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February 1, 2024 |
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| Every region must have the capacities to research, develop, manufacture, and distribute life-saving tools like vaccines, tests, and treatments." - Former New Zealand prime minister Helen Clark and Liberian ex-president Ellen Johnson Sirleaf, and other former world leaders and experts in a letter on the urgency for nations to agree to a strong pandemic treaty in May 2024 highlighted in AFP News via Barron's |
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The deadline for nations to agree to a global pandemic treaty is coming in May. WHO has warned there is a good chance that the deadline will be missed because countries or so split on the details of the treaty. In an editorial, Nature (UK) argues, “As part of the treaty discussions, LMICs are asking for public funders of scientific research to require that any pandemic-related drugs, vaccines or life-saving technologies that result from those organizations’ grants be shared equitably during a global health emergency. Funders should agree to this. It would be a one-time move, with the potential to save many lives. Funders could, for example, require grantees to openly share study results. They could also require that products arising from those studies be priced affordably. Moreover, funders could retain certain intellectual property (IP) rights to be used only when there’s a necessity to develop and distribute products equitably…. An international treaty is a rare opportunity for countries, companies and researchers to commit to making pandemic-related technologies accessible and affordable to all. Funders should take this opportunity and play their part in making that happen.”
AFP (France) via Barron’s reports that Former New Zealand prime minister Helen Clark and Liberian ex-president Ellen Johnson Sirleaf, other former world leaders and experts released a letter this week “on the fourth anniversary of the WHO declaring the worsening COVID-19 situation a public health emergency of international concern.… The letter signatories said the accord must be balanced, with all regions having guaranteed rapid access to pandemic-fighting tools, rather than charity filling the gaps, or private companies calling the shots. ‘Every region must have the capacities to research, develop, manufacture, and distribute life-saving tools like vaccines, tests, and treatments,’ they said. ‘Second, the accord must commit to a pathway to sustained financing for pandemic preparedness and response,’ they added.”
If You Are in a Hurry
- Read Bloomberg on the impact of climate change on cholera outbreaks.
- Read a call to action for the US State Department’s new Bureau of Global Health Security from Chris Collins in Global Health Now.
- Read STAT on a new global partnership to expand infectious disease surveillance.
- Read a study and a comment in The Lancet HIV on COVID deaths among people living with HIV in South Africa.
- Read a call for community led vaccination programs in Frontiers in Health Services.
- Read POLITICO on a report from the International Pandemic Preparedness Secretariat that finds the world is behind in preparing for the next pandemic.
New Dawn for Malaria Prevention
An editorial in The Lancet (US) hails the development and deployment of two malaria vaccines and notes ongoing challenges. “Now the deployment of both vaccines in the field opens new questions: should a booster be given each year to children until they reach school age? How easily can malaria vaccination be added to the complex immunisation schedule already in place for children in malaria-endemic countries? In the current landscape of highly localised malaria transmission… will vaccination remain cost-effective? Still, it seems the day when all children at risk of malaria can be offered a vaccine has arrived, and we cherish the work of all those who have paved the way to this historical achievement.”
African Countries Responding to Mpox and Other Diseases
Vox (US) reports that continued lack of access to mpox vaccine in DRC, “echoes, on a smaller scale, what African nations endured during the Covid-19 pandemic. In 2021 and 2022, as Covid vaccines were being widely distributed in wealthier nations, African countries were largely left behind…. During both Covid and the current mpox outbreak, the African public health response has been constrained by ‘limited research and development capacity, a complex trade-intellectual property regime which hinders the ability of manufacturers in Africa to produce available vaccines,’ Nelson Aghogho Evaborhene, a vaccinology expert at the University of the Witwatersrand in South Africa, told me.”
Climate Change Drives Cholera Spread in Africa
Cholera continues to spread in several African countries. Bloomberg (US) via Yahoo News reports, “The Africa Centres for Disease Control and Prevention, the continent’s chief health advisory body, has tied the worst outbreak of cholera in three years to climate change, saying adverse weather is raising the risk of this disease faster than in the rest of the world…. Outbreaks of cholera have swept across more than a dozen countries in the region over the past year, causing hundreds of deaths from rural Zambia to the outskirts of the capital of South Africa, the continent’s most developed nation. The surge in cases comes even as Africa is the region least responsible for climate change, but one of the hardest hit by adverse weather caused by a warming world.”
Health Times (Zimbabwe) reports, “A total of 2.3 million people, aged one year old and above, are set to benefit from the Oral Cholera Vaccination (OCV) campaign that has been launched in Harare…. The campaign will be carried out on a house-to-house, and cluster-to-cluster basis…. The staggered delivery of the vaccines into the country is a result of the current global shortage of OCV occasioned by high demand from several affected countries in this region that are rolling out similar vaccination campaigns.
Newsday (Zimbabwe) reports that some religious sects that have traditionally been resistant to vaccines, “have warmed up to the cholera mass vaccination exercise and pledged to lead awareness campaigns among their followers…. An apostolic sect behaviour change facilitator, said their followers had embraced the vaccination exercise after seeing the devastating effects of the disease.”
A study in Lancet Infectious Disease (UK) looked at efficacy of a single dose of the oral cholera vaccine among children in DRC. The study team found, “A single dose of Euvichol-Plus provided substantial protection against medically attended cholera for at least 36 months after vaccination in this cholera-endemic setting. Although the evidence provides support for similar levels of protection in young children and others in the short term, protection among children younger than 5 years might wane significantly during the third year after vaccination.”
A Call to Action for the New US State Department’s New Bureau of Global Health Security
Writing in Global Health Now (US), Chris Collins argues, “The new bureau has been established at a time when global health’s future is being hotly debated around the world. COVID-19 reminded us of the urgent need for stronger health security and health systems that can identify and respond to inevitable new disease threats. Yet four years after the new pandemic was recognized, health security programs remain woefully underfinanced and uncoordinated…. Today, the world needs leadership that advances impact and synergies rather than silos and false choices…. By continuing to have a laser-like focus on results, maximizing efficiencies, and working with countries to assume progressively greater leadership, the new bureau has the opportunity to advance our health security, build political support for US global health investments across the political spectrum, and save millions more lives.”
COVID and People Living with HIV in South Africa
A study in The Lancet HIV (UK) “investigated trends in COVID-19 admissions and factors associated with in-hospital COVID-19 mortality among people living with HIV and people without HIV…. HIV and immunosuppression might be important risk factors for mortality as COVID-19 becomes endemic.” The researchers found increased odds of in-hospital deaths among people living with HIV, especially those who were not on ART or had advanced HIV disease.
A comment in The Lancet HIV (UK) notes the severe impact of COVID in South Africa and the high rates of HIV there, writing, “Of note, there was no significant protection from mortality among people with HIV who were vaccinated when compared with people without HIV who were unvaccinated overall; however, among people with HIV, vaccination in the setting of immune reconstitution versus immunosuppression was protective. Jassat and colleagues suggest their findings support an additional vaccination dose for people with HIV and a further booster dose for those with low CD4 cell counts, in line with current WHO recommendations…. The consequences of the COVID-19 pandemic have been enormous, with loss of life and wellbeing. The pandemic has also underscored the medical and social disparities that affect the health of people around the world. Whether in preparing for the next pandemic or addressing current health threats, the findings from the current study shed light on the path to health for all.”
COVID in Pregnancy Risks to Newborns
Healthday (US) via US News reports, “Babies born to COVID-infected mothers have triple the risk of developing a breathing disorder that normally affects preemies, a new study shows. Researchers found that exposure to the coronavirus while in the womb increased a newborn’s risk of respiratory distress syndrome by sparking an ‘inflammatory cascade’ in the infants that affected their breathing.” Read the study in Nature Communications.
Longer-term Typhoid Vaccine Efficacy Among Children in Malawi
A study in The Lancet (UK) looked at longer term durability of efficacy of the typhoid vaccine among children in Malawi and found, “A single dose of Vi-TT is durably efficacious for at least 4 years among children aged 9 months to 12 years and shows efficacy in all age groups, including children younger than 2 years. These results support current WHO recommendations in typhoid-endemic areas for mass campaigns among children aged 9 months to 15 years, followed by routine introduction in the first 2 years of life.”
Self-Amplifying mRNA COVID Vaccine Approved
Nature (UK) reports, “Regulators in Japan have given a green light to a COVID-19 vaccine that uses self-amplifying messenger RNA (sa-mRNA), the first vaccine of this kind to get full approval…. The innovative sa-mRNA vaccine enables host cells in the body to make copies of the mRNA which encodes viral replicase genes in addition to immunogenic genes.… The self-replicative activity of sa-mRNA vaccines enables them to be used at lower concentrations than conventional mRNA vaccines to achieve similar or better antigen expression, meaning they could be safer and manufactured at large scale."
Expanding Infectious Disease Surveillance
STAT (US) reports, “Two research centers that have been at the forefront of following the evolution of the SARS-CoV-2 coronavirus — one in the UK and one in South Africa — have teamed up on a partnership that they say will expand their efforts to track emerging disease threats around the world. The collaboration between the UK’s Wellcome Sanger Institute and South Africa’s Centre for Epidemic Response and Innovation… comes as much of the infrastructure built up during the pandemic to sequence SARS-2 has dwindled…. Both institutions have strong international ties, with CERI sequencing coronavirus samples from more than two dozen African countries during the pandemic. One idea is to design sequencing tools and tests that can be rapidly deployed to just about anywhere in the world during an emerging outbreak, to find out whether it’s caused by a known pathogen, a new strain of a bug, or something new entirely.”
Call for Community Led Vaccination Rollout in African Countries
An opinion article in Frontiers in Health Services (Switzerland) argues, “The current top-down approach [to COVID vaccine rollout in Africa], driven by international agendas, has undermined public trust in African governments' health responses and led to vaccine hesitancy, fueled by a lack of information and effective awareness interventions. This contributed to wasting essential medicines and further mistrust in public health responses and resourcing. More evidence is urgently needed from a community perspective, i.e., those who continue to be most affected, on how the COVID-19 pandemic impacted public health systems, and how governments prepared for and responded to COVID-19, including their vaccine rollout strategies.”
New Insights into Chronic COVID
STAT (US) reports on new research published “in Science Translational Medicine [that] analyzed how long it took for people with different levels of immune compromise to clear the [SARS-CoV-2] virus, and how that virus evolved along the way. The work highlights the spectrum of risk for COVID becoming chronic — from high levels for people with blood cancers requiring bone marrow transplants, lower risk for people taking immune-suppressing drugs for autoimmune illness, and little risk for those with intact immunity. The 56 immunocompromised people in the study had a variety of conditions, but they all fall into a category of people overlooked as many in the world have moved on from the pandemic in its fifth year.” Read the study.
Refocus on Pandemic PrEP
POLITICO (US) reports on a report from the International Pandemic Preparedness Secretariat that finds “the world lags in developing potential tests, drugs and vaccines for most of the pathogens that can cause the next pandemic…. The IPPS is an international partnership of top government scientific advisers, the pharma industry and global health organizations focused on ensuring those products are available within the first 100 days of a pandemic threat. Approved drugs, tests and vaccines exist only for the two viruses that recently caused regional or global outbreaks: COVID-19 and the Zaire strain of Ebola, said the report, released today. And even those products aren’t always accessible to people who need them.”
Call for a “New Playbook” for GAVI
A Center for Global Development Blog post describes a new paper that calls for “a new playbook for Gavi to leverage its strengths, mitigate the impacts of disruptions, and remain fit-for-purpose in a changing world.”
Diphtheria Makes a Comeback in Guinea
NPR’s Goats and Soda Blog reports on an outbreak of diphtheria in Guinea, following 30 years without a case. “The disease, which was a global scourge for much of the 20th century, is also almost entirely preventable through vaccination. After the diphtheria inoculation was included on the World Health Organization's essential vaccine list in the 1970s, cases decreased dramatically worldwide.” Ankur Mutreja, a global health specialist with the Cambridge Institute of Therapeutic Immunology and Infectious Disease is quoted: "’Diphtheria is and has always been a disease of poverty,’ he emphasizes, with social unrest and poor vaccination coverage explaining most outbreaks nowadays. ‘It's not just the West Africa outbreak but numerous other [recent] outbreaks — after the earthquake in Haiti, after war in Syria, in Bangladesh when the Rohingyas were displaced in 2017.’” |
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