Tedros: COVID-19 Vaccination is ‘Bittersweet’ Amid Global Shortages
WHO Director General Dr Tedros Adhanom Ghebreyusus

Being vaccinated against COVID-19 this week was a “bittersweet” moment, reflecting both a “triumph of science” and a “gross distortion” in vaccine access, World Health Organization (WHO) Director General Dr Tedros Adhanom Ghebreyusus told the body’s media briefing on Friday.

Thanking health workers at the Geneva Emergency Hospital for vaccinating him on Wednesday, Dr Tedros said that his thoughts “were very much with the health workers around the world who have been fighting this pandemic for more than a year” but still could not get protected. 

“At present, only 0.3% of vaccine supply is going to low income countries. Trickle-down vaccination is not an effective strategy for fighting a deadly respiratory virus,” noted Tedros.

He described India’s COVID-19 surge as “hugely concerning”, but added that Nepal, Sri Lanka, Vietnam, Cambodia, Thailand and Egypt, were also dealing with spikes in cases and hospitalisations. 

“Some countries in the Americas still have high numbers of cases and as a region, the Americas accounted for 40% of all COVID-19 cases last week. There are also some spikes in some countries in Africa,” added Tedros.

However, he highlighted three developments that gave him hope. The first was that countries were sharing vaccines with COVAX, following Sweden’s announcement last week to share one million doses with the global vaccine platform. Norway, France and New Zealand have also pledged doses.

The second was “new deals on technology transfer, and sharing of know-how between international manufacturers to scale up vaccine production”, said Tedros.

A new WHO vaccine mRNA manufacturing training facility aims to train and develop more vaccine manufacturing professionals – who could help kickstart new vaccine facilities in LMICs.

Earlier this week, Health Policy Watch reported that WHO has already received some 42 expressions of interest from countries, institutions and biotech partners to create the hub to train professionals in vaccine manufacturing to help to jumpstart manufacturing LMICs.

The 42 expressions of interest from countries, institutions and biotech partners to create the mRNA vaccine technology transfer hub.

In addition, in the past week, COVAX unveiled a three-stage plan to enhance existing vaccine production capacity, developed by its new Supply Chain and Manufacturing Task Force as well as a new “vaccine manufacturing group” to further expand production long-term.   

The third reason for hope, said Tedros,  is the fact that more leaders, including Spanish Prime Minister Pedro Sanchez have called for the lifting of all trade barriers to address the pandemic. This follows last week’s announcement by the US that it supported text-based negotiations on the proposed TRIPS waiver, which has resulted in countries previously opposed to this to reconsider their position, including the European Union and the UK.

India Clamours for Remdesivir Despite WHO Research

WHO Chief Scientist Soumya Swaminathan

 

Amid India’s surge, the country has seen growing demand for the antiviral medicine, remdesivir – resulting in the government banning the export of the medicine or any of its active ingredients.

However, the WHO reiterated that large studies found that remdesivir had no effect on the SARS-CoV2 virus.

WHO Chief Scientist Soumya Swaminathan said that the development of therapeutics had fallen behind vaccine development, but corticosteroids showed the most promise of reducing mortality in severe COVID-19 cases.

On the other hand, the large Solidarity trial that had tested remdesivir had found that it had no impact on mortality when compared with the control group, said Swaminathan.

The Solidarity Trial, which published interim results last October, found that all four treatments evaluated – remdesivir, hydroxychloroquine, lopinavir/ritonavir and interferon – had “little or no effect on overall mortality, initiation of ventilation and duration of hospital stay in hospitalized patients”.

However, India had already registered remdesivir for emergency use last July and continues to insist on its efficacy despite the WHO’s position. Meanwhile, the drug’s manufacturer, Gilead has been quoted in the Indian media as saying that the WHO research is potentially  “biased”.

Remdesivir is being produced by seven Indian companies and retails at over $37 per 100mg.

Swaminathan said it was important that Indian doctors were aware of the WHO recommendations, but that member states were free to make their own policies.

“Oxygen is probably the most essential and the most life-saving right now of all the drugs and all countries need to be prepared now with the oxygen supplies,” she stressed.

US Mask-Wearing Decision: ‘Very Contextual’

Maria Van Kerkhove, WHO COVID-19 Technical Lead

While wearing masks is part of the WHO’s comprehensive strategy to address the pandemic, this was “very contextual”, said Maria van Kerkhove, the WHO’s COVID-19 Technical Lead, when asked about the decision by the US Centers for Disease Control (CDC) to allow fully vaccinated people to forgo masks outdoors and in many indoor settings.

“Fully vaccinated people can resume activities without wearing a mask or physically distancing, except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance,” the CDC announced on Thursday.

“It’s about how much virus is circulating around in the country. It’s about the amount of vaccines and vaccinations that are rolling out, it’s about the variants of interest and the variants of concern that are circulating,” said Van Kerkhove.

“We have to keep all of this in mind when thinking about how to adjust the policies associated with the use of masks, so it is contextual and all of these considerations need to be taken into account.”

While highlighting that Australia and New Zealand had been able to control the pandemic without vaccines, Van Kerkhove also cautioned that there were “uncertainties ahead because of these virus variants”. 

Mike Ryan, WHO’s executive director of health emergencies, added that any country that wanted to reduce or remove mask mandates had to consider both “the intensity of transmission and the level of vaccination coverage”.

Some countries were in a “strange period” of transition, where transmission hasn’t completely ended and people aren’t completely vaccinated. 

“And as long as we can sustain the public health measures, as long as we can keep the distance and as long as we can reduce exposure while we get vaccination levels to the highest level, then countries will be in a much stronger position when they do get to high vaccine coverage levels to start saying to people, you don’t have to wear a mask anymore,” said Ryan.

 

Image Credits: WHO.

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