It’s the season of high-level multilateral meetings aimed at taking on – or at least talking about – some of the most pressing issues on the global agenda. In many of these meetings the specter of COVID-19 and of the next pandemic make health a topic of conversation even in meetings not devoted to health. Health advocates were disappointed with the just finished African Climate Summit in Nairobi. Down to Earth (India) reports, “Health practitioners and experts attending.… Have expressed displeasure with the exclusion of health on the main agenda despite its inextricable link with climate change. Speaking at a side event within the summit, the specialists from the sector expressed worry that a comprehensive health standpoint is likely to miss from the ‘Nairobi Declaration’, which the meeting is intended to culminate in.”
 
Writing in The Standard (Kenya) as the summit got underway Dr Githinji Gitahi and Martin Muchangi argued, “Undeniably, health is the human face of the climate crisis whose reality is within our reach. People’s health and the health of the planet are inextricably linked. The clarity of science as guided by the Intergovernmental Panel on Climate Change (IPCC), whose latest report was released this year, shows that human-induced climate risks exacerbate both planetary and people’s health…. To win the debate on the climate crisis, health must feature prominently, especially in the ‘global boiling era’, as the United Nations Secretary-General, Antonio Guterres, puts it. We must begin to view the climate crisis not just as an abstract global challenge, but as a pressing health issue that needs to be urgently addressed.”
 
If You Are in A Hurry
 

• Read Nina Schwalbe in Financial Times on what is needed for a useful pandemic accord.
• Read Lakshmi Narasimhan Balaji in Forbes India on what the G20 needs to do to build more resilient, equitable, sustainable and inclusive health systems in low- and middle-income countries.
• Read Reuters on the latest on pandemic accord negotiations.
• Read Washington Post on how climate change is driving disease in Pakistan.
• Read Al Jazeera on concerns over a COVID-19 surge in the Northern hemisphere and the lack of data to know what is really going on.
• Read A Comment in The Lancet on the public health crisis of long COVID in low- and middle-income countries.
• Read Al Jazeera on the inflated prices South Africa paid for COVID-19 vaccines. 

More Calls for Action on Climate, Health and Pandemics
 
The Elders Zeid Ra'ad Al Hussein writes, “At the Africa Climate Summit in Nairobi, the G20 in New Delhi and United Nations General Assembly (UNGA) High-Level week in New York, leaders have an opportunity to commit to urgent, decisive action [on the climate crisis and pandemics]…. On pandemics, many global leaders have still not learned from the collective experience of COVID-19.  Pandemics are an existential threat, and future pandemics may be far worse…. Yet, there continues to be a chronic failure of political will to invest the effort and resources required to prevent and prepare for the next pandemic. This short-term approach exacerbates the impact of pandemics on the world’s poorest and most vulnerable people and makes deadly infectious diseases more likely.”
 
In an op-ed in Financial Times (UK), Nina Schwalbe warns that time is slipping away for a useful global pandemic accord: “The consequences of the clock winding down without a useful treaty to show for our efforts are significant. While current public health structures can of course be improved, the past has shown that progress requires something bigger. We need our leaders to have the courage and conviction to come together and commit to an ambitious pandemic treaty that will save lives. Otherwise, history is on track to repeat itself — in the form of more pandemics which could have been avoided.”
 
In a health policy analysis in The Lancet (UK) Matthew Kavanagh and colleagues write, “Across multiple pandemics, global health governance institutions have struggled to secure the compliance of states with international legal and political commitments, ranging from data sharing to observing WHO guidance to sharing vaccines. In response, governments are negotiating a new pandemic treaty and revising the International Health Regulations. Achieving compliance remains challenging, but international relations and international law research in areas outside of health offers insights…. We offer six specific, politically feasible mechanisms for new international agreements that, together, could create compliance pressures to shift state behaviour.”
 
Lakshmi Narasimhan Balaji writes in Forbes India (India), “The G20 health ministers, in their declaration in Gandhinagar, Gujarat, reaffirmed their commitment to Global Health Architecture to build more resilient, equitable, sustainable and inclusive health systems, especially in Low- and Middle-income Countries (LMICs) and Small Island Developing states…. We must act collectively to ensure all nations' well-being and health security. By proactively investing in prevention and empowering individuals, we can build a resilient health system capable of navigating through uncertain times and safeguarding the well-being of populations worldwide. The Joint Finance-Health Task Force established by G20 and the upcoming Brazil presidency of G20 have their agenda cut out to treat health as a productive sector, essential for economic recovery and eventually for economic growth and development—without human capital development, there is no real development.”
 
Reuters (UK) reports as discussions of the pandemic treaty resume, health officials, “are struggling to agree on funding for developing countries and measures to thwart jumps by pathogens from animals into humans…. Many health experts say that finding ways to stop potential pandemics before they can emerge is as crucial as any amount of readiness for when they do…. governments remain divided, failing to agree on some of the basics needed to strengthen health systems worldwide. Those basics, all issues that hindered a coordinated global response to the COVID-19 outbreak, include the sharing of information, costs and vaccines. The divisions arose anew in June, when the European Union negotiated new agreements with pharmaceutical companies to reserve vaccines for future pandemics. The agreements led critics to accuse the bloc of ‘vaccine apartheid.’”
 
South Africa Paid More for COVID-19 Vaccines
 
Al Jazeera (Qatar) reports, “Big pharmaceutical companies “bullied” South Africa into signing unfair agreements that forced the country to overpay for COVID-19 vaccines compared with Western nations, according to a nonprofit that lobbied for the details to be released…. ‘In simple terms, Big Pharma bullied South Africa into these conditions,’ HJI director Fatima Hassan told Al Jazeera. ‘Amid a deadly pandemic, when scarce vaccines were only going to the richest countries, the companies exploited our desperation.’… Hassan told Al Jazeera. ‘We hope that more countries will publish their contracts with Big Pharma, so that the world can see how the industry really conducts business.’”
 
New Mandates for Africa CDC
 
In a commentary in Nature (UK) the new Africa CDC director-general Jean Kaseya writes, “The Africa CDC faces many challenges, not least to apply the lessons learnt from COVID-19 as we strive to become a world-class, self-sustaining and agile institution. According to our 2022 priority ranking of infectious diseases, Ebola, cholera and COVID-19 have the highest epidemic potential across Africa, and the diseases the continent is least prepared for are the plague and Crimean–Congo hemorrhagic fever, as well as any as-yet unknown disease.” He lays out a plan to address health on the continent through six actions and concludes, “All six of these actions will require sustained support from African communities, AU member states, donors and other partners. I am convinced that a new way of doing public health in Africa is within reach.”
 
Epidemic Preparedness and Gender Inequalities
 
Ibrahima Cheikh Diong and Natasha Kofoworola Quist write in Daily Maverick (South Africa), “The COVID-19 pandemic emphasised the dire consequences of inadequate investment in epidemic preparedness, response, and resilience. This global wake-up call has particularly resonated in Africa, a continent grappling with frequent and severe endemic pandemics such as HIV/Aids and malaria, as well as other emerging and re-emerging epidemics…. Often, women bear the brunt of these crises owing to pre-existing gender inequalities which compound the vulnerability of women and girls. For example, during the COVID-19 pandemic, 60% of African girls lacked learning materials when school closed, compared to 44% of boys…. The world’s commitment to safeguarding global health demands that we utilise the knowledge and partnerships forged during COVID-19 to create a healthier and more equitable world for all. Investing in research, embracing innovation, and focusing on the most vulnerable, especially women, can prevent future pandemics and elevate health outcomes for those most in need.”
 
Climate Driven Disease
 
Washington Post (US) reports, “Pakistan is the epicenter of a new global wave of disease and death linked to climate change, according to a Washington Post analysis of climate data, leading scientific studies, interviews with experts and reporting from some of the places bearing the brunt of Earth’s heating. This examination of climate-fueled illnesses — tied to hotter temperatures, and swifter passage of pathogens and toxins — shows how countries across the globe are ill-prepared for the insidious, intensifying risks to almost every facet of human health.”
 
WHO Attempt to Regularize Traditional Medicine
 
The Conversation (Australia) reports, “In recognizing that traditional medicine and other alternative forms of healing are critical sources of health care for many people worldwide, the World Health Organization and the government of India co-hosted their first-ever Traditional Medicine Summit…. The summit brought together health care policymakers, traditional medicine workers and users, international organizations, academics and private sector stakeholders from 88 WHO member states. Leaders at the summit aimed to share best practices and scientific evidence and data around traditional medicine.”

Call for More Inclusive Clinical Trials
 
STAT (US) reports on a panel discussion about inclusivity in vaccine clinical trials, noting in recent RSV vaccine trials in the US the lack of “participants 80 and older. People who are immunocompromised and those who live in nursing homes were also not included.” Experts noted, “that some vaccine trials don’t include the oldest adults even when they’re the target demographic for the vaccine being tested…. [B]oth experts also suggested there are ways to make enrollment in vaccine trials more inclusive. Talbot noted that the COVID-19 pandemic and the record-setting development of those shots may be influencing expectations of how long it typically takes to gather vaccine data. ‘I think we have forgotten how to slow down a bit. We’re still in that hurry mode,” Talbot said about coming out of COVID-19.”
 
COVID-19 Surges and New Mutations
 
Global News (Canada) reports, “A surge in COVID-19 cases across countries in the Northern Hemisphere is causing concern for global health authorities, given that these regions usually witness a peak in respiratory illnesses during the winter months. [WHO].… Urged countries to strengthen their surveillance and reporting of COVID-19 amid the spike in hospitalizations in the last month, primarily in European nations. ‘The virus right now is reinfecting a large number of individuals — millions of people — each week,’ warned Dr. Maria Van Kerkhove, the WHO’s technical lead on the COVID-19 response. ‘We don’t have a good gauge on how many reinfections or infections there actually are because surveillance has declined. But we do have some indications on trends of impact.’”
 
Al Jazeera (Qatar) reports, “’We continue to see concerning trends for COVID-19 ahead of the winter season in the Northern Hemisphere,”’WHO chief Tedros Adhanom Ghebreyesus told an online news conference on Wednesday. ‘Deaths are increasing in some parts of the Middle East and Asia, intensive care unit admissions are increasing in Europe and hospitalisations are increasing in several regions,’ he said. Tedros noted, however, that only 43 countries – less than a quarter of the 194 WHO member states – are reporting COVID-19 deaths to the agency, and only 20 provide information about hospitalisations.”
 
The Public Health Crisis of Long COVID in Low- and Middle-Income Countries
 
A Comment in The Lancet notes, “Although the prevalence of long COVID is unknown, studies have suggested that between 10% and 45% of those infected experience long COVID, indicating that at least 65 million people suffer from symptoms that impair their functional and cognitive capacity. However, there is a paucity of studies examining patient cohorts from LMICs. Understanding the burden of long COVID in LMICs will help policy makers establish adequate access to services to ensure patients regain an improved quality of life…. As we learn from the COVID-19 pandemic and better prepare for emerging threats, it is crucial to further investigate post-infection syndromes. These investigations will contribute to future pandemic preparedness and ensure that LMICs are not once again marginalised in these efforts.”
 
COVID-19 and Anti-HIV Drugs
 
POZ Magazine (US) reports, “Recent studies continue to yield conflicting evidence about whether tenofovir reduces the risk of SARS-CoV-2 infection or severe COVID-19. What’s more, some patients have anecdotally reported that tenofovir improved their long COVID symptoms, but here, too, reports are mixed. The latest study, from researchers in the Netherlands, found that tenofovir disoproxil fumarate (TDF, or Viread) did not reduce the likelihood of acquiring SARS-CoV-2 or developing severe illness. As reported in the journal AIDS, this was also the case for two HIV integrase inhibitors and the non-nucleoside reverse transcriptase inhibitor etravirine (Intelence).
 
Updated mRNA Vaccines Effective Against Newer Variant
 
Reuters (UK) reports, “Moderna and rival Pfizer on Wednesday said their updated COVID-19 vaccines generated strong responses in testing against the highly mutated BA.2.86 subvariant of the coronavirus that has raised fears of a resurgence of infections.”