Neglects Prevention, Particularly ‘Zoonotic Spillover’ 15/02/2023 Kerry Cullinan INB co-chair Roland Driece The draft pandemic accord needs more emphasis on preventing pandemics at their source – where animal pathogens “spill over” to people – according to a number of organisations participating in a consultation on the document’s “zero draft” on Wednesday. Negotiations between World Health Organization (WHO) member states on the draft are due to begin at the fourth meeting of the Intergovernmental Negotiating Body (INB), scheduled to take place from 27 February to 3 March. However, Wednesday’s meeting gave WHO’s civil society stakeholders an opportunity to comment on the draft ahead of that meeting. Only member states will take part in the actual treaty negotiations, which are likely to start behind closed doors on the second day of the month-end meeting (called INB 4), INB co-chair Roland Driece told the meeting. INB 4 and the following INB5 meeting from 3 to 6 April would be approached as “one big meeting”, he added. While the start of the meeting would be open to all stakeholders, “as soon as member states tell us that they accept the zero draft as the zero draft, we will move into negotiation mode, and that means that only member states can be present,” said Driece. “So that’s why it’s so important that you tell us and member states now what you feel and think about this zero draft.” He added that he thought that the INB Bureau had done “a pretty decent job [of synthesizing stakeholders’ inputs]” but “this is an important moment for you all to share whether or not you share my optimism about that and tell us what you think is important”. Prevent ‘zoonotic spillover’ – environmental and animal health groups Across large swathes of Asia and Africa, wholesale markets often sell wild animals captured or bred for food consumption, and which may harbor dangerous viruses. Many scientists believe that SARS-CoV2 was transmitted to humans via live, wild animals, caged for slaughter in Wuhan’s wet market. An unprecedented number of organisations spoke about how the draft needs to pay more attention to pandemic prevention at the source; this means addressing the social, environmental and food safety factors that lead to the spillover of pathogens from wild animal populations into human communities. These drivers range from deforestation which has prompted animal populations like bats, which harbor a range of deadly pathogens from SARS-COV to Marburg, to move closer to human habitats; to wild animal trafficking and trade, both legal and illicit; as well as industrial production, sale and slaugher of wild animal species. The Wildlife Conservation Society recommended that the accord commit governments to “identifying and prioritising actions to prevent pathogen spillover in the first place” by prioritising tougher regulations on “markets and trade chains and wildlife domestic and international trade”. “We have extensive experience and expertise with habitat degredation, deforestation, forest degradation, wildlife trade and wildlife markets,” said the WCS representative. “And this isn’t about illegal trade, its about any live trade, particularly for food but also for other purposes, birds and mammals. We look forward to working with member states and the INB to ensure that first and foremost there are commitments by governments to avoid the spillover in the first place. And we do know how to do that, from a biodiversity perspective and in terms of markets.” The World Wildlife Fund (WWF) appealed for the “list of drivers of pathogen emergence risks to be expanded to include not just deforestation, but ecosystem loss, fragmentation and degradation”. “Deforestation alone omits many of the potentially important pandemic frontiers and ignores the role of fragmentation and degradation in increasing proximity between humans and wildlife,” said the WWF. Meanwhile, the World Organisation of Animal Health (WOAH) called for the inclusion of the full definition of “One Health” in the treaty. Its delegate also questioned why preparedness and response were stressed whereas “preventive actions targeting activities and places that increase the risk of zoonotic spillover” were not. Pointing to a lack of expertise to address zoonotic spillover, the Action for Animal Health Coalition said that member states needed to invest in increasing the animal health workforce. Equity obligations Oxfam’s Piotr Kolczynski, who also represented the People’s Vaccine Alliance. Meanwhile, Oxfam, also representing the People’s Vaccine Alliance, said that “the accord’s language must oblige governments to take specific actions to ensure equity; otherwise it would be very difficult to implement this”. The current zero draft also assumes that “critical public health interventions are based on the willingness of pharmaceutical companies to engage in voluntary mechanisms” but “these have proved to be largely insufficient during the current and previous pandemics,” said Piotr Kolczynski, of Oxfam and PVA. For this reason, it added, “the accord must require governments to invest in research and development and manufacturing capacities and to condition public funding on the sharing of technologies, knowledge and intellectual property with developers and manufacturers in the South”. In reference to the accord’s proposal that 20% of pandemic-related goods be allocated to the WHO for distribution, Oxfam stated that “equitable allocation of medical countermeasures cannot be achieved by reserving a 20% of production for 80% of the world’s population”. Medecins sans Frontieres (MSF), meanwhile, asked for a legal definition of “pandemic”, and “explicit reference to governments complying with international humanitarian law obligations in the context of pandemic preparedness, prevention and response”. It also demanded stronger language in relation to commitments to protect “humanitarian populations of concerns” and healthcare workers during pandemics. Private sector is a ‘critical partner’ IFPMA’s Grega Kumer, Deputy Director of Government Relations. “The private sector should be seen as a critical partner in preparedness, response and recovery, and should have a seat at the table,” stated Grega Kumer, Deputy Director of Government Relations at the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA). However, it warned that some of the accord’s proposals “would jeopardise our capacity to efficiently prepare for the next pandemic.” Key concerns it cited included proposals for a waiver on intellectual property rights (IP) for health products during a pandemic, as well as proposals that would “be “transactionally linking access to pathogens and sharing of benefits”. It also urged the INB to “avoid unnecessary overlaps and duplications including other multilateral organisations mandate and expertise such as WTO and WIPO”. While there were over 200 participants online, a handful of member states were also on hand to listen in person at WHO’s Geneva Headquarters to the inputs as they prepare for INB4, when the real negotiations begin for the accord that is due to be presented by May 2024 to the World Health Assembly. Image Credits: Peter Griffin/Public Domain Pictures. Mpox To Remain A Public Health Emergency of International Concern Says WHO 15/02/2023 Megha Kaveri Dr Tedros Adhanom Ghebreyesus speaking at the media briefing on Wednesday. The World Health Organization (WHO) declared on Wednesday that Mpox will continue to remain a Public Health Emergency of International Concern (PHEIC). The decision to continue with the status quo on Mpox was based on the recommendations made by an Mpox Emergency Committee, whose findings were published on the same day. “The emergency committee for the global outbreak of Mpox met to assess whether, in its view, the outbreak remains a public health emergency of international concern. The committee has advised me that, in its view, Mpox remains a global health emergency, and I have accepted that advice,” Dr Tedros Adhanom Ghebreyesus, director-general of the WHO, said at a press briefing on Wednesday. In its report, the Mpox committee, which met on 9 February, acknowledged the progress made in reducing the virus transmission and the sharp decline of reported cases. However, it also expressed concerns that “a few countries continued to see a sustained incidence of illness” while in other countries it’s likely that more cases are occuring under the radar. “More than 30 countries continue to report cases, and the possible underdetection and under-reporting of confirmed cases in some regions is concerning. Particularly in countries where animal-human transmission of Mpox has been reported before,” Tedros pointed out. In its report, the expert committee also expressed concerns about the possible resurgence of cases due to the expected resumption of LGBTQ social events and other mass gathering events; lack of access to vaccines and testing capacities in many lower-income countries; and the recurring zoonotic transmission in Africa. It added that “not all countries are receiving the support they need or have structures or systems to respond to mpox, including inadequate support for marginalized groups; and general fatigue among supporting agencies.” Returning from Syrian scenes of devastation Tedros spoke at the briefing shortly after returning to Geneva from a visit to earthquake affected areas in Syria. The 7.8 magnitude earthquake that hit Syria and Türkiye last week is now estimated to have killed over 41,000 people. I've never in my life seen the level of destruction as I did on the road from Aleppo to Damascus. Skeletons of houses. Almost no people in sight. Over a decade of war has taken an unimaginable toll. Syrians need our support now and in years to come to rebuild their lives. pic.twitter.com/Ym2zmDixdw — Tedros Adhanom Ghebreyesus (@DrTedros) February 14, 2023 Describing the damage caused to Aleppo and Damascus first due to the war, and now by the earthquake, Tedros said “I saw the destruction of entire communities, the unspeakable suffering of people, and the courage and determination of survivors and responders. As we drove from Aleppo to Damascus, I saw the legacy of conflict, with town after town destroyed and abandoned. Survivors are now facing freezing conditions without adequate shelter, heating, food, clean water, or medical care.” While two more cross-border points between Türkiye and Syria have been opened, Tedros said he had had asked Syrian president Bashar al-Assad to open still more crossings so that relief could reach people in need more rapidly. Humanitarian aid groups charge that the Syrian president has “weaponized aid” channeling available supplies to government controlled areas – while most of western Syria where the earthquake hit, is controlled by Kurdish and other Syrian anti-government militias. “WHO remains committed to supporting all people in the Syrian Arab Republic now and in the days, weeks, months, and years ahead,” Tedros added. The WHO has launched an appeal for $43 million to support its response in Syria and Türkiye and expects the amount to double by this weekend. Meanwhile, UN Secretary General Antonio Guterres called upon countries to fully fund a $397 million earthquake fund for Syria, in particular, which lacks resources to mount its own response. Marburg disease – ramping up diagnostics and clinical trial possibilities Touching back on the Marburg Virus Disease (MVD) outbreak in Equatorial Guinea, which has claimed nine lives, Tedros said that the WHO is working with the country’s health authorities to ramp up their diagnostic capacity. “So far, no confirmed cases have been reported in Cameroon and or Gabon,” he added, referring to the two countries that, along with Liberia, border Equatorial Guinea. “We’re also supporting the governments of Cameroon and Gabon to prepare to rapidly detect, isolate, and provide care for any suspected cases.” Following up on the Marburg Virus Vaccine Consortium (MARVAC)’s meeting on Tuesday, Tedros said that WHO is trying to accelerate talks on possibile clinical trials for Marburg virus diseaes vaccine candidates. But he reiterated that any decision on the trials of vaccines and therapeutics for Marburg needs to be taken by researchers and the national authorities of Equatorial Guinea. “In the meantime, WHO is convening the vaccine prioritization committee to identify which vaccine candidates should be evaluated first and prepare for potential trials. WHO is also discussing with the ministry of health, the possibility of providing access to experimental therapeutics as part of a clinical trial,” he said. Posts navigation Older postsNewer posts
Increasingly Brutal Attacks on Civilians by Islamist Rebels Take Toll on Mental Health in DR Congo 22/02/2023 Claude Muhindo Sengenya via The New Humanitarian The town of Beni in the DRC has been the scene of a number of ADF massacres. “We have never experienced such killings,” says an aid work as local health centres struggle to help survivors deal with mental health problems in the aftermath of increasingly brutal attacks by the Islamic rebel group, Allied Democratic Forces. Of the more than 100 armed groups active in DRC’s eastern provinces, one of the oldest and most violent is the Allied Democratic Forces (ADF), a militant movement of Ugandan origins that has pledged allegiance to the so-called Islamic State (IS). With the spotlight on the M23 – which is backed by Rwanda and has seized large chunks of territory in the east – The New Humanitarian spent time speaking with survivors of ADF atrocities and health workers addressing the conflict’s fallout. “I have been supporting displaced people of different wars for 20 years… [but] the ADF massacres have become serious and we have never experienced such killings,” said Marie-Jeanne Masika, who works for a local NGO helping conflict victims. Interviewees said recent measures taken to combat the ADF – from a joint Uganda-DRC military intervention to the introduction of martial law – have failed to improve security for civilians. Instead, the militants have expanded geographically, carrying out massacres, abductions, and bombings in urban areas that have struck targets including a government building, a cinema, and a church in recent months. Those affected by the long-running violence – which centres on North Kivu and Ituri provinces – raised warnings of a rising mental health toll. Yet local health workers said there is an absence of support for those needing psychosocial services. “Today, we must no longer reduce humanitarian assistance to the sole distribution of provisions… to victims,” said Masika. “A big problem also remains psychosocial care to avoid having mental illnesses in the future.” ‘We are in so much pain’ The ADF was formed in 1995 after members fled to DRC amid military pressure in Uganda. It has its roots in the repression of Ugandan Muslims, though its complex history and modus operandi is obscured by narratives that focus solely on its Islamist orientation. Military operations, including by UN peacekeepers, are frequently launched against the group. Yet they often result in ADF reprisal attacks designed to punish civilians who support the army and pressure the government to end offensives. Recent ADF raids have sought to undermine support for Uganda’s operations. That mission – which may be guided by economic interests rather than security concerns – was launched after IS claimed a triple suicide bombing in Kampala in late 2021. A meeting of displaced people who had fled recent ADF massacres healed at a cathedral in Butembo, a town in North Kivu, earlier this month, highlighted the suffering caused by the conflict. Kavugho Sikiliza, 42, said she had lost four of her relatives, including her son and daughter-in-law, in an ADF attack in Bashu chiefdom – in the North Kivu territory of Beni – last September. “We suffer so much. We have abandoned our fields and we no longer find anything to eat,” Kavugho said. “Today, we are spending the night in the bush; we have orphans who are struggling to [eat].” Next to Kavugho sat Yoha Nyasavo Bibiche. Six months ago, she saw her son killed by ADF rebels in Mungamba, in Ituri province. She is now living in Butembo but was recently forced out of her house there because she couldn’t afford rent. “As we were about to harvest, the ADF attacked the village and stabbed my son, who is dead,” said Bibiche. “We no longer have a home. Eating, dressing – it has become a headache.” Mental health toll The cumulative impact of attacks – which have killed thousands over the past decade – has led to serious mental health challenges, according to survivors and medical staff from three psychiatric centres in Beni and Butembo. Esdras Pika, a psychologist at a health centre in Butembo, said his clinic treats survivors of ADF killings, kidnap victims, and farmers and traders struggling to cope with the loss of their livelihoods. “Before 2015, the reasons that led patients to be admitted to mental healthcare here were often drug abuse [and] cases of romantic disappointment,” Pika said. “But today, most of the patients who come to us are victims of insecurity.” Kakule Kisonia, from Beni territory, said his brother went to the local Muyisa psychiatric centre after witnessing a recent ADF attack that cost the lives of his wife, sister, and two of his children. Kisonia said his brother’s behaviour changed after the attack. “Every night he shouted: Ba Nalu! Ba Nalu! [a reference to the ADF in Swahili],” Kisonia said. “Each time a neighbour came, he shouted that it was the ADF, and did not hesitate to take either a wooden stick or a machete to attack the visitors.” More support is needed Medical staff from the health centres said they receive around 30 patients per month who are victims of ADF attacks. Yet the staff said their clinics receive no support from the state or from aid organisations, and that patients must self-finance their treatment. “Most of the victims are in a state of serious vulnerability, but we too are private, unsubsidised structures,” said Pika from the Butembo clinic. “We have to buy the drugs, pay the state taxes, and pay our nursing staff. We have no choice.” Marie-Jeanne Masika, the local NGO worker, said some displaced families have come to her organisation presenting bills of more than $300 issued by health centres for psychiatric support. “It is too much for the victims, who have lost everything in the attacks, and these kinds of bills trouble them rather than relieve them,” said Masika, whose organisation is called Social Integration for the Promotion of the Needy (ISPRON). Mumbere Nyerere, an ADF victim who is receiving therapy, said paying for care represents a “big difficulty”. “I am the father of the family. Those who finance my care are my parents, older than me. It is I who should assist them,” Nyerere said. As attacks continue, Masika called for the government to subsidise clinics providing mental health support and said occupational therapy should be rolled out in villages to “tackle the problem at the base”. Georges Machokuona, a psychosocial worker in Butembo, said livelihood support is needed too: “Once they have returned home, most of those cured are faced with challenges… linked to survival, which led some to fall ill again.” This story was originally published by The New Humanitarian, which puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world. Image Credits: Robert Flummerfelt/ TNH, The New Humanitarian. Ukraine Gets New Emergency Funds for HIV and TB Programmes 21/02/2023 Kerry Cullinan Alliance Global’s Andrii C shelters in the NGO’s basement in Lviv and waits for air raid sirens to finish. The organisation is helping to get treatment to people living with HIV. On the eve of the first anniversary of Russia’s invasion of Ukraine, the Global Fund to Fight AIDS, Tuberculosis and Malaria has approved an additional $10.32 million in emergency funding to maintain essential HIV and tuberculosis (TB) services in Ukraine. The funds are earmarked for HIV and TB treatment, prevention and care, including for internally displaced persons and hard-to-reach communities. Since the start of the war, more than 13.5 million people have been internally displaced or forced to flee to neighbouring countries as refugees. “If displaced people don’t get the medicines they need, there is a high risk that they will actually die because of the lack of therapy,” said Dmytro Sherembei, head of 100% LIFE, a Global Fund-supported nongovernmental organization delivering HIV medications in war-affected Ukraine. In the past year, the Global Fund has allocated $25.32 million in emergency funds in addition to $119.48 million allocated to Ukraine to support the fight against HIV and TB in the country over the 2021-2023 period. Ukraine has the second-largest HIV epidemic in Eastern Europe and Central Asia, and a high burden of TB, including drug-resistant TB, according to the Global Fund in a statement on Tuesday. “Both HIV and TB require long-term treatment to reduce the risk of transmission and both diseases have the best outcome with early diagnosis. As people escape the fighting, they often lose access to health care and their medications. HIV and TB prevention and diagnosis services have also been significantly disrupted.” Needs more desperate “As the war rages on, the needs in the country are getting more severe and urgent,” said Peter Sands, the Global Fund’s Executive Director. “Damage and destruction to water, electricity and sanitation facilities, health facilities, as well as road and residential infrastructure continue to be reported across multiple areas throughout the country. The additional emergency funding that we are unlocking today is intended to support the government in filling the significant financing gaps across critical HIV and TB interventions. We will continue to monitor the situation closely.” The World Health Organization (WHO) reports that over 1,200 health facilities in the country have been attacked, and 170 of these facilities have been destroyed, leaving healthcare workers and patients displaced, injured or dead. “It’s been a year since the Russian Federation’s invasion of Ukraine, and today, the fighting and deadly missile strikes continue, bringing more destruction and devastating impact in several oblasts of the country,” said Minister of Health of Ukraine Viktor Liashko. “Despite the crisis and challenges, Ukraine’s HIV and TB programs sustained operations. The Global Fund’s investments through the emergency funding, on top of the ongoing grant, have proven invaluable, especially as health facilities have been damaged or destroyed and people continue to be displaced, causing them to lose access to health care, including treatment for HIV and TB.” Over the last 20 years, Ukraine has been a champion in maintaining long-term and innovative HIV and TB programs, according to the Global Fund. More than 100 community-based and community-led organizations have been delivering HIV and TB services to vulnerable people. Image Credits: Global Fund. Scientists Launch R&D Plan to Develop Broad Vaccine for Coronaviruses 21/02/2023 Kerry Cullinan SARS-Co-V2. Fifty influential scientists have developed a coronavirus vaccines research and development (R&D) roadmap aimed at developing broadly protective vaccines to combat fast-evolving coronaviruses threatening humans. “The COVID-19 pandemic marks the third time in just 20 years that a coronavirus has emerged to cause a public health crisis,” said Professor Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP). “Rather than waiting for a fourth coronavirus to emerge — or for the arrival of an especially dangerous SARS-CoV-2 variant — we must act now to develop better, longer-lasting and more broadly protective vaccines,” added Osterholm, whose centre spearheaded the development of the roadmap that was unveiled on Tuesday. CIDRAP unveils roadmap for advancing better coronavirus vaccines The roadmap provides a detailed a strategy to develop broadly protective vaccines—suitable for wide use—to tackle future #COVID19 variants and other worrisome coronaviruseshttps://t.co/yfv7nb5Jnq pic.twitter.com/mQBonJneZc — CIDRAP (@CIDRAP) February 21, 2023 The roadmap sets out steps to accelerate the development of broadly effective coronavirus vaccines capable of preventing severe disease and death that are suitable for all regions worldwide. New SARS-CoV-2 variants pose the most immediate threat and could evolve until they evade the protection of current vaccines. But the bigger fear is the emergence of a super-coronavirus that has the transmissibility of SARSCoV-2 combined with the deadliness of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). MERS-CoV spilled over from camels to humans in 2012 and kills about a third of the people it infects. To head off such a threat, the roadmap proposes a number of approaches. One could involve a stepwise process, starting with vaccines to protect against SARS-CoV-2 variants. As knowledge about coronaviruses expands, it may be possible to develop vaccines that are capable of protecting against multiple types of coronaviruses, including those likely to spill over from animals to humans in the future. “It is critical that we start now to develop vaccines that are future-ready for coronaviruses circulating in animals now, that might infect humans and cause pandemics in the future as SARS-CoV-3 and beyond,” said Professor Linfa Wang, executive director of Singapore’s Programme for Research in Epidemic Preparedness and Response (PREPARE). Wang, who was part of the team that developed the roadmap, also said that the work was daunting: “The coronavirus diversity in bats is so great that we even don’t know how much we really know about them.” Five work areas The roadmap proposes five areas of work: Virology: learning more about the global distribution of coronaviruses circulating in animal reservoirs that have the potential to spill over to humans. Immunology: learning more about human immunology to expand the breadth and durability of immune protection from vaccines and natural infection. This includes a better understanding of mucosal immunity, which may unlock new strategies to block infection such as nasal sprays. Vaccinology: identifying key preferred product characteristics for vaccines, including new technologies and identifying the best methods to assess vaccine efficacy. Animal and human infection models for vaccine research: expanding the range of suitable animal models, which is a key barrier to developing broadly protective coronavirus vaccines. Policy and financing: reinvigorating and sustaining a high level of political commitment and long-term investment in vaccine R&D and manufacturing to ensure the successful development and global distribution of broadly protective coronavirus vaccines. While praising the current COVID-19 vaccines, Wellcome Trust’s Dr Charlie Weller, said the roadmap would research “new ways to deliver vaccines, such as skin patches or intranasal vaccines – and maybe even vaccines that could block transmission”. Constant mutation “Coronaviruses such as SARS-CoV-2 are constantly mutating. With every infection, there is an interplay among host characteristics, past infection, and vaccination – each exerting further pressures on the virus to evolve and acquire further reproductive and fitness advantages,” wrote Dr Margaret Hamburg, former Food and Drug Administration (FDA) commissioner, and Dr Gregory Poland, from the Mayo Clinic’s Vaccine Research Group in the US in a commentary published in the journal, Vaccine. “As a consequence, we are chasing continually evolving viral opponents, leaving the global community in a reactive rather than proactive position in regard to vaccines, therapeutics, and public health policies.” They warn that the global community cannot afford “to play reactive catch up continuously, chasing the latest variant”, or expect people to get vaccinated several times a year. However, Hamburg and Poland added that the roadmap also needs “a governance or administrative structure” to better coordinate vaccine R&D and track progress –and accountability – on the goals and milestones that will further facilitate and accelerate this process. They point to the “siloed” activities by governments, industry and researchers, and how the roadmap can “build bridges between these various sectors” to reduce barriers and duplication, and improve efficiencies. Image Credits: Johnson&Johnson. Natural Immunity Against COVID-19 ‘At Least’ On Par With Vaccination in Preventing Death 21/02/2023 Stefan Anderson Natural immunity provides strong protection against severe illness from COVID-19, but obtaining it carries its own set of risks. New research published in The Lancet suggests that individuals who have previously been infected with COVID-19 have an 88% lower risk of hospitalization or death than those who have not. The study is the most comprehensive review of data on natural immunity to date, covering data from 65 studies across 19 countries published since January 2021. The analysis found that the strength and 10-month duration of protection conferred by natural immunity against severe illness is “at least” on par with that provided by two doses of Moderna and Pfizer-BioNtech’s mRNA vaccines. The study’s authors said the data suggests natural immunity in people recently infected with COVID-19 should be recognised by policymakers but warned against using their findings to undermine the importance of vaccination due to the risks associated with the first infection. “Vaccination is the safest way to acquire immunity, whereas acquiring natural immunity must be weighed against the risks of severe illness and death associated with the initial infection,” lead author Dr Stephen Lim of the University of Washington’s School of Medicine. Researchers also cautioned that differences between the infectious properties of COVID-19 variants mean protection levels can vary. Infection by pre-Omicron variants, for example, yielded substantially lower natural immunity protection against reinfection by the now dominant Omicron BA.1 variant, with just 36% protection remaining after the 10-month window. Nevertheless, protection against hospitalization and death remained high at 88%. “The weaker cross-variant immunity with the Omicron variant and its sub-lineages reflects the mutations they have that make them escape built-up immunity more easily than other variants,” report co-author Dr Hasan Nassereldine of the University of Washington’s School of Medicine said. “The limited data we have on natural immunity protection from the Omicron variant and its sub-lineages underscores the importance of continued assessment, particularly since they are estimated to have infected 46% of the global population between November 2021 and June 2022.” The analysis excluded studies examining “hybrid immunity” (the combination of immune responses from vaccination and natural infection) as well as data relating to Omicron XBB and its sub-lineages. The authors encouraged further research to fill the gaps in the study. Europeans Don’t Exercise Enough – And Policy-Makers Should Do More to Encourage Them 17/02/2023 Kerry Cullinan A third of Europeans don’t meet the World Health Organization’s (WHO) guidelines for physical activity – but if they did, this would avert over 10 000 premature deaths, almost four million cases of cardiovascular disease, three and a half million cases of depression and nearly a million cases of type two diabetes by 2050. This is according to a report launched on Friday by the WHO Europe and the Organisation for Economic Co-operation and Development (OECD), which urges policy-makers to adopt strategies to increase people’s physical activity. The findings are based on a recent Eurobarometer survey conducted for the European Commission which found that 45% of the respondents report that they never exercise or play sport, an increase of 6% since 2009. People in Finland (71%), Luxembourg (63%), the Netherlands (60%), and Denmark and Sweden (both 59%) were the most likely to exercise, while people in Portugal, Greece and Poland were least likely to exercise. “We find that it’s worse among women, with some countries having almost half of all adult women not meeting the WHO recommended guidelines on physical activity,” OECD health policy analyst Sabine Vuik told the launch on Friday. Meanwhile, less than a quarter of people who consider themselves to be working class exercise at least once a week, and over half of all adults surveyed said that they exercised less frequently since the COVID-19 pandemic. Recommended activity The WHO recommends that everyone does at least 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity every week. “This could be a half-hour run twice a week, running about 10 kilometres per hour, but it doesn’t need to be formal exercise. It can also be walking the dog every day for half an hour,” added Vuik. OECD health analyst Sabine Vuik “Our analysis shows that larger countries such as Germany, France and Italy can save more than €1 billion every year if everyone were to meet the physical activity guidelines. And across the EU, we could save €8 billion every year in healthcare expenditure if everyone meets the minimum recommended guidelines.” WHO Europe regional director Dr Hans Kluge, said that the report “provides evidence that investing in policies that promote physical activity not only improves individual well-being and population health, but also pays economic dividends”. “Every €1 invested in physical activity generates an almost two-fold return of €1.7 in economic benefits. We need to communicate the benefits of being active, not just the physical benefits, but the benefits to mental health, the environment and society in the WHO European Region, and we need to make sure that our systems can and will sustain these changes – as real, long-term transformation,” added Kluge, who is an avid cyclist and cycles to work and back daily. The report calls on policymakers to step up the policy response to increase physical activity in schools, in urban and transport design and in healthcare settings and workplaces. Since 2015, some EU countries have adopted policies to improve access to physical activity. For example, Finland adopted a resolution to promote active modes of transportation, Austria builds up co-operation between sports clubs and primary schools and Bulgaria develops a programme to help people whose jobs involve sitting for long periods. Investing in #PhysicalActivity improves individual and population health, while returning 1.7 EUR in economic benefits for every 1 EUR invested. New WHO/@OECD report funded by the #EU shares great ideas for policy makers to consider.👇https://t.co/Ri3xynx9bv@EU_Commission pic.twitter.com/A28qBknwiQ — WHO/Europe (@WHO_Europe) February 17, 2023 Lack of Test Kits for Marburg Virus Hamper Africa’s Response to Outbreak 16/02/2023 Paul Adepoju Dr Ahmed Ogwell Ouma, Acting Director of the Africa Centres for Disease Control. The Africa Centres for Disease Control and Prevention (Africa CDC) is closely monitoring Equatorial Guinea’s first-ever Marburg virus disease outbreak, Africa CDC acting director Dr Ahmed Ogwell Ouma told a media briefing on Thursday “One big challenge we have are test kits and we are working around the clock to try and get test kits to Equatorial Guinea and also to Cameroon and Gabon, to ensure that we have a very short turnaround time for samples being tested in the laboratory,” Ouma added. So far, one case has been confirmed and nine deaths have been reported, while there are 16 suspected cases in quarantine, and another 15 contacts are under observation. All cases have occurred in the province of Kie Ntem in the country’s western region. Ouma added that a key priority is to limit the spread of the virus, as well as monitor neighbouring countries such as Cameroon and Gabon for potential cross-border spillover. As reported by Health Policy Watch, on Tuesday, the WHO received updates from five vaccine developers who have been working on candidate vaccines. The WHO plans to convene a working group to prioritize existing vaccine candidates, with an eye to seeing if clinical trials for any of the vaccines can be launched in real time, particularly if the outbreak expands. Diphtheria, cholera, mpox, Lassa fever, and measles are some of the other health emergencies that African countries are also grappling with, alongside COVID-19, and Ouma, a Kenyan epidemiologist, said that his center is currently monitoring up to nine different public health events. Nigeria reported over 600 new cases of diphtheria and several African countries reported cases of cholera, including Malawi, where three-quarters of the continent’s cases have been reported. The continent has documented over 12 million cases of COVID-19 and 256,705 deaths, a case fatality rate of 2.1%, which is double the global average, Ouma told the media. While the number of new cases and deaths have decreased over the past several weeks, he emphasized the importance of continuing to encourage vaccination efforts and targeted campaigns to reach more people. “The general trend on the continent now is quite flat with the indications that we may be seeing further decreases in numbers and also in deaths,” Ouma told journalists. Ouma noted that Africa CDC is working with governments and health organizations to provide technical assistance and medical countermeasures as needed for these and other health emergencies. He added that the organization is also continuing to promote vaccination efforts and targeted campaigns to help prevent the spread of infectious diseases. Draft Pandemic Accord Neglects Prevention, Particularly ‘Zoonotic Spillover’ 15/02/2023 Kerry Cullinan INB co-chair Roland Driece The draft pandemic accord needs more emphasis on preventing pandemics at their source – where animal pathogens “spill over” to people – according to a number of organisations participating in a consultation on the document’s “zero draft” on Wednesday. Negotiations between World Health Organization (WHO) member states on the draft are due to begin at the fourth meeting of the Intergovernmental Negotiating Body (INB), scheduled to take place from 27 February to 3 March. However, Wednesday’s meeting gave WHO’s civil society stakeholders an opportunity to comment on the draft ahead of that meeting. Only member states will take part in the actual treaty negotiations, which are likely to start behind closed doors on the second day of the month-end meeting (called INB 4), INB co-chair Roland Driece told the meeting. INB 4 and the following INB5 meeting from 3 to 6 April would be approached as “one big meeting”, he added. While the start of the meeting would be open to all stakeholders, “as soon as member states tell us that they accept the zero draft as the zero draft, we will move into negotiation mode, and that means that only member states can be present,” said Driece. “So that’s why it’s so important that you tell us and member states now what you feel and think about this zero draft.” He added that he thought that the INB Bureau had done “a pretty decent job [of synthesizing stakeholders’ inputs]” but “this is an important moment for you all to share whether or not you share my optimism about that and tell us what you think is important”. Prevent ‘zoonotic spillover’ – environmental and animal health groups Across large swathes of Asia and Africa, wholesale markets often sell wild animals captured or bred for food consumption, and which may harbor dangerous viruses. Many scientists believe that SARS-CoV2 was transmitted to humans via live, wild animals, caged for slaughter in Wuhan’s wet market. An unprecedented number of organisations spoke about how the draft needs to pay more attention to pandemic prevention at the source; this means addressing the social, environmental and food safety factors that lead to the spillover of pathogens from wild animal populations into human communities. These drivers range from deforestation which has prompted animal populations like bats, which harbor a range of deadly pathogens from SARS-COV to Marburg, to move closer to human habitats; to wild animal trafficking and trade, both legal and illicit; as well as industrial production, sale and slaugher of wild animal species. The Wildlife Conservation Society recommended that the accord commit governments to “identifying and prioritising actions to prevent pathogen spillover in the first place” by prioritising tougher regulations on “markets and trade chains and wildlife domestic and international trade”. “We have extensive experience and expertise with habitat degredation, deforestation, forest degradation, wildlife trade and wildlife markets,” said the WCS representative. “And this isn’t about illegal trade, its about any live trade, particularly for food but also for other purposes, birds and mammals. We look forward to working with member states and the INB to ensure that first and foremost there are commitments by governments to avoid the spillover in the first place. And we do know how to do that, from a biodiversity perspective and in terms of markets.” The World Wildlife Fund (WWF) appealed for the “list of drivers of pathogen emergence risks to be expanded to include not just deforestation, but ecosystem loss, fragmentation and degradation”. “Deforestation alone omits many of the potentially important pandemic frontiers and ignores the role of fragmentation and degradation in increasing proximity between humans and wildlife,” said the WWF. Meanwhile, the World Organisation of Animal Health (WOAH) called for the inclusion of the full definition of “One Health” in the treaty. Its delegate also questioned why preparedness and response were stressed whereas “preventive actions targeting activities and places that increase the risk of zoonotic spillover” were not. Pointing to a lack of expertise to address zoonotic spillover, the Action for Animal Health Coalition said that member states needed to invest in increasing the animal health workforce. Equity obligations Oxfam’s Piotr Kolczynski, who also represented the People’s Vaccine Alliance. Meanwhile, Oxfam, also representing the People’s Vaccine Alliance, said that “the accord’s language must oblige governments to take specific actions to ensure equity; otherwise it would be very difficult to implement this”. The current zero draft also assumes that “critical public health interventions are based on the willingness of pharmaceutical companies to engage in voluntary mechanisms” but “these have proved to be largely insufficient during the current and previous pandemics,” said Piotr Kolczynski, of Oxfam and PVA. For this reason, it added, “the accord must require governments to invest in research and development and manufacturing capacities and to condition public funding on the sharing of technologies, knowledge and intellectual property with developers and manufacturers in the South”. In reference to the accord’s proposal that 20% of pandemic-related goods be allocated to the WHO for distribution, Oxfam stated that “equitable allocation of medical countermeasures cannot be achieved by reserving a 20% of production for 80% of the world’s population”. Medecins sans Frontieres (MSF), meanwhile, asked for a legal definition of “pandemic”, and “explicit reference to governments complying with international humanitarian law obligations in the context of pandemic preparedness, prevention and response”. It also demanded stronger language in relation to commitments to protect “humanitarian populations of concerns” and healthcare workers during pandemics. Private sector is a ‘critical partner’ IFPMA’s Grega Kumer, Deputy Director of Government Relations. “The private sector should be seen as a critical partner in preparedness, response and recovery, and should have a seat at the table,” stated Grega Kumer, Deputy Director of Government Relations at the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA). However, it warned that some of the accord’s proposals “would jeopardise our capacity to efficiently prepare for the next pandemic.” Key concerns it cited included proposals for a waiver on intellectual property rights (IP) for health products during a pandemic, as well as proposals that would “be “transactionally linking access to pathogens and sharing of benefits”. It also urged the INB to “avoid unnecessary overlaps and duplications including other multilateral organisations mandate and expertise such as WTO and WIPO”. While there were over 200 participants online, a handful of member states were also on hand to listen in person at WHO’s Geneva Headquarters to the inputs as they prepare for INB4, when the real negotiations begin for the accord that is due to be presented by May 2024 to the World Health Assembly. Image Credits: Peter Griffin/Public Domain Pictures. Mpox To Remain A Public Health Emergency of International Concern Says WHO 15/02/2023 Megha Kaveri Dr Tedros Adhanom Ghebreyesus speaking at the media briefing on Wednesday. The World Health Organization (WHO) declared on Wednesday that Mpox will continue to remain a Public Health Emergency of International Concern (PHEIC). The decision to continue with the status quo on Mpox was based on the recommendations made by an Mpox Emergency Committee, whose findings were published on the same day. “The emergency committee for the global outbreak of Mpox met to assess whether, in its view, the outbreak remains a public health emergency of international concern. The committee has advised me that, in its view, Mpox remains a global health emergency, and I have accepted that advice,” Dr Tedros Adhanom Ghebreyesus, director-general of the WHO, said at a press briefing on Wednesday. In its report, the Mpox committee, which met on 9 February, acknowledged the progress made in reducing the virus transmission and the sharp decline of reported cases. However, it also expressed concerns that “a few countries continued to see a sustained incidence of illness” while in other countries it’s likely that more cases are occuring under the radar. “More than 30 countries continue to report cases, and the possible underdetection and under-reporting of confirmed cases in some regions is concerning. Particularly in countries where animal-human transmission of Mpox has been reported before,” Tedros pointed out. In its report, the expert committee also expressed concerns about the possible resurgence of cases due to the expected resumption of LGBTQ social events and other mass gathering events; lack of access to vaccines and testing capacities in many lower-income countries; and the recurring zoonotic transmission in Africa. It added that “not all countries are receiving the support they need or have structures or systems to respond to mpox, including inadequate support for marginalized groups; and general fatigue among supporting agencies.” Returning from Syrian scenes of devastation Tedros spoke at the briefing shortly after returning to Geneva from a visit to earthquake affected areas in Syria. The 7.8 magnitude earthquake that hit Syria and Türkiye last week is now estimated to have killed over 41,000 people. I've never in my life seen the level of destruction as I did on the road from Aleppo to Damascus. Skeletons of houses. Almost no people in sight. Over a decade of war has taken an unimaginable toll. Syrians need our support now and in years to come to rebuild their lives. pic.twitter.com/Ym2zmDixdw — Tedros Adhanom Ghebreyesus (@DrTedros) February 14, 2023 Describing the damage caused to Aleppo and Damascus first due to the war, and now by the earthquake, Tedros said “I saw the destruction of entire communities, the unspeakable suffering of people, and the courage and determination of survivors and responders. As we drove from Aleppo to Damascus, I saw the legacy of conflict, with town after town destroyed and abandoned. Survivors are now facing freezing conditions without adequate shelter, heating, food, clean water, or medical care.” While two more cross-border points between Türkiye and Syria have been opened, Tedros said he had had asked Syrian president Bashar al-Assad to open still more crossings so that relief could reach people in need more rapidly. Humanitarian aid groups charge that the Syrian president has “weaponized aid” channeling available supplies to government controlled areas – while most of western Syria where the earthquake hit, is controlled by Kurdish and other Syrian anti-government militias. “WHO remains committed to supporting all people in the Syrian Arab Republic now and in the days, weeks, months, and years ahead,” Tedros added. The WHO has launched an appeal for $43 million to support its response in Syria and Türkiye and expects the amount to double by this weekend. Meanwhile, UN Secretary General Antonio Guterres called upon countries to fully fund a $397 million earthquake fund for Syria, in particular, which lacks resources to mount its own response. Marburg disease – ramping up diagnostics and clinical trial possibilities Touching back on the Marburg Virus Disease (MVD) outbreak in Equatorial Guinea, which has claimed nine lives, Tedros said that the WHO is working with the country’s health authorities to ramp up their diagnostic capacity. “So far, no confirmed cases have been reported in Cameroon and or Gabon,” he added, referring to the two countries that, along with Liberia, border Equatorial Guinea. “We’re also supporting the governments of Cameroon and Gabon to prepare to rapidly detect, isolate, and provide care for any suspected cases.” Following up on the Marburg Virus Vaccine Consortium (MARVAC)’s meeting on Tuesday, Tedros said that WHO is trying to accelerate talks on possibile clinical trials for Marburg virus diseaes vaccine candidates. But he reiterated that any decision on the trials of vaccines and therapeutics for Marburg needs to be taken by researchers and the national authorities of Equatorial Guinea. “In the meantime, WHO is convening the vaccine prioritization committee to identify which vaccine candidates should be evaluated first and prepare for potential trials. WHO is also discussing with the ministry of health, the possibility of providing access to experimental therapeutics as part of a clinical trial,” he said. Posts navigation Older postsNewer posts
The town of Beni in the DRC has been the scene of a number of ADF massacres. “We have never experienced such killings,” says an aid work as local health centres struggle to help survivors deal with mental health problems in the aftermath of increasingly brutal attacks by the Islamic rebel group, Allied Democratic Forces. Of the more than 100 armed groups active in DRC’s eastern provinces, one of the oldest and most violent is the Allied Democratic Forces (ADF), a militant movement of Ugandan origins that has pledged allegiance to the so-called Islamic State (IS). With the spotlight on the M23 – which is backed by Rwanda and has seized large chunks of territory in the east – The New Humanitarian spent time speaking with survivors of ADF atrocities and health workers addressing the conflict’s fallout. “I have been supporting displaced people of different wars for 20 years… [but] the ADF massacres have become serious and we have never experienced such killings,” said Marie-Jeanne Masika, who works for a local NGO helping conflict victims. Interviewees said recent measures taken to combat the ADF – from a joint Uganda-DRC military intervention to the introduction of martial law – have failed to improve security for civilians. Instead, the militants have expanded geographically, carrying out massacres, abductions, and bombings in urban areas that have struck targets including a government building, a cinema, and a church in recent months. Those affected by the long-running violence – which centres on North Kivu and Ituri provinces – raised warnings of a rising mental health toll. Yet local health workers said there is an absence of support for those needing psychosocial services. “Today, we must no longer reduce humanitarian assistance to the sole distribution of provisions… to victims,” said Masika. “A big problem also remains psychosocial care to avoid having mental illnesses in the future.” ‘We are in so much pain’ The ADF was formed in 1995 after members fled to DRC amid military pressure in Uganda. It has its roots in the repression of Ugandan Muslims, though its complex history and modus operandi is obscured by narratives that focus solely on its Islamist orientation. Military operations, including by UN peacekeepers, are frequently launched against the group. Yet they often result in ADF reprisal attacks designed to punish civilians who support the army and pressure the government to end offensives. Recent ADF raids have sought to undermine support for Uganda’s operations. That mission – which may be guided by economic interests rather than security concerns – was launched after IS claimed a triple suicide bombing in Kampala in late 2021. A meeting of displaced people who had fled recent ADF massacres healed at a cathedral in Butembo, a town in North Kivu, earlier this month, highlighted the suffering caused by the conflict. Kavugho Sikiliza, 42, said she had lost four of her relatives, including her son and daughter-in-law, in an ADF attack in Bashu chiefdom – in the North Kivu territory of Beni – last September. “We suffer so much. We have abandoned our fields and we no longer find anything to eat,” Kavugho said. “Today, we are spending the night in the bush; we have orphans who are struggling to [eat].” Next to Kavugho sat Yoha Nyasavo Bibiche. Six months ago, she saw her son killed by ADF rebels in Mungamba, in Ituri province. She is now living in Butembo but was recently forced out of her house there because she couldn’t afford rent. “As we were about to harvest, the ADF attacked the village and stabbed my son, who is dead,” said Bibiche. “We no longer have a home. Eating, dressing – it has become a headache.” Mental health toll The cumulative impact of attacks – which have killed thousands over the past decade – has led to serious mental health challenges, according to survivors and medical staff from three psychiatric centres in Beni and Butembo. Esdras Pika, a psychologist at a health centre in Butembo, said his clinic treats survivors of ADF killings, kidnap victims, and farmers and traders struggling to cope with the loss of their livelihoods. “Before 2015, the reasons that led patients to be admitted to mental healthcare here were often drug abuse [and] cases of romantic disappointment,” Pika said. “But today, most of the patients who come to us are victims of insecurity.” Kakule Kisonia, from Beni territory, said his brother went to the local Muyisa psychiatric centre after witnessing a recent ADF attack that cost the lives of his wife, sister, and two of his children. Kisonia said his brother’s behaviour changed after the attack. “Every night he shouted: Ba Nalu! Ba Nalu! [a reference to the ADF in Swahili],” Kisonia said. “Each time a neighbour came, he shouted that it was the ADF, and did not hesitate to take either a wooden stick or a machete to attack the visitors.” More support is needed Medical staff from the health centres said they receive around 30 patients per month who are victims of ADF attacks. Yet the staff said their clinics receive no support from the state or from aid organisations, and that patients must self-finance their treatment. “Most of the victims are in a state of serious vulnerability, but we too are private, unsubsidised structures,” said Pika from the Butembo clinic. “We have to buy the drugs, pay the state taxes, and pay our nursing staff. We have no choice.” Marie-Jeanne Masika, the local NGO worker, said some displaced families have come to her organisation presenting bills of more than $300 issued by health centres for psychiatric support. “It is too much for the victims, who have lost everything in the attacks, and these kinds of bills trouble them rather than relieve them,” said Masika, whose organisation is called Social Integration for the Promotion of the Needy (ISPRON). Mumbere Nyerere, an ADF victim who is receiving therapy, said paying for care represents a “big difficulty”. “I am the father of the family. Those who finance my care are my parents, older than me. It is I who should assist them,” Nyerere said. As attacks continue, Masika called for the government to subsidise clinics providing mental health support and said occupational therapy should be rolled out in villages to “tackle the problem at the base”. Georges Machokuona, a psychosocial worker in Butembo, said livelihood support is needed too: “Once they have returned home, most of those cured are faced with challenges… linked to survival, which led some to fall ill again.” This story was originally published by The New Humanitarian, which puts quality, independent journalism at the service of the millions of people affected by humanitarian crises around the world.
Ukraine Gets New Emergency Funds for HIV and TB Programmes 21/02/2023 Kerry Cullinan Alliance Global’s Andrii C shelters in the NGO’s basement in Lviv and waits for air raid sirens to finish. The organisation is helping to get treatment to people living with HIV. On the eve of the first anniversary of Russia’s invasion of Ukraine, the Global Fund to Fight AIDS, Tuberculosis and Malaria has approved an additional $10.32 million in emergency funding to maintain essential HIV and tuberculosis (TB) services in Ukraine. The funds are earmarked for HIV and TB treatment, prevention and care, including for internally displaced persons and hard-to-reach communities. Since the start of the war, more than 13.5 million people have been internally displaced or forced to flee to neighbouring countries as refugees. “If displaced people don’t get the medicines they need, there is a high risk that they will actually die because of the lack of therapy,” said Dmytro Sherembei, head of 100% LIFE, a Global Fund-supported nongovernmental organization delivering HIV medications in war-affected Ukraine. In the past year, the Global Fund has allocated $25.32 million in emergency funds in addition to $119.48 million allocated to Ukraine to support the fight against HIV and TB in the country over the 2021-2023 period. Ukraine has the second-largest HIV epidemic in Eastern Europe and Central Asia, and a high burden of TB, including drug-resistant TB, according to the Global Fund in a statement on Tuesday. “Both HIV and TB require long-term treatment to reduce the risk of transmission and both diseases have the best outcome with early diagnosis. As people escape the fighting, they often lose access to health care and their medications. HIV and TB prevention and diagnosis services have also been significantly disrupted.” Needs more desperate “As the war rages on, the needs in the country are getting more severe and urgent,” said Peter Sands, the Global Fund’s Executive Director. “Damage and destruction to water, electricity and sanitation facilities, health facilities, as well as road and residential infrastructure continue to be reported across multiple areas throughout the country. The additional emergency funding that we are unlocking today is intended to support the government in filling the significant financing gaps across critical HIV and TB interventions. We will continue to monitor the situation closely.” The World Health Organization (WHO) reports that over 1,200 health facilities in the country have been attacked, and 170 of these facilities have been destroyed, leaving healthcare workers and patients displaced, injured or dead. “It’s been a year since the Russian Federation’s invasion of Ukraine, and today, the fighting and deadly missile strikes continue, bringing more destruction and devastating impact in several oblasts of the country,” said Minister of Health of Ukraine Viktor Liashko. “Despite the crisis and challenges, Ukraine’s HIV and TB programs sustained operations. The Global Fund’s investments through the emergency funding, on top of the ongoing grant, have proven invaluable, especially as health facilities have been damaged or destroyed and people continue to be displaced, causing them to lose access to health care, including treatment for HIV and TB.” Over the last 20 years, Ukraine has been a champion in maintaining long-term and innovative HIV and TB programs, according to the Global Fund. More than 100 community-based and community-led organizations have been delivering HIV and TB services to vulnerable people. Image Credits: Global Fund. Scientists Launch R&D Plan to Develop Broad Vaccine for Coronaviruses 21/02/2023 Kerry Cullinan SARS-Co-V2. Fifty influential scientists have developed a coronavirus vaccines research and development (R&D) roadmap aimed at developing broadly protective vaccines to combat fast-evolving coronaviruses threatening humans. “The COVID-19 pandemic marks the third time in just 20 years that a coronavirus has emerged to cause a public health crisis,” said Professor Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP). “Rather than waiting for a fourth coronavirus to emerge — or for the arrival of an especially dangerous SARS-CoV-2 variant — we must act now to develop better, longer-lasting and more broadly protective vaccines,” added Osterholm, whose centre spearheaded the development of the roadmap that was unveiled on Tuesday. CIDRAP unveils roadmap for advancing better coronavirus vaccines The roadmap provides a detailed a strategy to develop broadly protective vaccines—suitable for wide use—to tackle future #COVID19 variants and other worrisome coronaviruseshttps://t.co/yfv7nb5Jnq pic.twitter.com/mQBonJneZc — CIDRAP (@CIDRAP) February 21, 2023 The roadmap sets out steps to accelerate the development of broadly effective coronavirus vaccines capable of preventing severe disease and death that are suitable for all regions worldwide. New SARS-CoV-2 variants pose the most immediate threat and could evolve until they evade the protection of current vaccines. But the bigger fear is the emergence of a super-coronavirus that has the transmissibility of SARSCoV-2 combined with the deadliness of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). MERS-CoV spilled over from camels to humans in 2012 and kills about a third of the people it infects. To head off such a threat, the roadmap proposes a number of approaches. One could involve a stepwise process, starting with vaccines to protect against SARS-CoV-2 variants. As knowledge about coronaviruses expands, it may be possible to develop vaccines that are capable of protecting against multiple types of coronaviruses, including those likely to spill over from animals to humans in the future. “It is critical that we start now to develop vaccines that are future-ready for coronaviruses circulating in animals now, that might infect humans and cause pandemics in the future as SARS-CoV-3 and beyond,” said Professor Linfa Wang, executive director of Singapore’s Programme for Research in Epidemic Preparedness and Response (PREPARE). Wang, who was part of the team that developed the roadmap, also said that the work was daunting: “The coronavirus diversity in bats is so great that we even don’t know how much we really know about them.” Five work areas The roadmap proposes five areas of work: Virology: learning more about the global distribution of coronaviruses circulating in animal reservoirs that have the potential to spill over to humans. Immunology: learning more about human immunology to expand the breadth and durability of immune protection from vaccines and natural infection. This includes a better understanding of mucosal immunity, which may unlock new strategies to block infection such as nasal sprays. Vaccinology: identifying key preferred product characteristics for vaccines, including new technologies and identifying the best methods to assess vaccine efficacy. Animal and human infection models for vaccine research: expanding the range of suitable animal models, which is a key barrier to developing broadly protective coronavirus vaccines. Policy and financing: reinvigorating and sustaining a high level of political commitment and long-term investment in vaccine R&D and manufacturing to ensure the successful development and global distribution of broadly protective coronavirus vaccines. While praising the current COVID-19 vaccines, Wellcome Trust’s Dr Charlie Weller, said the roadmap would research “new ways to deliver vaccines, such as skin patches or intranasal vaccines – and maybe even vaccines that could block transmission”. Constant mutation “Coronaviruses such as SARS-CoV-2 are constantly mutating. With every infection, there is an interplay among host characteristics, past infection, and vaccination – each exerting further pressures on the virus to evolve and acquire further reproductive and fitness advantages,” wrote Dr Margaret Hamburg, former Food and Drug Administration (FDA) commissioner, and Dr Gregory Poland, from the Mayo Clinic’s Vaccine Research Group in the US in a commentary published in the journal, Vaccine. “As a consequence, we are chasing continually evolving viral opponents, leaving the global community in a reactive rather than proactive position in regard to vaccines, therapeutics, and public health policies.” They warn that the global community cannot afford “to play reactive catch up continuously, chasing the latest variant”, or expect people to get vaccinated several times a year. However, Hamburg and Poland added that the roadmap also needs “a governance or administrative structure” to better coordinate vaccine R&D and track progress –and accountability – on the goals and milestones that will further facilitate and accelerate this process. They point to the “siloed” activities by governments, industry and researchers, and how the roadmap can “build bridges between these various sectors” to reduce barriers and duplication, and improve efficiencies. Image Credits: Johnson&Johnson. Natural Immunity Against COVID-19 ‘At Least’ On Par With Vaccination in Preventing Death 21/02/2023 Stefan Anderson Natural immunity provides strong protection against severe illness from COVID-19, but obtaining it carries its own set of risks. New research published in The Lancet suggests that individuals who have previously been infected with COVID-19 have an 88% lower risk of hospitalization or death than those who have not. The study is the most comprehensive review of data on natural immunity to date, covering data from 65 studies across 19 countries published since January 2021. The analysis found that the strength and 10-month duration of protection conferred by natural immunity against severe illness is “at least” on par with that provided by two doses of Moderna and Pfizer-BioNtech’s mRNA vaccines. The study’s authors said the data suggests natural immunity in people recently infected with COVID-19 should be recognised by policymakers but warned against using their findings to undermine the importance of vaccination due to the risks associated with the first infection. “Vaccination is the safest way to acquire immunity, whereas acquiring natural immunity must be weighed against the risks of severe illness and death associated with the initial infection,” lead author Dr Stephen Lim of the University of Washington’s School of Medicine. Researchers also cautioned that differences between the infectious properties of COVID-19 variants mean protection levels can vary. Infection by pre-Omicron variants, for example, yielded substantially lower natural immunity protection against reinfection by the now dominant Omicron BA.1 variant, with just 36% protection remaining after the 10-month window. Nevertheless, protection against hospitalization and death remained high at 88%. “The weaker cross-variant immunity with the Omicron variant and its sub-lineages reflects the mutations they have that make them escape built-up immunity more easily than other variants,” report co-author Dr Hasan Nassereldine of the University of Washington’s School of Medicine said. “The limited data we have on natural immunity protection from the Omicron variant and its sub-lineages underscores the importance of continued assessment, particularly since they are estimated to have infected 46% of the global population between November 2021 and June 2022.” The analysis excluded studies examining “hybrid immunity” (the combination of immune responses from vaccination and natural infection) as well as data relating to Omicron XBB and its sub-lineages. The authors encouraged further research to fill the gaps in the study. Europeans Don’t Exercise Enough – And Policy-Makers Should Do More to Encourage Them 17/02/2023 Kerry Cullinan A third of Europeans don’t meet the World Health Organization’s (WHO) guidelines for physical activity – but if they did, this would avert over 10 000 premature deaths, almost four million cases of cardiovascular disease, three and a half million cases of depression and nearly a million cases of type two diabetes by 2050. This is according to a report launched on Friday by the WHO Europe and the Organisation for Economic Co-operation and Development (OECD), which urges policy-makers to adopt strategies to increase people’s physical activity. The findings are based on a recent Eurobarometer survey conducted for the European Commission which found that 45% of the respondents report that they never exercise or play sport, an increase of 6% since 2009. People in Finland (71%), Luxembourg (63%), the Netherlands (60%), and Denmark and Sweden (both 59%) were the most likely to exercise, while people in Portugal, Greece and Poland were least likely to exercise. “We find that it’s worse among women, with some countries having almost half of all adult women not meeting the WHO recommended guidelines on physical activity,” OECD health policy analyst Sabine Vuik told the launch on Friday. Meanwhile, less than a quarter of people who consider themselves to be working class exercise at least once a week, and over half of all adults surveyed said that they exercised less frequently since the COVID-19 pandemic. Recommended activity The WHO recommends that everyone does at least 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity every week. “This could be a half-hour run twice a week, running about 10 kilometres per hour, but it doesn’t need to be formal exercise. It can also be walking the dog every day for half an hour,” added Vuik. OECD health analyst Sabine Vuik “Our analysis shows that larger countries such as Germany, France and Italy can save more than €1 billion every year if everyone were to meet the physical activity guidelines. And across the EU, we could save €8 billion every year in healthcare expenditure if everyone meets the minimum recommended guidelines.” WHO Europe regional director Dr Hans Kluge, said that the report “provides evidence that investing in policies that promote physical activity not only improves individual well-being and population health, but also pays economic dividends”. “Every €1 invested in physical activity generates an almost two-fold return of €1.7 in economic benefits. We need to communicate the benefits of being active, not just the physical benefits, but the benefits to mental health, the environment and society in the WHO European Region, and we need to make sure that our systems can and will sustain these changes – as real, long-term transformation,” added Kluge, who is an avid cyclist and cycles to work and back daily. The report calls on policymakers to step up the policy response to increase physical activity in schools, in urban and transport design and in healthcare settings and workplaces. Since 2015, some EU countries have adopted policies to improve access to physical activity. For example, Finland adopted a resolution to promote active modes of transportation, Austria builds up co-operation between sports clubs and primary schools and Bulgaria develops a programme to help people whose jobs involve sitting for long periods. Investing in #PhysicalActivity improves individual and population health, while returning 1.7 EUR in economic benefits for every 1 EUR invested. New WHO/@OECD report funded by the #EU shares great ideas for policy makers to consider.👇https://t.co/Ri3xynx9bv@EU_Commission pic.twitter.com/A28qBknwiQ — WHO/Europe (@WHO_Europe) February 17, 2023 Lack of Test Kits for Marburg Virus Hamper Africa’s Response to Outbreak 16/02/2023 Paul Adepoju Dr Ahmed Ogwell Ouma, Acting Director of the Africa Centres for Disease Control. The Africa Centres for Disease Control and Prevention (Africa CDC) is closely monitoring Equatorial Guinea’s first-ever Marburg virus disease outbreak, Africa CDC acting director Dr Ahmed Ogwell Ouma told a media briefing on Thursday “One big challenge we have are test kits and we are working around the clock to try and get test kits to Equatorial Guinea and also to Cameroon and Gabon, to ensure that we have a very short turnaround time for samples being tested in the laboratory,” Ouma added. So far, one case has been confirmed and nine deaths have been reported, while there are 16 suspected cases in quarantine, and another 15 contacts are under observation. All cases have occurred in the province of Kie Ntem in the country’s western region. Ouma added that a key priority is to limit the spread of the virus, as well as monitor neighbouring countries such as Cameroon and Gabon for potential cross-border spillover. As reported by Health Policy Watch, on Tuesday, the WHO received updates from five vaccine developers who have been working on candidate vaccines. The WHO plans to convene a working group to prioritize existing vaccine candidates, with an eye to seeing if clinical trials for any of the vaccines can be launched in real time, particularly if the outbreak expands. Diphtheria, cholera, mpox, Lassa fever, and measles are some of the other health emergencies that African countries are also grappling with, alongside COVID-19, and Ouma, a Kenyan epidemiologist, said that his center is currently monitoring up to nine different public health events. Nigeria reported over 600 new cases of diphtheria and several African countries reported cases of cholera, including Malawi, where three-quarters of the continent’s cases have been reported. The continent has documented over 12 million cases of COVID-19 and 256,705 deaths, a case fatality rate of 2.1%, which is double the global average, Ouma told the media. While the number of new cases and deaths have decreased over the past several weeks, he emphasized the importance of continuing to encourage vaccination efforts and targeted campaigns to reach more people. “The general trend on the continent now is quite flat with the indications that we may be seeing further decreases in numbers and also in deaths,” Ouma told journalists. Ouma noted that Africa CDC is working with governments and health organizations to provide technical assistance and medical countermeasures as needed for these and other health emergencies. He added that the organization is also continuing to promote vaccination efforts and targeted campaigns to help prevent the spread of infectious diseases. Draft Pandemic Accord Neglects Prevention, Particularly ‘Zoonotic Spillover’ 15/02/2023 Kerry Cullinan INB co-chair Roland Driece The draft pandemic accord needs more emphasis on preventing pandemics at their source – where animal pathogens “spill over” to people – according to a number of organisations participating in a consultation on the document’s “zero draft” on Wednesday. Negotiations between World Health Organization (WHO) member states on the draft are due to begin at the fourth meeting of the Intergovernmental Negotiating Body (INB), scheduled to take place from 27 February to 3 March. However, Wednesday’s meeting gave WHO’s civil society stakeholders an opportunity to comment on the draft ahead of that meeting. Only member states will take part in the actual treaty negotiations, which are likely to start behind closed doors on the second day of the month-end meeting (called INB 4), INB co-chair Roland Driece told the meeting. INB 4 and the following INB5 meeting from 3 to 6 April would be approached as “one big meeting”, he added. While the start of the meeting would be open to all stakeholders, “as soon as member states tell us that they accept the zero draft as the zero draft, we will move into negotiation mode, and that means that only member states can be present,” said Driece. “So that’s why it’s so important that you tell us and member states now what you feel and think about this zero draft.” He added that he thought that the INB Bureau had done “a pretty decent job [of synthesizing stakeholders’ inputs]” but “this is an important moment for you all to share whether or not you share my optimism about that and tell us what you think is important”. Prevent ‘zoonotic spillover’ – environmental and animal health groups Across large swathes of Asia and Africa, wholesale markets often sell wild animals captured or bred for food consumption, and which may harbor dangerous viruses. Many scientists believe that SARS-CoV2 was transmitted to humans via live, wild animals, caged for slaughter in Wuhan’s wet market. An unprecedented number of organisations spoke about how the draft needs to pay more attention to pandemic prevention at the source; this means addressing the social, environmental and food safety factors that lead to the spillover of pathogens from wild animal populations into human communities. These drivers range from deforestation which has prompted animal populations like bats, which harbor a range of deadly pathogens from SARS-COV to Marburg, to move closer to human habitats; to wild animal trafficking and trade, both legal and illicit; as well as industrial production, sale and slaugher of wild animal species. The Wildlife Conservation Society recommended that the accord commit governments to “identifying and prioritising actions to prevent pathogen spillover in the first place” by prioritising tougher regulations on “markets and trade chains and wildlife domestic and international trade”. “We have extensive experience and expertise with habitat degredation, deforestation, forest degradation, wildlife trade and wildlife markets,” said the WCS representative. “And this isn’t about illegal trade, its about any live trade, particularly for food but also for other purposes, birds and mammals. We look forward to working with member states and the INB to ensure that first and foremost there are commitments by governments to avoid the spillover in the first place. And we do know how to do that, from a biodiversity perspective and in terms of markets.” The World Wildlife Fund (WWF) appealed for the “list of drivers of pathogen emergence risks to be expanded to include not just deforestation, but ecosystem loss, fragmentation and degradation”. “Deforestation alone omits many of the potentially important pandemic frontiers and ignores the role of fragmentation and degradation in increasing proximity between humans and wildlife,” said the WWF. Meanwhile, the World Organisation of Animal Health (WOAH) called for the inclusion of the full definition of “One Health” in the treaty. Its delegate also questioned why preparedness and response were stressed whereas “preventive actions targeting activities and places that increase the risk of zoonotic spillover” were not. Pointing to a lack of expertise to address zoonotic spillover, the Action for Animal Health Coalition said that member states needed to invest in increasing the animal health workforce. Equity obligations Oxfam’s Piotr Kolczynski, who also represented the People’s Vaccine Alliance. Meanwhile, Oxfam, also representing the People’s Vaccine Alliance, said that “the accord’s language must oblige governments to take specific actions to ensure equity; otherwise it would be very difficult to implement this”. The current zero draft also assumes that “critical public health interventions are based on the willingness of pharmaceutical companies to engage in voluntary mechanisms” but “these have proved to be largely insufficient during the current and previous pandemics,” said Piotr Kolczynski, of Oxfam and PVA. For this reason, it added, “the accord must require governments to invest in research and development and manufacturing capacities and to condition public funding on the sharing of technologies, knowledge and intellectual property with developers and manufacturers in the South”. In reference to the accord’s proposal that 20% of pandemic-related goods be allocated to the WHO for distribution, Oxfam stated that “equitable allocation of medical countermeasures cannot be achieved by reserving a 20% of production for 80% of the world’s population”. Medecins sans Frontieres (MSF), meanwhile, asked for a legal definition of “pandemic”, and “explicit reference to governments complying with international humanitarian law obligations in the context of pandemic preparedness, prevention and response”. It also demanded stronger language in relation to commitments to protect “humanitarian populations of concerns” and healthcare workers during pandemics. Private sector is a ‘critical partner’ IFPMA’s Grega Kumer, Deputy Director of Government Relations. “The private sector should be seen as a critical partner in preparedness, response and recovery, and should have a seat at the table,” stated Grega Kumer, Deputy Director of Government Relations at the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA). However, it warned that some of the accord’s proposals “would jeopardise our capacity to efficiently prepare for the next pandemic.” Key concerns it cited included proposals for a waiver on intellectual property rights (IP) for health products during a pandemic, as well as proposals that would “be “transactionally linking access to pathogens and sharing of benefits”. It also urged the INB to “avoid unnecessary overlaps and duplications including other multilateral organisations mandate and expertise such as WTO and WIPO”. While there were over 200 participants online, a handful of member states were also on hand to listen in person at WHO’s Geneva Headquarters to the inputs as they prepare for INB4, when the real negotiations begin for the accord that is due to be presented by May 2024 to the World Health Assembly. Image Credits: Peter Griffin/Public Domain Pictures. Mpox To Remain A Public Health Emergency of International Concern Says WHO 15/02/2023 Megha Kaveri Dr Tedros Adhanom Ghebreyesus speaking at the media briefing on Wednesday. The World Health Organization (WHO) declared on Wednesday that Mpox will continue to remain a Public Health Emergency of International Concern (PHEIC). The decision to continue with the status quo on Mpox was based on the recommendations made by an Mpox Emergency Committee, whose findings were published on the same day. “The emergency committee for the global outbreak of Mpox met to assess whether, in its view, the outbreak remains a public health emergency of international concern. The committee has advised me that, in its view, Mpox remains a global health emergency, and I have accepted that advice,” Dr Tedros Adhanom Ghebreyesus, director-general of the WHO, said at a press briefing on Wednesday. In its report, the Mpox committee, which met on 9 February, acknowledged the progress made in reducing the virus transmission and the sharp decline of reported cases. However, it also expressed concerns that “a few countries continued to see a sustained incidence of illness” while in other countries it’s likely that more cases are occuring under the radar. “More than 30 countries continue to report cases, and the possible underdetection and under-reporting of confirmed cases in some regions is concerning. Particularly in countries where animal-human transmission of Mpox has been reported before,” Tedros pointed out. In its report, the expert committee also expressed concerns about the possible resurgence of cases due to the expected resumption of LGBTQ social events and other mass gathering events; lack of access to vaccines and testing capacities in many lower-income countries; and the recurring zoonotic transmission in Africa. It added that “not all countries are receiving the support they need or have structures or systems to respond to mpox, including inadequate support for marginalized groups; and general fatigue among supporting agencies.” Returning from Syrian scenes of devastation Tedros spoke at the briefing shortly after returning to Geneva from a visit to earthquake affected areas in Syria. The 7.8 magnitude earthquake that hit Syria and Türkiye last week is now estimated to have killed over 41,000 people. I've never in my life seen the level of destruction as I did on the road from Aleppo to Damascus. Skeletons of houses. Almost no people in sight. Over a decade of war has taken an unimaginable toll. Syrians need our support now and in years to come to rebuild their lives. pic.twitter.com/Ym2zmDixdw — Tedros Adhanom Ghebreyesus (@DrTedros) February 14, 2023 Describing the damage caused to Aleppo and Damascus first due to the war, and now by the earthquake, Tedros said “I saw the destruction of entire communities, the unspeakable suffering of people, and the courage and determination of survivors and responders. As we drove from Aleppo to Damascus, I saw the legacy of conflict, with town after town destroyed and abandoned. Survivors are now facing freezing conditions without adequate shelter, heating, food, clean water, or medical care.” While two more cross-border points between Türkiye and Syria have been opened, Tedros said he had had asked Syrian president Bashar al-Assad to open still more crossings so that relief could reach people in need more rapidly. Humanitarian aid groups charge that the Syrian president has “weaponized aid” channeling available supplies to government controlled areas – while most of western Syria where the earthquake hit, is controlled by Kurdish and other Syrian anti-government militias. “WHO remains committed to supporting all people in the Syrian Arab Republic now and in the days, weeks, months, and years ahead,” Tedros added. The WHO has launched an appeal for $43 million to support its response in Syria and Türkiye and expects the amount to double by this weekend. Meanwhile, UN Secretary General Antonio Guterres called upon countries to fully fund a $397 million earthquake fund for Syria, in particular, which lacks resources to mount its own response. Marburg disease – ramping up diagnostics and clinical trial possibilities Touching back on the Marburg Virus Disease (MVD) outbreak in Equatorial Guinea, which has claimed nine lives, Tedros said that the WHO is working with the country’s health authorities to ramp up their diagnostic capacity. “So far, no confirmed cases have been reported in Cameroon and or Gabon,” he added, referring to the two countries that, along with Liberia, border Equatorial Guinea. “We’re also supporting the governments of Cameroon and Gabon to prepare to rapidly detect, isolate, and provide care for any suspected cases.” Following up on the Marburg Virus Vaccine Consortium (MARVAC)’s meeting on Tuesday, Tedros said that WHO is trying to accelerate talks on possibile clinical trials for Marburg virus diseaes vaccine candidates. But he reiterated that any decision on the trials of vaccines and therapeutics for Marburg needs to be taken by researchers and the national authorities of Equatorial Guinea. “In the meantime, WHO is convening the vaccine prioritization committee to identify which vaccine candidates should be evaluated first and prepare for potential trials. WHO is also discussing with the ministry of health, the possibility of providing access to experimental therapeutics as part of a clinical trial,” he said. Posts navigation Older postsNewer posts
Scientists Launch R&D Plan to Develop Broad Vaccine for Coronaviruses 21/02/2023 Kerry Cullinan SARS-Co-V2. Fifty influential scientists have developed a coronavirus vaccines research and development (R&D) roadmap aimed at developing broadly protective vaccines to combat fast-evolving coronaviruses threatening humans. “The COVID-19 pandemic marks the third time in just 20 years that a coronavirus has emerged to cause a public health crisis,” said Professor Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP). “Rather than waiting for a fourth coronavirus to emerge — or for the arrival of an especially dangerous SARS-CoV-2 variant — we must act now to develop better, longer-lasting and more broadly protective vaccines,” added Osterholm, whose centre spearheaded the development of the roadmap that was unveiled on Tuesday. CIDRAP unveils roadmap for advancing better coronavirus vaccines The roadmap provides a detailed a strategy to develop broadly protective vaccines—suitable for wide use—to tackle future #COVID19 variants and other worrisome coronaviruseshttps://t.co/yfv7nb5Jnq pic.twitter.com/mQBonJneZc — CIDRAP (@CIDRAP) February 21, 2023 The roadmap sets out steps to accelerate the development of broadly effective coronavirus vaccines capable of preventing severe disease and death that are suitable for all regions worldwide. New SARS-CoV-2 variants pose the most immediate threat and could evolve until they evade the protection of current vaccines. But the bigger fear is the emergence of a super-coronavirus that has the transmissibility of SARSCoV-2 combined with the deadliness of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). MERS-CoV spilled over from camels to humans in 2012 and kills about a third of the people it infects. To head off such a threat, the roadmap proposes a number of approaches. One could involve a stepwise process, starting with vaccines to protect against SARS-CoV-2 variants. As knowledge about coronaviruses expands, it may be possible to develop vaccines that are capable of protecting against multiple types of coronaviruses, including those likely to spill over from animals to humans in the future. “It is critical that we start now to develop vaccines that are future-ready for coronaviruses circulating in animals now, that might infect humans and cause pandemics in the future as SARS-CoV-3 and beyond,” said Professor Linfa Wang, executive director of Singapore’s Programme for Research in Epidemic Preparedness and Response (PREPARE). Wang, who was part of the team that developed the roadmap, also said that the work was daunting: “The coronavirus diversity in bats is so great that we even don’t know how much we really know about them.” Five work areas The roadmap proposes five areas of work: Virology: learning more about the global distribution of coronaviruses circulating in animal reservoirs that have the potential to spill over to humans. Immunology: learning more about human immunology to expand the breadth and durability of immune protection from vaccines and natural infection. This includes a better understanding of mucosal immunity, which may unlock new strategies to block infection such as nasal sprays. Vaccinology: identifying key preferred product characteristics for vaccines, including new technologies and identifying the best methods to assess vaccine efficacy. Animal and human infection models for vaccine research: expanding the range of suitable animal models, which is a key barrier to developing broadly protective coronavirus vaccines. Policy and financing: reinvigorating and sustaining a high level of political commitment and long-term investment in vaccine R&D and manufacturing to ensure the successful development and global distribution of broadly protective coronavirus vaccines. While praising the current COVID-19 vaccines, Wellcome Trust’s Dr Charlie Weller, said the roadmap would research “new ways to deliver vaccines, such as skin patches or intranasal vaccines – and maybe even vaccines that could block transmission”. Constant mutation “Coronaviruses such as SARS-CoV-2 are constantly mutating. With every infection, there is an interplay among host characteristics, past infection, and vaccination – each exerting further pressures on the virus to evolve and acquire further reproductive and fitness advantages,” wrote Dr Margaret Hamburg, former Food and Drug Administration (FDA) commissioner, and Dr Gregory Poland, from the Mayo Clinic’s Vaccine Research Group in the US in a commentary published in the journal, Vaccine. “As a consequence, we are chasing continually evolving viral opponents, leaving the global community in a reactive rather than proactive position in regard to vaccines, therapeutics, and public health policies.” They warn that the global community cannot afford “to play reactive catch up continuously, chasing the latest variant”, or expect people to get vaccinated several times a year. However, Hamburg and Poland added that the roadmap also needs “a governance or administrative structure” to better coordinate vaccine R&D and track progress –and accountability – on the goals and milestones that will further facilitate and accelerate this process. They point to the “siloed” activities by governments, industry and researchers, and how the roadmap can “build bridges between these various sectors” to reduce barriers and duplication, and improve efficiencies. Image Credits: Johnson&Johnson. Natural Immunity Against COVID-19 ‘At Least’ On Par With Vaccination in Preventing Death 21/02/2023 Stefan Anderson Natural immunity provides strong protection against severe illness from COVID-19, but obtaining it carries its own set of risks. New research published in The Lancet suggests that individuals who have previously been infected with COVID-19 have an 88% lower risk of hospitalization or death than those who have not. The study is the most comprehensive review of data on natural immunity to date, covering data from 65 studies across 19 countries published since January 2021. The analysis found that the strength and 10-month duration of protection conferred by natural immunity against severe illness is “at least” on par with that provided by two doses of Moderna and Pfizer-BioNtech’s mRNA vaccines. The study’s authors said the data suggests natural immunity in people recently infected with COVID-19 should be recognised by policymakers but warned against using their findings to undermine the importance of vaccination due to the risks associated with the first infection. “Vaccination is the safest way to acquire immunity, whereas acquiring natural immunity must be weighed against the risks of severe illness and death associated with the initial infection,” lead author Dr Stephen Lim of the University of Washington’s School of Medicine. Researchers also cautioned that differences between the infectious properties of COVID-19 variants mean protection levels can vary. Infection by pre-Omicron variants, for example, yielded substantially lower natural immunity protection against reinfection by the now dominant Omicron BA.1 variant, with just 36% protection remaining after the 10-month window. Nevertheless, protection against hospitalization and death remained high at 88%. “The weaker cross-variant immunity with the Omicron variant and its sub-lineages reflects the mutations they have that make them escape built-up immunity more easily than other variants,” report co-author Dr Hasan Nassereldine of the University of Washington’s School of Medicine said. “The limited data we have on natural immunity protection from the Omicron variant and its sub-lineages underscores the importance of continued assessment, particularly since they are estimated to have infected 46% of the global population between November 2021 and June 2022.” The analysis excluded studies examining “hybrid immunity” (the combination of immune responses from vaccination and natural infection) as well as data relating to Omicron XBB and its sub-lineages. The authors encouraged further research to fill the gaps in the study. Europeans Don’t Exercise Enough – And Policy-Makers Should Do More to Encourage Them 17/02/2023 Kerry Cullinan A third of Europeans don’t meet the World Health Organization’s (WHO) guidelines for physical activity – but if they did, this would avert over 10 000 premature deaths, almost four million cases of cardiovascular disease, three and a half million cases of depression and nearly a million cases of type two diabetes by 2050. This is according to a report launched on Friday by the WHO Europe and the Organisation for Economic Co-operation and Development (OECD), which urges policy-makers to adopt strategies to increase people’s physical activity. The findings are based on a recent Eurobarometer survey conducted for the European Commission which found that 45% of the respondents report that they never exercise or play sport, an increase of 6% since 2009. People in Finland (71%), Luxembourg (63%), the Netherlands (60%), and Denmark and Sweden (both 59%) were the most likely to exercise, while people in Portugal, Greece and Poland were least likely to exercise. “We find that it’s worse among women, with some countries having almost half of all adult women not meeting the WHO recommended guidelines on physical activity,” OECD health policy analyst Sabine Vuik told the launch on Friday. Meanwhile, less than a quarter of people who consider themselves to be working class exercise at least once a week, and over half of all adults surveyed said that they exercised less frequently since the COVID-19 pandemic. Recommended activity The WHO recommends that everyone does at least 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity every week. “This could be a half-hour run twice a week, running about 10 kilometres per hour, but it doesn’t need to be formal exercise. It can also be walking the dog every day for half an hour,” added Vuik. OECD health analyst Sabine Vuik “Our analysis shows that larger countries such as Germany, France and Italy can save more than €1 billion every year if everyone were to meet the physical activity guidelines. And across the EU, we could save €8 billion every year in healthcare expenditure if everyone meets the minimum recommended guidelines.” WHO Europe regional director Dr Hans Kluge, said that the report “provides evidence that investing in policies that promote physical activity not only improves individual well-being and population health, but also pays economic dividends”. “Every €1 invested in physical activity generates an almost two-fold return of €1.7 in economic benefits. We need to communicate the benefits of being active, not just the physical benefits, but the benefits to mental health, the environment and society in the WHO European Region, and we need to make sure that our systems can and will sustain these changes – as real, long-term transformation,” added Kluge, who is an avid cyclist and cycles to work and back daily. The report calls on policymakers to step up the policy response to increase physical activity in schools, in urban and transport design and in healthcare settings and workplaces. Since 2015, some EU countries have adopted policies to improve access to physical activity. For example, Finland adopted a resolution to promote active modes of transportation, Austria builds up co-operation between sports clubs and primary schools and Bulgaria develops a programme to help people whose jobs involve sitting for long periods. Investing in #PhysicalActivity improves individual and population health, while returning 1.7 EUR in economic benefits for every 1 EUR invested. New WHO/@OECD report funded by the #EU shares great ideas for policy makers to consider.👇https://t.co/Ri3xynx9bv@EU_Commission pic.twitter.com/A28qBknwiQ — WHO/Europe (@WHO_Europe) February 17, 2023 Lack of Test Kits for Marburg Virus Hamper Africa’s Response to Outbreak 16/02/2023 Paul Adepoju Dr Ahmed Ogwell Ouma, Acting Director of the Africa Centres for Disease Control. The Africa Centres for Disease Control and Prevention (Africa CDC) is closely monitoring Equatorial Guinea’s first-ever Marburg virus disease outbreak, Africa CDC acting director Dr Ahmed Ogwell Ouma told a media briefing on Thursday “One big challenge we have are test kits and we are working around the clock to try and get test kits to Equatorial Guinea and also to Cameroon and Gabon, to ensure that we have a very short turnaround time for samples being tested in the laboratory,” Ouma added. So far, one case has been confirmed and nine deaths have been reported, while there are 16 suspected cases in quarantine, and another 15 contacts are under observation. All cases have occurred in the province of Kie Ntem in the country’s western region. Ouma added that a key priority is to limit the spread of the virus, as well as monitor neighbouring countries such as Cameroon and Gabon for potential cross-border spillover. As reported by Health Policy Watch, on Tuesday, the WHO received updates from five vaccine developers who have been working on candidate vaccines. The WHO plans to convene a working group to prioritize existing vaccine candidates, with an eye to seeing if clinical trials for any of the vaccines can be launched in real time, particularly if the outbreak expands. Diphtheria, cholera, mpox, Lassa fever, and measles are some of the other health emergencies that African countries are also grappling with, alongside COVID-19, and Ouma, a Kenyan epidemiologist, said that his center is currently monitoring up to nine different public health events. Nigeria reported over 600 new cases of diphtheria and several African countries reported cases of cholera, including Malawi, where three-quarters of the continent’s cases have been reported. The continent has documented over 12 million cases of COVID-19 and 256,705 deaths, a case fatality rate of 2.1%, which is double the global average, Ouma told the media. While the number of new cases and deaths have decreased over the past several weeks, he emphasized the importance of continuing to encourage vaccination efforts and targeted campaigns to reach more people. “The general trend on the continent now is quite flat with the indications that we may be seeing further decreases in numbers and also in deaths,” Ouma told journalists. Ouma noted that Africa CDC is working with governments and health organizations to provide technical assistance and medical countermeasures as needed for these and other health emergencies. He added that the organization is also continuing to promote vaccination efforts and targeted campaigns to help prevent the spread of infectious diseases. Draft Pandemic Accord Neglects Prevention, Particularly ‘Zoonotic Spillover’ 15/02/2023 Kerry Cullinan INB co-chair Roland Driece The draft pandemic accord needs more emphasis on preventing pandemics at their source – where animal pathogens “spill over” to people – according to a number of organisations participating in a consultation on the document’s “zero draft” on Wednesday. Negotiations between World Health Organization (WHO) member states on the draft are due to begin at the fourth meeting of the Intergovernmental Negotiating Body (INB), scheduled to take place from 27 February to 3 March. However, Wednesday’s meeting gave WHO’s civil society stakeholders an opportunity to comment on the draft ahead of that meeting. Only member states will take part in the actual treaty negotiations, which are likely to start behind closed doors on the second day of the month-end meeting (called INB 4), INB co-chair Roland Driece told the meeting. INB 4 and the following INB5 meeting from 3 to 6 April would be approached as “one big meeting”, he added. While the start of the meeting would be open to all stakeholders, “as soon as member states tell us that they accept the zero draft as the zero draft, we will move into negotiation mode, and that means that only member states can be present,” said Driece. “So that’s why it’s so important that you tell us and member states now what you feel and think about this zero draft.” He added that he thought that the INB Bureau had done “a pretty decent job [of synthesizing stakeholders’ inputs]” but “this is an important moment for you all to share whether or not you share my optimism about that and tell us what you think is important”. Prevent ‘zoonotic spillover’ – environmental and animal health groups Across large swathes of Asia and Africa, wholesale markets often sell wild animals captured or bred for food consumption, and which may harbor dangerous viruses. Many scientists believe that SARS-CoV2 was transmitted to humans via live, wild animals, caged for slaughter in Wuhan’s wet market. An unprecedented number of organisations spoke about how the draft needs to pay more attention to pandemic prevention at the source; this means addressing the social, environmental and food safety factors that lead to the spillover of pathogens from wild animal populations into human communities. These drivers range from deforestation which has prompted animal populations like bats, which harbor a range of deadly pathogens from SARS-COV to Marburg, to move closer to human habitats; to wild animal trafficking and trade, both legal and illicit; as well as industrial production, sale and slaugher of wild animal species. The Wildlife Conservation Society recommended that the accord commit governments to “identifying and prioritising actions to prevent pathogen spillover in the first place” by prioritising tougher regulations on “markets and trade chains and wildlife domestic and international trade”. “We have extensive experience and expertise with habitat degredation, deforestation, forest degradation, wildlife trade and wildlife markets,” said the WCS representative. “And this isn’t about illegal trade, its about any live trade, particularly for food but also for other purposes, birds and mammals. We look forward to working with member states and the INB to ensure that first and foremost there are commitments by governments to avoid the spillover in the first place. And we do know how to do that, from a biodiversity perspective and in terms of markets.” The World Wildlife Fund (WWF) appealed for the “list of drivers of pathogen emergence risks to be expanded to include not just deforestation, but ecosystem loss, fragmentation and degradation”. “Deforestation alone omits many of the potentially important pandemic frontiers and ignores the role of fragmentation and degradation in increasing proximity between humans and wildlife,” said the WWF. Meanwhile, the World Organisation of Animal Health (WOAH) called for the inclusion of the full definition of “One Health” in the treaty. Its delegate also questioned why preparedness and response were stressed whereas “preventive actions targeting activities and places that increase the risk of zoonotic spillover” were not. Pointing to a lack of expertise to address zoonotic spillover, the Action for Animal Health Coalition said that member states needed to invest in increasing the animal health workforce. Equity obligations Oxfam’s Piotr Kolczynski, who also represented the People’s Vaccine Alliance. Meanwhile, Oxfam, also representing the People’s Vaccine Alliance, said that “the accord’s language must oblige governments to take specific actions to ensure equity; otherwise it would be very difficult to implement this”. The current zero draft also assumes that “critical public health interventions are based on the willingness of pharmaceutical companies to engage in voluntary mechanisms” but “these have proved to be largely insufficient during the current and previous pandemics,” said Piotr Kolczynski, of Oxfam and PVA. For this reason, it added, “the accord must require governments to invest in research and development and manufacturing capacities and to condition public funding on the sharing of technologies, knowledge and intellectual property with developers and manufacturers in the South”. In reference to the accord’s proposal that 20% of pandemic-related goods be allocated to the WHO for distribution, Oxfam stated that “equitable allocation of medical countermeasures cannot be achieved by reserving a 20% of production for 80% of the world’s population”. Medecins sans Frontieres (MSF), meanwhile, asked for a legal definition of “pandemic”, and “explicit reference to governments complying with international humanitarian law obligations in the context of pandemic preparedness, prevention and response”. It also demanded stronger language in relation to commitments to protect “humanitarian populations of concerns” and healthcare workers during pandemics. Private sector is a ‘critical partner’ IFPMA’s Grega Kumer, Deputy Director of Government Relations. “The private sector should be seen as a critical partner in preparedness, response and recovery, and should have a seat at the table,” stated Grega Kumer, Deputy Director of Government Relations at the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA). However, it warned that some of the accord’s proposals “would jeopardise our capacity to efficiently prepare for the next pandemic.” Key concerns it cited included proposals for a waiver on intellectual property rights (IP) for health products during a pandemic, as well as proposals that would “be “transactionally linking access to pathogens and sharing of benefits”. It also urged the INB to “avoid unnecessary overlaps and duplications including other multilateral organisations mandate and expertise such as WTO and WIPO”. While there were over 200 participants online, a handful of member states were also on hand to listen in person at WHO’s Geneva Headquarters to the inputs as they prepare for INB4, when the real negotiations begin for the accord that is due to be presented by May 2024 to the World Health Assembly. Image Credits: Peter Griffin/Public Domain Pictures. Mpox To Remain A Public Health Emergency of International Concern Says WHO 15/02/2023 Megha Kaveri Dr Tedros Adhanom Ghebreyesus speaking at the media briefing on Wednesday. The World Health Organization (WHO) declared on Wednesday that Mpox will continue to remain a Public Health Emergency of International Concern (PHEIC). The decision to continue with the status quo on Mpox was based on the recommendations made by an Mpox Emergency Committee, whose findings were published on the same day. “The emergency committee for the global outbreak of Mpox met to assess whether, in its view, the outbreak remains a public health emergency of international concern. The committee has advised me that, in its view, Mpox remains a global health emergency, and I have accepted that advice,” Dr Tedros Adhanom Ghebreyesus, director-general of the WHO, said at a press briefing on Wednesday. In its report, the Mpox committee, which met on 9 February, acknowledged the progress made in reducing the virus transmission and the sharp decline of reported cases. However, it also expressed concerns that “a few countries continued to see a sustained incidence of illness” while in other countries it’s likely that more cases are occuring under the radar. “More than 30 countries continue to report cases, and the possible underdetection and under-reporting of confirmed cases in some regions is concerning. Particularly in countries where animal-human transmission of Mpox has been reported before,” Tedros pointed out. In its report, the expert committee also expressed concerns about the possible resurgence of cases due to the expected resumption of LGBTQ social events and other mass gathering events; lack of access to vaccines and testing capacities in many lower-income countries; and the recurring zoonotic transmission in Africa. It added that “not all countries are receiving the support they need or have structures or systems to respond to mpox, including inadequate support for marginalized groups; and general fatigue among supporting agencies.” Returning from Syrian scenes of devastation Tedros spoke at the briefing shortly after returning to Geneva from a visit to earthquake affected areas in Syria. The 7.8 magnitude earthquake that hit Syria and Türkiye last week is now estimated to have killed over 41,000 people. I've never in my life seen the level of destruction as I did on the road from Aleppo to Damascus. Skeletons of houses. Almost no people in sight. Over a decade of war has taken an unimaginable toll. Syrians need our support now and in years to come to rebuild their lives. pic.twitter.com/Ym2zmDixdw — Tedros Adhanom Ghebreyesus (@DrTedros) February 14, 2023 Describing the damage caused to Aleppo and Damascus first due to the war, and now by the earthquake, Tedros said “I saw the destruction of entire communities, the unspeakable suffering of people, and the courage and determination of survivors and responders. As we drove from Aleppo to Damascus, I saw the legacy of conflict, with town after town destroyed and abandoned. Survivors are now facing freezing conditions without adequate shelter, heating, food, clean water, or medical care.” While two more cross-border points between Türkiye and Syria have been opened, Tedros said he had had asked Syrian president Bashar al-Assad to open still more crossings so that relief could reach people in need more rapidly. Humanitarian aid groups charge that the Syrian president has “weaponized aid” channeling available supplies to government controlled areas – while most of western Syria where the earthquake hit, is controlled by Kurdish and other Syrian anti-government militias. “WHO remains committed to supporting all people in the Syrian Arab Republic now and in the days, weeks, months, and years ahead,” Tedros added. The WHO has launched an appeal for $43 million to support its response in Syria and Türkiye and expects the amount to double by this weekend. Meanwhile, UN Secretary General Antonio Guterres called upon countries to fully fund a $397 million earthquake fund for Syria, in particular, which lacks resources to mount its own response. Marburg disease – ramping up diagnostics and clinical trial possibilities Touching back on the Marburg Virus Disease (MVD) outbreak in Equatorial Guinea, which has claimed nine lives, Tedros said that the WHO is working with the country’s health authorities to ramp up their diagnostic capacity. “So far, no confirmed cases have been reported in Cameroon and or Gabon,” he added, referring to the two countries that, along with Liberia, border Equatorial Guinea. “We’re also supporting the governments of Cameroon and Gabon to prepare to rapidly detect, isolate, and provide care for any suspected cases.” Following up on the Marburg Virus Vaccine Consortium (MARVAC)’s meeting on Tuesday, Tedros said that WHO is trying to accelerate talks on possibile clinical trials for Marburg virus diseaes vaccine candidates. But he reiterated that any decision on the trials of vaccines and therapeutics for Marburg needs to be taken by researchers and the national authorities of Equatorial Guinea. “In the meantime, WHO is convening the vaccine prioritization committee to identify which vaccine candidates should be evaluated first and prepare for potential trials. WHO is also discussing with the ministry of health, the possibility of providing access to experimental therapeutics as part of a clinical trial,” he said. Posts navigation Older postsNewer posts
Natural Immunity Against COVID-19 ‘At Least’ On Par With Vaccination in Preventing Death 21/02/2023 Stefan Anderson Natural immunity provides strong protection against severe illness from COVID-19, but obtaining it carries its own set of risks. New research published in The Lancet suggests that individuals who have previously been infected with COVID-19 have an 88% lower risk of hospitalization or death than those who have not. The study is the most comprehensive review of data on natural immunity to date, covering data from 65 studies across 19 countries published since January 2021. The analysis found that the strength and 10-month duration of protection conferred by natural immunity against severe illness is “at least” on par with that provided by two doses of Moderna and Pfizer-BioNtech’s mRNA vaccines. The study’s authors said the data suggests natural immunity in people recently infected with COVID-19 should be recognised by policymakers but warned against using their findings to undermine the importance of vaccination due to the risks associated with the first infection. “Vaccination is the safest way to acquire immunity, whereas acquiring natural immunity must be weighed against the risks of severe illness and death associated with the initial infection,” lead author Dr Stephen Lim of the University of Washington’s School of Medicine. Researchers also cautioned that differences between the infectious properties of COVID-19 variants mean protection levels can vary. Infection by pre-Omicron variants, for example, yielded substantially lower natural immunity protection against reinfection by the now dominant Omicron BA.1 variant, with just 36% protection remaining after the 10-month window. Nevertheless, protection against hospitalization and death remained high at 88%. “The weaker cross-variant immunity with the Omicron variant and its sub-lineages reflects the mutations they have that make them escape built-up immunity more easily than other variants,” report co-author Dr Hasan Nassereldine of the University of Washington’s School of Medicine said. “The limited data we have on natural immunity protection from the Omicron variant and its sub-lineages underscores the importance of continued assessment, particularly since they are estimated to have infected 46% of the global population between November 2021 and June 2022.” The analysis excluded studies examining “hybrid immunity” (the combination of immune responses from vaccination and natural infection) as well as data relating to Omicron XBB and its sub-lineages. The authors encouraged further research to fill the gaps in the study. Europeans Don’t Exercise Enough – And Policy-Makers Should Do More to Encourage Them 17/02/2023 Kerry Cullinan A third of Europeans don’t meet the World Health Organization’s (WHO) guidelines for physical activity – but if they did, this would avert over 10 000 premature deaths, almost four million cases of cardiovascular disease, three and a half million cases of depression and nearly a million cases of type two diabetes by 2050. This is according to a report launched on Friday by the WHO Europe and the Organisation for Economic Co-operation and Development (OECD), which urges policy-makers to adopt strategies to increase people’s physical activity. The findings are based on a recent Eurobarometer survey conducted for the European Commission which found that 45% of the respondents report that they never exercise or play sport, an increase of 6% since 2009. People in Finland (71%), Luxembourg (63%), the Netherlands (60%), and Denmark and Sweden (both 59%) were the most likely to exercise, while people in Portugal, Greece and Poland were least likely to exercise. “We find that it’s worse among women, with some countries having almost half of all adult women not meeting the WHO recommended guidelines on physical activity,” OECD health policy analyst Sabine Vuik told the launch on Friday. Meanwhile, less than a quarter of people who consider themselves to be working class exercise at least once a week, and over half of all adults surveyed said that they exercised less frequently since the COVID-19 pandemic. Recommended activity The WHO recommends that everyone does at least 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity every week. “This could be a half-hour run twice a week, running about 10 kilometres per hour, but it doesn’t need to be formal exercise. It can also be walking the dog every day for half an hour,” added Vuik. OECD health analyst Sabine Vuik “Our analysis shows that larger countries such as Germany, France and Italy can save more than €1 billion every year if everyone were to meet the physical activity guidelines. And across the EU, we could save €8 billion every year in healthcare expenditure if everyone meets the minimum recommended guidelines.” WHO Europe regional director Dr Hans Kluge, said that the report “provides evidence that investing in policies that promote physical activity not only improves individual well-being and population health, but also pays economic dividends”. “Every €1 invested in physical activity generates an almost two-fold return of €1.7 in economic benefits. We need to communicate the benefits of being active, not just the physical benefits, but the benefits to mental health, the environment and society in the WHO European Region, and we need to make sure that our systems can and will sustain these changes – as real, long-term transformation,” added Kluge, who is an avid cyclist and cycles to work and back daily. The report calls on policymakers to step up the policy response to increase physical activity in schools, in urban and transport design and in healthcare settings and workplaces. Since 2015, some EU countries have adopted policies to improve access to physical activity. For example, Finland adopted a resolution to promote active modes of transportation, Austria builds up co-operation between sports clubs and primary schools and Bulgaria develops a programme to help people whose jobs involve sitting for long periods. Investing in #PhysicalActivity improves individual and population health, while returning 1.7 EUR in economic benefits for every 1 EUR invested. New WHO/@OECD report funded by the #EU shares great ideas for policy makers to consider.👇https://t.co/Ri3xynx9bv@EU_Commission pic.twitter.com/A28qBknwiQ — WHO/Europe (@WHO_Europe) February 17, 2023 Lack of Test Kits for Marburg Virus Hamper Africa’s Response to Outbreak 16/02/2023 Paul Adepoju Dr Ahmed Ogwell Ouma, Acting Director of the Africa Centres for Disease Control. The Africa Centres for Disease Control and Prevention (Africa CDC) is closely monitoring Equatorial Guinea’s first-ever Marburg virus disease outbreak, Africa CDC acting director Dr Ahmed Ogwell Ouma told a media briefing on Thursday “One big challenge we have are test kits and we are working around the clock to try and get test kits to Equatorial Guinea and also to Cameroon and Gabon, to ensure that we have a very short turnaround time for samples being tested in the laboratory,” Ouma added. So far, one case has been confirmed and nine deaths have been reported, while there are 16 suspected cases in quarantine, and another 15 contacts are under observation. All cases have occurred in the province of Kie Ntem in the country’s western region. Ouma added that a key priority is to limit the spread of the virus, as well as monitor neighbouring countries such as Cameroon and Gabon for potential cross-border spillover. As reported by Health Policy Watch, on Tuesday, the WHO received updates from five vaccine developers who have been working on candidate vaccines. The WHO plans to convene a working group to prioritize existing vaccine candidates, with an eye to seeing if clinical trials for any of the vaccines can be launched in real time, particularly if the outbreak expands. Diphtheria, cholera, mpox, Lassa fever, and measles are some of the other health emergencies that African countries are also grappling with, alongside COVID-19, and Ouma, a Kenyan epidemiologist, said that his center is currently monitoring up to nine different public health events. Nigeria reported over 600 new cases of diphtheria and several African countries reported cases of cholera, including Malawi, where three-quarters of the continent’s cases have been reported. The continent has documented over 12 million cases of COVID-19 and 256,705 deaths, a case fatality rate of 2.1%, which is double the global average, Ouma told the media. While the number of new cases and deaths have decreased over the past several weeks, he emphasized the importance of continuing to encourage vaccination efforts and targeted campaigns to reach more people. “The general trend on the continent now is quite flat with the indications that we may be seeing further decreases in numbers and also in deaths,” Ouma told journalists. Ouma noted that Africa CDC is working with governments and health organizations to provide technical assistance and medical countermeasures as needed for these and other health emergencies. He added that the organization is also continuing to promote vaccination efforts and targeted campaigns to help prevent the spread of infectious diseases. Draft Pandemic Accord Neglects Prevention, Particularly ‘Zoonotic Spillover’ 15/02/2023 Kerry Cullinan INB co-chair Roland Driece The draft pandemic accord needs more emphasis on preventing pandemics at their source – where animal pathogens “spill over” to people – according to a number of organisations participating in a consultation on the document’s “zero draft” on Wednesday. Negotiations between World Health Organization (WHO) member states on the draft are due to begin at the fourth meeting of the Intergovernmental Negotiating Body (INB), scheduled to take place from 27 February to 3 March. However, Wednesday’s meeting gave WHO’s civil society stakeholders an opportunity to comment on the draft ahead of that meeting. Only member states will take part in the actual treaty negotiations, which are likely to start behind closed doors on the second day of the month-end meeting (called INB 4), INB co-chair Roland Driece told the meeting. INB 4 and the following INB5 meeting from 3 to 6 April would be approached as “one big meeting”, he added. While the start of the meeting would be open to all stakeholders, “as soon as member states tell us that they accept the zero draft as the zero draft, we will move into negotiation mode, and that means that only member states can be present,” said Driece. “So that’s why it’s so important that you tell us and member states now what you feel and think about this zero draft.” He added that he thought that the INB Bureau had done “a pretty decent job [of synthesizing stakeholders’ inputs]” but “this is an important moment for you all to share whether or not you share my optimism about that and tell us what you think is important”. Prevent ‘zoonotic spillover’ – environmental and animal health groups Across large swathes of Asia and Africa, wholesale markets often sell wild animals captured or bred for food consumption, and which may harbor dangerous viruses. Many scientists believe that SARS-CoV2 was transmitted to humans via live, wild animals, caged for slaughter in Wuhan’s wet market. An unprecedented number of organisations spoke about how the draft needs to pay more attention to pandemic prevention at the source; this means addressing the social, environmental and food safety factors that lead to the spillover of pathogens from wild animal populations into human communities. These drivers range from deforestation which has prompted animal populations like bats, which harbor a range of deadly pathogens from SARS-COV to Marburg, to move closer to human habitats; to wild animal trafficking and trade, both legal and illicit; as well as industrial production, sale and slaugher of wild animal species. The Wildlife Conservation Society recommended that the accord commit governments to “identifying and prioritising actions to prevent pathogen spillover in the first place” by prioritising tougher regulations on “markets and trade chains and wildlife domestic and international trade”. “We have extensive experience and expertise with habitat degredation, deforestation, forest degradation, wildlife trade and wildlife markets,” said the WCS representative. “And this isn’t about illegal trade, its about any live trade, particularly for food but also for other purposes, birds and mammals. We look forward to working with member states and the INB to ensure that first and foremost there are commitments by governments to avoid the spillover in the first place. And we do know how to do that, from a biodiversity perspective and in terms of markets.” The World Wildlife Fund (WWF) appealed for the “list of drivers of pathogen emergence risks to be expanded to include not just deforestation, but ecosystem loss, fragmentation and degradation”. “Deforestation alone omits many of the potentially important pandemic frontiers and ignores the role of fragmentation and degradation in increasing proximity between humans and wildlife,” said the WWF. Meanwhile, the World Organisation of Animal Health (WOAH) called for the inclusion of the full definition of “One Health” in the treaty. Its delegate also questioned why preparedness and response were stressed whereas “preventive actions targeting activities and places that increase the risk of zoonotic spillover” were not. Pointing to a lack of expertise to address zoonotic spillover, the Action for Animal Health Coalition said that member states needed to invest in increasing the animal health workforce. Equity obligations Oxfam’s Piotr Kolczynski, who also represented the People’s Vaccine Alliance. Meanwhile, Oxfam, also representing the People’s Vaccine Alliance, said that “the accord’s language must oblige governments to take specific actions to ensure equity; otherwise it would be very difficult to implement this”. The current zero draft also assumes that “critical public health interventions are based on the willingness of pharmaceutical companies to engage in voluntary mechanisms” but “these have proved to be largely insufficient during the current and previous pandemics,” said Piotr Kolczynski, of Oxfam and PVA. For this reason, it added, “the accord must require governments to invest in research and development and manufacturing capacities and to condition public funding on the sharing of technologies, knowledge and intellectual property with developers and manufacturers in the South”. In reference to the accord’s proposal that 20% of pandemic-related goods be allocated to the WHO for distribution, Oxfam stated that “equitable allocation of medical countermeasures cannot be achieved by reserving a 20% of production for 80% of the world’s population”. Medecins sans Frontieres (MSF), meanwhile, asked for a legal definition of “pandemic”, and “explicit reference to governments complying with international humanitarian law obligations in the context of pandemic preparedness, prevention and response”. It also demanded stronger language in relation to commitments to protect “humanitarian populations of concerns” and healthcare workers during pandemics. Private sector is a ‘critical partner’ IFPMA’s Grega Kumer, Deputy Director of Government Relations. “The private sector should be seen as a critical partner in preparedness, response and recovery, and should have a seat at the table,” stated Grega Kumer, Deputy Director of Government Relations at the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA). However, it warned that some of the accord’s proposals “would jeopardise our capacity to efficiently prepare for the next pandemic.” Key concerns it cited included proposals for a waiver on intellectual property rights (IP) for health products during a pandemic, as well as proposals that would “be “transactionally linking access to pathogens and sharing of benefits”. It also urged the INB to “avoid unnecessary overlaps and duplications including other multilateral organisations mandate and expertise such as WTO and WIPO”. While there were over 200 participants online, a handful of member states were also on hand to listen in person at WHO’s Geneva Headquarters to the inputs as they prepare for INB4, when the real negotiations begin for the accord that is due to be presented by May 2024 to the World Health Assembly. Image Credits: Peter Griffin/Public Domain Pictures. Mpox To Remain A Public Health Emergency of International Concern Says WHO 15/02/2023 Megha Kaveri Dr Tedros Adhanom Ghebreyesus speaking at the media briefing on Wednesday. The World Health Organization (WHO) declared on Wednesday that Mpox will continue to remain a Public Health Emergency of International Concern (PHEIC). The decision to continue with the status quo on Mpox was based on the recommendations made by an Mpox Emergency Committee, whose findings were published on the same day. “The emergency committee for the global outbreak of Mpox met to assess whether, in its view, the outbreak remains a public health emergency of international concern. The committee has advised me that, in its view, Mpox remains a global health emergency, and I have accepted that advice,” Dr Tedros Adhanom Ghebreyesus, director-general of the WHO, said at a press briefing on Wednesday. In its report, the Mpox committee, which met on 9 February, acknowledged the progress made in reducing the virus transmission and the sharp decline of reported cases. However, it also expressed concerns that “a few countries continued to see a sustained incidence of illness” while in other countries it’s likely that more cases are occuring under the radar. “More than 30 countries continue to report cases, and the possible underdetection and under-reporting of confirmed cases in some regions is concerning. Particularly in countries where animal-human transmission of Mpox has been reported before,” Tedros pointed out. In its report, the expert committee also expressed concerns about the possible resurgence of cases due to the expected resumption of LGBTQ social events and other mass gathering events; lack of access to vaccines and testing capacities in many lower-income countries; and the recurring zoonotic transmission in Africa. It added that “not all countries are receiving the support they need or have structures or systems to respond to mpox, including inadequate support for marginalized groups; and general fatigue among supporting agencies.” Returning from Syrian scenes of devastation Tedros spoke at the briefing shortly after returning to Geneva from a visit to earthquake affected areas in Syria. The 7.8 magnitude earthquake that hit Syria and Türkiye last week is now estimated to have killed over 41,000 people. I've never in my life seen the level of destruction as I did on the road from Aleppo to Damascus. Skeletons of houses. Almost no people in sight. Over a decade of war has taken an unimaginable toll. Syrians need our support now and in years to come to rebuild their lives. pic.twitter.com/Ym2zmDixdw — Tedros Adhanom Ghebreyesus (@DrTedros) February 14, 2023 Describing the damage caused to Aleppo and Damascus first due to the war, and now by the earthquake, Tedros said “I saw the destruction of entire communities, the unspeakable suffering of people, and the courage and determination of survivors and responders. As we drove from Aleppo to Damascus, I saw the legacy of conflict, with town after town destroyed and abandoned. Survivors are now facing freezing conditions without adequate shelter, heating, food, clean water, or medical care.” While two more cross-border points between Türkiye and Syria have been opened, Tedros said he had had asked Syrian president Bashar al-Assad to open still more crossings so that relief could reach people in need more rapidly. Humanitarian aid groups charge that the Syrian president has “weaponized aid” channeling available supplies to government controlled areas – while most of western Syria where the earthquake hit, is controlled by Kurdish and other Syrian anti-government militias. “WHO remains committed to supporting all people in the Syrian Arab Republic now and in the days, weeks, months, and years ahead,” Tedros added. The WHO has launched an appeal for $43 million to support its response in Syria and Türkiye and expects the amount to double by this weekend. Meanwhile, UN Secretary General Antonio Guterres called upon countries to fully fund a $397 million earthquake fund for Syria, in particular, which lacks resources to mount its own response. Marburg disease – ramping up diagnostics and clinical trial possibilities Touching back on the Marburg Virus Disease (MVD) outbreak in Equatorial Guinea, which has claimed nine lives, Tedros said that the WHO is working with the country’s health authorities to ramp up their diagnostic capacity. “So far, no confirmed cases have been reported in Cameroon and or Gabon,” he added, referring to the two countries that, along with Liberia, border Equatorial Guinea. “We’re also supporting the governments of Cameroon and Gabon to prepare to rapidly detect, isolate, and provide care for any suspected cases.” Following up on the Marburg Virus Vaccine Consortium (MARVAC)’s meeting on Tuesday, Tedros said that WHO is trying to accelerate talks on possibile clinical trials for Marburg virus diseaes vaccine candidates. But he reiterated that any decision on the trials of vaccines and therapeutics for Marburg needs to be taken by researchers and the national authorities of Equatorial Guinea. “In the meantime, WHO is convening the vaccine prioritization committee to identify which vaccine candidates should be evaluated first and prepare for potential trials. WHO is also discussing with the ministry of health, the possibility of providing access to experimental therapeutics as part of a clinical trial,” he said. Posts navigation Older postsNewer posts
Europeans Don’t Exercise Enough – And Policy-Makers Should Do More to Encourage Them 17/02/2023 Kerry Cullinan A third of Europeans don’t meet the World Health Organization’s (WHO) guidelines for physical activity – but if they did, this would avert over 10 000 premature deaths, almost four million cases of cardiovascular disease, three and a half million cases of depression and nearly a million cases of type two diabetes by 2050. This is according to a report launched on Friday by the WHO Europe and the Organisation for Economic Co-operation and Development (OECD), which urges policy-makers to adopt strategies to increase people’s physical activity. The findings are based on a recent Eurobarometer survey conducted for the European Commission which found that 45% of the respondents report that they never exercise or play sport, an increase of 6% since 2009. People in Finland (71%), Luxembourg (63%), the Netherlands (60%), and Denmark and Sweden (both 59%) were the most likely to exercise, while people in Portugal, Greece and Poland were least likely to exercise. “We find that it’s worse among women, with some countries having almost half of all adult women not meeting the WHO recommended guidelines on physical activity,” OECD health policy analyst Sabine Vuik told the launch on Friday. Meanwhile, less than a quarter of people who consider themselves to be working class exercise at least once a week, and over half of all adults surveyed said that they exercised less frequently since the COVID-19 pandemic. Recommended activity The WHO recommends that everyone does at least 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity every week. “This could be a half-hour run twice a week, running about 10 kilometres per hour, but it doesn’t need to be formal exercise. It can also be walking the dog every day for half an hour,” added Vuik. OECD health analyst Sabine Vuik “Our analysis shows that larger countries such as Germany, France and Italy can save more than €1 billion every year if everyone were to meet the physical activity guidelines. And across the EU, we could save €8 billion every year in healthcare expenditure if everyone meets the minimum recommended guidelines.” WHO Europe regional director Dr Hans Kluge, said that the report “provides evidence that investing in policies that promote physical activity not only improves individual well-being and population health, but also pays economic dividends”. “Every €1 invested in physical activity generates an almost two-fold return of €1.7 in economic benefits. We need to communicate the benefits of being active, not just the physical benefits, but the benefits to mental health, the environment and society in the WHO European Region, and we need to make sure that our systems can and will sustain these changes – as real, long-term transformation,” added Kluge, who is an avid cyclist and cycles to work and back daily. The report calls on policymakers to step up the policy response to increase physical activity in schools, in urban and transport design and in healthcare settings and workplaces. Since 2015, some EU countries have adopted policies to improve access to physical activity. For example, Finland adopted a resolution to promote active modes of transportation, Austria builds up co-operation between sports clubs and primary schools and Bulgaria develops a programme to help people whose jobs involve sitting for long periods. Investing in #PhysicalActivity improves individual and population health, while returning 1.7 EUR in economic benefits for every 1 EUR invested. New WHO/@OECD report funded by the #EU shares great ideas for policy makers to consider.👇https://t.co/Ri3xynx9bv@EU_Commission pic.twitter.com/A28qBknwiQ — WHO/Europe (@WHO_Europe) February 17, 2023 Lack of Test Kits for Marburg Virus Hamper Africa’s Response to Outbreak 16/02/2023 Paul Adepoju Dr Ahmed Ogwell Ouma, Acting Director of the Africa Centres for Disease Control. The Africa Centres for Disease Control and Prevention (Africa CDC) is closely monitoring Equatorial Guinea’s first-ever Marburg virus disease outbreak, Africa CDC acting director Dr Ahmed Ogwell Ouma told a media briefing on Thursday “One big challenge we have are test kits and we are working around the clock to try and get test kits to Equatorial Guinea and also to Cameroon and Gabon, to ensure that we have a very short turnaround time for samples being tested in the laboratory,” Ouma added. So far, one case has been confirmed and nine deaths have been reported, while there are 16 suspected cases in quarantine, and another 15 contacts are under observation. All cases have occurred in the province of Kie Ntem in the country’s western region. Ouma added that a key priority is to limit the spread of the virus, as well as monitor neighbouring countries such as Cameroon and Gabon for potential cross-border spillover. As reported by Health Policy Watch, on Tuesday, the WHO received updates from five vaccine developers who have been working on candidate vaccines. The WHO plans to convene a working group to prioritize existing vaccine candidates, with an eye to seeing if clinical trials for any of the vaccines can be launched in real time, particularly if the outbreak expands. Diphtheria, cholera, mpox, Lassa fever, and measles are some of the other health emergencies that African countries are also grappling with, alongside COVID-19, and Ouma, a Kenyan epidemiologist, said that his center is currently monitoring up to nine different public health events. Nigeria reported over 600 new cases of diphtheria and several African countries reported cases of cholera, including Malawi, where three-quarters of the continent’s cases have been reported. The continent has documented over 12 million cases of COVID-19 and 256,705 deaths, a case fatality rate of 2.1%, which is double the global average, Ouma told the media. While the number of new cases and deaths have decreased over the past several weeks, he emphasized the importance of continuing to encourage vaccination efforts and targeted campaigns to reach more people. “The general trend on the continent now is quite flat with the indications that we may be seeing further decreases in numbers and also in deaths,” Ouma told journalists. Ouma noted that Africa CDC is working with governments and health organizations to provide technical assistance and medical countermeasures as needed for these and other health emergencies. He added that the organization is also continuing to promote vaccination efforts and targeted campaigns to help prevent the spread of infectious diseases. Draft Pandemic Accord Neglects Prevention, Particularly ‘Zoonotic Spillover’ 15/02/2023 Kerry Cullinan INB co-chair Roland Driece The draft pandemic accord needs more emphasis on preventing pandemics at their source – where animal pathogens “spill over” to people – according to a number of organisations participating in a consultation on the document’s “zero draft” on Wednesday. Negotiations between World Health Organization (WHO) member states on the draft are due to begin at the fourth meeting of the Intergovernmental Negotiating Body (INB), scheduled to take place from 27 February to 3 March. However, Wednesday’s meeting gave WHO’s civil society stakeholders an opportunity to comment on the draft ahead of that meeting. Only member states will take part in the actual treaty negotiations, which are likely to start behind closed doors on the second day of the month-end meeting (called INB 4), INB co-chair Roland Driece told the meeting. INB 4 and the following INB5 meeting from 3 to 6 April would be approached as “one big meeting”, he added. While the start of the meeting would be open to all stakeholders, “as soon as member states tell us that they accept the zero draft as the zero draft, we will move into negotiation mode, and that means that only member states can be present,” said Driece. “So that’s why it’s so important that you tell us and member states now what you feel and think about this zero draft.” He added that he thought that the INB Bureau had done “a pretty decent job [of synthesizing stakeholders’ inputs]” but “this is an important moment for you all to share whether or not you share my optimism about that and tell us what you think is important”. Prevent ‘zoonotic spillover’ – environmental and animal health groups Across large swathes of Asia and Africa, wholesale markets often sell wild animals captured or bred for food consumption, and which may harbor dangerous viruses. Many scientists believe that SARS-CoV2 was transmitted to humans via live, wild animals, caged for slaughter in Wuhan’s wet market. An unprecedented number of organisations spoke about how the draft needs to pay more attention to pandemic prevention at the source; this means addressing the social, environmental and food safety factors that lead to the spillover of pathogens from wild animal populations into human communities. These drivers range from deforestation which has prompted animal populations like bats, which harbor a range of deadly pathogens from SARS-COV to Marburg, to move closer to human habitats; to wild animal trafficking and trade, both legal and illicit; as well as industrial production, sale and slaugher of wild animal species. The Wildlife Conservation Society recommended that the accord commit governments to “identifying and prioritising actions to prevent pathogen spillover in the first place” by prioritising tougher regulations on “markets and trade chains and wildlife domestic and international trade”. “We have extensive experience and expertise with habitat degredation, deforestation, forest degradation, wildlife trade and wildlife markets,” said the WCS representative. “And this isn’t about illegal trade, its about any live trade, particularly for food but also for other purposes, birds and mammals. We look forward to working with member states and the INB to ensure that first and foremost there are commitments by governments to avoid the spillover in the first place. And we do know how to do that, from a biodiversity perspective and in terms of markets.” The World Wildlife Fund (WWF) appealed for the “list of drivers of pathogen emergence risks to be expanded to include not just deforestation, but ecosystem loss, fragmentation and degradation”. “Deforestation alone omits many of the potentially important pandemic frontiers and ignores the role of fragmentation and degradation in increasing proximity between humans and wildlife,” said the WWF. Meanwhile, the World Organisation of Animal Health (WOAH) called for the inclusion of the full definition of “One Health” in the treaty. Its delegate also questioned why preparedness and response were stressed whereas “preventive actions targeting activities and places that increase the risk of zoonotic spillover” were not. Pointing to a lack of expertise to address zoonotic spillover, the Action for Animal Health Coalition said that member states needed to invest in increasing the animal health workforce. Equity obligations Oxfam’s Piotr Kolczynski, who also represented the People’s Vaccine Alliance. Meanwhile, Oxfam, also representing the People’s Vaccine Alliance, said that “the accord’s language must oblige governments to take specific actions to ensure equity; otherwise it would be very difficult to implement this”. The current zero draft also assumes that “critical public health interventions are based on the willingness of pharmaceutical companies to engage in voluntary mechanisms” but “these have proved to be largely insufficient during the current and previous pandemics,” said Piotr Kolczynski, of Oxfam and PVA. For this reason, it added, “the accord must require governments to invest in research and development and manufacturing capacities and to condition public funding on the sharing of technologies, knowledge and intellectual property with developers and manufacturers in the South”. In reference to the accord’s proposal that 20% of pandemic-related goods be allocated to the WHO for distribution, Oxfam stated that “equitable allocation of medical countermeasures cannot be achieved by reserving a 20% of production for 80% of the world’s population”. Medecins sans Frontieres (MSF), meanwhile, asked for a legal definition of “pandemic”, and “explicit reference to governments complying with international humanitarian law obligations in the context of pandemic preparedness, prevention and response”. It also demanded stronger language in relation to commitments to protect “humanitarian populations of concerns” and healthcare workers during pandemics. Private sector is a ‘critical partner’ IFPMA’s Grega Kumer, Deputy Director of Government Relations. “The private sector should be seen as a critical partner in preparedness, response and recovery, and should have a seat at the table,” stated Grega Kumer, Deputy Director of Government Relations at the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA). However, it warned that some of the accord’s proposals “would jeopardise our capacity to efficiently prepare for the next pandemic.” Key concerns it cited included proposals for a waiver on intellectual property rights (IP) for health products during a pandemic, as well as proposals that would “be “transactionally linking access to pathogens and sharing of benefits”. It also urged the INB to “avoid unnecessary overlaps and duplications including other multilateral organisations mandate and expertise such as WTO and WIPO”. While there were over 200 participants online, a handful of member states were also on hand to listen in person at WHO’s Geneva Headquarters to the inputs as they prepare for INB4, when the real negotiations begin for the accord that is due to be presented by May 2024 to the World Health Assembly. Image Credits: Peter Griffin/Public Domain Pictures. Mpox To Remain A Public Health Emergency of International Concern Says WHO 15/02/2023 Megha Kaveri Dr Tedros Adhanom Ghebreyesus speaking at the media briefing on Wednesday. The World Health Organization (WHO) declared on Wednesday that Mpox will continue to remain a Public Health Emergency of International Concern (PHEIC). The decision to continue with the status quo on Mpox was based on the recommendations made by an Mpox Emergency Committee, whose findings were published on the same day. “The emergency committee for the global outbreak of Mpox met to assess whether, in its view, the outbreak remains a public health emergency of international concern. The committee has advised me that, in its view, Mpox remains a global health emergency, and I have accepted that advice,” Dr Tedros Adhanom Ghebreyesus, director-general of the WHO, said at a press briefing on Wednesday. In its report, the Mpox committee, which met on 9 February, acknowledged the progress made in reducing the virus transmission and the sharp decline of reported cases. However, it also expressed concerns that “a few countries continued to see a sustained incidence of illness” while in other countries it’s likely that more cases are occuring under the radar. “More than 30 countries continue to report cases, and the possible underdetection and under-reporting of confirmed cases in some regions is concerning. Particularly in countries where animal-human transmission of Mpox has been reported before,” Tedros pointed out. In its report, the expert committee also expressed concerns about the possible resurgence of cases due to the expected resumption of LGBTQ social events and other mass gathering events; lack of access to vaccines and testing capacities in many lower-income countries; and the recurring zoonotic transmission in Africa. It added that “not all countries are receiving the support they need or have structures or systems to respond to mpox, including inadequate support for marginalized groups; and general fatigue among supporting agencies.” Returning from Syrian scenes of devastation Tedros spoke at the briefing shortly after returning to Geneva from a visit to earthquake affected areas in Syria. The 7.8 magnitude earthquake that hit Syria and Türkiye last week is now estimated to have killed over 41,000 people. I've never in my life seen the level of destruction as I did on the road from Aleppo to Damascus. Skeletons of houses. Almost no people in sight. Over a decade of war has taken an unimaginable toll. Syrians need our support now and in years to come to rebuild their lives. pic.twitter.com/Ym2zmDixdw — Tedros Adhanom Ghebreyesus (@DrTedros) February 14, 2023 Describing the damage caused to Aleppo and Damascus first due to the war, and now by the earthquake, Tedros said “I saw the destruction of entire communities, the unspeakable suffering of people, and the courage and determination of survivors and responders. As we drove from Aleppo to Damascus, I saw the legacy of conflict, with town after town destroyed and abandoned. Survivors are now facing freezing conditions without adequate shelter, heating, food, clean water, or medical care.” While two more cross-border points between Türkiye and Syria have been opened, Tedros said he had had asked Syrian president Bashar al-Assad to open still more crossings so that relief could reach people in need more rapidly. Humanitarian aid groups charge that the Syrian president has “weaponized aid” channeling available supplies to government controlled areas – while most of western Syria where the earthquake hit, is controlled by Kurdish and other Syrian anti-government militias. “WHO remains committed to supporting all people in the Syrian Arab Republic now and in the days, weeks, months, and years ahead,” Tedros added. The WHO has launched an appeal for $43 million to support its response in Syria and Türkiye and expects the amount to double by this weekend. Meanwhile, UN Secretary General Antonio Guterres called upon countries to fully fund a $397 million earthquake fund for Syria, in particular, which lacks resources to mount its own response. Marburg disease – ramping up diagnostics and clinical trial possibilities Touching back on the Marburg Virus Disease (MVD) outbreak in Equatorial Guinea, which has claimed nine lives, Tedros said that the WHO is working with the country’s health authorities to ramp up their diagnostic capacity. “So far, no confirmed cases have been reported in Cameroon and or Gabon,” he added, referring to the two countries that, along with Liberia, border Equatorial Guinea. “We’re also supporting the governments of Cameroon and Gabon to prepare to rapidly detect, isolate, and provide care for any suspected cases.” Following up on the Marburg Virus Vaccine Consortium (MARVAC)’s meeting on Tuesday, Tedros said that WHO is trying to accelerate talks on possibile clinical trials for Marburg virus diseaes vaccine candidates. But he reiterated that any decision on the trials of vaccines and therapeutics for Marburg needs to be taken by researchers and the national authorities of Equatorial Guinea. “In the meantime, WHO is convening the vaccine prioritization committee to identify which vaccine candidates should be evaluated first and prepare for potential trials. WHO is also discussing with the ministry of health, the possibility of providing access to experimental therapeutics as part of a clinical trial,” he said. Posts navigation Older postsNewer posts
Lack of Test Kits for Marburg Virus Hamper Africa’s Response to Outbreak 16/02/2023 Paul Adepoju Dr Ahmed Ogwell Ouma, Acting Director of the Africa Centres for Disease Control. The Africa Centres for Disease Control and Prevention (Africa CDC) is closely monitoring Equatorial Guinea’s first-ever Marburg virus disease outbreak, Africa CDC acting director Dr Ahmed Ogwell Ouma told a media briefing on Thursday “One big challenge we have are test kits and we are working around the clock to try and get test kits to Equatorial Guinea and also to Cameroon and Gabon, to ensure that we have a very short turnaround time for samples being tested in the laboratory,” Ouma added. So far, one case has been confirmed and nine deaths have been reported, while there are 16 suspected cases in quarantine, and another 15 contacts are under observation. All cases have occurred in the province of Kie Ntem in the country’s western region. Ouma added that a key priority is to limit the spread of the virus, as well as monitor neighbouring countries such as Cameroon and Gabon for potential cross-border spillover. As reported by Health Policy Watch, on Tuesday, the WHO received updates from five vaccine developers who have been working on candidate vaccines. The WHO plans to convene a working group to prioritize existing vaccine candidates, with an eye to seeing if clinical trials for any of the vaccines can be launched in real time, particularly if the outbreak expands. Diphtheria, cholera, mpox, Lassa fever, and measles are some of the other health emergencies that African countries are also grappling with, alongside COVID-19, and Ouma, a Kenyan epidemiologist, said that his center is currently monitoring up to nine different public health events. Nigeria reported over 600 new cases of diphtheria and several African countries reported cases of cholera, including Malawi, where three-quarters of the continent’s cases have been reported. The continent has documented over 12 million cases of COVID-19 and 256,705 deaths, a case fatality rate of 2.1%, which is double the global average, Ouma told the media. While the number of new cases and deaths have decreased over the past several weeks, he emphasized the importance of continuing to encourage vaccination efforts and targeted campaigns to reach more people. “The general trend on the continent now is quite flat with the indications that we may be seeing further decreases in numbers and also in deaths,” Ouma told journalists. Ouma noted that Africa CDC is working with governments and health organizations to provide technical assistance and medical countermeasures as needed for these and other health emergencies. He added that the organization is also continuing to promote vaccination efforts and targeted campaigns to help prevent the spread of infectious diseases. Draft Pandemic Accord Neglects Prevention, Particularly ‘Zoonotic Spillover’ 15/02/2023 Kerry Cullinan INB co-chair Roland Driece The draft pandemic accord needs more emphasis on preventing pandemics at their source – where animal pathogens “spill over” to people – according to a number of organisations participating in a consultation on the document’s “zero draft” on Wednesday. Negotiations between World Health Organization (WHO) member states on the draft are due to begin at the fourth meeting of the Intergovernmental Negotiating Body (INB), scheduled to take place from 27 February to 3 March. However, Wednesday’s meeting gave WHO’s civil society stakeholders an opportunity to comment on the draft ahead of that meeting. Only member states will take part in the actual treaty negotiations, which are likely to start behind closed doors on the second day of the month-end meeting (called INB 4), INB co-chair Roland Driece told the meeting. INB 4 and the following INB5 meeting from 3 to 6 April would be approached as “one big meeting”, he added. While the start of the meeting would be open to all stakeholders, “as soon as member states tell us that they accept the zero draft as the zero draft, we will move into negotiation mode, and that means that only member states can be present,” said Driece. “So that’s why it’s so important that you tell us and member states now what you feel and think about this zero draft.” He added that he thought that the INB Bureau had done “a pretty decent job [of synthesizing stakeholders’ inputs]” but “this is an important moment for you all to share whether or not you share my optimism about that and tell us what you think is important”. Prevent ‘zoonotic spillover’ – environmental and animal health groups Across large swathes of Asia and Africa, wholesale markets often sell wild animals captured or bred for food consumption, and which may harbor dangerous viruses. Many scientists believe that SARS-CoV2 was transmitted to humans via live, wild animals, caged for slaughter in Wuhan’s wet market. An unprecedented number of organisations spoke about how the draft needs to pay more attention to pandemic prevention at the source; this means addressing the social, environmental and food safety factors that lead to the spillover of pathogens from wild animal populations into human communities. These drivers range from deforestation which has prompted animal populations like bats, which harbor a range of deadly pathogens from SARS-COV to Marburg, to move closer to human habitats; to wild animal trafficking and trade, both legal and illicit; as well as industrial production, sale and slaugher of wild animal species. The Wildlife Conservation Society recommended that the accord commit governments to “identifying and prioritising actions to prevent pathogen spillover in the first place” by prioritising tougher regulations on “markets and trade chains and wildlife domestic and international trade”. “We have extensive experience and expertise with habitat degredation, deforestation, forest degradation, wildlife trade and wildlife markets,” said the WCS representative. “And this isn’t about illegal trade, its about any live trade, particularly for food but also for other purposes, birds and mammals. We look forward to working with member states and the INB to ensure that first and foremost there are commitments by governments to avoid the spillover in the first place. And we do know how to do that, from a biodiversity perspective and in terms of markets.” The World Wildlife Fund (WWF) appealed for the “list of drivers of pathogen emergence risks to be expanded to include not just deforestation, but ecosystem loss, fragmentation and degradation”. “Deforestation alone omits many of the potentially important pandemic frontiers and ignores the role of fragmentation and degradation in increasing proximity between humans and wildlife,” said the WWF. Meanwhile, the World Organisation of Animal Health (WOAH) called for the inclusion of the full definition of “One Health” in the treaty. Its delegate also questioned why preparedness and response were stressed whereas “preventive actions targeting activities and places that increase the risk of zoonotic spillover” were not. Pointing to a lack of expertise to address zoonotic spillover, the Action for Animal Health Coalition said that member states needed to invest in increasing the animal health workforce. Equity obligations Oxfam’s Piotr Kolczynski, who also represented the People’s Vaccine Alliance. Meanwhile, Oxfam, also representing the People’s Vaccine Alliance, said that “the accord’s language must oblige governments to take specific actions to ensure equity; otherwise it would be very difficult to implement this”. The current zero draft also assumes that “critical public health interventions are based on the willingness of pharmaceutical companies to engage in voluntary mechanisms” but “these have proved to be largely insufficient during the current and previous pandemics,” said Piotr Kolczynski, of Oxfam and PVA. For this reason, it added, “the accord must require governments to invest in research and development and manufacturing capacities and to condition public funding on the sharing of technologies, knowledge and intellectual property with developers and manufacturers in the South”. In reference to the accord’s proposal that 20% of pandemic-related goods be allocated to the WHO for distribution, Oxfam stated that “equitable allocation of medical countermeasures cannot be achieved by reserving a 20% of production for 80% of the world’s population”. Medecins sans Frontieres (MSF), meanwhile, asked for a legal definition of “pandemic”, and “explicit reference to governments complying with international humanitarian law obligations in the context of pandemic preparedness, prevention and response”. It also demanded stronger language in relation to commitments to protect “humanitarian populations of concerns” and healthcare workers during pandemics. Private sector is a ‘critical partner’ IFPMA’s Grega Kumer, Deputy Director of Government Relations. “The private sector should be seen as a critical partner in preparedness, response and recovery, and should have a seat at the table,” stated Grega Kumer, Deputy Director of Government Relations at the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA). However, it warned that some of the accord’s proposals “would jeopardise our capacity to efficiently prepare for the next pandemic.” Key concerns it cited included proposals for a waiver on intellectual property rights (IP) for health products during a pandemic, as well as proposals that would “be “transactionally linking access to pathogens and sharing of benefits”. It also urged the INB to “avoid unnecessary overlaps and duplications including other multilateral organisations mandate and expertise such as WTO and WIPO”. While there were over 200 participants online, a handful of member states were also on hand to listen in person at WHO’s Geneva Headquarters to the inputs as they prepare for INB4, when the real negotiations begin for the accord that is due to be presented by May 2024 to the World Health Assembly. Image Credits: Peter Griffin/Public Domain Pictures. Mpox To Remain A Public Health Emergency of International Concern Says WHO 15/02/2023 Megha Kaveri Dr Tedros Adhanom Ghebreyesus speaking at the media briefing on Wednesday. The World Health Organization (WHO) declared on Wednesday that Mpox will continue to remain a Public Health Emergency of International Concern (PHEIC). The decision to continue with the status quo on Mpox was based on the recommendations made by an Mpox Emergency Committee, whose findings were published on the same day. “The emergency committee for the global outbreak of Mpox met to assess whether, in its view, the outbreak remains a public health emergency of international concern. The committee has advised me that, in its view, Mpox remains a global health emergency, and I have accepted that advice,” Dr Tedros Adhanom Ghebreyesus, director-general of the WHO, said at a press briefing on Wednesday. In its report, the Mpox committee, which met on 9 February, acknowledged the progress made in reducing the virus transmission and the sharp decline of reported cases. However, it also expressed concerns that “a few countries continued to see a sustained incidence of illness” while in other countries it’s likely that more cases are occuring under the radar. “More than 30 countries continue to report cases, and the possible underdetection and under-reporting of confirmed cases in some regions is concerning. Particularly in countries where animal-human transmission of Mpox has been reported before,” Tedros pointed out. In its report, the expert committee also expressed concerns about the possible resurgence of cases due to the expected resumption of LGBTQ social events and other mass gathering events; lack of access to vaccines and testing capacities in many lower-income countries; and the recurring zoonotic transmission in Africa. It added that “not all countries are receiving the support they need or have structures or systems to respond to mpox, including inadequate support for marginalized groups; and general fatigue among supporting agencies.” Returning from Syrian scenes of devastation Tedros spoke at the briefing shortly after returning to Geneva from a visit to earthquake affected areas in Syria. The 7.8 magnitude earthquake that hit Syria and Türkiye last week is now estimated to have killed over 41,000 people. I've never in my life seen the level of destruction as I did on the road from Aleppo to Damascus. Skeletons of houses. Almost no people in sight. Over a decade of war has taken an unimaginable toll. Syrians need our support now and in years to come to rebuild their lives. pic.twitter.com/Ym2zmDixdw — Tedros Adhanom Ghebreyesus (@DrTedros) February 14, 2023 Describing the damage caused to Aleppo and Damascus first due to the war, and now by the earthquake, Tedros said “I saw the destruction of entire communities, the unspeakable suffering of people, and the courage and determination of survivors and responders. As we drove from Aleppo to Damascus, I saw the legacy of conflict, with town after town destroyed and abandoned. Survivors are now facing freezing conditions without adequate shelter, heating, food, clean water, or medical care.” While two more cross-border points between Türkiye and Syria have been opened, Tedros said he had had asked Syrian president Bashar al-Assad to open still more crossings so that relief could reach people in need more rapidly. Humanitarian aid groups charge that the Syrian president has “weaponized aid” channeling available supplies to government controlled areas – while most of western Syria where the earthquake hit, is controlled by Kurdish and other Syrian anti-government militias. “WHO remains committed to supporting all people in the Syrian Arab Republic now and in the days, weeks, months, and years ahead,” Tedros added. The WHO has launched an appeal for $43 million to support its response in Syria and Türkiye and expects the amount to double by this weekend. Meanwhile, UN Secretary General Antonio Guterres called upon countries to fully fund a $397 million earthquake fund for Syria, in particular, which lacks resources to mount its own response. Marburg disease – ramping up diagnostics and clinical trial possibilities Touching back on the Marburg Virus Disease (MVD) outbreak in Equatorial Guinea, which has claimed nine lives, Tedros said that the WHO is working with the country’s health authorities to ramp up their diagnostic capacity. “So far, no confirmed cases have been reported in Cameroon and or Gabon,” he added, referring to the two countries that, along with Liberia, border Equatorial Guinea. “We’re also supporting the governments of Cameroon and Gabon to prepare to rapidly detect, isolate, and provide care for any suspected cases.” Following up on the Marburg Virus Vaccine Consortium (MARVAC)’s meeting on Tuesday, Tedros said that WHO is trying to accelerate talks on possibile clinical trials for Marburg virus diseaes vaccine candidates. But he reiterated that any decision on the trials of vaccines and therapeutics for Marburg needs to be taken by researchers and the national authorities of Equatorial Guinea. “In the meantime, WHO is convening the vaccine prioritization committee to identify which vaccine candidates should be evaluated first and prepare for potential trials. WHO is also discussing with the ministry of health, the possibility of providing access to experimental therapeutics as part of a clinical trial,” he said. Posts navigation Older postsNewer posts
Draft Pandemic Accord Neglects Prevention, Particularly ‘Zoonotic Spillover’ 15/02/2023 Kerry Cullinan INB co-chair Roland Driece The draft pandemic accord needs more emphasis on preventing pandemics at their source – where animal pathogens “spill over” to people – according to a number of organisations participating in a consultation on the document’s “zero draft” on Wednesday. Negotiations between World Health Organization (WHO) member states on the draft are due to begin at the fourth meeting of the Intergovernmental Negotiating Body (INB), scheduled to take place from 27 February to 3 March. However, Wednesday’s meeting gave WHO’s civil society stakeholders an opportunity to comment on the draft ahead of that meeting. Only member states will take part in the actual treaty negotiations, which are likely to start behind closed doors on the second day of the month-end meeting (called INB 4), INB co-chair Roland Driece told the meeting. INB 4 and the following INB5 meeting from 3 to 6 April would be approached as “one big meeting”, he added. While the start of the meeting would be open to all stakeholders, “as soon as member states tell us that they accept the zero draft as the zero draft, we will move into negotiation mode, and that means that only member states can be present,” said Driece. “So that’s why it’s so important that you tell us and member states now what you feel and think about this zero draft.” He added that he thought that the INB Bureau had done “a pretty decent job [of synthesizing stakeholders’ inputs]” but “this is an important moment for you all to share whether or not you share my optimism about that and tell us what you think is important”. Prevent ‘zoonotic spillover’ – environmental and animal health groups Across large swathes of Asia and Africa, wholesale markets often sell wild animals captured or bred for food consumption, and which may harbor dangerous viruses. Many scientists believe that SARS-CoV2 was transmitted to humans via live, wild animals, caged for slaughter in Wuhan’s wet market. An unprecedented number of organisations spoke about how the draft needs to pay more attention to pandemic prevention at the source; this means addressing the social, environmental and food safety factors that lead to the spillover of pathogens from wild animal populations into human communities. These drivers range from deforestation which has prompted animal populations like bats, which harbor a range of deadly pathogens from SARS-COV to Marburg, to move closer to human habitats; to wild animal trafficking and trade, both legal and illicit; as well as industrial production, sale and slaugher of wild animal species. The Wildlife Conservation Society recommended that the accord commit governments to “identifying and prioritising actions to prevent pathogen spillover in the first place” by prioritising tougher regulations on “markets and trade chains and wildlife domestic and international trade”. “We have extensive experience and expertise with habitat degredation, deforestation, forest degradation, wildlife trade and wildlife markets,” said the WCS representative. “And this isn’t about illegal trade, its about any live trade, particularly for food but also for other purposes, birds and mammals. We look forward to working with member states and the INB to ensure that first and foremost there are commitments by governments to avoid the spillover in the first place. And we do know how to do that, from a biodiversity perspective and in terms of markets.” The World Wildlife Fund (WWF) appealed for the “list of drivers of pathogen emergence risks to be expanded to include not just deforestation, but ecosystem loss, fragmentation and degradation”. “Deforestation alone omits many of the potentially important pandemic frontiers and ignores the role of fragmentation and degradation in increasing proximity between humans and wildlife,” said the WWF. Meanwhile, the World Organisation of Animal Health (WOAH) called for the inclusion of the full definition of “One Health” in the treaty. Its delegate also questioned why preparedness and response were stressed whereas “preventive actions targeting activities and places that increase the risk of zoonotic spillover” were not. Pointing to a lack of expertise to address zoonotic spillover, the Action for Animal Health Coalition said that member states needed to invest in increasing the animal health workforce. Equity obligations Oxfam’s Piotr Kolczynski, who also represented the People’s Vaccine Alliance. Meanwhile, Oxfam, also representing the People’s Vaccine Alliance, said that “the accord’s language must oblige governments to take specific actions to ensure equity; otherwise it would be very difficult to implement this”. The current zero draft also assumes that “critical public health interventions are based on the willingness of pharmaceutical companies to engage in voluntary mechanisms” but “these have proved to be largely insufficient during the current and previous pandemics,” said Piotr Kolczynski, of Oxfam and PVA. For this reason, it added, “the accord must require governments to invest in research and development and manufacturing capacities and to condition public funding on the sharing of technologies, knowledge and intellectual property with developers and manufacturers in the South”. In reference to the accord’s proposal that 20% of pandemic-related goods be allocated to the WHO for distribution, Oxfam stated that “equitable allocation of medical countermeasures cannot be achieved by reserving a 20% of production for 80% of the world’s population”. Medecins sans Frontieres (MSF), meanwhile, asked for a legal definition of “pandemic”, and “explicit reference to governments complying with international humanitarian law obligations in the context of pandemic preparedness, prevention and response”. It also demanded stronger language in relation to commitments to protect “humanitarian populations of concerns” and healthcare workers during pandemics. Private sector is a ‘critical partner’ IFPMA’s Grega Kumer, Deputy Director of Government Relations. “The private sector should be seen as a critical partner in preparedness, response and recovery, and should have a seat at the table,” stated Grega Kumer, Deputy Director of Government Relations at the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA). However, it warned that some of the accord’s proposals “would jeopardise our capacity to efficiently prepare for the next pandemic.” Key concerns it cited included proposals for a waiver on intellectual property rights (IP) for health products during a pandemic, as well as proposals that would “be “transactionally linking access to pathogens and sharing of benefits”. It also urged the INB to “avoid unnecessary overlaps and duplications including other multilateral organisations mandate and expertise such as WTO and WIPO”. While there were over 200 participants online, a handful of member states were also on hand to listen in person at WHO’s Geneva Headquarters to the inputs as they prepare for INB4, when the real negotiations begin for the accord that is due to be presented by May 2024 to the World Health Assembly. Image Credits: Peter Griffin/Public Domain Pictures. Mpox To Remain A Public Health Emergency of International Concern Says WHO 15/02/2023 Megha Kaveri Dr Tedros Adhanom Ghebreyesus speaking at the media briefing on Wednesday. The World Health Organization (WHO) declared on Wednesday that Mpox will continue to remain a Public Health Emergency of International Concern (PHEIC). The decision to continue with the status quo on Mpox was based on the recommendations made by an Mpox Emergency Committee, whose findings were published on the same day. “The emergency committee for the global outbreak of Mpox met to assess whether, in its view, the outbreak remains a public health emergency of international concern. The committee has advised me that, in its view, Mpox remains a global health emergency, and I have accepted that advice,” Dr Tedros Adhanom Ghebreyesus, director-general of the WHO, said at a press briefing on Wednesday. In its report, the Mpox committee, which met on 9 February, acknowledged the progress made in reducing the virus transmission and the sharp decline of reported cases. However, it also expressed concerns that “a few countries continued to see a sustained incidence of illness” while in other countries it’s likely that more cases are occuring under the radar. “More than 30 countries continue to report cases, and the possible underdetection and under-reporting of confirmed cases in some regions is concerning. Particularly in countries where animal-human transmission of Mpox has been reported before,” Tedros pointed out. In its report, the expert committee also expressed concerns about the possible resurgence of cases due to the expected resumption of LGBTQ social events and other mass gathering events; lack of access to vaccines and testing capacities in many lower-income countries; and the recurring zoonotic transmission in Africa. It added that “not all countries are receiving the support they need or have structures or systems to respond to mpox, including inadequate support for marginalized groups; and general fatigue among supporting agencies.” Returning from Syrian scenes of devastation Tedros spoke at the briefing shortly after returning to Geneva from a visit to earthquake affected areas in Syria. The 7.8 magnitude earthquake that hit Syria and Türkiye last week is now estimated to have killed over 41,000 people. I've never in my life seen the level of destruction as I did on the road from Aleppo to Damascus. Skeletons of houses. Almost no people in sight. Over a decade of war has taken an unimaginable toll. Syrians need our support now and in years to come to rebuild their lives. pic.twitter.com/Ym2zmDixdw — Tedros Adhanom Ghebreyesus (@DrTedros) February 14, 2023 Describing the damage caused to Aleppo and Damascus first due to the war, and now by the earthquake, Tedros said “I saw the destruction of entire communities, the unspeakable suffering of people, and the courage and determination of survivors and responders. As we drove from Aleppo to Damascus, I saw the legacy of conflict, with town after town destroyed and abandoned. Survivors are now facing freezing conditions without adequate shelter, heating, food, clean water, or medical care.” While two more cross-border points between Türkiye and Syria have been opened, Tedros said he had had asked Syrian president Bashar al-Assad to open still more crossings so that relief could reach people in need more rapidly. Humanitarian aid groups charge that the Syrian president has “weaponized aid” channeling available supplies to government controlled areas – while most of western Syria where the earthquake hit, is controlled by Kurdish and other Syrian anti-government militias. “WHO remains committed to supporting all people in the Syrian Arab Republic now and in the days, weeks, months, and years ahead,” Tedros added. The WHO has launched an appeal for $43 million to support its response in Syria and Türkiye and expects the amount to double by this weekend. Meanwhile, UN Secretary General Antonio Guterres called upon countries to fully fund a $397 million earthquake fund for Syria, in particular, which lacks resources to mount its own response. Marburg disease – ramping up diagnostics and clinical trial possibilities Touching back on the Marburg Virus Disease (MVD) outbreak in Equatorial Guinea, which has claimed nine lives, Tedros said that the WHO is working with the country’s health authorities to ramp up their diagnostic capacity. “So far, no confirmed cases have been reported in Cameroon and or Gabon,” he added, referring to the two countries that, along with Liberia, border Equatorial Guinea. “We’re also supporting the governments of Cameroon and Gabon to prepare to rapidly detect, isolate, and provide care for any suspected cases.” Following up on the Marburg Virus Vaccine Consortium (MARVAC)’s meeting on Tuesday, Tedros said that WHO is trying to accelerate talks on possibile clinical trials for Marburg virus diseaes vaccine candidates. But he reiterated that any decision on the trials of vaccines and therapeutics for Marburg needs to be taken by researchers and the national authorities of Equatorial Guinea. “In the meantime, WHO is convening the vaccine prioritization committee to identify which vaccine candidates should be evaluated first and prepare for potential trials. WHO is also discussing with the ministry of health, the possibility of providing access to experimental therapeutics as part of a clinical trial,” he said. Posts navigation Older postsNewer posts
Mpox To Remain A Public Health Emergency of International Concern Says WHO 15/02/2023 Megha Kaveri Dr Tedros Adhanom Ghebreyesus speaking at the media briefing on Wednesday. The World Health Organization (WHO) declared on Wednesday that Mpox will continue to remain a Public Health Emergency of International Concern (PHEIC). The decision to continue with the status quo on Mpox was based on the recommendations made by an Mpox Emergency Committee, whose findings were published on the same day. “The emergency committee for the global outbreak of Mpox met to assess whether, in its view, the outbreak remains a public health emergency of international concern. The committee has advised me that, in its view, Mpox remains a global health emergency, and I have accepted that advice,” Dr Tedros Adhanom Ghebreyesus, director-general of the WHO, said at a press briefing on Wednesday. In its report, the Mpox committee, which met on 9 February, acknowledged the progress made in reducing the virus transmission and the sharp decline of reported cases. However, it also expressed concerns that “a few countries continued to see a sustained incidence of illness” while in other countries it’s likely that more cases are occuring under the radar. “More than 30 countries continue to report cases, and the possible underdetection and under-reporting of confirmed cases in some regions is concerning. Particularly in countries where animal-human transmission of Mpox has been reported before,” Tedros pointed out. In its report, the expert committee also expressed concerns about the possible resurgence of cases due to the expected resumption of LGBTQ social events and other mass gathering events; lack of access to vaccines and testing capacities in many lower-income countries; and the recurring zoonotic transmission in Africa. It added that “not all countries are receiving the support they need or have structures or systems to respond to mpox, including inadequate support for marginalized groups; and general fatigue among supporting agencies.” Returning from Syrian scenes of devastation Tedros spoke at the briefing shortly after returning to Geneva from a visit to earthquake affected areas in Syria. The 7.8 magnitude earthquake that hit Syria and Türkiye last week is now estimated to have killed over 41,000 people. I've never in my life seen the level of destruction as I did on the road from Aleppo to Damascus. Skeletons of houses. Almost no people in sight. Over a decade of war has taken an unimaginable toll. Syrians need our support now and in years to come to rebuild their lives. pic.twitter.com/Ym2zmDixdw — Tedros Adhanom Ghebreyesus (@DrTedros) February 14, 2023 Describing the damage caused to Aleppo and Damascus first due to the war, and now by the earthquake, Tedros said “I saw the destruction of entire communities, the unspeakable suffering of people, and the courage and determination of survivors and responders. As we drove from Aleppo to Damascus, I saw the legacy of conflict, with town after town destroyed and abandoned. Survivors are now facing freezing conditions without adequate shelter, heating, food, clean water, or medical care.” While two more cross-border points between Türkiye and Syria have been opened, Tedros said he had had asked Syrian president Bashar al-Assad to open still more crossings so that relief could reach people in need more rapidly. Humanitarian aid groups charge that the Syrian president has “weaponized aid” channeling available supplies to government controlled areas – while most of western Syria where the earthquake hit, is controlled by Kurdish and other Syrian anti-government militias. “WHO remains committed to supporting all people in the Syrian Arab Republic now and in the days, weeks, months, and years ahead,” Tedros added. The WHO has launched an appeal for $43 million to support its response in Syria and Türkiye and expects the amount to double by this weekend. Meanwhile, UN Secretary General Antonio Guterres called upon countries to fully fund a $397 million earthquake fund for Syria, in particular, which lacks resources to mount its own response. Marburg disease – ramping up diagnostics and clinical trial possibilities Touching back on the Marburg Virus Disease (MVD) outbreak in Equatorial Guinea, which has claimed nine lives, Tedros said that the WHO is working with the country’s health authorities to ramp up their diagnostic capacity. “So far, no confirmed cases have been reported in Cameroon and or Gabon,” he added, referring to the two countries that, along with Liberia, border Equatorial Guinea. “We’re also supporting the governments of Cameroon and Gabon to prepare to rapidly detect, isolate, and provide care for any suspected cases.” Following up on the Marburg Virus Vaccine Consortium (MARVAC)’s meeting on Tuesday, Tedros said that WHO is trying to accelerate talks on possibile clinical trials for Marburg virus diseaes vaccine candidates. But he reiterated that any decision on the trials of vaccines and therapeutics for Marburg needs to be taken by researchers and the national authorities of Equatorial Guinea. “In the meantime, WHO is convening the vaccine prioritization committee to identify which vaccine candidates should be evaluated first and prepare for potential trials. WHO is also discussing with the ministry of health, the possibility of providing access to experimental therapeutics as part of a clinical trial,” he said. Posts navigation Older postsNewer posts