Pandemic Watch: We Still Don’t Have a Global Treaty for Pandemics, But IHR Amendments Could Pave the Way ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌

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[link removed] June 12, 2024
AVAC's weekly Pandemic Watch is a curated news digest on the latest pandemic prevention, preparedness and response (PPPR) news and resources.


When these changes [to the International Health Regulations] take effect, the world may be better placed than ever before to collectively avert the next pandemic." - Roojin Habibi The Conversation ([link removed]) on the IHR Amendments to the Global Treaty for Pandemics
Table of Contents
• If You Are in a Hurry (#If You Are in a Hurry)
• We Still Don’t Have a Global Treaty for Pandemics… (#We Still Don’t Have a Global Treaty for Pandemics…)
• …But IHR Amendments Could Pave the Way (#…But IHR Amendments Could Pave the Way)
• Dengue on the Rise (#Dengue on the Rise)
• Concerns Continue to Rise about Avian Flu (#Concerns Continue to Rise about Avian Flu)
• False Belief about MMR Vaccine Persists in US (#False Belief about MMR Vaccine Persists in US)
• New Long COVID Definition Proposed (#New Long COVID Definition Proposed)
• Paxlovid Long COVID Study Stopped Early for Non-efficacy (#Paxlovid Long COVID Study Stopped Early for Non-efficacy)
• Is COVID Linked to New, Rare Cancers? (#Is COVID Linked to New, Rare Cancers?)
• Combo COVID-Flu Vaccine Looks Good in Late-Stage Trial (#Combo COVID-Flu Vaccine Looks Good in Late-Stage Trial)

A safe and effective yellow fever vaccine has been in existence since 1937, yet the disease is still a threat in several countries, primarily in central Africa and Latin America. In Uganda, where the latest outbreak was earlier this year, the government has instituted a vaccination campaign with the hope of protecting millions of people. As Africa News ([link removed]) (France) reports, vaccine hesitancy is slowing uptake of the vaccine. “Together the mass vaccination programmes from 2023 and 2024 were supposed to deliver enough jabs to protect 27 million people. But to date, only 12 million people have been immunised and vaccine hesitancy is stalling the government's aim of eradicating the mosquito-borne virus from the country…. Doctor Michael Baganizi is the programme manager for the Uganda National Expanded Program on Immunization…. [Believes] the reticence of people to get the vaccine is
due to the fact that the disease is not as well-known as others like malaria…. James Odite [a nurse at a vaccine center] says the facility still has hundreds of unspent doses of the yellow fever vaccine. Odite says most of the people who came for the vaccination were people who wanted to travel to another country where the vaccine is a legal requirement for entry.”

If You Are in a Hurry

* Read The Conversation ([link removed]) on how amendment to the International Health Regulations could pave the way for a pandemic treaty.
* Read Latin American Post ([link removed]) on the alarming spread of dengue in Mexico and Brazil.
* Read KFF Health News ([link removed]) on what’s needed to respond to avian flu in the US.
* Then read an editorial from The Lancet ([link removed](24)01184-X/fulltext) calling for urgent action to respond to avian flu.
* Read MedPage Today ([link removed]) on a proposed new definition of long COVID.
* Read about a new survey from the Annenberg Public Policy Center ([link removed]) on misconceptions about the MMR vaccine in the US.


We Still Don’t Have a Global Treaty for Pandemics…

Devex ([link removed]) (US) reports countries at the World Health Assembly, “agreed to continue negotiations on the pandemic agreement for another year, and in what many deemed a historic move, adopted a package of amendments to the International Health Regulations — a legally binding instrument that defines the rights and obligations of countries during public health emergencies.”

Eurasia Review ([link removed]) (US) reports, “Attempts to agree a treaty to manage future pandemics risk losing momentum, health leaders gathered at the World Health Assembly warned, as fears grow over outbreaks of bird flu in the US and mpox in the Democratic Republic of the Congo…. Negotiations will continue, buoyed by the last-minute success in Geneva of a less-noticed, parallel effort to update the International Health Regulations (IHR), a set of rules aimed at preventing the spread of disease across borders. However, disease experts at the meeting expressed concern that with pandemic threats looming, both agreements may be too little, too late. Neither will come into force until 2027 at the earliest.

…But IHR Amendments Could Pave the Way

Roojin Habibi, Assistant Professor of Law at University of Ottawa writes in The Conversation ([link removed]) (Australia), “When these changes [to the International Health Regulations] take effect, the world may be better placed than ever before to collectively avert the next pandemic…. To begin with, the new regulations enhance transparency and the timeliness of information about important public health events. They also provide for a new “pandemic emergency” alert, aiming to prepare countries for an imminent threat before it’s too late to contain. Crucially, they also oblige countries to collaborate so that medicines, diagnostics and vaccines have a better chance of reaching people who need them the most, wherever they may be.”

Dengue on the Rise

AFP ([link removed]) (France) reports, “Cases of dengue and other mosquito-borne diseases are rising significantly in Europe as climate change creates warmer conditions that help invasive mosquitos spread, the EU's health agency warned…. ‘Europe is already seeing how climate change is creating more favourable conditions for invasive mosquitos to spread into previously unaffected areas and infect more people with diseases such as dengue,’ ECDC director Andrea Ammon said.”

Latin American Post ([link removed]) (Colombia) reports, “Dengue fever, a mosquito-borne viral infection, is wreaking havoc across the Americas. An alarming prediction is that it will affect almost all of Brazil and Mexico by 2039. According to a comprehensive study published in Nature Communications, this rapid spread poses significant challenges for the two largest countries in Latin America…. The study attributes the accelerated spread of dengue to climate change and increased human mobility. Rising temperatures, higher humidity levels, and increased rainfall create ideal breeding conditions for the Aedes aegypti mosquito, the primary vector for dengue. The global climate crisis exacerbates these environmental conditions, making previously unaffected areas vulnerable to outbreaks. Read the study in Nature Communications ([link removed]) .

The Star ([link removed]) (Malaysia) reports, “A 235.6% increase was recorded in the number of dengue cases between Dec 31 and June 10, from 2022 to 2024 [in Malaysia]. According to statistics from the Health Ministry, 67,775 dengue cases were recorded during this period in 2024.”

Concerns Continue to Rise about Avian Flu

While experts stress the risk of a major outbreak of avian flu among humans remains low, there is rising concern as more cases in animals and humans are documented.

Reuters ([link removed]) (UK) reports, “The bird flu virus strain that infected a Texas dairy farm worker in March was lethal to ferrets in experiments designed to mimic the disease in humans, the US Centers for Disease Control and Prevention (CDC) reported on Friday. Seasonal flu, by contrast, makes ferrets sick but does not kill them, the CDC said…. The US, Mexico and Australia have reported a total of five human cases of different versions of H5 bird flu since March. The three US cases were mild, with two dairy workers - one infected in Texas - experiencing just conjunctivitis, or pink eye, while a third case involved some respiratory symptoms. The man in Mexico, who had other chronic conditions, died from multiple factors, the WHO said on Friday.”

KFF Health News ([link removed]) (US) via MedPage Today reports, “If the government doesn't prepare to ramp up H5N1 bird flu testing… [some] researchers warn, the US could be caught off guard again by a pandemic…. Scientifically speaking, many diagnostic laboratories could detect the virus. However, red tape, billing issues, and minimal investment are barriers to quickly ramping up widespread availability of testing. At the moment, the FDA has authorized only the CDC's bird flu test, which is used only for people who work closely with livestock. State and federal authorities have detected bird flu in dairy cattle in 12 states. Three people who work on separate dairy farms tested positive, and it is presumed they caught the virus from cows. Yet researchers agree that number is an undercount given the CDC has tested only about 40 people for the disease.”

The New York Times ([link removed]) (US), “Elephant seals in South America died in massive numbers because the bird flu virus acquired mutations that allowed it to spread among mammals, according to a new study. The research offers the first genetic and epidemiological evidence of bird flu virus transmission among mammals. And the findings hold a warning: The virus, called H5N1, may similarly transform to cause large-scale infections in other mammalian species, including people…. Bird flu virus taken from the sea animals contained 18 mutations that enabled it to infect and spread among mammals more easily, and enhanced the severity of the disease, the researchers found. ‘The sheer number of mutations’ is cause for concern, said Dr. Malik Peiris, a virologist and bird flu expert at the University of Hong Kong, who was not involved in the work.” Read the study ([link removed]) which
has not been peer reviewed.

An editorial in The Lancet ([link removed](24)01184-X/fulltext) argues, “Action to curb this outbreak is needed urgently, including improving testing, surveillance, and reporting of infected animals and food products; vaccinating animal populations; transparent information sharing; developing and stockpiling human vaccine; and promoting protective measures among farm workers. All countries should build capacities to test, detect, and report infections, cases, and deaths above expected levels and share this information. Countries in need of external assistance to bolster their capacity should receive support…. Spillover of zoonoses into human populations stems ultimately from our ways of life and how they shape the human–animal interface. Our diets, our intensive farming practices, our livelihoods, our behaviours, and our cultures. Our exploitation of the natural world and our destruction of the environment. These issues are tractable through
interdisciplinary education, intersectoral collaboration, adequate funding, and integrated policies. The concept of One Health, although often acknowledged, is rarely prioritised and operationalised. The result is a missed opportunity to not just respond to pandemic threats, but to prevent them altogether.”

Reuters ([link removed]) (UK) reports, “The US government is nearing an agreement to fund a late-stage trial of Moderna's mRNA bird flu vaccine, the Financial Times reported on Thursday, as the outbreak spreads in dairy cows. Moderna told Reuters it was in discussions with the government on advancing its vaccine candidate, but did not confirm the funding, saying it has nothing further to add. Federal funding from the Biomedical Advanced Research and Development Authority (BARDA) could come as soon as next month and would include a promise to procure doses if late-stage trials are successful, the FT report said, citing people close to the discussions…. Moderna is testing the experimental shot, mRNA-1018, against several strains of the virus - including the currently circulating H5N1 variant. It said dosing in an early-to-mid stage study of the vaccine was completed, and it
expects data soon.”

False Belief about MMR Vaccine Persists in US

A new survey from the Annenberg Public Policy Center ([link removed]) found, “a quarter of US adults do not know that claims that the MMR vaccine causes autism are false.” Annenberg’s Kathleen Hall Jamieson is quoted: “The persistent false belief that the MMR vaccine causes autism continues to be problematic, especially in light of the recent increase in measles cases. Our studies on vaccination consistently show that the belief that the MMR vaccine causes autism is associated not simply with reluctance to take the measles vaccine but with vaccine hesitancy in general.” Read the survey findings ([link removed]) .


New Long COVID Definition Proposed

MedPage Today ([link removed]) reports, “A new report from the National Academies of Sciences, Engineering, and Medicine (NASEM) offers a new definition of long COVID in an effort to streamline the diagnosis and treatment of the condition, which has serious medical, social, and economic consequences for patients, according to the authoring committee. Long COVID should now be defined as an infection-related chronic condition that occurs after COVID-19 and remains present for at least 3 months ‘as a continuous, relapsing and remitting, or progressive disease state that affects one or more organ systems,’ the committee wrote. The definition does not require laboratory confirmation or other proof of initial infection.” Read the report. ([link removed])

Paxlovid Long COVID Study Stopped Early for Non-efficacy

MedPage Today ([link removed]) (US) reports, A 15-day course of the antiviral nirmatrelvir-ritonavir (Paxlovid) didn't improve symptoms of long COVID, according to a randomized controlled trial that was stopped early for lack of efficacy. The STOP-PASC trial showed no difference in improvement on a combined outcome of fatigue, brain fog, shortness of breath, body aches, and gastrointestinal and cardiovascular symptoms for nirmatrelvir-ritonavir compared with placebo-ritonavir over 10 weeks, Upinder Singh, MD, of Stanford University, and colleagues reported.…” Read the study in JAMA Internal Medicine ([link removed]) .

Is COVID Linked to New, Rare Cancers?

The Washington Post ([link removed]) (US) reports, “The uptick in aggressive, late-stage cancers since the dawn of the pandemic is confirmed by some early national data and a number of large cancer institutions. Many experts have mostly dismissed the trend as an expected consequence of disruptions to health care that began in 2020. But not everyone…. It will probably be many years before the world has conclusive answers about whether the coronavirus is complicit in the surge of cancer cases, but Patel and other concerned scientists are calling on the US government to make this question a priority knowing it could affect treatment and management of millions of cancer patients for decades to come.”

Combo COVID-Flu Vaccine Looks Good in Late-Stage Trial

CNN ([link removed]) (US) reports, “vaccine maker Moderna announced positive late-stage trial results for its COVID-flu combination vaccine it calls mRNA-1083. Calling the outcome of the late-stage trial ‘breakthrough results,’ Moderna’s Chief Medical Affairs Officer Francesca Ceddia told CNN that people in the trial who got mRNA-1083 showed an improved immune response compared with those who got the standalone flu and COVID vaccines that are available now. The results were true even for people in the trial who were 65 years and older. Generally, older people don’t mount as robust a response to vaccines as younger people do.”
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