China’s Chengdu enforces strict lockdown despite earthquake

Authorities in China’s southwestern city of Chengdu are sticking to the nation’s “zero-COVID” policy demanding a lockdown on the city’s 21 million inhabitants even in the face of a major earthquake that has killed at least 66 people in the region.

Chengdu, the capital of China’s Sichuan province, has been beset by a heatwave and drought this summer and last week was plunged into a lockdown after an increase in COVID cases.

Some in Chengdu say they were ordered to stay inside while the 6.8 magnitude earthquake struck a mountainous area in Luding County, about 200 km (125 miles) from Chengdu, while those that ran outside say their movements were severely restricted due to the pandemic.

Videos shared on Douyin, China’s TikTok platform, show panicked residents behind chained gates, shouting to be let out.

In one, a man swears at a security guard, rattling what appears to be his apartment gates and trying to open it, then shouts: “Hurry up, open the door, it’s an earthquake!” In response, the guards say: “It’s over, the earthquake’s already over.”

Another video claims to be an audio recording of a loudspeaker message: “Go back home and do not gather here, it’s just an earthquake. We [here in Sichuan] have a lot of experience [when it comes to earthquakes].

The 6.8-magnitude earthquake on Monday was the strongest Sichuan has seen since 2017. Provincial authorities said at least 66 people were dead, 253 people were injured and 15 others were missing as of Tuesday afternoon. 

Chengdu lockdown most severe since Shanghai 

Chengdu
Citizens in Chengdu, China, rush to gather necessities before city-wide lockdown.

Chengdu’s lockdown is the most severe since China’s largest city of Shanghai was placed in isolation over the spring and summer.

Starting last week, 1 September, residents were no longer allowed to leave their homes without special permission. Authorities also began citywide testing. 

Nationwide, China reported 1,499 new cases of local infection, most of them asymptomatic, on Tuesday. Sichuan province accounted for 138 of those cases.

In all, 65 million people across China in 33 cities are grappling with partial or full lockdowns, according to Chinese media, from Chengdu to the southern economic powerhouse of Shenzhen to the oil-producing city of Daqing, near Russia.  

Chengdu, which reported 121 cases, is showing signs of tightening restrictions. At least one district in Chengdu has banned even the ordering of takeout meals and coffee, according to a notice posted on the internet.

Business owners are preparing for the worst.  

Eli Sweet, an American who runs a chain of dance studios in Chengdu, told Bloomberg his business was already hit by power cuts across Sichuan province in recent weeks before the COVID lockdown. “We’re definitely teetering on the brink of dying,” he said of his chain of dance studios, “which is pretty sad considering we built this business from scratch to a pretty significant scale.”

The atmosphere in Chengdu, he added, has become one of “fatigue, annoyance and general compliance.”

Chinese president Xi Jinping’s “zero-COVID” strategy tested before October re-election  

Chengdu
China’s Xi Jinping in 18 May address before the World Health Assembly

China has stuck to its “zero-COVID” policy of compulsory testing, lockdowns, quarantines and masking despite moves from the rest of the world to open up again since the virus was first detected in the central Chinese city of Wuhan in 2019. 

World Health Organization Director General Dr Tedros Adhanom Ghebreyesus has called this strategy unsustainable in the face of the more infectious but less lethal Omicron variant that emerged in May. 

For China’s President Xi Jinping, his nation’s strategy may seem like evidence that the Communist Party’s system of governance has distinct advantages over Western democracy. But for George Magnus, a research associate at Oxford University, the situation may be masking a hard truth: China still isn’t in a position to handle a COVID-19 outbreak. 

“Its hospital system is not up to it, mRNA vaccines are not yet widely available, and the elderly vaccination rate is still low,” Magnus told Bloomberg. 

“This is a problem for the 2020s and for Xi, whose opponents in the party, sensing all this, and also Xi’s risky foreign policies, may not be as docile in the future as now,” he said.

With the Communist Party’s twice-a-decade leadership summit coming up in October, in which Jinping is expected to be re-elected as China’s top leader for another five years, the evolving situation in Chengdu, alongside the outbreaks in other cities, may in fact undermine Jinping’s proclamation that the “zero-COVID” strategy is a winning one.

“The more cities get locked down, the more Chinese will turn against COVID-zero,” said Frank Tsai, founder of consulting firm China Crossroads. 

“The party knows that there is a tipping point,” he said, “and it would be smart to get ahead of this tipping point and declare victory before it comes.”

Image Credits: Global News/Twitter , Manya Koetse/Twitter.

Maria van Kerkhove

Although COVID-19 and monkeypox cases are declining globally, World Health Organization (WHO) Director-General Dr Tedros Adhanom Ghebreyesus warned against complacency on Wednesday.

Although COVID-19 cases were down by 80% since February, “last week, one person died with COVID-19 every 44 seconds and most of those those those deaths are avoidable,” said Tedros.

“There is no guarantee these trends will persist. The most dangerous thing is to assume they will,” he added. “You might be tired of hearing me say the pandemic is not over. But I will keep saying it until it is. This virus will not just fade away.”

On monkeypox, Tedros said that there was a downward trend in Europe and although cases in the Americas also appeared to decline, it was “harder to draw firm conclusions about the epidemic in that region”.

“Some countries in the Americas continue to report increasing number of cases and in some, there is likely to be under-reporting due to stigma and discrimination or a lack of information for those who need it most. 

“But as I said earlier, a downward trend can be the most dangerous time if it opens the door to complacency,” stressed Tedros. “WHO continues to recommend that all countries persist with a tailored combination of public health measures: Testing, research and targeted vaccination where vaccines are available.”

He added that community engagement is vital, and that the WHO had consulted with community leaders from all over the world to listen to their views and concerns and to “emphasise the informed importance of responding to monkeypox using existing services and infrastructure, including those for HIV and sexual health”.

Tedros also stressed the importance of the global negotiations on an appropriate global instrument to address future pandemics, adding that more public hearings on this would be held by the WHO’s intergovernmental negotiating body (INB) later this month.

COVID vaccine schedule?

Meanwhile, WHO Executive Director of Health Emergencies, Dr Mike Ryan said that he hoped that it would be possible for the WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) to develop a vaccination schedule for COVID-19.

“Many countries now are offering people third and fourth doses of vaccine and we will have to come to a point where there’s some kind of schedule created that’s beyond the idea of a primary schedule,” said Ryan.

‘Obviously, it’s tough for countries to deal with ad hoc policy where you’re adding an extra booster on for certain people after so many months, and it’s very easy to become incoherent,” he added.

“I think governments are making the best decisions they can, based on the data that they have, but ultimately we need to settle down into some acceptable pattern of vaccination boosting.”

However, WHO technical lead on COVID-19, Maria van Kerkhove, said that while many people were hoping that SARS CoV2 would “fall into some kind of a seasonal pattern like we see with influenza, right now we don’t have that predictability”. 

“The reason for that is because we’re seeing this virus continue to evolve quite rapidly.”

ethiopia
Hirut Zemene Kassa, Ethiopian ambassador to the European Union

The Ethiopian ambassador to the European Union has spoken sharply against World Health Organization Director General Tedros Adhanom Ghebreyesus, calling his criticisms against the Ethiopian government and its role in the Tigray conflict in northern Ethiopia “unprofessional” and that he was using his position “degrading” and “abusing”. 

“The way he’s handling the matter is completely unprofessional to me,” Hirut Zemene said in an interview in Brussels on Wednesday afternoon. 

“He is a United Nations figure … The role he is playing right now … is very, very much degrading his position. I would think he would think about global health — like he says ‘global health for all’ — around the world, around Ethiopia, not only in one particular area.”

Tedros, an ethnic Tigrayan, has publicly denounced the Ethiopian government in the past for its blockade in the Tigray region, calling it a “complete blockade” on health and humanitarian aid.  

Zemene once worked under Tedros when the latter was foreign minister of Ethiopia under the previous government, and she helped celebrate Tedros’ election as WHO Director General in May 2017.

On Wednesday, however, she said he has been “abusing his position” at the WHO by commenting “about only one area” in northern Ethiopia — “a very shameful thing to do.”

“Financially, the government has supported him, invested resources in him, to be a representation of the world in the WHO, coming from Ethiopia,” Zemene said. 

Read more on Devex

Image Credits: UN Photo / Jean-Marc Ferré.

Many children with tuberculosis don’t receive the necessary treatment because of challenges with diagnosis.

Two-fifths of people with tuberculosis are unaware that they are infected because their diagnosis relies on outdated tests – something Unitaid and partners aim to change with a $30 million investment in new diagnostic technologies to enable same-day results.

Announcing the investment on Tuesday, the global health agency explained that the current diagnosis in low and middle-income countries relies on sputum tests that have low sensitivity, especially in the presence of HIV coinfection, require patients to make multiple visits to health centres and are “largely ineffective in diagnosing children or people in advanced stages of disease who have difficulty producing sputum”.

The announcement comes shortly after the publication in this month’s International Journal of Infectious Diseases of a massive 29-year study of TB in South Africa, which found that incidence and mortality were substantially reduced by the introduction of antiretroviral HIV therapy and increased screening.

South Africa has one of the highest TB rates in the world and the researchers, from the Universities of Cape Town and Stellenbosch, found that 8.8 million people had developed TB, and 2.1 million died during the study period from 1990 to 2019. 

HIV, which weakens a person’s immunity, was responsible for 4.8 million of the cases and 1.4 million deaths.

Testing doubled

The study also estimated the impact on TB incidence of various treatment interventions, finding that antiretroviral therapy (ART) and increased TB screening, were the most effective.

“Between 2005 and 2012, South Africa scaled-up efforts to identify TB cases and testing rates doubled. As a result, there were rapid reductions in TB incidence owing to increased TB screening during this period. In 2019, increased screening led to a 28% reduction in TB incidence,” according to lead author, Mmamapudi Kubjane, a researcher in the School of Public Health and Family Medicine at the University of Cape Town.

The study also found that the provision of ART led to a 20% reduction in TB incidence by 2019. 

“The benefits of ART in reducing incidence depend on CD4 count and duration of ART. HIV-positive individuals who initiate ART earlier at higher CD4 counts and stay on ART for longer experience the greatest benefits of ART,” said Kubjane.

The impact of the other treatment interventions – directly observed therapy (DOTS), isoniazid preventive therapy (IPT), and Xpert MTB/RIF – were “modest” single-figure percentages. Xpert MTB/RIF is a highly sensitive test that can simultaneously detect TB and resistance to the TB drug rifampin (RIF) in less than two hours.

When South Africa introduced this new Xpert MTB/RIF test in 2011 to replace sputum testing, it was expected to bring substantial health benefits – yet clinical trials have found little or no impact on TB mortality, according to recent analyses.

“To understand these dynamics better, modelling studies with detailed diagnostic algorithms that account for empirical treatment are required,” the study recommends.

Combination approaches to diagnosis

This is something that Untaid and its partners could tackle. Unitaid has partnered with FIND, the global alliance for diagnostics and the Liverpool School of Tropical Medicine (LSTM), to evaluate alternative TB sampling approaches, and develop and evaluate combination approaches to diagnosis. 

More than 10 million people each year fall ill with tuberculosis (TB), and an estimated four million people with TB – two out of every five – go undiagnosed, according to Unitaid.

“Efforts to reduce the TB burden are greatly hampered by the large number of people who never receive a diagnosis and therefore do not access treatment,” it adds. 

“For those who do receive a positive diagnosis, the process can be lengthy and sometimes means patients do not start on the correct treatment from the outset, which can lead to drug resistance.”

 

Image Credits: University of Cape Town Lung Institute.

argentina
Big food companies in Argentina now need to add warning labels to their ultra-processed products.

Consumers in Argentina are getting help to identify unhealthy food, thanks to new food promotion laws that mandate front-of-package warning labels, the first phase of which started recently. 

Last year, Argentina’s president signed one of the world’s strongest and most comprehensive food policy laws, requiring ultra-processed products with excess levels of sodium, sugar, fats and calories to include black octagonal warnings on the front of the package. 

Big food companies were given until 20 August to add the warnings, while small and medium food and beverage companies have until 20 February 2023 to do so. 

Companies that produce products that are high in sugar, calories, sodium and fat are prohibited from advertising these to children or selling them at schools.

Argentinian civil society groups applauded the start of the new law, emphasizing it was a step in the right direction after years of advocacy. 

“This moment is the time when people in Argentina will start to have the chance to know what they are eating,” said Luciana Castronuovo of Fundacion InterAmerica del Corazon (FIC) Argentina, speaking to the Global Health Advocacy Incubator. 

The law is comprehensive as it also includes the regulation of food marketing and school environments, guaranteeing the rights to health and healthy food of children and youth, Victoria Tiscornia, nutritionist and researcher at FIC Argentina, told Health Policy Watch. 

“This comprehensive law is evidence-based and includes the best public health standards to tackle the double burden of malnutrition in Argentina.”

‘Major step’ to ensuring the right to healthy food

Argentina’s accomplishment comes at a time when advocates are pushing for healthy food policies across Latin America in response to high rates of diet-related diseases like diabetes, obesity and heart disease and an increase in the availability of ultra-processed food and drinks.

For the past five years, civil society organizations in Argentina fought for a package of policies that include front-of-package warning labels (FOPL), marketing restrictions and the removal of unhealthy food and drinks from schools. 

“This law is a major step towards guaranteeing both the population’s right to healthy food and the right to information.,” said Tiscornia. “It seeks to provide clear and truthful information to consumers about the products they buy so that they can make informed decisions and choose the healthiest consumption options.”

The new law in Argentina is based on the experiences of other countries in the region, such as Chile, Mexico, and Peru, which have also implemented FOPL in their packaging.  

Chile was the first country to implement front-of-package labelling in 2016. Research has shown favourable significant positive changes in food choices as a result of labelling. Some 68% of people changed their eating habits and 20% of industries reformulated their products to comply with the established profile and thus avoid warning seals on the packaging. 

In addition, the purchase of sugar-sweetened beverages showed a significant decrease of almost 24% since the implementation of labelling.

Other parts of the world have also been working towards changing food policy with highly processed foods. Nigeria recently introduced a new tax on sugar-sweetened beverages in June in an effort to curb the growing rates of obesity, diabetes, and other diet-related non-communicable diseases in the country.  

Challenges in implementation and communication in months to come 

Supermarket in Argentina with processed sugary food products.

However, the new law in Argentina includes an article that allows companies to request a time extension for including the front of package warning labels (FOPL), Tiscornia added. 

FIC Argentina and other civil society organizations have been monitoring this process and conducting information requests but no official response explaining the number and reason for extensions has been yet provided. 

“This situation, although legal, affects the transparency of the policy process and the proper implementation of the law.” she said

FIC Argentina and other civil society groups will be facing many challenges in the coming months in regards to the new law, such as implementation and communication to the public, said Maga Ailén Merlo Vijarra from Argentinian human rights nonprofit FUNDEPS.

“In the coming months we will be working on disseminating key information about the law and the need for this public health strategy and we will also focus on the human right to healthy food.”

Products that were manufactured and packaged before the law came into force are not required to add labels. Additionally, rice, dry noodles and legumes, as well as fresh fruits and vegetables and milk, amongst other unprocessed or minimally processed foods are exempted from the labels. Table sugar and salt, vegetable oils, dried fruits and nuts, will also be exempted from labelling.

Vijarra noted that the challenges with implementation include understanding which products have labels and which companies will have extensions approved.

“In the coming months we expect to better protect Argentinean children and adolescents from abusive marketing strategies employed by the food industry, leading to a safer and healthier environment to develop and grow,” she concluded.

Image Credits: Global Health Policy Incubator , Vera and Jean-Christophe/Flickr .

Solar panels in the Egyptian desert.

The US government committed itself to supporting Nigeria’s transition away from fossil fuels during a meeting between US vice-president Kamala Harris and Nigeria’s vice-president, Yemi Osinbajo, last Friday.

However, despite global commitments to reduce fossil fuel reliance to address climate change, a number of African countries have recently committed to expanding their oil and coal production, including the Democratic Republic of Congo, Kenya, Ghana and South Africa. 

African leaders have also asserted that achieving global climate goals cannot come at the price of economic development on the continent – and they intend to invest in gas as a transitional form of energy on the continent’s path to renewable energy.

Nigeria launched its Energy Transition Plan on 24 August, mapping out how the country intends to achieve carbon emission neutrality by 2060, including by transitioning from petrol to gas – but the continent’s most populous nation needs over $400 billion to implement the plan and many western countries have moratoriums on financing hydrocarbon projects.

 

During last week’s meeting, Harris welcomed Nigeria’s Energy Transition Plan and applauded Osinbajo’s leadership for just energy transitions in Africa and “the two leaders committed to working closely to support Nigeria’s energy access and energy security goals, as well as our shared global climate goals”, according to a White House statement. 

Continued investment in oil

But some African countries’ actions are not in line with the globally set climate goals. The Democratic Republic of Congo is planning to issue 30 new licenses for oil rigs that could threaten some parts of the country’s rainforest.

“We had concerns about the announcement of the auction of these oil and gas exploration blocks, some of the blocks infringe on sensitive rainforest and peatland areas, including in the Virunga National Park and Salonga National Park,” said US Secretary of State Anthony Blinken during a recent visit to the DRC.

Meanwhile in Kenya, in early August President Uhuru Kenyatta commissioned the Kipevu terminal, a large new oil storage facility at the Mombasa port intended to store large volumes of oil for the country’s development. 

In August 2021, the government of Ghana revealed plans to invest $1.65 billion to accelerate oil and gas exploration via the acquisition and development of oil and gas assets.

Following an EU ban on coal importation from Russia, South Africa’s coal sales to Europe rose eight-fold during the first half of 2022 compared with last year.

‘Moral and economic madness’

After the 2021 Intergovernmental Panel on Climate Change report reported that the expansion of coal, oil and gas production is a great risk to global climate goals, United Nations Secretary-General António Guterres, described the expansion as “moral and economic madness”. 

But many African governments are getting behind the gas transition, arguing that moving immediately to renewable energy will hamper the continent’s economy and development.

In May, 10 countries – the Democratic Republic of Congo, Ghana, Kenya, Malawi, Morocco, Nigeria, Rwanda, Senegal, Uganda, and Zimbabwe – adopted a seven-point communique urging the international community to support gas “as a transition fuel and the long-term displacement of gas by renewable energy and green hydrogen for industrial development, if financially and technically sustainable”.

In Senegal, $5 billion is projected to be spent on the second phase of the country’s liquefied natural gas project. President Macky Sall is a firm critic of what he described as the hypocrisy of western governments that guzzle gas at home but have declared a virtual moratorium on financing hydrocarbon projects abroad.

“You cannot tell us that renewables alone can develop a continent — it has never been the case anywhere else and it cannot be the case in Africa,” Sall said.

Egypt to host COP27

In November, Egypt’s “green city” of Sharm El Sheikh will host the 27th United Nations climate change conference, COP27, and this will offer an opportunity to show what the continent is doing to align with global climate goals including net zero carbon emissions by 2060 and mainstreaming renewable energies.

Egypt has described the provision, mobilization and delivery of climate finance for developing countries as an urgent priority — particularly in light of current financial crises, debt challenges and increasing interest rates. 

“It is imperative to make appropriate financial flows that are based on needs identified through Nationally Determined Contributions (NDCs) and other vehicles, with a focus on concessional finance instruments, and grants as appropriate, while providing a clear revision of the definition of bankable projects that takes into consideration climate benefits and not only risks, and achieving cross-cutting impacts,” Egypt said on its website for COP27.

At COP26, a major talking point among African delegates and climate activists was the need for richer countries, who are also the world’s majornpolluters, to provide sufficient funds for developing countries to fight the crisis.

During COP26, South Africa, the European Union, France, Germany, the UK and the US launched an ambitious long-term Just Energy Transition Partnership (JETP) to support the South Africa’s decarbonisation efforts in order to move its economy towards more reliance on renewable energy resources. The JETP aims to mobilise $8.5 billion for South Africa, and Nigeria hopes to achieve similar support for its energy transition plan.

Bernard Pecoul Luis Pizzaro
Dr Bernard Pécoul (left) and new DNDi Executive Director Luis Pizarro. Photo by Kenny Mbala / DNDi

The Drugs for Neglected Diseases initiative (DNDi), one of the most important nonprofit drug developers in the world, has appointed a new leader to fill the shoes of its outgoing founder.

Dr Luis Pizarro, a Chilean-French doctor and global health expert, will serve as DNDi’s new executive director, succeeding DNDi founder Dr Bernard Pécoul, who has led the Geneva-based organisation for the past 19 years.

Pécoul said he was confident that Pizarro can fulfil the organisation’s promise to deliver 25 new treatments in its first 25 years through cross-regional collaboration, innovation in low- and middle-income countries, South-South cooperation, and better clinical research in endemic regions.

“Luis is the ideal person to lead that effort,” said Pécoul.

Twelve new treatments for six neglected diseases

DNDi launched in 2003 in response to the frustration felt by front-line researchers and doctors that drugs for neglected diseases were ineffective, unsafe, and unaffordable – or nonexistent.

Only 1% of new drugs developed between 1975 and 2000 could be used to treat neglected illnesses, even though they accounted for 11% of the global disease burden then.

When Médecins Sans Frontières won the 1999 Nobel Peace Prize for its pioneering humanitarian work on several continents, it chose to dedicate a portion of its prize money to helping to create a new nonprofit model for developing drugs for neglected populations, giving rise to DNDi.

Pécoul, fresh off leading the MSF Campaign for Access to Essential Medicines after founding it in 1998, was tapped to take the lead.

He has since overseen projects and partnerships spanning the globe that have developed and delivered 12 new treatments for six deadly neglected diseases including sleeping sickness, leishmaniasis, hepatitis C, Chagas and a landmark malaria treatment.

DNDi‘s treatments are developed as public goods, so they are affordable and have no patents, making them available for production by any generic drug manufacturer that meets quality standards.

Twenty five Treatments in 25 Years

DNDi
Dr. Luis Pizzaro, new Executive Director of the Drugs for Neglected Diseases Intiative. Photo by Kenny Mbala / DNDi

Under Pizarro’s leadership, DNDi has the ambitious goal of delivering another 13 treatments by 2028. But while Pécoul started from scratch, Pizarro takes over an organisation that now has more than 250 employees located across nine hubs in Africa, South-East and East Asia, North and Latin America, and 200 public-private partners.

As the first CEO of Solthis from 2007 until 2019, an international health organization dedicated to increasing access to care for HIV, and recent manager of Unitaid’s HIV portfolio, Pizarro has seen the urgency of the challenges faced by those DNDi was set up to help. 

“We have seen that during social and economic crises, the most neglected populations are always the ones that suffer the most,” he told Health Policy Watch.

“Neglected diseases are fuelling a vicious circle of poverty, as degraded socio-economic conditions lead to an increased prevalence of diseases, which translates into loss of income and education opportunities, and ultimately more poverty.”

Building on DNDi‘s success in establishing strong working partnerships with global pharmaceutical companies, academic, and research institutions, Pizarro says DNDi is ready to rise to the occasion.

“More than ever, there is a need for patient-centric and not-for-profit drug development models like DNDi”, he said. “I look forward to working with the DNDi team to bring like-minded stakeholders together and advance medical innovation in pursuit of our common vision: to deliver the best science to the most neglected populations.”

Amber Huett-Garcia has struggled with obesity since she was in first grade.

“Now in adulthood, despite reducing my BMI from 69 to 24 (245 lbs. lost), I still carry the expensive diagnosis of obesity,” she wrote in a recent blog for the Noncommunicable Disease Alliance (NCD Alliance). “I’ve used pharmacotherapy, surgical interventions, mental health care and more to achieve the combination of treatment needed to maintain healthy body weight, but not without cost.”

More than 650 million people are affected by obesity globally. It is an NCD that progresses overtime without medical intervention and lifestyle changes. For many, access to affordable medical care does not exist.

NCDs have become a major 21st century social justice issue, the alliance has said. They push poor households further into poverty and prevent developing countries from achieving strong and sustainable economies.

This week, the NCD Alliance will host The annual Global Week for Action on NCDs, including a special “Invest to Protect” virtual event on September 8 that will open with remarks by World Health Organization Director-General Dr. Tedros Adhanom Ghebreyesus and former New York City Mayor Michael Bloomberg, who is now WHO’s global ambassador for noncommunicable diseases and injuries.

The Global Week of Action on NCDs aims to get a message across to governments, donors, international agencies and the private sector: Invest in NCDs today, save lives and money tomorrow. Financing for NCDs has stagnated at a pitiful 1% to 2% of development assistance for health for two decades, causing many millions of deaths and pushing millions more into extreme poverty due to health care costs and disability.

“Many NCDs can be prevented through a set of cost-effective interventions,” explained NCD Alliance Executive Director Katie Dain. “We have the solutions, we have the tools, we have the know-how to prevent and treat NCDs. What’s needed is political will at the highest level.”

NCDs account for deaths of 41 million people a year

NCDs account for seven of the top 10 causes of death around the world, translating to the deaths of 41 million people and 74% of all deaths worldwide. And the number is projected to grow, according to the NCD Alliance, to 52 million people annually by 2030.

These top killers are cancers, cardiovascular disease, stroke, chronic respiratory diseases, diabetes, mental health and neurological conditions and chronic kidney disease.

For perspective: in 2020 some 1.5 million people died from tuberculosis, 627,000 from malaria and 680,000 from HIV/AIDS.

Moreover, although they hit everyone and every country, such as Garcia, who is living in the United States, the burden on low- and middle-income countries (LMICs) is much greater. In those countries, an estimated more than 85% of premature deaths between the ages of 30 and 70 are caused by NCDs.

COVID-19 further highlighted the challenges of NCDs, with 60% to 90% of more than six million COVID deaths being people who were living with one or more NCD. It has also likely exacerbated the NCD burden due to missed diagnoses and treatments.

For example, a recent report showed that for every week of lockdown, an estimated 2,300 cancer cases went undiagnosed. In LMICs, the alliance predicted, the situation is likely even worse, as these countries’ levels of undiagnosed NCDs were already extremely high before the pandemic.

“Sweeping changes, including legislation, were made in a matter of weeks to protect the public from COVID-19,” Dain said. “We need the same urgency to stop the premature morbidity and mortality caused by NCDs.”

NCDs expected to cost developing world $7 trillion between 2011 and 2030

NCDs are costing global GDP losses of between 3.5% and 5.9%. The alliance predicted they will cost $7 trillion in losses in the developing world over the period 2011-2030.

Just the five leading NCDs are estimated to cost the world more than $2 trillion annually.

But beyond the dollar signs, it is also costing human capital – in the short term by ending millions of lives and in the long term by leading to disabilities that keep people out of their jobs.

NCDs cause 80% of years lived with disability, according to a report by Institute for Health Metrics and Evaluation. Another report, this one by WHO, found that heart disease, diabetes, stroke, lung cancer, and chronic obstructive pulmonary disease were collectively responsible for nearly 100 million more healthy life-years lost in 2019 compared to 2000.

What actually are non communicable diseases? This infographic revisits all the basics for you to consolidate your knowledge.
What actually are non communicable diseases? This infographic revisits all the basics for you to consolidate your knowledge.

‘Best Buys” could save 10 million lives

In 2015, the World Health Organization rolled out a series of “Sustainable Development Goals” (SDGs), with member countries pledging among other things to deliver health and wellbeing for all. Item 3.4 called for the world to reduce premature mortality from NCDs by a third by 2030.

According to experts, including a report published by the Lancet, despite few efforts being made to date, if countries start now, this goal could still be achieved.

“All countries – and especially LMICs – can achieve or nearly achieve SDG 3.4, saving 39 million lives by 2030, by introducing a cost-effective package of NCD prevention and treatment interventions,” the NCD Alliance explained in its recent policy brief.

The steps needed were outlined in 2017 by WHO in a series of what it calls “Best Buys,” a set of 16 interventions that work on preventing and managing NCDs for prices that have an unprecedented return on investment. These include steps to reduce tobacco and alcohol use, improve unhealthy diets and increase physical exercise, as well as plans for the management of cardiovascular disease, diabetes and cervical cancer.

Implementation of the Best Buys in LMICs would translate to saving 10 million people from heart disease and stroke, for example. It would also add 50 million years of healthy life.

Moreover, on the financial side, the Lancet NCD Countdown 2030 showed that implementing this package of reforms would cost on average $18 billion annually between 2023 and 2030 but would generate an average net economic benefit of $2.7 trillion.

“Unless countries follow through on commitments to reduce mortality from noncommunicable diseases such as diabetes and hypertension, we ‘ll be nursing a huge part of the global population living with chronic conditions,” Dain said. “And most of this preventable suffering, illness and death will be amongst people living in poorer communities. We can avoid that future scenario by investing in cost-effective policies now.”

Dain added that “keeping citizens healthy from preventable NCDs is not simply about a government’s choice to invest in health, it is an investment in a country’s economic stability and security, in its own pandemic preparedness.”

Image Credits: oncommunicable Disease Alliance, Noncommunicable Disease Alliance.

pandemic
During the COVID-19 pandemic, health workers in Guatemala liaise with local partners to maintain essential ANC services, communicate accurate information, and provide social support to pregnant women, thanks to a USAID-supported programme of the NGO MSH.

The United Nations General Assembly voted to hold a summit of heads of state and other world leaders next year to find fair, long-lasting solutions for the global inequities and inadequate responses that the COVID-19 pandemic has all too painfully highlighted.

Delegates to the 193-nation assembly overwhelmingly approved the resolution in a consensus vote on Friday with the backing of 12 sponsors and 117 cosponsors.

The pandemic “revealed serious shortcomings at the country, regional and global levels in preparedness for, timely and effective prevention and detection of, and response to potential health emergencies, including in the capacity and resilience of health systems, indicating the need to better prepare for future health emergencies,” the resolution says.

The resolution calls for a one-day summit of heads of state, ministers and other government officials to be held sometime during the second half of September 2023, when the assembly holds its annual highest-profile gathering at the UN headquarters in New York City.

It is to be convened by the president of the General Assembly in collaboration with the World Health Organization (WHO), at the level of heads of state and government, by no later than the last day of general debate at its 78th session scheduled for 12-30 September 2023.

The summit is expected to “adopt a succinct political declaration aimed at, inter alia, mobilizing political will at the national, regional and international levels for pandemic prevention, preparedness and response,” the resolution says.

The assembly’s president also is supposed to appoint two co-facilitators to present “options and modalities” for the summit and the political declaration, it says. 

pandemic
Former Liberian President Ellen Johnson Sirleaf (left) and Former New Zealand Prime Minister Helen Clark (right), co-chairs of The Independent Panel presented a second report on Monday, 22 November, calling for quick action on a Pandemic Treaty or Convention

Pandemic summit a high priority of the Independent Panel

The Independent Panel chaired by former Liberian President Ellen Johnson Sirleaf and former New Zealand Prime Minister Helen Clark made it a key recommendation last year.

In their report, “COVID-19: Make It the Last Pandemic,” they argued that world leaders must do more to quickly fix vaccine equities and pandemic financing to head off the next disaster.

After the vote, nations such as Brazil, Korea, Switzerland and the US voiced support for the summit but cautioned it must complement the work in Geneva on the International Health Regulations (IHR) amendments and Intergovernmental Negotiating Body (INB) process.

The 194-nation World Health Assembly (WHA) in Geneva approved a resolution in May laying out the complex process it will use to update the IHR’s legally binding rules among nations for responding to global health emergencies like the pandemic.

In July, the INB agreed negotiations towards a pandemic “treaty” intended to improve the world’s pandemic prevention, preparedness and response will be set up in terms of Article 19 of WHO’s Constitution. That would allow WHA to make the treaty legally binding if a two-thirds majority approves it.

Broad support for pandemic summit

The resolution’s 12 sponsors were: Australia, Bangladesh, Canada, Costa Rica, Ghana, Indonesia, Jamaica, New Zealand, Rwanda, South Africa, Sweden and Vietnam.

Another 117 countries were co-sponsors:

Algeria, Andora, Angola, Argentina, Armenia, Austria, Bahrain, Barbados, Belgium, Britain, Bolivia, Bosnia and Herzegovina, Botswana, Bulgaria, Burkina-Faso, Cape Verde, Cambodia, Central African Republic, Chad, Chile, Colombia, Comoros, Côte d’Ivoire, Croatia, Cuba, Cyprus, Czech Republic, Denmark, Djibouti, Dominican Republic, Egypt, El Salvador, Equatorial Guinea, Estonia, Finland, France, Gabon, Gambia, Georgia, Germany, Greece, Grenada, Guinea, Guyana, Haiti, Honduras, Hungary, Iceland, Ireland, Israel, Italy, Japan, Jordan, Kenya, Kuwait, Laos, Latvia, Lebanon, Lesotho, LIberia, Liechtenstein, Lithuania, Luxembourg, Malawi, Malaysia, Maldives, Mali, Malta, Mauritius, Monaco, Montenegro, Moldova, Morocco, Mozambique, Namibia, Nepal, Netherlands, Nicaragua, Norway, Palau, Panama, Papua New Guinea, Poland, Portugal, Qatar, Romania, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, San Morino, Saudi Arabia, Senegal, Serbia, Seychelles, Singapore, Slovakia, Slovenia, South Sudan, Spain, Sudan, Suriname, Tanzania, Tajikistan, Togo, Timor-Leste, Trinidad and Tobago, Tunisia, Turkey, Turkmenistan, Uganda, Ukraine, United Arab Emirates, Uruguay, Vanuatu, Venezuela, Zambia and Zimbabwe.

Image Credits: MSH, @TheIndPanel.

Administering monkeypox doses in the United States after the US signs off on deployment of 1.1 milion doses

The fraction of monkeypox cases with no recent contact with men who have sex with men (MSM) continues to rise in the US – accounting for one-third of cases – suggesting a silent spread of the virus to other communities.

Men with recent MSM contact accounted for 65.78% of cases as of 20 August, according to the US Centers for Disease Control and Prevention (CDC) data, down from 72.44% a week earlier. Currently, men who had no recent MSM contact account for 27.71% of all US cases, while women account for 4.67% and those with other gender identities account for 1.84% of cases. 

monkeypox
Proportion of cases with known data on sexual history and gender reporting recent man-to-man sexual contact (MMSC) by the week in which monkeypox case was reported.

Overall, cases in the Americas continue to rise sharply, accounting for 60% of all cases compared to Europe’s 38% in the past month. The WHO European region is also demonstrating early signs of a declining infection.

However, there is a clear, disproportionate access globally to vaccines against monkeypox. The US holds nearly 80% of the Jynneos vaccine supplies used to fight monkeypox,  but it has only 35% of the global monkeypox cases. Most countries have no access to any doses, according to a Public Citizen analysis on Thursday.

“Once again, vaccines for an outbreak are not available in the vast majority of countries, including in the African states that have fought monkeypox for years,” said Peter Maybarduk, director of Public Citizen’s Access to Medicines Program. 

He called on the US to “put forward a plan to fight global monkeypox and avoid the tragic mistakes of the COVID crisis.”

The analysis compares vaccine access and monkeypox cases in more than a dozen countries. It shows the US and many European countries obtained most of the vaccine, while Africa, where monkeypox is endemic, has not gotten a single dose.

Lack of monkeypox vaccine access mirrors early days of COVID-19 

The World Health Organization has said little about the lack of monkeypox vaccine access and lopsided availability of vaccines overall, despite having been outspoken about the COVID-19 pandemic’s vaccine inequities.

What’s different in this case is there is only one manufacturer of monkeypox vaccines, Bavarian Nordic, and its European plant shut down in the spring for renovations. 

Officials from the Africa Centers for Disease Control Prevention and WHO African region have decried the continent’s lack of access to monkeypox vaccines.

In July, Africa CDC’s acting director, Ahmed Ogwell Ouma, drew attention to the disparity between WHO’s urgent declaration of monkeypox as a global public health emergency (PHEIC) and the sluggish response to the burgeoning risks in Africa.

Countries such as Democratic Republic of the Congo (DRC), which reported multiple deaths from monkeypox, have not received any doses or gotten any orders secured. 

Monkeypox cases and vaccines across 12 countries. Countries in Africa where the virus is endemic, such as DRC, have not secured a single dose.

In contrast, the US had 1.1 million vaccine doses on hand for 16,602 cases as of late August — 22 times more doses hoarded than in even the European Union and U.K. combined.

The US supply is enough to treat each case with 66 doses, and the country also had placed orders for nearly 7 million more doses.

Though the US is considered a hotspot for monkeypox, with cases rising across other groups with no MSM contact, advocacy groups say the disproportionate access is a disturbing contrast to WHO’s aim to eliminate monkeypox.  

“Alarm bells are ringing,” said Zain Rizvi, research director in Public Citizen’s Access to Medicines program. 

“As we have learned all too painfully throughout the coronavirus pandemic,” said Rizvi, an expert on pharmaceutical innovation and access to medicines, “we can’t solve a global public health emergency through national policies alone. A global plan is needed to curb this global crisis.”

Image Credits: The Hill/Twitter , US CDC , Public Citizen.