Pandemic Watch News Brief: The News You Need To Know ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌

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[link removed] January 11, 2024
AVAC's weekly Pandemic Watch is a curated news digest on the latest pandemic prevention, preparedness, and response (PPPR) news and resources.


We were promised that [this treaty] would be a tool to facilitate a more equitable response to pandemics. Now we're seeing, it's not only business as usual, but also some very dangerous side-slipping in the sense [that] now we're having governments saying, WHO shouldn't be dealing with IP at all.” - Jaume Vidal of Health Action International in Politico ([link removed])
Table of Contents
• If You Are in a Hurry (#If You Are in a Hurry)
• Expanding Vaccine Manufacturing in Africa (#Expanding Vaccine Manufacturing in Africa)
• Call to Invest in Africa’s Scientific Future (#Call to Invest in Africa’s Scientific Future)
• The World Needs an Immune System (#The World Needs an Immune System)
• Lessons Learned from the US Mpox Response (#Lessons Learned from the US Mpox Response)
• Long COVID in Low Income Countries (#Long COVID in Low Income Countries)
• Antimicrobial Resistance Deaths in Africa (#Antimicrobial Resistance Deaths in Africa)
• Cameroon to Introduce Malaria Vaccine (#Cameroon to Introduce Malaria Vaccine)
• The Dangerous Impact of Hydroxycholoroquine Misuse (#The Dangerous Impact of Hydroxycholoroquine Misuse)
• COVID Resurgence in the US (#COVID Resurgence in the US)
• FDA Warns Immunity at Risk in US (#FDA Warns Immunity at Risk in US)
• Early Mpox Treatment for PLWHIV (#Early Mpox Treatment for PLWHIV)
• Spain Brings Back Mask Mandates (#Spain Brings Back Mask Mandates)
• Rise of COVID in Some Southern Hemisphere Countries (#Rise of COVID in Some Southern Hemisphere Countries)
• Cholera in Zambia (#Cholera in Zambia)

As we enter the fourth year of COVID and memories of the worst of the pandemic fade, Politico ([link removed]) (US) warns the global pandemic treaty being negotiated by the WHO may never come to pass, leaving the world unprepared to respond to the next pandemic. The treaty is “meant to be a legally binding agreement that commits countries to monitor pandemic threats, beefs up their capacity to respond and sets out what nations would receive in return for sharing information on any disease-causing viruses or bacteria that they discover…. But two years since countries began brokering the rules, and with less than six months until the deadline for agreement, political attention has shifted to other issues and the usual compromises and concessions of international negotiations are nowhere to be seen, according to diplomats involved in the talks…. A recent draft of the agreement, obtained by
Politico, indicates that countries have shifted little in their initial positions on key provisions in the text, including on intellectual property rights, sharing information around pathogens, and transfer of technology.” Jaume Vidal of Health Action International is quoted: “We were promised that [this treaty] would be a tool to facilitate a more equitable response to pandemics. Now we're seeing, it's not only business as usual, but also some very dangerous side-slipping in the sense [that] now we're having governments saying, WHO shouldn't be dealing with IP at all.”

If ou Are in a Hurry

* Read a call to invest in Africa scientific future from Tulio de Oliveira and Cheryl Baxter in Science. ([link removed])
* Read Atul Gawande on developing a global immune system in The New York Times ([link removed]) .
* Read Demetre Daskalakis, Nikki Romanik and Ashish K. Jha on lessons learned from the mpox response inJAMA (Demetre%20Daskalakis,%20MD,%20MPH1%3B%20Nikki%20Romanik,%20MD2%3B%20Ashish%20K.%20Jha,%20MD,%20MPH3) .
* Read People’s Gazette ([link removed]) on Cameroon becoming the first central African country to bring in malaria vaccines.
* Read a JAMA ([link removed]) (US) commentary from FDA’s Peter Marks and Robert Califf on the dangers of waning immunity in the US.


Expanding Vaccine Manufacturing in Africa

Thelma Chioma Abeku writes in Nigeria Health Watch ([link removed]) (Nigeria) “Africa accounts for a significant share of the world’s cases of infectious diseases, placing a disproportionate burden on the continent. By promoting local African-led innovation in vaccine production, the continent is better positioned to be self-sufficient. Strengthening collaboration between member states to address infrastructure gaps in areas such as electricity supply, transportation, becomes essential to the establishment and maintenance of manufacturing facilities…. Africa can redefine its global health role by leading in local vaccine, diagnostics, and therapeutics manufacturing, through strategic investments, partnerships, and innovation. This would strengthen the continent’s ability to build a robust healthcare system and ensure health security.”

Call to Invest in Africa’s Scientific Future

Tulio de Oliveira and Cheryl Baxter write in Science ([link removed]) (US): “The need to build genomics capacity in Africa while simultaneously retaining skilled personnel is critical for several reasons. The substantial infectious disease burden in Africa is likely to worsen as the impacts of climate change become apparent. A recent review revealed that climate change has the potential to amplify more than 50% of known human pathogens. Genomic sequencing could be harnessed to elucidate the origin, genetic diversity, transmission patterns, and evolution of these pathogens. Strengthening capacity in genomics will enable researchers and health care professionals in Africa to generate region-specific data and knowledge that is crucial for understanding disease dynamics and developing targeted interventions, including the evaluation and development of diagnostics, therapeutics, and vaccines to improve public health outcomes…. Investing in Africa’s genomics
future is an imperative not just for the continent’s health but for global health security as well. By empowering African scientists and building strong genomics infrastructure, we can collectively mitigate the impact of infectious diseases and pave the way for a healthier future for all.”

The World Needs an Immune System

USAID’s Atul Gawande writes in a New York Times ([link removed]) (US) essay that in his work leading global health efforts the pattern he has seen is, “one emergency after another, often overlapping, diverting focus away from longer-term public health goals. And there’s no sign of this letting up…. But we can break the pattern. Longer-range investment in local preparedness for such events — in building what I think of as a global immune system — could reduce the threat these crises pose and even reduce dependence on foreign aid to weather them. As dangers rise, so can our capacity to get ahead of them. With the right strategy, we could use the mishaps, malefactors and shocks we face to strengthen our capacity to adapt. This is not about developing resilience (the ability to recover from crisis) or robustness (the ability to resist crisis). It is about developing what the writer Nassim Nicholas Taleb has called
antifragility — the ability to become stronger from crisis.”

Lessons Learned from the US Mpox Response

Demetre Daskalakis, Nikki Romanik and Ashish K. Jha write inJAMA (Demetre%20Daskalakis,%20MD,%20MPH1%3B%20Nikki%20Romanik,%20MD2%3B%20Ashish%20K.%20Jha,%20MD,%20MPH3) (US), “The primary strategy for mpox containment was to take an approach that deeply engaged the community most affected. Rather than the community as the object of a public health intervention, they became the vehicle. The views (often criticisms) of those most affected by the virus were used to inform policy and create shared accountability…. The last few years have been remarkable in how infectious diseases have taken a toll. The lesson from the mpox response is clear: community engagement and flexibility of response are necessary as well as the existing public health infrastructure that can be deployed to manage outbreaks. Medical countermeasures are key, but so are community partnerships, flexibility, and persistence. That is how infectious disease outbreaks should be managed now and in the future.”

Long COVID in Low Income Countries

Nature ([link removed]) (UK) reports, “Much of the world’s research on long COVID is conducted in wealthy regions, and data on the prevalence or severity of the condition in other locales are more limited. ‘The main story about long COVID in low- and middle-income countries is that there are relatively few studies,’ says Theo Vos, an epidemiologist at the Institute for Health Metrics and Evaluation in Seattle, Washington. ‘But wherever people have looked at it, they find it.’… a dearth of research on the condition in less-wealthy countries creates a double curse. An absence of information about prevalence and risk factors leaves advocates hamstrung: few physicians acknowledge that long COVID exists. The lack of data also hampers efforts to search for the mechanisms of the condition and tailor treatments. ‘You need data for action,’ says Waasila Jassat, a public-health specialist at Genesis Analytics, a consultancy firm in Johannesburg, South Africa.
‘You need evidence to advocate for services, and you cannot just use data from other countries.’”

Climate Change and Antibiotic Resistance

Nature ([link removed]) (UK) reports on efforts to understand the link between climate change and antibiotic resistance: “changing weather conditions that help bacteria thrive also play a part. And disasters stemming from extreme weather events such as floods, droughts, hurricanes and wildfires can exacerbate the issue because they often reduce access to clean water, leading to unsanitary conditions. When injuries and infections start to rise, more people use antibiotics, in turn pushing up the likelihood of resistance developing.” Steven Hoffman, an international lawyer and health-policy researcher at York University in Toronto says strong action is needed. “In a 2022 study, he and his colleagues called for a treaty to tackle drug-resistant pathogens — equivalent to the 2015 Paris climate agreement. He wants countries to articulate a single unifying goal, such as a 35% reduction in drug-resistant infections by 2035, and hopes that they will make progress
on this when they convene at a UN meeting on antimicrobial resistance in September. The meeting is only the second time that the issue has been the subject of a UN General Assembly.”

Antimicrobial Resistance Deaths in Africa

A study in The Lancet Global Health ([link removed](23)00539-9/fulltext) (UK) found “In the WHO African region in 2019, there were an estimated 1·05 million deaths (95% UI 829 000–1 316 000) associated with bacterial AMR and 250 000 deaths (192 000–325 000) attributable to bacterial AMR.” A press release from the Institute for Health Metrics and Evaluation ([link removed]) notes, “The number of deaths linked to AMR in the WHO African region is higher than those caused by both HIV/AIDS (639,554) and malaria (594,348), marking a pivotal shift in the health challenges facing the region. Despite the relatively low prevalence of resistance, the WHO African region had the highest burden of AMR mortality, which is partly due to the region’s high burden of infection-related mortality.” IHME argues, “As the world confronts the escalat
ing threat of antimicrobial resistance, the report highlights the need for global collaboration, targeted interventions, and sustained investments to address the complex challenges posed by AMR in the WHO African region.”

Cameroon to Introduce Malaria Vaccine

People’s Gazette ([link removed]) (Nigeria) reports, “Cameroon’s Minister of Public Health, Manaouda Malachieon, says Cameroon will introduce the malaria vaccine on January 22…. Cameroon took delivery of 331,200 doses of malaria vaccine in November 2023, the first consignment to arrive in the Central African country. Malaria is responsible for 70 per cent of deaths among children in Cameroon, according to the Ministry of Public Health.”

The Dangerous Impact of Hydroxycholoroquine Misuse

Politico ([link removed]) (US) reports, “Nearly 17,000 people may have died after taking hydroxycholoroquine during the first wave of COVID-19, according to a study by French researchers. The anti-malaria drug was prescribed to some patients hospitalized with COVID-19 during the first wave of the pandemic, "despite the absence of evidence documenting its clinical benefits," the researchers point out in their paper, published in the February issue of Biomedicine & Pharmacotherapy. Now, researchers have estimated that some 16,990 people in six countries — France, Belgium, Italy, Spain, Turkey and the US — may have died as a result.” Read the study. ([link removed])

COVID Resurgence in the US

The New York Times ([link removed]) (US) reports on a resurgence in COVID cases in the US. “Federal officials are relying on limited data to measure this year’s spread. After the end of the public health emergency in May, the Centers for Disease Control and Prevention stopped tracking the number of Covid infections. The agency now has only partial access to information from states about vaccination rates. But trends in wastewater data, positive tests, emergency department visits, hospitalization rates and deaths point to a rise in infections in all regions of the nation, according to the CDC. These patterns have prompted many hospitals to reinstate mask policies, after initially resisting a return to them this fall.”

FDA Warns Immunity at Risk in US

In a JAMA ([link removed]) (US) commentary FDA’s Peter Marks and Robert Califf write, “an increasing number of people in the US are now declining vaccination for a variety of reasons, ranging from safety concerns to religious beliefs…. the situation has now deteriorated to the point that population immunity against some vaccine-preventable infectious diseases is at risk, and thousands of excess deaths are likely to occur this season due to illnesses amenable to prevention or reduction in severity of illness with vaccines…. We believe that the best way to counter the current large volume of vaccine misinformation is to dilute it with large amounts of truthful, accessible scientific evidence. To reduce deaths, hospitalization, and the burden on families and the health care system, all those directly interacting with individuals in a health care setting, ranging from front office staff to retail pharmacists to primary care physicians, need to focus
at every appropriate opportunity on helping to ensure that individuals have the necessary information to make informed choices regarding vaccination, considering the benefits and risks.”

Early Mpox Treatment for PLWHIV

Healio ([link removed]) (US) reports, “People with HIV who were treated with tecovirimat within the first 7 days of mpox symptom onset were 13 times less likely to progress to severe mpox disease compared with those not treated or treated late, a recent study found.” The study authors note: “Results of the present study suggest that tecovirimat treatments should be started early at the time of suspected mpox diagnosis in all PWH, especially in those with nonsuppressed HIV viremia or mucosal site involvement,” they concluded, although “additional research is needed to confirm these findings.” Read the study in JAMA ([link removed]) .

Spain Brings Back Mask Mandates

The Guardian ([link removed]) (UK) reports, “Face masks will be mandatory in hospitals and health centres in Spain from Wednesday as the country experiences a surge in cases of flu, Covid and other respiratory illnesses. The government decision, which was made six months after the use of masks ceased to be obligatory in health facilities and pharmacies, has been met with opposition from some regional administrations. But Spain’s new health minister, Mónica García, overruled their objections and sought to present the move as a ‘commonsense measure’.”

Rise of COVID in Some Southern Hemisphere Countries

CIDRAP ([link removed]) (US) reports, “Some countries in the Southern Hemisphere, currently in their summer season, are experiencing higher-than-expected levels of respiratory disease activity for this time of year due to COVID-19, the Pan American Health Organization (PAHO) said yesterday in an epidemiologic update…. The alert comes amid expanding dominance of the JN.1 Omicron SARS-CoV-2 variant, which is thought to partially evade immunity from earlier infection, vaccination, or both. And though there's no evidence that JN.1 infections are more severe, some experts have warned that a surge in cases could put pressure on health systems.”

Cholera in Zambia

Times of Zambia ([link removed]) (Zambia) via All Africa reports, “Zambia has been battling cholera since January last year in a few districts, but fresh outbreaks in October have seen an escalation of the disease with cases now reported in 27 districts in six of the 10 provinces. The latest figures push Zambia closer to the top of the list of the countries with the highest number of cholera cases across the world…. last week, the World Health Organization responded to the Government SOS and pledged to provide Zambia with one million doses of cholera vaccines to help fight the waterborne disease. According to Government estimates, the country needs about seven million doses of cholera vaccines to control the spreading disease that is now in six provinces having just started in the Eastern Province.”
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