Chile pulled out of hosting the COP25 Climate Change Conference on Wednesday, following two weeks of protests in the hosting city of Santiago. The announcement throws preparations for the conference, scheduled for December, into disarray for the second time, after Brazil withdrew its request to host the 2019 conference late last year.

COP25 logo

It casts a shadow over the efforts of UN Secretary-General Antonio Guterrez to ramp up climate action in the wake of the UN Climate Action Summit in New York City in September.

“Earlier today, I was informed of the decision by the Government of Chile not to host COP25 in view of the difficult situation that the country is undergoing. We are currently exploring alternative hosting options,” United National Climate Change Executive Secretary Patricia Espinosa said in a statement.

Following a wave of massive civil unrest with over 1 million people taking to the streets to protest inequality, president Sebastian Pinera announced the decision to withdraw from hosting COP25, along with dropping the Asian-Pacific Economic Cooperation (APEC) Summit, which was planned for next month.

“As a president, I have a duty to put the needs of Chileans first. Therefore, with pain, we have decided to cancel APEC and COP summits to guarantee order and social peace, focus on dialogue, and a new social agenda to provide urgent solutions to major demands,” the president announced on Twitter (translated from Spanish).

 

Image Credits: COP25 Twitter.

Berlin, Germany – The Drugs for Neglected Diseases Initiative (DNDi) is celebrating its 15th anniversary and in a special event Tuesday night, founders and supporters of the product development partnership (PDP) gathered in Berlin to reflect on lessons learned and challenges that still lie ahead. Here below are excerpts of what they had to say.  

Marie-Paule Kieny, Chair of the Board of DNDi

15 years ago the Drugs for Neglected Diseases was created as a response to the frustration of clinicians and the desperation of patients facing the reality that their treatment was either ineffective, highly toxic, or unavailable, when it even existed at all.

Against this background DNDi was established as an experiment. After 15 years, what are lessons to be learned from these experiments?

DNDi is a needs-driven organization, we put patients and not profits as a value. Scientific independence guarantees a needs-based approach. Our research is collaborative, open and transparent; knowledge is worth something when its shared, open science is a key strategy. DNDi is only possible through collaboration – networking is a key part of our innovation. Public leadership is imperative to promote coherent ecosystems to make medicines available to all patients. Without sustainable, affordable accessible and adaptable medicines we will not be able to meet the Sustainable Development Goals.

Veronika von Messling, Director-General of the Life Sciences Division, Federal Ministry of Education and Research, Germany

The overall mission was to improve the health and quality of life of people suffering from neglected diseases, filling a gap that was left by pharmaceutical industries, because neglected diseases were not a priority. It is to DNDi’s credit that game-changing treatments for diseases such as sleeping sickness have been developed.

Research and development, innovation and access are drivers worldwide. The German government is committed to funding global health research because we are convinced this will contribute to global health.

We are aware that despite the remarkable advances made there are still significant gaps, and therefore Germany remains committed to further development of PDPs [product development partnerships] that ensure no one is left behind.

Soumya Swaminathan, Chief scientist, World Health Organization; former head of the Indian Medical Research Council

I can remember as a practitioner in India, when we were still doing spleen punctures for diagnosis of Kala Azar (visceral leishmaniasis). And all we had available were very toxic treatments. Children would come to us who were already skin and bone, their abdomens would be all bloated with enlarged livers and spleens. So it was torture for the patients and it was difficult for us as the treating physicians to subject our patients to so much discomfort, and many of them came too late to be cured.

Now thanks to treatments like those developed by DNDi, Kala-Azar has almost disappeared from the Indian sub-continent. We still have pockets in the most vulnerable groups. And it is because of poor housing that the sand flies breed. You improve housing and leishmaniasis disappears. It’s all tied up to development. More recently, I met Nathalie [Strub-Wourgaft] of DNDi when we were in Sudan at the world’s only Mycetoma Research Center. Mycetoma is not immediately fatal but it is incapacitating. The amazing thing to me was that DNDi was there, doing this collaboration on a clinical trial for a new mycetoma drug. Most people would not have heard of mycetoma. The victims would remain invisible unless organizations like WHO and DNDi spoke about it. Investments in science and research are very important, not only at global level but also at country level – this is where we see the whole end-to-end approach is needed. We need to be talking about neglected populations, neglected pathogens and neglected products – and not only neglected diseases.

You can have the product on the shelf, but how do you ensure access? Our job at WHO is to think through all of these things with our partners, including DNDi. So we have created a forum for the PDPs and their funders to come together and discuss their common challenges, opportunities and plan strategically. To think about issues such as “what does access look like?”

When you have publicly funded R&D, if that product is successful, how is it going to reach populations, how will it be priced, and how are countries going to be able to adopt innovations? Financing is one aspect, but the other aspect is the capacity of countries to absorb these innovations into the health system, and to be able to prioritize based on local needs.”

John Amuasi, Executive Director of the African Research Network for Neglected Tropical Disease

There is indeed a constant tussle between having the high-level endorsements for a new treatment and moving fast enough with the evidence available to put it in place on the ground. I would recommend some effort be put into the assessment of these technologies as actionable on the ground. Health Technology Assessments are very context specific and can relate to things like cultural practices that do influence the final decision on implementation.

Public interest R&D and research that is in the interest of the public is really two different things. I recognize the challenges inherent in getting leaders of low- and middle-income countries to commit more. When people such as ministers have to make these decisions, if they don’t think that people are interested, they will not focus on it, even if it is in the interest of the public. So in looking at public interest R&D one key question is how to draw the public interest in it.

Do people really judge their governments to the degree which their health has improved? If we are able to demonstrate clearly that our R&D activities impact directly on improving primary health care… via health system strengthening, I think we would be even more successful in our efforts in promoting R&D. If we can show how this work directly impacts on improving primary health care and universal health coverage, if this link can be exposed and made more visible it would go a long way to supporting public interest in R&D.

Jeremy Farrar, executive director of the Wellcome Trust

We are at a really critical juncture in global health. There is no doubt that investments we have made are starting to bear fruit, but at that very juncture we see a world that is looking very fragile. We have a world challenged by climate change, persistent and emerging infections and of course non-communicable diseases – and that double whammy is going to be an enormous challenge. None of us should underestimate the challenges of delivering Universal Health Coverage in this context.

If you look at the trends in the pharma industry, I worry that industry, while having been sometimes a difficult partner, could become even less of a partner and that is a worry as they step away from antibiotics, for example. I worry that we have been through a relative honeymoon period. There is a vacuum, and that vacuum has to be filled.

I think we have to think through more as a community how we can fill that vacuum, including in financing. As we go forward, how are we going to fill that gap? In terms of all of these PDPs,  DNDi, Medicines for Malaria Venture, etc., how can we put this on a more sustainable footing, one that isn’t just reliant on charity and philanthropy, through more innovative financing. There is an incredible opportunity because interest rates are almost at 0%. And if we don’t use this moment in time to access capital, I worry that we won’t be able to rely on governments stepping up, or on philanthropy, and we may look back on the 15 years that have passed as the easy period. So should we start to change and adapt to that future when we are at our strongest? I wonder if now isn’t the time to do that, given the prevailing winds?

I also call on Germany to not lose sight of multilateralism, as other countries shift away and become more nationalistic, that Germany and Europe stand up for the values that have made it what it is over the past few decades.

Bernard Pécoul, executive director of DNDi

When Médecins Sans Frontières (MSF) received the Nobel Peace Prize [in 1999], the decision was to dedicate the prize money to the creation of DNDi.  We are not driven by profit but by patient needs, we focus on populations for which there is no solution or very bad solutions. Our close links to MSF have kept us on track. When we started researching drugs for sleeping sickness it was still being treated with arsenic.  First we improved the treatment, now we have registered the first oral treatment.

Our vision has been the best science for the most neglected diseases.  It was easy to formulate and a lot harder to implement. But the fact that we established a relationship from the start with the Institut Pasteur helped us to bring scientific credibility on the table.  They helped us to select the initial projects.  DNDi is strongly rooted in the countries where the majority of our patients live.  We commit to strengthen the research institutions close to patients and communities. DNDi has strived for countries to lead the response rather than being passive beneficiaries. This is part of the vision.

DNDi believes in sharing our lessons learned, to shape [the research environment].  We have from the start supported the WHO role and worked closely with WHO to facilitate implementation and support development of new guidelines for drugs that we develop.”

Representatives from the founding partners of DNDi

Image Credits: E Fletcher/HP-Watch, Lukas Schramm/DNDi.

The Drugs for Neglected Diseases Initiative (DNDi) celebrates its 15th anniversary this week, as a non-profit drug R&D organization that sought to create an alternative model for developing drug treatments for the most neglected diseases and the world’s poorest populations. Since DNDi’s launch in 2003, the organization has developed eight new treatments, including the first-ever oral drug for sleeping sickness, fexinidazole. Executive Director Dr Bernard Pé‏‏‏coul, who has guided the organization since its creation in 2003, looks back on the mission and its progress.

Dr Pécoul holds the malaria treatment artesunate and amodiaquine (ASAQ), DNDi‘s first treatment successfully brought to market.

Health Policy Watch: You are celebrating the 15th anniversary of DNDi.  How did DNDi come about and what gap has it filled in the R&D landscape?

Bernard Pé‏‏‏coul: We were created in 2003 and started operations in 2004 based on an assessment that the R&D for neglected diseases was totally abandoned. At the time I was director of [the Médecins Sans Frontières (MSF) Campaign for Access to Essential Medicines]. We documented this imbalance in a publication, saying that it’s time to create a different model, at the time the gap was big, and they were trying to find other solutions. The three gaps we documented included:

  1. The lack of new drug candidates. So [in DNDi] we created a consortium to not only screen [candidate molecules] but also to lead optimization [of those molecules] until we have clear chemical entities ready to enter into clinical development.  In our portfolio we [now] have 22 chemical entities in this process, some led by us and some by other partners as leads.
  2. Barriers to clinical development. Typically, the private sector was not ready to enter these complicated clinical settings. This is really the phase in which DNDi is very active.  Typically, we are in charge of the clinical development, and we develop most of the phase 2 and phase 3 studies. We are not alone because we always work in partnership with institutions at the country level, with global health, institutions. At the same time, we try to secure a partnership with Pharma, or with several pharma companies, as this is also a phase where we need to consolidate industry partners for the next phase – which is registration of the product and distribution. So, while we collaborate with pharma to identify the molecules, we “de-risk” pharma because we oversee the clinical studies.
  3. The gap between product and treatment. There is a still a gap at the end of the pipeline, or a lack of incentives to complete the development of new formulations in ways that are more adapted to the field. This means combining creating formulations for children or combining drugs into fixed-dose formulations, which is what we did for malaria. That’s why we talk about treatments and not products.  Our objective is to respond to patient needs, and treatments respond better than products.

HP-Watch: Can you summarize the 3-4 biggest breakthroughs you have experienced in drug development – up to the recent approval of the new drug fexinidazole for sleeping sickness?

Pécoul: Fexinidazole was the first time we developed a product from beginning to the end. The previous successes have been improving new drugs from new formulations.  Altogether there have been another 7 initial treatments that we developed.

The first breakthrough was a malaria treatment combining [the two most effective malaria drugs]. We completed development of that in 2007, with registration and prequalification, and in the last 10-12 years more than 500 million people have received this this treatment in Africa. Our partner in this was Sanofi; they accepted non-exclusivity in the contract, so that there are also generic companies producing the combinations.

Then there was a new formulation for children for Chagas disease [a chronic and disabling disease transmitted by the triatomine bug in Latin America]. Many children are affected, but when we entered this portfolio, the only formulation available was an adult formulation. We were not able to deliver a proper dose for children affected with Chagas. [People would have to split the pill into pieces]. We partnered with pharma companies in Brazil and in Argentina to devise two sources of a paediatric formulation.

A child with HIV takes a paediatric dose of antiretroviral medication, a formulation which DNDi developed.

Then, we achieved something similar in developing paediatric formulations [of antiretroviral drug combinations] for HIV. The existing formulations could be very difficult to take, or they would need special handling, such as refrigeration. So, we are developing a new formulation adapted to kids that was just submitted to the US Food and Drug Administration (FDA) in October this year.  That is a four-in-one combination of the first-line drugs recommended by WHO, but for which today there is no formulation adapted to the kids. We have done this in partnership with the Indian-based generic company CIPLA.  This required a lot of research work, going back to pre-clinical studies.

HP-Watch: What are the key lessons you think have been learned from DNDi’s model, in terms of:  sustainable financing, ensuring more returns on public investments, an end to end approach?

Pécoul: We are releasing today a “model paper”, [a report] on lessons we have learned over our 15 years.  These include lessons about how to facilitate the regulatory process; on how important it is to be very strongly linked with governments and to have public leadership on R&D reflecting commitment from the affected country; and the importance of target [drug candidate] profiles. I think having access [and therefore affordability] in mind from the beginning is very important, this influences your choice of partners but also the candidates you will develop.

Because we are a not-for-profit, and we position access as a key element of our investment, we are trying to develop public goods (i.e. generics) as much as possible. This means that the fruit of the innovation will go back to the public at an affordable price.  The return on investment is more about benefits for the population.  At the same time, because we are not making any profit from what we invest, we have very few mechanisms to secure sustainable funding.

When we are investing on treatments for very neglected populations, so the opportunities to establish sustainable funding to finance our investments are very few:  the populations we serve, by definition, have no purchasing power.

you had stable insulin that you could use in tropical conditions, this would be an interesting innovation.

HP-Watch: So, are you looking at some aspects of NCDs as another future gap or opportunity?

Sample preparation at bio-repository CEADES-DNDi, a partner for DNDi’s clinical studies on Chagas in Bolivia

Pécoul: Not for the time being, but we are not closing the door.  A few years ago, we revisited our mission statement, and we talk about neglected populations [a broader concept than neglected diseases]. But at DNDi we have so far not had the capacity to respond to the big issue of access. We have tried to demonstrate that a different R&D model could work. But we are not the only solution to the problem of innovation and access.

HP-Watch: At the same time, with regards to R&D costs, DNDi’s assessment of its own R&D experiences indicates that costs are not necessarily as high as some of the industry estimates that are out there.  Can you describe and explain why the gap is so high?

Pécoul: We have estimated the cost of improving the treatment of existing drugs to be on the order of US$ 10-30 million. When we talk about developing wholly new chemical entities from scratch, and including attrition, then we are more talking about US$ 60-200 million. True, we are still far away from the US$ 2 billion [quoted by pharmaceutical industry sources].

But we need to be careful about comparing things that are not comparable. We are developing treatments in a field that is very abandoned; we [only] must demonstrate superiority against treatments that are very bad.

Much of the new research is industry documenting that their drug is slightly better than the previous one, and that is very costly. Most of the big companies have abandoned the field of communicable diseases. Secondly industry includes their opportunity costs or costs of capital for investing for years in a product. What we calculate is the real cost of developing. So, the way that we calculate is not the same.

The DNDi model is more cost-effective because it is tailored to achieving the goal that we are trying to pursue. But I don’t think that we could expect that a large pharma company would do the job [in the same way]. What we have achieved is to get a lot of support and commitment from [big] Pharma to pursue our goal.

HP-Watch: What challenges lie ahead?  Do you see DNDi continuing to address infectious diseases only, or could NCDs also be a target, insofar as they are an increasingly large proportion of the burden in LMICs but receive very little investment for treatments geared to low-income populations.

Pécoul: We still have a big challenge with leishmaniasis, it is very prevalent in many parts of the world, and we still use old products that are very difficult to use. We have identified a series of new chemical entities and we want to complete the development of an oral treatment for leishmaniasis. [As of now, there are no all-oral treatments.].

HP-Watch: Are there diseases that might be ripe for elimination?

A doctor dispenses fexinidazole, the first-ever oral treatment for sleeping sickness, which was developed by DNDi.

Pécoul: The best example is sleeping sickness. Fexinidazole, the new oral treatment developed for DNDi in 2018 is taken for 10 days, and is already a massive improvement on early options. But we have one project in the portfolio [pipeline] that would be a single dose treatment for sleeping sickness. If we are successful in developing a single dose, we could be successful in eliminating the Gambiense form of the disease, which is the most common one, and where the reservoir is primarily other human beings, although tsetse flies are vectors.

HP-Watch: What about malaria? Can you explain your involvement with that disease?

Pécoul: We were involved initially in malaria, where we developed two combination dose formulations, as mentioned.  But we completed the job and then transferred to Medicines for Malaria Venture.  They are a close partner of MMV, and they continuing to monitor these projects.

HP-Watch: And other disease frontiers where you see DNDi playing a role?

Pécoul: We will remain focused on NTDs, but not exclusively. For instance, in the last few years we have worked on paediatric formulations for HIV, and we also worked on adult medications for hepatitis C. We could at some point include some NCDs or other issues. For instance, there is the issue of snakebites. It is a neglected disease area.

But in all choices, we would have to assess the needs and the science to see if the scientific background is there to create the basis for success. We are not going back to basic research and we also must look if others are better positioned to do the job.

Concerning antimicrobial resistance, together with WHO we helped incubate GARDP, in which we are trying to use the model of DNDi to develop a new generation of treatments for AMR.

HP-Watch: Recently, DNDi worked with the European Medicines Agency [EMA] to make use of a special section of its regulatory code, known as “Article 58” to help fast-track regulatory approval of the new drug for sleeping sickness, fexinidazole, bringing African regulatory authorities into the process. Can you describe why that process represents a precedent that can help get new treatments to patients more rapidly?

Pécoul. Article 58 is an agreement between WHO and EMA, and in this agreement EMA reviews a dossier for a product that will be used outside of Europe, and they agree to include regulatory authorities from the countries involved.  So, in this case, representatives of the Democratic Republic of Congo (DRC), [which is one of the primary areas affected by sleeping sickness], were involved. That, in turn, helped expedite the national regulatory process, since DRC representatives sat on the EMA body that approved the drug. It’s a good example of collaboration on regulatory issues.

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Dr Bernard Pécoul has led the Drugs for Neglected Diseases initiative (DNDi) since its founding in 2003. Under his guidance, DNDi – a not-for-profit research and development organization – with hundreds of public and private partners, has delivered eight new treatments for the most neglected diseases (leishmaniasis, sleeping sickness, and Chagas disease) and for malaria. It has developed a robust portfolio of projects spanning from discovery to implementation for these diseases as well as filaria, paediatric HIV, mycetoma, and hepatitis C. As part of DNDi’s dynamic portfolio approach, Dr Pécoul also led the creation with WHO of GARDP, a new product development partnership to address R&D for new antibiotic treatments.

DNDi aims to deliver a total of 16 to 18 new treatments for neglected patients by 2023. The initiative, through its R&D work, also builds capacity in disease endemic countries through research platforms and technology transfers and advocates for greater public leadership to sustainably address the health needs of neglected patients.

Prior to DNDi, Dr Pécoul was Director of the Médecins Sans Frontières (MSF) Campaign for Access to Essential Medicines from 1998 to 2003, a position he took on after that of Executive Director of MSF-France. While working with MSF, Dr Pécoul carried out field missions in Africa, Latin America, and Asia. In 1988, he co-founded Epicentre, an MSF-affiliated NGO specialized in epidemiology.

Image Credits: Paul Kamau/ DNDi, FBBVA, Ana Ferreira/DNDi, Xavier Vahed/DNDi.

Berlin, Germany (29 October 2019) – Experts called on policy-makers to put human health and wellbeing at the centre of climate action decisions at the World Health Summit, which entered its third and final day Tuesday.

“There is a need for urgent action to reduce greenhouse emissions to protect health, because we have less than 30 years of emissions left to have a reasonable chance of keeping to a 2 degrees Celsius temperature rise above pre-industrial levels,” said Professor of Environmental Change and Public Health at the London School of Hygiene and Tropical Medicine, Sir Andy Haines.

His presentation during the session, “Climate Change and Public Health: Science Guiding Policy and Practice,” covered a slew of the health impacts of climate change, including those of the wildfires, infectious diseases and increased salinity, but also of the physical and mental health toll of floods, an expected rise in pollen allergies in Europe and the productivity of crops— among others.

Tuesday, the third day of the World Health Summit, also focused on Universal Health Coverage and The Global Action Plan for Healthy Lives and Well-Being for All, which aims to better align the work of 12 global health agencies to accelerate achievement of the Sustainable Development Goals.

A helicopter prepares to drop buckets of water on a forest fire near Yosemite National Park, California USA.

Wildfires around the world cause death, illness and disruptions in people’s lives- wildfires that feed on the hotter, drier weather brought about in certain areas by climate change.

Meanwhile, in Asia, hospitals struggle to accommodate hordes of dengue patients in severe outbreaks, while parts of southern Europe are seeing domestic transmission of this deadly virus for the first time— a virus carried by Aedes mosquitoes, which thrive in changes to rainfall patterns and warmer conditions.

Then, there are the “slow burn” effects of climate change: in Bangladesh, pregnant women living on the coast were found to have unusually high incidences of pre-eclampsia, linked to drinking groundwater with unusually high levels of sodium. Salination of groundwater and soil is linked to rising sea levels, and hypertension and blood pressure are linked to sodium intake.

These are just three examples of risks posed by climate change to human health, said Haines, a drop in the growing ocean of evidence indicating that the healthcare profession has a major stake in decisions on climate change — though the links range from the obvious to the highly complex.

According to Haines, the risks to health posed by climate change include the direct effects of increased exposures to heat and extreme events (e.g., floods or droughts), the effects mediated through ecosystems (such as changes in vector-borne diseases or nutrition) and those mediated through social systems (e.g., conflict or migration).

But it was not all doom and gloom.

“Decarbonizing the world economy will bring many benefits for health, for example, by reducing air pollution,” Sir Andy said, outlining the well-established benefits of healthy, sustainable cities, increased active travel and low carbon transport, and natural green spaces and trees.

For example, he said, the health co-benefits of decarbonising the European economy by phasing out fossil fuels would prevent about 430,000 people per year from dying from air pollution-related health problems in the European Union alone.

“There is an overlap between climate change and air pollution which allows us to bring to the negotiation table the 7 million deaths caused by air pollution, bringing then a very strong argument, because the burning of fossil fuels is a cause of climate change and air pollution,” said the WHO Director of Public Health, Environmental and Social Determinants of Health, Dr Maria Neira, in an interview with Health Policy Watch.

Dr Neira, presenting yesterday on a Roadmap for Climate Action for health, reiterated the point she made at the World Air Quality Conference in London last Wednesday – that putting heath at the centre of decisions would provide the policy coherence and “perfect arguments” needed to motivate people and spur action.

“There is the health argument— this is about noncommunicable diseases and communicable diseases, this is about our brain, how it is affected, this is about gender because of all those girls collecting wood instead of going to school,” she said.

It was also a political argument, she said: “It’s a question of telling our politicians 5 years from now, they will not be able to say ‘I didn’t know’. They are going to court in some places because they are not taking action to reduce their citizens’ exposure to air pollution.”

“There is also the financial argument— the externalities of using coal and fossil fuels are paid by our hospitals and health system,” Dr Neira continued.

As for questions of feasibility of action, Dr Neira was unfazed.

“Well, mayors are doing this. Last week in London, with the Mayor of London committing to endorse WHO Air Quality guidelines along with the C40 and the commitments made at the Climate Action Summit, so it’s feasible,” she said.

She was referring to the C40 network, a group of 94 megacities which had committed to bringing their air quality to safe levels by 2030, among other things by tracking and reporting on the health impacts of their policies.

“It’s a question of putting it on the political agenda as well,” she said.

Dr Neira emphasized that the health community had credibility and needed to use the strong arguments on how climate change was affecting people’s health, as well as the health benefits obtainable from executing the national commitments in the Paris Agreement, which the WHO has previously called “potentially the strongest health agreement of this century.”

Achieving the Health-Related Sustainable Development Goals

An afternoon keynote session explored how politicians can advance health, with speakers including WHO Director-General Tedros Adhanom Ghebreyesus and Brazil’s Minister of Health Luiz Henrique Mandetta.

Dr Tedros speaking at the keynote session, “Health is a Political Choice.”

“Universal health coverage is not a choice a country makes once. It’s a choice that must be made every day, in every policy decision. Disease patterns are always changing, and so are the needs and demands of populations. There are always people at risk of being left behind,” said Dr Tedros, listing antimicrobial resistance, air pollution and climate change as new challenges for countries to confront.

He repeated the call for countries to increase spending on primary health care by 1% GDP by 2030.

Dr Tedros also emphasized the role of global collaboration, noting that, “health is one of the few areas in which international cooperation offers the opportunity for countries to work together for a common cause. Multilateral engagement is not only the smart option, it’s the only option.”

The final session focused on the Global Action Plan for Healthy Lives and Well-Being for All, which aims to better align the work of 12 global health agencies to accelerate achievement of the Sustainable Development Goals.

The plan was introduced at the World Health Summit last year and launched in September at the UN General Assembly. The discussion led by Uganda’s Minister of Health Jane Ruth Aceng, Gavi CEO Seth Berkley, Wellcome Trust Director Jeremy Farrar, and Peter Sands, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, reported on progress and plans for the future.

(left-right) Jane Ruth Aceng, Seth Berkley, Ilona Kickbusch.

Moderator Ilona Kickbusch, chair of the Geneva Graduate Institute’s Global Health Centre, asked the panelists how the 12 agencies that are signatories to the Global Action Plan can “accelerate” their coordination in a meaningful way, noting that, “if we can work together with countries, that will be for a joint good, but if we don’t, it will be a collective failure,” she noted.

Berkeley said that Gavi had tried to create “purposeful collaboration” with fellow agencies such as the Global Fund in areas such as health system strengthening and digitalizing health records – “it makes sense to work together and that is something that Peter and I have tried to do,” he said.

As another concrete example of better collaboration, Sands noted that the Global Fund had just signed an agreement with the World Bank on a template for how the two agencies would do finance transactions, sharing reporting and audit day in a simplified way. “When you think about sustainability, challenges, being able to do those kind of blended finance transactions is very important.”

On financing, Jane Aceng said that the most important things are strengthening collaboration and transparency, noting that sometimes agencies enter countries and directly offer aid to populations without clarifying to Ministries of Health what resources are being brought into the country. “I want to have [knowledge of all financial resources] aligned into my plan, so at the end of the day… we can ask what did this money do? What has it translated into?”

Aceng said that increased transparency will help ensure accountability from both countries and external agencies, and allow all stakeholders to better allocate resources.

The World Health Summit is one of the world’s premier global health forums. This year, approximately 20 ministers from around the world, the Director-General of the WHO, top scientists, and leaders from the private sector and civil society are among the participants. For three days, over 2,500 participants from 100 countries will discuss ways to improve global health.

Other topics in the World Health Summit 2019 programme included discussion of strategies to advance Universal Health Coverage, combat the double burden of noncommunicable and neglected tropical diseases many low and middle income countries now face, improve health systems in Africa and around the world, fight against antimicrobial resistance, advance digital health, and implementing the UN’s Sustainable Development Goals.

Image Credits: U.S. Army National Guard/Master Sgt. Paul Wade, World Health Summit.

The World Health Organization has launched a plan to accelerate the use of digital technologies to meet global public health needs, following the first-ever meeting of a WHO Technical Advisory Group on digital health.

“All governments are facing increasing demands to provide health services to their citizens, and many digital technologies offer solutions to help meet these needs,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus in a press release issued on Friday at the close of the meeting.  “But countries require confidence in what works. The action plan agreed today focuses our efforts on helping the world benefit from digital health technologies and solutions while safeguarding the misuse of people’s data and protecting their health.”

Digital health experts developed an action plan to focus the new WHO Technical Advisory Group’s activities and priorities over the next two years at a two-day meeting  at WHO’s Geneva headquarters, focusing on defining WHO’s role in supporting digital transformation at the global and country level. Topics discussed included:

  • Developing a global framework for WHO to validate, implement and scale up digital health technology and solutions;
  • Recommendations for safe and ethical use of digital technologies to strengthen national health systems by improving quality and coverage of care, increasing access to health information;
  • Advice on advocacy and partnership models to accelerate use of digital health capabilities in countries to achieve better health outcomes;
  • Advice on emerging digital health technologies with global reach and impact, so no one is left behind.

WHO is particularly interested in using digital health as an “accelerator” to achieve Universal Health Coverage at the national level, said Bernardo Mariano, director of WHO’s Department of Digital Health and Innovation in a press conference. WHO is looking to achieve a “quadruple win” – for patients and providers, academia, governments, and the private sector – to “really use data to advance the achievement of Universal Health Coverage,” he said.

Steve Davis, co-chair of the new WHO Advisory Group and president/chief executive officer of Global Health at PATH, an international health technologies non-profit, added that the deployment of better data and digital health tools could particularly help in expanding primary health care coverage.

“The opportunity over the next 10 years, to be more precise about where the problems are, to get remote tools to reach new people, to empower the health workers, and to empower patients is extraordinary,” he said.

As examples, he said health systems would be strengthened by:  improving data flows; enabling health workers to be more productive by using electronic data collection systems; and getting new diagnostic and treatment tools into the hands of clinicians.

According to Mariano, the first Global Action Plan for Digital Health, covering 2020 – 2024, will be brought before WHO member states for approval at the World Health Assembly in May 2020. That will be two years after the passage of World Health Assembly Resolution (WHA/71 A71) that recognized the expanding role of role digital technologies in furthering health.

Image Credits: WHO.

A new knowledge hub Global Health Progress, highlighting over 200 collaborations between the biopharmaceutical industry involving more than 850 government, multilateral organization and civil society partners, was launched Friday by the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA). The hub provides a worldwide mapping of health-related initiatives in which IFPMA members are engaged, searchable by disease area, geographic region, target population, partner type, and programme strategy.

The hub aims to showcase innovation and best practices; connects users with the various industry initiatives and their partners in low- and middle-income countries; and enhance opportunities for further collaborations, said an IFPMA press release. Health systems strengthening and “local ownership” of initiatives are overarching principles of the initiatives portrayed, IFPMA added.

Examples of the hundreds of collaborations portrayed on the hub range from the more traditional R&D partnerships in drug development; to innovative initiatives to bolster health systems and train health workers, such as an E-Diabetes partnership aimed at primary health care workers in West Africa and a safer childbirth initiative in Myanmar. The hub also collates innovative health financing initiatives, such as the Mobile Health Smiles Wallet which supports free health services to patients in Nairobi’s slums, through the mobile health payments App M-Tiba.

“If we are to overcome today’s most pressing global health challenges, we need some fresh, out-of-the-box thinking and innovative alliances….  Global Health Progress is one way in which we are helping to drive new collaborations to strengthen healthcare systems. Effective partnerships will help our innovations to grow, reaching more patients worldwide,” said IFPMA’s Director General, Thomas Cueni (see related interview on Inside View).

Click here to access IFPMA’s new knowledge hub, Global Health Progress.

Image Credits: IFPMA/Global Health Progress.

As the World Health Summit opens Sunday in Berlin, one of the key themes running through the conference will be how industry, government and civil society leaders can collaborate more effectively to build strong health institutions – with a particular focus on building African capacities in a Monday keynote session. This means working across all aspects of health systems to improve health work force capacity, access to health finance and health products, and ultimately better care and treatment for patients, in line with the aims of Universal Health Coverage and the Sustainable Development Goals (SDGs). Ahead of this, I want to share with you some of the issues that will be raised in that session, highlighting why now is the time for us to come together to accelerate our actions to build strong health systems in this critical region of the world.

Over the last thirty years, strong economic growth in Africa has helped to reduce the proportion of people living in poverty from 56% in 1990 to 43% in 2012. Yet, as the continent’s population continues to expand — estimated to reach 2.5 billion people by 2050 – investments in robust health systems, to build a foundation of critical infrastructure and healthcare expertise, are key to inclusive and sustainable growth.

In 2001, all African Union countries pledged to allocate at least 15% of their annual budget to improve the health sector as part of The Abuja Declaration. Following this, many African countries have made strides in increasing domestic investments in health, however few countries have achieved this goal. In 2019, the “First Annual Africa Leadership meeting: Investing in Health” took place and reiterated that Member States must increase and reorient health spending to target diseases across the life cycle that have the greatest impact on mortality and human capital development.

These calls to action reflect the growing importance and need to involve cross-sector stakeholders to supplement and reinforce the services of the public sector in health. A report by the World Bank in 2007 found that the private sector delivered about half of Africa’s health products and services, demonstrating the important role cross-sector collaboration played a decade ago and continue to play.

The innovative biopharmaceutical industry brings valuable expertise and solutions to supporting attainment of the health-related SDGs, not only by developing lifesaving therapies but in partnering to innovate and strengthen the delivery of care. Members of IFPMA are currently engaged in 103 global health partnerships in Africa, across 47 different countries.

From these experiences, we have learned that we can achieve even more when we collaborate with diverse partners – not just with traditional development organizations but also with local governments, civil societies and other private sectors. We have had strategic collaborations with partners across Africa, including WHO AFRO and AUDA-NEPAD (New Partnership for Africa’s Development) to support the expansion of program strategies across the continent, while also collaborating with local partners to build capacity and strengthen regulatory and healthcare systems. IFPMA members recognize the value of their combined efforts when they work together and with other private sector companies and are currently collaborating together on 19 programs in Africa and 37 programs which involve other private sector organizations.

In working with other pharmaceutical companies, biotech, technology and telecom companies, logistics providers, and more, we seek to understand the expertise that each partner brings and how together we can develop holistic solutions to some of the most complex health challenges facing many African countries, including:

  • Maternal and child health: MSD for Mothers is working to improve the quality of maternal health and care services among private providers around the world, a current challenge in many African countries. The program uses research carried out in partnership with the London School of Hygiene and Tropical Medicine which highlighted a majority of women in rural areas sought care from private providers.
  • Growth of youth populations: DREAMS Innovation Challenge, in collaboration with PEPFAR, brings together thinkers from inside and outside HIV to implement solutions that address the root causes of increasing HIV risk among young girls.
  • Fighting corruption, waste and falsified medicines: We need to fight corruption, tackle waste, inefficiencies, substandard and falsified medicines across Africa. Fight the Fakes is a cross-sector campaign to tackle falsified medicine and involves a variety of stakeholders, including patients, health professionals, and public and private organizations. This complex global health challenge requires strong coordination and a comprehensive approach, including strengthening legislative frameworks, regulatory systems, and raising awareness.
  • Increasing access to care and treatment: Technology transfer programs are one way to help countries to strengthen regulatory systems, streamline supply chains, adopt more efficient procurement systems and ensure regular supplies of treatment. Gilead’s Technology Transfer program works to increase access to HIV treatment by providing generic manufacturers with licenses to produce drugs. In parallel, it is also important to build local capacity to address skills shortages and Boehringer Ingelheim’s training program works to increase healthcare workers’ technical skills while providing technology transfers.
  • Investing in the future health leaders: In collaboration with Chatham House and the Graduate Institute, IFPMA is working to support the development of the next generation of public health leaders in Africa. The fellowship aims to help participants develop the knowledge, insight and skills to become leaders in their countries. The program builds skills in leadership, policy formulation, analysis and implementation, as well as global health diplomacy.

We aspire to be a convener of other private sector expertise towards partnerships for health. As we increase our cross-sector collaboration, we are developing our understanding of the unique, innovative solutions we can develop by leveraging the strengths of specific business sectors, including:

  • Technology companies support to enhance service delivery and strengthen supply chains
    • GSK’s mVacciNation Partnership with Vodafone helps to strengthen supply chains for childhood immunization, and reached 977 children in Mozambique, Tanzania, Nigeria as of January 2019, delivering over 950,00 successful immunizations.
    • The Novartis Better Hearts, Better Cities initiative conducted a digital infrastructure assessment with Intel to understand challenges and opportunities to tackle hypertension via enhanced health literacy, prevention, screening, diagnosis, and patient management.
  • Telecom companies’ expertise to advance patient outreach, awareness and linkage to care
    • SMS for Life is a broad cross-sector partnership bringing together Novartis, Google, Safaricom, Vodafone, and Vodacom Tanzania to share health information with patients.
    • Be He@lthy, Be Mobile is a World Health Organization collaboration, including Novartis, Sanofi, GSK and Verizon, which reaches communities with targeted information to prevent non-communicable disease. Notably, the mDiabetes programme in Senegal has increased diabetes awareness, provided mTraining to healthcare workers and helped patients to manage diseases through remote consultations and support.
  • Medical devices and medical technology companies ensure patients have access to drugs, diagnostics and other infrastructure
    • Roche’s Global Access Program partners with diagnostic manufacturers as part of a holistic effort to expand access to viral load testing for HIV/AIDS.
    • Pfizer’s partnership with BD is bringing together innovative treatments and delivery systems to provide a new way of delivering contraceptive care to remote areas.

As we work towards our aspiration of ‘health for all’ across the globe and in Africa, we recognize collaboration is a foundational building block and benefits patients. By growing our partnerships, we are learning about effective program strategies that go beyond traditional corporate social responsibility and philanthropy approaches and are using these insights to strengthen and develop initiatives that change the way we are working across Africa.

I look forward to hearing panelists’ perspectives at the World Health Summit tomorrow on cross-sector collaborations and hope our discussions will start to ignite new partnerships, ultimately serving as a catalyst to bring together more collaborations over the next 10 years to support of the SDGs.

________________________________________________________________

 

Thomas B. Cueni is an economist, journalist and former Swiss diplomat, and today is director-general of the IFPMA, representing the innovative pharma industry and accredited organization in official relations with the United Nations.

 

 

Image Credits: IFPMA.

Wild polio virus type 3 (WPV3) has been eradicated worldwide, the World Health Organization declared Thursday following a review of the global data by an independent commission of experts. The announcement about WPV3, coinciding with World Polio Day, comes after wild polio virus type 2 (WPV2) was declared eradicated in 2015.  Although one other wild virus strain, as well as vaccine derived infections, still persist, the announcement brings polio one important step closer to eradication. That would make polio the second human disease to disappear from the planet, following smallpox, which was eradicated in 1980.

Oral polio vaccine is administered to a one-day old child in Ethiopia.

The last case of WPV3 was detected in Yobe, northern Nigeria in 2012. Seven years later, after no new cases of WPV3 were detected by the Global Polio Eradication Iniative’s (GPEI) global surveillance system, an official certificate of global WPV3 eradication was presented to the World Health Organization by the Global Commission for the Certification of Poliomyelitis Eradication, the independent body of experts responsible for certifying polio eradication.

“Today we’re celebrating another milestone on the road to a post-polio world – the eradication of wild polio virus type 3…But this is only a milestone – we have not reached our destination. The last mile, as we all know, is the hardest mile [to reach] and we must continue with greater dedication until polio is finally eradicated,” said Dr Tedros Adhanom Ghebreyesus, director-general of the WHO and chair of GPEI’s Polio Oversight Board, at Thursday’s event announcing the global eradication of WPV3.

In addition, no cases of wild polio virus type 1 (WPV1), the only wild-type strain still circulating, have been detected in Africa since 2016, also setting the WHO African Region on track to be certified for eradication of all wild types of polio virus in 2020. The WHO European region, the Americas and Southeast Asia eradicated all three strains of wild polio virus some years ago.

Still, WPV1 circulation in Pakistan and Afghanistan, and new cases of vaccine-derived polio virus remain barriers to global eradication. Despite differences at the genetic level, all the different strains of polio can cause paralysis or death – making the eradication of these last two types crucial to completely erasing the threat of polio.

WHO hopes that the announcement of the eradication of WPV3 will spur a renewed commitment to the global polio eradication campaign, led by the public-private partnership GPEI, which consists of WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC), the United Nations Children’s Fund (UNICEF) and the Bill & Melinda Gates Foundation. Donors and leaders in global health will announce new commitments to the GPEI’s Endgame Strategy 2021-2023 at the Reaching the Last Mile Forum on November 19th in Abu Dhabi, United Arab Emirates, which will convene under the theme “Accelerating the Pace.”

The Last Threats: Wild Polio Virus Type I (WPV1) and Vaccine-Derived Polio Virus (VDPV)

Now, there is only one strain of wild polio virus (type 1) circulating in pockets of Afghanistan and Pakistan – where insecurity and community mistrust hinder the eradication campaign. Pakistan in particular has seen an upsurge in cases with over 70 reported so far this year.

In addition, cases of vaccine-derived polio virus (VDPV), reported mainly in Africa, remain a threat to the eradication campaign. VDPV is caused by a mutated strain of the weakened virus found in the oral polio vaccine – when a population is underimmunized against wild polio virus, VDPV can circulate in the community until it mutates to regain the ability to attack the nervous system. Therefore, achieving high consistent vaccination coverage is still the best way to prevent VDPV outbreaks, according to GPEI. Still, most VDPVs appear to be less transmissible than strains of wild polio virus, and outbreaks can cease on their own or with additional immunization activities.

To tackle VDPV, a group of immunization experts at WHO announced two weeks ago that they are conducting clinical trials on a new oral polio vaccine formulation (nOPV2) that could offer the same level of protection against polio while reducing the risk of VDPV. They are working with an Indonesian manufacturer to produce a batch of over 100 million doses of the new formulation, which could be rolled out as early as June of next year.

“We remain fully committed to ensuring that all necessary resources are made available to eradicate all polio virus strains. We urge all our other stakeholders and partners to also stay the course until final success is achieved,” said Dr Tedros in a press release.

Image Credits: UNICEF Ethiopia/Mulugeta Ayene 2018.

Although it was governments that made the big commitments to tackle climate change in the 2015 Paris Agreement, mayors are leading the charge in reducing air pollution on the ground.

At a first-ever World Air Quality Conference, hosted by the City of London, mayors and city leaders from around the world convened Wednesday, to confer with each other and with experts from the World Health Organization and civil society about how to ramp up action on air pollution and climate change.

“When people ask me, ‘Why is WHO so engaged in this?’ I say, ‘I don’t just have one reason, I have 7 million good reasons,” said Maria Neira, director of WHO’s Department of Public Health, Environmental, and Social Determinants of Health, referring to the 7 million premature deaths attributable to air pollution every year.

That number has not so far triggered the kind of urgent action from governments that WHO would have hoped to see, Neira said, “But there is hope. We see opportunities like this one where many people – policymakers, people with responsibility at the city level – they are called to this field and saying, ‘this is a public health emergency.’”

Panel session on “The Global Threat of Air Pollution and the Climate Emergency” at the World Air Quality Conference.

As just one example of global action, mayors of the C40 network – a group of 94 megacities around the world representing over 700 million people and a quarter of the global economy – signed the “Clean Air Cities Declaration” just last month at the C40 Mayors Summit in Copenhagen.

The Declaration committed the 35 founding cities of the network to take “bold action to reduce pollution by 2025, and work towards meeting the WHO’s Air Quality Guidelines,” said Los Angeles Mayor Eric Garcetti, Summit chairman.

The WHO Guideline level for concentrations of PM2.5 – fine particles considered to be among the most health harmful due to their ability to penetrate the lungs and circulate in the bloodstream – is 10 micrograms/cubic meter of air.  However, outside of North America, many or most large cities worldwide exceed those levels. And the problems are particularly acute in emerging economies and developing regions where emissions of diesel and other fuels are higher in particulate content.

Along with high-level policy commitments, cities have begun to implement climate actions on the ground. London was the first megacity to sign onto the WHO/UN Environment/World Bank Breathe Life Campaign, committing to reach WHO’s Air Quality Guideline levels. The campaign now includes 70 cities, regions, and countries. The city has successfully implemented an “ultra-low” emissions zone in central London, historically the most polluted part of the city, which has contributed to slashing emissions in that area by over 1/3rd in under two years.

“I’m proud of what we’ve accomplished… but we’re not resting on our laurels. We still need to do much more. Many parts of London are still plagued by dangerously polluted air, as are parts of many other global cities. We know we can’t solve the problem alone,” said Shirley Rodrigues, deputy mayor of Environment and Energy for the City of London.

Although cities can take the leadership in such strategies, in other areas they are limited in their regulatory powers, and thus more action from national governments is still required to mitigate all the health effects of air pollution.

Christiana Figueres, former executive-secretary of the UN Framework Convention on Climate Change (UNFCCC), reminded the conference of the global commitments made by country governments in the 2015 Paris Agreement.

“Your choices will either put us on track for a more polluted future, or a future where we scrub it out of our lives for good,” said Figueres, currently Vice-Chair of the Global Covenant of Mayors for Climate and Energy.

Transportation Sector Emissions Targeted

WHO estimates that road transport is responsible for up to 30% of particulate emissions (PM) in European cities, and up to 50% of PM emissions in all OECD countries.  This is partly due to the high proportion of diesel passenger vehicles that circulate in developed economies outside of North America – where strict clean air legislation and other historical factors limited diesel vehicle use.

In response, more and more cities in Europe and elsewhere have now created low- or ultra-low emissions vehicle zones to keep older diesel vehicles out of the center city. Other tactics include the creation of pedestrian zones, as well as higher parking prices or commuter tolls on vehicles coming into the downtown area.

“Cities have enormous power in how they control transport and other activities,” said Andrea Fernandez, director of Governance and Global Partnerships, C40 Cities.

Along with London’s new “ultra-low” emissions zone, the city is shifting its public transport fleet to zero-emissions taxis and buses.

Thanks to these policies, average air pollution concentrations in the area have declined by 29%, while emissions in the “ultra-low” emissions zone have been reduced even more, according to a new report by the Mayor’s office.

London, along with the rest of the leading C40 cities that signed the Clean Air Cities Declaration, has pledged to only procure zero-emissions buses from 2025 and take other measures to ensure “major areas” of each city are zero-emissions by 2030.

City-to-city collaborations have also spurred some healthy competition, Neira observed. She noted that London, Santiago, and even Moscow seemed to be “competing” informally to see which city can roll out the most electric buses, outside of China.

Speaking directly to the mayors in the room, Neira said, “You are a kind of health minister. Most of the decisions you can take relating to sustainable transport will have a positive or negative impact on people’s health.”

Power of Cities is Still Limited

Still, most cities lack the regulatory power to control pollution emissions from many sources, including power plants and industries, which are generally governed by national regulations. Similarly, standards for fuel quality and tailpipe emission limits are usually fixed on a national scale, and those determine overall levels of vehicle efficiencies as well as the amount of polluting sulfur in diesel fuel.

National energy and air pollution standards also affect emissions from the use and burning of fuels such as wood, kerosene and coal in residential and commercial buildings, which can be highly polluting as compared to natural gas, LPG, solar or wind, which have few or no particulate emissions.

“London can reach the WHO air quality goals by 2030, but we can’t reach them without the power of the [national] government…it’s important we get the power to bear down on the other issues. We need government to devolve the powers down to the implementation level,” said Rodrigues.

Earlier this month, London’s Mayor Sadiq Khan was among the C40 Mayors to endorse a “a Global Green New Deal” targeting “transportation, buildings, industry, and waste” to keep global temperature rise below 1.5 degrees Celsius. The message was issued by city leaders attending the C40 World Mayors Summit in Copenhagen on 10 October.

In supporting the Global Green New Deal, the mayors of Paris, Copenhagen, Rio de Janeiro, Sydney, London and Tokyo, among others, challenged national leaders, CEO’s and investors to match the level of ambition detailed in the Global Green New Deal.

“World leaders met in New York just last month and once again failed to agree anything close to the level of action necessary to stop the climate crisis. Their ineptitude directly threatens all people around the globe as time keeps running against us,” a press release quoted C40 Chair and Mayor of Paris, Anne Hidalgo, as saying, referring to the UN Climate Summit on 23 September.

But health can be used to accelerate climate action. “Climate can feel a long way away, whereas public health is really immediate,” noted Polly Billington, director of UK100, a network of local government leaders across the United Kingdom dedicated to climate action.

(left-right) Polly Billington, Shirley Rodrigues, Andrea Fernandez, Maria Neira.

The WHO Director of the Department of Public Health, Environmental and Social Determinants of Health agreed, saying “If you put health up front, you will have the perfect argument to motivate people, you will have the coherence that is needed on the policies, you will have a perfect way to incorporate the economic arguments for climate action, for example, for reducing coal subsidies.”

Still, the link between climate and health is just beginning to be recognized on the global policy level, said Neira, noting that a report on air pollution and health was presented for the first time only last year at the COP24 conference, the major gathering of UN member states on climate action.

That is precisely why next year’s COP26 Conference should be themed around “health,” said Neira.

“We need to incorporate the health angle because that will prove that any investment needed to take climate action, the [positive] trade-off is already there.”

 

 

This article appears as part of the Health Policy Watch partnership with Covering Climate Now, a global collaboration of more than 300 news outlets to strengthen coverage of the climate story.  

 

 

Image Credits: London Mayor's Press Office, Mayor of London Environment Team, Mayor of London Environment Team.

The World Health Organization and UN Environment kicked off a week-long campaign asking countries to take more assertive action to ban lead paint, coinciding with International Lead Poisoning Prevention Week.

The Global Alliance to Ban Lead Paint,  a WHO-UN Environment Partnership involving countries and civil society, has set a goal to ban lead paint in all countries by 2020. To date, only 73 of the 194 WHO member states have legally binding control measures on lead paint.

“Of course this is an achievement, but we need more – much more. In fact, we need to triple our efforts,” said Dr. Maria Neira, director of WHO’s Department of Public Health, Social and Environmental Determinants of Health at WHO, in a video message. “Lead paint [poisoning] is preventable, and that’s why we need to attack the source of exposure to lead. Paints can be made without toxic lead – safe paints exist. That’s why it’s time to ban lead paint.“

According to WHO, there is no minimum “safe” level of exposure to lead, which is particularly toxic to children, and can reduce their IQ along with increasing the risk of developmental and behavioral problems. Lead paint is a leading source of domestic lead exposure in children.

The week-long campaign has three objectives:

  • Raise awareness about the health effects of lead poisoning;
  • Highlight countries’ and partners’ efforts to prevent childhood lead poisoning;
  • Urge further action to eliminate lead paint through regulatory action at country level.

Achieving these objectives falls under the broader Sustainable Development Goals agenda that aims to improve the management of “chemicals and all wastes throughout their life cycle” in an “environmentally sound” way and “significantly reduce their release to air, water and soil in order to minimize their adverse impacts on human health and the environment” by 2020.  This, WHO says, would “substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water, and soil pollution and contamination” by 2030.

Exposure to lead can also impact the reproductive system, kidneys, and cardiovascular system, along with impairing immune function. In 2017 alone, lead poisoning accounted for 1.06 million deaths, according to the Institute for Health Metrics and Evaluation (IHME). The IHME also estimates that in 2016, lead exposures accounted for 63.2% of the global burden of certain types of developmental intellectual disabilities, 10.3% of the global burden of high-blood pressure associated heart disease, 5.6% of the global burden of coronary heart disease and 6.2% of the global burden of stroke.

Lead poisoning results in a staggering global economic cost of $977 billion annually – with China and India bearing the brunt of the loss at $227 billion and $236 billion lost annually.

“We would like to call on governments, academia, industry civil society, on everyone… to raise awareness and address the devastating effects of lead exposure, especially for children,” said Neira, urging all stakeholders to hold events on the dangers of lead poisoning this week.  The campaign includes a series of posters, videos and social media materials in six languages that can be freely downloaded by individuals and groups that want to share the campaign messages.

Image Credits: UN Environment/ Global Alliance to Ban Lead Paint, WHO.