Pandemic Watch: Updates on the Pandemic Accord process, the latest on the mpox epidemic in DRC and more ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌

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AVAC's weekly Pandemic Watch is a curated news digest on the latest pandemic prevention, preparedness and response (PPPR) news and resources.


“We in the global malaria community are at a critical juncture in our journey toward malaria eradication. Decades of experience in deploying our existing interventions have made it clear that there is no single ‘silver bullet.’ - Trevor Mundel in NEJM ([link removed])
Table of Contents
• If You Are in a Hurry (#If You Are in a Hurry)
• Last Minute Pandemic Accord Talks (#Last Minute Pandemic Accord Talks)
• Why Are There Still No Mpox Vaccines or Treatment in DRC? (#Why Are There Still No Mpox Vaccines or Treatment in DRC?)
• Concerns Continue about Bird Flu in Cows in the US (#Concerns Continue about Bird Flu in Cows in the US)
• Vaccines in the Pipeline to Watch (#Vaccines in the Pipeline to Watch)
• Crackdown on Chinese Scientist Who Published the COVID Genomic Sequence (#Crackdown on Chinese Scientist Who Published the COVID Genomic Sequence)
• COVID Boosters Help Prevent Long COVID (#COVID Boosters Help Prevent Long COVID)
• Fewer People Want COVID Boosters (#Fewer People Want COVID Boosters)
• mRNA Vaccine Patent Disputes (#mRNA Vaccine Patent Disputes)
Humankind has lived with malaria for centuries and we’ve known about the parasite that causes it since 1880. Yet, it’s only in recent years that science has made strides in the search for a vaccine and only very recently that malaria vaccines have been rolled out for children in a handful of African countries. Now, there is potential for another prevention option on the horizon. Science ([link removed]) (US) reports, “A single dose of an experimental antibody drug protects children from malaria for up to 6 months, according to a clinical study published today in The New England Journal of Medicine. The therapy, an injectable monoclonal antibody called L9LS that has already shown success in adults, reduced infections and clinical disease in 6- to 10-year-olds in Mali. Although the drug is still undergoing clinical testing, the results suggest monoclonal antibodies could be an important addition to the
arsenal against this deadly disease, researchers say…. the researchers are testing L9LS in two further studies: one in Kenya focusing on children between 5 months and 5 years old, and another in Mali among women of childbearing age, in preparation for trials among pregnant people.”

In a NEJM ([link removed]) (US) editorial the Gates Foundation’s Trevor Mundel writes, “We in the global malaria community are at a critical juncture in our journey toward malaria eradication. Decades of experience in deploying our existing interventions have made it clear that there is no single ‘silver bullet.’… Although our existing tools remain effective for now, we know that the threat of drug and insecticide resistance necessitates a robust research-and-development pipeline capable of delivering not only improved versions of existing product classes but also transformative tools that represent entirely new paradigms for the treatment and prevention of malaria… Trials that not only provide clinical insight but also show operational feasibility and the potential for cost-effective scale would provide a compelling argument for the acceleration of development and prequalification of this new class of product.”

Meanwhile three additional African countries are beginning to roll out Malaria vaccines, as Health Policy News ([link removed]) (Switzerland) reports, “Rollout of malaria vaccines are starting in Benin, Sierra Leone and Liberia, and the West African countries plan to deliver more than 800 000 doses of the RTS,S or R21 vaccines, according to WHO. The new vaccine will be added to their immunisation programmes for children, and are expected to protect over 200,000 children from the life-threatening disease. The RTS.S vaccine can be administered to children as young as five months old.

Read the NEJM study ([link removed]) and an NIH press release ([link removed]) on the antibody research.

If You Are in a Hurry

* Read Health Policy Watch ([link removed]) on the last minute pandemic accord talks happening this week. And check out a Pandemic Accord explainer ([link removed]) from The United Nations Foundation for more information.
* Read NPR’s Goats and Soda Blog ([link removed]) on the escalating mpox outbreak in the DRC and why there are still no vaccines in the country.
* Read MedPage Today ([link removed]) on concerns that the US government is doing enough to address the avian flu outbreak in cattle.
* Then read STAT ([link removed]) on what we know and don’t know about the outbreak and what WHO says should be happening.
* Read GHTC’s Breakthroughs Blog ([link removed]) on five vaccines watch in the vaccine pipeline.
* Read CIDRAP ([link removed]) for an overview and Nature Medicine ([link removed]) , for the details of a 23-country survey on desire for COVID boosters and other vaccine attitudes.


Last Minute Pandemic Accord Talks

Health Policy Watch ([link removed]) (Switzerland) reports, “The World Health Organization’s (WHO) pandemic agreement negotiations begin their final two-week stretch on Monday (28 April) amid a gamble with the process, a show of unity from African member states – and more suggestions for the draft text. This final intergovernmental negotiating body (INB) meeting will focus on finding ‘common ground and consensus’, according to a decision taken at the last fractious meeting…. After the previous session at which member states expressed frustration with one another and the INB Bureau, the INB co-chairs have taken a gamble with the process this time – and member states may not play along. The multitude of bracketed contested text has been purged from the new draft, and the co-chairs want the meeting to focus on saying ‘yes’, rather than being bogged down by disagreements…. But the draft wil
l be considered as the default text where there is no consensus, which the co-chairs described as a ‘take it or leave it’ approach.

AFP ([link removed]) (France) via VOA reports, “The goal of the talks, which last 12 hours a day and run until May 10, is to get an agreement ready for adoption at the WHO's annual assembly of member states, which starts May 27…. The main disputes revolve around access and equity: access to pathogens detected within countries; access to pandemic-fighting products such as vaccines produced from that knowledge; and equitable distribution of not only counterpandemic tests, treatments and vaccinations but the means to produce them. The new draft focuses on setting up the basic framework and pushes some of the trickier details into further talks running into 2026, notably on how the planned WHO Pathogen Access and Benefit-Sharing (PABS) System will work in practice.

Read a Pandemic Accord explainer ([link removed]) from The United Nations Foundation.

Why Are There Still No Mpox Vaccines or Treatment in DRC?

NPR’s Goats and Soda Blog ([link removed]) (US) reports that amid the largest ever documented mpox outbreak in the DRC, “with more than 4,500 cases so far this year.… There are no vaccines or treatments in the country right now, and even the testing capacity is severely limited. Instead, this new phase of the mpox fight involves simply getting a better understanding of what exactly is going on…. Vaccines have been used to combat mpox outbreaks in other places, including the US, Europe and Japan. So far, they have not been approved for use in most African nations…. One challenge is that there is very limited data on how the vaccines work in children – who represent the majority of mpox cases in the DRC – and also minimal data on its use in populations that deal with other health issues, like malnutrition. In March, the WHO's vaccine advisory committee recommended
the off-label use of the mpox vaccine in children but urged further study.”

Concerns Continue about Bird Flu in Cows in the US

MedPage Today ([link removed]) (US) reports, “With H5N1 avian influenza causing unprecedented outbreaks in mammals ([link removed]) around the world -- including US dairy cattle -- infectious disease experts are raising concerns that the US isn't doing enough to get ahead of any potential problems. James Lawler, MD, MPH, of the University of Nebraska Medical Center's Global Center for Health Security, is quoted: "We need to get out in front of this quickly, to make sure that.... We assess the true scope of this problem. The more opportunity we give this virus to circulate in more species of mammals, the more likely we will get mutations that adapt it more effectively to other mammals, including humans."

Reuters ([link removed]) (UK) reports, “There is a risk that the H5N1 bird flu virus, present in many wild birds, may infect cows in countries beyond the United States as they migrate, a World Health Organization official said on Tuesday…. ‘With the virus carried around the world by migratory birds, certainly there is a risk for cows in other countries to be getting infected,’ Wenqing Zhang, head of WHO's Global Influenza Programme, said at a news briefing in Geneva…. Zhang reiterated that the U.N. agency deems the overall public health risk posed by the virus to be low but urged vigilance, especially among farm workers. While the virus is not thought to be able to spread through milk, Zhang repeated long-standing WHO advice to only consume pasteurised milk.”

In a long article looking at what is known – and not known – about H5N1 in dairy cattle, STAT ([link removed]) (US) reports, “The World Health Organization appears to be concerned about the possibility of undetected human cases. Maria Van Kerkhove, acting head of the department of epidemic and pandemic preparedness, told STAT she’d like to see, among other things, studies looking for antibodies to H5N1 in the blood of farm workers and people who’ve been in contact with farm workers, to determine if there have been unreported cases and possibly even spread from those individuals to others. ‘For every human case of avian influenza since its emergence in 1996, 1997, there has always been … active case-finding, extensive testing, serologic surveys around humans. And we would certainly want to see that in any country, including in the US,’ said Van Kerkhove. ‘I’ve heard and read quite a bit about some potential additional cases
. We’ve heard maybe conjunctivitis or whatnot. But I think what’s really critical now is to understand the extent of infection in humans. The more we look, potentially the more we can find. And if we’re not looking, then we’re perhaps missing something that could be quite significant.’”

Nature ([link removed]) (UK) reports, “A strain of highly pathogenic avian influenza has been silently spreading in US cattle for months, according to preliminary analysis of genomic data. The outbreak is likely to have begun when the virus jumped from an infected bird into a cow, probably around late December or early January. This implies a protracted, undetected spread of the virus — suggesting that more cattle across the United States, and even in neighbouring regions, could have been infected with avian influenza than currently reported.”

Ottawa Citizen ([link removed]) (Canada) reports, “As H5N1 bird flu spreads rapidly through livestock and other animals across the US, Canadian officials are exploring stockpiling ‘pre-pandemic’ H5N1 vaccines as a precaution…. Unlike the United States, Canada does not have a stockpile of H5N1 vaccines on hand, according to the Public Health Agency of Canada (PHAC). But it does have agreements in place for quick access to pandemic influenza vaccines if needed, said Nicholas Janveau, spokesperson for PHAC.

MedPage Today ([link removed]) (US) reports, “infectious disease experts are paying close attention to whether current influenza antivirals would be effective should H5N1 adapt to humans. All influenza viruses have extremely similar internal mechanisms for reproduction, William Schaffner, MD, of Vanderbilt University Medical Center in Nashville, Tennessee, and a spokesperson for the Infectious Diseases Society of America (IDSA), told MedPage Today. So if an antiviral works against one strain, it will also work on other strains, he said.”

Vaccines in the Pipeline to Watch

GHTC’s Breakthroughs Blog ([link removed]) (US) reports, “The last few years have highlighted more than ever the incredible power of vaccines—from the millions of lives saved by the unprecedented rapid development of COVID-19 vaccines to the approvals and early-stage rollout of the first-ever vaccines for malaria and chikungunya. We are now fortunate to have vaccines to prevent more than 20 life-threatening diseases, and immunization currently prevents 3.5 to 5 million deaths every year. While it is vital that countries continue to strengthen routine immunization programs to reach the 20 million children who missed out on one or more of their vaccines in 2022, it is also important that countries sustain strong investments in research and development to deliver the next generation of breakthrough vaccines. The five vaccines include: TB, Zika, Lassa fever, Nipah and Enterotoxigenic Escherichia coli (ETEC).

Crackdown on Chinese Scientist Who Published the COVID Genomic Sequence

AP ([link removed]) (US) via MedPage Today reports, “he first scientist to publish a sequence of the COVID-19 virus in China staged a sit-in protest outside his lab after authorities locked him out of the facility -- a sign of Beijing's continuing pressure on scientists opens in a new tab or window conducting research on the coronavirus. Zhang Yongzhen, PhD, wrote in an online post Monday that he and his team had been suddenly notified they were being evicted from their lab, the latest in a series of setbacks, demotions, and ousters since the virologist published the sequence in January 2020 without state approval…. ‘I won't leave, I won't quit, I am pursuing science and the truth!’ he wrote in a post on Chinese social media platform Weibo that was later deleted.”

COVID Boosters Help Prevent Long COVID

CIDRAP ([link removed]) (US) reports, “A new cross-sectional study published in Vaccine of US adults demonstrates that people who received the COVID-19 booster vaccine had 25% lower odds of having long COVID than their unvaccinated counterparts. The study was based on 8,757 respondents to the 2022 National Health Interview Survey, with data from a weighted sample size of 87,509,670 Americans. Authors used self-reported COVID-19 booster vaccination status and self-reported long-COVID status (defined as having new or persistent symptoms 3 or more months after an initial COVID-19 infection) to calculate odds ratios (ORs) of developing long COVID.” Read the study ([link removed]) .

Fewer People Want COVID Boosters

CIDRAP ([link removed]) (US) reports, “A new survey of 23,000 adults in 23 countries taken in October 2023 finds a lower intent to get a COVID-19 booster vaccine (71.6%), compared with 2022 (87.9%). Moreover, 60.8% expressed being more willing to get vaccinated for diseases other than COVID-19 as a result of their experiences during the pandemic, while 23.1% reported being less willing. ‘This study reveals that a substantial proportion of individuals express resistance to vaccination and that concerns about COVID-19 vaccination appear to have spilled over to affect other vaccine-preventable disease,’ the authors write.”

Read the study in Nature Medicine ([link removed]) , the authors conclude, “This study reveals that a substantial proportion of individuals express resistance to vaccination and that concerns about COVID-19 vaccination appear to have spilled over to affect other vaccine-preventable diseases. This underscores the increasingly urgent necessity for sustained vaccine education and trust-building efforts. Moreover, although we found that people were generally confident that society will handle future health crises better, there remains a notable lack of trust and potential adherence to the recommendations of public health authorities. Health system preparedness for future outbreaks and global health threats should include improving vaccine accessibility and vaccine demand through effective, culturally and contextually relevant public communication strategies and innovative use of digital and social media in health education employing infodemic
countermeasures.”

mRNA Vaccine Patent Disputes

Reuters ([link removed]) (UK) reports, “GlaxoSmithKline sued Pfizer and BioNTech in Delaware federal court on Thursday, accusing them of infringing GSK patents related to messenger RNA (mRNA) technology in the companies' blockbuster COVID-19 vaccines. GSK said in the lawsuit, opens new tab that Pfizer and BioNTech's Comirnaty vaccines violate the company's patent rights in mRNA-vaccine innovations developed "more than a decade before" the outbreak of the COVID-19 pandemic…. The lawsuit adds to a web of high-stakes US court cases involving Pfizer, BioNTech and Moderna over patent royalties for technology used in their vaccines, including a case brought by Moderna against Pfizer in 2022.”
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