Swiss Approve 1st Booster for Variants 29/08/2022 John Heilprin Gavi, The Vaccine Alliance, will receive 500 million doses of the Moderna vaccine Swiss drugs regulator Swissmedic announced it has temporarily authorized the first bivalent Covid-19 booster vaccine in the country. That clears the way for an eagerly anticipated second round of booster vaccinations that should better target Omicron sub-variants. Moderna’s COVID-19 mRNA-1273.214 vaccine, Spikevax, is the first COVID-19 vaccine that contains messenger ribonucleic acid (mRNA) against two coronavirus variants known as BA.1 and BA.4/5, Swissmedic said Monday. It is authorized for anyone 18 years or older. “In trials, a booster dose with this bivalent vaccine demonstrated higher antibody concentrations against the Omicron variants than a booster with Spikevax, the original COVID-19 vaccine from Moderna, with comparable side effects,” the agency said. Federal vaccination and public health officials will now draw up plans to offer the vaccine to the Swiss public. It is administered as a single dose of 0.5 ml (50 micrograms). Side effects like fever, headaches and muscle pains are “similar to that seen following administration of the second dose (100 micrograms) or the booster (50 micrograms) of the original vaccine,” according to the Swiss regulator. COVID booster vaccines have gained traction in several countries – US, Israel, Germany, UK, and others, but low- and middle-income countries lag significantly behind in shots. Booster Meets Safety Standards The original Moderna vaccine worked against early COVID-19 strains such as Alpha and Delta, but it provided little immunity against Omicron or its sub-variants, which are now causing all of the coronavirus infections that are being detected in Switzerland. Swissmedic said its review shows the booster vaccine meets the safety, efficacy and quality requirements. It contains 25 micrograms of mRNA-1273 (original Spikevax) and 25 micrograms of mRNA that targets the Omicron variant BA.1. “Compared to the original vaccine, trials have shown that this produces a stronger immune response against the Omicron variants BA.1 and BA.4/5,” Swissmedic said. “The protective effect of the bivalent vaccine against the original SARS-CoV-2 virus (Wuhan type) measured in the antibody concentration is equivalent to the effect of the original vaccine (Spikevax),” it said. The original vaccines were designed to train the body to fight the virus in the form in which it first emerged from Wuhan, China, at the end of 2019. But the virus continues to mutate. Switzerland during COVID-19 pandemic. Swiss Booster Approval Follows U.K. Moderna and Pfizer and BioNTech have submitted applications to the US Food and Drug Administration for emergency use authorization of their updated Covid-19 vaccine boosters. Both are bivalent vaccines that combine the original vaccines with ones that target Omicron sub-variants BA.4 and BA.5, which are prevalent in the United States. BioNTech said earlier this month it expects to begin delivering Omicron-adapted vaccines as early as October, subject to regulatory approval. Two weeks ago, the UK became the first country to approve a bivalent COVID-19 booster vaccine that works against both the original COVID-19 virus and the newer Omicron variant. An expert panel of advisers to the World Health Organization (WHO) recommended that countries consider a second COVID-19 booster dose for older, at-risk and immunocompromised people, echoing guidance from European and U.S. regulators. WHO’s Strategic Advisory Group of Experts (SAGE) on Immunization released its updated recommendations for a second vaccine booster dose for all elderly people using age-specific cutoffs to be defined by each country. It also recommended a second booster for adults with comorbidities that put them at higher risk of severe disease, including pregnant women and health care workers. Image Credits: Gavi , Marco Verch/Flickr, Transformer18/Flickr. WHO Lists Entities That Can Engage with Pandemic Treaty Negotiating Body 29/08/2022 Kerry Cullinan WHO member states at the INB meeting taking place 18-22 July 2022 in Geneva A wide range of groups including civil society, academic and health groups have been identified as stakeholders that are able to interact with the World Health Organization’s (WHO) Intergovernmental Negotiating Body (INB) on a pandemic preparedness instrument. The WHO published the list last week but stressed that it was a “living document with further possibilities for updates as deemed appropriate by the INB”. Earlier, an op-ed published by Health Policy Watch warned against the “pervasive influence” of pharmaceutical groups and businesses in pandemic preparedness. “The proposed modalities for engagement for relevant stakeholders do not in fact propose any safeguards against corporate political interference in the pandemic treaty and its making. In fact, they pave the way for an ever-increasing range of entities to gain a foothold of status with the organization – beyond the pharma and agribusiness interests, like CropLife International, already in recognized WHO relations,” noted Nicoletta Dentico and Ashka Naik. The International Chamber of Commerce, AdvaMed, the world’s largest medical technology association and Biotechnology Innovation Organization, the world’s largest biotech trade association are among the newly listed entities. Environmental actors In a positive development, the dearth of environmental and One Health groups has been partly rectified in the current list with the inclusion of the Wildlife Conservation Society and the One Health High Level Expert Panel. Wildlife Conservation Society’s Christine Franklin confirmed that her organisation had been recognised after initially struggling to engage with the INB. “In the preparations for negotiation of a possible global instrument on pandemic prevention and preparedness there has been remarkably little attention given to true pandemic prevention,” Dr Nigel Sizer, executive director of Preventing Pandemics at the Source, told Health Policy Watch in an earlier interview. “We know where most pandemics come from and we know how to reduce the risk of zoonotic spillover of the viruses that cause them,” he added. “Governments in general and health agencies, in particular, should embrace these approaches, including One Health efforts. They should also work much more closely with environmental agencies to address spillover risk from tropical deforestation, wildlife exploitation and trade, and intensive animal agriculture. The public health return on investment in such activities would be enormous.” In light of the monkeypox outbreak and COVID-19, Sizer said that the WHO and other key actors should do more to address ecosystem risks that increase “spillover risks” of pathogen leap from animal to human populations: “Such actions include shutting down or strictly regulating wildlife trade and markets, stopping deforestation and forest degradation, and providing better health to communities in emerging infectious disease hotspots, as well as strengthened veterinary care and biosecurity in animal husbandry,” according to Sizer, an internationally known conservationist. Reactive not proactive list However, the list of entities seems based largely on those that have applied to give presentations at INB meetings rather than a representative group of all non-state and UN-affiliated actors that should be in the room to negotiate a future pandemic treaty. Entities already in official relations with WHO are also considered “relevant stakeholders”. Official relations status not only allows civil society groups the privilege of expounding on their positions at the annual World Health Assembly, it gives them access to lengthy and detailed informal member state consultations and intergovernmental negotiating sessions that are closed to the general public and the media. Some 220 civil society actors hold that coveted status, mostly mainstream medical and health societies as well as pharma groups, but also agro-business foundations, such as CropLife International, as well as the outliers like the World Plumbing Council. Additional reporting by Elaine Fletcher. How to Know if You Should Work in Global Health 27/08/2022 Editorial team For emerging global health professionals from the world’s “south,” choosing whether to focus their energy on local issues or on international challenges is always a dilemma, Chief Planetary Health Scientist of Sunway Centre for Planetary Health in Malaysia Renzo Guinto argues. “One important crossroad that I’ve encountered is tension on whether I stay in the Philippines and, for example, receive my education here, gain more exposure in domestic public health, versus gain experiences from abroad,” he says in the latest episode of the “Global Health Matters” podcast with host Garry Aslanyan. “We have pressing global health challenges that we certainly can contribute in terms of solving them, but also we still have the baggage of the local health problems,” he adds. Defining Global Health As highlighted by Aslanyan, the term global health itself has recently come under significant scrutiny for carrying a connotation of “public health somewhere else.” “The conversation on decolonising global health is ongoing, and I trust that this episode will further contribute to this important discussion,” says the host. Aslanyan and Guinto discuss different elements of this challenge, together with Associate Professor in Global Health and Development at James Cook University in Australia Stephanie Topp, who also joins the podcast. “I am not clinically trained, I am not a health professional by background, I’m a historian by background. And it is the inequity in health outcomes and specifically then access to health care that is why I feel motivated to work in this area,” Topp highlights. Public Health Accountability An internship in Zambia exposed Topp to uncomfortable aspects of global health, where people in positions of power are not held accountable for their actions. This motivated the researcher to pursue a Ph.D. in order to work on creating knowledge that could be used to make informed decisions. Access to global health education is another crucial issue discussed by Aslanyan, Guinto and Topp. “Education that transcends borders is essential,” Guinto notes. “Unfortunately, this is something that is not within the reach of many. And what we need to really think about is how to make these educational opportunities more accessible, equitable and even democratic.” The key to solving these challenges, Topp argues, does not lie in biomedical knowledge, because biomedical knowledge does not address the question of equality. What is needed is global health experts “who can operate in urban planning, in environmental planning, in social service spaces, and who can inform decisions and work with decision-makers in those different sectors,” she says. “In the end, I think that global health education lacks sufficient investment in competencies that derive from the social sciences,” Topp adds. Listen to previous episodes on the Health Policy Website >> Learn more about “Global Health Matters” podcast>> Image Credits: Global Health Matters podcast. Poor Vaccines Coverage in Pandemic Blamed on Multiple Barriers 26/08/2022 John Heilprin & Dann Okoth Dr Elia Badjo, co-founder and executive director of the Democratic Republic of the Congo’s Conseils sur la Santé et Académie de Médecin ( COSAMED), helps people in the North Kivu region Some of the biggest obstacles to expanded vaccines coverage in the world’s poorest and most conflict-ridden nations are lack of cold chain storage, unpredictable supply chains, and transport barriers, not claims of “vaccine hesitancy” in the Global South, according to a new report. The picture of the steep challenges faced by 14 nations during the COVID-19 pandemic “is more nuanced than a simple attribution to ‘hesitancy’ or ‘poor education,’ consistent with findings elsewhere,” two advocacy groups and a research company conclude in a joint 55-page report Friday. “Our findings demonstrate that as the world moved and transitioned from COVID-19, massive inequities remain in access to all COVID-19 tools, including oxygen and rapid tests,” the report says. Among developed nations, some 1.1 billion COVID-19 vaccines were likely wasted since the global rollout began, according to findings in July by Airfinity, a global health surveillance firm. The two groups — International Treatment Preparedness Coalition (ITPC) and People’s Vaccine Alliance — and the Malaysian research company, Matahari Global Solutions, say “numerous structural access barriers exist” to the fair, widespread distribution of COVID-19 vaccines. Those include “insufficient” local cold chain storage and advance notice about arrival dates, which impedes national planning and implementation abilities. Other barriers include physical infrastructure, such as access roads, and in some places limited access to transportation that works and is affordable. Unpredictable wait times, fluctuating supply stocks and people’s inability to leave their jobs also play an important role, the study finds. In addition, it says, the lower vaccination rates are influenced by a lack of “access to information and suspicion of medical technologies brought to countries by Westerners and white men, owing to historical memory and perceptions of experimentation on Black bodies.” In most cases the information, including technical terms, was delivered in the “official language” — most often English, French or Spanish — instead of local languages. Study Dismisses Claims About Importance of Skepticism About Vaccines That contrasts with the so-called vaccine hesitancy that some pharmaceutical companies have blamed for low vaccination rates among poorer countries. The study looked at Bangladesh, Democratic Republic of the Congo (DRC), Haiti, Jamaica, Liberia, Madagascar, Nepal, Nigeria, Peru, Senegal, Somalia, Uganda and Ukraine, reflecting a variety of factors. Some, such as the DRC and Haiti, had internal conflicts and vaccination rates of less than 10% — in contrast to the World Health Organization’s recommended 70% target rate that some high-income countries already have achieved. Others such as Nigeria, Somalia and Ukraine were included primarily for their domestic turmoil or insecurity. Peru was studied due to its high numbers of COVID-19 deaths; Madagascar was put on the list because of relative exclusion from discussion among academic and policy circles. Dr. Elia Badjo, founder and executive director of COSAMED and the lead local consultant for the ITPC/PVA project in the Democratic Republic of Congo (DRC), said health workers hadn’ been paid since the start of the vaccination campaigns at the beginning of the pandemic due to lack of funds. “Many are not trained either,” he said, adding that Ebola and monkeypox outbreaks exacerbate the situation and stretch scarce public health resources. Violent conflicts also have displaced people and made them more inaccessible to health workers. In Uganda, Richard Musisi, executive director of Masala Association of Persons with Disabilities Living with HIV/AIDS (MADIPHA), said people with disabilities “were disproportionately affected by the COVID-19 pandemic. There were consistent vaccine stock-outs and limited awareness.” The study says doctors and nurses in several rural communities reported never having heard of Paxlovid or novel antivirals for COVID-19, while some nations had no outreach to LGBTIQ persons, those who cannot afford to self-isolate if they tested positive, or people living in single-room homes. “These point to the need for direct cash transfers during pandemics and long-term planning on social security nets on the domestic level, but also to the failure of global pandemic platforms to account for local and specialized contexts,” the study says. Report Cites Role in Vaccines of ‘Modern Day Slavery The unsalaried community health workers that are essential for pandemic response also are a top concern. “Across the 14 countries and territories, community health workers play an essential role in deployment of tools, community engagement, and vaccine uptake,” it says. “Yet they largely remain unpaid — a phenomenon some have described as modern day slavery.” The People’s Vaccine Alliance says the disregard for the needs of people in lower-income countries is evidence of “systemic racism” in the global COVID-19 response, though the study does not mention this term or others such as “racism” or “racial discrimination.” The group also emphasizes that true infection and death rates are likely to be far higher than official figures due to the inaccessibility of testing and vaccination sites among the studied nations. “PCR test results can take anywhere from 8 to 12 hours in Bangladesh to more than two weeks in rural DRC. People cannot leave work at short notice, travel long distances to a vaccination/testing site, and then wait for a long unpredictable period of time,” it says. “For rural populations and nomadic people in countries like Somalia, this problem is particularly acute. Mobile vaccination and testing is not widespread enough.” Approach to Vaccines in the Global South Left People ‘Abandoned’ Maaza Seyoum, the group’s Global South convenor, says the report shows that communities have repeatedly been let down by a system geared towards protecting people in wealthy countries – leaving people in the Global South abandoned. “Their lives have been treated as an afterthought,” Seyoum said. “Local populations are expected to shoulder blame and be grateful for what vaccines they do receive, when there has been little effort to meet their needs,” she said. “It is yet more evidence of the systemic racism that has plagued the global response to COVID-19.” Fifa A. Rahman, the report’s lead author and principal consultant at Matahari Global Solutions, says the report found “layered issues why people are not accessing vaccines” rather than an outright, widespread distrust of vaccines. “The vaccine hesitancy narrative is rooted in racism and colonialism and the idea that some people don’t know how to do certain things,” she said. “It’s the same kind of condescension that still happens and it’s really problematic. Part of it is intellectual laziness, but it’s largely due to ingrained racism and colonialism.” Image Credits: Joe Karp-Sawey/People's Vaccine Alliance. Tedros’ Second Term: WHO’s Triple Billion Goals Fall Short as Agency Sees Power Centralized, Over-Reliance on Consultants 26/08/2022 Elaine Ruth Fletcher On 24 May 2022, WHO Member States re-elected Dr Tedros Adhanom Ghebreyesus to serve a second five-year term as Director-General of the World Health Organization. “Power has been increasingly centralised around the Director-General’s office under Tedros’ leadership. This strategy might be advantageous in a crisis that demands a commander-in-control. But a lack of depth in wider leadership leaves shortcomings in the organisation. Thus states the prestigious medical journal, The Lancet, in an editorial marking the start of WHO Director General Dr Tedros Adhanom Ghebreyesus’ second term in office. The editorial notes that Tedros’ signature initiative, the Triple Billion programme, that aimed to bring better health, health-care coverage, health emergency response to three billion more people by 2023, is falling far short of its aims – with only 270 million more people accessing universal health coverage – as compared to WHO’s original aim of 1 billion: “WHO needs people of high calibre in programmatic leadership positions,” the unsigned editorial continues. “A wealth of expertise is available in WHO regional offices, and they deserve more support, engagement, and visibility. Member states might in fact prefer to fund regional offices rather than the Geneva headquarters. “Former Director-Generals appointed strong personalities, leaders in their areas of expertise and who had real convening power…..In its wider leadership, the WHO of today suffers a knowledge and expertise vacuum, with a heavy reliance on external experts and management consultants. Tedros would be wise to think about how leadership and responsibility is devolved to other dimensions and domains of his team.” See the complete text here. Trick or Treat? Artificial Sweeteners Impact Gut Bacteria, Could Alter Glucose Tolerance – Study 26/08/2022 Maayan Hoffman Sugar is more deadly than gunpowder Non-nutritive artificial sweeteners duplicate the taste of sugar but have fewer calories. As such, sugar alternatives like saccharin, sucralose, aspartame and stevia are often consumed in large quantities by people looking to watch their weight or shed a few pounds. But a team of researchers from Israel’s Weizmann Institute of Science said these alternative sugars should no longer be assumed safe because they can cause harm. In some people, they alter their microbiome (gut bacteria) and change blood sugar levels. “Our trial has shown that non-nutritive sweeteners may impair glucose responses by altering our microbiome, and they do so in a highly personalized manner, that is, by affecting each person in a unique way,” said Prof. Eran Elinav of Weizmann’s Systems Immunology Department, who led the study. Altering the Composition and Function of the Biome with Artificial Sweeteners Building off an animal trial conducted in 2014 that showed that some artificial sweeteners might contribute to changes in the sugar metabolism they are meant to prevent, a new team of researchers worked with 120 people who avoided artificially sweetened foods or drinks. The volunteers were divided into six groups: two controls and four who received one of four artificial sweeteners – saccharin, sucralose, aspartame or stevia – at lower than acceptable daily intake levels. In just two weeks, the researchers found consuming any of the sweeteners altered the composition and function of the microbiome and the small molecules that the gut microbes secrete into people’s blood. Moreover, saccharin and sucralose were found to alter glucose metabolism – the way a person disposes of glucose – which could contribute to metabolic disease, they said. No changes in either the microbiome or glucose tolerance were found in the two control groups that did not consume any alternative sugars. The findings were published on August 19 in the peer-reviewed journal Cell. “These findings reinforce the view of the microbiome as a hub that integrates the signals coming from the human body’s own systems and from external factors such as the food we eat, the medications we take, our lifestyle and physical surroundings,” Elinav said. Changes in the composition and function of gut microbes were observed in all four groups of trial participants who consumed non-nutritive sweeteners. Each group consumed one of the following: saccharine, sucralose, stevia or aspartame. The diagram shows increases in glucose levels in the saccharin and sucralose groups (two graphs on the left), compared to the stevia and aspartame groups (middle) and to the two control groups (right) Still Unproven That Sugar Is Healthier To help validate their findings and confirm that changes in the microbiome were responsible for impaired glucose tolerance, the researchers next implanted feces from more than 40 of the trial participants into healthy mice who were bred to have no gut bacteria of their own and who had never consumed artificial sweeteners. Those who received microbes from participants with the most pronounced alterations in glucose tolerance had more alterations in glucose tolerance themselves. This was compared to those mice that received microbes from people who had the least changes in glucose tolerance, and also had less changes. “The health implications of the changes that non-nutritive sweeteners may elicit in humans remain to be determined, and they merit new, long-term studies,” Elinav said. Previous studies have shown the detriments of eating artificial sweeteners, including weight gain, brain tumors and cancer. A BMJ study by French researchers in 2019 reinforced the link between consumption of sugar-laced sodas & fruit juices and cancer incidence, in particular breast cancer. Nonetheless, Elinav cautioned, the findings of this latest study do not imply that sugar is healthier than alternative sugars. Image Credits: Marco Verch. First African Manufactured Medicine to Prevent Malaria in Pregnant Women and Infants Quality-Approved by WHO 26/08/2022 Raisa Santos Pregnant women and children remain one of the groups at highest risk of complications from malaria infection. Kenyan manufacturer Universal Corporation LTD (UCL) has become the first African manufacturer to be issued a World Health Organization quality certification of a key antimalarial drug used to prevent infection in pregnant women and children. This certification, known as prequalification, will enable UCL to support regional efforts to combat malaria through local production of high-quality sulfadoxine-pyrimethamine (SP). Prequalification is a service provided by WHO to assess the quality, safety and efficacy of medicinal products. Quality assurance of UCL’s SP product Wiwal opens a route for procurement that will improve access and help strengthen Africa’s ability to combat endemic diseases. Young children and women are among the most vulnerable to the burden of malaria, with children under five accounting for 80% of all malaria deaths in Africa. SP is a generally well-tolerated, effective, and affordable medicine used to prevent malaria, yet adequate delivery and scale-up of this medicine is hampered in part by inadequate and unstable supply and, until now, a reliance on imported or poor-quality drugs. Its prequalification was achieved with funding from global health agency Unitaid and support from the Medicines for Malaria Venture (MMV). “Unitaid welcomes the certification of UCL to produce this quality-assured antimalarial medicine in Africa, where about 95% of all illness and death from malaria occurs,” said Dr Philippe Duneton, Executive Director of Unitaid. Reinforcing local production of medicines where they are needed most is critical to building stronger and more resilient health responses.” Disproportionate impact of malaria in Africa According to the latest World Malaria Report, released in 2021, there were an estimated 241 million cases of malaria and 627,000 resulting deaths worldwide in 2020. This represented about 14 million more cases in 2020 compared to 2019, and 69,000 more deaths. Approximately two-thirds of these additional deaths (47,000) were linked to disruptions in the provision of malaria prevention, diagnosis and treatment caused by the COVID-19 pandemic. The WHO African Region continues to carry a disproportionately high share of the global malaria burden. Global health leaders praised the prequalification announcement, calling it “excellent news” to those disproportionately impacted by malaria. “Ensuring the availability and accessibility of quality treatment for underserved communities, particularly women, newborns, and children who are disproportionately at high risk of death from malaria is a critical component to the full realization of the right to health,” said Joy Phumaphi, Executive Secretary of the African Leaders Malaria Alliance and MMV Board member. Lack of prequalified manufacturers raises concerns Health volunteers pick up supplies during a seasonal malaria chemoprevention campaign in Nigeria The lack of prequalified manufacturers in Africa raises concerns about the quality of medicines and supply insecurities that compromise the treatment of chronic and infectious diseases – risks that were clearly revealed when COVID-19 disrupted global supply chains and left Africa with limited access to vital products. Prequalification itself can be a long process, averaging 17 months in the process to reach product approval. UCL Founder and Managing Director Perviz Dhanani noted that in addition to being the first pharmaceutical company in Africa to receive prequalification for SP, it is also one of five manufacturers in Africa to receive quality certification for any product. It is clear that the production of quality medicines on the African continent is critical not only for the safety of Africa’s people but also for supporting regional supply availability and diversification in global production of medicines. “UCL is committed to supplying the African continent with quality medicines that are most needed by the people who live here. We’re filling a much-needed gap,” said Dhanani. Increased supply of SP is crucial to the long-term success of Unitaid’s malaria strategy, which includes nearly US$ 160 million invested to date to optimize and scale up delivery of SP through seasonal delivery and intermittent preventive treatment in pregnant women and infants. MMV is also working with Unitaid funding to support quality medicines critical to the malaria response. “Researchers and manufacturers from the countries hardest hit by malaria must be at the forefront of efforts to defeat the disease, which is why we welcome this wonderful news,” said David Reddy, MMV’s CEO. Image Credits: WHO, Elizabeth Poll/MMV, Munira Ismail_MSH. Africa Has Not Received a Single Dose of Monkeypox Vaccine – Even Though Virus is Endemic and Often More Deadly 25/08/2022 Paul Adepoju WHO African Regional Director, Dr Matshidiso Moeti Another COVID rerun: WHO and Africa CDC officials lament the complete lack of access to monkeypox vaccines on the continent where the virus is endemic – as well as often more deadly than elsewhere. Meanwhile, Mozambique and Malawi have seen a total of six wild poliovirus cases, although WHO officials continue to insist that since the cases are imported, this won’t affect Africa’s status as ‘wild poliovirus free.’ The African continent has not yet received any vaccine doses to combat the monkeypox virus, African health officials said Thursday, including nations where the disease is endemic and often more deadly than the clades surfacing around the world. More monkeypox testing kits also are urgently needed to improve the continent’s emergency response, top health officials warned in back-to-back briefings. “We still don’t have access to enough test kits. We are working on increasing that. We still don’t have access to any vaccines and that is a big concern,” said Africa CDC’s acting director, Ahmed Ogwell Ouma. He told Health Policy Watch that the sluggish response and lack of support for African countries doesn’t match the urgency called for in WHO’s declaration of monkeypox as a global public health emergency (PHEIC). “We need a coordinated international response where more is being put on the table to support the control of monkeypox as an outbreak of international concern,” Ouma said, stressing that Africa CDC has been providing as much guidance and support as it can for training and surveillance. Tedros Adhanom Ghebreyesus, WHO Director General, had declared monkeypox a public health emergency in July. Though no vaccines are available, WHO African Regional Director, Dr Matshidiso Moeti, said testing capacity is at least expanding, but not fast enough. “We have finally been able to obtain some tests, supplies and we have distributed these among countries to enable more rapid testing and confirmation of cases of monkeypox that will enable the diagnosis and ensure actions are taken faster,” Moeti told journalists on the margins of the 72nd WHO Regional Committee for Africa. She said WHO is working through its headquarters “to try to seek supplies of vaccines so that these may be available as we start to see new cases and we can have the experience of using this vaccine in Africa”. The Danish manufacturing plant of Bavarian Nordic, sole producer of the only WHO-approved monkeypox vaccine, MVA-BN, has been closed for renovations since spring and is not expected to reopen until late 2022, leading to a dire shortage of global supplies. WHO has repeatedly said it is “discussing” with vaccine suppliers. However, according to a recent Health Policy Watch investigation, there are only about 16.4 million stockpiled MVA-BN doses available in bulk or finished form until the end of this year. Unless a license is awarded to another vaccine manufacturer, the world will have to make do with existing doses, most of which reside in the United States and a few other wealthy countries. See related story: Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy Wild poliovirus cases expanding slowly Meanwhile, at a special African Regional Committee session on polio, WHO, African health ministers and their partners said they would work together to tackle wild poliovirus, which is seeing a comeback in east Africa due to the spread of a virus strain imported from Pakistan. There have now been six cases reported in the African Region from the outbreak which began last year in Malawi and has now reached Mozambique, all apparently with links to an imported case from Pakistan. WHO said the “imported” cases should not impact Africa’s certification as wild poliovirus free, and that “any child paralyzed from polio is one too many.” There are now 6 #WPV1 cases in the African Region, imported from Pakistan to #Malawi 🇲🇼 & more recently, #Mozambique 🇲🇿 While these do not negatively impact #Africa's 🌍indigenous wild polio-free certification, any child paralysed from #polio is 1 too many. #RC72AFRO #EndPolio pic.twitter.com/SVAvQzXR0m — WHO African Region (@WHOAFRO) August 24, 2022 COVID lockdowns impacted polio response Polio vaccination campaign in Malawi 2022 COVID-19 negatively impacted Africa’s polio response, said Dr Chris Elias, Polio Oversight Board Chair of the Gates Foundation, speaking at the meeting. By putting polio experts at the service of the COVID-19 response, the virus had time to spread. “Dozens of campaigns delayed, not only for polio but for measles and other diseases,” he said. “We need good quality routine immunization, campaigns and surveillance. Unfortunately, COVID-19 presented a huge challenge that gave polio time and freedom to act quickly.” Regarding wild polio, Ouma told Health Policy Watch that any presence of wild polio anywhere in the world poses a huge risk to the achievement that Africa recorded in eradicating the disease. Ouma called for more efforts to boost polio vaccination across the continent. “We need to put in place surveillance mechanisms that will be able to respond quickly when a case is identified,” he said. “It is our position that polio is not a regional or a country problem. It remains a global problem.” New regional health security strategy calls for 90% rapid response capacity by 2030 WHO Regional Committee meeting for Africa At the WHO Regional Committee meeting, African health ministers adopted a new eight-year strategy to transform health security and emergency response. Called the Regional Strategy for Health Security and Emergencies 2022–2030, it is intended to reduce the health and socioeconomic impacts of public health emergencies. The strategy includes goals for strengthening mechanisms for partnerships and multisectoral collaboration; ensuring sustained and predictable investment; and repurposing resources from polio eradication and COVID-19 to support strategic investments in systems and tools for public health emergencies. The adoption of the strategy means WHO’s member nations have now agreed to reach 12 strategy targets by 2030 – all aimed at strengthening capacity to prevent, prepare for, detect and respond to health emergencies. The strategy calls for 80% of member nations to have “predictable and sustainable” health security financing by 2030, with 90% able to mobilize an effective response to public health emergencies within 24 hours of detection. “This strategy is the fruit of extensive consultations with African health ministries and a range of other institutions, technical actors and partners across the continent. With their ongoing support and collaboration, it can help ensure that Africa is at the forefront of protecting the world against future pandemics,” Moeti said. Image Credits: WHO Africa. Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy 25/08/2022 John Heilprin Men queing for the monkeypox vaccine The global number of weekly new cases of monkeypox reported to the World Health Organization (WHO) declined by 21% for the first time since the infection that has been endemic to central and west Africa began to appear around the world earlier this year. Cases continued rising sharply in the Americas, however, in contrast to recent declines in European hotspots, WHO said in a report on Thursday showing 5,907 new monkeypox cases were reported in the past week, down from 7,477 new cases the previous week. That is a dramatic reversal from the 20% weekly increases in reported new monkeypox cases over the past month. More than 45,000 cases have been reported in 98 countries since late April. After four consecutive weeks of rising monkeypox cases globally, WHO says, the overall weekly decrease may reflect early signs of a declining infection rate in the European region but it will take time to see if that is sustained. Monkeypox cases in the Americas were still rising sharply, accounting for 60% of all cases compared to Europe’s 38% in the past month. WHO officials, meanwhile, say they are examining proposals to split scarce monkeypox vaccines doses to stretch supplies — a strategy adopted by the United States on August 10, in response to the global shortage of monkeypox vaccines. As part of that decision released earlier this month, US Health and Human Services Secretary Xavier Becerra issued a 564 determination, granting the US Food and Drug Administration the power to issue an emergency use authorization for vaccines. This gives the FDA permission to change the way the MVA-BN vaccine, made by Danish company Bavarian Nordic, is administered. Dr Kate O’Brien, WHO Director of Immunization, Vaccines and Biologicals, Group of monkeypox experts to examine the ‘fractional’ strategy Dr. Kate O’Brien, WHO’s Director of the Department of Immunization, Vaccines and Biologicals, said a strategic advisory group of experts will meet at the beginning of October to evaluate “some of these fractional dose issues” and the evidence for and against the strategy. Known as dose sparing, the U.S. fractional dose strategy splits the approved MVA-BN vaccine that is typically administered subcutaneously into five doses from each vaccine vial, and then delivers those “intradermally” just below the outermost layer of skin, known as the epidermis. “The strategy of what’s termed using fractional doses for vaccines is not a new strategy for vaccines,” O’Brien told a virtual press briefing on Thursday. “And we are looking really carefully at the evidence for the performance of these vaccines, these smallpox monkeypox vaccines,” she said, “to look at the equivalence or in fact, possibly the improved performance using fractional doses.” Along with extending the limited vaccine supplies, the procedure is supposed to provoke a more powerful immune reaction. But the strategy announced earlier by U.S. President Joe Biden’s administration is not going according to plan, Politico reports, with those administering the vaccine saying they’re getting only three or four doses out of each vial. Other media have reported the intradermal procedure’s more frequent use on men of color who have sought the vaccine recently, while white men who got in line first for the jab were able to get a full dose in the more proven, subcutaneous manner. Another complicating factor is the requirement for health workers to get extra training for the delicate intradermal procedure. The net result is speculation that if the outbreak continues to expand in the Americas, the US may be forced to fall back on another stockpile of ACAM2000 smallpox vaccines that are highly effective but can have dangerous side effects. Chronic Disease Focus of New Strategy 25/08/2022 Paul Adepoju 72nd WHO Regional Committee for Africa Ministers and government officials took on noncommunicable diseases, sickle cell disease, health system reforms in response to the COVID-19 pandemic, and measures to fight tuberculosis among children in Africa during their meeting of the 72nd WHO Regional Committee for Africa this week. In an effort to curb Africa’s chronic disease crisis, African health ministers adopted a new regional strategy to improve the diagnosis and treatment of severe forms of NCDs in district hospitals and first level referral facilities where care is often unavailable today. The new regional strategy for NCDs is known as PEN-PLUS. It addresses cardiovascular diseases, diabetes, cancer, and chronic lung disease that are responsible for almost 70% of all premature deaths worldwide – and a fast growing proportion of premature deaths in Africa. In addition, African nations face a special burden from sickle cell disease, which can cause severe anaemia and premature death if left untreated. In Africa, mortality from NCDs increased from 24% of total premature deaths in 2000 to more than 37% as of 2019. But many African countries lack adequate capacity to diagnosis and treat NCDs at the primary health care level, and most are only equipped to treat severe NCDs at tertiary health facilities, meaning big hospitals, located in large cities. The probability of premature death (age 30-70) from NCDs. This, WHO says, puts care beyond the reach of rural and poorer patients who typically rely on district hospitals and local health centres that lack the capacity and resources to effectively manage severe NCDs. Just 36% of countries have public hospitals stocked with basic NCD medications Knowing your blood pressure supports NCD prevention, diagnosis, and early treatment. PEN-PLUS, developed by WHO in collaboration with African health ministers over the past two years, offers a roadmap for countries to institute standardised programs to tackle chronic and severe NCDs by ensuring that essential medicines, technologies and diagnostics are available and accessible at district hospitals. It also encourages African governments to improve training and treatment protocols for chronic NCDs and to ensure that people at private hospitals can access services for severe NCDs Currently, just 36% of countries in the African region have public hospitals stocked with the medicines needed to treat NCDs, and private hospitals also must provide such services, according to WHO. In Liberia, Malawi, and Rwanda, where the strategy is already deployed, WHO says there has been a significant increase in the health and numbers of patients treated for severe chronic NCDs. In Africa, the most prevalent NCDs include Type 1 and 2 Diabetes, hypertension, heart disease and asthma, as well as sickle-cell disease, a genetic disorder, according to WHO data. Related to the drive against chronic NCDs, new campaign on sickle cell disease Health ministers also launched a campaign to tackle sickle cell disease, an inherited blood disorder that causes anaemia and can shorten lifespans, if left untreated. More than 66% of the 120 million people worldwide affected by sickle cell disease live in Africa, and approximately 1,000 African children are born with the disease every day. In 2019, the number of sickle cell disease deaths in the African region rose to 38,403 — a 26% increase from 2000. This rise in disease burden is attributed to a lack of investment in disease-fighting tools including prevention, early detection and proper care, according to WHO. The level of care has also been hampered by inadequate personnel and services, particularly at lower-level facilities. The campaign aims to shore up political will, engagement and financial resources for sickle cell disease prevention and control across the region. It draws on financial support and resources from the World Bank, U.S. Department of Health and Human Services, Novartis Foundation, Global Blood Therapeutics, and the Sickle in Africa consortium. Chief targets are schools, communities, health institutions and news media outlets. WHO notes that progress on controlling the disease in Africa is hindered by the absence of newborn screening programmes and surveillance, lack of accurate and reliable data on sickle cell disease and no data collection for sickle cell disease in most national surveys. “We need to shine the spotlight on this disease and help improve the quality of life of those living with it,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. Revamping Africa’s health systems in the wake of the pandemic Dr Matshidiso Moeti, WHO Regional Director for Africa, spoke at the session on childhood tuberculosis At the meeting, countries also agreed to institute other reforms in the region’s health systems in response to the COVID-19 pandemic, placing more emphasis on improved disease surveillance, as well as prevention and vaccination. “Domestic investment in health, including health research, has significant economic returns, while promoting resilience and sustainability; healthy populations translate to healthy economies,” Moeti said. Senegal’s Health Minister, Dr Marie Khemesse Ngom Ndiaye, said that due to the pandemic, her nation’s health system put more emphasis on resilience and investment. That “considerably strengthened disease prevention and management capacities,” she said. Fighting tuberculosis among children In terms of infectious diseases, long the major focus of African health programmes, more comprehensive and immediate measures are needed to fight tuberculosis among children in Africa, said representatives of WHO and the African Union, at the meeting. Their comments were echoed by the Stop TB Partnership and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). Currently, two-thirds of children with TB in WHO’s African Region fail to get diagnosed for the disease, WHO says, leading to an increased risk of rapid disease progression and mortality, especially in younger children. Among children under age five believed to have TB, just 32% in the African Region are adiagnosed and treated, the smallest proportion for that age group globally. Seventeen of the world’s 30 countries with the highest tuberculosis burden globally are in Africa, where 322,000 children and young adolescents under 15 years of age are affected. Minata Samate Cessouma, Commissioner for Health, African Union “There is an urgent need for innovative interventions to integrate tuberculosis diagnosis in nutrition programs to identify the disease in children quickly,” said Minata Samate Cessouma, African Union Commissioner for Health, Humanitarian Affairs and Social Development. “Children with tuberculosis are almost never spreading the disease and are always infected by an adult,” said Dr Lucica Ditiu, Executive Director of Stop TB Partnership, “so their suffering is a metric of our failures to diagnose and treat tuberculosis in children.” A child dies of tuberculosis somewhere in the world every two minutes, even though it is curable and preventable, she noted. . Tackling Malawi’s cholera outbreak At the meeting, WHO and UNICEF also announced joint plans to ramp up efforts to contain a cholera outbreak recently announced in Malawi. The outbreak has grown to 1,483 cases and 58 deaths in the northern and central regions, where it affects lakeshore communities and crowded, urban areas with insufficient water and sanitation facilities. The UN agencies say they will increase surveillance for early detection and management; improve the quality of case management at cholera treatment units; and provide critical supplies needed to manage cholera cases. They also plan to help improve water treatment, personal hygiene and household water storage. WHO’s Country Representative for Malawi, Dr Neema Rusibamayila Kimambo, stressed that every death from cholera is preventable. The UN health agency will offer additional support to Malawi’s Health Ministry to “help ensure that lives continue to be saved and a resilient health system is maintained during and beyond the current outbreak,” Kimambo said. UNICEF Malawi’s Representative, Rudolf Schwenk, said it’s urgent to help Malawi’s already overburdened public health services and health care delivery systems. “The good news is that we know the solutions,” Schwenk said. “We are on the ground providing humanitarian assistance in the affected districts, but we need more support to further scale up our response.” Image Credits: WHO, NCD Alliance, Twitter/Matshidiso Moeti, Twitter/WHO AFRO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
WHO Lists Entities That Can Engage with Pandemic Treaty Negotiating Body 29/08/2022 Kerry Cullinan WHO member states at the INB meeting taking place 18-22 July 2022 in Geneva A wide range of groups including civil society, academic and health groups have been identified as stakeholders that are able to interact with the World Health Organization’s (WHO) Intergovernmental Negotiating Body (INB) on a pandemic preparedness instrument. The WHO published the list last week but stressed that it was a “living document with further possibilities for updates as deemed appropriate by the INB”. Earlier, an op-ed published by Health Policy Watch warned against the “pervasive influence” of pharmaceutical groups and businesses in pandemic preparedness. “The proposed modalities for engagement for relevant stakeholders do not in fact propose any safeguards against corporate political interference in the pandemic treaty and its making. In fact, they pave the way for an ever-increasing range of entities to gain a foothold of status with the organization – beyond the pharma and agribusiness interests, like CropLife International, already in recognized WHO relations,” noted Nicoletta Dentico and Ashka Naik. The International Chamber of Commerce, AdvaMed, the world’s largest medical technology association and Biotechnology Innovation Organization, the world’s largest biotech trade association are among the newly listed entities. Environmental actors In a positive development, the dearth of environmental and One Health groups has been partly rectified in the current list with the inclusion of the Wildlife Conservation Society and the One Health High Level Expert Panel. Wildlife Conservation Society’s Christine Franklin confirmed that her organisation had been recognised after initially struggling to engage with the INB. “In the preparations for negotiation of a possible global instrument on pandemic prevention and preparedness there has been remarkably little attention given to true pandemic prevention,” Dr Nigel Sizer, executive director of Preventing Pandemics at the Source, told Health Policy Watch in an earlier interview. “We know where most pandemics come from and we know how to reduce the risk of zoonotic spillover of the viruses that cause them,” he added. “Governments in general and health agencies, in particular, should embrace these approaches, including One Health efforts. They should also work much more closely with environmental agencies to address spillover risk from tropical deforestation, wildlife exploitation and trade, and intensive animal agriculture. The public health return on investment in such activities would be enormous.” In light of the monkeypox outbreak and COVID-19, Sizer said that the WHO and other key actors should do more to address ecosystem risks that increase “spillover risks” of pathogen leap from animal to human populations: “Such actions include shutting down or strictly regulating wildlife trade and markets, stopping deforestation and forest degradation, and providing better health to communities in emerging infectious disease hotspots, as well as strengthened veterinary care and biosecurity in animal husbandry,” according to Sizer, an internationally known conservationist. Reactive not proactive list However, the list of entities seems based largely on those that have applied to give presentations at INB meetings rather than a representative group of all non-state and UN-affiliated actors that should be in the room to negotiate a future pandemic treaty. Entities already in official relations with WHO are also considered “relevant stakeholders”. Official relations status not only allows civil society groups the privilege of expounding on their positions at the annual World Health Assembly, it gives them access to lengthy and detailed informal member state consultations and intergovernmental negotiating sessions that are closed to the general public and the media. Some 220 civil society actors hold that coveted status, mostly mainstream medical and health societies as well as pharma groups, but also agro-business foundations, such as CropLife International, as well as the outliers like the World Plumbing Council. Additional reporting by Elaine Fletcher. How to Know if You Should Work in Global Health 27/08/2022 Editorial team For emerging global health professionals from the world’s “south,” choosing whether to focus their energy on local issues or on international challenges is always a dilemma, Chief Planetary Health Scientist of Sunway Centre for Planetary Health in Malaysia Renzo Guinto argues. “One important crossroad that I’ve encountered is tension on whether I stay in the Philippines and, for example, receive my education here, gain more exposure in domestic public health, versus gain experiences from abroad,” he says in the latest episode of the “Global Health Matters” podcast with host Garry Aslanyan. “We have pressing global health challenges that we certainly can contribute in terms of solving them, but also we still have the baggage of the local health problems,” he adds. Defining Global Health As highlighted by Aslanyan, the term global health itself has recently come under significant scrutiny for carrying a connotation of “public health somewhere else.” “The conversation on decolonising global health is ongoing, and I trust that this episode will further contribute to this important discussion,” says the host. Aslanyan and Guinto discuss different elements of this challenge, together with Associate Professor in Global Health and Development at James Cook University in Australia Stephanie Topp, who also joins the podcast. “I am not clinically trained, I am not a health professional by background, I’m a historian by background. And it is the inequity in health outcomes and specifically then access to health care that is why I feel motivated to work in this area,” Topp highlights. Public Health Accountability An internship in Zambia exposed Topp to uncomfortable aspects of global health, where people in positions of power are not held accountable for their actions. This motivated the researcher to pursue a Ph.D. in order to work on creating knowledge that could be used to make informed decisions. Access to global health education is another crucial issue discussed by Aslanyan, Guinto and Topp. “Education that transcends borders is essential,” Guinto notes. “Unfortunately, this is something that is not within the reach of many. And what we need to really think about is how to make these educational opportunities more accessible, equitable and even democratic.” The key to solving these challenges, Topp argues, does not lie in biomedical knowledge, because biomedical knowledge does not address the question of equality. What is needed is global health experts “who can operate in urban planning, in environmental planning, in social service spaces, and who can inform decisions and work with decision-makers in those different sectors,” she says. “In the end, I think that global health education lacks sufficient investment in competencies that derive from the social sciences,” Topp adds. Listen to previous episodes on the Health Policy Website >> Learn more about “Global Health Matters” podcast>> Image Credits: Global Health Matters podcast. Poor Vaccines Coverage in Pandemic Blamed on Multiple Barriers 26/08/2022 John Heilprin & Dann Okoth Dr Elia Badjo, co-founder and executive director of the Democratic Republic of the Congo’s Conseils sur la Santé et Académie de Médecin ( COSAMED), helps people in the North Kivu region Some of the biggest obstacles to expanded vaccines coverage in the world’s poorest and most conflict-ridden nations are lack of cold chain storage, unpredictable supply chains, and transport barriers, not claims of “vaccine hesitancy” in the Global South, according to a new report. The picture of the steep challenges faced by 14 nations during the COVID-19 pandemic “is more nuanced than a simple attribution to ‘hesitancy’ or ‘poor education,’ consistent with findings elsewhere,” two advocacy groups and a research company conclude in a joint 55-page report Friday. “Our findings demonstrate that as the world moved and transitioned from COVID-19, massive inequities remain in access to all COVID-19 tools, including oxygen and rapid tests,” the report says. Among developed nations, some 1.1 billion COVID-19 vaccines were likely wasted since the global rollout began, according to findings in July by Airfinity, a global health surveillance firm. The two groups — International Treatment Preparedness Coalition (ITPC) and People’s Vaccine Alliance — and the Malaysian research company, Matahari Global Solutions, say “numerous structural access barriers exist” to the fair, widespread distribution of COVID-19 vaccines. Those include “insufficient” local cold chain storage and advance notice about arrival dates, which impedes national planning and implementation abilities. Other barriers include physical infrastructure, such as access roads, and in some places limited access to transportation that works and is affordable. Unpredictable wait times, fluctuating supply stocks and people’s inability to leave their jobs also play an important role, the study finds. In addition, it says, the lower vaccination rates are influenced by a lack of “access to information and suspicion of medical technologies brought to countries by Westerners and white men, owing to historical memory and perceptions of experimentation on Black bodies.” In most cases the information, including technical terms, was delivered in the “official language” — most often English, French or Spanish — instead of local languages. Study Dismisses Claims About Importance of Skepticism About Vaccines That contrasts with the so-called vaccine hesitancy that some pharmaceutical companies have blamed for low vaccination rates among poorer countries. The study looked at Bangladesh, Democratic Republic of the Congo (DRC), Haiti, Jamaica, Liberia, Madagascar, Nepal, Nigeria, Peru, Senegal, Somalia, Uganda and Ukraine, reflecting a variety of factors. Some, such as the DRC and Haiti, had internal conflicts and vaccination rates of less than 10% — in contrast to the World Health Organization’s recommended 70% target rate that some high-income countries already have achieved. Others such as Nigeria, Somalia and Ukraine were included primarily for their domestic turmoil or insecurity. Peru was studied due to its high numbers of COVID-19 deaths; Madagascar was put on the list because of relative exclusion from discussion among academic and policy circles. Dr. Elia Badjo, founder and executive director of COSAMED and the lead local consultant for the ITPC/PVA project in the Democratic Republic of Congo (DRC), said health workers hadn’ been paid since the start of the vaccination campaigns at the beginning of the pandemic due to lack of funds. “Many are not trained either,” he said, adding that Ebola and monkeypox outbreaks exacerbate the situation and stretch scarce public health resources. Violent conflicts also have displaced people and made them more inaccessible to health workers. In Uganda, Richard Musisi, executive director of Masala Association of Persons with Disabilities Living with HIV/AIDS (MADIPHA), said people with disabilities “were disproportionately affected by the COVID-19 pandemic. There were consistent vaccine stock-outs and limited awareness.” The study says doctors and nurses in several rural communities reported never having heard of Paxlovid or novel antivirals for COVID-19, while some nations had no outreach to LGBTIQ persons, those who cannot afford to self-isolate if they tested positive, or people living in single-room homes. “These point to the need for direct cash transfers during pandemics and long-term planning on social security nets on the domestic level, but also to the failure of global pandemic platforms to account for local and specialized contexts,” the study says. Report Cites Role in Vaccines of ‘Modern Day Slavery The unsalaried community health workers that are essential for pandemic response also are a top concern. “Across the 14 countries and territories, community health workers play an essential role in deployment of tools, community engagement, and vaccine uptake,” it says. “Yet they largely remain unpaid — a phenomenon some have described as modern day slavery.” The People’s Vaccine Alliance says the disregard for the needs of people in lower-income countries is evidence of “systemic racism” in the global COVID-19 response, though the study does not mention this term or others such as “racism” or “racial discrimination.” The group also emphasizes that true infection and death rates are likely to be far higher than official figures due to the inaccessibility of testing and vaccination sites among the studied nations. “PCR test results can take anywhere from 8 to 12 hours in Bangladesh to more than two weeks in rural DRC. People cannot leave work at short notice, travel long distances to a vaccination/testing site, and then wait for a long unpredictable period of time,” it says. “For rural populations and nomadic people in countries like Somalia, this problem is particularly acute. Mobile vaccination and testing is not widespread enough.” Approach to Vaccines in the Global South Left People ‘Abandoned’ Maaza Seyoum, the group’s Global South convenor, says the report shows that communities have repeatedly been let down by a system geared towards protecting people in wealthy countries – leaving people in the Global South abandoned. “Their lives have been treated as an afterthought,” Seyoum said. “Local populations are expected to shoulder blame and be grateful for what vaccines they do receive, when there has been little effort to meet their needs,” she said. “It is yet more evidence of the systemic racism that has plagued the global response to COVID-19.” Fifa A. Rahman, the report’s lead author and principal consultant at Matahari Global Solutions, says the report found “layered issues why people are not accessing vaccines” rather than an outright, widespread distrust of vaccines. “The vaccine hesitancy narrative is rooted in racism and colonialism and the idea that some people don’t know how to do certain things,” she said. “It’s the same kind of condescension that still happens and it’s really problematic. Part of it is intellectual laziness, but it’s largely due to ingrained racism and colonialism.” Image Credits: Joe Karp-Sawey/People's Vaccine Alliance. Tedros’ Second Term: WHO’s Triple Billion Goals Fall Short as Agency Sees Power Centralized, Over-Reliance on Consultants 26/08/2022 Elaine Ruth Fletcher On 24 May 2022, WHO Member States re-elected Dr Tedros Adhanom Ghebreyesus to serve a second five-year term as Director-General of the World Health Organization. “Power has been increasingly centralised around the Director-General’s office under Tedros’ leadership. This strategy might be advantageous in a crisis that demands a commander-in-control. But a lack of depth in wider leadership leaves shortcomings in the organisation. Thus states the prestigious medical journal, The Lancet, in an editorial marking the start of WHO Director General Dr Tedros Adhanom Ghebreyesus’ second term in office. The editorial notes that Tedros’ signature initiative, the Triple Billion programme, that aimed to bring better health, health-care coverage, health emergency response to three billion more people by 2023, is falling far short of its aims – with only 270 million more people accessing universal health coverage – as compared to WHO’s original aim of 1 billion: “WHO needs people of high calibre in programmatic leadership positions,” the unsigned editorial continues. “A wealth of expertise is available in WHO regional offices, and they deserve more support, engagement, and visibility. Member states might in fact prefer to fund regional offices rather than the Geneva headquarters. “Former Director-Generals appointed strong personalities, leaders in their areas of expertise and who had real convening power…..In its wider leadership, the WHO of today suffers a knowledge and expertise vacuum, with a heavy reliance on external experts and management consultants. Tedros would be wise to think about how leadership and responsibility is devolved to other dimensions and domains of his team.” See the complete text here. Trick or Treat? Artificial Sweeteners Impact Gut Bacteria, Could Alter Glucose Tolerance – Study 26/08/2022 Maayan Hoffman Sugar is more deadly than gunpowder Non-nutritive artificial sweeteners duplicate the taste of sugar but have fewer calories. As such, sugar alternatives like saccharin, sucralose, aspartame and stevia are often consumed in large quantities by people looking to watch their weight or shed a few pounds. But a team of researchers from Israel’s Weizmann Institute of Science said these alternative sugars should no longer be assumed safe because they can cause harm. In some people, they alter their microbiome (gut bacteria) and change blood sugar levels. “Our trial has shown that non-nutritive sweeteners may impair glucose responses by altering our microbiome, and they do so in a highly personalized manner, that is, by affecting each person in a unique way,” said Prof. Eran Elinav of Weizmann’s Systems Immunology Department, who led the study. Altering the Composition and Function of the Biome with Artificial Sweeteners Building off an animal trial conducted in 2014 that showed that some artificial sweeteners might contribute to changes in the sugar metabolism they are meant to prevent, a new team of researchers worked with 120 people who avoided artificially sweetened foods or drinks. The volunteers were divided into six groups: two controls and four who received one of four artificial sweeteners – saccharin, sucralose, aspartame or stevia – at lower than acceptable daily intake levels. In just two weeks, the researchers found consuming any of the sweeteners altered the composition and function of the microbiome and the small molecules that the gut microbes secrete into people’s blood. Moreover, saccharin and sucralose were found to alter glucose metabolism – the way a person disposes of glucose – which could contribute to metabolic disease, they said. No changes in either the microbiome or glucose tolerance were found in the two control groups that did not consume any alternative sugars. The findings were published on August 19 in the peer-reviewed journal Cell. “These findings reinforce the view of the microbiome as a hub that integrates the signals coming from the human body’s own systems and from external factors such as the food we eat, the medications we take, our lifestyle and physical surroundings,” Elinav said. Changes in the composition and function of gut microbes were observed in all four groups of trial participants who consumed non-nutritive sweeteners. Each group consumed one of the following: saccharine, sucralose, stevia or aspartame. The diagram shows increases in glucose levels in the saccharin and sucralose groups (two graphs on the left), compared to the stevia and aspartame groups (middle) and to the two control groups (right) Still Unproven That Sugar Is Healthier To help validate their findings and confirm that changes in the microbiome were responsible for impaired glucose tolerance, the researchers next implanted feces from more than 40 of the trial participants into healthy mice who were bred to have no gut bacteria of their own and who had never consumed artificial sweeteners. Those who received microbes from participants with the most pronounced alterations in glucose tolerance had more alterations in glucose tolerance themselves. This was compared to those mice that received microbes from people who had the least changes in glucose tolerance, and also had less changes. “The health implications of the changes that non-nutritive sweeteners may elicit in humans remain to be determined, and they merit new, long-term studies,” Elinav said. Previous studies have shown the detriments of eating artificial sweeteners, including weight gain, brain tumors and cancer. A BMJ study by French researchers in 2019 reinforced the link between consumption of sugar-laced sodas & fruit juices and cancer incidence, in particular breast cancer. Nonetheless, Elinav cautioned, the findings of this latest study do not imply that sugar is healthier than alternative sugars. Image Credits: Marco Verch. First African Manufactured Medicine to Prevent Malaria in Pregnant Women and Infants Quality-Approved by WHO 26/08/2022 Raisa Santos Pregnant women and children remain one of the groups at highest risk of complications from malaria infection. Kenyan manufacturer Universal Corporation LTD (UCL) has become the first African manufacturer to be issued a World Health Organization quality certification of a key antimalarial drug used to prevent infection in pregnant women and children. This certification, known as prequalification, will enable UCL to support regional efforts to combat malaria through local production of high-quality sulfadoxine-pyrimethamine (SP). Prequalification is a service provided by WHO to assess the quality, safety and efficacy of medicinal products. Quality assurance of UCL’s SP product Wiwal opens a route for procurement that will improve access and help strengthen Africa’s ability to combat endemic diseases. Young children and women are among the most vulnerable to the burden of malaria, with children under five accounting for 80% of all malaria deaths in Africa. SP is a generally well-tolerated, effective, and affordable medicine used to prevent malaria, yet adequate delivery and scale-up of this medicine is hampered in part by inadequate and unstable supply and, until now, a reliance on imported or poor-quality drugs. Its prequalification was achieved with funding from global health agency Unitaid and support from the Medicines for Malaria Venture (MMV). “Unitaid welcomes the certification of UCL to produce this quality-assured antimalarial medicine in Africa, where about 95% of all illness and death from malaria occurs,” said Dr Philippe Duneton, Executive Director of Unitaid. Reinforcing local production of medicines where they are needed most is critical to building stronger and more resilient health responses.” Disproportionate impact of malaria in Africa According to the latest World Malaria Report, released in 2021, there were an estimated 241 million cases of malaria and 627,000 resulting deaths worldwide in 2020. This represented about 14 million more cases in 2020 compared to 2019, and 69,000 more deaths. Approximately two-thirds of these additional deaths (47,000) were linked to disruptions in the provision of malaria prevention, diagnosis and treatment caused by the COVID-19 pandemic. The WHO African Region continues to carry a disproportionately high share of the global malaria burden. Global health leaders praised the prequalification announcement, calling it “excellent news” to those disproportionately impacted by malaria. “Ensuring the availability and accessibility of quality treatment for underserved communities, particularly women, newborns, and children who are disproportionately at high risk of death from malaria is a critical component to the full realization of the right to health,” said Joy Phumaphi, Executive Secretary of the African Leaders Malaria Alliance and MMV Board member. Lack of prequalified manufacturers raises concerns Health volunteers pick up supplies during a seasonal malaria chemoprevention campaign in Nigeria The lack of prequalified manufacturers in Africa raises concerns about the quality of medicines and supply insecurities that compromise the treatment of chronic and infectious diseases – risks that were clearly revealed when COVID-19 disrupted global supply chains and left Africa with limited access to vital products. Prequalification itself can be a long process, averaging 17 months in the process to reach product approval. UCL Founder and Managing Director Perviz Dhanani noted that in addition to being the first pharmaceutical company in Africa to receive prequalification for SP, it is also one of five manufacturers in Africa to receive quality certification for any product. It is clear that the production of quality medicines on the African continent is critical not only for the safety of Africa’s people but also for supporting regional supply availability and diversification in global production of medicines. “UCL is committed to supplying the African continent with quality medicines that are most needed by the people who live here. We’re filling a much-needed gap,” said Dhanani. Increased supply of SP is crucial to the long-term success of Unitaid’s malaria strategy, which includes nearly US$ 160 million invested to date to optimize and scale up delivery of SP through seasonal delivery and intermittent preventive treatment in pregnant women and infants. MMV is also working with Unitaid funding to support quality medicines critical to the malaria response. “Researchers and manufacturers from the countries hardest hit by malaria must be at the forefront of efforts to defeat the disease, which is why we welcome this wonderful news,” said David Reddy, MMV’s CEO. Image Credits: WHO, Elizabeth Poll/MMV, Munira Ismail_MSH. Africa Has Not Received a Single Dose of Monkeypox Vaccine – Even Though Virus is Endemic and Often More Deadly 25/08/2022 Paul Adepoju WHO African Regional Director, Dr Matshidiso Moeti Another COVID rerun: WHO and Africa CDC officials lament the complete lack of access to monkeypox vaccines on the continent where the virus is endemic – as well as often more deadly than elsewhere. Meanwhile, Mozambique and Malawi have seen a total of six wild poliovirus cases, although WHO officials continue to insist that since the cases are imported, this won’t affect Africa’s status as ‘wild poliovirus free.’ The African continent has not yet received any vaccine doses to combat the monkeypox virus, African health officials said Thursday, including nations where the disease is endemic and often more deadly than the clades surfacing around the world. More monkeypox testing kits also are urgently needed to improve the continent’s emergency response, top health officials warned in back-to-back briefings. “We still don’t have access to enough test kits. We are working on increasing that. We still don’t have access to any vaccines and that is a big concern,” said Africa CDC’s acting director, Ahmed Ogwell Ouma. He told Health Policy Watch that the sluggish response and lack of support for African countries doesn’t match the urgency called for in WHO’s declaration of monkeypox as a global public health emergency (PHEIC). “We need a coordinated international response where more is being put on the table to support the control of monkeypox as an outbreak of international concern,” Ouma said, stressing that Africa CDC has been providing as much guidance and support as it can for training and surveillance. Tedros Adhanom Ghebreyesus, WHO Director General, had declared monkeypox a public health emergency in July. Though no vaccines are available, WHO African Regional Director, Dr Matshidiso Moeti, said testing capacity is at least expanding, but not fast enough. “We have finally been able to obtain some tests, supplies and we have distributed these among countries to enable more rapid testing and confirmation of cases of monkeypox that will enable the diagnosis and ensure actions are taken faster,” Moeti told journalists on the margins of the 72nd WHO Regional Committee for Africa. She said WHO is working through its headquarters “to try to seek supplies of vaccines so that these may be available as we start to see new cases and we can have the experience of using this vaccine in Africa”. The Danish manufacturing plant of Bavarian Nordic, sole producer of the only WHO-approved monkeypox vaccine, MVA-BN, has been closed for renovations since spring and is not expected to reopen until late 2022, leading to a dire shortage of global supplies. WHO has repeatedly said it is “discussing” with vaccine suppliers. However, according to a recent Health Policy Watch investigation, there are only about 16.4 million stockpiled MVA-BN doses available in bulk or finished form until the end of this year. Unless a license is awarded to another vaccine manufacturer, the world will have to make do with existing doses, most of which reside in the United States and a few other wealthy countries. See related story: Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy Wild poliovirus cases expanding slowly Meanwhile, at a special African Regional Committee session on polio, WHO, African health ministers and their partners said they would work together to tackle wild poliovirus, which is seeing a comeback in east Africa due to the spread of a virus strain imported from Pakistan. There have now been six cases reported in the African Region from the outbreak which began last year in Malawi and has now reached Mozambique, all apparently with links to an imported case from Pakistan. WHO said the “imported” cases should not impact Africa’s certification as wild poliovirus free, and that “any child paralyzed from polio is one too many.” There are now 6 #WPV1 cases in the African Region, imported from Pakistan to #Malawi 🇲🇼 & more recently, #Mozambique 🇲🇿 While these do not negatively impact #Africa's 🌍indigenous wild polio-free certification, any child paralysed from #polio is 1 too many. #RC72AFRO #EndPolio pic.twitter.com/SVAvQzXR0m — WHO African Region (@WHOAFRO) August 24, 2022 COVID lockdowns impacted polio response Polio vaccination campaign in Malawi 2022 COVID-19 negatively impacted Africa’s polio response, said Dr Chris Elias, Polio Oversight Board Chair of the Gates Foundation, speaking at the meeting. By putting polio experts at the service of the COVID-19 response, the virus had time to spread. “Dozens of campaigns delayed, not only for polio but for measles and other diseases,” he said. “We need good quality routine immunization, campaigns and surveillance. Unfortunately, COVID-19 presented a huge challenge that gave polio time and freedom to act quickly.” Regarding wild polio, Ouma told Health Policy Watch that any presence of wild polio anywhere in the world poses a huge risk to the achievement that Africa recorded in eradicating the disease. Ouma called for more efforts to boost polio vaccination across the continent. “We need to put in place surveillance mechanisms that will be able to respond quickly when a case is identified,” he said. “It is our position that polio is not a regional or a country problem. It remains a global problem.” New regional health security strategy calls for 90% rapid response capacity by 2030 WHO Regional Committee meeting for Africa At the WHO Regional Committee meeting, African health ministers adopted a new eight-year strategy to transform health security and emergency response. Called the Regional Strategy for Health Security and Emergencies 2022–2030, it is intended to reduce the health and socioeconomic impacts of public health emergencies. The strategy includes goals for strengthening mechanisms for partnerships and multisectoral collaboration; ensuring sustained and predictable investment; and repurposing resources from polio eradication and COVID-19 to support strategic investments in systems and tools for public health emergencies. The adoption of the strategy means WHO’s member nations have now agreed to reach 12 strategy targets by 2030 – all aimed at strengthening capacity to prevent, prepare for, detect and respond to health emergencies. The strategy calls for 80% of member nations to have “predictable and sustainable” health security financing by 2030, with 90% able to mobilize an effective response to public health emergencies within 24 hours of detection. “This strategy is the fruit of extensive consultations with African health ministries and a range of other institutions, technical actors and partners across the continent. With their ongoing support and collaboration, it can help ensure that Africa is at the forefront of protecting the world against future pandemics,” Moeti said. Image Credits: WHO Africa. Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy 25/08/2022 John Heilprin Men queing for the monkeypox vaccine The global number of weekly new cases of monkeypox reported to the World Health Organization (WHO) declined by 21% for the first time since the infection that has been endemic to central and west Africa began to appear around the world earlier this year. Cases continued rising sharply in the Americas, however, in contrast to recent declines in European hotspots, WHO said in a report on Thursday showing 5,907 new monkeypox cases were reported in the past week, down from 7,477 new cases the previous week. That is a dramatic reversal from the 20% weekly increases in reported new monkeypox cases over the past month. More than 45,000 cases have been reported in 98 countries since late April. After four consecutive weeks of rising monkeypox cases globally, WHO says, the overall weekly decrease may reflect early signs of a declining infection rate in the European region but it will take time to see if that is sustained. Monkeypox cases in the Americas were still rising sharply, accounting for 60% of all cases compared to Europe’s 38% in the past month. WHO officials, meanwhile, say they are examining proposals to split scarce monkeypox vaccines doses to stretch supplies — a strategy adopted by the United States on August 10, in response to the global shortage of monkeypox vaccines. As part of that decision released earlier this month, US Health and Human Services Secretary Xavier Becerra issued a 564 determination, granting the US Food and Drug Administration the power to issue an emergency use authorization for vaccines. This gives the FDA permission to change the way the MVA-BN vaccine, made by Danish company Bavarian Nordic, is administered. Dr Kate O’Brien, WHO Director of Immunization, Vaccines and Biologicals, Group of monkeypox experts to examine the ‘fractional’ strategy Dr. Kate O’Brien, WHO’s Director of the Department of Immunization, Vaccines and Biologicals, said a strategic advisory group of experts will meet at the beginning of October to evaluate “some of these fractional dose issues” and the evidence for and against the strategy. Known as dose sparing, the U.S. fractional dose strategy splits the approved MVA-BN vaccine that is typically administered subcutaneously into five doses from each vaccine vial, and then delivers those “intradermally” just below the outermost layer of skin, known as the epidermis. “The strategy of what’s termed using fractional doses for vaccines is not a new strategy for vaccines,” O’Brien told a virtual press briefing on Thursday. “And we are looking really carefully at the evidence for the performance of these vaccines, these smallpox monkeypox vaccines,” she said, “to look at the equivalence or in fact, possibly the improved performance using fractional doses.” Along with extending the limited vaccine supplies, the procedure is supposed to provoke a more powerful immune reaction. But the strategy announced earlier by U.S. President Joe Biden’s administration is not going according to plan, Politico reports, with those administering the vaccine saying they’re getting only three or four doses out of each vial. Other media have reported the intradermal procedure’s more frequent use on men of color who have sought the vaccine recently, while white men who got in line first for the jab were able to get a full dose in the more proven, subcutaneous manner. Another complicating factor is the requirement for health workers to get extra training for the delicate intradermal procedure. The net result is speculation that if the outbreak continues to expand in the Americas, the US may be forced to fall back on another stockpile of ACAM2000 smallpox vaccines that are highly effective but can have dangerous side effects. Chronic Disease Focus of New Strategy 25/08/2022 Paul Adepoju 72nd WHO Regional Committee for Africa Ministers and government officials took on noncommunicable diseases, sickle cell disease, health system reforms in response to the COVID-19 pandemic, and measures to fight tuberculosis among children in Africa during their meeting of the 72nd WHO Regional Committee for Africa this week. In an effort to curb Africa’s chronic disease crisis, African health ministers adopted a new regional strategy to improve the diagnosis and treatment of severe forms of NCDs in district hospitals and first level referral facilities where care is often unavailable today. The new regional strategy for NCDs is known as PEN-PLUS. It addresses cardiovascular diseases, diabetes, cancer, and chronic lung disease that are responsible for almost 70% of all premature deaths worldwide – and a fast growing proportion of premature deaths in Africa. In addition, African nations face a special burden from sickle cell disease, which can cause severe anaemia and premature death if left untreated. In Africa, mortality from NCDs increased from 24% of total premature deaths in 2000 to more than 37% as of 2019. But many African countries lack adequate capacity to diagnosis and treat NCDs at the primary health care level, and most are only equipped to treat severe NCDs at tertiary health facilities, meaning big hospitals, located in large cities. The probability of premature death (age 30-70) from NCDs. This, WHO says, puts care beyond the reach of rural and poorer patients who typically rely on district hospitals and local health centres that lack the capacity and resources to effectively manage severe NCDs. Just 36% of countries have public hospitals stocked with basic NCD medications Knowing your blood pressure supports NCD prevention, diagnosis, and early treatment. PEN-PLUS, developed by WHO in collaboration with African health ministers over the past two years, offers a roadmap for countries to institute standardised programs to tackle chronic and severe NCDs by ensuring that essential medicines, technologies and diagnostics are available and accessible at district hospitals. It also encourages African governments to improve training and treatment protocols for chronic NCDs and to ensure that people at private hospitals can access services for severe NCDs Currently, just 36% of countries in the African region have public hospitals stocked with the medicines needed to treat NCDs, and private hospitals also must provide such services, according to WHO. In Liberia, Malawi, and Rwanda, where the strategy is already deployed, WHO says there has been a significant increase in the health and numbers of patients treated for severe chronic NCDs. In Africa, the most prevalent NCDs include Type 1 and 2 Diabetes, hypertension, heart disease and asthma, as well as sickle-cell disease, a genetic disorder, according to WHO data. Related to the drive against chronic NCDs, new campaign on sickle cell disease Health ministers also launched a campaign to tackle sickle cell disease, an inherited blood disorder that causes anaemia and can shorten lifespans, if left untreated. More than 66% of the 120 million people worldwide affected by sickle cell disease live in Africa, and approximately 1,000 African children are born with the disease every day. In 2019, the number of sickle cell disease deaths in the African region rose to 38,403 — a 26% increase from 2000. This rise in disease burden is attributed to a lack of investment in disease-fighting tools including prevention, early detection and proper care, according to WHO. The level of care has also been hampered by inadequate personnel and services, particularly at lower-level facilities. The campaign aims to shore up political will, engagement and financial resources for sickle cell disease prevention and control across the region. It draws on financial support and resources from the World Bank, U.S. Department of Health and Human Services, Novartis Foundation, Global Blood Therapeutics, and the Sickle in Africa consortium. Chief targets are schools, communities, health institutions and news media outlets. WHO notes that progress on controlling the disease in Africa is hindered by the absence of newborn screening programmes and surveillance, lack of accurate and reliable data on sickle cell disease and no data collection for sickle cell disease in most national surveys. “We need to shine the spotlight on this disease and help improve the quality of life of those living with it,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. Revamping Africa’s health systems in the wake of the pandemic Dr Matshidiso Moeti, WHO Regional Director for Africa, spoke at the session on childhood tuberculosis At the meeting, countries also agreed to institute other reforms in the region’s health systems in response to the COVID-19 pandemic, placing more emphasis on improved disease surveillance, as well as prevention and vaccination. “Domestic investment in health, including health research, has significant economic returns, while promoting resilience and sustainability; healthy populations translate to healthy economies,” Moeti said. Senegal’s Health Minister, Dr Marie Khemesse Ngom Ndiaye, said that due to the pandemic, her nation’s health system put more emphasis on resilience and investment. That “considerably strengthened disease prevention and management capacities,” she said. Fighting tuberculosis among children In terms of infectious diseases, long the major focus of African health programmes, more comprehensive and immediate measures are needed to fight tuberculosis among children in Africa, said representatives of WHO and the African Union, at the meeting. Their comments were echoed by the Stop TB Partnership and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). Currently, two-thirds of children with TB in WHO’s African Region fail to get diagnosed for the disease, WHO says, leading to an increased risk of rapid disease progression and mortality, especially in younger children. Among children under age five believed to have TB, just 32% in the African Region are adiagnosed and treated, the smallest proportion for that age group globally. Seventeen of the world’s 30 countries with the highest tuberculosis burden globally are in Africa, where 322,000 children and young adolescents under 15 years of age are affected. Minata Samate Cessouma, Commissioner for Health, African Union “There is an urgent need for innovative interventions to integrate tuberculosis diagnosis in nutrition programs to identify the disease in children quickly,” said Minata Samate Cessouma, African Union Commissioner for Health, Humanitarian Affairs and Social Development. “Children with tuberculosis are almost never spreading the disease and are always infected by an adult,” said Dr Lucica Ditiu, Executive Director of Stop TB Partnership, “so their suffering is a metric of our failures to diagnose and treat tuberculosis in children.” A child dies of tuberculosis somewhere in the world every two minutes, even though it is curable and preventable, she noted. . Tackling Malawi’s cholera outbreak At the meeting, WHO and UNICEF also announced joint plans to ramp up efforts to contain a cholera outbreak recently announced in Malawi. The outbreak has grown to 1,483 cases and 58 deaths in the northern and central regions, where it affects lakeshore communities and crowded, urban areas with insufficient water and sanitation facilities. The UN agencies say they will increase surveillance for early detection and management; improve the quality of case management at cholera treatment units; and provide critical supplies needed to manage cholera cases. They also plan to help improve water treatment, personal hygiene and household water storage. WHO’s Country Representative for Malawi, Dr Neema Rusibamayila Kimambo, stressed that every death from cholera is preventable. The UN health agency will offer additional support to Malawi’s Health Ministry to “help ensure that lives continue to be saved and a resilient health system is maintained during and beyond the current outbreak,” Kimambo said. UNICEF Malawi’s Representative, Rudolf Schwenk, said it’s urgent to help Malawi’s already overburdened public health services and health care delivery systems. “The good news is that we know the solutions,” Schwenk said. “We are on the ground providing humanitarian assistance in the affected districts, but we need more support to further scale up our response.” Image Credits: WHO, NCD Alliance, Twitter/Matshidiso Moeti, Twitter/WHO AFRO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
How to Know if You Should Work in Global Health 27/08/2022 Editorial team For emerging global health professionals from the world’s “south,” choosing whether to focus their energy on local issues or on international challenges is always a dilemma, Chief Planetary Health Scientist of Sunway Centre for Planetary Health in Malaysia Renzo Guinto argues. “One important crossroad that I’ve encountered is tension on whether I stay in the Philippines and, for example, receive my education here, gain more exposure in domestic public health, versus gain experiences from abroad,” he says in the latest episode of the “Global Health Matters” podcast with host Garry Aslanyan. “We have pressing global health challenges that we certainly can contribute in terms of solving them, but also we still have the baggage of the local health problems,” he adds. Defining Global Health As highlighted by Aslanyan, the term global health itself has recently come under significant scrutiny for carrying a connotation of “public health somewhere else.” “The conversation on decolonising global health is ongoing, and I trust that this episode will further contribute to this important discussion,” says the host. Aslanyan and Guinto discuss different elements of this challenge, together with Associate Professor in Global Health and Development at James Cook University in Australia Stephanie Topp, who also joins the podcast. “I am not clinically trained, I am not a health professional by background, I’m a historian by background. And it is the inequity in health outcomes and specifically then access to health care that is why I feel motivated to work in this area,” Topp highlights. Public Health Accountability An internship in Zambia exposed Topp to uncomfortable aspects of global health, where people in positions of power are not held accountable for their actions. This motivated the researcher to pursue a Ph.D. in order to work on creating knowledge that could be used to make informed decisions. Access to global health education is another crucial issue discussed by Aslanyan, Guinto and Topp. “Education that transcends borders is essential,” Guinto notes. “Unfortunately, this is something that is not within the reach of many. And what we need to really think about is how to make these educational opportunities more accessible, equitable and even democratic.” The key to solving these challenges, Topp argues, does not lie in biomedical knowledge, because biomedical knowledge does not address the question of equality. What is needed is global health experts “who can operate in urban planning, in environmental planning, in social service spaces, and who can inform decisions and work with decision-makers in those different sectors,” she says. “In the end, I think that global health education lacks sufficient investment in competencies that derive from the social sciences,” Topp adds. Listen to previous episodes on the Health Policy Website >> Learn more about “Global Health Matters” podcast>> Image Credits: Global Health Matters podcast. Poor Vaccines Coverage in Pandemic Blamed on Multiple Barriers 26/08/2022 John Heilprin & Dann Okoth Dr Elia Badjo, co-founder and executive director of the Democratic Republic of the Congo’s Conseils sur la Santé et Académie de Médecin ( COSAMED), helps people in the North Kivu region Some of the biggest obstacles to expanded vaccines coverage in the world’s poorest and most conflict-ridden nations are lack of cold chain storage, unpredictable supply chains, and transport barriers, not claims of “vaccine hesitancy” in the Global South, according to a new report. The picture of the steep challenges faced by 14 nations during the COVID-19 pandemic “is more nuanced than a simple attribution to ‘hesitancy’ or ‘poor education,’ consistent with findings elsewhere,” two advocacy groups and a research company conclude in a joint 55-page report Friday. “Our findings demonstrate that as the world moved and transitioned from COVID-19, massive inequities remain in access to all COVID-19 tools, including oxygen and rapid tests,” the report says. Among developed nations, some 1.1 billion COVID-19 vaccines were likely wasted since the global rollout began, according to findings in July by Airfinity, a global health surveillance firm. The two groups — International Treatment Preparedness Coalition (ITPC) and People’s Vaccine Alliance — and the Malaysian research company, Matahari Global Solutions, say “numerous structural access barriers exist” to the fair, widespread distribution of COVID-19 vaccines. Those include “insufficient” local cold chain storage and advance notice about arrival dates, which impedes national planning and implementation abilities. Other barriers include physical infrastructure, such as access roads, and in some places limited access to transportation that works and is affordable. Unpredictable wait times, fluctuating supply stocks and people’s inability to leave their jobs also play an important role, the study finds. In addition, it says, the lower vaccination rates are influenced by a lack of “access to information and suspicion of medical technologies brought to countries by Westerners and white men, owing to historical memory and perceptions of experimentation on Black bodies.” In most cases the information, including technical terms, was delivered in the “official language” — most often English, French or Spanish — instead of local languages. Study Dismisses Claims About Importance of Skepticism About Vaccines That contrasts with the so-called vaccine hesitancy that some pharmaceutical companies have blamed for low vaccination rates among poorer countries. The study looked at Bangladesh, Democratic Republic of the Congo (DRC), Haiti, Jamaica, Liberia, Madagascar, Nepal, Nigeria, Peru, Senegal, Somalia, Uganda and Ukraine, reflecting a variety of factors. Some, such as the DRC and Haiti, had internal conflicts and vaccination rates of less than 10% — in contrast to the World Health Organization’s recommended 70% target rate that some high-income countries already have achieved. Others such as Nigeria, Somalia and Ukraine were included primarily for their domestic turmoil or insecurity. Peru was studied due to its high numbers of COVID-19 deaths; Madagascar was put on the list because of relative exclusion from discussion among academic and policy circles. Dr. Elia Badjo, founder and executive director of COSAMED and the lead local consultant for the ITPC/PVA project in the Democratic Republic of Congo (DRC), said health workers hadn’ been paid since the start of the vaccination campaigns at the beginning of the pandemic due to lack of funds. “Many are not trained either,” he said, adding that Ebola and monkeypox outbreaks exacerbate the situation and stretch scarce public health resources. Violent conflicts also have displaced people and made them more inaccessible to health workers. In Uganda, Richard Musisi, executive director of Masala Association of Persons with Disabilities Living with HIV/AIDS (MADIPHA), said people with disabilities “were disproportionately affected by the COVID-19 pandemic. There were consistent vaccine stock-outs and limited awareness.” The study says doctors and nurses in several rural communities reported never having heard of Paxlovid or novel antivirals for COVID-19, while some nations had no outreach to LGBTIQ persons, those who cannot afford to self-isolate if they tested positive, or people living in single-room homes. “These point to the need for direct cash transfers during pandemics and long-term planning on social security nets on the domestic level, but also to the failure of global pandemic platforms to account for local and specialized contexts,” the study says. Report Cites Role in Vaccines of ‘Modern Day Slavery The unsalaried community health workers that are essential for pandemic response also are a top concern. “Across the 14 countries and territories, community health workers play an essential role in deployment of tools, community engagement, and vaccine uptake,” it says. “Yet they largely remain unpaid — a phenomenon some have described as modern day slavery.” The People’s Vaccine Alliance says the disregard for the needs of people in lower-income countries is evidence of “systemic racism” in the global COVID-19 response, though the study does not mention this term or others such as “racism” or “racial discrimination.” The group also emphasizes that true infection and death rates are likely to be far higher than official figures due to the inaccessibility of testing and vaccination sites among the studied nations. “PCR test results can take anywhere from 8 to 12 hours in Bangladesh to more than two weeks in rural DRC. People cannot leave work at short notice, travel long distances to a vaccination/testing site, and then wait for a long unpredictable period of time,” it says. “For rural populations and nomadic people in countries like Somalia, this problem is particularly acute. Mobile vaccination and testing is not widespread enough.” Approach to Vaccines in the Global South Left People ‘Abandoned’ Maaza Seyoum, the group’s Global South convenor, says the report shows that communities have repeatedly been let down by a system geared towards protecting people in wealthy countries – leaving people in the Global South abandoned. “Their lives have been treated as an afterthought,” Seyoum said. “Local populations are expected to shoulder blame and be grateful for what vaccines they do receive, when there has been little effort to meet their needs,” she said. “It is yet more evidence of the systemic racism that has plagued the global response to COVID-19.” Fifa A. Rahman, the report’s lead author and principal consultant at Matahari Global Solutions, says the report found “layered issues why people are not accessing vaccines” rather than an outright, widespread distrust of vaccines. “The vaccine hesitancy narrative is rooted in racism and colonialism and the idea that some people don’t know how to do certain things,” she said. “It’s the same kind of condescension that still happens and it’s really problematic. Part of it is intellectual laziness, but it’s largely due to ingrained racism and colonialism.” Image Credits: Joe Karp-Sawey/People's Vaccine Alliance. Tedros’ Second Term: WHO’s Triple Billion Goals Fall Short as Agency Sees Power Centralized, Over-Reliance on Consultants 26/08/2022 Elaine Ruth Fletcher On 24 May 2022, WHO Member States re-elected Dr Tedros Adhanom Ghebreyesus to serve a second five-year term as Director-General of the World Health Organization. “Power has been increasingly centralised around the Director-General’s office under Tedros’ leadership. This strategy might be advantageous in a crisis that demands a commander-in-control. But a lack of depth in wider leadership leaves shortcomings in the organisation. Thus states the prestigious medical journal, The Lancet, in an editorial marking the start of WHO Director General Dr Tedros Adhanom Ghebreyesus’ second term in office. The editorial notes that Tedros’ signature initiative, the Triple Billion programme, that aimed to bring better health, health-care coverage, health emergency response to three billion more people by 2023, is falling far short of its aims – with only 270 million more people accessing universal health coverage – as compared to WHO’s original aim of 1 billion: “WHO needs people of high calibre in programmatic leadership positions,” the unsigned editorial continues. “A wealth of expertise is available in WHO regional offices, and they deserve more support, engagement, and visibility. Member states might in fact prefer to fund regional offices rather than the Geneva headquarters. “Former Director-Generals appointed strong personalities, leaders in their areas of expertise and who had real convening power…..In its wider leadership, the WHO of today suffers a knowledge and expertise vacuum, with a heavy reliance on external experts and management consultants. Tedros would be wise to think about how leadership and responsibility is devolved to other dimensions and domains of his team.” See the complete text here. Trick or Treat? Artificial Sweeteners Impact Gut Bacteria, Could Alter Glucose Tolerance – Study 26/08/2022 Maayan Hoffman Sugar is more deadly than gunpowder Non-nutritive artificial sweeteners duplicate the taste of sugar but have fewer calories. As such, sugar alternatives like saccharin, sucralose, aspartame and stevia are often consumed in large quantities by people looking to watch their weight or shed a few pounds. But a team of researchers from Israel’s Weizmann Institute of Science said these alternative sugars should no longer be assumed safe because they can cause harm. In some people, they alter their microbiome (gut bacteria) and change blood sugar levels. “Our trial has shown that non-nutritive sweeteners may impair glucose responses by altering our microbiome, and they do so in a highly personalized manner, that is, by affecting each person in a unique way,” said Prof. Eran Elinav of Weizmann’s Systems Immunology Department, who led the study. Altering the Composition and Function of the Biome with Artificial Sweeteners Building off an animal trial conducted in 2014 that showed that some artificial sweeteners might contribute to changes in the sugar metabolism they are meant to prevent, a new team of researchers worked with 120 people who avoided artificially sweetened foods or drinks. The volunteers were divided into six groups: two controls and four who received one of four artificial sweeteners – saccharin, sucralose, aspartame or stevia – at lower than acceptable daily intake levels. In just two weeks, the researchers found consuming any of the sweeteners altered the composition and function of the microbiome and the small molecules that the gut microbes secrete into people’s blood. Moreover, saccharin and sucralose were found to alter glucose metabolism – the way a person disposes of glucose – which could contribute to metabolic disease, they said. No changes in either the microbiome or glucose tolerance were found in the two control groups that did not consume any alternative sugars. The findings were published on August 19 in the peer-reviewed journal Cell. “These findings reinforce the view of the microbiome as a hub that integrates the signals coming from the human body’s own systems and from external factors such as the food we eat, the medications we take, our lifestyle and physical surroundings,” Elinav said. Changes in the composition and function of gut microbes were observed in all four groups of trial participants who consumed non-nutritive sweeteners. Each group consumed one of the following: saccharine, sucralose, stevia or aspartame. The diagram shows increases in glucose levels in the saccharin and sucralose groups (two graphs on the left), compared to the stevia and aspartame groups (middle) and to the two control groups (right) Still Unproven That Sugar Is Healthier To help validate their findings and confirm that changes in the microbiome were responsible for impaired glucose tolerance, the researchers next implanted feces from more than 40 of the trial participants into healthy mice who were bred to have no gut bacteria of their own and who had never consumed artificial sweeteners. Those who received microbes from participants with the most pronounced alterations in glucose tolerance had more alterations in glucose tolerance themselves. This was compared to those mice that received microbes from people who had the least changes in glucose tolerance, and also had less changes. “The health implications of the changes that non-nutritive sweeteners may elicit in humans remain to be determined, and they merit new, long-term studies,” Elinav said. Previous studies have shown the detriments of eating artificial sweeteners, including weight gain, brain tumors and cancer. A BMJ study by French researchers in 2019 reinforced the link between consumption of sugar-laced sodas & fruit juices and cancer incidence, in particular breast cancer. Nonetheless, Elinav cautioned, the findings of this latest study do not imply that sugar is healthier than alternative sugars. Image Credits: Marco Verch. First African Manufactured Medicine to Prevent Malaria in Pregnant Women and Infants Quality-Approved by WHO 26/08/2022 Raisa Santos Pregnant women and children remain one of the groups at highest risk of complications from malaria infection. Kenyan manufacturer Universal Corporation LTD (UCL) has become the first African manufacturer to be issued a World Health Organization quality certification of a key antimalarial drug used to prevent infection in pregnant women and children. This certification, known as prequalification, will enable UCL to support regional efforts to combat malaria through local production of high-quality sulfadoxine-pyrimethamine (SP). Prequalification is a service provided by WHO to assess the quality, safety and efficacy of medicinal products. Quality assurance of UCL’s SP product Wiwal opens a route for procurement that will improve access and help strengthen Africa’s ability to combat endemic diseases. Young children and women are among the most vulnerable to the burden of malaria, with children under five accounting for 80% of all malaria deaths in Africa. SP is a generally well-tolerated, effective, and affordable medicine used to prevent malaria, yet adequate delivery and scale-up of this medicine is hampered in part by inadequate and unstable supply and, until now, a reliance on imported or poor-quality drugs. Its prequalification was achieved with funding from global health agency Unitaid and support from the Medicines for Malaria Venture (MMV). “Unitaid welcomes the certification of UCL to produce this quality-assured antimalarial medicine in Africa, where about 95% of all illness and death from malaria occurs,” said Dr Philippe Duneton, Executive Director of Unitaid. Reinforcing local production of medicines where they are needed most is critical to building stronger and more resilient health responses.” Disproportionate impact of malaria in Africa According to the latest World Malaria Report, released in 2021, there were an estimated 241 million cases of malaria and 627,000 resulting deaths worldwide in 2020. This represented about 14 million more cases in 2020 compared to 2019, and 69,000 more deaths. Approximately two-thirds of these additional deaths (47,000) were linked to disruptions in the provision of malaria prevention, diagnosis and treatment caused by the COVID-19 pandemic. The WHO African Region continues to carry a disproportionately high share of the global malaria burden. Global health leaders praised the prequalification announcement, calling it “excellent news” to those disproportionately impacted by malaria. “Ensuring the availability and accessibility of quality treatment for underserved communities, particularly women, newborns, and children who are disproportionately at high risk of death from malaria is a critical component to the full realization of the right to health,” said Joy Phumaphi, Executive Secretary of the African Leaders Malaria Alliance and MMV Board member. Lack of prequalified manufacturers raises concerns Health volunteers pick up supplies during a seasonal malaria chemoprevention campaign in Nigeria The lack of prequalified manufacturers in Africa raises concerns about the quality of medicines and supply insecurities that compromise the treatment of chronic and infectious diseases – risks that were clearly revealed when COVID-19 disrupted global supply chains and left Africa with limited access to vital products. Prequalification itself can be a long process, averaging 17 months in the process to reach product approval. UCL Founder and Managing Director Perviz Dhanani noted that in addition to being the first pharmaceutical company in Africa to receive prequalification for SP, it is also one of five manufacturers in Africa to receive quality certification for any product. It is clear that the production of quality medicines on the African continent is critical not only for the safety of Africa’s people but also for supporting regional supply availability and diversification in global production of medicines. “UCL is committed to supplying the African continent with quality medicines that are most needed by the people who live here. We’re filling a much-needed gap,” said Dhanani. Increased supply of SP is crucial to the long-term success of Unitaid’s malaria strategy, which includes nearly US$ 160 million invested to date to optimize and scale up delivery of SP through seasonal delivery and intermittent preventive treatment in pregnant women and infants. MMV is also working with Unitaid funding to support quality medicines critical to the malaria response. “Researchers and manufacturers from the countries hardest hit by malaria must be at the forefront of efforts to defeat the disease, which is why we welcome this wonderful news,” said David Reddy, MMV’s CEO. Image Credits: WHO, Elizabeth Poll/MMV, Munira Ismail_MSH. Africa Has Not Received a Single Dose of Monkeypox Vaccine – Even Though Virus is Endemic and Often More Deadly 25/08/2022 Paul Adepoju WHO African Regional Director, Dr Matshidiso Moeti Another COVID rerun: WHO and Africa CDC officials lament the complete lack of access to monkeypox vaccines on the continent where the virus is endemic – as well as often more deadly than elsewhere. Meanwhile, Mozambique and Malawi have seen a total of six wild poliovirus cases, although WHO officials continue to insist that since the cases are imported, this won’t affect Africa’s status as ‘wild poliovirus free.’ The African continent has not yet received any vaccine doses to combat the monkeypox virus, African health officials said Thursday, including nations where the disease is endemic and often more deadly than the clades surfacing around the world. More monkeypox testing kits also are urgently needed to improve the continent’s emergency response, top health officials warned in back-to-back briefings. “We still don’t have access to enough test kits. We are working on increasing that. We still don’t have access to any vaccines and that is a big concern,” said Africa CDC’s acting director, Ahmed Ogwell Ouma. He told Health Policy Watch that the sluggish response and lack of support for African countries doesn’t match the urgency called for in WHO’s declaration of monkeypox as a global public health emergency (PHEIC). “We need a coordinated international response where more is being put on the table to support the control of monkeypox as an outbreak of international concern,” Ouma said, stressing that Africa CDC has been providing as much guidance and support as it can for training and surveillance. Tedros Adhanom Ghebreyesus, WHO Director General, had declared monkeypox a public health emergency in July. Though no vaccines are available, WHO African Regional Director, Dr Matshidiso Moeti, said testing capacity is at least expanding, but not fast enough. “We have finally been able to obtain some tests, supplies and we have distributed these among countries to enable more rapid testing and confirmation of cases of monkeypox that will enable the diagnosis and ensure actions are taken faster,” Moeti told journalists on the margins of the 72nd WHO Regional Committee for Africa. She said WHO is working through its headquarters “to try to seek supplies of vaccines so that these may be available as we start to see new cases and we can have the experience of using this vaccine in Africa”. The Danish manufacturing plant of Bavarian Nordic, sole producer of the only WHO-approved monkeypox vaccine, MVA-BN, has been closed for renovations since spring and is not expected to reopen until late 2022, leading to a dire shortage of global supplies. WHO has repeatedly said it is “discussing” with vaccine suppliers. However, according to a recent Health Policy Watch investigation, there are only about 16.4 million stockpiled MVA-BN doses available in bulk or finished form until the end of this year. Unless a license is awarded to another vaccine manufacturer, the world will have to make do with existing doses, most of which reside in the United States and a few other wealthy countries. See related story: Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy Wild poliovirus cases expanding slowly Meanwhile, at a special African Regional Committee session on polio, WHO, African health ministers and their partners said they would work together to tackle wild poliovirus, which is seeing a comeback in east Africa due to the spread of a virus strain imported from Pakistan. There have now been six cases reported in the African Region from the outbreak which began last year in Malawi and has now reached Mozambique, all apparently with links to an imported case from Pakistan. WHO said the “imported” cases should not impact Africa’s certification as wild poliovirus free, and that “any child paralyzed from polio is one too many.” There are now 6 #WPV1 cases in the African Region, imported from Pakistan to #Malawi 🇲🇼 & more recently, #Mozambique 🇲🇿 While these do not negatively impact #Africa's 🌍indigenous wild polio-free certification, any child paralysed from #polio is 1 too many. #RC72AFRO #EndPolio pic.twitter.com/SVAvQzXR0m — WHO African Region (@WHOAFRO) August 24, 2022 COVID lockdowns impacted polio response Polio vaccination campaign in Malawi 2022 COVID-19 negatively impacted Africa’s polio response, said Dr Chris Elias, Polio Oversight Board Chair of the Gates Foundation, speaking at the meeting. By putting polio experts at the service of the COVID-19 response, the virus had time to spread. “Dozens of campaigns delayed, not only for polio but for measles and other diseases,” he said. “We need good quality routine immunization, campaigns and surveillance. Unfortunately, COVID-19 presented a huge challenge that gave polio time and freedom to act quickly.” Regarding wild polio, Ouma told Health Policy Watch that any presence of wild polio anywhere in the world poses a huge risk to the achievement that Africa recorded in eradicating the disease. Ouma called for more efforts to boost polio vaccination across the continent. “We need to put in place surveillance mechanisms that will be able to respond quickly when a case is identified,” he said. “It is our position that polio is not a regional or a country problem. It remains a global problem.” New regional health security strategy calls for 90% rapid response capacity by 2030 WHO Regional Committee meeting for Africa At the WHO Regional Committee meeting, African health ministers adopted a new eight-year strategy to transform health security and emergency response. Called the Regional Strategy for Health Security and Emergencies 2022–2030, it is intended to reduce the health and socioeconomic impacts of public health emergencies. The strategy includes goals for strengthening mechanisms for partnerships and multisectoral collaboration; ensuring sustained and predictable investment; and repurposing resources from polio eradication and COVID-19 to support strategic investments in systems and tools for public health emergencies. The adoption of the strategy means WHO’s member nations have now agreed to reach 12 strategy targets by 2030 – all aimed at strengthening capacity to prevent, prepare for, detect and respond to health emergencies. The strategy calls for 80% of member nations to have “predictable and sustainable” health security financing by 2030, with 90% able to mobilize an effective response to public health emergencies within 24 hours of detection. “This strategy is the fruit of extensive consultations with African health ministries and a range of other institutions, technical actors and partners across the continent. With their ongoing support and collaboration, it can help ensure that Africa is at the forefront of protecting the world against future pandemics,” Moeti said. Image Credits: WHO Africa. Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy 25/08/2022 John Heilprin Men queing for the monkeypox vaccine The global number of weekly new cases of monkeypox reported to the World Health Organization (WHO) declined by 21% for the first time since the infection that has been endemic to central and west Africa began to appear around the world earlier this year. Cases continued rising sharply in the Americas, however, in contrast to recent declines in European hotspots, WHO said in a report on Thursday showing 5,907 new monkeypox cases were reported in the past week, down from 7,477 new cases the previous week. That is a dramatic reversal from the 20% weekly increases in reported new monkeypox cases over the past month. More than 45,000 cases have been reported in 98 countries since late April. After four consecutive weeks of rising monkeypox cases globally, WHO says, the overall weekly decrease may reflect early signs of a declining infection rate in the European region but it will take time to see if that is sustained. Monkeypox cases in the Americas were still rising sharply, accounting for 60% of all cases compared to Europe’s 38% in the past month. WHO officials, meanwhile, say they are examining proposals to split scarce monkeypox vaccines doses to stretch supplies — a strategy adopted by the United States on August 10, in response to the global shortage of monkeypox vaccines. As part of that decision released earlier this month, US Health and Human Services Secretary Xavier Becerra issued a 564 determination, granting the US Food and Drug Administration the power to issue an emergency use authorization for vaccines. This gives the FDA permission to change the way the MVA-BN vaccine, made by Danish company Bavarian Nordic, is administered. Dr Kate O’Brien, WHO Director of Immunization, Vaccines and Biologicals, Group of monkeypox experts to examine the ‘fractional’ strategy Dr. Kate O’Brien, WHO’s Director of the Department of Immunization, Vaccines and Biologicals, said a strategic advisory group of experts will meet at the beginning of October to evaluate “some of these fractional dose issues” and the evidence for and against the strategy. Known as dose sparing, the U.S. fractional dose strategy splits the approved MVA-BN vaccine that is typically administered subcutaneously into five doses from each vaccine vial, and then delivers those “intradermally” just below the outermost layer of skin, known as the epidermis. “The strategy of what’s termed using fractional doses for vaccines is not a new strategy for vaccines,” O’Brien told a virtual press briefing on Thursday. “And we are looking really carefully at the evidence for the performance of these vaccines, these smallpox monkeypox vaccines,” she said, “to look at the equivalence or in fact, possibly the improved performance using fractional doses.” Along with extending the limited vaccine supplies, the procedure is supposed to provoke a more powerful immune reaction. But the strategy announced earlier by U.S. President Joe Biden’s administration is not going according to plan, Politico reports, with those administering the vaccine saying they’re getting only three or four doses out of each vial. Other media have reported the intradermal procedure’s more frequent use on men of color who have sought the vaccine recently, while white men who got in line first for the jab were able to get a full dose in the more proven, subcutaneous manner. Another complicating factor is the requirement for health workers to get extra training for the delicate intradermal procedure. The net result is speculation that if the outbreak continues to expand in the Americas, the US may be forced to fall back on another stockpile of ACAM2000 smallpox vaccines that are highly effective but can have dangerous side effects. Chronic Disease Focus of New Strategy 25/08/2022 Paul Adepoju 72nd WHO Regional Committee for Africa Ministers and government officials took on noncommunicable diseases, sickle cell disease, health system reforms in response to the COVID-19 pandemic, and measures to fight tuberculosis among children in Africa during their meeting of the 72nd WHO Regional Committee for Africa this week. In an effort to curb Africa’s chronic disease crisis, African health ministers adopted a new regional strategy to improve the diagnosis and treatment of severe forms of NCDs in district hospitals and first level referral facilities where care is often unavailable today. The new regional strategy for NCDs is known as PEN-PLUS. It addresses cardiovascular diseases, diabetes, cancer, and chronic lung disease that are responsible for almost 70% of all premature deaths worldwide – and a fast growing proportion of premature deaths in Africa. In addition, African nations face a special burden from sickle cell disease, which can cause severe anaemia and premature death if left untreated. In Africa, mortality from NCDs increased from 24% of total premature deaths in 2000 to more than 37% as of 2019. But many African countries lack adequate capacity to diagnosis and treat NCDs at the primary health care level, and most are only equipped to treat severe NCDs at tertiary health facilities, meaning big hospitals, located in large cities. The probability of premature death (age 30-70) from NCDs. This, WHO says, puts care beyond the reach of rural and poorer patients who typically rely on district hospitals and local health centres that lack the capacity and resources to effectively manage severe NCDs. Just 36% of countries have public hospitals stocked with basic NCD medications Knowing your blood pressure supports NCD prevention, diagnosis, and early treatment. PEN-PLUS, developed by WHO in collaboration with African health ministers over the past two years, offers a roadmap for countries to institute standardised programs to tackle chronic and severe NCDs by ensuring that essential medicines, technologies and diagnostics are available and accessible at district hospitals. It also encourages African governments to improve training and treatment protocols for chronic NCDs and to ensure that people at private hospitals can access services for severe NCDs Currently, just 36% of countries in the African region have public hospitals stocked with the medicines needed to treat NCDs, and private hospitals also must provide such services, according to WHO. In Liberia, Malawi, and Rwanda, where the strategy is already deployed, WHO says there has been a significant increase in the health and numbers of patients treated for severe chronic NCDs. In Africa, the most prevalent NCDs include Type 1 and 2 Diabetes, hypertension, heart disease and asthma, as well as sickle-cell disease, a genetic disorder, according to WHO data. Related to the drive against chronic NCDs, new campaign on sickle cell disease Health ministers also launched a campaign to tackle sickle cell disease, an inherited blood disorder that causes anaemia and can shorten lifespans, if left untreated. More than 66% of the 120 million people worldwide affected by sickle cell disease live in Africa, and approximately 1,000 African children are born with the disease every day. In 2019, the number of sickle cell disease deaths in the African region rose to 38,403 — a 26% increase from 2000. This rise in disease burden is attributed to a lack of investment in disease-fighting tools including prevention, early detection and proper care, according to WHO. The level of care has also been hampered by inadequate personnel and services, particularly at lower-level facilities. The campaign aims to shore up political will, engagement and financial resources for sickle cell disease prevention and control across the region. It draws on financial support and resources from the World Bank, U.S. Department of Health and Human Services, Novartis Foundation, Global Blood Therapeutics, and the Sickle in Africa consortium. Chief targets are schools, communities, health institutions and news media outlets. WHO notes that progress on controlling the disease in Africa is hindered by the absence of newborn screening programmes and surveillance, lack of accurate and reliable data on sickle cell disease and no data collection for sickle cell disease in most national surveys. “We need to shine the spotlight on this disease and help improve the quality of life of those living with it,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. Revamping Africa’s health systems in the wake of the pandemic Dr Matshidiso Moeti, WHO Regional Director for Africa, spoke at the session on childhood tuberculosis At the meeting, countries also agreed to institute other reforms in the region’s health systems in response to the COVID-19 pandemic, placing more emphasis on improved disease surveillance, as well as prevention and vaccination. “Domestic investment in health, including health research, has significant economic returns, while promoting resilience and sustainability; healthy populations translate to healthy economies,” Moeti said. Senegal’s Health Minister, Dr Marie Khemesse Ngom Ndiaye, said that due to the pandemic, her nation’s health system put more emphasis on resilience and investment. That “considerably strengthened disease prevention and management capacities,” she said. Fighting tuberculosis among children In terms of infectious diseases, long the major focus of African health programmes, more comprehensive and immediate measures are needed to fight tuberculosis among children in Africa, said representatives of WHO and the African Union, at the meeting. Their comments were echoed by the Stop TB Partnership and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). Currently, two-thirds of children with TB in WHO’s African Region fail to get diagnosed for the disease, WHO says, leading to an increased risk of rapid disease progression and mortality, especially in younger children. Among children under age five believed to have TB, just 32% in the African Region are adiagnosed and treated, the smallest proportion for that age group globally. Seventeen of the world’s 30 countries with the highest tuberculosis burden globally are in Africa, where 322,000 children and young adolescents under 15 years of age are affected. Minata Samate Cessouma, Commissioner for Health, African Union “There is an urgent need for innovative interventions to integrate tuberculosis diagnosis in nutrition programs to identify the disease in children quickly,” said Minata Samate Cessouma, African Union Commissioner for Health, Humanitarian Affairs and Social Development. “Children with tuberculosis are almost never spreading the disease and are always infected by an adult,” said Dr Lucica Ditiu, Executive Director of Stop TB Partnership, “so their suffering is a metric of our failures to diagnose and treat tuberculosis in children.” A child dies of tuberculosis somewhere in the world every two minutes, even though it is curable and preventable, she noted. . Tackling Malawi’s cholera outbreak At the meeting, WHO and UNICEF also announced joint plans to ramp up efforts to contain a cholera outbreak recently announced in Malawi. The outbreak has grown to 1,483 cases and 58 deaths in the northern and central regions, where it affects lakeshore communities and crowded, urban areas with insufficient water and sanitation facilities. The UN agencies say they will increase surveillance for early detection and management; improve the quality of case management at cholera treatment units; and provide critical supplies needed to manage cholera cases. They also plan to help improve water treatment, personal hygiene and household water storage. WHO’s Country Representative for Malawi, Dr Neema Rusibamayila Kimambo, stressed that every death from cholera is preventable. The UN health agency will offer additional support to Malawi’s Health Ministry to “help ensure that lives continue to be saved and a resilient health system is maintained during and beyond the current outbreak,” Kimambo said. UNICEF Malawi’s Representative, Rudolf Schwenk, said it’s urgent to help Malawi’s already overburdened public health services and health care delivery systems. “The good news is that we know the solutions,” Schwenk said. “We are on the ground providing humanitarian assistance in the affected districts, but we need more support to further scale up our response.” Image Credits: WHO, NCD Alliance, Twitter/Matshidiso Moeti, Twitter/WHO AFRO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Poor Vaccines Coverage in Pandemic Blamed on Multiple Barriers 26/08/2022 John Heilprin & Dann Okoth Dr Elia Badjo, co-founder and executive director of the Democratic Republic of the Congo’s Conseils sur la Santé et Académie de Médecin ( COSAMED), helps people in the North Kivu region Some of the biggest obstacles to expanded vaccines coverage in the world’s poorest and most conflict-ridden nations are lack of cold chain storage, unpredictable supply chains, and transport barriers, not claims of “vaccine hesitancy” in the Global South, according to a new report. The picture of the steep challenges faced by 14 nations during the COVID-19 pandemic “is more nuanced than a simple attribution to ‘hesitancy’ or ‘poor education,’ consistent with findings elsewhere,” two advocacy groups and a research company conclude in a joint 55-page report Friday. “Our findings demonstrate that as the world moved and transitioned from COVID-19, massive inequities remain in access to all COVID-19 tools, including oxygen and rapid tests,” the report says. Among developed nations, some 1.1 billion COVID-19 vaccines were likely wasted since the global rollout began, according to findings in July by Airfinity, a global health surveillance firm. The two groups — International Treatment Preparedness Coalition (ITPC) and People’s Vaccine Alliance — and the Malaysian research company, Matahari Global Solutions, say “numerous structural access barriers exist” to the fair, widespread distribution of COVID-19 vaccines. Those include “insufficient” local cold chain storage and advance notice about arrival dates, which impedes national planning and implementation abilities. Other barriers include physical infrastructure, such as access roads, and in some places limited access to transportation that works and is affordable. Unpredictable wait times, fluctuating supply stocks and people’s inability to leave their jobs also play an important role, the study finds. In addition, it says, the lower vaccination rates are influenced by a lack of “access to information and suspicion of medical technologies brought to countries by Westerners and white men, owing to historical memory and perceptions of experimentation on Black bodies.” In most cases the information, including technical terms, was delivered in the “official language” — most often English, French or Spanish — instead of local languages. Study Dismisses Claims About Importance of Skepticism About Vaccines That contrasts with the so-called vaccine hesitancy that some pharmaceutical companies have blamed for low vaccination rates among poorer countries. The study looked at Bangladesh, Democratic Republic of the Congo (DRC), Haiti, Jamaica, Liberia, Madagascar, Nepal, Nigeria, Peru, Senegal, Somalia, Uganda and Ukraine, reflecting a variety of factors. Some, such as the DRC and Haiti, had internal conflicts and vaccination rates of less than 10% — in contrast to the World Health Organization’s recommended 70% target rate that some high-income countries already have achieved. Others such as Nigeria, Somalia and Ukraine were included primarily for their domestic turmoil or insecurity. Peru was studied due to its high numbers of COVID-19 deaths; Madagascar was put on the list because of relative exclusion from discussion among academic and policy circles. Dr. Elia Badjo, founder and executive director of COSAMED and the lead local consultant for the ITPC/PVA project in the Democratic Republic of Congo (DRC), said health workers hadn’ been paid since the start of the vaccination campaigns at the beginning of the pandemic due to lack of funds. “Many are not trained either,” he said, adding that Ebola and monkeypox outbreaks exacerbate the situation and stretch scarce public health resources. Violent conflicts also have displaced people and made them more inaccessible to health workers. In Uganda, Richard Musisi, executive director of Masala Association of Persons with Disabilities Living with HIV/AIDS (MADIPHA), said people with disabilities “were disproportionately affected by the COVID-19 pandemic. There were consistent vaccine stock-outs and limited awareness.” The study says doctors and nurses in several rural communities reported never having heard of Paxlovid or novel antivirals for COVID-19, while some nations had no outreach to LGBTIQ persons, those who cannot afford to self-isolate if they tested positive, or people living in single-room homes. “These point to the need for direct cash transfers during pandemics and long-term planning on social security nets on the domestic level, but also to the failure of global pandemic platforms to account for local and specialized contexts,” the study says. Report Cites Role in Vaccines of ‘Modern Day Slavery The unsalaried community health workers that are essential for pandemic response also are a top concern. “Across the 14 countries and territories, community health workers play an essential role in deployment of tools, community engagement, and vaccine uptake,” it says. “Yet they largely remain unpaid — a phenomenon some have described as modern day slavery.” The People’s Vaccine Alliance says the disregard for the needs of people in lower-income countries is evidence of “systemic racism” in the global COVID-19 response, though the study does not mention this term or others such as “racism” or “racial discrimination.” The group also emphasizes that true infection and death rates are likely to be far higher than official figures due to the inaccessibility of testing and vaccination sites among the studied nations. “PCR test results can take anywhere from 8 to 12 hours in Bangladesh to more than two weeks in rural DRC. People cannot leave work at short notice, travel long distances to a vaccination/testing site, and then wait for a long unpredictable period of time,” it says. “For rural populations and nomadic people in countries like Somalia, this problem is particularly acute. Mobile vaccination and testing is not widespread enough.” Approach to Vaccines in the Global South Left People ‘Abandoned’ Maaza Seyoum, the group’s Global South convenor, says the report shows that communities have repeatedly been let down by a system geared towards protecting people in wealthy countries – leaving people in the Global South abandoned. “Their lives have been treated as an afterthought,” Seyoum said. “Local populations are expected to shoulder blame and be grateful for what vaccines they do receive, when there has been little effort to meet their needs,” she said. “It is yet more evidence of the systemic racism that has plagued the global response to COVID-19.” Fifa A. Rahman, the report’s lead author and principal consultant at Matahari Global Solutions, says the report found “layered issues why people are not accessing vaccines” rather than an outright, widespread distrust of vaccines. “The vaccine hesitancy narrative is rooted in racism and colonialism and the idea that some people don’t know how to do certain things,” she said. “It’s the same kind of condescension that still happens and it’s really problematic. Part of it is intellectual laziness, but it’s largely due to ingrained racism and colonialism.” Image Credits: Joe Karp-Sawey/People's Vaccine Alliance. Tedros’ Second Term: WHO’s Triple Billion Goals Fall Short as Agency Sees Power Centralized, Over-Reliance on Consultants 26/08/2022 Elaine Ruth Fletcher On 24 May 2022, WHO Member States re-elected Dr Tedros Adhanom Ghebreyesus to serve a second five-year term as Director-General of the World Health Organization. “Power has been increasingly centralised around the Director-General’s office under Tedros’ leadership. This strategy might be advantageous in a crisis that demands a commander-in-control. But a lack of depth in wider leadership leaves shortcomings in the organisation. Thus states the prestigious medical journal, The Lancet, in an editorial marking the start of WHO Director General Dr Tedros Adhanom Ghebreyesus’ second term in office. The editorial notes that Tedros’ signature initiative, the Triple Billion programme, that aimed to bring better health, health-care coverage, health emergency response to three billion more people by 2023, is falling far short of its aims – with only 270 million more people accessing universal health coverage – as compared to WHO’s original aim of 1 billion: “WHO needs people of high calibre in programmatic leadership positions,” the unsigned editorial continues. “A wealth of expertise is available in WHO regional offices, and they deserve more support, engagement, and visibility. Member states might in fact prefer to fund regional offices rather than the Geneva headquarters. “Former Director-Generals appointed strong personalities, leaders in their areas of expertise and who had real convening power…..In its wider leadership, the WHO of today suffers a knowledge and expertise vacuum, with a heavy reliance on external experts and management consultants. Tedros would be wise to think about how leadership and responsibility is devolved to other dimensions and domains of his team.” See the complete text here. Trick or Treat? Artificial Sweeteners Impact Gut Bacteria, Could Alter Glucose Tolerance – Study 26/08/2022 Maayan Hoffman Sugar is more deadly than gunpowder Non-nutritive artificial sweeteners duplicate the taste of sugar but have fewer calories. As such, sugar alternatives like saccharin, sucralose, aspartame and stevia are often consumed in large quantities by people looking to watch their weight or shed a few pounds. But a team of researchers from Israel’s Weizmann Institute of Science said these alternative sugars should no longer be assumed safe because they can cause harm. In some people, they alter their microbiome (gut bacteria) and change blood sugar levels. “Our trial has shown that non-nutritive sweeteners may impair glucose responses by altering our microbiome, and they do so in a highly personalized manner, that is, by affecting each person in a unique way,” said Prof. Eran Elinav of Weizmann’s Systems Immunology Department, who led the study. Altering the Composition and Function of the Biome with Artificial Sweeteners Building off an animal trial conducted in 2014 that showed that some artificial sweeteners might contribute to changes in the sugar metabolism they are meant to prevent, a new team of researchers worked with 120 people who avoided artificially sweetened foods or drinks. The volunteers were divided into six groups: two controls and four who received one of four artificial sweeteners – saccharin, sucralose, aspartame or stevia – at lower than acceptable daily intake levels. In just two weeks, the researchers found consuming any of the sweeteners altered the composition and function of the microbiome and the small molecules that the gut microbes secrete into people’s blood. Moreover, saccharin and sucralose were found to alter glucose metabolism – the way a person disposes of glucose – which could contribute to metabolic disease, they said. No changes in either the microbiome or glucose tolerance were found in the two control groups that did not consume any alternative sugars. The findings were published on August 19 in the peer-reviewed journal Cell. “These findings reinforce the view of the microbiome as a hub that integrates the signals coming from the human body’s own systems and from external factors such as the food we eat, the medications we take, our lifestyle and physical surroundings,” Elinav said. Changes in the composition and function of gut microbes were observed in all four groups of trial participants who consumed non-nutritive sweeteners. Each group consumed one of the following: saccharine, sucralose, stevia or aspartame. The diagram shows increases in glucose levels in the saccharin and sucralose groups (two graphs on the left), compared to the stevia and aspartame groups (middle) and to the two control groups (right) Still Unproven That Sugar Is Healthier To help validate their findings and confirm that changes in the microbiome were responsible for impaired glucose tolerance, the researchers next implanted feces from more than 40 of the trial participants into healthy mice who were bred to have no gut bacteria of their own and who had never consumed artificial sweeteners. Those who received microbes from participants with the most pronounced alterations in glucose tolerance had more alterations in glucose tolerance themselves. This was compared to those mice that received microbes from people who had the least changes in glucose tolerance, and also had less changes. “The health implications of the changes that non-nutritive sweeteners may elicit in humans remain to be determined, and they merit new, long-term studies,” Elinav said. Previous studies have shown the detriments of eating artificial sweeteners, including weight gain, brain tumors and cancer. A BMJ study by French researchers in 2019 reinforced the link between consumption of sugar-laced sodas & fruit juices and cancer incidence, in particular breast cancer. Nonetheless, Elinav cautioned, the findings of this latest study do not imply that sugar is healthier than alternative sugars. Image Credits: Marco Verch. First African Manufactured Medicine to Prevent Malaria in Pregnant Women and Infants Quality-Approved by WHO 26/08/2022 Raisa Santos Pregnant women and children remain one of the groups at highest risk of complications from malaria infection. Kenyan manufacturer Universal Corporation LTD (UCL) has become the first African manufacturer to be issued a World Health Organization quality certification of a key antimalarial drug used to prevent infection in pregnant women and children. This certification, known as prequalification, will enable UCL to support regional efforts to combat malaria through local production of high-quality sulfadoxine-pyrimethamine (SP). Prequalification is a service provided by WHO to assess the quality, safety and efficacy of medicinal products. Quality assurance of UCL’s SP product Wiwal opens a route for procurement that will improve access and help strengthen Africa’s ability to combat endemic diseases. Young children and women are among the most vulnerable to the burden of malaria, with children under five accounting for 80% of all malaria deaths in Africa. SP is a generally well-tolerated, effective, and affordable medicine used to prevent malaria, yet adequate delivery and scale-up of this medicine is hampered in part by inadequate and unstable supply and, until now, a reliance on imported or poor-quality drugs. Its prequalification was achieved with funding from global health agency Unitaid and support from the Medicines for Malaria Venture (MMV). “Unitaid welcomes the certification of UCL to produce this quality-assured antimalarial medicine in Africa, where about 95% of all illness and death from malaria occurs,” said Dr Philippe Duneton, Executive Director of Unitaid. Reinforcing local production of medicines where they are needed most is critical to building stronger and more resilient health responses.” Disproportionate impact of malaria in Africa According to the latest World Malaria Report, released in 2021, there were an estimated 241 million cases of malaria and 627,000 resulting deaths worldwide in 2020. This represented about 14 million more cases in 2020 compared to 2019, and 69,000 more deaths. Approximately two-thirds of these additional deaths (47,000) were linked to disruptions in the provision of malaria prevention, diagnosis and treatment caused by the COVID-19 pandemic. The WHO African Region continues to carry a disproportionately high share of the global malaria burden. Global health leaders praised the prequalification announcement, calling it “excellent news” to those disproportionately impacted by malaria. “Ensuring the availability and accessibility of quality treatment for underserved communities, particularly women, newborns, and children who are disproportionately at high risk of death from malaria is a critical component to the full realization of the right to health,” said Joy Phumaphi, Executive Secretary of the African Leaders Malaria Alliance and MMV Board member. Lack of prequalified manufacturers raises concerns Health volunteers pick up supplies during a seasonal malaria chemoprevention campaign in Nigeria The lack of prequalified manufacturers in Africa raises concerns about the quality of medicines and supply insecurities that compromise the treatment of chronic and infectious diseases – risks that were clearly revealed when COVID-19 disrupted global supply chains and left Africa with limited access to vital products. Prequalification itself can be a long process, averaging 17 months in the process to reach product approval. UCL Founder and Managing Director Perviz Dhanani noted that in addition to being the first pharmaceutical company in Africa to receive prequalification for SP, it is also one of five manufacturers in Africa to receive quality certification for any product. It is clear that the production of quality medicines on the African continent is critical not only for the safety of Africa’s people but also for supporting regional supply availability and diversification in global production of medicines. “UCL is committed to supplying the African continent with quality medicines that are most needed by the people who live here. We’re filling a much-needed gap,” said Dhanani. Increased supply of SP is crucial to the long-term success of Unitaid’s malaria strategy, which includes nearly US$ 160 million invested to date to optimize and scale up delivery of SP through seasonal delivery and intermittent preventive treatment in pregnant women and infants. MMV is also working with Unitaid funding to support quality medicines critical to the malaria response. “Researchers and manufacturers from the countries hardest hit by malaria must be at the forefront of efforts to defeat the disease, which is why we welcome this wonderful news,” said David Reddy, MMV’s CEO. Image Credits: WHO, Elizabeth Poll/MMV, Munira Ismail_MSH. Africa Has Not Received a Single Dose of Monkeypox Vaccine – Even Though Virus is Endemic and Often More Deadly 25/08/2022 Paul Adepoju WHO African Regional Director, Dr Matshidiso Moeti Another COVID rerun: WHO and Africa CDC officials lament the complete lack of access to monkeypox vaccines on the continent where the virus is endemic – as well as often more deadly than elsewhere. Meanwhile, Mozambique and Malawi have seen a total of six wild poliovirus cases, although WHO officials continue to insist that since the cases are imported, this won’t affect Africa’s status as ‘wild poliovirus free.’ The African continent has not yet received any vaccine doses to combat the monkeypox virus, African health officials said Thursday, including nations where the disease is endemic and often more deadly than the clades surfacing around the world. More monkeypox testing kits also are urgently needed to improve the continent’s emergency response, top health officials warned in back-to-back briefings. “We still don’t have access to enough test kits. We are working on increasing that. We still don’t have access to any vaccines and that is a big concern,” said Africa CDC’s acting director, Ahmed Ogwell Ouma. He told Health Policy Watch that the sluggish response and lack of support for African countries doesn’t match the urgency called for in WHO’s declaration of monkeypox as a global public health emergency (PHEIC). “We need a coordinated international response where more is being put on the table to support the control of monkeypox as an outbreak of international concern,” Ouma said, stressing that Africa CDC has been providing as much guidance and support as it can for training and surveillance. Tedros Adhanom Ghebreyesus, WHO Director General, had declared monkeypox a public health emergency in July. Though no vaccines are available, WHO African Regional Director, Dr Matshidiso Moeti, said testing capacity is at least expanding, but not fast enough. “We have finally been able to obtain some tests, supplies and we have distributed these among countries to enable more rapid testing and confirmation of cases of monkeypox that will enable the diagnosis and ensure actions are taken faster,” Moeti told journalists on the margins of the 72nd WHO Regional Committee for Africa. She said WHO is working through its headquarters “to try to seek supplies of vaccines so that these may be available as we start to see new cases and we can have the experience of using this vaccine in Africa”. The Danish manufacturing plant of Bavarian Nordic, sole producer of the only WHO-approved monkeypox vaccine, MVA-BN, has been closed for renovations since spring and is not expected to reopen until late 2022, leading to a dire shortage of global supplies. WHO has repeatedly said it is “discussing” with vaccine suppliers. However, according to a recent Health Policy Watch investigation, there are only about 16.4 million stockpiled MVA-BN doses available in bulk or finished form until the end of this year. Unless a license is awarded to another vaccine manufacturer, the world will have to make do with existing doses, most of which reside in the United States and a few other wealthy countries. See related story: Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy Wild poliovirus cases expanding slowly Meanwhile, at a special African Regional Committee session on polio, WHO, African health ministers and their partners said they would work together to tackle wild poliovirus, which is seeing a comeback in east Africa due to the spread of a virus strain imported from Pakistan. There have now been six cases reported in the African Region from the outbreak which began last year in Malawi and has now reached Mozambique, all apparently with links to an imported case from Pakistan. WHO said the “imported” cases should not impact Africa’s certification as wild poliovirus free, and that “any child paralyzed from polio is one too many.” There are now 6 #WPV1 cases in the African Region, imported from Pakistan to #Malawi 🇲🇼 & more recently, #Mozambique 🇲🇿 While these do not negatively impact #Africa's 🌍indigenous wild polio-free certification, any child paralysed from #polio is 1 too many. #RC72AFRO #EndPolio pic.twitter.com/SVAvQzXR0m — WHO African Region (@WHOAFRO) August 24, 2022 COVID lockdowns impacted polio response Polio vaccination campaign in Malawi 2022 COVID-19 negatively impacted Africa’s polio response, said Dr Chris Elias, Polio Oversight Board Chair of the Gates Foundation, speaking at the meeting. By putting polio experts at the service of the COVID-19 response, the virus had time to spread. “Dozens of campaigns delayed, not only for polio but for measles and other diseases,” he said. “We need good quality routine immunization, campaigns and surveillance. Unfortunately, COVID-19 presented a huge challenge that gave polio time and freedom to act quickly.” Regarding wild polio, Ouma told Health Policy Watch that any presence of wild polio anywhere in the world poses a huge risk to the achievement that Africa recorded in eradicating the disease. Ouma called for more efforts to boost polio vaccination across the continent. “We need to put in place surveillance mechanisms that will be able to respond quickly when a case is identified,” he said. “It is our position that polio is not a regional or a country problem. It remains a global problem.” New regional health security strategy calls for 90% rapid response capacity by 2030 WHO Regional Committee meeting for Africa At the WHO Regional Committee meeting, African health ministers adopted a new eight-year strategy to transform health security and emergency response. Called the Regional Strategy for Health Security and Emergencies 2022–2030, it is intended to reduce the health and socioeconomic impacts of public health emergencies. The strategy includes goals for strengthening mechanisms for partnerships and multisectoral collaboration; ensuring sustained and predictable investment; and repurposing resources from polio eradication and COVID-19 to support strategic investments in systems and tools for public health emergencies. The adoption of the strategy means WHO’s member nations have now agreed to reach 12 strategy targets by 2030 – all aimed at strengthening capacity to prevent, prepare for, detect and respond to health emergencies. The strategy calls for 80% of member nations to have “predictable and sustainable” health security financing by 2030, with 90% able to mobilize an effective response to public health emergencies within 24 hours of detection. “This strategy is the fruit of extensive consultations with African health ministries and a range of other institutions, technical actors and partners across the continent. With their ongoing support and collaboration, it can help ensure that Africa is at the forefront of protecting the world against future pandemics,” Moeti said. Image Credits: WHO Africa. Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy 25/08/2022 John Heilprin Men queing for the monkeypox vaccine The global number of weekly new cases of monkeypox reported to the World Health Organization (WHO) declined by 21% for the first time since the infection that has been endemic to central and west Africa began to appear around the world earlier this year. Cases continued rising sharply in the Americas, however, in contrast to recent declines in European hotspots, WHO said in a report on Thursday showing 5,907 new monkeypox cases were reported in the past week, down from 7,477 new cases the previous week. That is a dramatic reversal from the 20% weekly increases in reported new monkeypox cases over the past month. More than 45,000 cases have been reported in 98 countries since late April. After four consecutive weeks of rising monkeypox cases globally, WHO says, the overall weekly decrease may reflect early signs of a declining infection rate in the European region but it will take time to see if that is sustained. Monkeypox cases in the Americas were still rising sharply, accounting for 60% of all cases compared to Europe’s 38% in the past month. WHO officials, meanwhile, say they are examining proposals to split scarce monkeypox vaccines doses to stretch supplies — a strategy adopted by the United States on August 10, in response to the global shortage of monkeypox vaccines. As part of that decision released earlier this month, US Health and Human Services Secretary Xavier Becerra issued a 564 determination, granting the US Food and Drug Administration the power to issue an emergency use authorization for vaccines. This gives the FDA permission to change the way the MVA-BN vaccine, made by Danish company Bavarian Nordic, is administered. Dr Kate O’Brien, WHO Director of Immunization, Vaccines and Biologicals, Group of monkeypox experts to examine the ‘fractional’ strategy Dr. Kate O’Brien, WHO’s Director of the Department of Immunization, Vaccines and Biologicals, said a strategic advisory group of experts will meet at the beginning of October to evaluate “some of these fractional dose issues” and the evidence for and against the strategy. Known as dose sparing, the U.S. fractional dose strategy splits the approved MVA-BN vaccine that is typically administered subcutaneously into five doses from each vaccine vial, and then delivers those “intradermally” just below the outermost layer of skin, known as the epidermis. “The strategy of what’s termed using fractional doses for vaccines is not a new strategy for vaccines,” O’Brien told a virtual press briefing on Thursday. “And we are looking really carefully at the evidence for the performance of these vaccines, these smallpox monkeypox vaccines,” she said, “to look at the equivalence or in fact, possibly the improved performance using fractional doses.” Along with extending the limited vaccine supplies, the procedure is supposed to provoke a more powerful immune reaction. But the strategy announced earlier by U.S. President Joe Biden’s administration is not going according to plan, Politico reports, with those administering the vaccine saying they’re getting only three or four doses out of each vial. Other media have reported the intradermal procedure’s more frequent use on men of color who have sought the vaccine recently, while white men who got in line first for the jab were able to get a full dose in the more proven, subcutaneous manner. Another complicating factor is the requirement for health workers to get extra training for the delicate intradermal procedure. The net result is speculation that if the outbreak continues to expand in the Americas, the US may be forced to fall back on another stockpile of ACAM2000 smallpox vaccines that are highly effective but can have dangerous side effects. Chronic Disease Focus of New Strategy 25/08/2022 Paul Adepoju 72nd WHO Regional Committee for Africa Ministers and government officials took on noncommunicable diseases, sickle cell disease, health system reforms in response to the COVID-19 pandemic, and measures to fight tuberculosis among children in Africa during their meeting of the 72nd WHO Regional Committee for Africa this week. In an effort to curb Africa’s chronic disease crisis, African health ministers adopted a new regional strategy to improve the diagnosis and treatment of severe forms of NCDs in district hospitals and first level referral facilities where care is often unavailable today. The new regional strategy for NCDs is known as PEN-PLUS. It addresses cardiovascular diseases, diabetes, cancer, and chronic lung disease that are responsible for almost 70% of all premature deaths worldwide – and a fast growing proportion of premature deaths in Africa. In addition, African nations face a special burden from sickle cell disease, which can cause severe anaemia and premature death if left untreated. In Africa, mortality from NCDs increased from 24% of total premature deaths in 2000 to more than 37% as of 2019. But many African countries lack adequate capacity to diagnosis and treat NCDs at the primary health care level, and most are only equipped to treat severe NCDs at tertiary health facilities, meaning big hospitals, located in large cities. The probability of premature death (age 30-70) from NCDs. This, WHO says, puts care beyond the reach of rural and poorer patients who typically rely on district hospitals and local health centres that lack the capacity and resources to effectively manage severe NCDs. Just 36% of countries have public hospitals stocked with basic NCD medications Knowing your blood pressure supports NCD prevention, diagnosis, and early treatment. PEN-PLUS, developed by WHO in collaboration with African health ministers over the past two years, offers a roadmap for countries to institute standardised programs to tackle chronic and severe NCDs by ensuring that essential medicines, technologies and diagnostics are available and accessible at district hospitals. It also encourages African governments to improve training and treatment protocols for chronic NCDs and to ensure that people at private hospitals can access services for severe NCDs Currently, just 36% of countries in the African region have public hospitals stocked with the medicines needed to treat NCDs, and private hospitals also must provide such services, according to WHO. In Liberia, Malawi, and Rwanda, where the strategy is already deployed, WHO says there has been a significant increase in the health and numbers of patients treated for severe chronic NCDs. In Africa, the most prevalent NCDs include Type 1 and 2 Diabetes, hypertension, heart disease and asthma, as well as sickle-cell disease, a genetic disorder, according to WHO data. Related to the drive against chronic NCDs, new campaign on sickle cell disease Health ministers also launched a campaign to tackle sickle cell disease, an inherited blood disorder that causes anaemia and can shorten lifespans, if left untreated. More than 66% of the 120 million people worldwide affected by sickle cell disease live in Africa, and approximately 1,000 African children are born with the disease every day. In 2019, the number of sickle cell disease deaths in the African region rose to 38,403 — a 26% increase from 2000. This rise in disease burden is attributed to a lack of investment in disease-fighting tools including prevention, early detection and proper care, according to WHO. The level of care has also been hampered by inadequate personnel and services, particularly at lower-level facilities. The campaign aims to shore up political will, engagement and financial resources for sickle cell disease prevention and control across the region. It draws on financial support and resources from the World Bank, U.S. Department of Health and Human Services, Novartis Foundation, Global Blood Therapeutics, and the Sickle in Africa consortium. Chief targets are schools, communities, health institutions and news media outlets. WHO notes that progress on controlling the disease in Africa is hindered by the absence of newborn screening programmes and surveillance, lack of accurate and reliable data on sickle cell disease and no data collection for sickle cell disease in most national surveys. “We need to shine the spotlight on this disease and help improve the quality of life of those living with it,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. Revamping Africa’s health systems in the wake of the pandemic Dr Matshidiso Moeti, WHO Regional Director for Africa, spoke at the session on childhood tuberculosis At the meeting, countries also agreed to institute other reforms in the region’s health systems in response to the COVID-19 pandemic, placing more emphasis on improved disease surveillance, as well as prevention and vaccination. “Domestic investment in health, including health research, has significant economic returns, while promoting resilience and sustainability; healthy populations translate to healthy economies,” Moeti said. Senegal’s Health Minister, Dr Marie Khemesse Ngom Ndiaye, said that due to the pandemic, her nation’s health system put more emphasis on resilience and investment. That “considerably strengthened disease prevention and management capacities,” she said. Fighting tuberculosis among children In terms of infectious diseases, long the major focus of African health programmes, more comprehensive and immediate measures are needed to fight tuberculosis among children in Africa, said representatives of WHO and the African Union, at the meeting. Their comments were echoed by the Stop TB Partnership and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). Currently, two-thirds of children with TB in WHO’s African Region fail to get diagnosed for the disease, WHO says, leading to an increased risk of rapid disease progression and mortality, especially in younger children. Among children under age five believed to have TB, just 32% in the African Region are adiagnosed and treated, the smallest proportion for that age group globally. Seventeen of the world’s 30 countries with the highest tuberculosis burden globally are in Africa, where 322,000 children and young adolescents under 15 years of age are affected. Minata Samate Cessouma, Commissioner for Health, African Union “There is an urgent need for innovative interventions to integrate tuberculosis diagnosis in nutrition programs to identify the disease in children quickly,” said Minata Samate Cessouma, African Union Commissioner for Health, Humanitarian Affairs and Social Development. “Children with tuberculosis are almost never spreading the disease and are always infected by an adult,” said Dr Lucica Ditiu, Executive Director of Stop TB Partnership, “so their suffering is a metric of our failures to diagnose and treat tuberculosis in children.” A child dies of tuberculosis somewhere in the world every two minutes, even though it is curable and preventable, she noted. . Tackling Malawi’s cholera outbreak At the meeting, WHO and UNICEF also announced joint plans to ramp up efforts to contain a cholera outbreak recently announced in Malawi. The outbreak has grown to 1,483 cases and 58 deaths in the northern and central regions, where it affects lakeshore communities and crowded, urban areas with insufficient water and sanitation facilities. The UN agencies say they will increase surveillance for early detection and management; improve the quality of case management at cholera treatment units; and provide critical supplies needed to manage cholera cases. They also plan to help improve water treatment, personal hygiene and household water storage. WHO’s Country Representative for Malawi, Dr Neema Rusibamayila Kimambo, stressed that every death from cholera is preventable. The UN health agency will offer additional support to Malawi’s Health Ministry to “help ensure that lives continue to be saved and a resilient health system is maintained during and beyond the current outbreak,” Kimambo said. UNICEF Malawi’s Representative, Rudolf Schwenk, said it’s urgent to help Malawi’s already overburdened public health services and health care delivery systems. “The good news is that we know the solutions,” Schwenk said. “We are on the ground providing humanitarian assistance in the affected districts, but we need more support to further scale up our response.” Image Credits: WHO, NCD Alliance, Twitter/Matshidiso Moeti, Twitter/WHO AFRO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Tedros’ Second Term: WHO’s Triple Billion Goals Fall Short as Agency Sees Power Centralized, Over-Reliance on Consultants 26/08/2022 Elaine Ruth Fletcher On 24 May 2022, WHO Member States re-elected Dr Tedros Adhanom Ghebreyesus to serve a second five-year term as Director-General of the World Health Organization. “Power has been increasingly centralised around the Director-General’s office under Tedros’ leadership. This strategy might be advantageous in a crisis that demands a commander-in-control. But a lack of depth in wider leadership leaves shortcomings in the organisation. Thus states the prestigious medical journal, The Lancet, in an editorial marking the start of WHO Director General Dr Tedros Adhanom Ghebreyesus’ second term in office. The editorial notes that Tedros’ signature initiative, the Triple Billion programme, that aimed to bring better health, health-care coverage, health emergency response to three billion more people by 2023, is falling far short of its aims – with only 270 million more people accessing universal health coverage – as compared to WHO’s original aim of 1 billion: “WHO needs people of high calibre in programmatic leadership positions,” the unsigned editorial continues. “A wealth of expertise is available in WHO regional offices, and they deserve more support, engagement, and visibility. Member states might in fact prefer to fund regional offices rather than the Geneva headquarters. “Former Director-Generals appointed strong personalities, leaders in their areas of expertise and who had real convening power…..In its wider leadership, the WHO of today suffers a knowledge and expertise vacuum, with a heavy reliance on external experts and management consultants. Tedros would be wise to think about how leadership and responsibility is devolved to other dimensions and domains of his team.” See the complete text here. Trick or Treat? Artificial Sweeteners Impact Gut Bacteria, Could Alter Glucose Tolerance – Study 26/08/2022 Maayan Hoffman Sugar is more deadly than gunpowder Non-nutritive artificial sweeteners duplicate the taste of sugar but have fewer calories. As such, sugar alternatives like saccharin, sucralose, aspartame and stevia are often consumed in large quantities by people looking to watch their weight or shed a few pounds. But a team of researchers from Israel’s Weizmann Institute of Science said these alternative sugars should no longer be assumed safe because they can cause harm. In some people, they alter their microbiome (gut bacteria) and change blood sugar levels. “Our trial has shown that non-nutritive sweeteners may impair glucose responses by altering our microbiome, and they do so in a highly personalized manner, that is, by affecting each person in a unique way,” said Prof. Eran Elinav of Weizmann’s Systems Immunology Department, who led the study. Altering the Composition and Function of the Biome with Artificial Sweeteners Building off an animal trial conducted in 2014 that showed that some artificial sweeteners might contribute to changes in the sugar metabolism they are meant to prevent, a new team of researchers worked with 120 people who avoided artificially sweetened foods or drinks. The volunteers were divided into six groups: two controls and four who received one of four artificial sweeteners – saccharin, sucralose, aspartame or stevia – at lower than acceptable daily intake levels. In just two weeks, the researchers found consuming any of the sweeteners altered the composition and function of the microbiome and the small molecules that the gut microbes secrete into people’s blood. Moreover, saccharin and sucralose were found to alter glucose metabolism – the way a person disposes of glucose – which could contribute to metabolic disease, they said. No changes in either the microbiome or glucose tolerance were found in the two control groups that did not consume any alternative sugars. The findings were published on August 19 in the peer-reviewed journal Cell. “These findings reinforce the view of the microbiome as a hub that integrates the signals coming from the human body’s own systems and from external factors such as the food we eat, the medications we take, our lifestyle and physical surroundings,” Elinav said. Changes in the composition and function of gut microbes were observed in all four groups of trial participants who consumed non-nutritive sweeteners. Each group consumed one of the following: saccharine, sucralose, stevia or aspartame. The diagram shows increases in glucose levels in the saccharin and sucralose groups (two graphs on the left), compared to the stevia and aspartame groups (middle) and to the two control groups (right) Still Unproven That Sugar Is Healthier To help validate their findings and confirm that changes in the microbiome were responsible for impaired glucose tolerance, the researchers next implanted feces from more than 40 of the trial participants into healthy mice who were bred to have no gut bacteria of their own and who had never consumed artificial sweeteners. Those who received microbes from participants with the most pronounced alterations in glucose tolerance had more alterations in glucose tolerance themselves. This was compared to those mice that received microbes from people who had the least changes in glucose tolerance, and also had less changes. “The health implications of the changes that non-nutritive sweeteners may elicit in humans remain to be determined, and they merit new, long-term studies,” Elinav said. Previous studies have shown the detriments of eating artificial sweeteners, including weight gain, brain tumors and cancer. A BMJ study by French researchers in 2019 reinforced the link between consumption of sugar-laced sodas & fruit juices and cancer incidence, in particular breast cancer. Nonetheless, Elinav cautioned, the findings of this latest study do not imply that sugar is healthier than alternative sugars. Image Credits: Marco Verch. First African Manufactured Medicine to Prevent Malaria in Pregnant Women and Infants Quality-Approved by WHO 26/08/2022 Raisa Santos Pregnant women and children remain one of the groups at highest risk of complications from malaria infection. Kenyan manufacturer Universal Corporation LTD (UCL) has become the first African manufacturer to be issued a World Health Organization quality certification of a key antimalarial drug used to prevent infection in pregnant women and children. This certification, known as prequalification, will enable UCL to support regional efforts to combat malaria through local production of high-quality sulfadoxine-pyrimethamine (SP). Prequalification is a service provided by WHO to assess the quality, safety and efficacy of medicinal products. Quality assurance of UCL’s SP product Wiwal opens a route for procurement that will improve access and help strengthen Africa’s ability to combat endemic diseases. Young children and women are among the most vulnerable to the burden of malaria, with children under five accounting for 80% of all malaria deaths in Africa. SP is a generally well-tolerated, effective, and affordable medicine used to prevent malaria, yet adequate delivery and scale-up of this medicine is hampered in part by inadequate and unstable supply and, until now, a reliance on imported or poor-quality drugs. Its prequalification was achieved with funding from global health agency Unitaid and support from the Medicines for Malaria Venture (MMV). “Unitaid welcomes the certification of UCL to produce this quality-assured antimalarial medicine in Africa, where about 95% of all illness and death from malaria occurs,” said Dr Philippe Duneton, Executive Director of Unitaid. Reinforcing local production of medicines where they are needed most is critical to building stronger and more resilient health responses.” Disproportionate impact of malaria in Africa According to the latest World Malaria Report, released in 2021, there were an estimated 241 million cases of malaria and 627,000 resulting deaths worldwide in 2020. This represented about 14 million more cases in 2020 compared to 2019, and 69,000 more deaths. Approximately two-thirds of these additional deaths (47,000) were linked to disruptions in the provision of malaria prevention, diagnosis and treatment caused by the COVID-19 pandemic. The WHO African Region continues to carry a disproportionately high share of the global malaria burden. Global health leaders praised the prequalification announcement, calling it “excellent news” to those disproportionately impacted by malaria. “Ensuring the availability and accessibility of quality treatment for underserved communities, particularly women, newborns, and children who are disproportionately at high risk of death from malaria is a critical component to the full realization of the right to health,” said Joy Phumaphi, Executive Secretary of the African Leaders Malaria Alliance and MMV Board member. Lack of prequalified manufacturers raises concerns Health volunteers pick up supplies during a seasonal malaria chemoprevention campaign in Nigeria The lack of prequalified manufacturers in Africa raises concerns about the quality of medicines and supply insecurities that compromise the treatment of chronic and infectious diseases – risks that were clearly revealed when COVID-19 disrupted global supply chains and left Africa with limited access to vital products. Prequalification itself can be a long process, averaging 17 months in the process to reach product approval. UCL Founder and Managing Director Perviz Dhanani noted that in addition to being the first pharmaceutical company in Africa to receive prequalification for SP, it is also one of five manufacturers in Africa to receive quality certification for any product. It is clear that the production of quality medicines on the African continent is critical not only for the safety of Africa’s people but also for supporting regional supply availability and diversification in global production of medicines. “UCL is committed to supplying the African continent with quality medicines that are most needed by the people who live here. We’re filling a much-needed gap,” said Dhanani. Increased supply of SP is crucial to the long-term success of Unitaid’s malaria strategy, which includes nearly US$ 160 million invested to date to optimize and scale up delivery of SP through seasonal delivery and intermittent preventive treatment in pregnant women and infants. MMV is also working with Unitaid funding to support quality medicines critical to the malaria response. “Researchers and manufacturers from the countries hardest hit by malaria must be at the forefront of efforts to defeat the disease, which is why we welcome this wonderful news,” said David Reddy, MMV’s CEO. Image Credits: WHO, Elizabeth Poll/MMV, Munira Ismail_MSH. Africa Has Not Received a Single Dose of Monkeypox Vaccine – Even Though Virus is Endemic and Often More Deadly 25/08/2022 Paul Adepoju WHO African Regional Director, Dr Matshidiso Moeti Another COVID rerun: WHO and Africa CDC officials lament the complete lack of access to monkeypox vaccines on the continent where the virus is endemic – as well as often more deadly than elsewhere. Meanwhile, Mozambique and Malawi have seen a total of six wild poliovirus cases, although WHO officials continue to insist that since the cases are imported, this won’t affect Africa’s status as ‘wild poliovirus free.’ The African continent has not yet received any vaccine doses to combat the monkeypox virus, African health officials said Thursday, including nations where the disease is endemic and often more deadly than the clades surfacing around the world. More monkeypox testing kits also are urgently needed to improve the continent’s emergency response, top health officials warned in back-to-back briefings. “We still don’t have access to enough test kits. We are working on increasing that. We still don’t have access to any vaccines and that is a big concern,” said Africa CDC’s acting director, Ahmed Ogwell Ouma. He told Health Policy Watch that the sluggish response and lack of support for African countries doesn’t match the urgency called for in WHO’s declaration of monkeypox as a global public health emergency (PHEIC). “We need a coordinated international response where more is being put on the table to support the control of monkeypox as an outbreak of international concern,” Ouma said, stressing that Africa CDC has been providing as much guidance and support as it can for training and surveillance. Tedros Adhanom Ghebreyesus, WHO Director General, had declared monkeypox a public health emergency in July. Though no vaccines are available, WHO African Regional Director, Dr Matshidiso Moeti, said testing capacity is at least expanding, but not fast enough. “We have finally been able to obtain some tests, supplies and we have distributed these among countries to enable more rapid testing and confirmation of cases of monkeypox that will enable the diagnosis and ensure actions are taken faster,” Moeti told journalists on the margins of the 72nd WHO Regional Committee for Africa. She said WHO is working through its headquarters “to try to seek supplies of vaccines so that these may be available as we start to see new cases and we can have the experience of using this vaccine in Africa”. The Danish manufacturing plant of Bavarian Nordic, sole producer of the only WHO-approved monkeypox vaccine, MVA-BN, has been closed for renovations since spring and is not expected to reopen until late 2022, leading to a dire shortage of global supplies. WHO has repeatedly said it is “discussing” with vaccine suppliers. However, according to a recent Health Policy Watch investigation, there are only about 16.4 million stockpiled MVA-BN doses available in bulk or finished form until the end of this year. Unless a license is awarded to another vaccine manufacturer, the world will have to make do with existing doses, most of which reside in the United States and a few other wealthy countries. See related story: Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy Wild poliovirus cases expanding slowly Meanwhile, at a special African Regional Committee session on polio, WHO, African health ministers and their partners said they would work together to tackle wild poliovirus, which is seeing a comeback in east Africa due to the spread of a virus strain imported from Pakistan. There have now been six cases reported in the African Region from the outbreak which began last year in Malawi and has now reached Mozambique, all apparently with links to an imported case from Pakistan. WHO said the “imported” cases should not impact Africa’s certification as wild poliovirus free, and that “any child paralyzed from polio is one too many.” There are now 6 #WPV1 cases in the African Region, imported from Pakistan to #Malawi 🇲🇼 & more recently, #Mozambique 🇲🇿 While these do not negatively impact #Africa's 🌍indigenous wild polio-free certification, any child paralysed from #polio is 1 too many. #RC72AFRO #EndPolio pic.twitter.com/SVAvQzXR0m — WHO African Region (@WHOAFRO) August 24, 2022 COVID lockdowns impacted polio response Polio vaccination campaign in Malawi 2022 COVID-19 negatively impacted Africa’s polio response, said Dr Chris Elias, Polio Oversight Board Chair of the Gates Foundation, speaking at the meeting. By putting polio experts at the service of the COVID-19 response, the virus had time to spread. “Dozens of campaigns delayed, not only for polio but for measles and other diseases,” he said. “We need good quality routine immunization, campaigns and surveillance. Unfortunately, COVID-19 presented a huge challenge that gave polio time and freedom to act quickly.” Regarding wild polio, Ouma told Health Policy Watch that any presence of wild polio anywhere in the world poses a huge risk to the achievement that Africa recorded in eradicating the disease. Ouma called for more efforts to boost polio vaccination across the continent. “We need to put in place surveillance mechanisms that will be able to respond quickly when a case is identified,” he said. “It is our position that polio is not a regional or a country problem. It remains a global problem.” New regional health security strategy calls for 90% rapid response capacity by 2030 WHO Regional Committee meeting for Africa At the WHO Regional Committee meeting, African health ministers adopted a new eight-year strategy to transform health security and emergency response. Called the Regional Strategy for Health Security and Emergencies 2022–2030, it is intended to reduce the health and socioeconomic impacts of public health emergencies. The strategy includes goals for strengthening mechanisms for partnerships and multisectoral collaboration; ensuring sustained and predictable investment; and repurposing resources from polio eradication and COVID-19 to support strategic investments in systems and tools for public health emergencies. The adoption of the strategy means WHO’s member nations have now agreed to reach 12 strategy targets by 2030 – all aimed at strengthening capacity to prevent, prepare for, detect and respond to health emergencies. The strategy calls for 80% of member nations to have “predictable and sustainable” health security financing by 2030, with 90% able to mobilize an effective response to public health emergencies within 24 hours of detection. “This strategy is the fruit of extensive consultations with African health ministries and a range of other institutions, technical actors and partners across the continent. With their ongoing support and collaboration, it can help ensure that Africa is at the forefront of protecting the world against future pandemics,” Moeti said. Image Credits: WHO Africa. Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy 25/08/2022 John Heilprin Men queing for the monkeypox vaccine The global number of weekly new cases of monkeypox reported to the World Health Organization (WHO) declined by 21% for the first time since the infection that has been endemic to central and west Africa began to appear around the world earlier this year. Cases continued rising sharply in the Americas, however, in contrast to recent declines in European hotspots, WHO said in a report on Thursday showing 5,907 new monkeypox cases were reported in the past week, down from 7,477 new cases the previous week. That is a dramatic reversal from the 20% weekly increases in reported new monkeypox cases over the past month. More than 45,000 cases have been reported in 98 countries since late April. After four consecutive weeks of rising monkeypox cases globally, WHO says, the overall weekly decrease may reflect early signs of a declining infection rate in the European region but it will take time to see if that is sustained. Monkeypox cases in the Americas were still rising sharply, accounting for 60% of all cases compared to Europe’s 38% in the past month. WHO officials, meanwhile, say they are examining proposals to split scarce monkeypox vaccines doses to stretch supplies — a strategy adopted by the United States on August 10, in response to the global shortage of monkeypox vaccines. As part of that decision released earlier this month, US Health and Human Services Secretary Xavier Becerra issued a 564 determination, granting the US Food and Drug Administration the power to issue an emergency use authorization for vaccines. This gives the FDA permission to change the way the MVA-BN vaccine, made by Danish company Bavarian Nordic, is administered. Dr Kate O’Brien, WHO Director of Immunization, Vaccines and Biologicals, Group of monkeypox experts to examine the ‘fractional’ strategy Dr. Kate O’Brien, WHO’s Director of the Department of Immunization, Vaccines and Biologicals, said a strategic advisory group of experts will meet at the beginning of October to evaluate “some of these fractional dose issues” and the evidence for and against the strategy. Known as dose sparing, the U.S. fractional dose strategy splits the approved MVA-BN vaccine that is typically administered subcutaneously into five doses from each vaccine vial, and then delivers those “intradermally” just below the outermost layer of skin, known as the epidermis. “The strategy of what’s termed using fractional doses for vaccines is not a new strategy for vaccines,” O’Brien told a virtual press briefing on Thursday. “And we are looking really carefully at the evidence for the performance of these vaccines, these smallpox monkeypox vaccines,” she said, “to look at the equivalence or in fact, possibly the improved performance using fractional doses.” Along with extending the limited vaccine supplies, the procedure is supposed to provoke a more powerful immune reaction. But the strategy announced earlier by U.S. President Joe Biden’s administration is not going according to plan, Politico reports, with those administering the vaccine saying they’re getting only three or four doses out of each vial. Other media have reported the intradermal procedure’s more frequent use on men of color who have sought the vaccine recently, while white men who got in line first for the jab were able to get a full dose in the more proven, subcutaneous manner. Another complicating factor is the requirement for health workers to get extra training for the delicate intradermal procedure. The net result is speculation that if the outbreak continues to expand in the Americas, the US may be forced to fall back on another stockpile of ACAM2000 smallpox vaccines that are highly effective but can have dangerous side effects. Chronic Disease Focus of New Strategy 25/08/2022 Paul Adepoju 72nd WHO Regional Committee for Africa Ministers and government officials took on noncommunicable diseases, sickle cell disease, health system reforms in response to the COVID-19 pandemic, and measures to fight tuberculosis among children in Africa during their meeting of the 72nd WHO Regional Committee for Africa this week. In an effort to curb Africa’s chronic disease crisis, African health ministers adopted a new regional strategy to improve the diagnosis and treatment of severe forms of NCDs in district hospitals and first level referral facilities where care is often unavailable today. The new regional strategy for NCDs is known as PEN-PLUS. It addresses cardiovascular diseases, diabetes, cancer, and chronic lung disease that are responsible for almost 70% of all premature deaths worldwide – and a fast growing proportion of premature deaths in Africa. In addition, African nations face a special burden from sickle cell disease, which can cause severe anaemia and premature death if left untreated. In Africa, mortality from NCDs increased from 24% of total premature deaths in 2000 to more than 37% as of 2019. But many African countries lack adequate capacity to diagnosis and treat NCDs at the primary health care level, and most are only equipped to treat severe NCDs at tertiary health facilities, meaning big hospitals, located in large cities. The probability of premature death (age 30-70) from NCDs. This, WHO says, puts care beyond the reach of rural and poorer patients who typically rely on district hospitals and local health centres that lack the capacity and resources to effectively manage severe NCDs. Just 36% of countries have public hospitals stocked with basic NCD medications Knowing your blood pressure supports NCD prevention, diagnosis, and early treatment. PEN-PLUS, developed by WHO in collaboration with African health ministers over the past two years, offers a roadmap for countries to institute standardised programs to tackle chronic and severe NCDs by ensuring that essential medicines, technologies and diagnostics are available and accessible at district hospitals. It also encourages African governments to improve training and treatment protocols for chronic NCDs and to ensure that people at private hospitals can access services for severe NCDs Currently, just 36% of countries in the African region have public hospitals stocked with the medicines needed to treat NCDs, and private hospitals also must provide such services, according to WHO. In Liberia, Malawi, and Rwanda, where the strategy is already deployed, WHO says there has been a significant increase in the health and numbers of patients treated for severe chronic NCDs. In Africa, the most prevalent NCDs include Type 1 and 2 Diabetes, hypertension, heart disease and asthma, as well as sickle-cell disease, a genetic disorder, according to WHO data. Related to the drive against chronic NCDs, new campaign on sickle cell disease Health ministers also launched a campaign to tackle sickle cell disease, an inherited blood disorder that causes anaemia and can shorten lifespans, if left untreated. More than 66% of the 120 million people worldwide affected by sickle cell disease live in Africa, and approximately 1,000 African children are born with the disease every day. In 2019, the number of sickle cell disease deaths in the African region rose to 38,403 — a 26% increase from 2000. This rise in disease burden is attributed to a lack of investment in disease-fighting tools including prevention, early detection and proper care, according to WHO. The level of care has also been hampered by inadequate personnel and services, particularly at lower-level facilities. The campaign aims to shore up political will, engagement and financial resources for sickle cell disease prevention and control across the region. It draws on financial support and resources from the World Bank, U.S. Department of Health and Human Services, Novartis Foundation, Global Blood Therapeutics, and the Sickle in Africa consortium. Chief targets are schools, communities, health institutions and news media outlets. WHO notes that progress on controlling the disease in Africa is hindered by the absence of newborn screening programmes and surveillance, lack of accurate and reliable data on sickle cell disease and no data collection for sickle cell disease in most national surveys. “We need to shine the spotlight on this disease and help improve the quality of life of those living with it,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. Revamping Africa’s health systems in the wake of the pandemic Dr Matshidiso Moeti, WHO Regional Director for Africa, spoke at the session on childhood tuberculosis At the meeting, countries also agreed to institute other reforms in the region’s health systems in response to the COVID-19 pandemic, placing more emphasis on improved disease surveillance, as well as prevention and vaccination. “Domestic investment in health, including health research, has significant economic returns, while promoting resilience and sustainability; healthy populations translate to healthy economies,” Moeti said. Senegal’s Health Minister, Dr Marie Khemesse Ngom Ndiaye, said that due to the pandemic, her nation’s health system put more emphasis on resilience and investment. That “considerably strengthened disease prevention and management capacities,” she said. Fighting tuberculosis among children In terms of infectious diseases, long the major focus of African health programmes, more comprehensive and immediate measures are needed to fight tuberculosis among children in Africa, said representatives of WHO and the African Union, at the meeting. Their comments were echoed by the Stop TB Partnership and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). Currently, two-thirds of children with TB in WHO’s African Region fail to get diagnosed for the disease, WHO says, leading to an increased risk of rapid disease progression and mortality, especially in younger children. Among children under age five believed to have TB, just 32% in the African Region are adiagnosed and treated, the smallest proportion for that age group globally. Seventeen of the world’s 30 countries with the highest tuberculosis burden globally are in Africa, where 322,000 children and young adolescents under 15 years of age are affected. Minata Samate Cessouma, Commissioner for Health, African Union “There is an urgent need for innovative interventions to integrate tuberculosis diagnosis in nutrition programs to identify the disease in children quickly,” said Minata Samate Cessouma, African Union Commissioner for Health, Humanitarian Affairs and Social Development. “Children with tuberculosis are almost never spreading the disease and are always infected by an adult,” said Dr Lucica Ditiu, Executive Director of Stop TB Partnership, “so their suffering is a metric of our failures to diagnose and treat tuberculosis in children.” A child dies of tuberculosis somewhere in the world every two minutes, even though it is curable and preventable, she noted. . Tackling Malawi’s cholera outbreak At the meeting, WHO and UNICEF also announced joint plans to ramp up efforts to contain a cholera outbreak recently announced in Malawi. The outbreak has grown to 1,483 cases and 58 deaths in the northern and central regions, where it affects lakeshore communities and crowded, urban areas with insufficient water and sanitation facilities. The UN agencies say they will increase surveillance for early detection and management; improve the quality of case management at cholera treatment units; and provide critical supplies needed to manage cholera cases. They also plan to help improve water treatment, personal hygiene and household water storage. WHO’s Country Representative for Malawi, Dr Neema Rusibamayila Kimambo, stressed that every death from cholera is preventable. The UN health agency will offer additional support to Malawi’s Health Ministry to “help ensure that lives continue to be saved and a resilient health system is maintained during and beyond the current outbreak,” Kimambo said. UNICEF Malawi’s Representative, Rudolf Schwenk, said it’s urgent to help Malawi’s already overburdened public health services and health care delivery systems. “The good news is that we know the solutions,” Schwenk said. “We are on the ground providing humanitarian assistance in the affected districts, but we need more support to further scale up our response.” Image Credits: WHO, NCD Alliance, Twitter/Matshidiso Moeti, Twitter/WHO AFRO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Trick or Treat? Artificial Sweeteners Impact Gut Bacteria, Could Alter Glucose Tolerance – Study 26/08/2022 Maayan Hoffman Sugar is more deadly than gunpowder Non-nutritive artificial sweeteners duplicate the taste of sugar but have fewer calories. As such, sugar alternatives like saccharin, sucralose, aspartame and stevia are often consumed in large quantities by people looking to watch their weight or shed a few pounds. But a team of researchers from Israel’s Weizmann Institute of Science said these alternative sugars should no longer be assumed safe because they can cause harm. In some people, they alter their microbiome (gut bacteria) and change blood sugar levels. “Our trial has shown that non-nutritive sweeteners may impair glucose responses by altering our microbiome, and they do so in a highly personalized manner, that is, by affecting each person in a unique way,” said Prof. Eran Elinav of Weizmann’s Systems Immunology Department, who led the study. Altering the Composition and Function of the Biome with Artificial Sweeteners Building off an animal trial conducted in 2014 that showed that some artificial sweeteners might contribute to changes in the sugar metabolism they are meant to prevent, a new team of researchers worked with 120 people who avoided artificially sweetened foods or drinks. The volunteers were divided into six groups: two controls and four who received one of four artificial sweeteners – saccharin, sucralose, aspartame or stevia – at lower than acceptable daily intake levels. In just two weeks, the researchers found consuming any of the sweeteners altered the composition and function of the microbiome and the small molecules that the gut microbes secrete into people’s blood. Moreover, saccharin and sucralose were found to alter glucose metabolism – the way a person disposes of glucose – which could contribute to metabolic disease, they said. No changes in either the microbiome or glucose tolerance were found in the two control groups that did not consume any alternative sugars. The findings were published on August 19 in the peer-reviewed journal Cell. “These findings reinforce the view of the microbiome as a hub that integrates the signals coming from the human body’s own systems and from external factors such as the food we eat, the medications we take, our lifestyle and physical surroundings,” Elinav said. Changes in the composition and function of gut microbes were observed in all four groups of trial participants who consumed non-nutritive sweeteners. Each group consumed one of the following: saccharine, sucralose, stevia or aspartame. The diagram shows increases in glucose levels in the saccharin and sucralose groups (two graphs on the left), compared to the stevia and aspartame groups (middle) and to the two control groups (right) Still Unproven That Sugar Is Healthier To help validate their findings and confirm that changes in the microbiome were responsible for impaired glucose tolerance, the researchers next implanted feces from more than 40 of the trial participants into healthy mice who were bred to have no gut bacteria of their own and who had never consumed artificial sweeteners. Those who received microbes from participants with the most pronounced alterations in glucose tolerance had more alterations in glucose tolerance themselves. This was compared to those mice that received microbes from people who had the least changes in glucose tolerance, and also had less changes. “The health implications of the changes that non-nutritive sweeteners may elicit in humans remain to be determined, and they merit new, long-term studies,” Elinav said. Previous studies have shown the detriments of eating artificial sweeteners, including weight gain, brain tumors and cancer. A BMJ study by French researchers in 2019 reinforced the link between consumption of sugar-laced sodas & fruit juices and cancer incidence, in particular breast cancer. Nonetheless, Elinav cautioned, the findings of this latest study do not imply that sugar is healthier than alternative sugars. Image Credits: Marco Verch. First African Manufactured Medicine to Prevent Malaria in Pregnant Women and Infants Quality-Approved by WHO 26/08/2022 Raisa Santos Pregnant women and children remain one of the groups at highest risk of complications from malaria infection. Kenyan manufacturer Universal Corporation LTD (UCL) has become the first African manufacturer to be issued a World Health Organization quality certification of a key antimalarial drug used to prevent infection in pregnant women and children. This certification, known as prequalification, will enable UCL to support regional efforts to combat malaria through local production of high-quality sulfadoxine-pyrimethamine (SP). Prequalification is a service provided by WHO to assess the quality, safety and efficacy of medicinal products. Quality assurance of UCL’s SP product Wiwal opens a route for procurement that will improve access and help strengthen Africa’s ability to combat endemic diseases. Young children and women are among the most vulnerable to the burden of malaria, with children under five accounting for 80% of all malaria deaths in Africa. SP is a generally well-tolerated, effective, and affordable medicine used to prevent malaria, yet adequate delivery and scale-up of this medicine is hampered in part by inadequate and unstable supply and, until now, a reliance on imported or poor-quality drugs. Its prequalification was achieved with funding from global health agency Unitaid and support from the Medicines for Malaria Venture (MMV). “Unitaid welcomes the certification of UCL to produce this quality-assured antimalarial medicine in Africa, where about 95% of all illness and death from malaria occurs,” said Dr Philippe Duneton, Executive Director of Unitaid. Reinforcing local production of medicines where they are needed most is critical to building stronger and more resilient health responses.” Disproportionate impact of malaria in Africa According to the latest World Malaria Report, released in 2021, there were an estimated 241 million cases of malaria and 627,000 resulting deaths worldwide in 2020. This represented about 14 million more cases in 2020 compared to 2019, and 69,000 more deaths. Approximately two-thirds of these additional deaths (47,000) were linked to disruptions in the provision of malaria prevention, diagnosis and treatment caused by the COVID-19 pandemic. The WHO African Region continues to carry a disproportionately high share of the global malaria burden. Global health leaders praised the prequalification announcement, calling it “excellent news” to those disproportionately impacted by malaria. “Ensuring the availability and accessibility of quality treatment for underserved communities, particularly women, newborns, and children who are disproportionately at high risk of death from malaria is a critical component to the full realization of the right to health,” said Joy Phumaphi, Executive Secretary of the African Leaders Malaria Alliance and MMV Board member. Lack of prequalified manufacturers raises concerns Health volunteers pick up supplies during a seasonal malaria chemoprevention campaign in Nigeria The lack of prequalified manufacturers in Africa raises concerns about the quality of medicines and supply insecurities that compromise the treatment of chronic and infectious diseases – risks that were clearly revealed when COVID-19 disrupted global supply chains and left Africa with limited access to vital products. Prequalification itself can be a long process, averaging 17 months in the process to reach product approval. UCL Founder and Managing Director Perviz Dhanani noted that in addition to being the first pharmaceutical company in Africa to receive prequalification for SP, it is also one of five manufacturers in Africa to receive quality certification for any product. It is clear that the production of quality medicines on the African continent is critical not only for the safety of Africa’s people but also for supporting regional supply availability and diversification in global production of medicines. “UCL is committed to supplying the African continent with quality medicines that are most needed by the people who live here. We’re filling a much-needed gap,” said Dhanani. Increased supply of SP is crucial to the long-term success of Unitaid’s malaria strategy, which includes nearly US$ 160 million invested to date to optimize and scale up delivery of SP through seasonal delivery and intermittent preventive treatment in pregnant women and infants. MMV is also working with Unitaid funding to support quality medicines critical to the malaria response. “Researchers and manufacturers from the countries hardest hit by malaria must be at the forefront of efforts to defeat the disease, which is why we welcome this wonderful news,” said David Reddy, MMV’s CEO. Image Credits: WHO, Elizabeth Poll/MMV, Munira Ismail_MSH. Africa Has Not Received a Single Dose of Monkeypox Vaccine – Even Though Virus is Endemic and Often More Deadly 25/08/2022 Paul Adepoju WHO African Regional Director, Dr Matshidiso Moeti Another COVID rerun: WHO and Africa CDC officials lament the complete lack of access to monkeypox vaccines on the continent where the virus is endemic – as well as often more deadly than elsewhere. Meanwhile, Mozambique and Malawi have seen a total of six wild poliovirus cases, although WHO officials continue to insist that since the cases are imported, this won’t affect Africa’s status as ‘wild poliovirus free.’ The African continent has not yet received any vaccine doses to combat the monkeypox virus, African health officials said Thursday, including nations where the disease is endemic and often more deadly than the clades surfacing around the world. More monkeypox testing kits also are urgently needed to improve the continent’s emergency response, top health officials warned in back-to-back briefings. “We still don’t have access to enough test kits. We are working on increasing that. We still don’t have access to any vaccines and that is a big concern,” said Africa CDC’s acting director, Ahmed Ogwell Ouma. He told Health Policy Watch that the sluggish response and lack of support for African countries doesn’t match the urgency called for in WHO’s declaration of monkeypox as a global public health emergency (PHEIC). “We need a coordinated international response where more is being put on the table to support the control of monkeypox as an outbreak of international concern,” Ouma said, stressing that Africa CDC has been providing as much guidance and support as it can for training and surveillance. Tedros Adhanom Ghebreyesus, WHO Director General, had declared monkeypox a public health emergency in July. Though no vaccines are available, WHO African Regional Director, Dr Matshidiso Moeti, said testing capacity is at least expanding, but not fast enough. “We have finally been able to obtain some tests, supplies and we have distributed these among countries to enable more rapid testing and confirmation of cases of monkeypox that will enable the diagnosis and ensure actions are taken faster,” Moeti told journalists on the margins of the 72nd WHO Regional Committee for Africa. She said WHO is working through its headquarters “to try to seek supplies of vaccines so that these may be available as we start to see new cases and we can have the experience of using this vaccine in Africa”. The Danish manufacturing plant of Bavarian Nordic, sole producer of the only WHO-approved monkeypox vaccine, MVA-BN, has been closed for renovations since spring and is not expected to reopen until late 2022, leading to a dire shortage of global supplies. WHO has repeatedly said it is “discussing” with vaccine suppliers. However, according to a recent Health Policy Watch investigation, there are only about 16.4 million stockpiled MVA-BN doses available in bulk or finished form until the end of this year. Unless a license is awarded to another vaccine manufacturer, the world will have to make do with existing doses, most of which reside in the United States and a few other wealthy countries. See related story: Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy Wild poliovirus cases expanding slowly Meanwhile, at a special African Regional Committee session on polio, WHO, African health ministers and their partners said they would work together to tackle wild poliovirus, which is seeing a comeback in east Africa due to the spread of a virus strain imported from Pakistan. There have now been six cases reported in the African Region from the outbreak which began last year in Malawi and has now reached Mozambique, all apparently with links to an imported case from Pakistan. WHO said the “imported” cases should not impact Africa’s certification as wild poliovirus free, and that “any child paralyzed from polio is one too many.” There are now 6 #WPV1 cases in the African Region, imported from Pakistan to #Malawi 🇲🇼 & more recently, #Mozambique 🇲🇿 While these do not negatively impact #Africa's 🌍indigenous wild polio-free certification, any child paralysed from #polio is 1 too many. #RC72AFRO #EndPolio pic.twitter.com/SVAvQzXR0m — WHO African Region (@WHOAFRO) August 24, 2022 COVID lockdowns impacted polio response Polio vaccination campaign in Malawi 2022 COVID-19 negatively impacted Africa’s polio response, said Dr Chris Elias, Polio Oversight Board Chair of the Gates Foundation, speaking at the meeting. By putting polio experts at the service of the COVID-19 response, the virus had time to spread. “Dozens of campaigns delayed, not only for polio but for measles and other diseases,” he said. “We need good quality routine immunization, campaigns and surveillance. Unfortunately, COVID-19 presented a huge challenge that gave polio time and freedom to act quickly.” Regarding wild polio, Ouma told Health Policy Watch that any presence of wild polio anywhere in the world poses a huge risk to the achievement that Africa recorded in eradicating the disease. Ouma called for more efforts to boost polio vaccination across the continent. “We need to put in place surveillance mechanisms that will be able to respond quickly when a case is identified,” he said. “It is our position that polio is not a regional or a country problem. It remains a global problem.” New regional health security strategy calls for 90% rapid response capacity by 2030 WHO Regional Committee meeting for Africa At the WHO Regional Committee meeting, African health ministers adopted a new eight-year strategy to transform health security and emergency response. Called the Regional Strategy for Health Security and Emergencies 2022–2030, it is intended to reduce the health and socioeconomic impacts of public health emergencies. The strategy includes goals for strengthening mechanisms for partnerships and multisectoral collaboration; ensuring sustained and predictable investment; and repurposing resources from polio eradication and COVID-19 to support strategic investments in systems and tools for public health emergencies. The adoption of the strategy means WHO’s member nations have now agreed to reach 12 strategy targets by 2030 – all aimed at strengthening capacity to prevent, prepare for, detect and respond to health emergencies. The strategy calls for 80% of member nations to have “predictable and sustainable” health security financing by 2030, with 90% able to mobilize an effective response to public health emergencies within 24 hours of detection. “This strategy is the fruit of extensive consultations with African health ministries and a range of other institutions, technical actors and partners across the continent. With their ongoing support and collaboration, it can help ensure that Africa is at the forefront of protecting the world against future pandemics,” Moeti said. Image Credits: WHO Africa. Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy 25/08/2022 John Heilprin Men queing for the monkeypox vaccine The global number of weekly new cases of monkeypox reported to the World Health Organization (WHO) declined by 21% for the first time since the infection that has been endemic to central and west Africa began to appear around the world earlier this year. Cases continued rising sharply in the Americas, however, in contrast to recent declines in European hotspots, WHO said in a report on Thursday showing 5,907 new monkeypox cases were reported in the past week, down from 7,477 new cases the previous week. That is a dramatic reversal from the 20% weekly increases in reported new monkeypox cases over the past month. More than 45,000 cases have been reported in 98 countries since late April. After four consecutive weeks of rising monkeypox cases globally, WHO says, the overall weekly decrease may reflect early signs of a declining infection rate in the European region but it will take time to see if that is sustained. Monkeypox cases in the Americas were still rising sharply, accounting for 60% of all cases compared to Europe’s 38% in the past month. WHO officials, meanwhile, say they are examining proposals to split scarce monkeypox vaccines doses to stretch supplies — a strategy adopted by the United States on August 10, in response to the global shortage of monkeypox vaccines. As part of that decision released earlier this month, US Health and Human Services Secretary Xavier Becerra issued a 564 determination, granting the US Food and Drug Administration the power to issue an emergency use authorization for vaccines. This gives the FDA permission to change the way the MVA-BN vaccine, made by Danish company Bavarian Nordic, is administered. Dr Kate O’Brien, WHO Director of Immunization, Vaccines and Biologicals, Group of monkeypox experts to examine the ‘fractional’ strategy Dr. Kate O’Brien, WHO’s Director of the Department of Immunization, Vaccines and Biologicals, said a strategic advisory group of experts will meet at the beginning of October to evaluate “some of these fractional dose issues” and the evidence for and against the strategy. Known as dose sparing, the U.S. fractional dose strategy splits the approved MVA-BN vaccine that is typically administered subcutaneously into five doses from each vaccine vial, and then delivers those “intradermally” just below the outermost layer of skin, known as the epidermis. “The strategy of what’s termed using fractional doses for vaccines is not a new strategy for vaccines,” O’Brien told a virtual press briefing on Thursday. “And we are looking really carefully at the evidence for the performance of these vaccines, these smallpox monkeypox vaccines,” she said, “to look at the equivalence or in fact, possibly the improved performance using fractional doses.” Along with extending the limited vaccine supplies, the procedure is supposed to provoke a more powerful immune reaction. But the strategy announced earlier by U.S. President Joe Biden’s administration is not going according to plan, Politico reports, with those administering the vaccine saying they’re getting only three or four doses out of each vial. Other media have reported the intradermal procedure’s more frequent use on men of color who have sought the vaccine recently, while white men who got in line first for the jab were able to get a full dose in the more proven, subcutaneous manner. Another complicating factor is the requirement for health workers to get extra training for the delicate intradermal procedure. The net result is speculation that if the outbreak continues to expand in the Americas, the US may be forced to fall back on another stockpile of ACAM2000 smallpox vaccines that are highly effective but can have dangerous side effects. Chronic Disease Focus of New Strategy 25/08/2022 Paul Adepoju 72nd WHO Regional Committee for Africa Ministers and government officials took on noncommunicable diseases, sickle cell disease, health system reforms in response to the COVID-19 pandemic, and measures to fight tuberculosis among children in Africa during their meeting of the 72nd WHO Regional Committee for Africa this week. In an effort to curb Africa’s chronic disease crisis, African health ministers adopted a new regional strategy to improve the diagnosis and treatment of severe forms of NCDs in district hospitals and first level referral facilities where care is often unavailable today. The new regional strategy for NCDs is known as PEN-PLUS. It addresses cardiovascular diseases, diabetes, cancer, and chronic lung disease that are responsible for almost 70% of all premature deaths worldwide – and a fast growing proportion of premature deaths in Africa. In addition, African nations face a special burden from sickle cell disease, which can cause severe anaemia and premature death if left untreated. In Africa, mortality from NCDs increased from 24% of total premature deaths in 2000 to more than 37% as of 2019. But many African countries lack adequate capacity to diagnosis and treat NCDs at the primary health care level, and most are only equipped to treat severe NCDs at tertiary health facilities, meaning big hospitals, located in large cities. The probability of premature death (age 30-70) from NCDs. This, WHO says, puts care beyond the reach of rural and poorer patients who typically rely on district hospitals and local health centres that lack the capacity and resources to effectively manage severe NCDs. Just 36% of countries have public hospitals stocked with basic NCD medications Knowing your blood pressure supports NCD prevention, diagnosis, and early treatment. PEN-PLUS, developed by WHO in collaboration with African health ministers over the past two years, offers a roadmap for countries to institute standardised programs to tackle chronic and severe NCDs by ensuring that essential medicines, technologies and diagnostics are available and accessible at district hospitals. It also encourages African governments to improve training and treatment protocols for chronic NCDs and to ensure that people at private hospitals can access services for severe NCDs Currently, just 36% of countries in the African region have public hospitals stocked with the medicines needed to treat NCDs, and private hospitals also must provide such services, according to WHO. In Liberia, Malawi, and Rwanda, where the strategy is already deployed, WHO says there has been a significant increase in the health and numbers of patients treated for severe chronic NCDs. In Africa, the most prevalent NCDs include Type 1 and 2 Diabetes, hypertension, heart disease and asthma, as well as sickle-cell disease, a genetic disorder, according to WHO data. Related to the drive against chronic NCDs, new campaign on sickle cell disease Health ministers also launched a campaign to tackle sickle cell disease, an inherited blood disorder that causes anaemia and can shorten lifespans, if left untreated. More than 66% of the 120 million people worldwide affected by sickle cell disease live in Africa, and approximately 1,000 African children are born with the disease every day. In 2019, the number of sickle cell disease deaths in the African region rose to 38,403 — a 26% increase from 2000. This rise in disease burden is attributed to a lack of investment in disease-fighting tools including prevention, early detection and proper care, according to WHO. The level of care has also been hampered by inadequate personnel and services, particularly at lower-level facilities. The campaign aims to shore up political will, engagement and financial resources for sickle cell disease prevention and control across the region. It draws on financial support and resources from the World Bank, U.S. Department of Health and Human Services, Novartis Foundation, Global Blood Therapeutics, and the Sickle in Africa consortium. Chief targets are schools, communities, health institutions and news media outlets. WHO notes that progress on controlling the disease in Africa is hindered by the absence of newborn screening programmes and surveillance, lack of accurate and reliable data on sickle cell disease and no data collection for sickle cell disease in most national surveys. “We need to shine the spotlight on this disease and help improve the quality of life of those living with it,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. Revamping Africa’s health systems in the wake of the pandemic Dr Matshidiso Moeti, WHO Regional Director for Africa, spoke at the session on childhood tuberculosis At the meeting, countries also agreed to institute other reforms in the region’s health systems in response to the COVID-19 pandemic, placing more emphasis on improved disease surveillance, as well as prevention and vaccination. “Domestic investment in health, including health research, has significant economic returns, while promoting resilience and sustainability; healthy populations translate to healthy economies,” Moeti said. Senegal’s Health Minister, Dr Marie Khemesse Ngom Ndiaye, said that due to the pandemic, her nation’s health system put more emphasis on resilience and investment. That “considerably strengthened disease prevention and management capacities,” she said. Fighting tuberculosis among children In terms of infectious diseases, long the major focus of African health programmes, more comprehensive and immediate measures are needed to fight tuberculosis among children in Africa, said representatives of WHO and the African Union, at the meeting. Their comments were echoed by the Stop TB Partnership and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). Currently, two-thirds of children with TB in WHO’s African Region fail to get diagnosed for the disease, WHO says, leading to an increased risk of rapid disease progression and mortality, especially in younger children. Among children under age five believed to have TB, just 32% in the African Region are adiagnosed and treated, the smallest proportion for that age group globally. Seventeen of the world’s 30 countries with the highest tuberculosis burden globally are in Africa, where 322,000 children and young adolescents under 15 years of age are affected. Minata Samate Cessouma, Commissioner for Health, African Union “There is an urgent need for innovative interventions to integrate tuberculosis diagnosis in nutrition programs to identify the disease in children quickly,” said Minata Samate Cessouma, African Union Commissioner for Health, Humanitarian Affairs and Social Development. “Children with tuberculosis are almost never spreading the disease and are always infected by an adult,” said Dr Lucica Ditiu, Executive Director of Stop TB Partnership, “so their suffering is a metric of our failures to diagnose and treat tuberculosis in children.” A child dies of tuberculosis somewhere in the world every two minutes, even though it is curable and preventable, she noted. . Tackling Malawi’s cholera outbreak At the meeting, WHO and UNICEF also announced joint plans to ramp up efforts to contain a cholera outbreak recently announced in Malawi. The outbreak has grown to 1,483 cases and 58 deaths in the northern and central regions, where it affects lakeshore communities and crowded, urban areas with insufficient water and sanitation facilities. The UN agencies say they will increase surveillance for early detection and management; improve the quality of case management at cholera treatment units; and provide critical supplies needed to manage cholera cases. They also plan to help improve water treatment, personal hygiene and household water storage. WHO’s Country Representative for Malawi, Dr Neema Rusibamayila Kimambo, stressed that every death from cholera is preventable. The UN health agency will offer additional support to Malawi’s Health Ministry to “help ensure that lives continue to be saved and a resilient health system is maintained during and beyond the current outbreak,” Kimambo said. UNICEF Malawi’s Representative, Rudolf Schwenk, said it’s urgent to help Malawi’s already overburdened public health services and health care delivery systems. “The good news is that we know the solutions,” Schwenk said. “We are on the ground providing humanitarian assistance in the affected districts, but we need more support to further scale up our response.” Image Credits: WHO, NCD Alliance, Twitter/Matshidiso Moeti, Twitter/WHO AFRO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
First African Manufactured Medicine to Prevent Malaria in Pregnant Women and Infants Quality-Approved by WHO 26/08/2022 Raisa Santos Pregnant women and children remain one of the groups at highest risk of complications from malaria infection. Kenyan manufacturer Universal Corporation LTD (UCL) has become the first African manufacturer to be issued a World Health Organization quality certification of a key antimalarial drug used to prevent infection in pregnant women and children. This certification, known as prequalification, will enable UCL to support regional efforts to combat malaria through local production of high-quality sulfadoxine-pyrimethamine (SP). Prequalification is a service provided by WHO to assess the quality, safety and efficacy of medicinal products. Quality assurance of UCL’s SP product Wiwal opens a route for procurement that will improve access and help strengthen Africa’s ability to combat endemic diseases. Young children and women are among the most vulnerable to the burden of malaria, with children under five accounting for 80% of all malaria deaths in Africa. SP is a generally well-tolerated, effective, and affordable medicine used to prevent malaria, yet adequate delivery and scale-up of this medicine is hampered in part by inadequate and unstable supply and, until now, a reliance on imported or poor-quality drugs. Its prequalification was achieved with funding from global health agency Unitaid and support from the Medicines for Malaria Venture (MMV). “Unitaid welcomes the certification of UCL to produce this quality-assured antimalarial medicine in Africa, where about 95% of all illness and death from malaria occurs,” said Dr Philippe Duneton, Executive Director of Unitaid. Reinforcing local production of medicines where they are needed most is critical to building stronger and more resilient health responses.” Disproportionate impact of malaria in Africa According to the latest World Malaria Report, released in 2021, there were an estimated 241 million cases of malaria and 627,000 resulting deaths worldwide in 2020. This represented about 14 million more cases in 2020 compared to 2019, and 69,000 more deaths. Approximately two-thirds of these additional deaths (47,000) were linked to disruptions in the provision of malaria prevention, diagnosis and treatment caused by the COVID-19 pandemic. The WHO African Region continues to carry a disproportionately high share of the global malaria burden. Global health leaders praised the prequalification announcement, calling it “excellent news” to those disproportionately impacted by malaria. “Ensuring the availability and accessibility of quality treatment for underserved communities, particularly women, newborns, and children who are disproportionately at high risk of death from malaria is a critical component to the full realization of the right to health,” said Joy Phumaphi, Executive Secretary of the African Leaders Malaria Alliance and MMV Board member. Lack of prequalified manufacturers raises concerns Health volunteers pick up supplies during a seasonal malaria chemoprevention campaign in Nigeria The lack of prequalified manufacturers in Africa raises concerns about the quality of medicines and supply insecurities that compromise the treatment of chronic and infectious diseases – risks that were clearly revealed when COVID-19 disrupted global supply chains and left Africa with limited access to vital products. Prequalification itself can be a long process, averaging 17 months in the process to reach product approval. UCL Founder and Managing Director Perviz Dhanani noted that in addition to being the first pharmaceutical company in Africa to receive prequalification for SP, it is also one of five manufacturers in Africa to receive quality certification for any product. It is clear that the production of quality medicines on the African continent is critical not only for the safety of Africa’s people but also for supporting regional supply availability and diversification in global production of medicines. “UCL is committed to supplying the African continent with quality medicines that are most needed by the people who live here. We’re filling a much-needed gap,” said Dhanani. Increased supply of SP is crucial to the long-term success of Unitaid’s malaria strategy, which includes nearly US$ 160 million invested to date to optimize and scale up delivery of SP through seasonal delivery and intermittent preventive treatment in pregnant women and infants. MMV is also working with Unitaid funding to support quality medicines critical to the malaria response. “Researchers and manufacturers from the countries hardest hit by malaria must be at the forefront of efforts to defeat the disease, which is why we welcome this wonderful news,” said David Reddy, MMV’s CEO. Image Credits: WHO, Elizabeth Poll/MMV, Munira Ismail_MSH. Africa Has Not Received a Single Dose of Monkeypox Vaccine – Even Though Virus is Endemic and Often More Deadly 25/08/2022 Paul Adepoju WHO African Regional Director, Dr Matshidiso Moeti Another COVID rerun: WHO and Africa CDC officials lament the complete lack of access to monkeypox vaccines on the continent where the virus is endemic – as well as often more deadly than elsewhere. Meanwhile, Mozambique and Malawi have seen a total of six wild poliovirus cases, although WHO officials continue to insist that since the cases are imported, this won’t affect Africa’s status as ‘wild poliovirus free.’ The African continent has not yet received any vaccine doses to combat the monkeypox virus, African health officials said Thursday, including nations where the disease is endemic and often more deadly than the clades surfacing around the world. More monkeypox testing kits also are urgently needed to improve the continent’s emergency response, top health officials warned in back-to-back briefings. “We still don’t have access to enough test kits. We are working on increasing that. We still don’t have access to any vaccines and that is a big concern,” said Africa CDC’s acting director, Ahmed Ogwell Ouma. He told Health Policy Watch that the sluggish response and lack of support for African countries doesn’t match the urgency called for in WHO’s declaration of monkeypox as a global public health emergency (PHEIC). “We need a coordinated international response where more is being put on the table to support the control of monkeypox as an outbreak of international concern,” Ouma said, stressing that Africa CDC has been providing as much guidance and support as it can for training and surveillance. Tedros Adhanom Ghebreyesus, WHO Director General, had declared monkeypox a public health emergency in July. Though no vaccines are available, WHO African Regional Director, Dr Matshidiso Moeti, said testing capacity is at least expanding, but not fast enough. “We have finally been able to obtain some tests, supplies and we have distributed these among countries to enable more rapid testing and confirmation of cases of monkeypox that will enable the diagnosis and ensure actions are taken faster,” Moeti told journalists on the margins of the 72nd WHO Regional Committee for Africa. She said WHO is working through its headquarters “to try to seek supplies of vaccines so that these may be available as we start to see new cases and we can have the experience of using this vaccine in Africa”. The Danish manufacturing plant of Bavarian Nordic, sole producer of the only WHO-approved monkeypox vaccine, MVA-BN, has been closed for renovations since spring and is not expected to reopen until late 2022, leading to a dire shortage of global supplies. WHO has repeatedly said it is “discussing” with vaccine suppliers. However, according to a recent Health Policy Watch investigation, there are only about 16.4 million stockpiled MVA-BN doses available in bulk or finished form until the end of this year. Unless a license is awarded to another vaccine manufacturer, the world will have to make do with existing doses, most of which reside in the United States and a few other wealthy countries. See related story: Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy Wild poliovirus cases expanding slowly Meanwhile, at a special African Regional Committee session on polio, WHO, African health ministers and their partners said they would work together to tackle wild poliovirus, which is seeing a comeback in east Africa due to the spread of a virus strain imported from Pakistan. There have now been six cases reported in the African Region from the outbreak which began last year in Malawi and has now reached Mozambique, all apparently with links to an imported case from Pakistan. WHO said the “imported” cases should not impact Africa’s certification as wild poliovirus free, and that “any child paralyzed from polio is one too many.” There are now 6 #WPV1 cases in the African Region, imported from Pakistan to #Malawi 🇲🇼 & more recently, #Mozambique 🇲🇿 While these do not negatively impact #Africa's 🌍indigenous wild polio-free certification, any child paralysed from #polio is 1 too many. #RC72AFRO #EndPolio pic.twitter.com/SVAvQzXR0m — WHO African Region (@WHOAFRO) August 24, 2022 COVID lockdowns impacted polio response Polio vaccination campaign in Malawi 2022 COVID-19 negatively impacted Africa’s polio response, said Dr Chris Elias, Polio Oversight Board Chair of the Gates Foundation, speaking at the meeting. By putting polio experts at the service of the COVID-19 response, the virus had time to spread. “Dozens of campaigns delayed, not only for polio but for measles and other diseases,” he said. “We need good quality routine immunization, campaigns and surveillance. Unfortunately, COVID-19 presented a huge challenge that gave polio time and freedom to act quickly.” Regarding wild polio, Ouma told Health Policy Watch that any presence of wild polio anywhere in the world poses a huge risk to the achievement that Africa recorded in eradicating the disease. Ouma called for more efforts to boost polio vaccination across the continent. “We need to put in place surveillance mechanisms that will be able to respond quickly when a case is identified,” he said. “It is our position that polio is not a regional or a country problem. It remains a global problem.” New regional health security strategy calls for 90% rapid response capacity by 2030 WHO Regional Committee meeting for Africa At the WHO Regional Committee meeting, African health ministers adopted a new eight-year strategy to transform health security and emergency response. Called the Regional Strategy for Health Security and Emergencies 2022–2030, it is intended to reduce the health and socioeconomic impacts of public health emergencies. The strategy includes goals for strengthening mechanisms for partnerships and multisectoral collaboration; ensuring sustained and predictable investment; and repurposing resources from polio eradication and COVID-19 to support strategic investments in systems and tools for public health emergencies. The adoption of the strategy means WHO’s member nations have now agreed to reach 12 strategy targets by 2030 – all aimed at strengthening capacity to prevent, prepare for, detect and respond to health emergencies. The strategy calls for 80% of member nations to have “predictable and sustainable” health security financing by 2030, with 90% able to mobilize an effective response to public health emergencies within 24 hours of detection. “This strategy is the fruit of extensive consultations with African health ministries and a range of other institutions, technical actors and partners across the continent. With their ongoing support and collaboration, it can help ensure that Africa is at the forefront of protecting the world against future pandemics,” Moeti said. Image Credits: WHO Africa. Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy 25/08/2022 John Heilprin Men queing for the monkeypox vaccine The global number of weekly new cases of monkeypox reported to the World Health Organization (WHO) declined by 21% for the first time since the infection that has been endemic to central and west Africa began to appear around the world earlier this year. Cases continued rising sharply in the Americas, however, in contrast to recent declines in European hotspots, WHO said in a report on Thursday showing 5,907 new monkeypox cases were reported in the past week, down from 7,477 new cases the previous week. That is a dramatic reversal from the 20% weekly increases in reported new monkeypox cases over the past month. More than 45,000 cases have been reported in 98 countries since late April. After four consecutive weeks of rising monkeypox cases globally, WHO says, the overall weekly decrease may reflect early signs of a declining infection rate in the European region but it will take time to see if that is sustained. Monkeypox cases in the Americas were still rising sharply, accounting for 60% of all cases compared to Europe’s 38% in the past month. WHO officials, meanwhile, say they are examining proposals to split scarce monkeypox vaccines doses to stretch supplies — a strategy adopted by the United States on August 10, in response to the global shortage of monkeypox vaccines. As part of that decision released earlier this month, US Health and Human Services Secretary Xavier Becerra issued a 564 determination, granting the US Food and Drug Administration the power to issue an emergency use authorization for vaccines. This gives the FDA permission to change the way the MVA-BN vaccine, made by Danish company Bavarian Nordic, is administered. Dr Kate O’Brien, WHO Director of Immunization, Vaccines and Biologicals, Group of monkeypox experts to examine the ‘fractional’ strategy Dr. Kate O’Brien, WHO’s Director of the Department of Immunization, Vaccines and Biologicals, said a strategic advisory group of experts will meet at the beginning of October to evaluate “some of these fractional dose issues” and the evidence for and against the strategy. Known as dose sparing, the U.S. fractional dose strategy splits the approved MVA-BN vaccine that is typically administered subcutaneously into five doses from each vaccine vial, and then delivers those “intradermally” just below the outermost layer of skin, known as the epidermis. “The strategy of what’s termed using fractional doses for vaccines is not a new strategy for vaccines,” O’Brien told a virtual press briefing on Thursday. “And we are looking really carefully at the evidence for the performance of these vaccines, these smallpox monkeypox vaccines,” she said, “to look at the equivalence or in fact, possibly the improved performance using fractional doses.” Along with extending the limited vaccine supplies, the procedure is supposed to provoke a more powerful immune reaction. But the strategy announced earlier by U.S. President Joe Biden’s administration is not going according to plan, Politico reports, with those administering the vaccine saying they’re getting only three or four doses out of each vial. Other media have reported the intradermal procedure’s more frequent use on men of color who have sought the vaccine recently, while white men who got in line first for the jab were able to get a full dose in the more proven, subcutaneous manner. Another complicating factor is the requirement for health workers to get extra training for the delicate intradermal procedure. The net result is speculation that if the outbreak continues to expand in the Americas, the US may be forced to fall back on another stockpile of ACAM2000 smallpox vaccines that are highly effective but can have dangerous side effects. Chronic Disease Focus of New Strategy 25/08/2022 Paul Adepoju 72nd WHO Regional Committee for Africa Ministers and government officials took on noncommunicable diseases, sickle cell disease, health system reforms in response to the COVID-19 pandemic, and measures to fight tuberculosis among children in Africa during their meeting of the 72nd WHO Regional Committee for Africa this week. In an effort to curb Africa’s chronic disease crisis, African health ministers adopted a new regional strategy to improve the diagnosis and treatment of severe forms of NCDs in district hospitals and first level referral facilities where care is often unavailable today. The new regional strategy for NCDs is known as PEN-PLUS. It addresses cardiovascular diseases, diabetes, cancer, and chronic lung disease that are responsible for almost 70% of all premature deaths worldwide – and a fast growing proportion of premature deaths in Africa. In addition, African nations face a special burden from sickle cell disease, which can cause severe anaemia and premature death if left untreated. In Africa, mortality from NCDs increased from 24% of total premature deaths in 2000 to more than 37% as of 2019. But many African countries lack adequate capacity to diagnosis and treat NCDs at the primary health care level, and most are only equipped to treat severe NCDs at tertiary health facilities, meaning big hospitals, located in large cities. The probability of premature death (age 30-70) from NCDs. This, WHO says, puts care beyond the reach of rural and poorer patients who typically rely on district hospitals and local health centres that lack the capacity and resources to effectively manage severe NCDs. Just 36% of countries have public hospitals stocked with basic NCD medications Knowing your blood pressure supports NCD prevention, diagnosis, and early treatment. PEN-PLUS, developed by WHO in collaboration with African health ministers over the past two years, offers a roadmap for countries to institute standardised programs to tackle chronic and severe NCDs by ensuring that essential medicines, technologies and diagnostics are available and accessible at district hospitals. It also encourages African governments to improve training and treatment protocols for chronic NCDs and to ensure that people at private hospitals can access services for severe NCDs Currently, just 36% of countries in the African region have public hospitals stocked with the medicines needed to treat NCDs, and private hospitals also must provide such services, according to WHO. In Liberia, Malawi, and Rwanda, where the strategy is already deployed, WHO says there has been a significant increase in the health and numbers of patients treated for severe chronic NCDs. In Africa, the most prevalent NCDs include Type 1 and 2 Diabetes, hypertension, heart disease and asthma, as well as sickle-cell disease, a genetic disorder, according to WHO data. Related to the drive against chronic NCDs, new campaign on sickle cell disease Health ministers also launched a campaign to tackle sickle cell disease, an inherited blood disorder that causes anaemia and can shorten lifespans, if left untreated. More than 66% of the 120 million people worldwide affected by sickle cell disease live in Africa, and approximately 1,000 African children are born with the disease every day. In 2019, the number of sickle cell disease deaths in the African region rose to 38,403 — a 26% increase from 2000. This rise in disease burden is attributed to a lack of investment in disease-fighting tools including prevention, early detection and proper care, according to WHO. The level of care has also been hampered by inadequate personnel and services, particularly at lower-level facilities. The campaign aims to shore up political will, engagement and financial resources for sickle cell disease prevention and control across the region. It draws on financial support and resources from the World Bank, U.S. Department of Health and Human Services, Novartis Foundation, Global Blood Therapeutics, and the Sickle in Africa consortium. Chief targets are schools, communities, health institutions and news media outlets. WHO notes that progress on controlling the disease in Africa is hindered by the absence of newborn screening programmes and surveillance, lack of accurate and reliable data on sickle cell disease and no data collection for sickle cell disease in most national surveys. “We need to shine the spotlight on this disease and help improve the quality of life of those living with it,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. Revamping Africa’s health systems in the wake of the pandemic Dr Matshidiso Moeti, WHO Regional Director for Africa, spoke at the session on childhood tuberculosis At the meeting, countries also agreed to institute other reforms in the region’s health systems in response to the COVID-19 pandemic, placing more emphasis on improved disease surveillance, as well as prevention and vaccination. “Domestic investment in health, including health research, has significant economic returns, while promoting resilience and sustainability; healthy populations translate to healthy economies,” Moeti said. Senegal’s Health Minister, Dr Marie Khemesse Ngom Ndiaye, said that due to the pandemic, her nation’s health system put more emphasis on resilience and investment. That “considerably strengthened disease prevention and management capacities,” she said. Fighting tuberculosis among children In terms of infectious diseases, long the major focus of African health programmes, more comprehensive and immediate measures are needed to fight tuberculosis among children in Africa, said representatives of WHO and the African Union, at the meeting. Their comments were echoed by the Stop TB Partnership and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). Currently, two-thirds of children with TB in WHO’s African Region fail to get diagnosed for the disease, WHO says, leading to an increased risk of rapid disease progression and mortality, especially in younger children. Among children under age five believed to have TB, just 32% in the African Region are adiagnosed and treated, the smallest proportion for that age group globally. Seventeen of the world’s 30 countries with the highest tuberculosis burden globally are in Africa, where 322,000 children and young adolescents under 15 years of age are affected. Minata Samate Cessouma, Commissioner for Health, African Union “There is an urgent need for innovative interventions to integrate tuberculosis diagnosis in nutrition programs to identify the disease in children quickly,” said Minata Samate Cessouma, African Union Commissioner for Health, Humanitarian Affairs and Social Development. “Children with tuberculosis are almost never spreading the disease and are always infected by an adult,” said Dr Lucica Ditiu, Executive Director of Stop TB Partnership, “so their suffering is a metric of our failures to diagnose and treat tuberculosis in children.” A child dies of tuberculosis somewhere in the world every two minutes, even though it is curable and preventable, she noted. . Tackling Malawi’s cholera outbreak At the meeting, WHO and UNICEF also announced joint plans to ramp up efforts to contain a cholera outbreak recently announced in Malawi. The outbreak has grown to 1,483 cases and 58 deaths in the northern and central regions, where it affects lakeshore communities and crowded, urban areas with insufficient water and sanitation facilities. The UN agencies say they will increase surveillance for early detection and management; improve the quality of case management at cholera treatment units; and provide critical supplies needed to manage cholera cases. They also plan to help improve water treatment, personal hygiene and household water storage. WHO’s Country Representative for Malawi, Dr Neema Rusibamayila Kimambo, stressed that every death from cholera is preventable. The UN health agency will offer additional support to Malawi’s Health Ministry to “help ensure that lives continue to be saved and a resilient health system is maintained during and beyond the current outbreak,” Kimambo said. UNICEF Malawi’s Representative, Rudolf Schwenk, said it’s urgent to help Malawi’s already overburdened public health services and health care delivery systems. “The good news is that we know the solutions,” Schwenk said. “We are on the ground providing humanitarian assistance in the affected districts, but we need more support to further scale up our response.” Image Credits: WHO, NCD Alliance, Twitter/Matshidiso Moeti, Twitter/WHO AFRO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Africa Has Not Received a Single Dose of Monkeypox Vaccine – Even Though Virus is Endemic and Often More Deadly 25/08/2022 Paul Adepoju WHO African Regional Director, Dr Matshidiso Moeti Another COVID rerun: WHO and Africa CDC officials lament the complete lack of access to monkeypox vaccines on the continent where the virus is endemic – as well as often more deadly than elsewhere. Meanwhile, Mozambique and Malawi have seen a total of six wild poliovirus cases, although WHO officials continue to insist that since the cases are imported, this won’t affect Africa’s status as ‘wild poliovirus free.’ The African continent has not yet received any vaccine doses to combat the monkeypox virus, African health officials said Thursday, including nations where the disease is endemic and often more deadly than the clades surfacing around the world. More monkeypox testing kits also are urgently needed to improve the continent’s emergency response, top health officials warned in back-to-back briefings. “We still don’t have access to enough test kits. We are working on increasing that. We still don’t have access to any vaccines and that is a big concern,” said Africa CDC’s acting director, Ahmed Ogwell Ouma. He told Health Policy Watch that the sluggish response and lack of support for African countries doesn’t match the urgency called for in WHO’s declaration of monkeypox as a global public health emergency (PHEIC). “We need a coordinated international response where more is being put on the table to support the control of monkeypox as an outbreak of international concern,” Ouma said, stressing that Africa CDC has been providing as much guidance and support as it can for training and surveillance. Tedros Adhanom Ghebreyesus, WHO Director General, had declared monkeypox a public health emergency in July. Though no vaccines are available, WHO African Regional Director, Dr Matshidiso Moeti, said testing capacity is at least expanding, but not fast enough. “We have finally been able to obtain some tests, supplies and we have distributed these among countries to enable more rapid testing and confirmation of cases of monkeypox that will enable the diagnosis and ensure actions are taken faster,” Moeti told journalists on the margins of the 72nd WHO Regional Committee for Africa. She said WHO is working through its headquarters “to try to seek supplies of vaccines so that these may be available as we start to see new cases and we can have the experience of using this vaccine in Africa”. The Danish manufacturing plant of Bavarian Nordic, sole producer of the only WHO-approved monkeypox vaccine, MVA-BN, has been closed for renovations since spring and is not expected to reopen until late 2022, leading to a dire shortage of global supplies. WHO has repeatedly said it is “discussing” with vaccine suppliers. However, according to a recent Health Policy Watch investigation, there are only about 16.4 million stockpiled MVA-BN doses available in bulk or finished form until the end of this year. Unless a license is awarded to another vaccine manufacturer, the world will have to make do with existing doses, most of which reside in the United States and a few other wealthy countries. See related story: Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy Wild poliovirus cases expanding slowly Meanwhile, at a special African Regional Committee session on polio, WHO, African health ministers and their partners said they would work together to tackle wild poliovirus, which is seeing a comeback in east Africa due to the spread of a virus strain imported from Pakistan. There have now been six cases reported in the African Region from the outbreak which began last year in Malawi and has now reached Mozambique, all apparently with links to an imported case from Pakistan. WHO said the “imported” cases should not impact Africa’s certification as wild poliovirus free, and that “any child paralyzed from polio is one too many.” There are now 6 #WPV1 cases in the African Region, imported from Pakistan to #Malawi 🇲🇼 & more recently, #Mozambique 🇲🇿 While these do not negatively impact #Africa's 🌍indigenous wild polio-free certification, any child paralysed from #polio is 1 too many. #RC72AFRO #EndPolio pic.twitter.com/SVAvQzXR0m — WHO African Region (@WHOAFRO) August 24, 2022 COVID lockdowns impacted polio response Polio vaccination campaign in Malawi 2022 COVID-19 negatively impacted Africa’s polio response, said Dr Chris Elias, Polio Oversight Board Chair of the Gates Foundation, speaking at the meeting. By putting polio experts at the service of the COVID-19 response, the virus had time to spread. “Dozens of campaigns delayed, not only for polio but for measles and other diseases,” he said. “We need good quality routine immunization, campaigns and surveillance. Unfortunately, COVID-19 presented a huge challenge that gave polio time and freedom to act quickly.” Regarding wild polio, Ouma told Health Policy Watch that any presence of wild polio anywhere in the world poses a huge risk to the achievement that Africa recorded in eradicating the disease. Ouma called for more efforts to boost polio vaccination across the continent. “We need to put in place surveillance mechanisms that will be able to respond quickly when a case is identified,” he said. “It is our position that polio is not a regional or a country problem. It remains a global problem.” New regional health security strategy calls for 90% rapid response capacity by 2030 WHO Regional Committee meeting for Africa At the WHO Regional Committee meeting, African health ministers adopted a new eight-year strategy to transform health security and emergency response. Called the Regional Strategy for Health Security and Emergencies 2022–2030, it is intended to reduce the health and socioeconomic impacts of public health emergencies. The strategy includes goals for strengthening mechanisms for partnerships and multisectoral collaboration; ensuring sustained and predictable investment; and repurposing resources from polio eradication and COVID-19 to support strategic investments in systems and tools for public health emergencies. The adoption of the strategy means WHO’s member nations have now agreed to reach 12 strategy targets by 2030 – all aimed at strengthening capacity to prevent, prepare for, detect and respond to health emergencies. The strategy calls for 80% of member nations to have “predictable and sustainable” health security financing by 2030, with 90% able to mobilize an effective response to public health emergencies within 24 hours of detection. “This strategy is the fruit of extensive consultations with African health ministries and a range of other institutions, technical actors and partners across the continent. With their ongoing support and collaboration, it can help ensure that Africa is at the forefront of protecting the world against future pandemics,” Moeti said. Image Credits: WHO Africa. Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy 25/08/2022 John Heilprin Men queing for the monkeypox vaccine The global number of weekly new cases of monkeypox reported to the World Health Organization (WHO) declined by 21% for the first time since the infection that has been endemic to central and west Africa began to appear around the world earlier this year. Cases continued rising sharply in the Americas, however, in contrast to recent declines in European hotspots, WHO said in a report on Thursday showing 5,907 new monkeypox cases were reported in the past week, down from 7,477 new cases the previous week. That is a dramatic reversal from the 20% weekly increases in reported new monkeypox cases over the past month. More than 45,000 cases have been reported in 98 countries since late April. After four consecutive weeks of rising monkeypox cases globally, WHO says, the overall weekly decrease may reflect early signs of a declining infection rate in the European region but it will take time to see if that is sustained. Monkeypox cases in the Americas were still rising sharply, accounting for 60% of all cases compared to Europe’s 38% in the past month. WHO officials, meanwhile, say they are examining proposals to split scarce monkeypox vaccines doses to stretch supplies — a strategy adopted by the United States on August 10, in response to the global shortage of monkeypox vaccines. As part of that decision released earlier this month, US Health and Human Services Secretary Xavier Becerra issued a 564 determination, granting the US Food and Drug Administration the power to issue an emergency use authorization for vaccines. This gives the FDA permission to change the way the MVA-BN vaccine, made by Danish company Bavarian Nordic, is administered. Dr Kate O’Brien, WHO Director of Immunization, Vaccines and Biologicals, Group of monkeypox experts to examine the ‘fractional’ strategy Dr. Kate O’Brien, WHO’s Director of the Department of Immunization, Vaccines and Biologicals, said a strategic advisory group of experts will meet at the beginning of October to evaluate “some of these fractional dose issues” and the evidence for and against the strategy. Known as dose sparing, the U.S. fractional dose strategy splits the approved MVA-BN vaccine that is typically administered subcutaneously into five doses from each vaccine vial, and then delivers those “intradermally” just below the outermost layer of skin, known as the epidermis. “The strategy of what’s termed using fractional doses for vaccines is not a new strategy for vaccines,” O’Brien told a virtual press briefing on Thursday. “And we are looking really carefully at the evidence for the performance of these vaccines, these smallpox monkeypox vaccines,” she said, “to look at the equivalence or in fact, possibly the improved performance using fractional doses.” Along with extending the limited vaccine supplies, the procedure is supposed to provoke a more powerful immune reaction. But the strategy announced earlier by U.S. President Joe Biden’s administration is not going according to plan, Politico reports, with those administering the vaccine saying they’re getting only three or four doses out of each vial. Other media have reported the intradermal procedure’s more frequent use on men of color who have sought the vaccine recently, while white men who got in line first for the jab were able to get a full dose in the more proven, subcutaneous manner. Another complicating factor is the requirement for health workers to get extra training for the delicate intradermal procedure. The net result is speculation that if the outbreak continues to expand in the Americas, the US may be forced to fall back on another stockpile of ACAM2000 smallpox vaccines that are highly effective but can have dangerous side effects. Chronic Disease Focus of New Strategy 25/08/2022 Paul Adepoju 72nd WHO Regional Committee for Africa Ministers and government officials took on noncommunicable diseases, sickle cell disease, health system reforms in response to the COVID-19 pandemic, and measures to fight tuberculosis among children in Africa during their meeting of the 72nd WHO Regional Committee for Africa this week. In an effort to curb Africa’s chronic disease crisis, African health ministers adopted a new regional strategy to improve the diagnosis and treatment of severe forms of NCDs in district hospitals and first level referral facilities where care is often unavailable today. The new regional strategy for NCDs is known as PEN-PLUS. It addresses cardiovascular diseases, diabetes, cancer, and chronic lung disease that are responsible for almost 70% of all premature deaths worldwide – and a fast growing proportion of premature deaths in Africa. In addition, African nations face a special burden from sickle cell disease, which can cause severe anaemia and premature death if left untreated. In Africa, mortality from NCDs increased from 24% of total premature deaths in 2000 to more than 37% as of 2019. But many African countries lack adequate capacity to diagnosis and treat NCDs at the primary health care level, and most are only equipped to treat severe NCDs at tertiary health facilities, meaning big hospitals, located in large cities. The probability of premature death (age 30-70) from NCDs. This, WHO says, puts care beyond the reach of rural and poorer patients who typically rely on district hospitals and local health centres that lack the capacity and resources to effectively manage severe NCDs. Just 36% of countries have public hospitals stocked with basic NCD medications Knowing your blood pressure supports NCD prevention, diagnosis, and early treatment. PEN-PLUS, developed by WHO in collaboration with African health ministers over the past two years, offers a roadmap for countries to institute standardised programs to tackle chronic and severe NCDs by ensuring that essential medicines, technologies and diagnostics are available and accessible at district hospitals. It also encourages African governments to improve training and treatment protocols for chronic NCDs and to ensure that people at private hospitals can access services for severe NCDs Currently, just 36% of countries in the African region have public hospitals stocked with the medicines needed to treat NCDs, and private hospitals also must provide such services, according to WHO. In Liberia, Malawi, and Rwanda, where the strategy is already deployed, WHO says there has been a significant increase in the health and numbers of patients treated for severe chronic NCDs. In Africa, the most prevalent NCDs include Type 1 and 2 Diabetes, hypertension, heart disease and asthma, as well as sickle-cell disease, a genetic disorder, according to WHO data. Related to the drive against chronic NCDs, new campaign on sickle cell disease Health ministers also launched a campaign to tackle sickle cell disease, an inherited blood disorder that causes anaemia and can shorten lifespans, if left untreated. More than 66% of the 120 million people worldwide affected by sickle cell disease live in Africa, and approximately 1,000 African children are born with the disease every day. In 2019, the number of sickle cell disease deaths in the African region rose to 38,403 — a 26% increase from 2000. This rise in disease burden is attributed to a lack of investment in disease-fighting tools including prevention, early detection and proper care, according to WHO. The level of care has also been hampered by inadequate personnel and services, particularly at lower-level facilities. The campaign aims to shore up political will, engagement and financial resources for sickle cell disease prevention and control across the region. It draws on financial support and resources from the World Bank, U.S. Department of Health and Human Services, Novartis Foundation, Global Blood Therapeutics, and the Sickle in Africa consortium. Chief targets are schools, communities, health institutions and news media outlets. WHO notes that progress on controlling the disease in Africa is hindered by the absence of newborn screening programmes and surveillance, lack of accurate and reliable data on sickle cell disease and no data collection for sickle cell disease in most national surveys. “We need to shine the spotlight on this disease and help improve the quality of life of those living with it,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. Revamping Africa’s health systems in the wake of the pandemic Dr Matshidiso Moeti, WHO Regional Director for Africa, spoke at the session on childhood tuberculosis At the meeting, countries also agreed to institute other reforms in the region’s health systems in response to the COVID-19 pandemic, placing more emphasis on improved disease surveillance, as well as prevention and vaccination. “Domestic investment in health, including health research, has significant economic returns, while promoting resilience and sustainability; healthy populations translate to healthy economies,” Moeti said. Senegal’s Health Minister, Dr Marie Khemesse Ngom Ndiaye, said that due to the pandemic, her nation’s health system put more emphasis on resilience and investment. That “considerably strengthened disease prevention and management capacities,” she said. Fighting tuberculosis among children In terms of infectious diseases, long the major focus of African health programmes, more comprehensive and immediate measures are needed to fight tuberculosis among children in Africa, said representatives of WHO and the African Union, at the meeting. Their comments were echoed by the Stop TB Partnership and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). Currently, two-thirds of children with TB in WHO’s African Region fail to get diagnosed for the disease, WHO says, leading to an increased risk of rapid disease progression and mortality, especially in younger children. Among children under age five believed to have TB, just 32% in the African Region are adiagnosed and treated, the smallest proportion for that age group globally. Seventeen of the world’s 30 countries with the highest tuberculosis burden globally are in Africa, where 322,000 children and young adolescents under 15 years of age are affected. Minata Samate Cessouma, Commissioner for Health, African Union “There is an urgent need for innovative interventions to integrate tuberculosis diagnosis in nutrition programs to identify the disease in children quickly,” said Minata Samate Cessouma, African Union Commissioner for Health, Humanitarian Affairs and Social Development. “Children with tuberculosis are almost never spreading the disease and are always infected by an adult,” said Dr Lucica Ditiu, Executive Director of Stop TB Partnership, “so their suffering is a metric of our failures to diagnose and treat tuberculosis in children.” A child dies of tuberculosis somewhere in the world every two minutes, even though it is curable and preventable, she noted. . Tackling Malawi’s cholera outbreak At the meeting, WHO and UNICEF also announced joint plans to ramp up efforts to contain a cholera outbreak recently announced in Malawi. The outbreak has grown to 1,483 cases and 58 deaths in the northern and central regions, where it affects lakeshore communities and crowded, urban areas with insufficient water and sanitation facilities. The UN agencies say they will increase surveillance for early detection and management; improve the quality of case management at cholera treatment units; and provide critical supplies needed to manage cholera cases. They also plan to help improve water treatment, personal hygiene and household water storage. WHO’s Country Representative for Malawi, Dr Neema Rusibamayila Kimambo, stressed that every death from cholera is preventable. The UN health agency will offer additional support to Malawi’s Health Ministry to “help ensure that lives continue to be saved and a resilient health system is maintained during and beyond the current outbreak,” Kimambo said. UNICEF Malawi’s Representative, Rudolf Schwenk, said it’s urgent to help Malawi’s already overburdened public health services and health care delivery systems. “The good news is that we know the solutions,” Schwenk said. “We are on the ground providing humanitarian assistance in the affected districts, but we need more support to further scale up our response.” Image Credits: WHO, NCD Alliance, Twitter/Matshidiso Moeti, Twitter/WHO AFRO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy 25/08/2022 John Heilprin Men queing for the monkeypox vaccine The global number of weekly new cases of monkeypox reported to the World Health Organization (WHO) declined by 21% for the first time since the infection that has been endemic to central and west Africa began to appear around the world earlier this year. Cases continued rising sharply in the Americas, however, in contrast to recent declines in European hotspots, WHO said in a report on Thursday showing 5,907 new monkeypox cases were reported in the past week, down from 7,477 new cases the previous week. That is a dramatic reversal from the 20% weekly increases in reported new monkeypox cases over the past month. More than 45,000 cases have been reported in 98 countries since late April. After four consecutive weeks of rising monkeypox cases globally, WHO says, the overall weekly decrease may reflect early signs of a declining infection rate in the European region but it will take time to see if that is sustained. Monkeypox cases in the Americas were still rising sharply, accounting for 60% of all cases compared to Europe’s 38% in the past month. WHO officials, meanwhile, say they are examining proposals to split scarce monkeypox vaccines doses to stretch supplies — a strategy adopted by the United States on August 10, in response to the global shortage of monkeypox vaccines. As part of that decision released earlier this month, US Health and Human Services Secretary Xavier Becerra issued a 564 determination, granting the US Food and Drug Administration the power to issue an emergency use authorization for vaccines. This gives the FDA permission to change the way the MVA-BN vaccine, made by Danish company Bavarian Nordic, is administered. Dr Kate O’Brien, WHO Director of Immunization, Vaccines and Biologicals, Group of monkeypox experts to examine the ‘fractional’ strategy Dr. Kate O’Brien, WHO’s Director of the Department of Immunization, Vaccines and Biologicals, said a strategic advisory group of experts will meet at the beginning of October to evaluate “some of these fractional dose issues” and the evidence for and against the strategy. Known as dose sparing, the U.S. fractional dose strategy splits the approved MVA-BN vaccine that is typically administered subcutaneously into five doses from each vaccine vial, and then delivers those “intradermally” just below the outermost layer of skin, known as the epidermis. “The strategy of what’s termed using fractional doses for vaccines is not a new strategy for vaccines,” O’Brien told a virtual press briefing on Thursday. “And we are looking really carefully at the evidence for the performance of these vaccines, these smallpox monkeypox vaccines,” she said, “to look at the equivalence or in fact, possibly the improved performance using fractional doses.” Along with extending the limited vaccine supplies, the procedure is supposed to provoke a more powerful immune reaction. But the strategy announced earlier by U.S. President Joe Biden’s administration is not going according to plan, Politico reports, with those administering the vaccine saying they’re getting only three or four doses out of each vial. Other media have reported the intradermal procedure’s more frequent use on men of color who have sought the vaccine recently, while white men who got in line first for the jab were able to get a full dose in the more proven, subcutaneous manner. Another complicating factor is the requirement for health workers to get extra training for the delicate intradermal procedure. The net result is speculation that if the outbreak continues to expand in the Americas, the US may be forced to fall back on another stockpile of ACAM2000 smallpox vaccines that are highly effective but can have dangerous side effects. Chronic Disease Focus of New Strategy 25/08/2022 Paul Adepoju 72nd WHO Regional Committee for Africa Ministers and government officials took on noncommunicable diseases, sickle cell disease, health system reforms in response to the COVID-19 pandemic, and measures to fight tuberculosis among children in Africa during their meeting of the 72nd WHO Regional Committee for Africa this week. In an effort to curb Africa’s chronic disease crisis, African health ministers adopted a new regional strategy to improve the diagnosis and treatment of severe forms of NCDs in district hospitals and first level referral facilities where care is often unavailable today. The new regional strategy for NCDs is known as PEN-PLUS. It addresses cardiovascular diseases, diabetes, cancer, and chronic lung disease that are responsible for almost 70% of all premature deaths worldwide – and a fast growing proportion of premature deaths in Africa. In addition, African nations face a special burden from sickle cell disease, which can cause severe anaemia and premature death if left untreated. In Africa, mortality from NCDs increased from 24% of total premature deaths in 2000 to more than 37% as of 2019. But many African countries lack adequate capacity to diagnosis and treat NCDs at the primary health care level, and most are only equipped to treat severe NCDs at tertiary health facilities, meaning big hospitals, located in large cities. The probability of premature death (age 30-70) from NCDs. This, WHO says, puts care beyond the reach of rural and poorer patients who typically rely on district hospitals and local health centres that lack the capacity and resources to effectively manage severe NCDs. Just 36% of countries have public hospitals stocked with basic NCD medications Knowing your blood pressure supports NCD prevention, diagnosis, and early treatment. PEN-PLUS, developed by WHO in collaboration with African health ministers over the past two years, offers a roadmap for countries to institute standardised programs to tackle chronic and severe NCDs by ensuring that essential medicines, technologies and diagnostics are available and accessible at district hospitals. It also encourages African governments to improve training and treatment protocols for chronic NCDs and to ensure that people at private hospitals can access services for severe NCDs Currently, just 36% of countries in the African region have public hospitals stocked with the medicines needed to treat NCDs, and private hospitals also must provide such services, according to WHO. In Liberia, Malawi, and Rwanda, where the strategy is already deployed, WHO says there has been a significant increase in the health and numbers of patients treated for severe chronic NCDs. In Africa, the most prevalent NCDs include Type 1 and 2 Diabetes, hypertension, heart disease and asthma, as well as sickle-cell disease, a genetic disorder, according to WHO data. Related to the drive against chronic NCDs, new campaign on sickle cell disease Health ministers also launched a campaign to tackle sickle cell disease, an inherited blood disorder that causes anaemia and can shorten lifespans, if left untreated. More than 66% of the 120 million people worldwide affected by sickle cell disease live in Africa, and approximately 1,000 African children are born with the disease every day. In 2019, the number of sickle cell disease deaths in the African region rose to 38,403 — a 26% increase from 2000. This rise in disease burden is attributed to a lack of investment in disease-fighting tools including prevention, early detection and proper care, according to WHO. The level of care has also been hampered by inadequate personnel and services, particularly at lower-level facilities. The campaign aims to shore up political will, engagement and financial resources for sickle cell disease prevention and control across the region. It draws on financial support and resources from the World Bank, U.S. Department of Health and Human Services, Novartis Foundation, Global Blood Therapeutics, and the Sickle in Africa consortium. Chief targets are schools, communities, health institutions and news media outlets. WHO notes that progress on controlling the disease in Africa is hindered by the absence of newborn screening programmes and surveillance, lack of accurate and reliable data on sickle cell disease and no data collection for sickle cell disease in most national surveys. “We need to shine the spotlight on this disease and help improve the quality of life of those living with it,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. Revamping Africa’s health systems in the wake of the pandemic Dr Matshidiso Moeti, WHO Regional Director for Africa, spoke at the session on childhood tuberculosis At the meeting, countries also agreed to institute other reforms in the region’s health systems in response to the COVID-19 pandemic, placing more emphasis on improved disease surveillance, as well as prevention and vaccination. “Domestic investment in health, including health research, has significant economic returns, while promoting resilience and sustainability; healthy populations translate to healthy economies,” Moeti said. Senegal’s Health Minister, Dr Marie Khemesse Ngom Ndiaye, said that due to the pandemic, her nation’s health system put more emphasis on resilience and investment. That “considerably strengthened disease prevention and management capacities,” she said. Fighting tuberculosis among children In terms of infectious diseases, long the major focus of African health programmes, more comprehensive and immediate measures are needed to fight tuberculosis among children in Africa, said representatives of WHO and the African Union, at the meeting. Their comments were echoed by the Stop TB Partnership and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). Currently, two-thirds of children with TB in WHO’s African Region fail to get diagnosed for the disease, WHO says, leading to an increased risk of rapid disease progression and mortality, especially in younger children. Among children under age five believed to have TB, just 32% in the African Region are adiagnosed and treated, the smallest proportion for that age group globally. Seventeen of the world’s 30 countries with the highest tuberculosis burden globally are in Africa, where 322,000 children and young adolescents under 15 years of age are affected. Minata Samate Cessouma, Commissioner for Health, African Union “There is an urgent need for innovative interventions to integrate tuberculosis diagnosis in nutrition programs to identify the disease in children quickly,” said Minata Samate Cessouma, African Union Commissioner for Health, Humanitarian Affairs and Social Development. “Children with tuberculosis are almost never spreading the disease and are always infected by an adult,” said Dr Lucica Ditiu, Executive Director of Stop TB Partnership, “so their suffering is a metric of our failures to diagnose and treat tuberculosis in children.” A child dies of tuberculosis somewhere in the world every two minutes, even though it is curable and preventable, she noted. . Tackling Malawi’s cholera outbreak At the meeting, WHO and UNICEF also announced joint plans to ramp up efforts to contain a cholera outbreak recently announced in Malawi. The outbreak has grown to 1,483 cases and 58 deaths in the northern and central regions, where it affects lakeshore communities and crowded, urban areas with insufficient water and sanitation facilities. The UN agencies say they will increase surveillance for early detection and management; improve the quality of case management at cholera treatment units; and provide critical supplies needed to manage cholera cases. They also plan to help improve water treatment, personal hygiene and household water storage. WHO’s Country Representative for Malawi, Dr Neema Rusibamayila Kimambo, stressed that every death from cholera is preventable. The UN health agency will offer additional support to Malawi’s Health Ministry to “help ensure that lives continue to be saved and a resilient health system is maintained during and beyond the current outbreak,” Kimambo said. UNICEF Malawi’s Representative, Rudolf Schwenk, said it’s urgent to help Malawi’s already overburdened public health services and health care delivery systems. “The good news is that we know the solutions,” Schwenk said. “We are on the ground providing humanitarian assistance in the affected districts, but we need more support to further scale up our response.” Image Credits: WHO, NCD Alliance, Twitter/Matshidiso Moeti, Twitter/WHO AFRO. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy
Chronic Disease Focus of New Strategy 25/08/2022 Paul Adepoju 72nd WHO Regional Committee for Africa Ministers and government officials took on noncommunicable diseases, sickle cell disease, health system reforms in response to the COVID-19 pandemic, and measures to fight tuberculosis among children in Africa during their meeting of the 72nd WHO Regional Committee for Africa this week. In an effort to curb Africa’s chronic disease crisis, African health ministers adopted a new regional strategy to improve the diagnosis and treatment of severe forms of NCDs in district hospitals and first level referral facilities where care is often unavailable today. The new regional strategy for NCDs is known as PEN-PLUS. It addresses cardiovascular diseases, diabetes, cancer, and chronic lung disease that are responsible for almost 70% of all premature deaths worldwide – and a fast growing proportion of premature deaths in Africa. In addition, African nations face a special burden from sickle cell disease, which can cause severe anaemia and premature death if left untreated. In Africa, mortality from NCDs increased from 24% of total premature deaths in 2000 to more than 37% as of 2019. But many African countries lack adequate capacity to diagnosis and treat NCDs at the primary health care level, and most are only equipped to treat severe NCDs at tertiary health facilities, meaning big hospitals, located in large cities. The probability of premature death (age 30-70) from NCDs. This, WHO says, puts care beyond the reach of rural and poorer patients who typically rely on district hospitals and local health centres that lack the capacity and resources to effectively manage severe NCDs. Just 36% of countries have public hospitals stocked with basic NCD medications Knowing your blood pressure supports NCD prevention, diagnosis, and early treatment. PEN-PLUS, developed by WHO in collaboration with African health ministers over the past two years, offers a roadmap for countries to institute standardised programs to tackle chronic and severe NCDs by ensuring that essential medicines, technologies and diagnostics are available and accessible at district hospitals. It also encourages African governments to improve training and treatment protocols for chronic NCDs and to ensure that people at private hospitals can access services for severe NCDs Currently, just 36% of countries in the African region have public hospitals stocked with the medicines needed to treat NCDs, and private hospitals also must provide such services, according to WHO. In Liberia, Malawi, and Rwanda, where the strategy is already deployed, WHO says there has been a significant increase in the health and numbers of patients treated for severe chronic NCDs. In Africa, the most prevalent NCDs include Type 1 and 2 Diabetes, hypertension, heart disease and asthma, as well as sickle-cell disease, a genetic disorder, according to WHO data. Related to the drive against chronic NCDs, new campaign on sickle cell disease Health ministers also launched a campaign to tackle sickle cell disease, an inherited blood disorder that causes anaemia and can shorten lifespans, if left untreated. More than 66% of the 120 million people worldwide affected by sickle cell disease live in Africa, and approximately 1,000 African children are born with the disease every day. In 2019, the number of sickle cell disease deaths in the African region rose to 38,403 — a 26% increase from 2000. This rise in disease burden is attributed to a lack of investment in disease-fighting tools including prevention, early detection and proper care, according to WHO. The level of care has also been hampered by inadequate personnel and services, particularly at lower-level facilities. The campaign aims to shore up political will, engagement and financial resources for sickle cell disease prevention and control across the region. It draws on financial support and resources from the World Bank, U.S. Department of Health and Human Services, Novartis Foundation, Global Blood Therapeutics, and the Sickle in Africa consortium. Chief targets are schools, communities, health institutions and news media outlets. WHO notes that progress on controlling the disease in Africa is hindered by the absence of newborn screening programmes and surveillance, lack of accurate and reliable data on sickle cell disease and no data collection for sickle cell disease in most national surveys. “We need to shine the spotlight on this disease and help improve the quality of life of those living with it,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. Revamping Africa’s health systems in the wake of the pandemic Dr Matshidiso Moeti, WHO Regional Director for Africa, spoke at the session on childhood tuberculosis At the meeting, countries also agreed to institute other reforms in the region’s health systems in response to the COVID-19 pandemic, placing more emphasis on improved disease surveillance, as well as prevention and vaccination. “Domestic investment in health, including health research, has significant economic returns, while promoting resilience and sustainability; healthy populations translate to healthy economies,” Moeti said. Senegal’s Health Minister, Dr Marie Khemesse Ngom Ndiaye, said that due to the pandemic, her nation’s health system put more emphasis on resilience and investment. That “considerably strengthened disease prevention and management capacities,” she said. Fighting tuberculosis among children In terms of infectious diseases, long the major focus of African health programmes, more comprehensive and immediate measures are needed to fight tuberculosis among children in Africa, said representatives of WHO and the African Union, at the meeting. Their comments were echoed by the Stop TB Partnership and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). Currently, two-thirds of children with TB in WHO’s African Region fail to get diagnosed for the disease, WHO says, leading to an increased risk of rapid disease progression and mortality, especially in younger children. Among children under age five believed to have TB, just 32% in the African Region are adiagnosed and treated, the smallest proportion for that age group globally. Seventeen of the world’s 30 countries with the highest tuberculosis burden globally are in Africa, where 322,000 children and young adolescents under 15 years of age are affected. Minata Samate Cessouma, Commissioner for Health, African Union “There is an urgent need for innovative interventions to integrate tuberculosis diagnosis in nutrition programs to identify the disease in children quickly,” said Minata Samate Cessouma, African Union Commissioner for Health, Humanitarian Affairs and Social Development. “Children with tuberculosis are almost never spreading the disease and are always infected by an adult,” said Dr Lucica Ditiu, Executive Director of Stop TB Partnership, “so their suffering is a metric of our failures to diagnose and treat tuberculosis in children.” A child dies of tuberculosis somewhere in the world every two minutes, even though it is curable and preventable, she noted. . Tackling Malawi’s cholera outbreak At the meeting, WHO and UNICEF also announced joint plans to ramp up efforts to contain a cholera outbreak recently announced in Malawi. The outbreak has grown to 1,483 cases and 58 deaths in the northern and central regions, where it affects lakeshore communities and crowded, urban areas with insufficient water and sanitation facilities. The UN agencies say they will increase surveillance for early detection and management; improve the quality of case management at cholera treatment units; and provide critical supplies needed to manage cholera cases. They also plan to help improve water treatment, personal hygiene and household water storage. WHO’s Country Representative for Malawi, Dr Neema Rusibamayila Kimambo, stressed that every death from cholera is preventable. The UN health agency will offer additional support to Malawi’s Health Ministry to “help ensure that lives continue to be saved and a resilient health system is maintained during and beyond the current outbreak,” Kimambo said. UNICEF Malawi’s Representative, Rudolf Schwenk, said it’s urgent to help Malawi’s already overburdened public health services and health care delivery systems. “The good news is that we know the solutions,” Schwenk said. “We are on the ground providing humanitarian assistance in the affected districts, but we need more support to further scale up our response.” Image Credits: WHO, NCD Alliance, Twitter/Matshidiso Moeti, Twitter/WHO AFRO. Posts navigation Older postsNewer posts