Global Fund Endorses Integrated Health Systems to Prepare for Pandemics 05/05/2022 Paul Adepoju Francoise Vanni, Director of External Relations at The Global Fund The Global Fund intends to further prioritise integrated health systems and boost people-centred approaches, it was announced at the Geneva Health Forum on Wednesday. Although urgent improvements in health and community systems only made up about 14% of its $3.4 billion COVID-19 budget, the organisation expressed strong commitment to these themes in future. New priorities emerge According to the World Health Organization (WHO), “integrated health systems” is a humanistic method of organising and managing health services that focuses on delivering to people the care that they need, in ways that are prompt, effective, user-friendly, and cost-effective. Speaking at the Geneva Health Forum on Wednesday, Francoise Vanni, Director of External Relations at The Global Fund, noted that this new strategy reinforces The Global Fund’s mission, as the needs of people take centre-stage more than ever. “We will be focusing and incorporating this on things like supply chains, digital health information systems, digital health, community health workers and other key areas of health systems,” Vanni said. She noted that integrated health systems have become necessary considering the growing challenges in accessing healthcare and burgeoning health issues affecting the population. Change necessitated by COVID-19 The COVID-19 pandemic has proven a major eye-opener for the global health financing landscape, setting new standards and models for successful programme implementation. It is therefore no wonder that the Global Fund, one of the largest global health financing and partnership organisations, has shifted its focus to integrated health systems as part of its aim to invest additional resources in fighting epidemics. To date, the Fund’s COVID-19 Response Mechanism (C19RM) has supported countries to mitigate the impact of the pandemic on more routine HIV, TB and malaria programmes. It is largely because of its partnerships with communities and local stakeholders, Vanni says, that The Global Fund was able to respond so quickly to the COVID-19 pandemic. “These frontline responders were key”, she added, and were part of the inspiration to reboot the organisation’s future priorities. Increasing preparation and prevention budgets Out of The Global Fund’s Total COVID-19 approved 2021 funding of nearly $3.4 billion, nearly $472 million was spent on urgent improvements in health and community systems. This represented less than 14% of the total amount but Vanni revealed this would significantly improve in preparation for future pandemics. Stopping Human Diseases Often Starts With Animals 05/05/2022 Svĕt Lustig Vijay Vaccinating dogs against rabies prevents the disease in people. As many neglected tropical diseases (NTDs) spread via vectors like ticks or domestic mammals, human-centric prevention programmes alone are inadequate – and adopting more holistic approaches such as the routine vaccination of animals is logical. This was the key message conveyed by health and policy experts at a panel discussion, “For a new approach to NTDs based on One Health”, at the Geneva Health Forum on Wednesday. ‘One Health’ is a perspective that acknowledges the interconnectedness of human health with animals, microorganisms and the wider environment. A solution aiming at more lasting, sustainable health development, it moves beyond treating disease in humans to tackle the root causes of the spread of diseases. Dirk Engels, former NTD director at the World Health Organization (WHO) and a member of the Swiss Alliance Against Neglected Tropical Diseases (SANTD), highlighted the potential of One Health approaches to eradicate diseases in animal reservoirs, reduce the population growth of infected animals, and consequently save more human lives. Rabies, with its high mortality rate of 80% and explicit animal-to-human transmission, is particularly amenable to holistic control methods. As the WHO’s Bernadette Abela-Ridder remarked, rabies control is often restricted to post-exposure prophylaxis in humans, despite the potential of mass vaccination in dogs to curb rabies deaths quickly, cheaply and effectively – as 99% of rabies cases are dog-mediated. “We know vaccinating dogs prevents rabies,” she said – yet outside the South American continent, where several countries have successfully brought down rabies deaths through mass dog vaccination campaigns, “nobody actually does it”. “If you want to stop rabies in humans very quickly, you vaccinate the dogs,” she added. “Dogs are part of the patchwork of our society, yet nobody is responsible for them: who will take care of dogs and pay for costs of vaccination?” Not only would this One Health-inspired strategy address the root cause of the disease, it would also circumvent the hassles of current human prophylaxis, which involves a combined multi-dose treatment administered over two weeks. NTDs are a group of 20 preventable and treatable diseases that disproportionately affect marginalized populations in Africa, Latin America, and Asia Developing ‘bite-sized’ strategies For novel strategies against NTDs to persist, countries need to buy into the value of the approach. Indeed, a barrier to embracing One Health is its breadth, noted Abela-Ridder, being a concept that encompasses virtually any component of our environment. This can understandably feel overwhelming for governments. However, segmenting such preventive strategies into “bite-sized” pieces will make them far more manageable to implement. In the case of rabies control, for example, this might look like identifying one high-priority target vector, and one single intervention mode – that is, dogs and vaccination. This, together with strong and motivated leadership at the national level, is the key for holistic approaches to function as effectively and sustainably as possible. Encouragingly, some countries have already set up dedicated supra-ministerial units for cross-cutting action on One Health. For successful provincial, district and community level implementation, the best place to start is building on existing intersectoral collaboration. To achieve this, José María Gutiérrez, a One Health expert at the University of Costa Rica, raised the importance of cooperating with local administrators and parliamentarians on novel NTD prevention. They “have the key” to the intersectoral resources that will cement local programmes, even if the changes start by being “small, but incremental”. Galvanising the private sector Meanwhile, in another GHF session on One Health, speakers acknowledged that the private sector could play an important role in operationalising this approach. The speakers stressed that, in a resource-constrained world, every sector intersects with another in a web rather than a linear value chain – and more companies are starting to understand this inter-dependency. Uta Jungermann of the World Business Council For Sustainable Development said one of the entry points for private sector involvement was in improving health systems: “There’s a question of how to exchange the know-how, innovative capabilities, stakeholder networks, and what unique expertise businesses can bring to the table and identifying health system resilience gaps and then developing strategies to close them,” she said. Ilona Kickbusch of the WHO Council on the Economics of Health for All, called for the private sector to be “activated”. “I think there are good opportunities,” said Kickbusch. “There are so-called CEO roundtables. There are pharmaceutical associations. But they talk among themselves. And then here we talk a bit among ourselves. So this dialogue needs to happen and I know that the World Economic Forum is doing a great job in bringing this together, but we need more, especially for the One Health concept”. * Additional reporting by Shadi Khan Saif. Image Credits: Daniel Stewart, Our World in Data. Breeding Superbugs – Veterinary Drugs, More than Human Ones, Drive AMR 04/05/2022 Elaine Ruth Fletcher Drug overuse in livestock is driving antimicrobial resistance. The main hotspots are in Asia, with Africa’s use of antibiotics far behind. Animals, not humans are the largest consumers of antimicrobial drugs – and thus the leading factor driving antimicrobial resistance. But WHO and other UN actors are still dancing around the ‘cattle, chickens and pigs’ in the room. And member states aren’t keen to track animal antibiotic use trends – even at the cost of future health risks. More than 73% of all antimicrobial drugs sold in the world are used in animals. And mores than human uses, the booming veterinary drug market is most probably the leading factor in growing antimicrobial resistance that is rendering common antibiotics and antiviral agents progressively more useless – also driving pandemic risks. Even so, there is no systematic global tracking of drugs sold and used on animals as well as humans by the three big UN and multilateral organizations responsible, including the World Organization for Animal Health (OIE), the World Health Organization (WHO) and the Food and Agriculture Organization (FAO). And despite pledges to tackle pandemic risks and AMR together, it’s unlikely such surveillance will begin anytime soon. Thomas Van Boeckel, of Zurich ETH, explains how soaring animal consumption of antibiotics, and human consumption of industrial meat, are the leading factors driving AMR Meanwhile, around the world, veterinarians are making huge profits from selling animal drugs to farmers and thus driving their swelling use – particularly in India, China and other parts of Asia, said Thomas Van Boeckel of ETH Zurich at a seminar on Achieving Sustainable Antibiotic Access using a One Health Approach, at the Geneva Health Forum, on Tuesday. “In 2017, about three quarters of all the antibiotics that we sold on this planet were used in animals, mostly to help them grow faster and to prevent infection,” Van Boeckel said. “So in the context of development, if you see the emergence of new resistant genes, it’s like playing the lottery and losing, well, you have more chances to lose the [AMR] lottery in animals. And once they’re there [drug resistant microbes] they can eventually result in untreatable infections in humans if they’re transmitted.” LMIC livestock – the ticking AMR time bomb no one is tracking Mapping of AMR hotspots Van Boeckel and his interdisciplinary team, comprised of food scientists, ecologists, pharmacists and veterinarians, as well as disease modelers and epidemiologists from Brazil, China, and India as well as Europe and the United States, have mapped hundreds of studies to come up with an initial ‘heat map’ of the world’s AMR hotspots. They are constantly developing that knowledge base on an open data site, Resistancebank.org. The group’s findings combine exhaustive data from animal drug sales, with reference to over 100 different types of antibiotics reported by countries – and mapped against livestock densities of cattle, chickens, and pigs. They then compared that data with hundreds of local studies and reports of antimicrobial resistance, referring to major indicator bacteria, like E coli, Staphylococcus, Campylobacter, and salmonella. Combined together, they yield a profile of the leading AMR hotspots across the world: The resulting “heat maps” demonstrate a clear correlation between drug overuse and drug resistance by mutating pathogens. Their research relies upon hundreds of local studies on farms, markets and slaughterhouses, routinely done “by academics and veterinarians and microbiologists, who go out and look at what’s around their institute, to identify new resistant [pathogen] genes – something microbiologists like to do very much. But such studies typically are scattered across the literature and published in small journals that “hardly get any exposure.” Brought together, however, they provide powerful insights. “One of the cool things is that you can zoom in to see where the problem is inside a country as well as the main regions identified as having high resistance,” says Van Boeckel. Not surprisingly, most of the AMR hotspots are largely in the same places that have the largest use of antibiotics, per kilogram per meat, such as South India, South and Northeast China, and some parts of Latin America. Trends in Asia are particularly worrisome since antimicrobial use for livestock and poultry is slated to grow even more across Asia in this decade, and represent two-thirds of the world’s veterinary consumption of antimicrobials by 2030. Regions by region, trends in animal antimicrobial sales in LMICs largely correspond with growth in AMR hotspots. By 2030, Asia will consume two-third’s of the world’s veterinary antibiotics China is the largest consumer of antibiotics in animals. “In 2017… the world used around 90,000 tons of antimicrobials in animals – at the time China was by far the largest consumer of antibiotics in animals,” reported Van Boeckel. “By 2030, Asia will use more than two-thirds of the veterinary antibiotics in the world – while Africa will use only 6%. So arguably, Africa has little responsibility for the state of resistance and AMR today,” he said. “And in Europe and North America, we’ve had fairly high levels of antibiotic use over the last 20 years, but they are slowly declining, thanks to increased awareness about the need for stewardship in our farms.” With the notable exception of Brazil, most of the 40 countries reporting systematically on veterinary antimicrobial use are major meat exporters – “which likely want to keep a good image in the securities export market,” said Van Boeckel. But among countries producing meat for mostly domestic consumption systematic national reporting is more sparse – and the researchers had to gather their data from a hybrid of commercial and research study sources. Low- and middle-income countries failing to track AMR trends But perhaps even more significantly, low- and middle-income countries are generally not tracking trends in AMR trends in livestock in any systematic manner, Van Boeckel pointed out. Such surveillance is critical since the first sign of superbugs is likely to occur in and around animals, not people, given their role of animals as the world’s biggest antibiotic consumers. “In Europe, we have systematic surveillance systems with a compelling metric for AMR for two to three decades, and we report this information at the national level,” Van Boeckel said. That surveillance eventually helped drive a wave of awareness and ultimately a European Union ban on the use of health- promoting antibiotics in 2006. Now, as the bulk of veterinary antibiotic use has shifted to low and middle income countries, “that’s really where the attention should be in the future.” However, out of 135 low and middle income countries that the team explored, only one, Colombia, had a government-run surveillance system that generates public data. Pigs and chickens incubating more superbugs than cattle Superbugs increased almost 200% more in pigs and chickens than cattle. The team also has mapped trends by species. And that shows resistant pathogens increasing at a faster rate amongst pigs and chickens – whereas the prevalence of AMR amongst cattle is rising more moderately. “Our goal for the next step is going to be to use that information to produce a global map of resistance levels across limited income countries. So concretely, we want to move from content information to continue continuous coverage of resistance level to do what some would call a heat map,” he said. Meat-heavier diets and exports in Asia and Americas driving trends Meat-heavy diets fuel AMR. One key factor driving trends are the financial incentives offered by animal health companies to veterinarians – which reap a hefty profit from selling more and more drugs to farmers with little knowledge of the products. They do so with minimal interference from governments, not only in Asia but also in some developed countries too, Van Boeckel says. Another is the growing, and seemingly unquenchable hunger for more animal products in emerging economies as well as developed countries, which is the more fundamental driver of soaring livestock production, which in turn leads to more veterinary antibiotic use – and therefore AMR. Van Boeckel compared the daily, per capita consumption of meat in Mali, which averages less than 27 grams a day, to that of China, at 136 grams, and Australia, at a whopping 260 grams. Those contrasts are captured in a series of photos that reflect a family’s typical weekly household food consumption across the three continents. The photos reflect not only more meat, but also heavier consumption of ultra-processed foods and sugary drinks in emerging economies and developed ones – dietary trends that are simultaneously harming people’s health, the planet – and driving AMR. Policy solutions – a user fee for veterinary antibiotics? Targets to reduce antimicrobial use include regulation and meat reduction. Along with better tracking, global agencies need to be thinking about the kinds of policy solutions that would really bring the AMR under control, he stresses. His team mapped out several key possibilities to proejct their results: Regulatory action to reduce the use of antibiotics in livestock worldwide to 50 milligrams per kilogram of meat produced, roughly the European median, would reduce veterinary antibiotic use by 64%; Regulatory action among only OECD countries and China to do the same – would lead to an almost equally sharp reduction in veterinary antibiotics of 60%; Consumer action to reduce meat consumption to just 60 grams a day – “about the equivalent of one Big Mac” – also would reduce antibiotic use in livestock by some 66%; “In other words, maybe we shouldn’t undermine the development of certain countries through livestock farming, as long as we have the OECD and China in the deal. We can make a significant difference,” says Van Boeckel. Yet another solution is to impose stiffer taxes, or user fees on antibiotics, which would in turn curb the incentives that now exist to farmers to purchase them at all – particularly when alternatives exist such as better sanitation practices, including more vaccination against preventible diseases. In UN – One Health rhetoric but little real action Jorge Matheu Alvarez of WHO discusses challenges of more harmonized surveillance of human and animal antimicrobial use and AMR trends. Such systematic global tracking of human and veterinary drug sales, and AMR trends should in fact be done by governments, and collected by the UN and its partners, Van Boeckel asserts. But data on antimicrobial drug sales for human and animal use – and AMR trends in both populations – is not collated and reported systematically by the major UN and multilateral organizations responsible. WHO, through its Global Antimicrobial Resistance and Surveillance System (GLASS), is trying improve surveillance of AMR in association with drugs used for human health, said Jorge Matheu Alvarez of WHO, who also appeared at the session. But tracking antibiotic consumption in animals or AMR in livestock isn’t really WHO’s job, he said. OIE tracks some data on veterinary use of antimicrobials, but that data remains very partial, with only 133 countries reporting to OIE at all. Many countries that do report lack data on actual quantities of antibiotics used or sold. In addition, the data is not transparent. Some 71% of countries that do report to OIE don’t make their data public. And therefore OIE’s data is presented only in terms of aggregate global quantities, rather by region or country. No data on AMR trends in animals is published by the member state organization. WHO, FAO, OIE and the World Animal Health Organization have recently launched a new One Health collaboration together with the UN Environment Programme. Both FAO and OIE have included antimicrobial stewardship in the animal sector in their global action plans, Alvarez noted saying: “we are making progress in the collaboration in these One Health areas.” The catalogue of #climate disasters is growing. With each page turned, the impacts on people, animals & environment are more severe. @UNEP is proud to have joined the Quadripartite Alliance on #OneHealth. Science ➕ collaboration ➕ action 🟰 success. #GHF2022 pic.twitter.com/BHWXeV2U9Y — Inger Andersen (@andersen_inger) May 4, 2022 Alvarez says FAO, OIE and WHO will soon begin placing the surveillance data they do collect on a single platform, called the Tripartite Integrated Surveillance System on AMR (TISSA). “Here we will host the One Health information collected by the different organizations on AMR, antimicrobial consumption and use of antimicrobials,” he told Health Policy Watch. But animal and human data thus collected won’t likely be reported and presented in a comparable manner for some time to come, he admits, because of different data collection methods. Member states are highly resistant to reporting on their antibiotic drug sales and consumption – because they see it has implications for their global trade in meat, the panelists also noted. “We need to be clearer and provide more guidance in the animal sector,” Alvarez told the panel session. The session was hosted by the Global Antibiotic R&D Partnership (GARDP), which aims to acccelerate the development of new antibiotic treatments for drug resistant infections and also attended by the Foundation for Innovative New Diagnostics (FIND), which is ramping up the development and deployment of infection tests to reduce unecessary use of antibiotics in humans. Says Van Boeckel, “I’ve been in this field for about ten years, and I thought something would have happened by now. I’ve been expecting a globally harmonized AMR surveillance system by the FAO and OIE that reports that data. And I can only ask the question, why hasn’t that happened? Until those agencies, and the member states that control them, rise to the challenge, surveillance of critical AMR trends will likely remain the purview of research teams such as Van Boeckel’s. But meanwhile, the neglect of animals’ antibiotic consumption remains just another pandemic waiting to happen, he warns: “If we want to inform policy in the short term, we need an alternative systematic surveillance system for LMICs, where we’ve seen that conditions may unfortunately be the worst, when it comes to development of resistance, in the coming decades.” –Updated on 5 May, 2022 Image Credits: Thomas Van Boekel, Health Policy Watch , Van Boeckel et al, ETH Zurich, Tiseo et al 2020, Antibiotics . What Worked to Reach Marginalised Communities During COVID-19? 04/05/2022 Aishwarya Tendolkar NorWest co-op offers community-based programmes to indigenous communities Protecting indigenous communities in Canada and refugees in central and Eastern Europe from COVID-19 requires community-based approaches that could be applied in other healthcare crises. This emerged from field actors who shared their experiences and lessons at the Geneva Health Forum on Tuesday. In Canada’s Manitoba province, indigenous communities were mistrustful of mass COVID-19 vaccinations, but reaching them was a priority for NorWest Co-op Community Health Centre. NorWest’s Kristin Bergen and Michelle Kirkbride identified the indigenous and ethnic communities they wanted to reach and then enlisted support from their leaders. They also stressed that to reach those who were most isolated and vulnerable, it was essential to help with things like booking clinic appointments and transport. In addition, Bergen and Kirkbridge stressed the importance of offering mental health support for the isolated communities that become less reachable in pandemics and during Canadian winters. NorWest had a trained trauma team to help people to cope with pandemic stress, and empowered community members to talk about mental health to reduce stigma and build trust. NorWest also provided the community with effective information on COVID-19 and vaccines. Mental health support The need for psychosocial support and mental health support was also highlighted by the International Federation of Red Cross and Red Crescent Societies’ (IFRC) Sherry Joseph. Online communication helped IFRC reach out to many communities and refugees in central and Eastern Europe, while a network of volunteers assisted IFRC teams in Hungary, Romania, Czechia and Ukraine to ensure that refugees also received vaccinations and medical help. Sherry added that IFRC is scaling up first aid skills in remote populations, ensuring continuity of vaccination programs, developing mental health programs, and making sure their workers and volunteers are equipped to deal with individuals who have escaped from traumatic zones. “We have learnt to smile with our eyes,” he said since masks hide them and smiling is a key way of extending warmth and support to the communities that IFRC caters to. Joseph added that IFRC is setting up mental health hotlines, especially for the refugees from Ukraine. Image Credits: NorWest Co-op. How to Protect the Environment and be Profitable at the Same Time 04/05/2022 Raisa Santos Environment-friendly approaches: Health experts have called on global leaders to tackle environmental issues affecting health and health systems. It is possible for industry to implement environmentally friendly approaches that are also profitable, Bertrand Piccard, chair of the Solar Impulse Foundation, told the Geneva Health Forum. “I have been working on identifying solutions that can reconcile ecology and economy that means to protect the environment and at the same time create jobs and be economically viable for the industry, the economy and the financial world,” said Piccard. The Swiss organisation, Solar Impulse Foundation, works to identify sustainable, clean and profitable solutions for climate action and offers political and industry leaders a guide on implementing these solutions on a large scale. Replace, reduce and recycle Some of its concepts include the solar-powered automatic irrigation system, electric cabinet with recycled batteries and the circular high-quality furniture made from recycled materials. Piccard pointed out that are new business opportunities to be grabbed by leaders in the industry who can develop efficient solutions to protect the environment: “It’s clear that the environment has a huge link to (public) health…. efficient solutions improve the health of everybody.” To back this argument, he presented the example of a French start-up that captures the heat from chimneys of factories for recycling to reduce the energy bill of the same enterprise by 20%. “It produces less carbon, less energy, and it’s a business opportunity that expands and creates jobs,” said Piccard. “This is what I call qualitative growth. You develop the economy by replacing what is polluting with what is protecting the environment, so you can reconcile ecology and economy.” Piccard also noted the importance of both sides i.e. businesses and environmentalists striving hand-in-hand towards this goal. “You need the ‘green activists’ to move forward to push the politicians and you need the industry to produce the solutions. That will help us live in a more efficient way and be more environmentally friendly.” Climate neutrality ambitions Piccard praised the European Commission’s recent announcement that 100 European Union (EU) cities and 12 non-EU cities are participating in a program to become climate neutral by 2030. Bertrand Piccard, chair of the Solar Impulse Foundation. According to the EU plan, the 112 participating cities – in which roughly 75 million people live – will prepare plans and contracts to set out action and investment plans in order to achieve climate neutrality in the coming eight years. The ultimate goal of climate neutrality, as defined by the United Nations (UN), is to achieve zero greenhouse gas emissions by balancing the emissions so they are equal (or less than) the emissions that get removed through the planet’s natural absorption. Piccard stated that problems brought about by pollution and greenhouse gases should be tackled incrementally to bring cities closer to becoming climate neutral. “You cannot take the big problems and find solutions. It doesn’t work because most of the problems are not identified correctly so you need to do the opposite. You need to go through the solutions and look at which solution can be implemented where and each time you reduce a little bit of CO2, a little bit of inefficiency, a little bit of pollution, but altogether you can solve the problem.” Protecting the environment requires everyone to rethink the phrase ‘changing behaviours’ and use the word ‘modernise’ instead when addressing climate change in low- and middle-income countries, he added. “You have to modernise old infrastructures. You have to modernise all energy sources. You have to modernise the way to construct the buildings, you have to modernise mobility.” When it comes to changing behaviours, Piccard said that few people made minimal changes with minimal impact, with a majority refusing to renounce their habits. “You will say yes, of course, I will renounce a little bit. I will take the aeroplane only three times a week instead of four. But it doesn’t change the world.” Speaking specifically about the stance of the developing countries on the contested issue of emissions, Piccard added: “We have to go from [a narrative of saying] protection of the environment is threatening our lifestyles, [which is] expensive and boring, to a narrative where protection of the environment is exciting, profitable, creative, interesting, and modernising.” The developing countries should use new technologies, said Piccard. “They want to reach our (developed world) levels of development. They want to be like Europe and North America. [In order to modernise] they can use efficient systems, use renewable energies in order to have local economic development.” “It’s a question of narrative, because we need to take people with us otherwise they will not follow, they will resist.” As the developed and the developing countries continue to have contested viewpoints on this matter, the latest UN report suggests the emissions from fossil fuel combustion in the three regions of Asia and the Pacific, Africa and Latin America grew by 26% over the past decade, as compared to 260% growth in the prior two decades. The fossil fuel combustion emissions of developed countries shrank by about 10% over both of those periods. Europe Must take advantage of ‘COVID-19 Ceasefire’ to Prepare for Next Wave, says WHO’s Kluge 04/05/2022 Maayan Hoffman Dr Hans Kluge, WHO Regional Director for Europe. The European Region and COVID-19 are in a “kind of ceasefire,” according to World Health Organization’s (WHO) Regional Director for Europe, Dr Hans Kluge. It is now up to the region’s 53 member states to take advantage of this window to prepare for the next fight, he said. “It is quiet and we have to take advantage of this, because obviously the fact that the virus spread so fast and so many people have been infected means that a new mutant is already here,” Kluge said Wednesday during an interview at the Geneva Health Forum. “The virus has surprised us many times.” Kluge, who started his role on 1 February 2020 just as the pandemic began, spoke via video link from his office in Denmark. There have been at least 191 million reported COVID-19 infections in Europe and more than 2.2 million deaths since the start of the pandemic two years ago, according to Reuters COVID tracker. The average new daily cases in the region have dropped from a recent peak of 1.7 million in February to fewer than 230,000 in recent days. However, Germany leads the world in the daily average number of new cases, Reuters said, accounting for one in every six infections reported worldwide. Moreover, as Kluge noted, it is not possible to track how fast the virus is spreading in Ukraine as a result of the Russian invasion. Reuters COVID-19 tracker shows a decline in average daily cases across the European region. He urged the region to implement a pan-European system that could pick up on any threat from antimicrobial resistance, a dangerous virus or climate change “very quickly – we need an alert system.” And he said that the region needs its political systems to take action when there is such an alert. Kluge also said that the most important ingredient in any COVID-19 toolkit must be equal access to vaccines and affordable antivirals. “The best way to combat infectious disease is a combination of prevention and treatment: vaccines and medicines,” according to Kluge. The comments were especially meaningful on Wednesday, a day after the World Trade Organization’s TRIPS Council announced that it will finally discuss a compromise proposal on a waiver of intellectual property rights on COVID-19 vaccines. However, antivirals are not included in the compromise. While Pfizer and Merck – the companies with effective COVID-19 antivirals – have entered into voluntary licensing agreements with the Medicine Patents Pool to enable generic companies to make the drugs for certain low-income countries, the agreements and countries the deal applies to are restricted. Kluge offered a four-step COVID-19 exit strategy for the region: 1. Implement a plan for protecting the most vulnerable “We may at some point have to shift from mass action to more routine vaccination of just the vulnerable people,” Kluge said. 2. Vaccinate and boost “We will need to do whatever it takes to vaccinate the unvaccinated and boost the vaccinated,” he added. 3. Beef up surveillance “We need a system that is able to pick up new COVID-19 variants very quickly so that national lockdowns can be avoided,” said Kluge. 4. Deal with the backlog of patients with other diseases Kluge noted that the healthcare sector is also facing a shadow pandemic – dealing with the backlog of patients who are suffering due to postponement of elective surgeries, cancer and other screenings, mental health issues and long COVID. He said around 20% of people infected with the virus continue to experience some symptoms even months later. “We need more knowledge about long COVID,” Kluge stressed. But he admitted that rolling out this exit strategy could be “tricky,” as a result of complacency by the public and political leaders whose memories are “very short.” “Heads of states and governments need to make the investment in health and health systems that is key for a resilient society and preparedness,” said Kluge. “Health is not everything, but without health, there is nothing.” Image Credits: WHO, Screenshot. Four COVID-19 Lessons and How to Make Humanity More Resilient 04/05/2022 Maayan Hoffman Tatiana Valovaya, Director-General of the United Nations Office at Genevai during World Humanitarian Day. 19 August 2019. The COVID-19 pandemic blindsided most of the world as it swept from China across the world at an unprecedent pace, infecting, ultimately killing millions of people. But more than two years later, there are some lessons that can be learned, said Tatiana Valovaya, director-general of the United Nations in Geneva on Tuesday evening. At the Opening Ceremony for the Geneva Health Forum, Valovaya delivered the four key takeaways from the pandemic for public health professionals. Her colleague, likewise, offered “concerned actions” that could be taken in at least five key areas to make humanity more resilient to future health threats. In total, nine people addressed attendees during the opening ceremony, which drew over 1000 people and is the first major global health event hosted in Geneva since the pandemic began. The speakers included Valovaya; Antoine Geissbuhler and Véronique Maye, Geneva Health Forum’s co-presidents; Bertrand Levrat, CEO of the University Hospitals of Geneva; Mauro Poggia, minister of health, population and security for the state of Geneva; Jürg Lauber, Swiss ambassador and permanent representative to the Office of the United Nations in Geneva; Zsuzsanna Jakab, deputy director-general of the World Health Organization; Monique Eloit, director-general of the World Organisation for Animal Health (OIE); and Peter Maurer, president of the International Committee of the Red Cross. What lessons were learned? 1 – We live in a globalized world and are all interconnected and interdependent. “We can only be as safe or as healthy as all other people around that world are,” said Valovaya. “That means we have to work in solidarity.” 2 – We can do a lot to improve environmental degradation. This notion was supported by Eloit in her keynote address. “I will insist on how it is crucial to transform our relationship with the environment,” she said. “We need to move from response to prevention.” 3 – We have to fight inequality. “During the pandemic, we saw that those who were very vulnerable were the first to suffer,” noted Valovaya. “We saw this with access to healthcare, vaccines and even clean water.” 4 – All of the challenges that humanity is facing are global. “Global challenges need global solutions,” she said. “We need multilateralism that is inclusive and integrated. Only together can we find solutions.” While the world continues to tackle COVID-19, something which Eloit stressed is “still ongoing, while we continue to face other challenges,” the international community must simultaneously fight the climate crisis, she said. Dr. Zsuzsanna Jakab, Deputy Director-General of the World Health Organization, at the Palais des Nations, Geneva, Switzerland, February 24, 2020, in one of the last face-to-face UN meetings before the COVID pandemic. Thirteen million people die from preventable environmental factors WHO estimates that 13 million people die every year as a result of preventable environmental factors and that 90% of the global population breathes unhealthy air, Jakab noted. “Concerted action is needed across at least five key areas to make humanity more resilient to future health threats,” she stressed. The first is understanding that health is not negotiable. The second is the need to shift from health systems focused purely on treating diseases to health systems focused on disease prevention and health promotion. Next, equity is not a ‘nice to have’. “The vulnerability of one single nation makes the whole world more vulnerable to disease threats,” she said, echoing Valovaya’s sentiments. “We must move from a fragmented health architecture to a cohesive architecture with stronger governance, financing and tools. Finally, we must shift from a siloed, sectored approach to human health to a One Health approach, said Jakab. One Health was defined in December 2021 by the inter-agency One Health High-Level Expert Panel (OHHLEP) as “an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems. It recognizes the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and inter-dependent. It was a major focus of the first day of the Geneva Health Forum. “OHHLEP’s goal is to move One Health from concept to practice,” Eloit stressed in her talk, which helped culminate the formal opening ceremony. In the morning, the opening panel was on “One Health: is there a paradigm shift?” “We all have a role to play,” concluded Eloit. “We have a responsibility to make tomorrow safer than today.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Flickr. ‘Epidemic’ of Obesity in Europe 03/05/2022 Kerry Cullinan Impact of obesity on health Almost two-thirds of adults and a third of children are overweight or obese in the World Health Organization (WHO) European Region and this is driving cancer and other diseases, according to the WHO European Regional Obesity Report 2022 report released on Tuesday. The highest prevalence is in Turkey, Malta, Israel and the UK (WHO Europe has different members from the European Union), but there is an upward trend in all 53 member countries. Driving cancers Obesity is the cause of 13 different types of cancer, as well as a risk factor in strokes, heart attacks, type 2 diabetes and other non-communicable diseases, according to the report. For some countries in the region, obesity is predicted to overtake smoking as the main risk factor for preventable cancer. The report also highlights that obesity is a condition, not just a risk factor, that needs to be specifically treated and managed. “In Europe and Central Asia, no single country is going to meet the WHO Global NCD target of halting the rise of obesity by 2025,” said Dr Hans Kluge, WHO Regional Director for Europe. Adult obesity in the 53-country European Region is higher than in any other WHO region except the the Americas. More males (63%) are overweight than among females (54%) while obesity is more prevalent among females (24%) than among males (22%). Obesity rates in Europe (2016) 50% 60% 70% Orange = all adults, Blue = males, Green = females The COVID-19 pandemic has highlighted the danger of obesity, with patients with obesity being more likely to experience complications and death from the virus. “Preliminary data also suggest that during the current pandemic, people have had higher exposure to obesity risk factors, including an increase in sedentary lifestyles and consumption of unhealthy foods,” according to the report. Addressing unhealthy environments “Obesity is influenced by the environment, so it is important to look at this problem from the perspective of every stage of life. For example, the life of children and adolescents is impacted by digital environments, including marketing of unhealthy food and drinks,” said Dr Kremlin Wickramasinghe, Acting Head of the WHO European Office for the Prevention and Control of NCDs, which produced the report. “Restricting the marketing of unhealthy foods to children, taxation of sugar-sweetened beverages and improving health system response for obesity management are currently among the most actively discussed policy areas in the WHO European Region,” Wickramasinghe added. Other policies that show promise in reducing levels of obesity and overweight include improving access to obesity and overweight management services in primary health care, promoting breastfeeding and school-based interventions. The report also highlights interventions at supermarkets and takeaway outlets, which are the primary food sources. These include removing unhealthy foods from checkouts and nearby aisles and restricting takeaway outlets. Improving the quality of parks and playgrounds, as well as providing adequate infrastructure for active transport are other suggestions. Image Credits: rawpixel/unsplash. After Months of Deadlock, WTO’s TRIPS Council Will Finally Discuss Intellectual Property Waiver Compromise 03/05/2022 Kerry Cullinan WTO Director-General Ngozi Okonjo-Iweala In a significant breakthrough, the World Trade Organization’s (WTO) TRIPS Council on Friday will finally discuss a compromise proposal on a waiver of intellectual property (IP) rights on COVID-19 vaccines – almost 18 months after it was first proposed by India and South Africa. Members attending an informal meeting of the TRIPS Council on Tuesday were told that the text of an “outcome document” from the “quad” of the European Union, US, India and South Africa would be circulated to them “within hours” from WTO Director-General Ngozi Okonjo-Iweala’s office. The outcome document, which was later posted on the WTO website, is very similar to that which was leaked in mid-March – but it has been termed an “outcome document” rather than an agreement as there are still a couple of points of disagreement. Disagreement over who should be eligible The main point of disagreement relates to which countries should be able to benefit from the waiver (footnote 1). All developing country members that have not yet achieved a significant export capacity – namely 10% of the world’s COVID-19 vaccine market – are supposed to benefit from the flexibilities. Apparently, China has been unhappy about being excluded while a country like India with large generic manufacturing capacity, may be included. But the new TRIPS Council chairperson, Sierra Leone’s Ambassador Lansana Gberie, told Tuesday’s meeting that the superpower “seemed favourably disposed” towards the compromise – also contained in footnote 1 – that states “all developing country members with capacity are encouraged to opt out from these flexibilities”, according to a WTO official. While the waiver only applies to vaccines, WTO members will have six months to decide whether to extend it to cover the production and distribution of COVID-19 diagnostics and therapeutics. According to the draft document, eligible WTO members will be able to limit TRIPS article Section 28, which deals with exclusive patents, by authorizing the production and supply of COVID-19 vaccines without the patent holder’s consent, and with minimal transaction costs. Single authorisation for multiple patents Another deviation from draft agreement that was leaked in mid-March is related to whether countries will have to list all the patents that they will be waiving – widely criticised for imposing onerous requirements on countries. This appears set to go, according to footnote 3. Eligible countries may issue a single authorisation to use multiple patents and can export the vaccines they produce under this authorisation to other eligible members, particularly countries in greatest need, and to supply regional or international initiatives such as COVAX (a waiver of TRIPS Art. 31(f).) Eligible members will also be able to use any of their legal instruments to impose a waiver on vaccines, and the protection of clinical trial data under TRIPS will not be an obstacle to implementing this proposal. Payment for any vaccines produced under TRIPS waiver conditions for export is to take account of the humanitarian and not-for-profit purpose of the vaccine programme, to support manufacturers to produce and supply vaccines at affordable prices. The duration of the flexibilities would be either three or five years, and eligible members would be exempted from legal challenges under the WTO dispute settlement mechanism. The earlier agreement was widely condemned by health activist groups, who objected the waiver being confined to vaccines and excluding some of the world’s major COVID-19 vaccine producers. In addition, a diplomatic source told Health Policy Watch that he did not know the value of the waiver given that there was an apparent surplus of COVID-19 vaccines. The results of the formal discussion on Friday will be reported to the General Council, which is scheduled to meet on 9 and 10 May. Image Credits: Jess Hurd/ Global Justice Now, Africa Centre for International Trade&Development. Europeans May Have to Sleep Under Mosquito Nets as Climate Change Alters Disease Patterns 03/05/2022 Maayan Hoffman Geneva Health Forum session, “Impact of climate change on health.” From left: Moderator Maximilian Jungmann, University of Heidelberg; Alfonso Gomez, City of Geneva; Maria Neira, World Health Organization; Gueladio Cisse, CGIEC Swiss TPH; and Valérie D’Acremont, University of Lausanne. Children sick with malaria, adults in bed with fevers and rashes as a result of the Zika virus, tick-borne illnesses – all of these diseases are on the rise as a result of climate change, according to Valérie D’Acremont of the University of Lausanne. She spoke on Tuesday at the Geneva Health Forum during a special session on the impact of climate change on health, addressing the question: “what is the scale of the problem and what action needs to be taken?” “It is clear that there has been an increase in transmission of [existing] pathogens and of new pathogens,” said D’Acremont, a Swiss physician who is also working on a project in Africa. For example, the spread of malaria, caused by a parasite that spreads to humans and other animals through the bites of infected female mosquitoes, increases in temperatures of around 25ºC. “In West Africa, it is too hot, so malaria might be going down, but in East Africa, the opposite is the case and we see an increase in malaria,” she said. Adding to the challenge are compromised health systems, the result of two years of the COVID-19 pandemic, which has seen the world losing some of its gains against malaria over the last 20 years. Mosquitoes, similarly, are more prone to spreading Zika virus in around 30ºC, which means that the world’s tropical areas are seeing more and more of the disease, and it is likely to extend to Europe and other countries. “We see it already in Italy,” D’Acremont stressed. “We might one day have to sleep under bed nets like they do in Africa.” Tick-borne diseases are spreading in Switzerland, also as a result of climate change, she added. There has been a two-thirds increase in the number of people hospitalized for ticks in Switzerland from 2009 to 2019, according to a recent report by RTS. Moreover, the number of tick bites rose from around 10,000 per year between 2012 and 2016 to around 14,000 a year in the last four years. “Journalists like to hear this story because it frightens people,” D’Acremont said but added that the main challenge was that people die from these diseases when coupled with other pre-existing conditions, such as diabetes, hypertension or malnutrition. These are also often a result of climate change or failing to take care of the environment and our food sources. “Climate change has a huge impact on this too, especially undernutrition and respiratory problems,” she said. Alfonso Gomez of the City of Geneva addresses the Geneva Health Forum on May 3, 2022. We need to stop exploiting animals, destroying nature Climate change has become an inescapable reality. The most recent Intergovernmental Panel on Climate Change (IPPC) report showed what people already knew: There is now scientific consensus that climate change is impacting people’s health and wellbeing in all hemispheres. Sometimes the effect is direct, Gueladio Cisse of CGIEC Swiss TPH, who also spoke at the session, said. Sometimes it is indirect. Sometimes the effect comes at once, and other times it has a slower but also longer-term impact. “If there is a heatwave, the next thing you know people are dying over the course of two or three days,” Cisse said as an example. Other times, a general increase in temperature allows pathogens to grow and makes humans more vulnerable to disease. The good news, said Dr Maria Neira, of the World Health Organization, is that the scientific community has been “pulling together in a historic way all the evidence we have on climate change… They are telling us things like if we don’t take measure now, this might put civilization at risk.” D’Acremont agreed but said that while research was useful, now is the time to do research in the field by monitoring the impact of steps taken to curb environmental hazards. “We need a paradigm shift to go to prevention,” she said. “Take COVID. It is nice to have a preparedness plan, but the problem is that another pandemic or event could come and it is new and we cannot be prepared.” Instead, she said, “we need to stop destroying nature, stop exploiting animals and start preparing ourselves by being in better health. During the crisis is too late… We have to shift the reality now to preventive care. That is true for northern and southern countries.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Maayan Hoffman. 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.
Stopping Human Diseases Often Starts With Animals 05/05/2022 Svĕt Lustig Vijay Vaccinating dogs against rabies prevents the disease in people. As many neglected tropical diseases (NTDs) spread via vectors like ticks or domestic mammals, human-centric prevention programmes alone are inadequate – and adopting more holistic approaches such as the routine vaccination of animals is logical. This was the key message conveyed by health and policy experts at a panel discussion, “For a new approach to NTDs based on One Health”, at the Geneva Health Forum on Wednesday. ‘One Health’ is a perspective that acknowledges the interconnectedness of human health with animals, microorganisms and the wider environment. A solution aiming at more lasting, sustainable health development, it moves beyond treating disease in humans to tackle the root causes of the spread of diseases. Dirk Engels, former NTD director at the World Health Organization (WHO) and a member of the Swiss Alliance Against Neglected Tropical Diseases (SANTD), highlighted the potential of One Health approaches to eradicate diseases in animal reservoirs, reduce the population growth of infected animals, and consequently save more human lives. Rabies, with its high mortality rate of 80% and explicit animal-to-human transmission, is particularly amenable to holistic control methods. As the WHO’s Bernadette Abela-Ridder remarked, rabies control is often restricted to post-exposure prophylaxis in humans, despite the potential of mass vaccination in dogs to curb rabies deaths quickly, cheaply and effectively – as 99% of rabies cases are dog-mediated. “We know vaccinating dogs prevents rabies,” she said – yet outside the South American continent, where several countries have successfully brought down rabies deaths through mass dog vaccination campaigns, “nobody actually does it”. “If you want to stop rabies in humans very quickly, you vaccinate the dogs,” she added. “Dogs are part of the patchwork of our society, yet nobody is responsible for them: who will take care of dogs and pay for costs of vaccination?” Not only would this One Health-inspired strategy address the root cause of the disease, it would also circumvent the hassles of current human prophylaxis, which involves a combined multi-dose treatment administered over two weeks. NTDs are a group of 20 preventable and treatable diseases that disproportionately affect marginalized populations in Africa, Latin America, and Asia Developing ‘bite-sized’ strategies For novel strategies against NTDs to persist, countries need to buy into the value of the approach. Indeed, a barrier to embracing One Health is its breadth, noted Abela-Ridder, being a concept that encompasses virtually any component of our environment. This can understandably feel overwhelming for governments. However, segmenting such preventive strategies into “bite-sized” pieces will make them far more manageable to implement. In the case of rabies control, for example, this might look like identifying one high-priority target vector, and one single intervention mode – that is, dogs and vaccination. This, together with strong and motivated leadership at the national level, is the key for holistic approaches to function as effectively and sustainably as possible. Encouragingly, some countries have already set up dedicated supra-ministerial units for cross-cutting action on One Health. For successful provincial, district and community level implementation, the best place to start is building on existing intersectoral collaboration. To achieve this, José María Gutiérrez, a One Health expert at the University of Costa Rica, raised the importance of cooperating with local administrators and parliamentarians on novel NTD prevention. They “have the key” to the intersectoral resources that will cement local programmes, even if the changes start by being “small, but incremental”. Galvanising the private sector Meanwhile, in another GHF session on One Health, speakers acknowledged that the private sector could play an important role in operationalising this approach. The speakers stressed that, in a resource-constrained world, every sector intersects with another in a web rather than a linear value chain – and more companies are starting to understand this inter-dependency. Uta Jungermann of the World Business Council For Sustainable Development said one of the entry points for private sector involvement was in improving health systems: “There’s a question of how to exchange the know-how, innovative capabilities, stakeholder networks, and what unique expertise businesses can bring to the table and identifying health system resilience gaps and then developing strategies to close them,” she said. Ilona Kickbusch of the WHO Council on the Economics of Health for All, called for the private sector to be “activated”. “I think there are good opportunities,” said Kickbusch. “There are so-called CEO roundtables. There are pharmaceutical associations. But they talk among themselves. And then here we talk a bit among ourselves. So this dialogue needs to happen and I know that the World Economic Forum is doing a great job in bringing this together, but we need more, especially for the One Health concept”. * Additional reporting by Shadi Khan Saif. Image Credits: Daniel Stewart, Our World in Data. Breeding Superbugs – Veterinary Drugs, More than Human Ones, Drive AMR 04/05/2022 Elaine Ruth Fletcher Drug overuse in livestock is driving antimicrobial resistance. The main hotspots are in Asia, with Africa’s use of antibiotics far behind. Animals, not humans are the largest consumers of antimicrobial drugs – and thus the leading factor driving antimicrobial resistance. But WHO and other UN actors are still dancing around the ‘cattle, chickens and pigs’ in the room. And member states aren’t keen to track animal antibiotic use trends – even at the cost of future health risks. More than 73% of all antimicrobial drugs sold in the world are used in animals. And mores than human uses, the booming veterinary drug market is most probably the leading factor in growing antimicrobial resistance that is rendering common antibiotics and antiviral agents progressively more useless – also driving pandemic risks. Even so, there is no systematic global tracking of drugs sold and used on animals as well as humans by the three big UN and multilateral organizations responsible, including the World Organization for Animal Health (OIE), the World Health Organization (WHO) and the Food and Agriculture Organization (FAO). And despite pledges to tackle pandemic risks and AMR together, it’s unlikely such surveillance will begin anytime soon. Thomas Van Boeckel, of Zurich ETH, explains how soaring animal consumption of antibiotics, and human consumption of industrial meat, are the leading factors driving AMR Meanwhile, around the world, veterinarians are making huge profits from selling animal drugs to farmers and thus driving their swelling use – particularly in India, China and other parts of Asia, said Thomas Van Boeckel of ETH Zurich at a seminar on Achieving Sustainable Antibiotic Access using a One Health Approach, at the Geneva Health Forum, on Tuesday. “In 2017, about three quarters of all the antibiotics that we sold on this planet were used in animals, mostly to help them grow faster and to prevent infection,” Van Boeckel said. “So in the context of development, if you see the emergence of new resistant genes, it’s like playing the lottery and losing, well, you have more chances to lose the [AMR] lottery in animals. And once they’re there [drug resistant microbes] they can eventually result in untreatable infections in humans if they’re transmitted.” LMIC livestock – the ticking AMR time bomb no one is tracking Mapping of AMR hotspots Van Boeckel and his interdisciplinary team, comprised of food scientists, ecologists, pharmacists and veterinarians, as well as disease modelers and epidemiologists from Brazil, China, and India as well as Europe and the United States, have mapped hundreds of studies to come up with an initial ‘heat map’ of the world’s AMR hotspots. They are constantly developing that knowledge base on an open data site, Resistancebank.org. The group’s findings combine exhaustive data from animal drug sales, with reference to over 100 different types of antibiotics reported by countries – and mapped against livestock densities of cattle, chickens, and pigs. They then compared that data with hundreds of local studies and reports of antimicrobial resistance, referring to major indicator bacteria, like E coli, Staphylococcus, Campylobacter, and salmonella. Combined together, they yield a profile of the leading AMR hotspots across the world: The resulting “heat maps” demonstrate a clear correlation between drug overuse and drug resistance by mutating pathogens. Their research relies upon hundreds of local studies on farms, markets and slaughterhouses, routinely done “by academics and veterinarians and microbiologists, who go out and look at what’s around their institute, to identify new resistant [pathogen] genes – something microbiologists like to do very much. But such studies typically are scattered across the literature and published in small journals that “hardly get any exposure.” Brought together, however, they provide powerful insights. “One of the cool things is that you can zoom in to see where the problem is inside a country as well as the main regions identified as having high resistance,” says Van Boeckel. Not surprisingly, most of the AMR hotspots are largely in the same places that have the largest use of antibiotics, per kilogram per meat, such as South India, South and Northeast China, and some parts of Latin America. Trends in Asia are particularly worrisome since antimicrobial use for livestock and poultry is slated to grow even more across Asia in this decade, and represent two-thirds of the world’s veterinary consumption of antimicrobials by 2030. Regions by region, trends in animal antimicrobial sales in LMICs largely correspond with growth in AMR hotspots. By 2030, Asia will consume two-third’s of the world’s veterinary antibiotics China is the largest consumer of antibiotics in animals. “In 2017… the world used around 90,000 tons of antimicrobials in animals – at the time China was by far the largest consumer of antibiotics in animals,” reported Van Boeckel. “By 2030, Asia will use more than two-thirds of the veterinary antibiotics in the world – while Africa will use only 6%. So arguably, Africa has little responsibility for the state of resistance and AMR today,” he said. “And in Europe and North America, we’ve had fairly high levels of antibiotic use over the last 20 years, but they are slowly declining, thanks to increased awareness about the need for stewardship in our farms.” With the notable exception of Brazil, most of the 40 countries reporting systematically on veterinary antimicrobial use are major meat exporters – “which likely want to keep a good image in the securities export market,” said Van Boeckel. But among countries producing meat for mostly domestic consumption systematic national reporting is more sparse – and the researchers had to gather their data from a hybrid of commercial and research study sources. Low- and middle-income countries failing to track AMR trends But perhaps even more significantly, low- and middle-income countries are generally not tracking trends in AMR trends in livestock in any systematic manner, Van Boeckel pointed out. Such surveillance is critical since the first sign of superbugs is likely to occur in and around animals, not people, given their role of animals as the world’s biggest antibiotic consumers. “In Europe, we have systematic surveillance systems with a compelling metric for AMR for two to three decades, and we report this information at the national level,” Van Boeckel said. That surveillance eventually helped drive a wave of awareness and ultimately a European Union ban on the use of health- promoting antibiotics in 2006. Now, as the bulk of veterinary antibiotic use has shifted to low and middle income countries, “that’s really where the attention should be in the future.” However, out of 135 low and middle income countries that the team explored, only one, Colombia, had a government-run surveillance system that generates public data. Pigs and chickens incubating more superbugs than cattle Superbugs increased almost 200% more in pigs and chickens than cattle. The team also has mapped trends by species. And that shows resistant pathogens increasing at a faster rate amongst pigs and chickens – whereas the prevalence of AMR amongst cattle is rising more moderately. “Our goal for the next step is going to be to use that information to produce a global map of resistance levels across limited income countries. So concretely, we want to move from content information to continue continuous coverage of resistance level to do what some would call a heat map,” he said. Meat-heavier diets and exports in Asia and Americas driving trends Meat-heavy diets fuel AMR. One key factor driving trends are the financial incentives offered by animal health companies to veterinarians – which reap a hefty profit from selling more and more drugs to farmers with little knowledge of the products. They do so with minimal interference from governments, not only in Asia but also in some developed countries too, Van Boeckel says. Another is the growing, and seemingly unquenchable hunger for more animal products in emerging economies as well as developed countries, which is the more fundamental driver of soaring livestock production, which in turn leads to more veterinary antibiotic use – and therefore AMR. Van Boeckel compared the daily, per capita consumption of meat in Mali, which averages less than 27 grams a day, to that of China, at 136 grams, and Australia, at a whopping 260 grams. Those contrasts are captured in a series of photos that reflect a family’s typical weekly household food consumption across the three continents. The photos reflect not only more meat, but also heavier consumption of ultra-processed foods and sugary drinks in emerging economies and developed ones – dietary trends that are simultaneously harming people’s health, the planet – and driving AMR. Policy solutions – a user fee for veterinary antibiotics? Targets to reduce antimicrobial use include regulation and meat reduction. Along with better tracking, global agencies need to be thinking about the kinds of policy solutions that would really bring the AMR under control, he stresses. His team mapped out several key possibilities to proejct their results: Regulatory action to reduce the use of antibiotics in livestock worldwide to 50 milligrams per kilogram of meat produced, roughly the European median, would reduce veterinary antibiotic use by 64%; Regulatory action among only OECD countries and China to do the same – would lead to an almost equally sharp reduction in veterinary antibiotics of 60%; Consumer action to reduce meat consumption to just 60 grams a day – “about the equivalent of one Big Mac” – also would reduce antibiotic use in livestock by some 66%; “In other words, maybe we shouldn’t undermine the development of certain countries through livestock farming, as long as we have the OECD and China in the deal. We can make a significant difference,” says Van Boeckel. Yet another solution is to impose stiffer taxes, or user fees on antibiotics, which would in turn curb the incentives that now exist to farmers to purchase them at all – particularly when alternatives exist such as better sanitation practices, including more vaccination against preventible diseases. In UN – One Health rhetoric but little real action Jorge Matheu Alvarez of WHO discusses challenges of more harmonized surveillance of human and animal antimicrobial use and AMR trends. Such systematic global tracking of human and veterinary drug sales, and AMR trends should in fact be done by governments, and collected by the UN and its partners, Van Boeckel asserts. But data on antimicrobial drug sales for human and animal use – and AMR trends in both populations – is not collated and reported systematically by the major UN and multilateral organizations responsible. WHO, through its Global Antimicrobial Resistance and Surveillance System (GLASS), is trying improve surveillance of AMR in association with drugs used for human health, said Jorge Matheu Alvarez of WHO, who also appeared at the session. But tracking antibiotic consumption in animals or AMR in livestock isn’t really WHO’s job, he said. OIE tracks some data on veterinary use of antimicrobials, but that data remains very partial, with only 133 countries reporting to OIE at all. Many countries that do report lack data on actual quantities of antibiotics used or sold. In addition, the data is not transparent. Some 71% of countries that do report to OIE don’t make their data public. And therefore OIE’s data is presented only in terms of aggregate global quantities, rather by region or country. No data on AMR trends in animals is published by the member state organization. WHO, FAO, OIE and the World Animal Health Organization have recently launched a new One Health collaboration together with the UN Environment Programme. Both FAO and OIE have included antimicrobial stewardship in the animal sector in their global action plans, Alvarez noted saying: “we are making progress in the collaboration in these One Health areas.” The catalogue of #climate disasters is growing. With each page turned, the impacts on people, animals & environment are more severe. @UNEP is proud to have joined the Quadripartite Alliance on #OneHealth. Science ➕ collaboration ➕ action 🟰 success. #GHF2022 pic.twitter.com/BHWXeV2U9Y — Inger Andersen (@andersen_inger) May 4, 2022 Alvarez says FAO, OIE and WHO will soon begin placing the surveillance data they do collect on a single platform, called the Tripartite Integrated Surveillance System on AMR (TISSA). “Here we will host the One Health information collected by the different organizations on AMR, antimicrobial consumption and use of antimicrobials,” he told Health Policy Watch. But animal and human data thus collected won’t likely be reported and presented in a comparable manner for some time to come, he admits, because of different data collection methods. Member states are highly resistant to reporting on their antibiotic drug sales and consumption – because they see it has implications for their global trade in meat, the panelists also noted. “We need to be clearer and provide more guidance in the animal sector,” Alvarez told the panel session. The session was hosted by the Global Antibiotic R&D Partnership (GARDP), which aims to acccelerate the development of new antibiotic treatments for drug resistant infections and also attended by the Foundation for Innovative New Diagnostics (FIND), which is ramping up the development and deployment of infection tests to reduce unecessary use of antibiotics in humans. Says Van Boeckel, “I’ve been in this field for about ten years, and I thought something would have happened by now. I’ve been expecting a globally harmonized AMR surveillance system by the FAO and OIE that reports that data. And I can only ask the question, why hasn’t that happened? Until those agencies, and the member states that control them, rise to the challenge, surveillance of critical AMR trends will likely remain the purview of research teams such as Van Boeckel’s. But meanwhile, the neglect of animals’ antibiotic consumption remains just another pandemic waiting to happen, he warns: “If we want to inform policy in the short term, we need an alternative systematic surveillance system for LMICs, where we’ve seen that conditions may unfortunately be the worst, when it comes to development of resistance, in the coming decades.” –Updated on 5 May, 2022 Image Credits: Thomas Van Boekel, Health Policy Watch , Van Boeckel et al, ETH Zurich, Tiseo et al 2020, Antibiotics . What Worked to Reach Marginalised Communities During COVID-19? 04/05/2022 Aishwarya Tendolkar NorWest co-op offers community-based programmes to indigenous communities Protecting indigenous communities in Canada and refugees in central and Eastern Europe from COVID-19 requires community-based approaches that could be applied in other healthcare crises. This emerged from field actors who shared their experiences and lessons at the Geneva Health Forum on Tuesday. In Canada’s Manitoba province, indigenous communities were mistrustful of mass COVID-19 vaccinations, but reaching them was a priority for NorWest Co-op Community Health Centre. NorWest’s Kristin Bergen and Michelle Kirkbride identified the indigenous and ethnic communities they wanted to reach and then enlisted support from their leaders. They also stressed that to reach those who were most isolated and vulnerable, it was essential to help with things like booking clinic appointments and transport. In addition, Bergen and Kirkbridge stressed the importance of offering mental health support for the isolated communities that become less reachable in pandemics and during Canadian winters. NorWest had a trained trauma team to help people to cope with pandemic stress, and empowered community members to talk about mental health to reduce stigma and build trust. NorWest also provided the community with effective information on COVID-19 and vaccines. Mental health support The need for psychosocial support and mental health support was also highlighted by the International Federation of Red Cross and Red Crescent Societies’ (IFRC) Sherry Joseph. Online communication helped IFRC reach out to many communities and refugees in central and Eastern Europe, while a network of volunteers assisted IFRC teams in Hungary, Romania, Czechia and Ukraine to ensure that refugees also received vaccinations and medical help. Sherry added that IFRC is scaling up first aid skills in remote populations, ensuring continuity of vaccination programs, developing mental health programs, and making sure their workers and volunteers are equipped to deal with individuals who have escaped from traumatic zones. “We have learnt to smile with our eyes,” he said since masks hide them and smiling is a key way of extending warmth and support to the communities that IFRC caters to. Joseph added that IFRC is setting up mental health hotlines, especially for the refugees from Ukraine. Image Credits: NorWest Co-op. How to Protect the Environment and be Profitable at the Same Time 04/05/2022 Raisa Santos Environment-friendly approaches: Health experts have called on global leaders to tackle environmental issues affecting health and health systems. It is possible for industry to implement environmentally friendly approaches that are also profitable, Bertrand Piccard, chair of the Solar Impulse Foundation, told the Geneva Health Forum. “I have been working on identifying solutions that can reconcile ecology and economy that means to protect the environment and at the same time create jobs and be economically viable for the industry, the economy and the financial world,” said Piccard. The Swiss organisation, Solar Impulse Foundation, works to identify sustainable, clean and profitable solutions for climate action and offers political and industry leaders a guide on implementing these solutions on a large scale. Replace, reduce and recycle Some of its concepts include the solar-powered automatic irrigation system, electric cabinet with recycled batteries and the circular high-quality furniture made from recycled materials. Piccard pointed out that are new business opportunities to be grabbed by leaders in the industry who can develop efficient solutions to protect the environment: “It’s clear that the environment has a huge link to (public) health…. efficient solutions improve the health of everybody.” To back this argument, he presented the example of a French start-up that captures the heat from chimneys of factories for recycling to reduce the energy bill of the same enterprise by 20%. “It produces less carbon, less energy, and it’s a business opportunity that expands and creates jobs,” said Piccard. “This is what I call qualitative growth. You develop the economy by replacing what is polluting with what is protecting the environment, so you can reconcile ecology and economy.” Piccard also noted the importance of both sides i.e. businesses and environmentalists striving hand-in-hand towards this goal. “You need the ‘green activists’ to move forward to push the politicians and you need the industry to produce the solutions. That will help us live in a more efficient way and be more environmentally friendly.” Climate neutrality ambitions Piccard praised the European Commission’s recent announcement that 100 European Union (EU) cities and 12 non-EU cities are participating in a program to become climate neutral by 2030. Bertrand Piccard, chair of the Solar Impulse Foundation. According to the EU plan, the 112 participating cities – in which roughly 75 million people live – will prepare plans and contracts to set out action and investment plans in order to achieve climate neutrality in the coming eight years. The ultimate goal of climate neutrality, as defined by the United Nations (UN), is to achieve zero greenhouse gas emissions by balancing the emissions so they are equal (or less than) the emissions that get removed through the planet’s natural absorption. Piccard stated that problems brought about by pollution and greenhouse gases should be tackled incrementally to bring cities closer to becoming climate neutral. “You cannot take the big problems and find solutions. It doesn’t work because most of the problems are not identified correctly so you need to do the opposite. You need to go through the solutions and look at which solution can be implemented where and each time you reduce a little bit of CO2, a little bit of inefficiency, a little bit of pollution, but altogether you can solve the problem.” Protecting the environment requires everyone to rethink the phrase ‘changing behaviours’ and use the word ‘modernise’ instead when addressing climate change in low- and middle-income countries, he added. “You have to modernise old infrastructures. You have to modernise all energy sources. You have to modernise the way to construct the buildings, you have to modernise mobility.” When it comes to changing behaviours, Piccard said that few people made minimal changes with minimal impact, with a majority refusing to renounce their habits. “You will say yes, of course, I will renounce a little bit. I will take the aeroplane only three times a week instead of four. But it doesn’t change the world.” Speaking specifically about the stance of the developing countries on the contested issue of emissions, Piccard added: “We have to go from [a narrative of saying] protection of the environment is threatening our lifestyles, [which is] expensive and boring, to a narrative where protection of the environment is exciting, profitable, creative, interesting, and modernising.” The developing countries should use new technologies, said Piccard. “They want to reach our (developed world) levels of development. They want to be like Europe and North America. [In order to modernise] they can use efficient systems, use renewable energies in order to have local economic development.” “It’s a question of narrative, because we need to take people with us otherwise they will not follow, they will resist.” As the developed and the developing countries continue to have contested viewpoints on this matter, the latest UN report suggests the emissions from fossil fuel combustion in the three regions of Asia and the Pacific, Africa and Latin America grew by 26% over the past decade, as compared to 260% growth in the prior two decades. The fossil fuel combustion emissions of developed countries shrank by about 10% over both of those periods. Europe Must take advantage of ‘COVID-19 Ceasefire’ to Prepare for Next Wave, says WHO’s Kluge 04/05/2022 Maayan Hoffman Dr Hans Kluge, WHO Regional Director for Europe. The European Region and COVID-19 are in a “kind of ceasefire,” according to World Health Organization’s (WHO) Regional Director for Europe, Dr Hans Kluge. It is now up to the region’s 53 member states to take advantage of this window to prepare for the next fight, he said. “It is quiet and we have to take advantage of this, because obviously the fact that the virus spread so fast and so many people have been infected means that a new mutant is already here,” Kluge said Wednesday during an interview at the Geneva Health Forum. “The virus has surprised us many times.” Kluge, who started his role on 1 February 2020 just as the pandemic began, spoke via video link from his office in Denmark. There have been at least 191 million reported COVID-19 infections in Europe and more than 2.2 million deaths since the start of the pandemic two years ago, according to Reuters COVID tracker. The average new daily cases in the region have dropped from a recent peak of 1.7 million in February to fewer than 230,000 in recent days. However, Germany leads the world in the daily average number of new cases, Reuters said, accounting for one in every six infections reported worldwide. Moreover, as Kluge noted, it is not possible to track how fast the virus is spreading in Ukraine as a result of the Russian invasion. Reuters COVID-19 tracker shows a decline in average daily cases across the European region. He urged the region to implement a pan-European system that could pick up on any threat from antimicrobial resistance, a dangerous virus or climate change “very quickly – we need an alert system.” And he said that the region needs its political systems to take action when there is such an alert. Kluge also said that the most important ingredient in any COVID-19 toolkit must be equal access to vaccines and affordable antivirals. “The best way to combat infectious disease is a combination of prevention and treatment: vaccines and medicines,” according to Kluge. The comments were especially meaningful on Wednesday, a day after the World Trade Organization’s TRIPS Council announced that it will finally discuss a compromise proposal on a waiver of intellectual property rights on COVID-19 vaccines. However, antivirals are not included in the compromise. While Pfizer and Merck – the companies with effective COVID-19 antivirals – have entered into voluntary licensing agreements with the Medicine Patents Pool to enable generic companies to make the drugs for certain low-income countries, the agreements and countries the deal applies to are restricted. Kluge offered a four-step COVID-19 exit strategy for the region: 1. Implement a plan for protecting the most vulnerable “We may at some point have to shift from mass action to more routine vaccination of just the vulnerable people,” Kluge said. 2. Vaccinate and boost “We will need to do whatever it takes to vaccinate the unvaccinated and boost the vaccinated,” he added. 3. Beef up surveillance “We need a system that is able to pick up new COVID-19 variants very quickly so that national lockdowns can be avoided,” said Kluge. 4. Deal with the backlog of patients with other diseases Kluge noted that the healthcare sector is also facing a shadow pandemic – dealing with the backlog of patients who are suffering due to postponement of elective surgeries, cancer and other screenings, mental health issues and long COVID. He said around 20% of people infected with the virus continue to experience some symptoms even months later. “We need more knowledge about long COVID,” Kluge stressed. But he admitted that rolling out this exit strategy could be “tricky,” as a result of complacency by the public and political leaders whose memories are “very short.” “Heads of states and governments need to make the investment in health and health systems that is key for a resilient society and preparedness,” said Kluge. “Health is not everything, but without health, there is nothing.” Image Credits: WHO, Screenshot. Four COVID-19 Lessons and How to Make Humanity More Resilient 04/05/2022 Maayan Hoffman Tatiana Valovaya, Director-General of the United Nations Office at Genevai during World Humanitarian Day. 19 August 2019. The COVID-19 pandemic blindsided most of the world as it swept from China across the world at an unprecedent pace, infecting, ultimately killing millions of people. But more than two years later, there are some lessons that can be learned, said Tatiana Valovaya, director-general of the United Nations in Geneva on Tuesday evening. At the Opening Ceremony for the Geneva Health Forum, Valovaya delivered the four key takeaways from the pandemic for public health professionals. Her colleague, likewise, offered “concerned actions” that could be taken in at least five key areas to make humanity more resilient to future health threats. In total, nine people addressed attendees during the opening ceremony, which drew over 1000 people and is the first major global health event hosted in Geneva since the pandemic began. The speakers included Valovaya; Antoine Geissbuhler and Véronique Maye, Geneva Health Forum’s co-presidents; Bertrand Levrat, CEO of the University Hospitals of Geneva; Mauro Poggia, minister of health, population and security for the state of Geneva; Jürg Lauber, Swiss ambassador and permanent representative to the Office of the United Nations in Geneva; Zsuzsanna Jakab, deputy director-general of the World Health Organization; Monique Eloit, director-general of the World Organisation for Animal Health (OIE); and Peter Maurer, president of the International Committee of the Red Cross. What lessons were learned? 1 – We live in a globalized world and are all interconnected and interdependent. “We can only be as safe or as healthy as all other people around that world are,” said Valovaya. “That means we have to work in solidarity.” 2 – We can do a lot to improve environmental degradation. This notion was supported by Eloit in her keynote address. “I will insist on how it is crucial to transform our relationship with the environment,” she said. “We need to move from response to prevention.” 3 – We have to fight inequality. “During the pandemic, we saw that those who were very vulnerable were the first to suffer,” noted Valovaya. “We saw this with access to healthcare, vaccines and even clean water.” 4 – All of the challenges that humanity is facing are global. “Global challenges need global solutions,” she said. “We need multilateralism that is inclusive and integrated. Only together can we find solutions.” While the world continues to tackle COVID-19, something which Eloit stressed is “still ongoing, while we continue to face other challenges,” the international community must simultaneously fight the climate crisis, she said. Dr. Zsuzsanna Jakab, Deputy Director-General of the World Health Organization, at the Palais des Nations, Geneva, Switzerland, February 24, 2020, in one of the last face-to-face UN meetings before the COVID pandemic. Thirteen million people die from preventable environmental factors WHO estimates that 13 million people die every year as a result of preventable environmental factors and that 90% of the global population breathes unhealthy air, Jakab noted. “Concerted action is needed across at least five key areas to make humanity more resilient to future health threats,” she stressed. The first is understanding that health is not negotiable. The second is the need to shift from health systems focused purely on treating diseases to health systems focused on disease prevention and health promotion. Next, equity is not a ‘nice to have’. “The vulnerability of one single nation makes the whole world more vulnerable to disease threats,” she said, echoing Valovaya’s sentiments. “We must move from a fragmented health architecture to a cohesive architecture with stronger governance, financing and tools. Finally, we must shift from a siloed, sectored approach to human health to a One Health approach, said Jakab. One Health was defined in December 2021 by the inter-agency One Health High-Level Expert Panel (OHHLEP) as “an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems. It recognizes the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and inter-dependent. It was a major focus of the first day of the Geneva Health Forum. “OHHLEP’s goal is to move One Health from concept to practice,” Eloit stressed in her talk, which helped culminate the formal opening ceremony. In the morning, the opening panel was on “One Health: is there a paradigm shift?” “We all have a role to play,” concluded Eloit. “We have a responsibility to make tomorrow safer than today.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Flickr. ‘Epidemic’ of Obesity in Europe 03/05/2022 Kerry Cullinan Impact of obesity on health Almost two-thirds of adults and a third of children are overweight or obese in the World Health Organization (WHO) European Region and this is driving cancer and other diseases, according to the WHO European Regional Obesity Report 2022 report released on Tuesday. The highest prevalence is in Turkey, Malta, Israel and the UK (WHO Europe has different members from the European Union), but there is an upward trend in all 53 member countries. Driving cancers Obesity is the cause of 13 different types of cancer, as well as a risk factor in strokes, heart attacks, type 2 diabetes and other non-communicable diseases, according to the report. For some countries in the region, obesity is predicted to overtake smoking as the main risk factor for preventable cancer. The report also highlights that obesity is a condition, not just a risk factor, that needs to be specifically treated and managed. “In Europe and Central Asia, no single country is going to meet the WHO Global NCD target of halting the rise of obesity by 2025,” said Dr Hans Kluge, WHO Regional Director for Europe. Adult obesity in the 53-country European Region is higher than in any other WHO region except the the Americas. More males (63%) are overweight than among females (54%) while obesity is more prevalent among females (24%) than among males (22%). Obesity rates in Europe (2016) 50% 60% 70% Orange = all adults, Blue = males, Green = females The COVID-19 pandemic has highlighted the danger of obesity, with patients with obesity being more likely to experience complications and death from the virus. “Preliminary data also suggest that during the current pandemic, people have had higher exposure to obesity risk factors, including an increase in sedentary lifestyles and consumption of unhealthy foods,” according to the report. Addressing unhealthy environments “Obesity is influenced by the environment, so it is important to look at this problem from the perspective of every stage of life. For example, the life of children and adolescents is impacted by digital environments, including marketing of unhealthy food and drinks,” said Dr Kremlin Wickramasinghe, Acting Head of the WHO European Office for the Prevention and Control of NCDs, which produced the report. “Restricting the marketing of unhealthy foods to children, taxation of sugar-sweetened beverages and improving health system response for obesity management are currently among the most actively discussed policy areas in the WHO European Region,” Wickramasinghe added. Other policies that show promise in reducing levels of obesity and overweight include improving access to obesity and overweight management services in primary health care, promoting breastfeeding and school-based interventions. The report also highlights interventions at supermarkets and takeaway outlets, which are the primary food sources. These include removing unhealthy foods from checkouts and nearby aisles and restricting takeaway outlets. Improving the quality of parks and playgrounds, as well as providing adequate infrastructure for active transport are other suggestions. Image Credits: rawpixel/unsplash. After Months of Deadlock, WTO’s TRIPS Council Will Finally Discuss Intellectual Property Waiver Compromise 03/05/2022 Kerry Cullinan WTO Director-General Ngozi Okonjo-Iweala In a significant breakthrough, the World Trade Organization’s (WTO) TRIPS Council on Friday will finally discuss a compromise proposal on a waiver of intellectual property (IP) rights on COVID-19 vaccines – almost 18 months after it was first proposed by India and South Africa. Members attending an informal meeting of the TRIPS Council on Tuesday were told that the text of an “outcome document” from the “quad” of the European Union, US, India and South Africa would be circulated to them “within hours” from WTO Director-General Ngozi Okonjo-Iweala’s office. The outcome document, which was later posted on the WTO website, is very similar to that which was leaked in mid-March – but it has been termed an “outcome document” rather than an agreement as there are still a couple of points of disagreement. Disagreement over who should be eligible The main point of disagreement relates to which countries should be able to benefit from the waiver (footnote 1). All developing country members that have not yet achieved a significant export capacity – namely 10% of the world’s COVID-19 vaccine market – are supposed to benefit from the flexibilities. Apparently, China has been unhappy about being excluded while a country like India with large generic manufacturing capacity, may be included. But the new TRIPS Council chairperson, Sierra Leone’s Ambassador Lansana Gberie, told Tuesday’s meeting that the superpower “seemed favourably disposed” towards the compromise – also contained in footnote 1 – that states “all developing country members with capacity are encouraged to opt out from these flexibilities”, according to a WTO official. While the waiver only applies to vaccines, WTO members will have six months to decide whether to extend it to cover the production and distribution of COVID-19 diagnostics and therapeutics. According to the draft document, eligible WTO members will be able to limit TRIPS article Section 28, which deals with exclusive patents, by authorizing the production and supply of COVID-19 vaccines without the patent holder’s consent, and with minimal transaction costs. Single authorisation for multiple patents Another deviation from draft agreement that was leaked in mid-March is related to whether countries will have to list all the patents that they will be waiving – widely criticised for imposing onerous requirements on countries. This appears set to go, according to footnote 3. Eligible countries may issue a single authorisation to use multiple patents and can export the vaccines they produce under this authorisation to other eligible members, particularly countries in greatest need, and to supply regional or international initiatives such as COVAX (a waiver of TRIPS Art. 31(f).) Eligible members will also be able to use any of their legal instruments to impose a waiver on vaccines, and the protection of clinical trial data under TRIPS will not be an obstacle to implementing this proposal. Payment for any vaccines produced under TRIPS waiver conditions for export is to take account of the humanitarian and not-for-profit purpose of the vaccine programme, to support manufacturers to produce and supply vaccines at affordable prices. The duration of the flexibilities would be either three or five years, and eligible members would be exempted from legal challenges under the WTO dispute settlement mechanism. The earlier agreement was widely condemned by health activist groups, who objected the waiver being confined to vaccines and excluding some of the world’s major COVID-19 vaccine producers. In addition, a diplomatic source told Health Policy Watch that he did not know the value of the waiver given that there was an apparent surplus of COVID-19 vaccines. The results of the formal discussion on Friday will be reported to the General Council, which is scheduled to meet on 9 and 10 May. Image Credits: Jess Hurd/ Global Justice Now, Africa Centre for International Trade&Development. Europeans May Have to Sleep Under Mosquito Nets as Climate Change Alters Disease Patterns 03/05/2022 Maayan Hoffman Geneva Health Forum session, “Impact of climate change on health.” From left: Moderator Maximilian Jungmann, University of Heidelberg; Alfonso Gomez, City of Geneva; Maria Neira, World Health Organization; Gueladio Cisse, CGIEC Swiss TPH; and Valérie D’Acremont, University of Lausanne. Children sick with malaria, adults in bed with fevers and rashes as a result of the Zika virus, tick-borne illnesses – all of these diseases are on the rise as a result of climate change, according to Valérie D’Acremont of the University of Lausanne. She spoke on Tuesday at the Geneva Health Forum during a special session on the impact of climate change on health, addressing the question: “what is the scale of the problem and what action needs to be taken?” “It is clear that there has been an increase in transmission of [existing] pathogens and of new pathogens,” said D’Acremont, a Swiss physician who is also working on a project in Africa. For example, the spread of malaria, caused by a parasite that spreads to humans and other animals through the bites of infected female mosquitoes, increases in temperatures of around 25ºC. “In West Africa, it is too hot, so malaria might be going down, but in East Africa, the opposite is the case and we see an increase in malaria,” she said. Adding to the challenge are compromised health systems, the result of two years of the COVID-19 pandemic, which has seen the world losing some of its gains against malaria over the last 20 years. Mosquitoes, similarly, are more prone to spreading Zika virus in around 30ºC, which means that the world’s tropical areas are seeing more and more of the disease, and it is likely to extend to Europe and other countries. “We see it already in Italy,” D’Acremont stressed. “We might one day have to sleep under bed nets like they do in Africa.” Tick-borne diseases are spreading in Switzerland, also as a result of climate change, she added. There has been a two-thirds increase in the number of people hospitalized for ticks in Switzerland from 2009 to 2019, according to a recent report by RTS. Moreover, the number of tick bites rose from around 10,000 per year between 2012 and 2016 to around 14,000 a year in the last four years. “Journalists like to hear this story because it frightens people,” D’Acremont said but added that the main challenge was that people die from these diseases when coupled with other pre-existing conditions, such as diabetes, hypertension or malnutrition. These are also often a result of climate change or failing to take care of the environment and our food sources. “Climate change has a huge impact on this too, especially undernutrition and respiratory problems,” she said. Alfonso Gomez of the City of Geneva addresses the Geneva Health Forum on May 3, 2022. We need to stop exploiting animals, destroying nature Climate change has become an inescapable reality. The most recent Intergovernmental Panel on Climate Change (IPPC) report showed what people already knew: There is now scientific consensus that climate change is impacting people’s health and wellbeing in all hemispheres. Sometimes the effect is direct, Gueladio Cisse of CGIEC Swiss TPH, who also spoke at the session, said. Sometimes it is indirect. Sometimes the effect comes at once, and other times it has a slower but also longer-term impact. “If there is a heatwave, the next thing you know people are dying over the course of two or three days,” Cisse said as an example. Other times, a general increase in temperature allows pathogens to grow and makes humans more vulnerable to disease. The good news, said Dr Maria Neira, of the World Health Organization, is that the scientific community has been “pulling together in a historic way all the evidence we have on climate change… They are telling us things like if we don’t take measure now, this might put civilization at risk.” D’Acremont agreed but said that while research was useful, now is the time to do research in the field by monitoring the impact of steps taken to curb environmental hazards. “We need a paradigm shift to go to prevention,” she said. “Take COVID. It is nice to have a preparedness plan, but the problem is that another pandemic or event could come and it is new and we cannot be prepared.” Instead, she said, “we need to stop destroying nature, stop exploiting animals and start preparing ourselves by being in better health. During the crisis is too late… We have to shift the reality now to preventive care. That is true for northern and southern countries.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Maayan Hoffman. 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.
Breeding Superbugs – Veterinary Drugs, More than Human Ones, Drive AMR 04/05/2022 Elaine Ruth Fletcher Drug overuse in livestock is driving antimicrobial resistance. The main hotspots are in Asia, with Africa’s use of antibiotics far behind. Animals, not humans are the largest consumers of antimicrobial drugs – and thus the leading factor driving antimicrobial resistance. But WHO and other UN actors are still dancing around the ‘cattle, chickens and pigs’ in the room. And member states aren’t keen to track animal antibiotic use trends – even at the cost of future health risks. More than 73% of all antimicrobial drugs sold in the world are used in animals. And mores than human uses, the booming veterinary drug market is most probably the leading factor in growing antimicrobial resistance that is rendering common antibiotics and antiviral agents progressively more useless – also driving pandemic risks. Even so, there is no systematic global tracking of drugs sold and used on animals as well as humans by the three big UN and multilateral organizations responsible, including the World Organization for Animal Health (OIE), the World Health Organization (WHO) and the Food and Agriculture Organization (FAO). And despite pledges to tackle pandemic risks and AMR together, it’s unlikely such surveillance will begin anytime soon. Thomas Van Boeckel, of Zurich ETH, explains how soaring animal consumption of antibiotics, and human consumption of industrial meat, are the leading factors driving AMR Meanwhile, around the world, veterinarians are making huge profits from selling animal drugs to farmers and thus driving their swelling use – particularly in India, China and other parts of Asia, said Thomas Van Boeckel of ETH Zurich at a seminar on Achieving Sustainable Antibiotic Access using a One Health Approach, at the Geneva Health Forum, on Tuesday. “In 2017, about three quarters of all the antibiotics that we sold on this planet were used in animals, mostly to help them grow faster and to prevent infection,” Van Boeckel said. “So in the context of development, if you see the emergence of new resistant genes, it’s like playing the lottery and losing, well, you have more chances to lose the [AMR] lottery in animals. And once they’re there [drug resistant microbes] they can eventually result in untreatable infections in humans if they’re transmitted.” LMIC livestock – the ticking AMR time bomb no one is tracking Mapping of AMR hotspots Van Boeckel and his interdisciplinary team, comprised of food scientists, ecologists, pharmacists and veterinarians, as well as disease modelers and epidemiologists from Brazil, China, and India as well as Europe and the United States, have mapped hundreds of studies to come up with an initial ‘heat map’ of the world’s AMR hotspots. They are constantly developing that knowledge base on an open data site, Resistancebank.org. The group’s findings combine exhaustive data from animal drug sales, with reference to over 100 different types of antibiotics reported by countries – and mapped against livestock densities of cattle, chickens, and pigs. They then compared that data with hundreds of local studies and reports of antimicrobial resistance, referring to major indicator bacteria, like E coli, Staphylococcus, Campylobacter, and salmonella. Combined together, they yield a profile of the leading AMR hotspots across the world: The resulting “heat maps” demonstrate a clear correlation between drug overuse and drug resistance by mutating pathogens. Their research relies upon hundreds of local studies on farms, markets and slaughterhouses, routinely done “by academics and veterinarians and microbiologists, who go out and look at what’s around their institute, to identify new resistant [pathogen] genes – something microbiologists like to do very much. But such studies typically are scattered across the literature and published in small journals that “hardly get any exposure.” Brought together, however, they provide powerful insights. “One of the cool things is that you can zoom in to see where the problem is inside a country as well as the main regions identified as having high resistance,” says Van Boeckel. Not surprisingly, most of the AMR hotspots are largely in the same places that have the largest use of antibiotics, per kilogram per meat, such as South India, South and Northeast China, and some parts of Latin America. Trends in Asia are particularly worrisome since antimicrobial use for livestock and poultry is slated to grow even more across Asia in this decade, and represent two-thirds of the world’s veterinary consumption of antimicrobials by 2030. Regions by region, trends in animal antimicrobial sales in LMICs largely correspond with growth in AMR hotspots. By 2030, Asia will consume two-third’s of the world’s veterinary antibiotics China is the largest consumer of antibiotics in animals. “In 2017… the world used around 90,000 tons of antimicrobials in animals – at the time China was by far the largest consumer of antibiotics in animals,” reported Van Boeckel. “By 2030, Asia will use more than two-thirds of the veterinary antibiotics in the world – while Africa will use only 6%. So arguably, Africa has little responsibility for the state of resistance and AMR today,” he said. “And in Europe and North America, we’ve had fairly high levels of antibiotic use over the last 20 years, but they are slowly declining, thanks to increased awareness about the need for stewardship in our farms.” With the notable exception of Brazil, most of the 40 countries reporting systematically on veterinary antimicrobial use are major meat exporters – “which likely want to keep a good image in the securities export market,” said Van Boeckel. But among countries producing meat for mostly domestic consumption systematic national reporting is more sparse – and the researchers had to gather their data from a hybrid of commercial and research study sources. Low- and middle-income countries failing to track AMR trends But perhaps even more significantly, low- and middle-income countries are generally not tracking trends in AMR trends in livestock in any systematic manner, Van Boeckel pointed out. Such surveillance is critical since the first sign of superbugs is likely to occur in and around animals, not people, given their role of animals as the world’s biggest antibiotic consumers. “In Europe, we have systematic surveillance systems with a compelling metric for AMR for two to three decades, and we report this information at the national level,” Van Boeckel said. That surveillance eventually helped drive a wave of awareness and ultimately a European Union ban on the use of health- promoting antibiotics in 2006. Now, as the bulk of veterinary antibiotic use has shifted to low and middle income countries, “that’s really where the attention should be in the future.” However, out of 135 low and middle income countries that the team explored, only one, Colombia, had a government-run surveillance system that generates public data. Pigs and chickens incubating more superbugs than cattle Superbugs increased almost 200% more in pigs and chickens than cattle. The team also has mapped trends by species. And that shows resistant pathogens increasing at a faster rate amongst pigs and chickens – whereas the prevalence of AMR amongst cattle is rising more moderately. “Our goal for the next step is going to be to use that information to produce a global map of resistance levels across limited income countries. So concretely, we want to move from content information to continue continuous coverage of resistance level to do what some would call a heat map,” he said. Meat-heavier diets and exports in Asia and Americas driving trends Meat-heavy diets fuel AMR. One key factor driving trends are the financial incentives offered by animal health companies to veterinarians – which reap a hefty profit from selling more and more drugs to farmers with little knowledge of the products. They do so with minimal interference from governments, not only in Asia but also in some developed countries too, Van Boeckel says. Another is the growing, and seemingly unquenchable hunger for more animal products in emerging economies as well as developed countries, which is the more fundamental driver of soaring livestock production, which in turn leads to more veterinary antibiotic use – and therefore AMR. Van Boeckel compared the daily, per capita consumption of meat in Mali, which averages less than 27 grams a day, to that of China, at 136 grams, and Australia, at a whopping 260 grams. Those contrasts are captured in a series of photos that reflect a family’s typical weekly household food consumption across the three continents. The photos reflect not only more meat, but also heavier consumption of ultra-processed foods and sugary drinks in emerging economies and developed ones – dietary trends that are simultaneously harming people’s health, the planet – and driving AMR. Policy solutions – a user fee for veterinary antibiotics? Targets to reduce antimicrobial use include regulation and meat reduction. Along with better tracking, global agencies need to be thinking about the kinds of policy solutions that would really bring the AMR under control, he stresses. His team mapped out several key possibilities to proejct their results: Regulatory action to reduce the use of antibiotics in livestock worldwide to 50 milligrams per kilogram of meat produced, roughly the European median, would reduce veterinary antibiotic use by 64%; Regulatory action among only OECD countries and China to do the same – would lead to an almost equally sharp reduction in veterinary antibiotics of 60%; Consumer action to reduce meat consumption to just 60 grams a day – “about the equivalent of one Big Mac” – also would reduce antibiotic use in livestock by some 66%; “In other words, maybe we shouldn’t undermine the development of certain countries through livestock farming, as long as we have the OECD and China in the deal. We can make a significant difference,” says Van Boeckel. Yet another solution is to impose stiffer taxes, or user fees on antibiotics, which would in turn curb the incentives that now exist to farmers to purchase them at all – particularly when alternatives exist such as better sanitation practices, including more vaccination against preventible diseases. In UN – One Health rhetoric but little real action Jorge Matheu Alvarez of WHO discusses challenges of more harmonized surveillance of human and animal antimicrobial use and AMR trends. Such systematic global tracking of human and veterinary drug sales, and AMR trends should in fact be done by governments, and collected by the UN and its partners, Van Boeckel asserts. But data on antimicrobial drug sales for human and animal use – and AMR trends in both populations – is not collated and reported systematically by the major UN and multilateral organizations responsible. WHO, through its Global Antimicrobial Resistance and Surveillance System (GLASS), is trying improve surveillance of AMR in association with drugs used for human health, said Jorge Matheu Alvarez of WHO, who also appeared at the session. But tracking antibiotic consumption in animals or AMR in livestock isn’t really WHO’s job, he said. OIE tracks some data on veterinary use of antimicrobials, but that data remains very partial, with only 133 countries reporting to OIE at all. Many countries that do report lack data on actual quantities of antibiotics used or sold. In addition, the data is not transparent. Some 71% of countries that do report to OIE don’t make their data public. And therefore OIE’s data is presented only in terms of aggregate global quantities, rather by region or country. No data on AMR trends in animals is published by the member state organization. WHO, FAO, OIE and the World Animal Health Organization have recently launched a new One Health collaboration together with the UN Environment Programme. Both FAO and OIE have included antimicrobial stewardship in the animal sector in their global action plans, Alvarez noted saying: “we are making progress in the collaboration in these One Health areas.” The catalogue of #climate disasters is growing. With each page turned, the impacts on people, animals & environment are more severe. @UNEP is proud to have joined the Quadripartite Alliance on #OneHealth. Science ➕ collaboration ➕ action 🟰 success. #GHF2022 pic.twitter.com/BHWXeV2U9Y — Inger Andersen (@andersen_inger) May 4, 2022 Alvarez says FAO, OIE and WHO will soon begin placing the surveillance data they do collect on a single platform, called the Tripartite Integrated Surveillance System on AMR (TISSA). “Here we will host the One Health information collected by the different organizations on AMR, antimicrobial consumption and use of antimicrobials,” he told Health Policy Watch. But animal and human data thus collected won’t likely be reported and presented in a comparable manner for some time to come, he admits, because of different data collection methods. Member states are highly resistant to reporting on their antibiotic drug sales and consumption – because they see it has implications for their global trade in meat, the panelists also noted. “We need to be clearer and provide more guidance in the animal sector,” Alvarez told the panel session. The session was hosted by the Global Antibiotic R&D Partnership (GARDP), which aims to acccelerate the development of new antibiotic treatments for drug resistant infections and also attended by the Foundation for Innovative New Diagnostics (FIND), which is ramping up the development and deployment of infection tests to reduce unecessary use of antibiotics in humans. Says Van Boeckel, “I’ve been in this field for about ten years, and I thought something would have happened by now. I’ve been expecting a globally harmonized AMR surveillance system by the FAO and OIE that reports that data. And I can only ask the question, why hasn’t that happened? Until those agencies, and the member states that control them, rise to the challenge, surveillance of critical AMR trends will likely remain the purview of research teams such as Van Boeckel’s. But meanwhile, the neglect of animals’ antibiotic consumption remains just another pandemic waiting to happen, he warns: “If we want to inform policy in the short term, we need an alternative systematic surveillance system for LMICs, where we’ve seen that conditions may unfortunately be the worst, when it comes to development of resistance, in the coming decades.” –Updated on 5 May, 2022 Image Credits: Thomas Van Boekel, Health Policy Watch , Van Boeckel et al, ETH Zurich, Tiseo et al 2020, Antibiotics . What Worked to Reach Marginalised Communities During COVID-19? 04/05/2022 Aishwarya Tendolkar NorWest co-op offers community-based programmes to indigenous communities Protecting indigenous communities in Canada and refugees in central and Eastern Europe from COVID-19 requires community-based approaches that could be applied in other healthcare crises. This emerged from field actors who shared their experiences and lessons at the Geneva Health Forum on Tuesday. In Canada’s Manitoba province, indigenous communities were mistrustful of mass COVID-19 vaccinations, but reaching them was a priority for NorWest Co-op Community Health Centre. NorWest’s Kristin Bergen and Michelle Kirkbride identified the indigenous and ethnic communities they wanted to reach and then enlisted support from their leaders. They also stressed that to reach those who were most isolated and vulnerable, it was essential to help with things like booking clinic appointments and transport. In addition, Bergen and Kirkbridge stressed the importance of offering mental health support for the isolated communities that become less reachable in pandemics and during Canadian winters. NorWest had a trained trauma team to help people to cope with pandemic stress, and empowered community members to talk about mental health to reduce stigma and build trust. NorWest also provided the community with effective information on COVID-19 and vaccines. Mental health support The need for psychosocial support and mental health support was also highlighted by the International Federation of Red Cross and Red Crescent Societies’ (IFRC) Sherry Joseph. Online communication helped IFRC reach out to many communities and refugees in central and Eastern Europe, while a network of volunteers assisted IFRC teams in Hungary, Romania, Czechia and Ukraine to ensure that refugees also received vaccinations and medical help. Sherry added that IFRC is scaling up first aid skills in remote populations, ensuring continuity of vaccination programs, developing mental health programs, and making sure their workers and volunteers are equipped to deal with individuals who have escaped from traumatic zones. “We have learnt to smile with our eyes,” he said since masks hide them and smiling is a key way of extending warmth and support to the communities that IFRC caters to. Joseph added that IFRC is setting up mental health hotlines, especially for the refugees from Ukraine. Image Credits: NorWest Co-op. How to Protect the Environment and be Profitable at the Same Time 04/05/2022 Raisa Santos Environment-friendly approaches: Health experts have called on global leaders to tackle environmental issues affecting health and health systems. It is possible for industry to implement environmentally friendly approaches that are also profitable, Bertrand Piccard, chair of the Solar Impulse Foundation, told the Geneva Health Forum. “I have been working on identifying solutions that can reconcile ecology and economy that means to protect the environment and at the same time create jobs and be economically viable for the industry, the economy and the financial world,” said Piccard. The Swiss organisation, Solar Impulse Foundation, works to identify sustainable, clean and profitable solutions for climate action and offers political and industry leaders a guide on implementing these solutions on a large scale. Replace, reduce and recycle Some of its concepts include the solar-powered automatic irrigation system, electric cabinet with recycled batteries and the circular high-quality furniture made from recycled materials. Piccard pointed out that are new business opportunities to be grabbed by leaders in the industry who can develop efficient solutions to protect the environment: “It’s clear that the environment has a huge link to (public) health…. efficient solutions improve the health of everybody.” To back this argument, he presented the example of a French start-up that captures the heat from chimneys of factories for recycling to reduce the energy bill of the same enterprise by 20%. “It produces less carbon, less energy, and it’s a business opportunity that expands and creates jobs,” said Piccard. “This is what I call qualitative growth. You develop the economy by replacing what is polluting with what is protecting the environment, so you can reconcile ecology and economy.” Piccard also noted the importance of both sides i.e. businesses and environmentalists striving hand-in-hand towards this goal. “You need the ‘green activists’ to move forward to push the politicians and you need the industry to produce the solutions. That will help us live in a more efficient way and be more environmentally friendly.” Climate neutrality ambitions Piccard praised the European Commission’s recent announcement that 100 European Union (EU) cities and 12 non-EU cities are participating in a program to become climate neutral by 2030. Bertrand Piccard, chair of the Solar Impulse Foundation. According to the EU plan, the 112 participating cities – in which roughly 75 million people live – will prepare plans and contracts to set out action and investment plans in order to achieve climate neutrality in the coming eight years. The ultimate goal of climate neutrality, as defined by the United Nations (UN), is to achieve zero greenhouse gas emissions by balancing the emissions so they are equal (or less than) the emissions that get removed through the planet’s natural absorption. Piccard stated that problems brought about by pollution and greenhouse gases should be tackled incrementally to bring cities closer to becoming climate neutral. “You cannot take the big problems and find solutions. It doesn’t work because most of the problems are not identified correctly so you need to do the opposite. You need to go through the solutions and look at which solution can be implemented where and each time you reduce a little bit of CO2, a little bit of inefficiency, a little bit of pollution, but altogether you can solve the problem.” Protecting the environment requires everyone to rethink the phrase ‘changing behaviours’ and use the word ‘modernise’ instead when addressing climate change in low- and middle-income countries, he added. “You have to modernise old infrastructures. You have to modernise all energy sources. You have to modernise the way to construct the buildings, you have to modernise mobility.” When it comes to changing behaviours, Piccard said that few people made minimal changes with minimal impact, with a majority refusing to renounce their habits. “You will say yes, of course, I will renounce a little bit. I will take the aeroplane only three times a week instead of four. But it doesn’t change the world.” Speaking specifically about the stance of the developing countries on the contested issue of emissions, Piccard added: “We have to go from [a narrative of saying] protection of the environment is threatening our lifestyles, [which is] expensive and boring, to a narrative where protection of the environment is exciting, profitable, creative, interesting, and modernising.” The developing countries should use new technologies, said Piccard. “They want to reach our (developed world) levels of development. They want to be like Europe and North America. [In order to modernise] they can use efficient systems, use renewable energies in order to have local economic development.” “It’s a question of narrative, because we need to take people with us otherwise they will not follow, they will resist.” As the developed and the developing countries continue to have contested viewpoints on this matter, the latest UN report suggests the emissions from fossil fuel combustion in the three regions of Asia and the Pacific, Africa and Latin America grew by 26% over the past decade, as compared to 260% growth in the prior two decades. The fossil fuel combustion emissions of developed countries shrank by about 10% over both of those periods. Europe Must take advantage of ‘COVID-19 Ceasefire’ to Prepare for Next Wave, says WHO’s Kluge 04/05/2022 Maayan Hoffman Dr Hans Kluge, WHO Regional Director for Europe. The European Region and COVID-19 are in a “kind of ceasefire,” according to World Health Organization’s (WHO) Regional Director for Europe, Dr Hans Kluge. It is now up to the region’s 53 member states to take advantage of this window to prepare for the next fight, he said. “It is quiet and we have to take advantage of this, because obviously the fact that the virus spread so fast and so many people have been infected means that a new mutant is already here,” Kluge said Wednesday during an interview at the Geneva Health Forum. “The virus has surprised us many times.” Kluge, who started his role on 1 February 2020 just as the pandemic began, spoke via video link from his office in Denmark. There have been at least 191 million reported COVID-19 infections in Europe and more than 2.2 million deaths since the start of the pandemic two years ago, according to Reuters COVID tracker. The average new daily cases in the region have dropped from a recent peak of 1.7 million in February to fewer than 230,000 in recent days. However, Germany leads the world in the daily average number of new cases, Reuters said, accounting for one in every six infections reported worldwide. Moreover, as Kluge noted, it is not possible to track how fast the virus is spreading in Ukraine as a result of the Russian invasion. Reuters COVID-19 tracker shows a decline in average daily cases across the European region. He urged the region to implement a pan-European system that could pick up on any threat from antimicrobial resistance, a dangerous virus or climate change “very quickly – we need an alert system.” And he said that the region needs its political systems to take action when there is such an alert. Kluge also said that the most important ingredient in any COVID-19 toolkit must be equal access to vaccines and affordable antivirals. “The best way to combat infectious disease is a combination of prevention and treatment: vaccines and medicines,” according to Kluge. The comments were especially meaningful on Wednesday, a day after the World Trade Organization’s TRIPS Council announced that it will finally discuss a compromise proposal on a waiver of intellectual property rights on COVID-19 vaccines. However, antivirals are not included in the compromise. While Pfizer and Merck – the companies with effective COVID-19 antivirals – have entered into voluntary licensing agreements with the Medicine Patents Pool to enable generic companies to make the drugs for certain low-income countries, the agreements and countries the deal applies to are restricted. Kluge offered a four-step COVID-19 exit strategy for the region: 1. Implement a plan for protecting the most vulnerable “We may at some point have to shift from mass action to more routine vaccination of just the vulnerable people,” Kluge said. 2. Vaccinate and boost “We will need to do whatever it takes to vaccinate the unvaccinated and boost the vaccinated,” he added. 3. Beef up surveillance “We need a system that is able to pick up new COVID-19 variants very quickly so that national lockdowns can be avoided,” said Kluge. 4. Deal with the backlog of patients with other diseases Kluge noted that the healthcare sector is also facing a shadow pandemic – dealing with the backlog of patients who are suffering due to postponement of elective surgeries, cancer and other screenings, mental health issues and long COVID. He said around 20% of people infected with the virus continue to experience some symptoms even months later. “We need more knowledge about long COVID,” Kluge stressed. But he admitted that rolling out this exit strategy could be “tricky,” as a result of complacency by the public and political leaders whose memories are “very short.” “Heads of states and governments need to make the investment in health and health systems that is key for a resilient society and preparedness,” said Kluge. “Health is not everything, but without health, there is nothing.” Image Credits: WHO, Screenshot. Four COVID-19 Lessons and How to Make Humanity More Resilient 04/05/2022 Maayan Hoffman Tatiana Valovaya, Director-General of the United Nations Office at Genevai during World Humanitarian Day. 19 August 2019. The COVID-19 pandemic blindsided most of the world as it swept from China across the world at an unprecedent pace, infecting, ultimately killing millions of people. But more than two years later, there are some lessons that can be learned, said Tatiana Valovaya, director-general of the United Nations in Geneva on Tuesday evening. At the Opening Ceremony for the Geneva Health Forum, Valovaya delivered the four key takeaways from the pandemic for public health professionals. Her colleague, likewise, offered “concerned actions” that could be taken in at least five key areas to make humanity more resilient to future health threats. In total, nine people addressed attendees during the opening ceremony, which drew over 1000 people and is the first major global health event hosted in Geneva since the pandemic began. The speakers included Valovaya; Antoine Geissbuhler and Véronique Maye, Geneva Health Forum’s co-presidents; Bertrand Levrat, CEO of the University Hospitals of Geneva; Mauro Poggia, minister of health, population and security for the state of Geneva; Jürg Lauber, Swiss ambassador and permanent representative to the Office of the United Nations in Geneva; Zsuzsanna Jakab, deputy director-general of the World Health Organization; Monique Eloit, director-general of the World Organisation for Animal Health (OIE); and Peter Maurer, president of the International Committee of the Red Cross. What lessons were learned? 1 – We live in a globalized world and are all interconnected and interdependent. “We can only be as safe or as healthy as all other people around that world are,” said Valovaya. “That means we have to work in solidarity.” 2 – We can do a lot to improve environmental degradation. This notion was supported by Eloit in her keynote address. “I will insist on how it is crucial to transform our relationship with the environment,” she said. “We need to move from response to prevention.” 3 – We have to fight inequality. “During the pandemic, we saw that those who were very vulnerable were the first to suffer,” noted Valovaya. “We saw this with access to healthcare, vaccines and even clean water.” 4 – All of the challenges that humanity is facing are global. “Global challenges need global solutions,” she said. “We need multilateralism that is inclusive and integrated. Only together can we find solutions.” While the world continues to tackle COVID-19, something which Eloit stressed is “still ongoing, while we continue to face other challenges,” the international community must simultaneously fight the climate crisis, she said. Dr. Zsuzsanna Jakab, Deputy Director-General of the World Health Organization, at the Palais des Nations, Geneva, Switzerland, February 24, 2020, in one of the last face-to-face UN meetings before the COVID pandemic. Thirteen million people die from preventable environmental factors WHO estimates that 13 million people die every year as a result of preventable environmental factors and that 90% of the global population breathes unhealthy air, Jakab noted. “Concerted action is needed across at least five key areas to make humanity more resilient to future health threats,” she stressed. The first is understanding that health is not negotiable. The second is the need to shift from health systems focused purely on treating diseases to health systems focused on disease prevention and health promotion. Next, equity is not a ‘nice to have’. “The vulnerability of one single nation makes the whole world more vulnerable to disease threats,” she said, echoing Valovaya’s sentiments. “We must move from a fragmented health architecture to a cohesive architecture with stronger governance, financing and tools. Finally, we must shift from a siloed, sectored approach to human health to a One Health approach, said Jakab. One Health was defined in December 2021 by the inter-agency One Health High-Level Expert Panel (OHHLEP) as “an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems. It recognizes the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and inter-dependent. It was a major focus of the first day of the Geneva Health Forum. “OHHLEP’s goal is to move One Health from concept to practice,” Eloit stressed in her talk, which helped culminate the formal opening ceremony. In the morning, the opening panel was on “One Health: is there a paradigm shift?” “We all have a role to play,” concluded Eloit. “We have a responsibility to make tomorrow safer than today.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Flickr. ‘Epidemic’ of Obesity in Europe 03/05/2022 Kerry Cullinan Impact of obesity on health Almost two-thirds of adults and a third of children are overweight or obese in the World Health Organization (WHO) European Region and this is driving cancer and other diseases, according to the WHO European Regional Obesity Report 2022 report released on Tuesday. The highest prevalence is in Turkey, Malta, Israel and the UK (WHO Europe has different members from the European Union), but there is an upward trend in all 53 member countries. Driving cancers Obesity is the cause of 13 different types of cancer, as well as a risk factor in strokes, heart attacks, type 2 diabetes and other non-communicable diseases, according to the report. For some countries in the region, obesity is predicted to overtake smoking as the main risk factor for preventable cancer. The report also highlights that obesity is a condition, not just a risk factor, that needs to be specifically treated and managed. “In Europe and Central Asia, no single country is going to meet the WHO Global NCD target of halting the rise of obesity by 2025,” said Dr Hans Kluge, WHO Regional Director for Europe. Adult obesity in the 53-country European Region is higher than in any other WHO region except the the Americas. More males (63%) are overweight than among females (54%) while obesity is more prevalent among females (24%) than among males (22%). Obesity rates in Europe (2016) 50% 60% 70% Orange = all adults, Blue = males, Green = females The COVID-19 pandemic has highlighted the danger of obesity, with patients with obesity being more likely to experience complications and death from the virus. “Preliminary data also suggest that during the current pandemic, people have had higher exposure to obesity risk factors, including an increase in sedentary lifestyles and consumption of unhealthy foods,” according to the report. Addressing unhealthy environments “Obesity is influenced by the environment, so it is important to look at this problem from the perspective of every stage of life. For example, the life of children and adolescents is impacted by digital environments, including marketing of unhealthy food and drinks,” said Dr Kremlin Wickramasinghe, Acting Head of the WHO European Office for the Prevention and Control of NCDs, which produced the report. “Restricting the marketing of unhealthy foods to children, taxation of sugar-sweetened beverages and improving health system response for obesity management are currently among the most actively discussed policy areas in the WHO European Region,” Wickramasinghe added. Other policies that show promise in reducing levels of obesity and overweight include improving access to obesity and overweight management services in primary health care, promoting breastfeeding and school-based interventions. The report also highlights interventions at supermarkets and takeaway outlets, which are the primary food sources. These include removing unhealthy foods from checkouts and nearby aisles and restricting takeaway outlets. Improving the quality of parks and playgrounds, as well as providing adequate infrastructure for active transport are other suggestions. Image Credits: rawpixel/unsplash. After Months of Deadlock, WTO’s TRIPS Council Will Finally Discuss Intellectual Property Waiver Compromise 03/05/2022 Kerry Cullinan WTO Director-General Ngozi Okonjo-Iweala In a significant breakthrough, the World Trade Organization’s (WTO) TRIPS Council on Friday will finally discuss a compromise proposal on a waiver of intellectual property (IP) rights on COVID-19 vaccines – almost 18 months after it was first proposed by India and South Africa. Members attending an informal meeting of the TRIPS Council on Tuesday were told that the text of an “outcome document” from the “quad” of the European Union, US, India and South Africa would be circulated to them “within hours” from WTO Director-General Ngozi Okonjo-Iweala’s office. The outcome document, which was later posted on the WTO website, is very similar to that which was leaked in mid-March – but it has been termed an “outcome document” rather than an agreement as there are still a couple of points of disagreement. Disagreement over who should be eligible The main point of disagreement relates to which countries should be able to benefit from the waiver (footnote 1). All developing country members that have not yet achieved a significant export capacity – namely 10% of the world’s COVID-19 vaccine market – are supposed to benefit from the flexibilities. Apparently, China has been unhappy about being excluded while a country like India with large generic manufacturing capacity, may be included. But the new TRIPS Council chairperson, Sierra Leone’s Ambassador Lansana Gberie, told Tuesday’s meeting that the superpower “seemed favourably disposed” towards the compromise – also contained in footnote 1 – that states “all developing country members with capacity are encouraged to opt out from these flexibilities”, according to a WTO official. While the waiver only applies to vaccines, WTO members will have six months to decide whether to extend it to cover the production and distribution of COVID-19 diagnostics and therapeutics. According to the draft document, eligible WTO members will be able to limit TRIPS article Section 28, which deals with exclusive patents, by authorizing the production and supply of COVID-19 vaccines without the patent holder’s consent, and with minimal transaction costs. Single authorisation for multiple patents Another deviation from draft agreement that was leaked in mid-March is related to whether countries will have to list all the patents that they will be waiving – widely criticised for imposing onerous requirements on countries. This appears set to go, according to footnote 3. Eligible countries may issue a single authorisation to use multiple patents and can export the vaccines they produce under this authorisation to other eligible members, particularly countries in greatest need, and to supply regional or international initiatives such as COVAX (a waiver of TRIPS Art. 31(f).) Eligible members will also be able to use any of their legal instruments to impose a waiver on vaccines, and the protection of clinical trial data under TRIPS will not be an obstacle to implementing this proposal. Payment for any vaccines produced under TRIPS waiver conditions for export is to take account of the humanitarian and not-for-profit purpose of the vaccine programme, to support manufacturers to produce and supply vaccines at affordable prices. The duration of the flexibilities would be either three or five years, and eligible members would be exempted from legal challenges under the WTO dispute settlement mechanism. The earlier agreement was widely condemned by health activist groups, who objected the waiver being confined to vaccines and excluding some of the world’s major COVID-19 vaccine producers. In addition, a diplomatic source told Health Policy Watch that he did not know the value of the waiver given that there was an apparent surplus of COVID-19 vaccines. The results of the formal discussion on Friday will be reported to the General Council, which is scheduled to meet on 9 and 10 May. Image Credits: Jess Hurd/ Global Justice Now, Africa Centre for International Trade&Development. Europeans May Have to Sleep Under Mosquito Nets as Climate Change Alters Disease Patterns 03/05/2022 Maayan Hoffman Geneva Health Forum session, “Impact of climate change on health.” From left: Moderator Maximilian Jungmann, University of Heidelberg; Alfonso Gomez, City of Geneva; Maria Neira, World Health Organization; Gueladio Cisse, CGIEC Swiss TPH; and Valérie D’Acremont, University of Lausanne. Children sick with malaria, adults in bed with fevers and rashes as a result of the Zika virus, tick-borne illnesses – all of these diseases are on the rise as a result of climate change, according to Valérie D’Acremont of the University of Lausanne. She spoke on Tuesday at the Geneva Health Forum during a special session on the impact of climate change on health, addressing the question: “what is the scale of the problem and what action needs to be taken?” “It is clear that there has been an increase in transmission of [existing] pathogens and of new pathogens,” said D’Acremont, a Swiss physician who is also working on a project in Africa. For example, the spread of malaria, caused by a parasite that spreads to humans and other animals through the bites of infected female mosquitoes, increases in temperatures of around 25ºC. “In West Africa, it is too hot, so malaria might be going down, but in East Africa, the opposite is the case and we see an increase in malaria,” she said. Adding to the challenge are compromised health systems, the result of two years of the COVID-19 pandemic, which has seen the world losing some of its gains against malaria over the last 20 years. Mosquitoes, similarly, are more prone to spreading Zika virus in around 30ºC, which means that the world’s tropical areas are seeing more and more of the disease, and it is likely to extend to Europe and other countries. “We see it already in Italy,” D’Acremont stressed. “We might one day have to sleep under bed nets like they do in Africa.” Tick-borne diseases are spreading in Switzerland, also as a result of climate change, she added. There has been a two-thirds increase in the number of people hospitalized for ticks in Switzerland from 2009 to 2019, according to a recent report by RTS. Moreover, the number of tick bites rose from around 10,000 per year between 2012 and 2016 to around 14,000 a year in the last four years. “Journalists like to hear this story because it frightens people,” D’Acremont said but added that the main challenge was that people die from these diseases when coupled with other pre-existing conditions, such as diabetes, hypertension or malnutrition. These are also often a result of climate change or failing to take care of the environment and our food sources. “Climate change has a huge impact on this too, especially undernutrition and respiratory problems,” she said. Alfonso Gomez of the City of Geneva addresses the Geneva Health Forum on May 3, 2022. We need to stop exploiting animals, destroying nature Climate change has become an inescapable reality. The most recent Intergovernmental Panel on Climate Change (IPPC) report showed what people already knew: There is now scientific consensus that climate change is impacting people’s health and wellbeing in all hemispheres. Sometimes the effect is direct, Gueladio Cisse of CGIEC Swiss TPH, who also spoke at the session, said. Sometimes it is indirect. Sometimes the effect comes at once, and other times it has a slower but also longer-term impact. “If there is a heatwave, the next thing you know people are dying over the course of two or three days,” Cisse said as an example. Other times, a general increase in temperature allows pathogens to grow and makes humans more vulnerable to disease. The good news, said Dr Maria Neira, of the World Health Organization, is that the scientific community has been “pulling together in a historic way all the evidence we have on climate change… They are telling us things like if we don’t take measure now, this might put civilization at risk.” D’Acremont agreed but said that while research was useful, now is the time to do research in the field by monitoring the impact of steps taken to curb environmental hazards. “We need a paradigm shift to go to prevention,” she said. “Take COVID. It is nice to have a preparedness plan, but the problem is that another pandemic or event could come and it is new and we cannot be prepared.” Instead, she said, “we need to stop destroying nature, stop exploiting animals and start preparing ourselves by being in better health. During the crisis is too late… We have to shift the reality now to preventive care. That is true for northern and southern countries.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Maayan Hoffman. 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.
What Worked to Reach Marginalised Communities During COVID-19? 04/05/2022 Aishwarya Tendolkar NorWest co-op offers community-based programmes to indigenous communities Protecting indigenous communities in Canada and refugees in central and Eastern Europe from COVID-19 requires community-based approaches that could be applied in other healthcare crises. This emerged from field actors who shared their experiences and lessons at the Geneva Health Forum on Tuesday. In Canada’s Manitoba province, indigenous communities were mistrustful of mass COVID-19 vaccinations, but reaching them was a priority for NorWest Co-op Community Health Centre. NorWest’s Kristin Bergen and Michelle Kirkbride identified the indigenous and ethnic communities they wanted to reach and then enlisted support from their leaders. They also stressed that to reach those who were most isolated and vulnerable, it was essential to help with things like booking clinic appointments and transport. In addition, Bergen and Kirkbridge stressed the importance of offering mental health support for the isolated communities that become less reachable in pandemics and during Canadian winters. NorWest had a trained trauma team to help people to cope with pandemic stress, and empowered community members to talk about mental health to reduce stigma and build trust. NorWest also provided the community with effective information on COVID-19 and vaccines. Mental health support The need for psychosocial support and mental health support was also highlighted by the International Federation of Red Cross and Red Crescent Societies’ (IFRC) Sherry Joseph. Online communication helped IFRC reach out to many communities and refugees in central and Eastern Europe, while a network of volunteers assisted IFRC teams in Hungary, Romania, Czechia and Ukraine to ensure that refugees also received vaccinations and medical help. Sherry added that IFRC is scaling up first aid skills in remote populations, ensuring continuity of vaccination programs, developing mental health programs, and making sure their workers and volunteers are equipped to deal with individuals who have escaped from traumatic zones. “We have learnt to smile with our eyes,” he said since masks hide them and smiling is a key way of extending warmth and support to the communities that IFRC caters to. Joseph added that IFRC is setting up mental health hotlines, especially for the refugees from Ukraine. Image Credits: NorWest Co-op. How to Protect the Environment and be Profitable at the Same Time 04/05/2022 Raisa Santos Environment-friendly approaches: Health experts have called on global leaders to tackle environmental issues affecting health and health systems. It is possible for industry to implement environmentally friendly approaches that are also profitable, Bertrand Piccard, chair of the Solar Impulse Foundation, told the Geneva Health Forum. “I have been working on identifying solutions that can reconcile ecology and economy that means to protect the environment and at the same time create jobs and be economically viable for the industry, the economy and the financial world,” said Piccard. The Swiss organisation, Solar Impulse Foundation, works to identify sustainable, clean and profitable solutions for climate action and offers political and industry leaders a guide on implementing these solutions on a large scale. Replace, reduce and recycle Some of its concepts include the solar-powered automatic irrigation system, electric cabinet with recycled batteries and the circular high-quality furniture made from recycled materials. Piccard pointed out that are new business opportunities to be grabbed by leaders in the industry who can develop efficient solutions to protect the environment: “It’s clear that the environment has a huge link to (public) health…. efficient solutions improve the health of everybody.” To back this argument, he presented the example of a French start-up that captures the heat from chimneys of factories for recycling to reduce the energy bill of the same enterprise by 20%. “It produces less carbon, less energy, and it’s a business opportunity that expands and creates jobs,” said Piccard. “This is what I call qualitative growth. You develop the economy by replacing what is polluting with what is protecting the environment, so you can reconcile ecology and economy.” Piccard also noted the importance of both sides i.e. businesses and environmentalists striving hand-in-hand towards this goal. “You need the ‘green activists’ to move forward to push the politicians and you need the industry to produce the solutions. That will help us live in a more efficient way and be more environmentally friendly.” Climate neutrality ambitions Piccard praised the European Commission’s recent announcement that 100 European Union (EU) cities and 12 non-EU cities are participating in a program to become climate neutral by 2030. Bertrand Piccard, chair of the Solar Impulse Foundation. According to the EU plan, the 112 participating cities – in which roughly 75 million people live – will prepare plans and contracts to set out action and investment plans in order to achieve climate neutrality in the coming eight years. The ultimate goal of climate neutrality, as defined by the United Nations (UN), is to achieve zero greenhouse gas emissions by balancing the emissions so they are equal (or less than) the emissions that get removed through the planet’s natural absorption. Piccard stated that problems brought about by pollution and greenhouse gases should be tackled incrementally to bring cities closer to becoming climate neutral. “You cannot take the big problems and find solutions. It doesn’t work because most of the problems are not identified correctly so you need to do the opposite. You need to go through the solutions and look at which solution can be implemented where and each time you reduce a little bit of CO2, a little bit of inefficiency, a little bit of pollution, but altogether you can solve the problem.” Protecting the environment requires everyone to rethink the phrase ‘changing behaviours’ and use the word ‘modernise’ instead when addressing climate change in low- and middle-income countries, he added. “You have to modernise old infrastructures. You have to modernise all energy sources. You have to modernise the way to construct the buildings, you have to modernise mobility.” When it comes to changing behaviours, Piccard said that few people made minimal changes with minimal impact, with a majority refusing to renounce their habits. “You will say yes, of course, I will renounce a little bit. I will take the aeroplane only three times a week instead of four. But it doesn’t change the world.” Speaking specifically about the stance of the developing countries on the contested issue of emissions, Piccard added: “We have to go from [a narrative of saying] protection of the environment is threatening our lifestyles, [which is] expensive and boring, to a narrative where protection of the environment is exciting, profitable, creative, interesting, and modernising.” The developing countries should use new technologies, said Piccard. “They want to reach our (developed world) levels of development. They want to be like Europe and North America. [In order to modernise] they can use efficient systems, use renewable energies in order to have local economic development.” “It’s a question of narrative, because we need to take people with us otherwise they will not follow, they will resist.” As the developed and the developing countries continue to have contested viewpoints on this matter, the latest UN report suggests the emissions from fossil fuel combustion in the three regions of Asia and the Pacific, Africa and Latin America grew by 26% over the past decade, as compared to 260% growth in the prior two decades. The fossil fuel combustion emissions of developed countries shrank by about 10% over both of those periods. Europe Must take advantage of ‘COVID-19 Ceasefire’ to Prepare for Next Wave, says WHO’s Kluge 04/05/2022 Maayan Hoffman Dr Hans Kluge, WHO Regional Director for Europe. The European Region and COVID-19 are in a “kind of ceasefire,” according to World Health Organization’s (WHO) Regional Director for Europe, Dr Hans Kluge. It is now up to the region’s 53 member states to take advantage of this window to prepare for the next fight, he said. “It is quiet and we have to take advantage of this, because obviously the fact that the virus spread so fast and so many people have been infected means that a new mutant is already here,” Kluge said Wednesday during an interview at the Geneva Health Forum. “The virus has surprised us many times.” Kluge, who started his role on 1 February 2020 just as the pandemic began, spoke via video link from his office in Denmark. There have been at least 191 million reported COVID-19 infections in Europe and more than 2.2 million deaths since the start of the pandemic two years ago, according to Reuters COVID tracker. The average new daily cases in the region have dropped from a recent peak of 1.7 million in February to fewer than 230,000 in recent days. However, Germany leads the world in the daily average number of new cases, Reuters said, accounting for one in every six infections reported worldwide. Moreover, as Kluge noted, it is not possible to track how fast the virus is spreading in Ukraine as a result of the Russian invasion. Reuters COVID-19 tracker shows a decline in average daily cases across the European region. He urged the region to implement a pan-European system that could pick up on any threat from antimicrobial resistance, a dangerous virus or climate change “very quickly – we need an alert system.” And he said that the region needs its political systems to take action when there is such an alert. Kluge also said that the most important ingredient in any COVID-19 toolkit must be equal access to vaccines and affordable antivirals. “The best way to combat infectious disease is a combination of prevention and treatment: vaccines and medicines,” according to Kluge. The comments were especially meaningful on Wednesday, a day after the World Trade Organization’s TRIPS Council announced that it will finally discuss a compromise proposal on a waiver of intellectual property rights on COVID-19 vaccines. However, antivirals are not included in the compromise. While Pfizer and Merck – the companies with effective COVID-19 antivirals – have entered into voluntary licensing agreements with the Medicine Patents Pool to enable generic companies to make the drugs for certain low-income countries, the agreements and countries the deal applies to are restricted. Kluge offered a four-step COVID-19 exit strategy for the region: 1. Implement a plan for protecting the most vulnerable “We may at some point have to shift from mass action to more routine vaccination of just the vulnerable people,” Kluge said. 2. Vaccinate and boost “We will need to do whatever it takes to vaccinate the unvaccinated and boost the vaccinated,” he added. 3. Beef up surveillance “We need a system that is able to pick up new COVID-19 variants very quickly so that national lockdowns can be avoided,” said Kluge. 4. Deal with the backlog of patients with other diseases Kluge noted that the healthcare sector is also facing a shadow pandemic – dealing with the backlog of patients who are suffering due to postponement of elective surgeries, cancer and other screenings, mental health issues and long COVID. He said around 20% of people infected with the virus continue to experience some symptoms even months later. “We need more knowledge about long COVID,” Kluge stressed. But he admitted that rolling out this exit strategy could be “tricky,” as a result of complacency by the public and political leaders whose memories are “very short.” “Heads of states and governments need to make the investment in health and health systems that is key for a resilient society and preparedness,” said Kluge. “Health is not everything, but without health, there is nothing.” Image Credits: WHO, Screenshot. Four COVID-19 Lessons and How to Make Humanity More Resilient 04/05/2022 Maayan Hoffman Tatiana Valovaya, Director-General of the United Nations Office at Genevai during World Humanitarian Day. 19 August 2019. The COVID-19 pandemic blindsided most of the world as it swept from China across the world at an unprecedent pace, infecting, ultimately killing millions of people. But more than two years later, there are some lessons that can be learned, said Tatiana Valovaya, director-general of the United Nations in Geneva on Tuesday evening. At the Opening Ceremony for the Geneva Health Forum, Valovaya delivered the four key takeaways from the pandemic for public health professionals. Her colleague, likewise, offered “concerned actions” that could be taken in at least five key areas to make humanity more resilient to future health threats. In total, nine people addressed attendees during the opening ceremony, which drew over 1000 people and is the first major global health event hosted in Geneva since the pandemic began. The speakers included Valovaya; Antoine Geissbuhler and Véronique Maye, Geneva Health Forum’s co-presidents; Bertrand Levrat, CEO of the University Hospitals of Geneva; Mauro Poggia, minister of health, population and security for the state of Geneva; Jürg Lauber, Swiss ambassador and permanent representative to the Office of the United Nations in Geneva; Zsuzsanna Jakab, deputy director-general of the World Health Organization; Monique Eloit, director-general of the World Organisation for Animal Health (OIE); and Peter Maurer, president of the International Committee of the Red Cross. What lessons were learned? 1 – We live in a globalized world and are all interconnected and interdependent. “We can only be as safe or as healthy as all other people around that world are,” said Valovaya. “That means we have to work in solidarity.” 2 – We can do a lot to improve environmental degradation. This notion was supported by Eloit in her keynote address. “I will insist on how it is crucial to transform our relationship with the environment,” she said. “We need to move from response to prevention.” 3 – We have to fight inequality. “During the pandemic, we saw that those who were very vulnerable were the first to suffer,” noted Valovaya. “We saw this with access to healthcare, vaccines and even clean water.” 4 – All of the challenges that humanity is facing are global. “Global challenges need global solutions,” she said. “We need multilateralism that is inclusive and integrated. Only together can we find solutions.” While the world continues to tackle COVID-19, something which Eloit stressed is “still ongoing, while we continue to face other challenges,” the international community must simultaneously fight the climate crisis, she said. Dr. Zsuzsanna Jakab, Deputy Director-General of the World Health Organization, at the Palais des Nations, Geneva, Switzerland, February 24, 2020, in one of the last face-to-face UN meetings before the COVID pandemic. Thirteen million people die from preventable environmental factors WHO estimates that 13 million people die every year as a result of preventable environmental factors and that 90% of the global population breathes unhealthy air, Jakab noted. “Concerted action is needed across at least five key areas to make humanity more resilient to future health threats,” she stressed. The first is understanding that health is not negotiable. The second is the need to shift from health systems focused purely on treating diseases to health systems focused on disease prevention and health promotion. Next, equity is not a ‘nice to have’. “The vulnerability of one single nation makes the whole world more vulnerable to disease threats,” she said, echoing Valovaya’s sentiments. “We must move from a fragmented health architecture to a cohesive architecture with stronger governance, financing and tools. Finally, we must shift from a siloed, sectored approach to human health to a One Health approach, said Jakab. One Health was defined in December 2021 by the inter-agency One Health High-Level Expert Panel (OHHLEP) as “an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems. It recognizes the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and inter-dependent. It was a major focus of the first day of the Geneva Health Forum. “OHHLEP’s goal is to move One Health from concept to practice,” Eloit stressed in her talk, which helped culminate the formal opening ceremony. In the morning, the opening panel was on “One Health: is there a paradigm shift?” “We all have a role to play,” concluded Eloit. “We have a responsibility to make tomorrow safer than today.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Flickr. ‘Epidemic’ of Obesity in Europe 03/05/2022 Kerry Cullinan Impact of obesity on health Almost two-thirds of adults and a third of children are overweight or obese in the World Health Organization (WHO) European Region and this is driving cancer and other diseases, according to the WHO European Regional Obesity Report 2022 report released on Tuesday. The highest prevalence is in Turkey, Malta, Israel and the UK (WHO Europe has different members from the European Union), but there is an upward trend in all 53 member countries. Driving cancers Obesity is the cause of 13 different types of cancer, as well as a risk factor in strokes, heart attacks, type 2 diabetes and other non-communicable diseases, according to the report. For some countries in the region, obesity is predicted to overtake smoking as the main risk factor for preventable cancer. The report also highlights that obesity is a condition, not just a risk factor, that needs to be specifically treated and managed. “In Europe and Central Asia, no single country is going to meet the WHO Global NCD target of halting the rise of obesity by 2025,” said Dr Hans Kluge, WHO Regional Director for Europe. Adult obesity in the 53-country European Region is higher than in any other WHO region except the the Americas. More males (63%) are overweight than among females (54%) while obesity is more prevalent among females (24%) than among males (22%). Obesity rates in Europe (2016) 50% 60% 70% Orange = all adults, Blue = males, Green = females The COVID-19 pandemic has highlighted the danger of obesity, with patients with obesity being more likely to experience complications and death from the virus. “Preliminary data also suggest that during the current pandemic, people have had higher exposure to obesity risk factors, including an increase in sedentary lifestyles and consumption of unhealthy foods,” according to the report. Addressing unhealthy environments “Obesity is influenced by the environment, so it is important to look at this problem from the perspective of every stage of life. For example, the life of children and adolescents is impacted by digital environments, including marketing of unhealthy food and drinks,” said Dr Kremlin Wickramasinghe, Acting Head of the WHO European Office for the Prevention and Control of NCDs, which produced the report. “Restricting the marketing of unhealthy foods to children, taxation of sugar-sweetened beverages and improving health system response for obesity management are currently among the most actively discussed policy areas in the WHO European Region,” Wickramasinghe added. Other policies that show promise in reducing levels of obesity and overweight include improving access to obesity and overweight management services in primary health care, promoting breastfeeding and school-based interventions. The report also highlights interventions at supermarkets and takeaway outlets, which are the primary food sources. These include removing unhealthy foods from checkouts and nearby aisles and restricting takeaway outlets. Improving the quality of parks and playgrounds, as well as providing adequate infrastructure for active transport are other suggestions. Image Credits: rawpixel/unsplash. After Months of Deadlock, WTO’s TRIPS Council Will Finally Discuss Intellectual Property Waiver Compromise 03/05/2022 Kerry Cullinan WTO Director-General Ngozi Okonjo-Iweala In a significant breakthrough, the World Trade Organization’s (WTO) TRIPS Council on Friday will finally discuss a compromise proposal on a waiver of intellectual property (IP) rights on COVID-19 vaccines – almost 18 months after it was first proposed by India and South Africa. Members attending an informal meeting of the TRIPS Council on Tuesday were told that the text of an “outcome document” from the “quad” of the European Union, US, India and South Africa would be circulated to them “within hours” from WTO Director-General Ngozi Okonjo-Iweala’s office. The outcome document, which was later posted on the WTO website, is very similar to that which was leaked in mid-March – but it has been termed an “outcome document” rather than an agreement as there are still a couple of points of disagreement. Disagreement over who should be eligible The main point of disagreement relates to which countries should be able to benefit from the waiver (footnote 1). All developing country members that have not yet achieved a significant export capacity – namely 10% of the world’s COVID-19 vaccine market – are supposed to benefit from the flexibilities. Apparently, China has been unhappy about being excluded while a country like India with large generic manufacturing capacity, may be included. But the new TRIPS Council chairperson, Sierra Leone’s Ambassador Lansana Gberie, told Tuesday’s meeting that the superpower “seemed favourably disposed” towards the compromise – also contained in footnote 1 – that states “all developing country members with capacity are encouraged to opt out from these flexibilities”, according to a WTO official. While the waiver only applies to vaccines, WTO members will have six months to decide whether to extend it to cover the production and distribution of COVID-19 diagnostics and therapeutics. According to the draft document, eligible WTO members will be able to limit TRIPS article Section 28, which deals with exclusive patents, by authorizing the production and supply of COVID-19 vaccines without the patent holder’s consent, and with minimal transaction costs. Single authorisation for multiple patents Another deviation from draft agreement that was leaked in mid-March is related to whether countries will have to list all the patents that they will be waiving – widely criticised for imposing onerous requirements on countries. This appears set to go, according to footnote 3. Eligible countries may issue a single authorisation to use multiple patents and can export the vaccines they produce under this authorisation to other eligible members, particularly countries in greatest need, and to supply regional or international initiatives such as COVAX (a waiver of TRIPS Art. 31(f).) Eligible members will also be able to use any of their legal instruments to impose a waiver on vaccines, and the protection of clinical trial data under TRIPS will not be an obstacle to implementing this proposal. Payment for any vaccines produced under TRIPS waiver conditions for export is to take account of the humanitarian and not-for-profit purpose of the vaccine programme, to support manufacturers to produce and supply vaccines at affordable prices. The duration of the flexibilities would be either three or five years, and eligible members would be exempted from legal challenges under the WTO dispute settlement mechanism. The earlier agreement was widely condemned by health activist groups, who objected the waiver being confined to vaccines and excluding some of the world’s major COVID-19 vaccine producers. In addition, a diplomatic source told Health Policy Watch that he did not know the value of the waiver given that there was an apparent surplus of COVID-19 vaccines. The results of the formal discussion on Friday will be reported to the General Council, which is scheduled to meet on 9 and 10 May. Image Credits: Jess Hurd/ Global Justice Now, Africa Centre for International Trade&Development. Europeans May Have to Sleep Under Mosquito Nets as Climate Change Alters Disease Patterns 03/05/2022 Maayan Hoffman Geneva Health Forum session, “Impact of climate change on health.” From left: Moderator Maximilian Jungmann, University of Heidelberg; Alfonso Gomez, City of Geneva; Maria Neira, World Health Organization; Gueladio Cisse, CGIEC Swiss TPH; and Valérie D’Acremont, University of Lausanne. Children sick with malaria, adults in bed with fevers and rashes as a result of the Zika virus, tick-borne illnesses – all of these diseases are on the rise as a result of climate change, according to Valérie D’Acremont of the University of Lausanne. She spoke on Tuesday at the Geneva Health Forum during a special session on the impact of climate change on health, addressing the question: “what is the scale of the problem and what action needs to be taken?” “It is clear that there has been an increase in transmission of [existing] pathogens and of new pathogens,” said D’Acremont, a Swiss physician who is also working on a project in Africa. For example, the spread of malaria, caused by a parasite that spreads to humans and other animals through the bites of infected female mosquitoes, increases in temperatures of around 25ºC. “In West Africa, it is too hot, so malaria might be going down, but in East Africa, the opposite is the case and we see an increase in malaria,” she said. Adding to the challenge are compromised health systems, the result of two years of the COVID-19 pandemic, which has seen the world losing some of its gains against malaria over the last 20 years. Mosquitoes, similarly, are more prone to spreading Zika virus in around 30ºC, which means that the world’s tropical areas are seeing more and more of the disease, and it is likely to extend to Europe and other countries. “We see it already in Italy,” D’Acremont stressed. “We might one day have to sleep under bed nets like they do in Africa.” Tick-borne diseases are spreading in Switzerland, also as a result of climate change, she added. There has been a two-thirds increase in the number of people hospitalized for ticks in Switzerland from 2009 to 2019, according to a recent report by RTS. Moreover, the number of tick bites rose from around 10,000 per year between 2012 and 2016 to around 14,000 a year in the last four years. “Journalists like to hear this story because it frightens people,” D’Acremont said but added that the main challenge was that people die from these diseases when coupled with other pre-existing conditions, such as diabetes, hypertension or malnutrition. These are also often a result of climate change or failing to take care of the environment and our food sources. “Climate change has a huge impact on this too, especially undernutrition and respiratory problems,” she said. Alfonso Gomez of the City of Geneva addresses the Geneva Health Forum on May 3, 2022. We need to stop exploiting animals, destroying nature Climate change has become an inescapable reality. The most recent Intergovernmental Panel on Climate Change (IPPC) report showed what people already knew: There is now scientific consensus that climate change is impacting people’s health and wellbeing in all hemispheres. Sometimes the effect is direct, Gueladio Cisse of CGIEC Swiss TPH, who also spoke at the session, said. Sometimes it is indirect. Sometimes the effect comes at once, and other times it has a slower but also longer-term impact. “If there is a heatwave, the next thing you know people are dying over the course of two or three days,” Cisse said as an example. Other times, a general increase in temperature allows pathogens to grow and makes humans more vulnerable to disease. The good news, said Dr Maria Neira, of the World Health Organization, is that the scientific community has been “pulling together in a historic way all the evidence we have on climate change… They are telling us things like if we don’t take measure now, this might put civilization at risk.” D’Acremont agreed but said that while research was useful, now is the time to do research in the field by monitoring the impact of steps taken to curb environmental hazards. “We need a paradigm shift to go to prevention,” she said. “Take COVID. It is nice to have a preparedness plan, but the problem is that another pandemic or event could come and it is new and we cannot be prepared.” Instead, she said, “we need to stop destroying nature, stop exploiting animals and start preparing ourselves by being in better health. During the crisis is too late… We have to shift the reality now to preventive care. That is true for northern and southern countries.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Maayan Hoffman. 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 Protect the Environment and be Profitable at the Same Time 04/05/2022 Raisa Santos Environment-friendly approaches: Health experts have called on global leaders to tackle environmental issues affecting health and health systems. It is possible for industry to implement environmentally friendly approaches that are also profitable, Bertrand Piccard, chair of the Solar Impulse Foundation, told the Geneva Health Forum. “I have been working on identifying solutions that can reconcile ecology and economy that means to protect the environment and at the same time create jobs and be economically viable for the industry, the economy and the financial world,” said Piccard. The Swiss organisation, Solar Impulse Foundation, works to identify sustainable, clean and profitable solutions for climate action and offers political and industry leaders a guide on implementing these solutions on a large scale. Replace, reduce and recycle Some of its concepts include the solar-powered automatic irrigation system, electric cabinet with recycled batteries and the circular high-quality furniture made from recycled materials. Piccard pointed out that are new business opportunities to be grabbed by leaders in the industry who can develop efficient solutions to protect the environment: “It’s clear that the environment has a huge link to (public) health…. efficient solutions improve the health of everybody.” To back this argument, he presented the example of a French start-up that captures the heat from chimneys of factories for recycling to reduce the energy bill of the same enterprise by 20%. “It produces less carbon, less energy, and it’s a business opportunity that expands and creates jobs,” said Piccard. “This is what I call qualitative growth. You develop the economy by replacing what is polluting with what is protecting the environment, so you can reconcile ecology and economy.” Piccard also noted the importance of both sides i.e. businesses and environmentalists striving hand-in-hand towards this goal. “You need the ‘green activists’ to move forward to push the politicians and you need the industry to produce the solutions. That will help us live in a more efficient way and be more environmentally friendly.” Climate neutrality ambitions Piccard praised the European Commission’s recent announcement that 100 European Union (EU) cities and 12 non-EU cities are participating in a program to become climate neutral by 2030. Bertrand Piccard, chair of the Solar Impulse Foundation. According to the EU plan, the 112 participating cities – in which roughly 75 million people live – will prepare plans and contracts to set out action and investment plans in order to achieve climate neutrality in the coming eight years. The ultimate goal of climate neutrality, as defined by the United Nations (UN), is to achieve zero greenhouse gas emissions by balancing the emissions so they are equal (or less than) the emissions that get removed through the planet’s natural absorption. Piccard stated that problems brought about by pollution and greenhouse gases should be tackled incrementally to bring cities closer to becoming climate neutral. “You cannot take the big problems and find solutions. It doesn’t work because most of the problems are not identified correctly so you need to do the opposite. You need to go through the solutions and look at which solution can be implemented where and each time you reduce a little bit of CO2, a little bit of inefficiency, a little bit of pollution, but altogether you can solve the problem.” Protecting the environment requires everyone to rethink the phrase ‘changing behaviours’ and use the word ‘modernise’ instead when addressing climate change in low- and middle-income countries, he added. “You have to modernise old infrastructures. You have to modernise all energy sources. You have to modernise the way to construct the buildings, you have to modernise mobility.” When it comes to changing behaviours, Piccard said that few people made minimal changes with minimal impact, with a majority refusing to renounce their habits. “You will say yes, of course, I will renounce a little bit. I will take the aeroplane only three times a week instead of four. But it doesn’t change the world.” Speaking specifically about the stance of the developing countries on the contested issue of emissions, Piccard added: “We have to go from [a narrative of saying] protection of the environment is threatening our lifestyles, [which is] expensive and boring, to a narrative where protection of the environment is exciting, profitable, creative, interesting, and modernising.” The developing countries should use new technologies, said Piccard. “They want to reach our (developed world) levels of development. They want to be like Europe and North America. [In order to modernise] they can use efficient systems, use renewable energies in order to have local economic development.” “It’s a question of narrative, because we need to take people with us otherwise they will not follow, they will resist.” As the developed and the developing countries continue to have contested viewpoints on this matter, the latest UN report suggests the emissions from fossil fuel combustion in the three regions of Asia and the Pacific, Africa and Latin America grew by 26% over the past decade, as compared to 260% growth in the prior two decades. The fossil fuel combustion emissions of developed countries shrank by about 10% over both of those periods. Europe Must take advantage of ‘COVID-19 Ceasefire’ to Prepare for Next Wave, says WHO’s Kluge 04/05/2022 Maayan Hoffman Dr Hans Kluge, WHO Regional Director for Europe. The European Region and COVID-19 are in a “kind of ceasefire,” according to World Health Organization’s (WHO) Regional Director for Europe, Dr Hans Kluge. It is now up to the region’s 53 member states to take advantage of this window to prepare for the next fight, he said. “It is quiet and we have to take advantage of this, because obviously the fact that the virus spread so fast and so many people have been infected means that a new mutant is already here,” Kluge said Wednesday during an interview at the Geneva Health Forum. “The virus has surprised us many times.” Kluge, who started his role on 1 February 2020 just as the pandemic began, spoke via video link from his office in Denmark. There have been at least 191 million reported COVID-19 infections in Europe and more than 2.2 million deaths since the start of the pandemic two years ago, according to Reuters COVID tracker. The average new daily cases in the region have dropped from a recent peak of 1.7 million in February to fewer than 230,000 in recent days. However, Germany leads the world in the daily average number of new cases, Reuters said, accounting for one in every six infections reported worldwide. Moreover, as Kluge noted, it is not possible to track how fast the virus is spreading in Ukraine as a result of the Russian invasion. Reuters COVID-19 tracker shows a decline in average daily cases across the European region. He urged the region to implement a pan-European system that could pick up on any threat from antimicrobial resistance, a dangerous virus or climate change “very quickly – we need an alert system.” And he said that the region needs its political systems to take action when there is such an alert. Kluge also said that the most important ingredient in any COVID-19 toolkit must be equal access to vaccines and affordable antivirals. “The best way to combat infectious disease is a combination of prevention and treatment: vaccines and medicines,” according to Kluge. The comments were especially meaningful on Wednesday, a day after the World Trade Organization’s TRIPS Council announced that it will finally discuss a compromise proposal on a waiver of intellectual property rights on COVID-19 vaccines. However, antivirals are not included in the compromise. While Pfizer and Merck – the companies with effective COVID-19 antivirals – have entered into voluntary licensing agreements with the Medicine Patents Pool to enable generic companies to make the drugs for certain low-income countries, the agreements and countries the deal applies to are restricted. Kluge offered a four-step COVID-19 exit strategy for the region: 1. Implement a plan for protecting the most vulnerable “We may at some point have to shift from mass action to more routine vaccination of just the vulnerable people,” Kluge said. 2. Vaccinate and boost “We will need to do whatever it takes to vaccinate the unvaccinated and boost the vaccinated,” he added. 3. Beef up surveillance “We need a system that is able to pick up new COVID-19 variants very quickly so that national lockdowns can be avoided,” said Kluge. 4. Deal with the backlog of patients with other diseases Kluge noted that the healthcare sector is also facing a shadow pandemic – dealing with the backlog of patients who are suffering due to postponement of elective surgeries, cancer and other screenings, mental health issues and long COVID. He said around 20% of people infected with the virus continue to experience some symptoms even months later. “We need more knowledge about long COVID,” Kluge stressed. But he admitted that rolling out this exit strategy could be “tricky,” as a result of complacency by the public and political leaders whose memories are “very short.” “Heads of states and governments need to make the investment in health and health systems that is key for a resilient society and preparedness,” said Kluge. “Health is not everything, but without health, there is nothing.” Image Credits: WHO, Screenshot. Four COVID-19 Lessons and How to Make Humanity More Resilient 04/05/2022 Maayan Hoffman Tatiana Valovaya, Director-General of the United Nations Office at Genevai during World Humanitarian Day. 19 August 2019. The COVID-19 pandemic blindsided most of the world as it swept from China across the world at an unprecedent pace, infecting, ultimately killing millions of people. But more than two years later, there are some lessons that can be learned, said Tatiana Valovaya, director-general of the United Nations in Geneva on Tuesday evening. At the Opening Ceremony for the Geneva Health Forum, Valovaya delivered the four key takeaways from the pandemic for public health professionals. Her colleague, likewise, offered “concerned actions” that could be taken in at least five key areas to make humanity more resilient to future health threats. In total, nine people addressed attendees during the opening ceremony, which drew over 1000 people and is the first major global health event hosted in Geneva since the pandemic began. The speakers included Valovaya; Antoine Geissbuhler and Véronique Maye, Geneva Health Forum’s co-presidents; Bertrand Levrat, CEO of the University Hospitals of Geneva; Mauro Poggia, minister of health, population and security for the state of Geneva; Jürg Lauber, Swiss ambassador and permanent representative to the Office of the United Nations in Geneva; Zsuzsanna Jakab, deputy director-general of the World Health Organization; Monique Eloit, director-general of the World Organisation for Animal Health (OIE); and Peter Maurer, president of the International Committee of the Red Cross. What lessons were learned? 1 – We live in a globalized world and are all interconnected and interdependent. “We can only be as safe or as healthy as all other people around that world are,” said Valovaya. “That means we have to work in solidarity.” 2 – We can do a lot to improve environmental degradation. This notion was supported by Eloit in her keynote address. “I will insist on how it is crucial to transform our relationship with the environment,” she said. “We need to move from response to prevention.” 3 – We have to fight inequality. “During the pandemic, we saw that those who were very vulnerable were the first to suffer,” noted Valovaya. “We saw this with access to healthcare, vaccines and even clean water.” 4 – All of the challenges that humanity is facing are global. “Global challenges need global solutions,” she said. “We need multilateralism that is inclusive and integrated. Only together can we find solutions.” While the world continues to tackle COVID-19, something which Eloit stressed is “still ongoing, while we continue to face other challenges,” the international community must simultaneously fight the climate crisis, she said. Dr. Zsuzsanna Jakab, Deputy Director-General of the World Health Organization, at the Palais des Nations, Geneva, Switzerland, February 24, 2020, in one of the last face-to-face UN meetings before the COVID pandemic. Thirteen million people die from preventable environmental factors WHO estimates that 13 million people die every year as a result of preventable environmental factors and that 90% of the global population breathes unhealthy air, Jakab noted. “Concerted action is needed across at least five key areas to make humanity more resilient to future health threats,” she stressed. The first is understanding that health is not negotiable. The second is the need to shift from health systems focused purely on treating diseases to health systems focused on disease prevention and health promotion. Next, equity is not a ‘nice to have’. “The vulnerability of one single nation makes the whole world more vulnerable to disease threats,” she said, echoing Valovaya’s sentiments. “We must move from a fragmented health architecture to a cohesive architecture with stronger governance, financing and tools. Finally, we must shift from a siloed, sectored approach to human health to a One Health approach, said Jakab. One Health was defined in December 2021 by the inter-agency One Health High-Level Expert Panel (OHHLEP) as “an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems. It recognizes the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and inter-dependent. It was a major focus of the first day of the Geneva Health Forum. “OHHLEP’s goal is to move One Health from concept to practice,” Eloit stressed in her talk, which helped culminate the formal opening ceremony. In the morning, the opening panel was on “One Health: is there a paradigm shift?” “We all have a role to play,” concluded Eloit. “We have a responsibility to make tomorrow safer than today.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Flickr. ‘Epidemic’ of Obesity in Europe 03/05/2022 Kerry Cullinan Impact of obesity on health Almost two-thirds of adults and a third of children are overweight or obese in the World Health Organization (WHO) European Region and this is driving cancer and other diseases, according to the WHO European Regional Obesity Report 2022 report released on Tuesday. The highest prevalence is in Turkey, Malta, Israel and the UK (WHO Europe has different members from the European Union), but there is an upward trend in all 53 member countries. Driving cancers Obesity is the cause of 13 different types of cancer, as well as a risk factor in strokes, heart attacks, type 2 diabetes and other non-communicable diseases, according to the report. For some countries in the region, obesity is predicted to overtake smoking as the main risk factor for preventable cancer. The report also highlights that obesity is a condition, not just a risk factor, that needs to be specifically treated and managed. “In Europe and Central Asia, no single country is going to meet the WHO Global NCD target of halting the rise of obesity by 2025,” said Dr Hans Kluge, WHO Regional Director for Europe. Adult obesity in the 53-country European Region is higher than in any other WHO region except the the Americas. More males (63%) are overweight than among females (54%) while obesity is more prevalent among females (24%) than among males (22%). Obesity rates in Europe (2016) 50% 60% 70% Orange = all adults, Blue = males, Green = females The COVID-19 pandemic has highlighted the danger of obesity, with patients with obesity being more likely to experience complications and death from the virus. “Preliminary data also suggest that during the current pandemic, people have had higher exposure to obesity risk factors, including an increase in sedentary lifestyles and consumption of unhealthy foods,” according to the report. Addressing unhealthy environments “Obesity is influenced by the environment, so it is important to look at this problem from the perspective of every stage of life. For example, the life of children and adolescents is impacted by digital environments, including marketing of unhealthy food and drinks,” said Dr Kremlin Wickramasinghe, Acting Head of the WHO European Office for the Prevention and Control of NCDs, which produced the report. “Restricting the marketing of unhealthy foods to children, taxation of sugar-sweetened beverages and improving health system response for obesity management are currently among the most actively discussed policy areas in the WHO European Region,” Wickramasinghe added. Other policies that show promise in reducing levels of obesity and overweight include improving access to obesity and overweight management services in primary health care, promoting breastfeeding and school-based interventions. The report also highlights interventions at supermarkets and takeaway outlets, which are the primary food sources. These include removing unhealthy foods from checkouts and nearby aisles and restricting takeaway outlets. Improving the quality of parks and playgrounds, as well as providing adequate infrastructure for active transport are other suggestions. Image Credits: rawpixel/unsplash. After Months of Deadlock, WTO’s TRIPS Council Will Finally Discuss Intellectual Property Waiver Compromise 03/05/2022 Kerry Cullinan WTO Director-General Ngozi Okonjo-Iweala In a significant breakthrough, the World Trade Organization’s (WTO) TRIPS Council on Friday will finally discuss a compromise proposal on a waiver of intellectual property (IP) rights on COVID-19 vaccines – almost 18 months after it was first proposed by India and South Africa. Members attending an informal meeting of the TRIPS Council on Tuesday were told that the text of an “outcome document” from the “quad” of the European Union, US, India and South Africa would be circulated to them “within hours” from WTO Director-General Ngozi Okonjo-Iweala’s office. The outcome document, which was later posted on the WTO website, is very similar to that which was leaked in mid-March – but it has been termed an “outcome document” rather than an agreement as there are still a couple of points of disagreement. Disagreement over who should be eligible The main point of disagreement relates to which countries should be able to benefit from the waiver (footnote 1). All developing country members that have not yet achieved a significant export capacity – namely 10% of the world’s COVID-19 vaccine market – are supposed to benefit from the flexibilities. Apparently, China has been unhappy about being excluded while a country like India with large generic manufacturing capacity, may be included. But the new TRIPS Council chairperson, Sierra Leone’s Ambassador Lansana Gberie, told Tuesday’s meeting that the superpower “seemed favourably disposed” towards the compromise – also contained in footnote 1 – that states “all developing country members with capacity are encouraged to opt out from these flexibilities”, according to a WTO official. While the waiver only applies to vaccines, WTO members will have six months to decide whether to extend it to cover the production and distribution of COVID-19 diagnostics and therapeutics. According to the draft document, eligible WTO members will be able to limit TRIPS article Section 28, which deals with exclusive patents, by authorizing the production and supply of COVID-19 vaccines without the patent holder’s consent, and with minimal transaction costs. Single authorisation for multiple patents Another deviation from draft agreement that was leaked in mid-March is related to whether countries will have to list all the patents that they will be waiving – widely criticised for imposing onerous requirements on countries. This appears set to go, according to footnote 3. Eligible countries may issue a single authorisation to use multiple patents and can export the vaccines they produce under this authorisation to other eligible members, particularly countries in greatest need, and to supply regional or international initiatives such as COVAX (a waiver of TRIPS Art. 31(f).) Eligible members will also be able to use any of their legal instruments to impose a waiver on vaccines, and the protection of clinical trial data under TRIPS will not be an obstacle to implementing this proposal. Payment for any vaccines produced under TRIPS waiver conditions for export is to take account of the humanitarian and not-for-profit purpose of the vaccine programme, to support manufacturers to produce and supply vaccines at affordable prices. The duration of the flexibilities would be either three or five years, and eligible members would be exempted from legal challenges under the WTO dispute settlement mechanism. The earlier agreement was widely condemned by health activist groups, who objected the waiver being confined to vaccines and excluding some of the world’s major COVID-19 vaccine producers. In addition, a diplomatic source told Health Policy Watch that he did not know the value of the waiver given that there was an apparent surplus of COVID-19 vaccines. The results of the formal discussion on Friday will be reported to the General Council, which is scheduled to meet on 9 and 10 May. Image Credits: Jess Hurd/ Global Justice Now, Africa Centre for International Trade&Development. Europeans May Have to Sleep Under Mosquito Nets as Climate Change Alters Disease Patterns 03/05/2022 Maayan Hoffman Geneva Health Forum session, “Impact of climate change on health.” From left: Moderator Maximilian Jungmann, University of Heidelberg; Alfonso Gomez, City of Geneva; Maria Neira, World Health Organization; Gueladio Cisse, CGIEC Swiss TPH; and Valérie D’Acremont, University of Lausanne. Children sick with malaria, adults in bed with fevers and rashes as a result of the Zika virus, tick-borne illnesses – all of these diseases are on the rise as a result of climate change, according to Valérie D’Acremont of the University of Lausanne. She spoke on Tuesday at the Geneva Health Forum during a special session on the impact of climate change on health, addressing the question: “what is the scale of the problem and what action needs to be taken?” “It is clear that there has been an increase in transmission of [existing] pathogens and of new pathogens,” said D’Acremont, a Swiss physician who is also working on a project in Africa. For example, the spread of malaria, caused by a parasite that spreads to humans and other animals through the bites of infected female mosquitoes, increases in temperatures of around 25ºC. “In West Africa, it is too hot, so malaria might be going down, but in East Africa, the opposite is the case and we see an increase in malaria,” she said. Adding to the challenge are compromised health systems, the result of two years of the COVID-19 pandemic, which has seen the world losing some of its gains against malaria over the last 20 years. Mosquitoes, similarly, are more prone to spreading Zika virus in around 30ºC, which means that the world’s tropical areas are seeing more and more of the disease, and it is likely to extend to Europe and other countries. “We see it already in Italy,” D’Acremont stressed. “We might one day have to sleep under bed nets like they do in Africa.” Tick-borne diseases are spreading in Switzerland, also as a result of climate change, she added. There has been a two-thirds increase in the number of people hospitalized for ticks in Switzerland from 2009 to 2019, according to a recent report by RTS. Moreover, the number of tick bites rose from around 10,000 per year between 2012 and 2016 to around 14,000 a year in the last four years. “Journalists like to hear this story because it frightens people,” D’Acremont said but added that the main challenge was that people die from these diseases when coupled with other pre-existing conditions, such as diabetes, hypertension or malnutrition. These are also often a result of climate change or failing to take care of the environment and our food sources. “Climate change has a huge impact on this too, especially undernutrition and respiratory problems,” she said. Alfonso Gomez of the City of Geneva addresses the Geneva Health Forum on May 3, 2022. We need to stop exploiting animals, destroying nature Climate change has become an inescapable reality. The most recent Intergovernmental Panel on Climate Change (IPPC) report showed what people already knew: There is now scientific consensus that climate change is impacting people’s health and wellbeing in all hemispheres. Sometimes the effect is direct, Gueladio Cisse of CGIEC Swiss TPH, who also spoke at the session, said. Sometimes it is indirect. Sometimes the effect comes at once, and other times it has a slower but also longer-term impact. “If there is a heatwave, the next thing you know people are dying over the course of two or three days,” Cisse said as an example. Other times, a general increase in temperature allows pathogens to grow and makes humans more vulnerable to disease. The good news, said Dr Maria Neira, of the World Health Organization, is that the scientific community has been “pulling together in a historic way all the evidence we have on climate change… They are telling us things like if we don’t take measure now, this might put civilization at risk.” D’Acremont agreed but said that while research was useful, now is the time to do research in the field by monitoring the impact of steps taken to curb environmental hazards. “We need a paradigm shift to go to prevention,” she said. “Take COVID. It is nice to have a preparedness plan, but the problem is that another pandemic or event could come and it is new and we cannot be prepared.” Instead, she said, “we need to stop destroying nature, stop exploiting animals and start preparing ourselves by being in better health. During the crisis is too late… We have to shift the reality now to preventive care. That is true for northern and southern countries.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Maayan Hoffman. 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.
Europe Must take advantage of ‘COVID-19 Ceasefire’ to Prepare for Next Wave, says WHO’s Kluge 04/05/2022 Maayan Hoffman Dr Hans Kluge, WHO Regional Director for Europe. The European Region and COVID-19 are in a “kind of ceasefire,” according to World Health Organization’s (WHO) Regional Director for Europe, Dr Hans Kluge. It is now up to the region’s 53 member states to take advantage of this window to prepare for the next fight, he said. “It is quiet and we have to take advantage of this, because obviously the fact that the virus spread so fast and so many people have been infected means that a new mutant is already here,” Kluge said Wednesday during an interview at the Geneva Health Forum. “The virus has surprised us many times.” Kluge, who started his role on 1 February 2020 just as the pandemic began, spoke via video link from his office in Denmark. There have been at least 191 million reported COVID-19 infections in Europe and more than 2.2 million deaths since the start of the pandemic two years ago, according to Reuters COVID tracker. The average new daily cases in the region have dropped from a recent peak of 1.7 million in February to fewer than 230,000 in recent days. However, Germany leads the world in the daily average number of new cases, Reuters said, accounting for one in every six infections reported worldwide. Moreover, as Kluge noted, it is not possible to track how fast the virus is spreading in Ukraine as a result of the Russian invasion. Reuters COVID-19 tracker shows a decline in average daily cases across the European region. He urged the region to implement a pan-European system that could pick up on any threat from antimicrobial resistance, a dangerous virus or climate change “very quickly – we need an alert system.” And he said that the region needs its political systems to take action when there is such an alert. Kluge also said that the most important ingredient in any COVID-19 toolkit must be equal access to vaccines and affordable antivirals. “The best way to combat infectious disease is a combination of prevention and treatment: vaccines and medicines,” according to Kluge. The comments were especially meaningful on Wednesday, a day after the World Trade Organization’s TRIPS Council announced that it will finally discuss a compromise proposal on a waiver of intellectual property rights on COVID-19 vaccines. However, antivirals are not included in the compromise. While Pfizer and Merck – the companies with effective COVID-19 antivirals – have entered into voluntary licensing agreements with the Medicine Patents Pool to enable generic companies to make the drugs for certain low-income countries, the agreements and countries the deal applies to are restricted. Kluge offered a four-step COVID-19 exit strategy for the region: 1. Implement a plan for protecting the most vulnerable “We may at some point have to shift from mass action to more routine vaccination of just the vulnerable people,” Kluge said. 2. Vaccinate and boost “We will need to do whatever it takes to vaccinate the unvaccinated and boost the vaccinated,” he added. 3. Beef up surveillance “We need a system that is able to pick up new COVID-19 variants very quickly so that national lockdowns can be avoided,” said Kluge. 4. Deal with the backlog of patients with other diseases Kluge noted that the healthcare sector is also facing a shadow pandemic – dealing with the backlog of patients who are suffering due to postponement of elective surgeries, cancer and other screenings, mental health issues and long COVID. He said around 20% of people infected with the virus continue to experience some symptoms even months later. “We need more knowledge about long COVID,” Kluge stressed. But he admitted that rolling out this exit strategy could be “tricky,” as a result of complacency by the public and political leaders whose memories are “very short.” “Heads of states and governments need to make the investment in health and health systems that is key for a resilient society and preparedness,” said Kluge. “Health is not everything, but without health, there is nothing.” Image Credits: WHO, Screenshot. Four COVID-19 Lessons and How to Make Humanity More Resilient 04/05/2022 Maayan Hoffman Tatiana Valovaya, Director-General of the United Nations Office at Genevai during World Humanitarian Day. 19 August 2019. The COVID-19 pandemic blindsided most of the world as it swept from China across the world at an unprecedent pace, infecting, ultimately killing millions of people. But more than two years later, there are some lessons that can be learned, said Tatiana Valovaya, director-general of the United Nations in Geneva on Tuesday evening. At the Opening Ceremony for the Geneva Health Forum, Valovaya delivered the four key takeaways from the pandemic for public health professionals. Her colleague, likewise, offered “concerned actions” that could be taken in at least five key areas to make humanity more resilient to future health threats. In total, nine people addressed attendees during the opening ceremony, which drew over 1000 people and is the first major global health event hosted in Geneva since the pandemic began. The speakers included Valovaya; Antoine Geissbuhler and Véronique Maye, Geneva Health Forum’s co-presidents; Bertrand Levrat, CEO of the University Hospitals of Geneva; Mauro Poggia, minister of health, population and security for the state of Geneva; Jürg Lauber, Swiss ambassador and permanent representative to the Office of the United Nations in Geneva; Zsuzsanna Jakab, deputy director-general of the World Health Organization; Monique Eloit, director-general of the World Organisation for Animal Health (OIE); and Peter Maurer, president of the International Committee of the Red Cross. What lessons were learned? 1 – We live in a globalized world and are all interconnected and interdependent. “We can only be as safe or as healthy as all other people around that world are,” said Valovaya. “That means we have to work in solidarity.” 2 – We can do a lot to improve environmental degradation. This notion was supported by Eloit in her keynote address. “I will insist on how it is crucial to transform our relationship with the environment,” she said. “We need to move from response to prevention.” 3 – We have to fight inequality. “During the pandemic, we saw that those who were very vulnerable were the first to suffer,” noted Valovaya. “We saw this with access to healthcare, vaccines and even clean water.” 4 – All of the challenges that humanity is facing are global. “Global challenges need global solutions,” she said. “We need multilateralism that is inclusive and integrated. Only together can we find solutions.” While the world continues to tackle COVID-19, something which Eloit stressed is “still ongoing, while we continue to face other challenges,” the international community must simultaneously fight the climate crisis, she said. Dr. Zsuzsanna Jakab, Deputy Director-General of the World Health Organization, at the Palais des Nations, Geneva, Switzerland, February 24, 2020, in one of the last face-to-face UN meetings before the COVID pandemic. Thirteen million people die from preventable environmental factors WHO estimates that 13 million people die every year as a result of preventable environmental factors and that 90% of the global population breathes unhealthy air, Jakab noted. “Concerted action is needed across at least five key areas to make humanity more resilient to future health threats,” she stressed. The first is understanding that health is not negotiable. The second is the need to shift from health systems focused purely on treating diseases to health systems focused on disease prevention and health promotion. Next, equity is not a ‘nice to have’. “The vulnerability of one single nation makes the whole world more vulnerable to disease threats,” she said, echoing Valovaya’s sentiments. “We must move from a fragmented health architecture to a cohesive architecture with stronger governance, financing and tools. Finally, we must shift from a siloed, sectored approach to human health to a One Health approach, said Jakab. One Health was defined in December 2021 by the inter-agency One Health High-Level Expert Panel (OHHLEP) as “an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems. It recognizes the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and inter-dependent. It was a major focus of the first day of the Geneva Health Forum. “OHHLEP’s goal is to move One Health from concept to practice,” Eloit stressed in her talk, which helped culminate the formal opening ceremony. In the morning, the opening panel was on “One Health: is there a paradigm shift?” “We all have a role to play,” concluded Eloit. “We have a responsibility to make tomorrow safer than today.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Flickr. ‘Epidemic’ of Obesity in Europe 03/05/2022 Kerry Cullinan Impact of obesity on health Almost two-thirds of adults and a third of children are overweight or obese in the World Health Organization (WHO) European Region and this is driving cancer and other diseases, according to the WHO European Regional Obesity Report 2022 report released on Tuesday. The highest prevalence is in Turkey, Malta, Israel and the UK (WHO Europe has different members from the European Union), but there is an upward trend in all 53 member countries. Driving cancers Obesity is the cause of 13 different types of cancer, as well as a risk factor in strokes, heart attacks, type 2 diabetes and other non-communicable diseases, according to the report. For some countries in the region, obesity is predicted to overtake smoking as the main risk factor for preventable cancer. The report also highlights that obesity is a condition, not just a risk factor, that needs to be specifically treated and managed. “In Europe and Central Asia, no single country is going to meet the WHO Global NCD target of halting the rise of obesity by 2025,” said Dr Hans Kluge, WHO Regional Director for Europe. Adult obesity in the 53-country European Region is higher than in any other WHO region except the the Americas. More males (63%) are overweight than among females (54%) while obesity is more prevalent among females (24%) than among males (22%). Obesity rates in Europe (2016) 50% 60% 70% Orange = all adults, Blue = males, Green = females The COVID-19 pandemic has highlighted the danger of obesity, with patients with obesity being more likely to experience complications and death from the virus. “Preliminary data also suggest that during the current pandemic, people have had higher exposure to obesity risk factors, including an increase in sedentary lifestyles and consumption of unhealthy foods,” according to the report. Addressing unhealthy environments “Obesity is influenced by the environment, so it is important to look at this problem from the perspective of every stage of life. For example, the life of children and adolescents is impacted by digital environments, including marketing of unhealthy food and drinks,” said Dr Kremlin Wickramasinghe, Acting Head of the WHO European Office for the Prevention and Control of NCDs, which produced the report. “Restricting the marketing of unhealthy foods to children, taxation of sugar-sweetened beverages and improving health system response for obesity management are currently among the most actively discussed policy areas in the WHO European Region,” Wickramasinghe added. Other policies that show promise in reducing levels of obesity and overweight include improving access to obesity and overweight management services in primary health care, promoting breastfeeding and school-based interventions. The report also highlights interventions at supermarkets and takeaway outlets, which are the primary food sources. These include removing unhealthy foods from checkouts and nearby aisles and restricting takeaway outlets. Improving the quality of parks and playgrounds, as well as providing adequate infrastructure for active transport are other suggestions. Image Credits: rawpixel/unsplash. After Months of Deadlock, WTO’s TRIPS Council Will Finally Discuss Intellectual Property Waiver Compromise 03/05/2022 Kerry Cullinan WTO Director-General Ngozi Okonjo-Iweala In a significant breakthrough, the World Trade Organization’s (WTO) TRIPS Council on Friday will finally discuss a compromise proposal on a waiver of intellectual property (IP) rights on COVID-19 vaccines – almost 18 months after it was first proposed by India and South Africa. Members attending an informal meeting of the TRIPS Council on Tuesday were told that the text of an “outcome document” from the “quad” of the European Union, US, India and South Africa would be circulated to them “within hours” from WTO Director-General Ngozi Okonjo-Iweala’s office. The outcome document, which was later posted on the WTO website, is very similar to that which was leaked in mid-March – but it has been termed an “outcome document” rather than an agreement as there are still a couple of points of disagreement. Disagreement over who should be eligible The main point of disagreement relates to which countries should be able to benefit from the waiver (footnote 1). All developing country members that have not yet achieved a significant export capacity – namely 10% of the world’s COVID-19 vaccine market – are supposed to benefit from the flexibilities. Apparently, China has been unhappy about being excluded while a country like India with large generic manufacturing capacity, may be included. But the new TRIPS Council chairperson, Sierra Leone’s Ambassador Lansana Gberie, told Tuesday’s meeting that the superpower “seemed favourably disposed” towards the compromise – also contained in footnote 1 – that states “all developing country members with capacity are encouraged to opt out from these flexibilities”, according to a WTO official. While the waiver only applies to vaccines, WTO members will have six months to decide whether to extend it to cover the production and distribution of COVID-19 diagnostics and therapeutics. According to the draft document, eligible WTO members will be able to limit TRIPS article Section 28, which deals with exclusive patents, by authorizing the production and supply of COVID-19 vaccines without the patent holder’s consent, and with minimal transaction costs. Single authorisation for multiple patents Another deviation from draft agreement that was leaked in mid-March is related to whether countries will have to list all the patents that they will be waiving – widely criticised for imposing onerous requirements on countries. This appears set to go, according to footnote 3. Eligible countries may issue a single authorisation to use multiple patents and can export the vaccines they produce under this authorisation to other eligible members, particularly countries in greatest need, and to supply regional or international initiatives such as COVAX (a waiver of TRIPS Art. 31(f).) Eligible members will also be able to use any of their legal instruments to impose a waiver on vaccines, and the protection of clinical trial data under TRIPS will not be an obstacle to implementing this proposal. Payment for any vaccines produced under TRIPS waiver conditions for export is to take account of the humanitarian and not-for-profit purpose of the vaccine programme, to support manufacturers to produce and supply vaccines at affordable prices. The duration of the flexibilities would be either three or five years, and eligible members would be exempted from legal challenges under the WTO dispute settlement mechanism. The earlier agreement was widely condemned by health activist groups, who objected the waiver being confined to vaccines and excluding some of the world’s major COVID-19 vaccine producers. In addition, a diplomatic source told Health Policy Watch that he did not know the value of the waiver given that there was an apparent surplus of COVID-19 vaccines. The results of the formal discussion on Friday will be reported to the General Council, which is scheduled to meet on 9 and 10 May. Image Credits: Jess Hurd/ Global Justice Now, Africa Centre for International Trade&Development. Europeans May Have to Sleep Under Mosquito Nets as Climate Change Alters Disease Patterns 03/05/2022 Maayan Hoffman Geneva Health Forum session, “Impact of climate change on health.” From left: Moderator Maximilian Jungmann, University of Heidelberg; Alfonso Gomez, City of Geneva; Maria Neira, World Health Organization; Gueladio Cisse, CGIEC Swiss TPH; and Valérie D’Acremont, University of Lausanne. Children sick with malaria, adults in bed with fevers and rashes as a result of the Zika virus, tick-borne illnesses – all of these diseases are on the rise as a result of climate change, according to Valérie D’Acremont of the University of Lausanne. She spoke on Tuesday at the Geneva Health Forum during a special session on the impact of climate change on health, addressing the question: “what is the scale of the problem and what action needs to be taken?” “It is clear that there has been an increase in transmission of [existing] pathogens and of new pathogens,” said D’Acremont, a Swiss physician who is also working on a project in Africa. For example, the spread of malaria, caused by a parasite that spreads to humans and other animals through the bites of infected female mosquitoes, increases in temperatures of around 25ºC. “In West Africa, it is too hot, so malaria might be going down, but in East Africa, the opposite is the case and we see an increase in malaria,” she said. Adding to the challenge are compromised health systems, the result of two years of the COVID-19 pandemic, which has seen the world losing some of its gains against malaria over the last 20 years. Mosquitoes, similarly, are more prone to spreading Zika virus in around 30ºC, which means that the world’s tropical areas are seeing more and more of the disease, and it is likely to extend to Europe and other countries. “We see it already in Italy,” D’Acremont stressed. “We might one day have to sleep under bed nets like they do in Africa.” Tick-borne diseases are spreading in Switzerland, also as a result of climate change, she added. There has been a two-thirds increase in the number of people hospitalized for ticks in Switzerland from 2009 to 2019, according to a recent report by RTS. Moreover, the number of tick bites rose from around 10,000 per year between 2012 and 2016 to around 14,000 a year in the last four years. “Journalists like to hear this story because it frightens people,” D’Acremont said but added that the main challenge was that people die from these diseases when coupled with other pre-existing conditions, such as diabetes, hypertension or malnutrition. These are also often a result of climate change or failing to take care of the environment and our food sources. “Climate change has a huge impact on this too, especially undernutrition and respiratory problems,” she said. Alfonso Gomez of the City of Geneva addresses the Geneva Health Forum on May 3, 2022. We need to stop exploiting animals, destroying nature Climate change has become an inescapable reality. The most recent Intergovernmental Panel on Climate Change (IPPC) report showed what people already knew: There is now scientific consensus that climate change is impacting people’s health and wellbeing in all hemispheres. Sometimes the effect is direct, Gueladio Cisse of CGIEC Swiss TPH, who also spoke at the session, said. Sometimes it is indirect. Sometimes the effect comes at once, and other times it has a slower but also longer-term impact. “If there is a heatwave, the next thing you know people are dying over the course of two or three days,” Cisse said as an example. Other times, a general increase in temperature allows pathogens to grow and makes humans more vulnerable to disease. The good news, said Dr Maria Neira, of the World Health Organization, is that the scientific community has been “pulling together in a historic way all the evidence we have on climate change… They are telling us things like if we don’t take measure now, this might put civilization at risk.” D’Acremont agreed but said that while research was useful, now is the time to do research in the field by monitoring the impact of steps taken to curb environmental hazards. “We need a paradigm shift to go to prevention,” she said. “Take COVID. It is nice to have a preparedness plan, but the problem is that another pandemic or event could come and it is new and we cannot be prepared.” Instead, she said, “we need to stop destroying nature, stop exploiting animals and start preparing ourselves by being in better health. During the crisis is too late… We have to shift the reality now to preventive care. That is true for northern and southern countries.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Maayan Hoffman. 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.
Four COVID-19 Lessons and How to Make Humanity More Resilient 04/05/2022 Maayan Hoffman Tatiana Valovaya, Director-General of the United Nations Office at Genevai during World Humanitarian Day. 19 August 2019. The COVID-19 pandemic blindsided most of the world as it swept from China across the world at an unprecedent pace, infecting, ultimately killing millions of people. But more than two years later, there are some lessons that can be learned, said Tatiana Valovaya, director-general of the United Nations in Geneva on Tuesday evening. At the Opening Ceremony for the Geneva Health Forum, Valovaya delivered the four key takeaways from the pandemic for public health professionals. Her colleague, likewise, offered “concerned actions” that could be taken in at least five key areas to make humanity more resilient to future health threats. In total, nine people addressed attendees during the opening ceremony, which drew over 1000 people and is the first major global health event hosted in Geneva since the pandemic began. The speakers included Valovaya; Antoine Geissbuhler and Véronique Maye, Geneva Health Forum’s co-presidents; Bertrand Levrat, CEO of the University Hospitals of Geneva; Mauro Poggia, minister of health, population and security for the state of Geneva; Jürg Lauber, Swiss ambassador and permanent representative to the Office of the United Nations in Geneva; Zsuzsanna Jakab, deputy director-general of the World Health Organization; Monique Eloit, director-general of the World Organisation for Animal Health (OIE); and Peter Maurer, president of the International Committee of the Red Cross. What lessons were learned? 1 – We live in a globalized world and are all interconnected and interdependent. “We can only be as safe or as healthy as all other people around that world are,” said Valovaya. “That means we have to work in solidarity.” 2 – We can do a lot to improve environmental degradation. This notion was supported by Eloit in her keynote address. “I will insist on how it is crucial to transform our relationship with the environment,” she said. “We need to move from response to prevention.” 3 – We have to fight inequality. “During the pandemic, we saw that those who were very vulnerable were the first to suffer,” noted Valovaya. “We saw this with access to healthcare, vaccines and even clean water.” 4 – All of the challenges that humanity is facing are global. “Global challenges need global solutions,” she said. “We need multilateralism that is inclusive and integrated. Only together can we find solutions.” While the world continues to tackle COVID-19, something which Eloit stressed is “still ongoing, while we continue to face other challenges,” the international community must simultaneously fight the climate crisis, she said. Dr. Zsuzsanna Jakab, Deputy Director-General of the World Health Organization, at the Palais des Nations, Geneva, Switzerland, February 24, 2020, in one of the last face-to-face UN meetings before the COVID pandemic. Thirteen million people die from preventable environmental factors WHO estimates that 13 million people die every year as a result of preventable environmental factors and that 90% of the global population breathes unhealthy air, Jakab noted. “Concerted action is needed across at least five key areas to make humanity more resilient to future health threats,” she stressed. The first is understanding that health is not negotiable. The second is the need to shift from health systems focused purely on treating diseases to health systems focused on disease prevention and health promotion. Next, equity is not a ‘nice to have’. “The vulnerability of one single nation makes the whole world more vulnerable to disease threats,” she said, echoing Valovaya’s sentiments. “We must move from a fragmented health architecture to a cohesive architecture with stronger governance, financing and tools. Finally, we must shift from a siloed, sectored approach to human health to a One Health approach, said Jakab. One Health was defined in December 2021 by the inter-agency One Health High-Level Expert Panel (OHHLEP) as “an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems. It recognizes the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and inter-dependent. It was a major focus of the first day of the Geneva Health Forum. “OHHLEP’s goal is to move One Health from concept to practice,” Eloit stressed in her talk, which helped culminate the formal opening ceremony. In the morning, the opening panel was on “One Health: is there a paradigm shift?” “We all have a role to play,” concluded Eloit. “We have a responsibility to make tomorrow safer than today.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Flickr. ‘Epidemic’ of Obesity in Europe 03/05/2022 Kerry Cullinan Impact of obesity on health Almost two-thirds of adults and a third of children are overweight or obese in the World Health Organization (WHO) European Region and this is driving cancer and other diseases, according to the WHO European Regional Obesity Report 2022 report released on Tuesday. The highest prevalence is in Turkey, Malta, Israel and the UK (WHO Europe has different members from the European Union), but there is an upward trend in all 53 member countries. Driving cancers Obesity is the cause of 13 different types of cancer, as well as a risk factor in strokes, heart attacks, type 2 diabetes and other non-communicable diseases, according to the report. For some countries in the region, obesity is predicted to overtake smoking as the main risk factor for preventable cancer. The report also highlights that obesity is a condition, not just a risk factor, that needs to be specifically treated and managed. “In Europe and Central Asia, no single country is going to meet the WHO Global NCD target of halting the rise of obesity by 2025,” said Dr Hans Kluge, WHO Regional Director for Europe. Adult obesity in the 53-country European Region is higher than in any other WHO region except the the Americas. More males (63%) are overweight than among females (54%) while obesity is more prevalent among females (24%) than among males (22%). Obesity rates in Europe (2016) 50% 60% 70% Orange = all adults, Blue = males, Green = females The COVID-19 pandemic has highlighted the danger of obesity, with patients with obesity being more likely to experience complications and death from the virus. “Preliminary data also suggest that during the current pandemic, people have had higher exposure to obesity risk factors, including an increase in sedentary lifestyles and consumption of unhealthy foods,” according to the report. Addressing unhealthy environments “Obesity is influenced by the environment, so it is important to look at this problem from the perspective of every stage of life. For example, the life of children and adolescents is impacted by digital environments, including marketing of unhealthy food and drinks,” said Dr Kremlin Wickramasinghe, Acting Head of the WHO European Office for the Prevention and Control of NCDs, which produced the report. “Restricting the marketing of unhealthy foods to children, taxation of sugar-sweetened beverages and improving health system response for obesity management are currently among the most actively discussed policy areas in the WHO European Region,” Wickramasinghe added. Other policies that show promise in reducing levels of obesity and overweight include improving access to obesity and overweight management services in primary health care, promoting breastfeeding and school-based interventions. The report also highlights interventions at supermarkets and takeaway outlets, which are the primary food sources. These include removing unhealthy foods from checkouts and nearby aisles and restricting takeaway outlets. Improving the quality of parks and playgrounds, as well as providing adequate infrastructure for active transport are other suggestions. Image Credits: rawpixel/unsplash. After Months of Deadlock, WTO’s TRIPS Council Will Finally Discuss Intellectual Property Waiver Compromise 03/05/2022 Kerry Cullinan WTO Director-General Ngozi Okonjo-Iweala In a significant breakthrough, the World Trade Organization’s (WTO) TRIPS Council on Friday will finally discuss a compromise proposal on a waiver of intellectual property (IP) rights on COVID-19 vaccines – almost 18 months after it was first proposed by India and South Africa. Members attending an informal meeting of the TRIPS Council on Tuesday were told that the text of an “outcome document” from the “quad” of the European Union, US, India and South Africa would be circulated to them “within hours” from WTO Director-General Ngozi Okonjo-Iweala’s office. The outcome document, which was later posted on the WTO website, is very similar to that which was leaked in mid-March – but it has been termed an “outcome document” rather than an agreement as there are still a couple of points of disagreement. Disagreement over who should be eligible The main point of disagreement relates to which countries should be able to benefit from the waiver (footnote 1). All developing country members that have not yet achieved a significant export capacity – namely 10% of the world’s COVID-19 vaccine market – are supposed to benefit from the flexibilities. Apparently, China has been unhappy about being excluded while a country like India with large generic manufacturing capacity, may be included. But the new TRIPS Council chairperson, Sierra Leone’s Ambassador Lansana Gberie, told Tuesday’s meeting that the superpower “seemed favourably disposed” towards the compromise – also contained in footnote 1 – that states “all developing country members with capacity are encouraged to opt out from these flexibilities”, according to a WTO official. While the waiver only applies to vaccines, WTO members will have six months to decide whether to extend it to cover the production and distribution of COVID-19 diagnostics and therapeutics. According to the draft document, eligible WTO members will be able to limit TRIPS article Section 28, which deals with exclusive patents, by authorizing the production and supply of COVID-19 vaccines without the patent holder’s consent, and with minimal transaction costs. Single authorisation for multiple patents Another deviation from draft agreement that was leaked in mid-March is related to whether countries will have to list all the patents that they will be waiving – widely criticised for imposing onerous requirements on countries. This appears set to go, according to footnote 3. Eligible countries may issue a single authorisation to use multiple patents and can export the vaccines they produce under this authorisation to other eligible members, particularly countries in greatest need, and to supply regional or international initiatives such as COVAX (a waiver of TRIPS Art. 31(f).) Eligible members will also be able to use any of their legal instruments to impose a waiver on vaccines, and the protection of clinical trial data under TRIPS will not be an obstacle to implementing this proposal. Payment for any vaccines produced under TRIPS waiver conditions for export is to take account of the humanitarian and not-for-profit purpose of the vaccine programme, to support manufacturers to produce and supply vaccines at affordable prices. The duration of the flexibilities would be either three or five years, and eligible members would be exempted from legal challenges under the WTO dispute settlement mechanism. The earlier agreement was widely condemned by health activist groups, who objected the waiver being confined to vaccines and excluding some of the world’s major COVID-19 vaccine producers. In addition, a diplomatic source told Health Policy Watch that he did not know the value of the waiver given that there was an apparent surplus of COVID-19 vaccines. The results of the formal discussion on Friday will be reported to the General Council, which is scheduled to meet on 9 and 10 May. Image Credits: Jess Hurd/ Global Justice Now, Africa Centre for International Trade&Development. Europeans May Have to Sleep Under Mosquito Nets as Climate Change Alters Disease Patterns 03/05/2022 Maayan Hoffman Geneva Health Forum session, “Impact of climate change on health.” From left: Moderator Maximilian Jungmann, University of Heidelberg; Alfonso Gomez, City of Geneva; Maria Neira, World Health Organization; Gueladio Cisse, CGIEC Swiss TPH; and Valérie D’Acremont, University of Lausanne. Children sick with malaria, adults in bed with fevers and rashes as a result of the Zika virus, tick-borne illnesses – all of these diseases are on the rise as a result of climate change, according to Valérie D’Acremont of the University of Lausanne. She spoke on Tuesday at the Geneva Health Forum during a special session on the impact of climate change on health, addressing the question: “what is the scale of the problem and what action needs to be taken?” “It is clear that there has been an increase in transmission of [existing] pathogens and of new pathogens,” said D’Acremont, a Swiss physician who is also working on a project in Africa. For example, the spread of malaria, caused by a parasite that spreads to humans and other animals through the bites of infected female mosquitoes, increases in temperatures of around 25ºC. “In West Africa, it is too hot, so malaria might be going down, but in East Africa, the opposite is the case and we see an increase in malaria,” she said. Adding to the challenge are compromised health systems, the result of two years of the COVID-19 pandemic, which has seen the world losing some of its gains against malaria over the last 20 years. Mosquitoes, similarly, are more prone to spreading Zika virus in around 30ºC, which means that the world’s tropical areas are seeing more and more of the disease, and it is likely to extend to Europe and other countries. “We see it already in Italy,” D’Acremont stressed. “We might one day have to sleep under bed nets like they do in Africa.” Tick-borne diseases are spreading in Switzerland, also as a result of climate change, she added. There has been a two-thirds increase in the number of people hospitalized for ticks in Switzerland from 2009 to 2019, according to a recent report by RTS. Moreover, the number of tick bites rose from around 10,000 per year between 2012 and 2016 to around 14,000 a year in the last four years. “Journalists like to hear this story because it frightens people,” D’Acremont said but added that the main challenge was that people die from these diseases when coupled with other pre-existing conditions, such as diabetes, hypertension or malnutrition. These are also often a result of climate change or failing to take care of the environment and our food sources. “Climate change has a huge impact on this too, especially undernutrition and respiratory problems,” she said. Alfonso Gomez of the City of Geneva addresses the Geneva Health Forum on May 3, 2022. We need to stop exploiting animals, destroying nature Climate change has become an inescapable reality. The most recent Intergovernmental Panel on Climate Change (IPPC) report showed what people already knew: There is now scientific consensus that climate change is impacting people’s health and wellbeing in all hemispheres. Sometimes the effect is direct, Gueladio Cisse of CGIEC Swiss TPH, who also spoke at the session, said. Sometimes it is indirect. Sometimes the effect comes at once, and other times it has a slower but also longer-term impact. “If there is a heatwave, the next thing you know people are dying over the course of two or three days,” Cisse said as an example. Other times, a general increase in temperature allows pathogens to grow and makes humans more vulnerable to disease. The good news, said Dr Maria Neira, of the World Health Organization, is that the scientific community has been “pulling together in a historic way all the evidence we have on climate change… They are telling us things like if we don’t take measure now, this might put civilization at risk.” D’Acremont agreed but said that while research was useful, now is the time to do research in the field by monitoring the impact of steps taken to curb environmental hazards. “We need a paradigm shift to go to prevention,” she said. “Take COVID. It is nice to have a preparedness plan, but the problem is that another pandemic or event could come and it is new and we cannot be prepared.” Instead, she said, “we need to stop destroying nature, stop exploiting animals and start preparing ourselves by being in better health. During the crisis is too late… We have to shift the reality now to preventive care. That is true for northern and southern countries.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Maayan Hoffman. 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.
‘Epidemic’ of Obesity in Europe 03/05/2022 Kerry Cullinan Impact of obesity on health Almost two-thirds of adults and a third of children are overweight or obese in the World Health Organization (WHO) European Region and this is driving cancer and other diseases, according to the WHO European Regional Obesity Report 2022 report released on Tuesday. The highest prevalence is in Turkey, Malta, Israel and the UK (WHO Europe has different members from the European Union), but there is an upward trend in all 53 member countries. Driving cancers Obesity is the cause of 13 different types of cancer, as well as a risk factor in strokes, heart attacks, type 2 diabetes and other non-communicable diseases, according to the report. For some countries in the region, obesity is predicted to overtake smoking as the main risk factor for preventable cancer. The report also highlights that obesity is a condition, not just a risk factor, that needs to be specifically treated and managed. “In Europe and Central Asia, no single country is going to meet the WHO Global NCD target of halting the rise of obesity by 2025,” said Dr Hans Kluge, WHO Regional Director for Europe. Adult obesity in the 53-country European Region is higher than in any other WHO region except the the Americas. More males (63%) are overweight than among females (54%) while obesity is more prevalent among females (24%) than among males (22%). Obesity rates in Europe (2016) 50% 60% 70% Orange = all adults, Blue = males, Green = females The COVID-19 pandemic has highlighted the danger of obesity, with patients with obesity being more likely to experience complications and death from the virus. “Preliminary data also suggest that during the current pandemic, people have had higher exposure to obesity risk factors, including an increase in sedentary lifestyles and consumption of unhealthy foods,” according to the report. Addressing unhealthy environments “Obesity is influenced by the environment, so it is important to look at this problem from the perspective of every stage of life. For example, the life of children and adolescents is impacted by digital environments, including marketing of unhealthy food and drinks,” said Dr Kremlin Wickramasinghe, Acting Head of the WHO European Office for the Prevention and Control of NCDs, which produced the report. “Restricting the marketing of unhealthy foods to children, taxation of sugar-sweetened beverages and improving health system response for obesity management are currently among the most actively discussed policy areas in the WHO European Region,” Wickramasinghe added. Other policies that show promise in reducing levels of obesity and overweight include improving access to obesity and overweight management services in primary health care, promoting breastfeeding and school-based interventions. The report also highlights interventions at supermarkets and takeaway outlets, which are the primary food sources. These include removing unhealthy foods from checkouts and nearby aisles and restricting takeaway outlets. Improving the quality of parks and playgrounds, as well as providing adequate infrastructure for active transport are other suggestions. Image Credits: rawpixel/unsplash. After Months of Deadlock, WTO’s TRIPS Council Will Finally Discuss Intellectual Property Waiver Compromise 03/05/2022 Kerry Cullinan WTO Director-General Ngozi Okonjo-Iweala In a significant breakthrough, the World Trade Organization’s (WTO) TRIPS Council on Friday will finally discuss a compromise proposal on a waiver of intellectual property (IP) rights on COVID-19 vaccines – almost 18 months after it was first proposed by India and South Africa. Members attending an informal meeting of the TRIPS Council on Tuesday were told that the text of an “outcome document” from the “quad” of the European Union, US, India and South Africa would be circulated to them “within hours” from WTO Director-General Ngozi Okonjo-Iweala’s office. The outcome document, which was later posted on the WTO website, is very similar to that which was leaked in mid-March – but it has been termed an “outcome document” rather than an agreement as there are still a couple of points of disagreement. Disagreement over who should be eligible The main point of disagreement relates to which countries should be able to benefit from the waiver (footnote 1). All developing country members that have not yet achieved a significant export capacity – namely 10% of the world’s COVID-19 vaccine market – are supposed to benefit from the flexibilities. Apparently, China has been unhappy about being excluded while a country like India with large generic manufacturing capacity, may be included. But the new TRIPS Council chairperson, Sierra Leone’s Ambassador Lansana Gberie, told Tuesday’s meeting that the superpower “seemed favourably disposed” towards the compromise – also contained in footnote 1 – that states “all developing country members with capacity are encouraged to opt out from these flexibilities”, according to a WTO official. While the waiver only applies to vaccines, WTO members will have six months to decide whether to extend it to cover the production and distribution of COVID-19 diagnostics and therapeutics. According to the draft document, eligible WTO members will be able to limit TRIPS article Section 28, which deals with exclusive patents, by authorizing the production and supply of COVID-19 vaccines without the patent holder’s consent, and with minimal transaction costs. Single authorisation for multiple patents Another deviation from draft agreement that was leaked in mid-March is related to whether countries will have to list all the patents that they will be waiving – widely criticised for imposing onerous requirements on countries. This appears set to go, according to footnote 3. Eligible countries may issue a single authorisation to use multiple patents and can export the vaccines they produce under this authorisation to other eligible members, particularly countries in greatest need, and to supply regional or international initiatives such as COVAX (a waiver of TRIPS Art. 31(f).) Eligible members will also be able to use any of their legal instruments to impose a waiver on vaccines, and the protection of clinical trial data under TRIPS will not be an obstacle to implementing this proposal. Payment for any vaccines produced under TRIPS waiver conditions for export is to take account of the humanitarian and not-for-profit purpose of the vaccine programme, to support manufacturers to produce and supply vaccines at affordable prices. The duration of the flexibilities would be either three or five years, and eligible members would be exempted from legal challenges under the WTO dispute settlement mechanism. The earlier agreement was widely condemned by health activist groups, who objected the waiver being confined to vaccines and excluding some of the world’s major COVID-19 vaccine producers. In addition, a diplomatic source told Health Policy Watch that he did not know the value of the waiver given that there was an apparent surplus of COVID-19 vaccines. The results of the formal discussion on Friday will be reported to the General Council, which is scheduled to meet on 9 and 10 May. Image Credits: Jess Hurd/ Global Justice Now, Africa Centre for International Trade&Development. Europeans May Have to Sleep Under Mosquito Nets as Climate Change Alters Disease Patterns 03/05/2022 Maayan Hoffman Geneva Health Forum session, “Impact of climate change on health.” From left: Moderator Maximilian Jungmann, University of Heidelberg; Alfonso Gomez, City of Geneva; Maria Neira, World Health Organization; Gueladio Cisse, CGIEC Swiss TPH; and Valérie D’Acremont, University of Lausanne. Children sick with malaria, adults in bed with fevers and rashes as a result of the Zika virus, tick-borne illnesses – all of these diseases are on the rise as a result of climate change, according to Valérie D’Acremont of the University of Lausanne. She spoke on Tuesday at the Geneva Health Forum during a special session on the impact of climate change on health, addressing the question: “what is the scale of the problem and what action needs to be taken?” “It is clear that there has been an increase in transmission of [existing] pathogens and of new pathogens,” said D’Acremont, a Swiss physician who is also working on a project in Africa. For example, the spread of malaria, caused by a parasite that spreads to humans and other animals through the bites of infected female mosquitoes, increases in temperatures of around 25ºC. “In West Africa, it is too hot, so malaria might be going down, but in East Africa, the opposite is the case and we see an increase in malaria,” she said. Adding to the challenge are compromised health systems, the result of two years of the COVID-19 pandemic, which has seen the world losing some of its gains against malaria over the last 20 years. Mosquitoes, similarly, are more prone to spreading Zika virus in around 30ºC, which means that the world’s tropical areas are seeing more and more of the disease, and it is likely to extend to Europe and other countries. “We see it already in Italy,” D’Acremont stressed. “We might one day have to sleep under bed nets like they do in Africa.” Tick-borne diseases are spreading in Switzerland, also as a result of climate change, she added. There has been a two-thirds increase in the number of people hospitalized for ticks in Switzerland from 2009 to 2019, according to a recent report by RTS. Moreover, the number of tick bites rose from around 10,000 per year between 2012 and 2016 to around 14,000 a year in the last four years. “Journalists like to hear this story because it frightens people,” D’Acremont said but added that the main challenge was that people die from these diseases when coupled with other pre-existing conditions, such as diabetes, hypertension or malnutrition. These are also often a result of climate change or failing to take care of the environment and our food sources. “Climate change has a huge impact on this too, especially undernutrition and respiratory problems,” she said. Alfonso Gomez of the City of Geneva addresses the Geneva Health Forum on May 3, 2022. We need to stop exploiting animals, destroying nature Climate change has become an inescapable reality. The most recent Intergovernmental Panel on Climate Change (IPPC) report showed what people already knew: There is now scientific consensus that climate change is impacting people’s health and wellbeing in all hemispheres. Sometimes the effect is direct, Gueladio Cisse of CGIEC Swiss TPH, who also spoke at the session, said. Sometimes it is indirect. Sometimes the effect comes at once, and other times it has a slower but also longer-term impact. “If there is a heatwave, the next thing you know people are dying over the course of two or three days,” Cisse said as an example. Other times, a general increase in temperature allows pathogens to grow and makes humans more vulnerable to disease. The good news, said Dr Maria Neira, of the World Health Organization, is that the scientific community has been “pulling together in a historic way all the evidence we have on climate change… They are telling us things like if we don’t take measure now, this might put civilization at risk.” D’Acremont agreed but said that while research was useful, now is the time to do research in the field by monitoring the impact of steps taken to curb environmental hazards. “We need a paradigm shift to go to prevention,” she said. “Take COVID. It is nice to have a preparedness plan, but the problem is that another pandemic or event could come and it is new and we cannot be prepared.” Instead, she said, “we need to stop destroying nature, stop exploiting animals and start preparing ourselves by being in better health. During the crisis is too late… We have to shift the reality now to preventive care. That is true for northern and southern countries.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Maayan Hoffman. 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.
After Months of Deadlock, WTO’s TRIPS Council Will Finally Discuss Intellectual Property Waiver Compromise 03/05/2022 Kerry Cullinan WTO Director-General Ngozi Okonjo-Iweala In a significant breakthrough, the World Trade Organization’s (WTO) TRIPS Council on Friday will finally discuss a compromise proposal on a waiver of intellectual property (IP) rights on COVID-19 vaccines – almost 18 months after it was first proposed by India and South Africa. Members attending an informal meeting of the TRIPS Council on Tuesday were told that the text of an “outcome document” from the “quad” of the European Union, US, India and South Africa would be circulated to them “within hours” from WTO Director-General Ngozi Okonjo-Iweala’s office. The outcome document, which was later posted on the WTO website, is very similar to that which was leaked in mid-March – but it has been termed an “outcome document” rather than an agreement as there are still a couple of points of disagreement. Disagreement over who should be eligible The main point of disagreement relates to which countries should be able to benefit from the waiver (footnote 1). All developing country members that have not yet achieved a significant export capacity – namely 10% of the world’s COVID-19 vaccine market – are supposed to benefit from the flexibilities. Apparently, China has been unhappy about being excluded while a country like India with large generic manufacturing capacity, may be included. But the new TRIPS Council chairperson, Sierra Leone’s Ambassador Lansana Gberie, told Tuesday’s meeting that the superpower “seemed favourably disposed” towards the compromise – also contained in footnote 1 – that states “all developing country members with capacity are encouraged to opt out from these flexibilities”, according to a WTO official. While the waiver only applies to vaccines, WTO members will have six months to decide whether to extend it to cover the production and distribution of COVID-19 diagnostics and therapeutics. According to the draft document, eligible WTO members will be able to limit TRIPS article Section 28, which deals with exclusive patents, by authorizing the production and supply of COVID-19 vaccines without the patent holder’s consent, and with minimal transaction costs. Single authorisation for multiple patents Another deviation from draft agreement that was leaked in mid-March is related to whether countries will have to list all the patents that they will be waiving – widely criticised for imposing onerous requirements on countries. This appears set to go, according to footnote 3. Eligible countries may issue a single authorisation to use multiple patents and can export the vaccines they produce under this authorisation to other eligible members, particularly countries in greatest need, and to supply regional or international initiatives such as COVAX (a waiver of TRIPS Art. 31(f).) Eligible members will also be able to use any of their legal instruments to impose a waiver on vaccines, and the protection of clinical trial data under TRIPS will not be an obstacle to implementing this proposal. Payment for any vaccines produced under TRIPS waiver conditions for export is to take account of the humanitarian and not-for-profit purpose of the vaccine programme, to support manufacturers to produce and supply vaccines at affordable prices. The duration of the flexibilities would be either three or five years, and eligible members would be exempted from legal challenges under the WTO dispute settlement mechanism. The earlier agreement was widely condemned by health activist groups, who objected the waiver being confined to vaccines and excluding some of the world’s major COVID-19 vaccine producers. In addition, a diplomatic source told Health Policy Watch that he did not know the value of the waiver given that there was an apparent surplus of COVID-19 vaccines. The results of the formal discussion on Friday will be reported to the General Council, which is scheduled to meet on 9 and 10 May. Image Credits: Jess Hurd/ Global Justice Now, Africa Centre for International Trade&Development. Europeans May Have to Sleep Under Mosquito Nets as Climate Change Alters Disease Patterns 03/05/2022 Maayan Hoffman Geneva Health Forum session, “Impact of climate change on health.” From left: Moderator Maximilian Jungmann, University of Heidelberg; Alfonso Gomez, City of Geneva; Maria Neira, World Health Organization; Gueladio Cisse, CGIEC Swiss TPH; and Valérie D’Acremont, University of Lausanne. Children sick with malaria, adults in bed with fevers and rashes as a result of the Zika virus, tick-borne illnesses – all of these diseases are on the rise as a result of climate change, according to Valérie D’Acremont of the University of Lausanne. She spoke on Tuesday at the Geneva Health Forum during a special session on the impact of climate change on health, addressing the question: “what is the scale of the problem and what action needs to be taken?” “It is clear that there has been an increase in transmission of [existing] pathogens and of new pathogens,” said D’Acremont, a Swiss physician who is also working on a project in Africa. For example, the spread of malaria, caused by a parasite that spreads to humans and other animals through the bites of infected female mosquitoes, increases in temperatures of around 25ºC. “In West Africa, it is too hot, so malaria might be going down, but in East Africa, the opposite is the case and we see an increase in malaria,” she said. Adding to the challenge are compromised health systems, the result of two years of the COVID-19 pandemic, which has seen the world losing some of its gains against malaria over the last 20 years. Mosquitoes, similarly, are more prone to spreading Zika virus in around 30ºC, which means that the world’s tropical areas are seeing more and more of the disease, and it is likely to extend to Europe and other countries. “We see it already in Italy,” D’Acremont stressed. “We might one day have to sleep under bed nets like they do in Africa.” Tick-borne diseases are spreading in Switzerland, also as a result of climate change, she added. There has been a two-thirds increase in the number of people hospitalized for ticks in Switzerland from 2009 to 2019, according to a recent report by RTS. Moreover, the number of tick bites rose from around 10,000 per year between 2012 and 2016 to around 14,000 a year in the last four years. “Journalists like to hear this story because it frightens people,” D’Acremont said but added that the main challenge was that people die from these diseases when coupled with other pre-existing conditions, such as diabetes, hypertension or malnutrition. These are also often a result of climate change or failing to take care of the environment and our food sources. “Climate change has a huge impact on this too, especially undernutrition and respiratory problems,” she said. Alfonso Gomez of the City of Geneva addresses the Geneva Health Forum on May 3, 2022. We need to stop exploiting animals, destroying nature Climate change has become an inescapable reality. The most recent Intergovernmental Panel on Climate Change (IPPC) report showed what people already knew: There is now scientific consensus that climate change is impacting people’s health and wellbeing in all hemispheres. Sometimes the effect is direct, Gueladio Cisse of CGIEC Swiss TPH, who also spoke at the session, said. Sometimes it is indirect. Sometimes the effect comes at once, and other times it has a slower but also longer-term impact. “If there is a heatwave, the next thing you know people are dying over the course of two or three days,” Cisse said as an example. Other times, a general increase in temperature allows pathogens to grow and makes humans more vulnerable to disease. The good news, said Dr Maria Neira, of the World Health Organization, is that the scientific community has been “pulling together in a historic way all the evidence we have on climate change… They are telling us things like if we don’t take measure now, this might put civilization at risk.” D’Acremont agreed but said that while research was useful, now is the time to do research in the field by monitoring the impact of steps taken to curb environmental hazards. “We need a paradigm shift to go to prevention,” she said. “Take COVID. It is nice to have a preparedness plan, but the problem is that another pandemic or event could come and it is new and we cannot be prepared.” Instead, she said, “we need to stop destroying nature, stop exploiting animals and start preparing ourselves by being in better health. During the crisis is too late… We have to shift the reality now to preventive care. That is true for northern and southern countries.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Maayan Hoffman. 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
Europeans May Have to Sleep Under Mosquito Nets as Climate Change Alters Disease Patterns 03/05/2022 Maayan Hoffman Geneva Health Forum session, “Impact of climate change on health.” From left: Moderator Maximilian Jungmann, University of Heidelberg; Alfonso Gomez, City of Geneva; Maria Neira, World Health Organization; Gueladio Cisse, CGIEC Swiss TPH; and Valérie D’Acremont, University of Lausanne. Children sick with malaria, adults in bed with fevers and rashes as a result of the Zika virus, tick-borne illnesses – all of these diseases are on the rise as a result of climate change, according to Valérie D’Acremont of the University of Lausanne. She spoke on Tuesday at the Geneva Health Forum during a special session on the impact of climate change on health, addressing the question: “what is the scale of the problem and what action needs to be taken?” “It is clear that there has been an increase in transmission of [existing] pathogens and of new pathogens,” said D’Acremont, a Swiss physician who is also working on a project in Africa. For example, the spread of malaria, caused by a parasite that spreads to humans and other animals through the bites of infected female mosquitoes, increases in temperatures of around 25ºC. “In West Africa, it is too hot, so malaria might be going down, but in East Africa, the opposite is the case and we see an increase in malaria,” she said. Adding to the challenge are compromised health systems, the result of two years of the COVID-19 pandemic, which has seen the world losing some of its gains against malaria over the last 20 years. Mosquitoes, similarly, are more prone to spreading Zika virus in around 30ºC, which means that the world’s tropical areas are seeing more and more of the disease, and it is likely to extend to Europe and other countries. “We see it already in Italy,” D’Acremont stressed. “We might one day have to sleep under bed nets like they do in Africa.” Tick-borne diseases are spreading in Switzerland, also as a result of climate change, she added. There has been a two-thirds increase in the number of people hospitalized for ticks in Switzerland from 2009 to 2019, according to a recent report by RTS. Moreover, the number of tick bites rose from around 10,000 per year between 2012 and 2016 to around 14,000 a year in the last four years. “Journalists like to hear this story because it frightens people,” D’Acremont said but added that the main challenge was that people die from these diseases when coupled with other pre-existing conditions, such as diabetes, hypertension or malnutrition. These are also often a result of climate change or failing to take care of the environment and our food sources. “Climate change has a huge impact on this too, especially undernutrition and respiratory problems,” she said. Alfonso Gomez of the City of Geneva addresses the Geneva Health Forum on May 3, 2022. We need to stop exploiting animals, destroying nature Climate change has become an inescapable reality. The most recent Intergovernmental Panel on Climate Change (IPPC) report showed what people already knew: There is now scientific consensus that climate change is impacting people’s health and wellbeing in all hemispheres. Sometimes the effect is direct, Gueladio Cisse of CGIEC Swiss TPH, who also spoke at the session, said. Sometimes it is indirect. Sometimes the effect comes at once, and other times it has a slower but also longer-term impact. “If there is a heatwave, the next thing you know people are dying over the course of two or three days,” Cisse said as an example. Other times, a general increase in temperature allows pathogens to grow and makes humans more vulnerable to disease. The good news, said Dr Maria Neira, of the World Health Organization, is that the scientific community has been “pulling together in a historic way all the evidence we have on climate change… They are telling us things like if we don’t take measure now, this might put civilization at risk.” D’Acremont agreed but said that while research was useful, now is the time to do research in the field by monitoring the impact of steps taken to curb environmental hazards. “We need a paradigm shift to go to prevention,” she said. “Take COVID. It is nice to have a preparedness plan, but the problem is that another pandemic or event could come and it is new and we cannot be prepared.” Instead, she said, “we need to stop destroying nature, stop exploiting animals and start preparing ourselves by being in better health. During the crisis is too late… We have to shift the reality now to preventive care. That is true for northern and southern countries.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Maayan Hoffman. Posts navigation Older postsNewer posts