As the World Health Assembly ended this week, WHO’s Tedros warned that challenges remain. Health Policy Watch (Switzerland) reports Tedros told delegates, “Your challenge as Member States is to negotiate a strong accord for approval, just 12 months from now. This accord is a generational opportunity that we must seize. We are the generation that lived through the COVID-19 pandemic, so we must be the generation that learns the lessons it taught us and makes the changes to keep future generations safer.”
 
Advocates continued to raise concerns about a leaked version of a new draft of the Pandemic Accord. In a statement The People’s Vaccine argued, “Rich countries and pharmaceutical companies seem to want lower-income countries to share pathogens without any commitment to share medical products, technology, or knowhow in return. They don’t want to recognise that it’s a two-way street. If they want access to pathogens – and to profit from resulting countermeasures – they need to guarantee benefits in return. COVID-19 and HIV before it clearly showed that we cannot depend on the good will of pharmaceutical companies to ensure equitable access. In reality, pharmaceutical companies sold doses to the richest countries for the highest profits. Poorer nations were left at the back in the queue. We’ve had enough of warm words. We need strong binding commitments.”
 

If You Are in a Hurry

 

• Read a Lancet (UK) editorial about renewed interest in vaccinology.
• Read The Guardian on a promising new meningitis for Africa that could be available in months.
• Read NPR’s Goats and Soda Blog on a new syringe-free delivery method for the measles vaccine that could be available in 5-7 years.
• Read LA Times on the need to make mpox vaccines available outside of rich countries.
• Read CIDRAP on new outbreaks of bird flu in mammals in North America.
• Read Think Global Health on pandemics on a planet of cities.

 

New Meningitis Vaccine a Gamechanger for Africa

 
The Guardian (UK) reports, “An effective, affordable meningitis vaccine has been successfully tested in Africa, raising hopes for the elimination of a disease that kills 250,000 people a year. The NmCV-5 vaccine, developed by the Serum Institute of India and global health organisation Path, will protect against the five main meningococcal strains found in Africa, including the emerging X strain, for which there is currently no licensed injection…. NmCV-5 will be available in the coming months. Protection against the X strain is particularly important because it has the potential to spread rapidly and there are currently no vaccines to prevent or control it….” Read the study results in NEJM (US).
 

Africa Still Waits for Mpox Vaccines

 
LA Times (US) reports, “As US public health officials brace for a possible resurgence of mpox ahead of the summer festival season, experts are warning that European and North American governments aren’t doing nearly enough to ensure that hard-hit African countries can also beat back the virus.” The mpox vaccine has driven down new cases of mpox in the US and Europe. “But in lower-income countries such as those African countries where mpox (the virus formerly known as monkeypox) is endemic, health officials still do not have access to the vaccine. That could lead to the virus’ reemergence as a global threat.” Dr. Amesh Adalja argues, “The current global mpox outbreak was ‘a consequence of inaction when it came to the outbreak in Africa. The strategy of containing monkeypox has to be to vaccinate the at-risk population in Western countries as well as vaccinate at the source to stop the spillover from animal species into humans. You have to do both.’”
 

Can Trust Be Restored Between Africa and Rich Countries?

 
Devex (US) reports, “COVID-19 shattered trust between Africa and the wealthy countries that hoarded vaccines. So what will it take to rebuild that trust? Acknowledgment would be a good start, said the World Health Organization’s Dr. Ayoade Alakija…. Changing the system is what Alakija will work toward as co-chair of the ACT, or Access to COVID-19 Tools, Accelerator, which she pointed out continues its work despite the world having seemingly moved on from the pandemic…. Today, Alakija said Africa is again being left out of the conversation, this time around long COVID. She said the severity of the pandemic on Africa was initially dismissed because it’s such a young continent, so now there are scant statistics on who caught the disease — and thus what the long-term effects may be for them.”
 

Potential New Delivery System for Measles Vaccines

 
NPR’s Goats and Soda Blog (US) reports that many vaccine experts “are downright giddy about vaccine clinical trial results” that show promise for a syringe-free delivery system for the measles vaccine. “There's no syringe involved. Rather, there's a small adhesive patch — think Band-Aid — containing tiny microarray ‘needles’ made from the vaccine in dry form. A small clinical trial in The Gambia compared this new delivery system to traditional syringe delivery. “A month and a half after vaccination, the researchers assessed the immune responses of the trial participants. There were similarly robust responses for both vaccination methods…. While the early clinical trial news is promising for the measles-rubella microarray patch, scientists say it could take at least five to seven years before it is available for sale. That goal, says Goodson, will require much larger clinical trials and authorization from a country's regulatory agencies — as well as a willingness by vaccine manufacturers to spend money on the technology.”
 

Bird Flu Updates

 
CIDRAP (US) reports, “Following sporadic detections of a Eurasian H5N5 avian influenza in Canadian wild birds, officials reported the virus for the first time in mammals—raccoons found dead on Prince Edward Island. In other developments, the United States reported several more detections involving H5N1 in mammals, and H5N1 outbreaks continue in wild birds and poultry on different continents.”
 
Nature (UK) reports, “US officials have authorized the vaccination of the critically endangered California condor (Gymnogyps californianus) against a type of avian flu spreading globally. It is the first time that the United States has approved inoculation of any bird against highly pathogenic avian influenza (HPAI). The authorization comes as an H5N1 strain of avian influenza, a type of HPAI, has spread to an unprecedented number of countries, lasted longer than a typical outbreak and killed hundreds of millions of birds, as well as many mammals, worldwide. Some countries already vaccinate birds, including commercial flocks, against avian flu. The severity of the outbreak is driving some nations that have been hesitant, including the United States, to follow suit.
 
The Globe & Mail’s Decibel Podcast (Canada) looks at the pandemic potential of bird flu, reporting “Avian influenza is getting more serious each year, as an unprecedented number of birds either succumb to the virus or are culled to prevent spread. After a dog in Ontario and thousands of sea lions died from the flu, there’s growing concern about this strain’s ability to infect mammals.” Infectious disease doc Dr. Samira Mubareka says she’s more worried about bird flu now than she was at this time last year, noting that in Canada “the virus has become established unfortunately in wild birds…. But it has also caused a substantial number of outbreaks in domestic poultry…. That in and of itself is concerning.” She says even more concerning “is the spillover into animals…we’re observing things about this virus that we haven’t before.”
 
Reuters (UK) reports, “Governments should consider vaccinating poultry against bird flu, which has killed hundreds of millions of birds and infected mammals worldwide, to prevent the virus from turning into a new pandemic, the head of the World Organisation for Animal Health (WOAH) said. The severity of the current outbreak of avian influenza, commonly called bird flu, and the economic and personal damage it has caused, has led governments to reconsider vaccinating poultry. However, some, like the United States, remain reluctant mainly because of the trade curbs this would entail.”
 

A Renewed Interest in Vaccinology

 
A Lancet (UK) editorial argues, “Amid the global decline in vaccination coverage [during the COLVID pandemic], a few tales of endurance lift the pall of gloom. India registered a strong resurgence in essential immunisations in 2022, Kenya engaged local leaders to increase immunisation among its nomadic populations, and Uganda sustained high vaccination rates during the pandemic…. Although tales of resilience emerge from all calamities, the one legacy of the COVID-19 pandemic that we can wholly embrace is the renewed interest in vaccinology. Adenovirus-vectored vaccines, previously used against Ebola virus, were developed and administered against COVID-19 at a pandemic scale with demonstrable success. Evidence of the effectiveness and safety of mRNA vaccines against COVID-19 is driving further research in applying mRNA technologies to thwart existing diseases and future pandemics. This is the new we take forward; the hope of advancement and restored trust in vaccines.”
 

Building Oxygen Supplies in African Countries

 
The Guardian (UK) reports, “Accessing medical oxygen was a major challenge during the pandemic. The key, and often fatal, complication of COVID-19 is depletion of oxygen in the blood. A study of 64 hospitals in 10 African countries found that half of the COVID-19 patients who died never received oxygen. Since the pandemic, increasing the continent’s oxygen security has become a priority for African governments and global health organisations to prepare for future health emergencies, but also to help patients with other serious conditions.”
 

Cities and Pandemics

 
Think Global Health (US) looks at what a “planet of cities” means for emerging disease threats, reporting, “Contagions spread quickly through the networks of trade, tourism, and technologies — and through the political ecologies of extended urbanization. Because the risks and mode of transmission of emerging and rapidly evolving pathogens are neither well understood by science nor properly regulated by government, processes of extended urbanization can increase vulnerability to infectious diseases. Interactions people have with one another and with the ecology around them, as well as sociopolitical dimensions of cities such as their form of governance, sociodemography, and infrastructure, all have roles.”
 

Cholera Vaccine Shortage Continues

 
Health Policy Watch (Switzerland) reports, “As a wave of cholera outbreaks spreads around the world, Gavi, the Vaccine Alliance said it expects the global shortage of oral cholera vaccines to continue until the end of 2025. Supply of oral cholera vaccines for preventative use could catch up to demand by 2026, but ‘urgent action is needed,’ according to a vaccine production roadmap published by Gavi, the World Health Organization (WHO) and other global health partners.…”
 

Uganda Rolls Out Mass Yellow Fever Vaccination

 
The Independent (Uganda) reports, “The government has rolled out a mass vaccination campaign against yellow fever disease in the country…. Uganda National Expanded Program on Immunisation (UNEPI) says that Uganda is currently classified as a yellow fever endemic high-risk country by the World Health Organization, however, it still has a low immunity population.”
 

Paxlovid Gets Full US FDA Approval

 
Axios (US) reports, “The Food and Drug Administration granted full approval Thursday to Pfizer's COVID antiviral pill Paxlovid for adults considered at high risk for getting severely ill from COVID-19…. The FDA signaled the treatment has met its ‘rigorous standards for safety and effectiveness.…’”
 

US COVID-19 Hospitalizations Reach Record New Low

 
CBS News (US) reports, “The number of Americans hospitalized with COVID-19 has fallen to a new record low nationwide, the Centers for Disease Control and Prevention reports. For the first time, preliminary figures from the CDC totalled just 8,256 COVID-19 hospitalizations for the past week, marking a record low for this key remaining indicator to track the threat posed by the virus. The CDC's data, updated late Thursday, has never before fallen below 9,000 weekly admissions of COVID-19 patients, since it first began tracking this metric over the summer of 2020, early during the pandemic.
 

Ranking the Deadliest Viruses

 
Popular Science (US) looks at COVID-19 in the context of other viruses and ranks the most deadly viruses the world has seen, noting “the coronavirus directly or indirectly killed about 15 million people worldwide, according to estimates from the World Health Organization. In the United States, more people died in 2020 and 2021 than during the 1918 influenza pandemic, which was widely called the most deadly in recorded history.” Yet to epidemiologists, “the raw number of mortalities caused by a given virus doesn’t always paint the full picture of a pathogen’s danger—especially when comparing viral outbreaks across time…. Instead of just looking at tallied mortalities, epidemiologists use a metric called the “case fatality rate” or “case fatality ratio” as a measure of how likely a virus is to be lethal.” Influenza, HIV and smallpox all rank among the deadliest viruses, along with SARS-Cov-2.
 

CDC Conference COVID-19 Cases Reach 181

 
Washington Post (US) reports, “The tally of people infected with the coronavirus after attending a high-profile Centers for Disease Control and Prevention conference in April has risen to at least 181, the agency reported Friday. No one was hospitalized…. The outbreak of COVID-19 cases at the conference underscores the persistence of an evolving and highly infectious virus…. With in-person conferences and summer travel underway, infectious-disease experts say the CDC event is a reminder that the coronavirus is not going away.”