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May 22, 2024 |
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| The pandemic agreement provides the foundation on which to build the world’s future collaborative approach to prevent the next pandemic threat. It is not a piece of paper. At its heart, it is a life-saving instrument that will set out how countries will engage with each other to protect their populations, strengthen public health and avoid unnecessary disruptions to societies and economies.” - Dr Tedros Adhanom Ghebreyesus in Al Jazeera |
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Without a doubt the question of the moment is: Will we have a pandemic treaty? And the follow-up question has to be: Will it do what we need it to do? As we wait for the answer to those questions several experts are weighing in on the media and conspiracy theorists, anti-vaxxers and far right politicians are spewing anti-treaty rhetoric all over the internet. In the midst of this, WHO’s Tedros writes in an opinion in Al Jazeera (Qatar) that as a response to the COVID pandemic and the inequities it spawned a group of world leaders called for unity. “They said the world must never again be left so vulnerable to another pandemic. They concurred that governments must never again fail to cooperate in sharing vital information, medical equipment and medicines. And they stressed that never again can the world’s poorest countries and communities be left at the end of the queue when it comes to access to life-saving tools like vaccines. Equity, we said then, and continue to say now, must be our guiding light…. The pandemic agreement provides the foundation on which to build the world’s future collaborative approach to prevent the next pandemic threat. It is not a piece of paper. At its heart, it is a life-saving instrument that will set out how countries will engage with each other to protect their populations, strengthen public health and avoid unnecessary disruptions to societies and economies.”
Health Policy Watch (Switzerland) reports that as the talks continue this week, “There are many outstanding articles and little prospect that the agreement will be completed in time for the World Health Assembly (WHA) next week, but participants hope that the broad outlines of the agreement and the way forward will have been reached by Friday.”
If You Are in a Hurry
- Read an AVAC blog post on what the lack of civil society engagement in the pandemic treaty negotiations may have cost the agreement.
- Read a comment in The Lancet that calls for a one health approach and transparent data sharing to build a global response to avian flu.
- Read an opinion piece in Health Policy Watch from vaccine experts on the importance of technology transfer in the pandemic treaty.
- Read Health Policy Watch on an alliance among African anti-rights groups and anti-vaxxers to attack WHO and the pandemic treaty.
- Read Clinical Trials Arena on good news from a COVID preventive antibody study.
- Read The Guardian on the role of biodiversity loss in disease outbreaks.
More on the Pandemic Treaty
AVAC’s Samantha Rick and colleagues from the Coalition of Advocates for Global Health and Pandemic Preparedness write in an AVAC blog post about the lack of engagement with civil society in the pandemic treaty negotiations. “We have seen throughout the 40 years of the HIV/AIDS response that meaningful engagement turns the tide when biomedical innovations fall short of their potential because of real-world challenges. Decision makers, government representatives, and multilateral institutional leaders must enshrine a baseline level of meaningful civil society engagement practices where and when international decisions are made. As lessons from the global HIV response show us, it is possible, if not probable, that many of the outstanding issues in the Pandemic Accord could have been solved with civil society input and influence, as knowledge-brokers who bring unique insights, find solution, and foster trust where it’s needed most.”
An opinion piece in Health Policy Watch (Switzerland) from “sixteen leading scientists and manufacturers involved in vaccine development and production worldwide” argues, “The overarching goal of ensuring that the world will deal more equitably with the next pandemic appears to be elusive as we near the deadline of May 2024 for the close of the negotiations…. Paradoxically, ensuring the spread of technical know-how and manufacturing capacity to lower-income countries, which is central to these outcomes, is a strong area of disagreement amongst WHO’s Member States about the Pandemic Agreement, although the WHO has been leading an effort over the past two years to do just this…. A global pandemic agreement that addresses the issue of technical know-how for manufacturing will ensure that the next time around, the global community is prepared ahead of time to accelerate this shift. Ultimately, when governments agree on principles like sharing and equity, it is ordinary people who benefit. At the same time, in the face of conflict and chaos, it is ordinary people who suffer.”
A Nature (UK) editorial says, “Millions of people died of COVID-19 because the fundamental principle of equity between nations was ignored during the outbreak. That must not be allowed to happen again…. The world needs this treaty, without delay: there’s been no let-up in public-health threats, and the next pandemic will not respect any human timetable. But the world also needs the right treaty. As in all complex negotiations, compromise — on all sides — will be necessary to get the final version over the finishing line. But all sides must also remember that there is little point to an agreement that doesn’t improve pandemic preparedness and response — or one that ignores or undermines the principle of equity between nations.”
Kerry Cullinan reports in Health Policy Watch (Switzerland) “Right-wing African Members of Parliament (MPs), including some of the continent’s most vociferous anti-abortion, anti-LGBTQ lawmakers, united with anti-vaxx conspiracy theorists for the first time at a conference in early May. Aside from the expected rhetoric against abortion and LGBTQ people, the African Inter-Parliamentary Conference on Family Values and Sovereignty gave a platform to a speaker who claimed that a range of vaccines were unnecessary or designed to reduce African fertility – including the COVID-19, Human Papillomavirus (HPV), malaria and even tetanus vaccines. Others agitated against the World Health Organization’s (WHO) pandemic agreement currently being negotiated, describing it as a ‘power grab’ aimed at imposing abortion, same-sex marriage and lockdowns on the world.”
Vaccine Skeptics and Measles Misinformation
KFF (US) reports in the US, “a growing number of parents are deciding not to get their children vaccinated against measles as well as diseases like polio and pertussis. Unvaccinated people, or those whose immunization status is unknown, account for 80% of the measles cases this year. Many parents have been influenced by a flood of misinformation spouted by politicians, podcast hosts, and influential figures on television and social media. These personalities repeat decades-old notions that erode confidence in the established science backing routine childhood vaccines.”
Good News from COVID Antibody Study
Clinical Trials Arena (UK) AstraZeneca has announced that the Phase III SUPERNOVA clinical trial of its sipavibart (formerly AZD3152) met the primary endpoints in preventing COVID-19 among immunocompromised individuals. A long-acting antibody, sipavibart was assessed in the trial as Covid-19 pre-exposure prophylaxis (prevention)…. SUPERNOVA is the only large Phase III trial to provide efficacy data in immunocompromised patients against recent variants…. The company is currently engaging with regulatory authorities to discuss potential authorisation or approval pathways for sipavibart based on these findings.”
Avian Flu Updates
ABC News (Australia) reports, “Australia has recorded its first ever human case of bird flu, after H5N1 avian influenza was detected in a child travelling home to Victoria [from India]. The Victorian Department of Health confirmed the child returning to the country became unwell in March and subsequently tested positive to the avian influenza, also known as bird flu…. The department reassured the community that the chances of additional human cases was ‘very low’.”
A comment in The Lancet (UK) from Noah Kojima and colleagues argue, “One Health strategies are foundational for the surveillance and control of avian influenza viruses. To help guide the One Health response, we highlight here core knowledge and areas needed for preparedness. Locally, all those responsible for animal and public health need to raise awareness of avian influenza viruses and the need to identify, report, and test potential suspected animal and human cases…. Transparent data sharing is crucial and all stake-holding institutions should ensure rapid dissemination of results for public health action through national or international public health institutions as occurred during the COVID-19 pandemic. Capacity for virological assessments, diagnostics, and vaccine preparedness should be prioritized.”
STAT (US) reports the US CDC, “asked local and state health officials Tuesday to maintain flu surveillance operations at peak-season levels over the summer in a bid to remain watchful for any signs of human-to-human spread of the H5N1 bird flu virus. Flu surveillance activity is generally conducted at low levels during the late spring and summer months, in recognition of the fact that as temperatures rise, transmission of seasonal flu viruses drops to minimal levels in the Northern Hemisphere…. The CDC and others are using detection of influenza A viruses in wastewater to try to look for places where the H5N1 virus might be spreading. H5N1 is an influenza A virus; so too are the H3N2 and H1N1 viruses that circulate during flu season. But because the latter two typically circulate at very low levels during the summer, it’s thought that detecting flu A in wastewater could signal presence of H5N1 in a community — whether that’s in wild birds, cows, milk disposed of by an affected farm, or people.”
STAT (US) reports, “Scientists from the University of Washington and the Fred Hutchinson Cancer Center have managed to generate a full genetic sequence of H5N1 virus from milk, a development they suggest means commercially purchased milk products could be used to monitor the progress of the bird flu outbreak in dairy cattle and to check for important changes in the virus over time.”
Science (US) looks at the opportunities and challenges for developing an H5N1 vaccine for cows, noting several companies have expressed interest, “But companies must weigh several factors before jumping in. Strict rules around research with H5N1 and other highly pathogenic type A avian influenza viruses slow down the development of vaccines. The market could vanish if the outbreak peters out or is brought under control by ramping up biosecurity efforts, such as improving hygiene in dairy parlors. Also unclear is whether USDA will even allow the use of vaccination, which might complicate exportation of dairy products.”
KFF's What the Health podcast (US) looks at the public health challenges of avian flu in cows, noting, “Stumbles in the early response to bird flu bear an uncomfortable resemblance to the early days of covid, including the troubles protecting workers who could be exposed to the disease. Notably, the Department of Agriculture benefited from millions in covid relief funds designed to strengthen disease surveillance.” Politico’s Alice Miranda Ollstein says, “it’s also like a scary repeat of some of the specifics of covid, which really hit agricultural workers really hard. And a lot of that wasn’t known at the time, but we know it now. And a lot of workers in these agricultural, meatpacking, and other sectors, were just really devastated and forced to keep working during the outbreak. This sector in particular has been resistant to public health enforcement and we’re just seeing that repeat once again with a potentially more deadly virus should it make the jump to humans.”
Risks from Endemic Tropical Diseases in Nigeria
Punch (Nigeria) reports, “Data from the World Health Organisation has estimated that 138.9 million Nigerians require interventions against Neglected Tropical Diseases…. The body also said NTDs are endemic in Nigeria as it ranks first in the African region and second globally after India.”
Biodiversity Loss and Infectious Disease
The Guardian (UK) reports, “Biodiversity loss is the biggest environmental driver of infectious disease outbreaks, making them more dangerous and widespread, a study has found. New infectious diseases are on the rise and they often originate in wildlife. In meta-analysis published in the journal Nature, researchers found that of all the ‘global change drivers’ that are destroying ecosystems, loss of species was the greatest in increasing the risk of outbreaks. Biodiversity loss was followed by climate change and introduction of non-native species.” Read the meta-analysis in Nature.
Will Climate Change Fuel Diseases?
FT (UK) reports on the grave public health threat of antibiotic-resistant “superbugs” which some fear will be made worse by climate change. Center for Global Development’s Anthony McDonnell is quoted: “There are currently no good estimates of how much worse climate-related disasters will make the burden of resistance — but it is clear that the risks are very large. This area requires far more research to enable us to determine the tools needed to deal with this worrying inevitably.”
A WHO statement says, its “Task Team on Climate Change, Neglected Tropical Diseases (NTDs) and Malaria, in partnership with Reaching the Last Mile (RLM), has released a major scoping review published in Transactions of the Royal Society of Tropical Medicine and Hygiene. The review of 42 693 articles reveals that there is not yet sufficient understanding of the actual and potential impacts of human-induced changes to climate patterns on malaria and NTDs. Rising temperatures and changing weather patterns are altering the spread of vector-borne diseases, with significant implications for human health and placing additional strain on systems. As the geographic range of disease vectors like mosquitoes expands, so does the risk of introducing – or reintroducing – these diseases to new, unprepared areas. The findings of this review highlight that these shifts in prevalence, incidence, range and intensity of malaria and a number of NTDs may be felt hardest in those communities already disproportionately impacted by them.” Read the scoping review in Transactions of the Royal Society of Tropical Medicine and Hygiene.
WHO Prequalifies Second Dengue Vaccine
News-Medical (UK) reports, “A new vaccine for dengue received prequalification from the World Health Organization (WHO) on 10 May 2024. TAK-003 is the second dengue vaccine to be prequalified by WHO. Developed by Takeda, it is a live-attenuated vaccine containing weakened versions of the four serotypes of the virus that cause dengue. WHO recommends the use of TAK-003 in children aged 6–16 years in settings with high dengue burden and transmission intensity. The vaccine should be administered in a 2-dose schedule with a 3-month interval between doses.”
COVID and Pregnancy
CIDRAP (US) reports, “Findings from a large study in California, which distinguished the COVID-19 pandemic period from individual SARS-CoV-2 infections, suggest that SARS-CoV-2 infection is tied to increased preterm birth (PTB), high blood pressure during pregnancy, and severe maternal morbidity…. ‘This study adds to understanding of the associations between COVID-19 and perinatal health in a large, diverse population by distinguishing the connections of SARS-CoV-2 infection from those of the COVID-19 pandemic period with PTB and birth parent conditions,’ the authors concluded.” Read the study in JAMA Network Open.
COVID Still More Deadly than Flu
MedPage Today reports, “Patients hospitalized with COVID-19 were more likely to die than those hospitalized with influenza during the fall and winter of 2023-2024, according to an analysis of Veterans Affairs data. Among over 11,000 patients hospitalized for either illness during this past fall and winter, 5.7% of patients with COVID-19 died within 30 days of admission versus 4.24% of patients with influenza, reported Ziyad Al-Aly, MD, of the VA St. Louis Health Care System, and colleagues. Read the study in JAMA.
Long COVID Research
MedPage Today (US) reports, “With 17 million adults reporting long COVID symptoms like brain fog and fatigue, the idea of viral persistence has gained traction…. in research published last month in Lancet Infectious Diseases, Peluso and colleagues studied plasma samples from 171 immunocompetent people who had COVID, using an ultrasensitive assay to measure the concentration of SARS-CoV-2 antigens… The researchers found that a quarter of COVID-infected people had SARS-CoV-2 antigens in their blood for up to 14 months after infection. The most common was spike. Read the study in The Lancet Infectious Diseases. |
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