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March 20, 2024 |
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| Our insecurity about immediate needs like health care and caregiving is corroding trust in government, other institutions, and one another, leaving us less prepared for the next public health crisis." Céline Gounder in NPR’s Goats and Soda Blog |
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The eradication of smallpox in 1980 was a public health triumph. What are the lessons we can learn from that global exercise to apply to the health threats we face in 2024? Physician and epidemiologist, Céline Gounder writes in NPR’s Goats and Soda Blog (US) that the “smallpox leaders of the 1960s and '70s showed moral imagination: While many doctors and scientists thought it would be impossible to stop a disease that had lasted for millennia, the eradication champions had a wider vision for how the world could see not just less smallpox, or fewer deaths, but elimination of the disease completely. They did not limit themselves to obvious or incremental improvements.”
Gounder says of the smallpox eradiation program in South Asia: “By many, many measures, the program was a success. Indeed, smallpox was stopped. Still, in the all-consuming push to end the virus, public health writ large often failed to meet people's basic needs, such as housing or food.” She argues that following the worst of the COVID pandemic, “we're back to business as usual, with financial, housing, food, health care, and caregiving insecurity all on the rise in the US. What trust was built with these communities [of color] is again eroding. Insecurity, a form of worry over unmet basic needs, robs us of our ability to imagine big and better. Our insecurity about immediate needs like health care and caregiving is corroding trust in government, other institutions, and one another, leaving us less prepared for the next public health crisis.”
You can listen to Gounder’s podcast Epidemic: ‘Eradicating Smallpox’ here.
If You Are in a Hurry
- Read Health Policy Watch and Science for the latest on negotiations for the pandemic treaty and then read Africa CDC’s Jean Kaseya in All Africa on what Africa needs from the trearty.
- Read The Guardian (UK) on a plan to release bacteria-infected mosquitoes in more areas of Brazil to help fight dengue outbreaks.
- And then read Vox on why dengue rates and deaths are increasing in many places.
- Read Nature on a good news story for COVID vaccine access in Sierra Leone that can be replicated in other countries.
- Read Poynter on COVID misinformation four years on.
The Latest on Pandemic Treaty Negotiations
As the 9th (and final before the treaty goes to the World health Assembly) meeting of the Intergovernmental Negotiating Body for the pandemic treaty got underway this week, WHO’s Tedros addressed the group. In his remarks (via All Africa) Tedros urged the group to agree on “the fundamental objectives of the agreement, “ calling it “mission-critical for humanity that you do” and arguing: “The task is large and time is short, but the potential benefit cannot be measured, and will endure for generations.”
Health Policy Watch (Switzerland) reports, “member states abandoned careful diplomatic language at the start of the final round of negotiations…. Exposing deep divisions between countries from the global North and South. An unprecedented 11 African countries spoke during the two-hour opening session, largely expressing support for the latest pandemic agreement draft as a ‘good start’ for text-based negotiations. But the opposite was so for developed countries. Switzerland, which is home to numerous pharmaceutical companies, said that it ‘does not accept the text in its current state’.”
Science (US) reports, “Observers from developing nations say the agreement doesn’t give them strong enough assurances that they will fare better during the next pandemic. ‘There is a systematic marginalization of developing country proposals on equity,’ says Nithin Ramakrishnan, an India-based lawyer with the Third World Network, one of more than 100 ‘stakeholders’ that provided input during the negotiations. ‘The process is being carefully designed to avoid any form of detailed legal obligations.’” Nelson Aghogho Evaborhene, a vaccine specialist at the University of the Witwatersrand is quoted: “Trade-offs and compromises in the final text must uphold principles on equity. Otherwise, we may continue to sow seeds of plagues and count the dead when the next pandemic hits.”
Africa CDC’s Jean Kaseya writes in an opinion piece in All Africa (South Africa), “The inequities laid bare during the COVID-19 pandemic touched a raw nerve, evidenced by the outcry from the global health community about our flawed global health security frameworks. A global pandemic agreement must put equity at the heart of the prevention, preparation, and response work for the next outbreak. African states are working together to ensure that we are in a position to ensure a strong pandemic response for our communities and for the world…. We can mitigate the anticipated threats if we build the capacity to manufacture vaccines, diagnostics, and therapeutics locally. We want to see a final pandemic treaty that provides unfettered ground for meaningful participation and co-creation of decisions. Benefit sharing has to be fairly addressed, technology transfer must be facilitated, and clear research and development conditions upon pandemic funding must be clearly stated and established in domestic laws, including on affordable pricing plans.”
An opinion piece in The Star (Malaysia) argues, “After 29 million deaths, generational trauma and multibillion-dollar debts we will be paying off for decades, the international community appears to have learned nothing from the COVID-19 pandemic. The main challenges to agreeing the draft treaty are concentrated in two global health flashpoints: control of knowledge and sharing of resources. For countries in the Global South like Indonesia, passing the treaty will be possible only if rich countries facilitate the distribution of diagnostics, vaccines and medicines…. By failing to ground the treaty in existing human rights obligations and inadequately addressing human rights concerns that arise during public health emergencies, governments risk repeating history when the next global health crisis hits.
Good News for COVID Vaccine Access in Sierra Leone
Nature (UK) reports, “Deploying mobile COVID-19 vaccination clinics in rural areas of Sierra Leone increased vaccination rates sharply, according to an ambitious experiment involving 150 villages. The effort is an outlier: many more studies examine vaccine hesitancy and misinformation than focus on vaccine access. ‘The investigators made a great effort to bring vaccines to remote communities,’ says Jean Nachega, an infectious-disease epidemiologist at the University of Pittsburgh in Pennsylvania, who has highlighted challenges in COVID-19 vaccine access in Africa. The model could be transferred easily to other countries, he adds, calling the campaign ‘very laudable’.”
Dengue Rages in South America
Buenos Aries Herald (Argentina) reports, “Dengue cases are skyrocketing in Argentina. In the first 10 weeks of 2024, health authorities detected just over 11 times more cases than in the same period of 2023. To date, 69 people have died this year. While there is a vaccine available, the government is not currently planning to add it to the mandatory immunization schedule, which would make it free and widely accessible…. Strikingly, Argentina detected cases throughout the entire 2023/2024 season, including during winter, when the mosquito-borne disease usually subsides. The report shows a steady increase in early October, showing how peak season started sooner.”
Vox (US) reports, “Since the 1950s, there’s been a marked increase in the number of severe dengue cases and fatalities. Increased awareness of dengue and improved diagnostics likely explain some of that increase, but the dramatic spikes in case numbers, especially in the last few years, suggest something bigger is at work. Part of the dengue surge is likely due to the expansion of urban centers in tropical climates and the increased travel in those regions. The World Health Organization has identified climate change as another primary cause of dengue’s aggressive expansion over the past 70 years. Hotter temperatures and the attendant changes in weather patterns make it easier for the mosquitoes that carry dengue to proliferate. In Bangladesh, for example, where dengue has long thrived, the rainy season has extended by more than a month in recent years. Wet weather and humidity mean more standing water where mosquitoes flourish and easily reproduce.”
The Guardian (UK) reports, “A dengue-fighting strategy that involves releasing bacteria-infected mosquitoes will be rolled out to six Brazilian cities in the coming months as the country battles a severe outbreak of dengue fever, a viral disease transmitted by the Aedes aegypti mosquito…. amid ‘a significant change in the pattern of dengue’ – with earlier and bigger spikes in infections – the government is turning to newer technologies with medium-term results, such as vaccines and the release of mosquitoes infected with bacteria that limit the transmission of dengue and other arboviruses to humans.”
Measles Outbreaks Continue
Healthline (US) reports the US CDC recommended families traveling abroad with infants as young as 6 months get their child vaccinated against measles a few months ahead of the routine immunization schedule. Young children usually receive the measles, mumps, and rubella (MMR)Trusted Source vaccine starting at 12 months. Measles outbreaks around the US, most recently in Chicago, and those around the world are underscored by low vaccination rates.”
Simultaneous Mpox, Hepatitis A, and Meningococcal Disease Outbreaks
CIDRAP (US) reports, “In Florida in 2022, concurrent outbreaks of mpox, hepatitis A, and invasive meningococcal disease (IMD) were noted among men who have sex with men (MSM). A report on the outbreaks, published yesterday in Emerging Infectious Diseases, emphasizes the need to offer vaccination against these diseases among at-risk groups. The authors say, “We did not identify any instances of the same person being part of both the hepatitis A and IMD outbreaks. However, among mpox cases, 4 patients were also part of the hepatitis A outbreak, and 3 others were part of the IMD outbreak… Vaccination against hepatitis A, meningococcal disease, and mpox should be encouraged among MSM, consistent with national guidelines and, where feasible, offered with other program services to the same at-risk population." Read the study in Emerging Infectious Diseases.
The US Congress and Scientific Citations
Science (US) reports, “members of Congress and their staffers are consuming plenty of research, judging by the number of citations to technical papers found in committee documents over the past few decades, a study finds…. Overall, the study found the percentage of committee documents containing citations to scientific papers went up during the 26-year study period, with citations appearing about six times more often in 2020 than in 1995, rising from 5% to nearly 30%. But that trend masks a partisan divide: Committees under Democratic control were almost twice as likely to cite technical papers as panels led by Republicans. And Democrat- and Republican-led committees overwhelmingly cited different papers, with only about 5% of cited papers drawing a reference from both sides at least once during the study period…. The research team also found that committees controlled by Democrats were more likely to cite papers that were recent, had undergone peer review, and were widely cited among scientists—in other words, papers the scientific community considered important.” Read the preprint study on SocArXiv Papers.
COVID Misinformation Four Years On
Poynter (US) reports, “Four years later, people’s lives are largely free of the extreme public health measures that restricted them early in the pandemic. But COVID-19 misinformation persists, although it’s now centered mostly on vaccines and vaccine-related conspiracy theories….’From a misinformation researcher perspective, [there has been] shifting levels of trust,’ said Tara Kirk Sell, senior scholar at the Johns Hopkins Center for Health Security. ‘Early on in the pandemic, there was a lot of: “this isn’t real,” fake cures, and then later on, we see more vaccine-focused mis- and disinformation and a more partisan type of disinformation and misinformation.’”
COVID Grief Four Years On
Science News (US) reports, “There has been little official recognition in the United States of the profound grief people have experienced and continue to experience. There is no federal monument to honor the dead — mourners have constructed their own memorials. A resolution to commemorate the first Monday of March as ‘COVID-19 Victims Memorial Day’ awaits action by the US Congress.” In an interview demographer Emily Smith-Greenaway, who has studied the impacts of COVID deaths says, “Societies have demographic memory. There is a generational effect any time we have a mortality crisis. A war or any large-scale mortality event lingers in the population, in the lives and memories of those who survived it. This pandemic will stay with us for a very long time. [There are] young people who remember losing their grandma, but they couldn’t go see her in the hospital, or remember losing a parent in this sudden way because they brought COVID-19 home from school. So many lives were imprinted at such an early stage of life.”
New Mpox Vaccine Study in UK
PharmaTimes (UK) reports, “The National Institute for Health and Care Research (NIHR) has announced a new phase 1/2 trial, delivered by the NIHR Clinical Research Network and sponsored by Moderna, to test the effectiveness of an investigational mRNA vaccine for mpox. The mPower trial will evaluate the safety and immune response to mRNA-1769, which aims to protect against illness caused by the mpox virus.
Remembering a Polio Survivor
A New York Times (US) obituary of Paul Alexander who lived for 72 years mostly in an iron lung says “He was one of the last few people in the United States living inside an iron lung, which works by rhythmically changing air pressure in the chamber to force air in and out of the lungs. And in the final weeks of his life, he drew a following on TikTok by sharing what it had been like to live so long with the help of an antiquated machine.” |
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