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Dear Colleagues,
As promised a few weeks ago, we warmly invite you to provide your feedback on the weekly IHP newsletter (/knowledge management tool) by filling out a survey. Let’s face it, it’s been a while (five years) 😊. As our flyer puts it, in spite of our wicked and infodemic times, IHP still aims to be a “one week stop” on global health policies, global health governance and health policy & systems research in the SDG & planetary health era, times of multiple interconnected crises and Decolonizing Global Health. “ We hope you appreciate the service, and consider it complementary to the work of our colleagues at Global Health Now, Devex, Health Policy Watch, Geneva Health Files, the People’s Health Dispatch and many others. Among others, we ‘d like your feedback on the recent ‘refocusing’ of the Highlights section. And don’t worry, it should take maximum 15 minutes of your time! Thanks in advance for taking the effort. You can even win a (book) prize! (For the survey: see here.)
Over then to this week’s global health policy news, broadly interpreted.
Now that we have entered the “catastrophocene” , the COP27 organizers seem to have decided they might as well speed up the new era a bit further still by having Coca-Cola, once again, as a “supporting sponsor”. I suggest Coca-Cola uses as its slogan in Egypt: “We’re so Coked”. As for the World Cup football coming up later this year in Qatar, it appears FIFA and AB InBev are ‘jointly’ working behind the scenes towards “more alcohol”. If I recall well, FIFA is an official partner of WHO, under the motto ‘teaming up for Health’. So how about ‘BOO!!!… ZZZED’ as a catchy World Cup slogan for AB InBev?
In other news, while the world is increasingly being washed away, the WISH conference took place in Doha, and there was also quite some action in Geneva ( @WTO (TRIPS Council & other meetings); @WHO (pandemic treaty consultations re ‘equity’ )), in Yerevan, Armenia (with the launch of the Emergency Medical Teams 2030 Strategy) as well as online (eg: the European Investment Bank-WHO ‘Investing in Health for All’ meeting). As ‘Health for All’ sounds slightly naïve in the year 2022, adding the word ‘Investing’ probably gives it a bit more “street cred” in the corridors of power. The “investments” sounded, as always, rather limited, though, not exactly like the ‘Global Public Investment’ we urgently need.
On a more positive note, in global dementia news, I’m overjoyed “WHO Set 2030 as Deadline to Find (a) Cure for Alzheimer’s Disease” (great timing as far as I’m concerned 😊 ).
Enjoy your reading.
Kristof Decoster
https://news.un.org/en/story/2022/10/1129272
“Amid mounting health emergencies globally – such as the COVID-19 pandemic, climate-related crises, and the war in Ukraine – the World Health Organization (WHO) on Wednesday announced an initiative to strengthen rapid response. The Emergency Medical Teams (EMT) 2030 Strategy was launched at a meeting in Yerevan, Armenia, bringing together health workers, technical experts and international partners from 110 countries. ….”
“…. The new strategy is the blueprint to continue to development of a network of effective and high-performing national, subnational and regional EMTs, in line with the agency's classifications and standards. “As we build a new and stronger architecture for health emergency preparedness and response, a rapidly deployable global health emergency corps will be vital, building on the experience and capacities of Emergency Medical Teams,” said the WHO Director-General, Tedros Adhanom Ghebreyesus, in his opening statement. “The EMT 2030 strategy envisions a world in which every country has the ability to respond rapidly and effectively to national emergencies, leveraging regional and sub-regional capacities to support vulnerable communities and others in need.” ….”
https://healthpolicy-watch.news/entrenching-equity-in-future-pandemic-treaty/
Coverage of the INB informal consultation on Wednesday.
“While there is unanimous agreement that equity is the essential ingredient in any future pandemic treaty ‘recipe’, World Health Organization (WHO) member states are unclear about how can it be incorporated practically. This emerged from an informal consultation on how to “operationalise and achieve” equity convened on Wednesday by the WHO intergovernmental negotiation body (INB), which has been charged with shaping the treaty or instrument to pandemic-proof the world…..”
“It is the second of four informal consultations planned before the INB reconvenes in December to negotiate a draft agreement to be presented to member states. The first focused on legal issues, while the third – taking place on Friday – will consider the thorny question of intellectual property. The fourth, on 14 October, will consider “One Health”….”
Quote: “Dr Ayoade Alakija, co-chair of the African Vaccine Delivery Alliance, said that the number one equity measure in a “binding treaty” should be to ensure manufacturing capacity across all regions….. ”
Also with the views of Mohga Kamal-Yanni, senior health advisor for the People Vaccine Alliance, and Yuanqiong Hu, senior legal and policy advisor for Medicins sans Frontieres (MSF) Access Campaign, among others.
Just by way of example, that apparently, the usual cycle of panic and neglect’ seems to have started once again …. Till the next pandemic?
“Rick Bright explains why he’s leaving the Rockfeller Foundation after its surprise move.”
“When public health specialist Rick Bright launched the Pandemic Prevention Institute (PPI) under the aegis of the Rockefeller Foundation last year, he recognized that several other efforts—some old, some new—had similarly ambitious visions for how to make the world safer from pathogens. “No one can do it all,” Bright told Science in October 2021, when the institute was 7 months old. “We have to now come together to decide how we divide and conquer this ecosystem.” …. …. But as Bloomberg revealed on 26 September, Rockefeller now has unexpectedly decided to break apart PPI, to which it had pledged $150 million over 3 years. In particular, it will fold some of PPI’s work into the foundation’s increasing efforts on climate change, which many scientists argue will increase outbreaks of novel threats by altering the movements of pathogen-carrying animals and increasing their interactions with humans. And as a result of this strategic shift, Bright is leaving Rockefeller……”
News from the GPMB Board meeting last week. “The Global Preparedness Monitoring Board (GPMB) has …. announced the appointment of a new Board membership, with Joy Phumaphi to serve as co-Chair, and Sir Jeremy Farrar to serve alongside her on an interim basis. ….. ….. The GPMB is co-convened by the World Health Organization and World Bank Group and is charged with providing a comprehensive appraisal of global preparedness for health emergencies…..”
“… The COVID-19 pandemic has revealed gaps in how the world understands and monitors preparedness, with human elements such as leadership and trust and the performance of multiple sectors found to be crucial to response, and therefore to the evaluation of overall preparedness. With this perspective in mind, in renewing its Board, the GPMB has sought a membership that can bring a widened perspective. The Board’s co-Conveners, WHO and the World Bank Group, identified former policymakers, diplomats, and other leading professionals with expertise including human rights, economics, law, veterinary epidemiology, environment, gender, global health, and development. Members were selected based on their leadership, reputation, and independence, with a view to ensuring diversity and balance in gender, geography, and sectoral experience…..” Do check out the names.Among others, Tedros said that the Global Preparedness Monitoring Board’s role as an independent watchdog will be essential for the new global architecture.
A Glassman et al; https://www.cgdev.org/blog/critical-moment-new-fund-pandemic-preparedness
Neat analysis of the current state of affairs re the FIF. A few chunks:
“On June 30, nearly one year after the HLIP delivered its report to the G20 in Venice, the Board of the World Bank Group voted to approve the establishment of a new Financial Intermediary Fund (FIF) for Pandemic Preparedness and Response. Now, decisionmakers are bogged down in the details and debates over administrative matters, with less effort given to how preparedness can be measurably improved in the countries that are most vulnerable to pandemic risk. This time next year, what will the new fund have accomplished?....”
“…. The Sums committed are woefully inadequate…. … Keeping our eyes on the ball: making the money work to support government preparedness: On September 8 and 9, the Governing Board of the new pandemic fund convened for their first meeting. Amidst the administrative discussions on governing board members, civil society representation, and institutional politics, however, we need to focus on what the fund must do: provide better, additional, on-budget funding to governments and partners to make measurable progress on pandemic preparedness in low- and middle-income countries. To get this done, the pandemic FIF must be different…..” They offer three suggestions in this respect.
And they conclude: ““While the new fund is a good start, amounts committed are far from adequate and administrative arrangements are distracting from the main purpose of the fund. As some declare COVID-19 over and competing short-term needs beckon, preparedness is again falling off the agenda, back into the cycle of panic and neglect.”
https://genevahealthfiles.substack.com/p/the-fragmentation-in-emergencies?utm_source=email
Last week Friday’s analysis on the World Bank’s Financial Intermediary Fund. …. This analysis looks at the state of play in the creation of the Fund and what this could mean for preparedness, prevention and response to health emergencies in the future.
A few quotes & chunks:
“We are keen on reporting on the financialization of global health, and now, the financialization of health emergencies….”
“….As early as November 2022, the FIF will solicit proposals for investments….”….. Further, the Governing Board will appoint a Technical Advisory Panel, chaired by WHO. The panel composed of experts will assess proposals for funding, based on technical merit and make recommendations to the Governing Board. A statement from the Fund also said that this would ensure “linkages to the International Health Regulations, as part of the broader global PPR architecture.”….”
Priti Patnaik’s analysis also had sections on the need for reliable funding for PPR (the context), The Governance question at the FIF, on implementing entities, ….
And one last quote from her analysis: “…. More than two years into the pandemic of COVID-19, the FIF is one of the early proposals to fund pandemic prevention preparedness and response that has already been established. And yet, expectations are already very low on what it can accomplish including for reasons such as lack of originality in tackling the multi-faceted matter of financing to prepare and respond to health emergencies. ….. ….. Calling for a paradigmatic shift in financing, some experts have proposed ‘global public investment’ - a concept in international public finance - “whereby all countries contribute, benefit, and make decisions on equal terms. Within a GPI framework, all countries contribute according to a proportional formula and are empowered as decision makers through well designed constituencies that are based on key criteria such as income level. Well designed constituencies can help break decision-making blocs that only advance certain political or regional interests...”
https://www.who.int/publications/m/item/barbados--introduction-of-a-pandemic-debt-suspension-clause
“The WHO Council on the Economics of Health for All congratulates the Government of Barbados on the closing of its sovereign debt conversion focused on marine conservation, which includes the world’s first “pandemic clause” to be used in a primary market issuance…..”
“…. the “pandemic clause” also offers a novel approach to enabling countries to have the fiscal space required to cope if another major global health disaster arises. The clause does this by including conditional provisions for the temporary deferral of interest payments on debt in the event of a new pandemic that meets certain predefined criteria. The expectation is that these funds will then be transparently deployed to strengthen national pandemic response efforts…..”
“Global vaccine purchasing mechanisms including Gavi and the United Nations have been urged to purchase a minimum of 30% of their vaccines from African manufacturers, according to a resolution, Call to Action: Africa’s new public health order adopted by African member states on the sidelines of the recent United Nations general assembly (UNGA). The resolution, championed by the African Union Commission and Africa Centres for Disease Control and Prevention (Africa CDC), argues that vaccine-purchasing mechanisms can stimulate private sector investment in vaccine manufacturing…..”
“…. The full implementation of Africa’s New Public Health Order will drive global health security, according to Africa CDC which presented the call to governments, multilateral organizations, philanthropies, the private sector, and civil society organizations on the sidelines of the 77th UNGA….”
Update on the mRNA hub in South-Africa. Some chunks:
“….. “The hub’s future is not without obstacles and potential pitfalls, however. For it to succeed, it will need to persuade governments to buy doses from local manufacturers, even if they are initially more expensive. Its freedom to operate is also under threat. Moderna has filed several patents in South Africa and has refused to cooperate and share technology with the hub in Africa, likening the replica vaccine to a “copy of a Louis Vuitton handbag”. In addition, Moderna is suing fellow mRNA vaccine manufacturers Pfizer and BioNTech, which has raised fears that it could enforce patents against the hub regarding any future vaccines it may develop for illnesses other than Covid…..”
“… Gore believes Moderna will stand by its pledge and denies that patents will become a problem. “We’re not going to infringe the patents,” he says. “Clearly, we’re not wanting to enter into disputes with the pharmaceutical industry.” He hopes that if there is a patent blocking possible progress, the hub will be granted a licence. However, Fatima Hassan, a South African human rights lawyer and founder of the Health Justice Initiative, is sceptical. She says that that there is no guarantee Moderna will not take legal action if and when there are possible future breakthroughs or advances, such as any new mRNA vaccines developed at the hub. “What is plan B?” she asks. “You are all naive to assume that [Moderna] is going to come to the table and things are going to be fine. If Moderna can sue Pfizer, they will have no hesitation to sue the hub.” She is critical of the hub being pushed as a solution to vaccine inequity and a model of empowerment for low and middle-income countries, when much of the decision-making around it is being done by organisations including WHO and MPP, both based in Geneva.”
“The hub has already come under attack from another arm of big pharma. The kENUP Foundation is a Malta-based consultancy hired by BioNTech, the company that produces the Pfizer Covid vaccine. In a document sent to South African government officials, the foundation said the hub’s activity should be stopped……”
https://healthpolicy-watch.news/whos-mrna-hub-animal-trial-on-vaccine/
“The mRNA Vaccine Technology Transfer Hub in South Africa will start animal studies on its first vaccine candidate, a COVID-19 vaccine, in October. If all goes according to plan, human clinical trials will begin towards the end of 2023. ….”
PS: “….. The WHO also announced that it has ranked South Africa’s vaccine regulatory system at the ML-3 level in its global classification system for medical products regulatory authorities. This is the second highest level in this system, and means that the country has “a stable, well-functioning and integrated regulatory system” that ensures the quality, safety and efficacy of vaccines produced, imported or distributed in the country. “This is an important new step, not only for South Africa, but for the region towards self-sufficiency in vaccines and medicines,” WHO Regional Director for Africa Dr Matshidiso Moeti said in a press release. ….”
See WHO - South Africa’s vaccine regulator reaches new WHO level to ensure safety, quality and effectiveness
https://www.theguardian.com/us-news/2022/oct/05/us-covid-recovery-global-vaccine-testing-wto
Advocacy ahead of a WTO Council meeting on IP (on Thursday). “Congressional group writes letter urging Biden to extend WTO agreement aimed at easing generic vaccine exports.”
“US recovery from the Covid pandemic is in “jeopardy” unless the Biden administration supports making treatment and testing for the disease more readily available to low-income countries, a powerful congressional group has warned Joe Biden. In a letter to Joe Biden led by congressman Earl Blumenauer, chairman of the subcommittee on trade, the group urged the president to extend a June World Trade Organisation (WTO) agreement aimed at easing exports of generic vaccines to treatments and therapeutics. The letter comes ahead of what is expected to be a contentious meeting of the WTO council for trade-related aspects of intellectual property rights that starts on Thursday, where the proposals will be discussed. …. As more contagious variants of the disease emerge it is “critically important” that the US backs the agreement to ease access to therapeutics and treatments for poorer nations, the group writes. The proposals are being championed by South Africa and India but face stiff opposition from the pharmaceutical industry and Switzerland and the UK…..”
https://healthpolicy-watch.news/a-push-for-public-goods-to-fight-pandemics/
From late last week. “At a World Trade Organization Public Forum this week, public health advocates argued for the creation of a new WTO framework to stimulate voluntary offers by countries to supply more ‘public goods’ to trading partners and the world, including investments, assets and know-how critical to protecting the world against future pandemics and other health or environmental crises. “ “A panel discussion at the World Trade Organization’s Public Forum on Friday took up the topic of a novel trade-based initiative that they say could help incentivize countries to share new technologies, assets and know-how more readily – not only for meeting health emergencies, but other types of health and environmental challenges. The idea, says James Love, director of Knowledge Ecology International (KEI), is to create a new framework for recognizing ‘public goods’ within the WTO trade rules, whereby governments can make voluntary, but binding, offers to supply such goods to other WTO trading partners – including, but not limited to public health products, investments and know-how. The initiative on public goods is modeled after the General Agreement on Trade in Services (GATS), a landmark deal from the Uruguay Round negotiations in 1995…..” “…. a GATS-like framework for ‘public goods’ could allow, for instance, rich countries to pledge to share money or know-how on vaccines or medicines – in exchange for a developing countries’ pledge to reduce tariffs on electric car imports or even to conserve a biodiverse ecosystem of global significance – as part of the wheeling and dealing that anyways takes place around more conventional trade agreements. ….. PS: “…. The question of how and if medicines, vaccines and other public health products could be redefined as ”public goods” also lies at the heart of World Health Organization talks on a proposed new pandemic accord, which began with broad agreement over the summer that a new legal instrument should complement but not repeat provisions of the existing WHO International Health Regulations, while respecting national sovereignty in terms of public health responses. …. “https://www.ft.com/content/a481c129-c5aa-4972-84a8-3a45bb000098
“Pharma company still ‘eager’ to collaborate with Beijing, despite collapse of initial talks.”
“Moderna has refused to hand over to China the core intellectual property behind the development of its breakthrough Covid-19 vaccine, leading to a collapse in negotiations on its sale there, according to multiple people familiar with the matter. The Massachusetts-based pharmaceutical company turned down Beijing’s request to hand over the recipe for its messenger RNA vaccine because of commercial and safety concerns, said two people involved in negotiations that took place between 2020 and 2021. The vaccine maker says it is still “eager” to sell the product to China. …. To date, Beijing has offered two routes for foreign Covid-19 vaccine makers to distribute in China, dependent on regulatory approval: carrying out a full technology transfer to a domestic drugmaker or establishing a manufacturing facility in China with a local partner, while keeping control of the underlying technology. Moderna was pressed to take the former option. …. The Moderna leadership did not want to hand over the vaccine recipe to a Chinese partner because of the reputational damage if the local partner botched the manufacturing, said two people with knowledge of the matter.”
“…. Industry insiders observed that the company’s willingness to reopen talks with China, the last remaining major economy without an mRNA jab, has been driven by sluggish demand for vaccines in the wealthier countries where it first targeted sales……”
“As diabetes rises rapidly worldwide, causing 6.7 million deaths per year, access to insulin is an increasingly urgent global health priority. While a new report by the Access to Medicine Foundation identifies ways in which pharmaceutical companies are now seeking sustainable approaches to scaling up access, industry efforts currently fall short in addressing the extent of the insulin inequity problem. The three companies that dominate the global insulin market – Eli Lilly, Novo Nordisk and Sanofi – are pursuing a patchwork of strategies to expand access to their products in low- and middle-income countries (LMICs). The report also examines initiatives from biosimilar manufacturer Biocon, shedding light on the potential role of biosimilar insulins in improving affordability and widening access. Increasing access to analogue insulins, not just human insulins, should be a priority – so that people in LMICs have the same product choices that have been widely available to those in high-income countries for decades.;…”
By Julian Cribb; https://johnmenadue.com/here-comes-the-catastrophocene/
See also this week’s intro. “The good news is that the Anthropocene is almost over. It will have been the shortest geological epoch in all of Earth history. The bad news is that the Catastrophocene is just beginning…..”
“…. This is a period marked by the interaction of ten catastrophic risks which many scientists are now warning could precipitate the end of human civilisation – and potentially bring about the departure of our species from an uninhabitable Earth…..”
“….. It is the interaction of these ten mega-threats which now constitutes the new age – The Catastrophocene…..”
To compensate for the previous read, here’s a more uplifting one.
“Renewables, decarbonisation, activism, cooperation … The challenge is immense, but the situation is far from hopeless.”
https://www.reuters.com/world/africa/african-countries-push-common-energy-position-cop27-2022-10-04/
“African countries will use the COP27 climate talks in Egypt next month to advocate for a common energy position that recognises fossil fuels are necessary in the short term to expand economies and electricity access, the continent’s top energy official said on Tuesday. The African position, criticised by environmental groups, could overshadow global climate talks in Sharm El-Sheikh seeking to build on the previous Glasgow summit and make good on financing targets by rich nations to poorer countries that have fallen far short of the promised $100 billion a year by 2020…..”
Related: Reuters - African countries to push for more fossil fuel projects at COP27
“A group of the most-vulnerable nations to global warming plan to step up demands for compensation at the international climate summit scheduled for November. The Climate Vulnerable Forum, which represents 55 countries including island-nations threatened by rising sea levels such as the Maldives and poor African states struggling with droughts and floods, made compensation for damage from events tied to global warming their key demand. The funding should come from wealthy nations that have historically contributed the most to global warming through greenhouse gas emissions, it said. ….. …. “We call for the establishment of a dedicated international funding commitment and mechanisms to address climate change loss and damage by responsible - wealthy, capable and highly polluting - nations,” the group said in a statement released at a meeting of African nations in Kinshasa, the Democratic Republic of Congo, on Tuesday ahead of the COP27 climate summit.”
Related: African leaders must stand together at COP27 to counter the Global North’s divide-and-rule tactics (by G Moore & T Moss)
https://www.thelancet.com/issue/S2542-5196(22)X0010-7
Interesting issue.
Start with the Editorial - Flood of injustice
Re Pakistan’s recent (giga-) flooding crisis.
Conclusion: “Events like this exemplify the injustice of climate change being driven primarily by high income nations emissions but having the worst effects in low- and middle-income countries. That climate change likely intensified these extreme monsoon rains should reignite discussions over climate finance, the timely provision of which could have helped minimise these floods and their impacts. It will also likely reignite discussions about loss and damage and the potential need for compensation mechanisms ahead of the next UN climate Conference.”
Make sure you also have a thorough look at:
Perspective - Interactions between climate and COVID-19
Personal View: Navigating fundamental tensions towards a decolonial relational vision of planetary health
Coverage of the online event. “Russia’s war in Ukraine is draining resources to build better health systems, while Sino-American rivalry is undermining the global solidarity needed to address future pandemics. But the massive under-investment in new antibiotics to combat drug-resistant “superbugs” and weak primary health systems might be the biggest enemies of global health. This was according to global health leaders who were discussing how to attract better investment in health at an event organised by European Investment Bank (EIB) and the World Health Organization (WHO) on Monday.”
“One of the biggest investments needed is in research and development (R&D) for new antibiotic drugs in the face of rising drug resistance – but this field attracts less than 5% of venture capital investment in pharmaceutical R&D. ….”
Quote: “…. We thank the EIB for its commitment of 500 million Euros to support primary health care in sub-Saharan countries. And we welcome your plans to extend this partnership to other countries and regions. …. These investments come at a critical juncture. Currently, the world is going at one-quarter the pace needed to reach the health-related Sustainable Development Goals. As an example, consider that even before the pandemic hit, the estimated annual financing gap for 67 low- and middle-income countries to reach the health-related SDGs was 134 billion US dollars per year, rising to 371 billion US dollars by 2030. Things have only become more difficult, and the pressures on economies and multilateral institutions greater, in the wake of COVID-19. …..”
https://www.devex.com/news/ncds-are-top-global-killer-but-trust-fund-coffers-are-empty-104021
“Noncommunicable diseases account for 74% of deaths globally. But a trust fund meant to provide initial support for countries that want to curb these deaths has not yet raised money for its work. The Health4Life Fund is a multipartner trust fund dedicated to NCDs and mental health. It was established in May 2021 and led by the World Health Organization, UNICEF, and the United Nations Development Programme. The fund aims to raise $250 million in five years, and 25 countries have to date expressed interest in accessing the fund, including Sierra Leone, which hopes to use the funding to carry out a survey to fully assess the burden of NCDs across the country. But without funding at the moment, it’s unclear when the trust fund would be able to issue grants…..”
“Dr. Nick Banatvala, head of the Secretariat for the U.N. Interagency Task Force on the Prevention and Control of Noncommunicable Diseases, said the fund is in startup phase — it has received funding from the European Union for that — and has received some pledges for its work at the sidelines of last week’s 77th U.N. General Assembly in New York. The Aspen Institute has committed to raising over $5 million over the next three years, and Unexia — a new blockchain project that Anyona said is using decentralized finance to pool global health funding — has pledged to raise $50 million for the trust fund. Meanwhile, Uruguay, Kenya, and Thailand are also considering how they can support the fund, Banatvala said. But the trust fund needs actual funding to be operational. ….….. He added that the task force has also been in discussions with the usual donor countries from the Organisation for Economic Co-operation and Development-Development Assistance Committee. But said they are “not yet in a position” to make a full commitment for the fund…..”
“Cholera cases have surged this year, especially in places of poverty and conflict, with outbreaks reported in 26 countries and fatality rates rising sharply, a World Health Organization official said [last week] on Friday.” “In a typical year, fewer than 20 countries report outbreaks of the disease which is spread by the ingestion of contaminated food or water and can cause acute diarrhoea. "…
“The average fatality rate so far this year has almost tripled compared with the five-year average and is currently around 3% in Africa…. …. He said only a few million doses of vaccines were available for use before the end of this year, citing a shortage of manufacturers among the problems…..”
“WHO maintains an emergency stockpile of cholera vaccines. "So it's very clear that we do not have enough vaccine to respond to both acute outbreaks and even less to be able to implement preventive vaccination campaigns that could be a way to reduce the risk for many countries," he said…..”
PS: See also dr Tedros at a media briefing on Wednesday: ‘Worrying upsurge’ in deadly cholera, warns Tedros, in wide-ranging global health update
The view from South-Africa on this question.
“South Africa's answer to Prof Chris Whitty warns Covid-19 might yet have a few nasty surprises in store. ….. …Prof Salim Abdool Karim is all too aware that the public and even scientists are bored of the pandemic. …the coronavirus still has plenty of potential to evolve. But while that might leave nasty surprises in store, Prof Karim also believes that the other ingredients needed to reach a pandemic endgame are coming together. …. the end – if not yet here – can be glimpsed…..”
https://www.who.int/news/item/04-10-2022-who-launches-a-blueprint-for-dementia-research
“WHO developed a blueprint for dementia research, the first WHO initiative of its kind for noncommunicable diseases. The blueprint is designed to provide guidance to policy makers, funders, and the research community on dementia research, making it more efficient, equitable, and impactful…..”
Coverage via HPW - WHO Sets 2030 as Deadline to Find Cure for Alzheimer’s Disease
“The World Health Organization (WHO) has pushed the deadline to find a cure for Alzheimer’s disease from 2025 to 2030. The earlier deadline had been decided on at the 2013 G8 Dementia Summit. Alzheimer’s disease is the most common form of dementia and makes up 60-70% of the global dementia cases. WHO’s A Blueprint for Dementia Research, which was launched on Tuesday, identifies gaps in dementia research and sets time-bound goals to tackle the disease. It found that most countries were behind on the targets set in 2017 on public health response to dementia. ….”
PS: at the time of publication this morning, The Lancet hadn’t yet published today’s issue. So do check it out for yourself!
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(22)00429-6/fulltext
“Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age groups in 204 locations from 1990 to 2019.”
Interpretation of the findings: “Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young.”
L Cabane; https://www.tandfonline.com/doi/full/10.1080/14747731.2022.2082130?scroll=top&needAccess=true
We quite enjoyed this paper. “The term ‘global health’ has become the dominant way to describe worldwide interventions on health since the 2000s. Despite significant discussions about the meaning of the term, there is still a lack of understanding about how it came to dominate global thinking and the implications of such a shift. This article traces the emergence and diffusion of ‘global health’ as a concept. It focuses particularly on the role of US experts and universities in shaping the ‘global’. It uses a combination of interviews, literature review and archives to trace its apparition in expert discourses and diffusion in universities. It shows that the definition of ‘global health’ came out of and contributed to American dominance in globalization. In addition to bringing a fresh perspective on the origins of global health, the paper contributes to the globalization debates by showing the co-constitution of scientific and political fields in globalization.”
KR Pandey et al ; https://blogs.bmj.com/bmjgh/2022/10/04/global-healths-identity-crisis/
Blog of the week.
« Lately, the field of global health–led by journals like the BMJ Global Health that often set the discourse–has opened itself up for introspection. Researchers and writers from around the world have been critiquing the field, its theory and praxis. As encouraging as this attempt at introspection and critique is, it runs the risk of not asking the right questions: what is global health anyway? Who sets the agenda? And what does global health hope to achieve? In light of these fundamental questions, we begin to see a dissonance between the hopes and vision laid out for global health and its reality. ….”
« …. From the vantage point of a developing country, influencing global health’s agenda or normative discourse always felt out of reach. This is why the current global health paradigm feels inauthentic and even irrelevant for people there. Trying to influence the global health agenda feels like trying to blend into the popular culture when the purveyors of that culture are on the other side of the world. No wonder there is a dissonance between the vision of global health and what it has come to mean to the very people it purports to help. …. …. The ongoing introspection in global health journals is a good idea—any attempt at self-reflection and humility is worthwhile. However, true progress—to make global health relevant for everybody— requires the Global South to elevate and shape its own normative discourse and agenda, to generate local knowledge for a global world, and to lead in solving its own problems. That’s how to create an authentic and relevant global health agenda. Until this is the case, any egalitarian vision of global health that is relevant to the entire world will remain out of reach. And global health will continue on with its identity crisis. »
Check out some of the research reports: https://2022.wish.org.qa/
Among others: Food security and health & Building health system resilience A roadmap for navigating future pandemics
And via UN News: COVID-19: Report reveals mental health ‘pandemic’
“…. in another global health development, countries are failing when it comes to protecting the mental health and wellbeing of health and care workers, WHO and partners said in a new report issued on Wednesday. The study examines the impact of the COVID-19 pandemic on the mental health of these professionals, warning that this too is a ‘pandemic’. At least a quarter of those surveyed reported anxiety, depression and burnout symptoms. …. The report was published by the Qatar Foundation, World Innovation Summit for Health (WISH), in collaboration with WHO. …..”
“The World Health Organization, with support from the Qatar Ministry of Health, today launched the AI-powered WHO Digital Health Worker, Florence version 2.0, offering an innovative and interactive platform to share a myriad of health topics in seven languages at the World Innovation Summit for Health (WISH) in Qatar. Florence can share advice on mental health, give tips to destress, provide guidance on how to eat right, be more active, and quit tobacco and e-cigarettes. She can also offer information on COVID-19 vaccines and more. Florence 2.0 is now available in English with Arabic, French, Spanish, Chinese, Hindi and Russian to follow…..”
PS: Politico found her a little ‘creepy’ : )
https://www.worldhealthsummit.org/
Press release: World Health Summit 2022: Together with WHO and Government Officials from around the world (as of 6 Oct)
“Climate change and health, pandemic preparedness, food security, digital transformation, sustainable health systems, and the role of Germany, the G7 and the G20 in global health – issues like these are topping the agenda of the World Health Summit 2022 from October 16-18 in Berlin. For the first time the World Health Summit will be co-organized by the World Health Organization (WHO)…..”
“WHS 2022 will focus on “Making the Choice for Health” by reflecting on the most pressing topics, including: Investment for Health and Well-Being; Climate Change and Planetary Health; Architecture for Pandemic Preparedness; Digital Transformation for Health; Food Systems and Health; Health Systems Resilience and Equity; Global Health for Peace.”
In addition to the official program, check out also World Health Summit: The Most Important Side Events 2022
“The world faces growing recession risks and a “fundamental shift” away from relative stability to an age of breakdown in international relations and more frequent natural disasters, the head of the International Monetary Fund has warned….” “….In her curtain-raiser speech before the Washington-based fund’s annual meeting of up to 190 member countries next week, she said dealing with the impact from Covid-19, Russia’s war in Ukraine and climate disasters was being made more difficult by geopolitical fragmentation…..”
“World Bank & IMF’s approaches to global crisis response questioned; World Bank President David Malpass’s latest gaffe makes him likely target of protests at Annual Meetings; Global civil society campaign against austerity gathers strength.”
“U.S. Treasury Secretary Janet Yellen wants multilateral development banks to “evolve,” and move beyond country lending in an effort to do more to tackle global challenges. In a policy speech on Thursday, Yellen conceded that “multilateral development banks cannot provide financing on the scale that is needed. But they are a critical part of the solution.” She outlined several key areas of potential reform, which could have wide-ranging implications. Yellen said she wanted MDBs to support global and regional initiatives that deliver public benefits, in addition to considering funding for local governments. She also said banks should consider the prospect of using concessional resources for middle-income countries. And she raised the prospect of banks taking more risk with their balance sheet in order to spend more…..”
M Ahmed et al; https://www.cgdev.org/blog/what-were-watching-years-annual-meetings
More from a macro-economic/debt perspective. ““The World Bank/IMF Annual Meetings begin next week—against a backdrop of mounting economic crises and uncertainty. How can we reduce global debt? Rethink the MDB/IMF system to address pressing issues like pandemics, climate change, and food security? Support poor countries where they need the most assistance? Our experts share what to watch at this year’s meetings, where the Bank, Fund, and shareholders need to step up—and what’s next…..”
· Related: CGD (blog) - The World Is in Crisis, So Where's the Lending? (by C Kenny)
“….fragile global recovery from the shock of the COVID pandemic is being buffeted by the impact of war on food, fuel, and fertilizer prices along with rising interest rates and general inflation. It is surely an urgent moment for multilateral support from the IMF and World Bank. And yet, the institutions’ financial statements suggest that support is declining. Figuring out why and what to do about it should be priority one at the upcoming World Bank-IMF annual meetings…..”
· Related: WP op-ed (by L Summers & M Ahmed) – IMF-World Bank meetings are the last stop before a coming economic storm
“When they gather in Washington next week for the International Monetary Fund and World Bank Group annual meetings, the world’s finance ministers face what has been labeled a polycrisis: Challenges ranging from increased interest rates, climate change and an epically strong dollar, to food-supply shortages, high inflation and a still-prevalent pandemic all combine to threaten not just the global economy but also the livelihoods of hundreds of millions….”
“….What is at stake — what will greatly depend on decisions that finance ministers make next week — is whether developing countries suffer a lost decade of economic opportunity, as happened to many countries in the 1980s, or whether they are enabled to maintain momentum, as occurred after the 2009 financial crisis. While much will depend on national policy choices, the external environment will be enormously important for most countries. Global cooperation through the IMF and the World Bank matters a great deal. The challenge for these institutions will be not to just discuss new funds and funding mechanisms but to actually deliver the greatly increased support the moment demands. Action in three areas is essential:….”
Draft agenda was: “Outcomes from the Diagnostics and Therapeutics Working Group - Q&A; Initial insights from the ACT-A Evaluation Q&A; ACT-A in the next phase: Major directions for ACT-A’s plan of work for the next 6 months.”
Related: ACT-A Commitment Tracker
Update as of 3 October. “As of 03 October 2022, pledges towards the 2021-22 funding target now total US$ 5.9 billion, counting towards the US$ 16.85 billion grant financing ask, bringing the 2021-22 funding gap to US$ 10.95 billion – as detailed in the snapshot of grant funding below……”
A Vassall et al ; https://www.bmj.com/content/378/bmj.o2320
Recommended read by a few health economists. « The fund must spend wisely and promote equity.“
Conclusion: « The Global Fund and those it funds must further embed their activities within domestic priority setting, further integrate disease programmes with health systems strengthening, and align fully with equity orientated reform of health sector financing.”
“The Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria has formally launched the process for selecting its next Chair and Vice-Chair for a 3-year term from 2023-2026, to succeed the current Board Leadership, whose terms expire in May 2023. The role of Chair is currently held by Dr. Donald Kaberuka, and that of the Vice-Chair by Lady Roslyn Morauta. The Board Chair and Vice-Chair act as ambassadors and advocates for the Global Fund’s work and lead the Board, which determines the Global Fund’s strategy and policies…..”
K Dodson; https://www.thinkglobalhealth.org/article/five-global-health-takeaways-77th-un-general-assembly
Worth a read.
“President Joe Biden intends to nominate Surgeon General Vivek Murthy to be the U.S. representative on the World Health Organization's executive board, administration officials told Reuters on Tuesday. Murthy has served as the top U.S. doctor under Biden and under former President Barack Obama. He will continue in that role while taking on the WHO position, if confirmed by the U.S. Senate…..”
S Pattanshetty et al; https://www.orfonline.org/expert-speak/indias-g20-presidency/
“India's upcoming presidency could be an opportunity to make global health governance more democratic and evidence-based.”
And see also this: “#G20 Joint Finance and Health Task Force (JFHTF) has emerged as a major global platform for discussing efforts to prevent, detect, and respond to #health emergencies, note @SanjayPattansh1 et al.” “
And a Link:
UNAIDS - UNAIDS welcomes Angeli Achrekar and Christine Stegling as Deputy Executive Directors
https://odi.org/en/insights/managing-a-new-era-of-imf-lending-conditions/
“…. Next month, the International Monetary Fund (IMF)’s much-awaited Resilience and Sustainability Trust (RST) is expected to be operational. The new trust is being funded through $40 billion-worth of commitments from various G20 nations to channel Special Drawing Rights (SDRs) to the IMF. The IMF will in turn provide highly concessional long-term lending for up to 143 countries to support economic and financial ‘resilience’ in the face of climate and pandemic-related threats….
“…. IMF staff and their government counterparts now find themselves with the challenge of agreeing lending conditions that are ostensibly related to ‘global public goods’. In this respect, the IMF Board Paper states that ‘RST loans would initially support measures addressing climate change and enhancing pandemic preparedness given their global public good nature; other challenges could be added over time.’….”
Coverage of the new UNCTAD report. “Report says policies of high interest rates and austerity risk triggering global recession that will hit developing nations hardest.”
“The interest rate rises and austerity the world’s richest nations are using to fight sky-high inflation risk a painful global recession that would hurt developing countries most, the UN has warned. In its annual trade and development report, the UN Conference on Trade and Development (Unctad) said a drive by major central banks to ramp up rates in response to soaring prices represented an “imprudent gamble” that could dangerously backfire. The UN agency said an urgent “course correction” was required to prevent a cascading series of crises of debt, health, and climate emergency for poorer countries struggling to cope with the economic hit from the Covid pandemic and Russia’s war in Ukraine. …. … Challenging the assumption that a sharp monetary shock administered by central bankers was required, it said much of the current inflationary burst was being driven by soaring prices for energy, food, and friction in global trade rather than excess demand for goods and services. The report said measures including strategic price controls, windfall taxes, anti-trust measures and tighter regulations on commodity speculation were needed to combat inflationary pressures at source without pushing poorer countries over the precipice…..”
Related: UN News – Policy mistakes could trigger worse recession than 2007 crisis: UNCTAD
https://www.devex.com/news/money-matters-who-gets-gates-grants-104121
“…. This week we’ve looked in depth at more than 25 years of funding data from the Gates Foundation and its predecessors and found out which organizations received the most money. …. Bill dollars: If the Bill & Melinda Gates Foundation were a country, it would have been the ninth biggest provider of ODA in 2021 — somewhere between Sweden and the Netherlands on the list of donors. …. The answer is that much of it is going to Gavi, the Vaccine Alliance, which has received roughly $1 in every $12 the foundation has ever given — more than $6 billion so far. …. ….. And a lot more is going to the World Health Organization, which has so far received $3.6 billion…..”
A Bougrea, J Orbie et al ; https://kluwerlawonline.com/journalarticle/European+Foreign+Affairs+Review/27.3/EERR2022026
“After years of discussions, the European Union’s (EU’s) new development finance architecture finally came into being under the umbrella of the ‘Status Quo Plus’. This article aims to, firstly, bring much-needed clarification in the nebulous landscape of EU development finance; and secondly, gain a more profound understanding of recent changes by examining to what extent they witness change or continuity. Based on a large variety of empirical data and secondary literature, we find that EU development finance has witnessed significant institutional changes while ideological trends are continued. Institutionally, we elaborate on the simplification of instruments, a shift in their accessibility – in favour of national development agencies and private actors whereby the European Investment Bank (EIB) loses its monopoly on commercial guarantees – and a reshuffling of power play in favour of the European Commission and (larger) EU Member States. In terms of policy content and underlying ideology, however, we observe a deepening of the trend towards financialization within EU (development finance) institutions which ties in with the geopoliticization of aid. We conclude that the ‘Plus’ represents institutional change that nevertheless primarily served (intentionally or not) to support a continuing ideological commitment to selling development finance to the market…..”
https://www.kff.org/global-health-policy/fact-sheet/the-u-s-government-and-global-polio-efforts/
“This factsheet offers a snapshot of global polio eradication efforts and examines the US Government’s role in addressing polio worldwide. “ Among which:
“The U.S. government (U.S.) has been engaged in efforts to address polio for decades, as a partner in and the second largest donor to the Global Polio Eradication Initiative and as a supporter of developing countries’ efforts. U.S. funding for polio is $253 million in FY 2022, up from $134 million in FY 2009…..”
M Rudasingwa et al ; https://www.tandfonline.com/doi/full/10.1080/17441692.2022.2129726
« Building synergies is seen as an effective strategy to address and decrease existing fragmentation in health systems of low-and middle-income countries (LMICs). To that end, different programmes, such as the Sector Wide Approach, have been adopted to increase health system synergies. Despite these efforts, fragmentation remains an enduring problem, hampering health system performance in LMICs. This study is part of the Lancet Commission on synergies between Universal Health Coverage, Health Security, and Health Promotion; we aimed to document synergising strategies adopted by Rwanda. …. We found that Rwanda adopted three main strategies to increase health system synergies: (1) alignment of health programmes with national health policies and strategies, (2) increased coordination across national health institutions, and (3) effective monitoring and evaluation frameworks. ….”
S O Frimpong et al; https://jogh.org/2022/jogh-12-03053
“…. In this viewpoint, we discuss how agriculture can be harnessed to achieve UHC through revenue generation from cash crop production, purchase of user fees with improved farmer income levels, prevention of diseases, and the control of obesity and its associated NCDs. Since case studies have often been used to examine social innovations due to their heterogeneous nature, we further employ a case study of Cocoa360s model to show how agriculture can be leveraged to finance health and educational access, two major social determinants of health…..”
N Ramakrishnan & K M Gopakumar; https://www.twn.my/title2/health.info/2022/hi221001.htm
“The World Health Organization Director-General (DG) is aiming to control the content of the amendment of the International Health Regulations (IHR) 2005 through the IHR Amendments Review Committee. …. “
“…. The draft ToR developed by WHO DG shows all the potential signs that the RC could be used by vested interests to delegitimize the proposals from developing countries to amend IHR 2005, especially those requiring equitable access to health products and technologies for addressing the PHEIC.”
https://www.sciencedaily.com/releases/2022/09/220930112636.htm
“Evoking parallels to HIV, authors are calling on global health community to be vigilant.”
Global Health Centre (Policy Brief) – The deep prevention of future pandemics through a One Health approach: What role for a pandemic instrument? https://www.governingpandemics.org/_files/ugd/356854_3f30135c0cc74b25958931d2a0f25e69.pdf
By G Le Moli, S Moon et al;
“Ministers and high-ranking officials of African nations have urged rich countries to do more to combat the climate crisis, and called the failure to meet a funding promise from 2009 “shameful”. At a conference in Giza, Egypt, on Wednesday in the run-up to next month’s UN climate summit, Wael Aboulmagd, Egypt’s special representative for Cop27, attacked wealthier nations for not honouring an agreement to provide $100bn (£87.5bn) a year to developing countries by 2020….”
L Chancel: https://www.nature.com/articles/s41893-022-00955-z
« All humans contribute to climate change but not equally. Here I estimate the global inequality of individual greenhouse gas (GHG) emissions between 1990 and 2019 using a newly assembled dataset of income and wealth inequality, environmental input-output tables and a framework differentiating emissions from consumption and investments. In my benchmark estimates, I find that the bottom 50% of the world population emitted 12% of global emissions in 2019, whereas the top 10% emitted 48% of the total. Since 1990, the bottom 50% of the world population has been responsible for only 16% of all emissions, whereas the top 1% has been responsible for 23% of the total. While per-capita emissions of the global top 1% increased since 1990, emissions from low- and middle-income groups within rich countries declined. Contrary to the situation in 1990, 63% of the global inequality in individual emissions is now due to a gap between low and high emitters within countries rather than between countries. Finally, the bulk of total emissions from the global top 1% of the world population comes from their investments rather than from their consumption. »
“Oxfam research suggests up to 40% of bank’s reported climate-related spending cannot be accounted for.”
“…. Of $17.2bn that the World Bank reported it spent on climate finance in 2020, as much as $7bn cannot be independently verified, according to research by the charity Oxfam. …. …. Oxfam examined the $21.3bn of climate finance the bank reported in 2020, of which $17.2bn was provided by the bank’s two main lending arms, the International Development Association and the International Bank for Reconstruction and Development…..”
“The World Bank has provided nearly $15bn of finance directly to fossil fuel projects since the Paris agreement was signed in 2015, and is likely to have spurred far greater investment indirectly, new research has found. Funding for “upstream” oil and gas projects from the World Bank was meant to stop from 2019, but the Big Shift Global, a coalition of more than 50 NGOs, has found the bank and its subsidiaries funding oil refinery and gas processing since then. As the bank is also instrumental in helping to catalyse investment from other donors and the private sector, its direct funding of $14.8bn to fossil fuel since the Paris agreement is likely to be the tip of the iceberg when it comes to assistance to high-carbon development, according to the report published on Thursday…..”
“Young people from some of the countries most affected by climate breakdown have warned they are not victims but a force to be reckoned with in the run-up to a UN climate conference in Egypt. Led by climate groups across Africa and the Middle East, hundreds of activists from countries that are the least responsible for the crisis but are experiencing the worst impacts have gathered in Tunisia to prepare for what they say will be a collective fight for justice for their countries and communities, which they will take to Cop27 next month. They are campaigning on issues including adaptation funding and recompense for damage from countries that have been the most responsible for global heating…..”
R Guinto et al; https://www.bmj.com/content/378/bmj-2022-071535
Part of a new BMJ Series on Food security, climate change & public health.
« Renzo R Guinto and colleagues discuss why the health sector must embrace the planetary health approach and advocate concrete solutions for fixing the food system .»
Some key messages: “Today’s food system is both a cause and a consequence of large scale social and environmental change, including the evolving climate emergency; The health sector must go beyond the traditional clinical approach and embrace planetary health to improve the health of both people and the planet ; Actions include adopting the planetary health diet, incorporating sustainability in dietary guidelines, healthcare, and nutrition programs; and revisiting indigenous diets; The principle of equity must be at the centre of advocacy for food system transformation.”
https://www.bmj.com/content/378/bmj-2022-071533
From the same series. “Projections of future food security require careful interpretation because they are often based on models that include only a subset of biophysical variables and have inherent uncertainties, caution Samuel Myers and colleagues.”
https://news.un.org/en/story/2022/10/1129242
“Climate change and environmental degradation are escalating the risk and prevalence of violence against women and girls across the world, a UN-appointed independent human rights expert warned on Wednesday.”
“Presenting a report to the General Assembly on its causes and consequences, Reem Alsalem, UN Special Rapporteur on violence against women and girls described climate change as “the most consequential threat multiplier for women and girls, with far-reaching impacts on new and existing forms of gendered inequities”…..”
Firms Aren’t Reporting Financial Risks of Carbon Emissions, Study Finds - Bloomberg
“Companies in industries with the biggest carbon footprints aren’t reporting how their emissions feed into financial risk, according to an analysis of corporate reports by the Carbon Tracker Initiative. The nonprofit, which looked at 134 financial statements from last year in sectors spanning fossil fuels, mining, manufacturing, automotive and technology, found that almost all failed to consider the financial impact of climate change. Auditors are generally also ignoring the financial risks of emissions, according to the study published on Thursday…..”
J Meckling et al; https://www.science.org/doi/10.1126/science.adc9973
“Policy-driven change hinges on institutions that support insulation or compensation.”
And a link:
· Health Affairs - Global Disability Justice In Climate Disasters: Mobilizing People With Disabilities As Change Agents
First issue of the monthly COVID-19 Vaccine Delivery Partnership Update. This report covers the month of August 2022.
See also WHO - COVID-19 Vaccine Delivery Partnership - August 2022
“Global vaccine inequity persists – 63% of the total population across the WHO Member States have completed their primary vaccination, while only 18% of people in lower-income countries (LICs) have, and 23% in Africa. However, progress is possible, 51% of the population in AMC92 countries have now completed primary series, up from 28% in January, and 57% have received at least one dose. The average primary series coverage rate among the 34 countries identified for concerted support has increased from just 3% in January to 17%. Vaccination coverage among the people most at-risk remains low, especially in low-income countries where, on average, 24% of health workers and 54% of older adults remain unvaccinated. In most AMC92 countries, booster coverage is below 10%, and in 30 countries, booster coverage is currently estimated to be below 1%.”
“The Medicines Patent Pool (MPP) has signed a voluntary licence agreement with Japanese pharmaceutical company, Shionogi, to enable generic companies to produce its COVID-19 antiviral treatment pill candidate, provided it gets regulatory approval…..”
See also Devex - MPP has a licensing deal for a new oral COVID-19 antiviral pill
“The administration's plans to create a new accelerator for Covid vaccines and treatments has hit a wall.”
https://www.ft.com/content/5504ad3a-eef2-49eb-b8dc-2a417d6f711c
“EcoHealth had already been criticised for failing to disclose details of Wuhan lab coronavirus work.”
“Senior Republicans have hit out at the Biden administration’s decision to award hundreds of thousands of dollars to a virus-hunting group that is already under fire for its previous work with China’s Wuhan Institute of Virology. Three members of Congress have urged health officials to reverse a recent decision to grant $500,000 to the EcoHealth Alliance to fund its work hunting for new coronaviruses. The grant is one of four given to the organisation since the start of the pandemic, adding up to more than $7mn…..”
Kibrom A. Abay; https://documents1.worldbank.org/curated/en/099439009132230066/pdf/IDU0a252038a0259c04a26099f00ae922b7f52b3.pdf
“…. This paper combines per capita gross domestic product growth from national accounts with data from High-Frequency Phone Surveys for several countries to estimate the net impact of the pandemic on poverty. It finds that the pandemic increased poverty in Africa by 1.5–1.7 percentage points in 2020, relatively smaller than early estimates and projections. The paper also finds that countries affected by fragility, conflict, and violence experienced the greatest increases in poverty, about 2.1 percentage points in 2020. Furthermore, the paper assesses and synthesizes empirical evidence on the role that social protection systems played in mitigating the adverse impact of the COVID-19 crisis in Africa…..”
https://www.nature.com/articles/d41586-022-03157-x
“Emerging variants and waning immunity are likely to push infections higher in the northern hemisphere as influenza also makes a comeback.”
“Evidence is building that the northern hemisphere is on course for a surge of COVID-19 cases this autumn and winter. New immune-evading strains of the SARS-CoV-2 Omicron variant, behaviour changes, and waning immunity mean that many countries could soon see large numbers of COVID infections — and potentially hospitalizations — say scientists. Nature explores the factors that might drive a COVID-19 wave — and what countries can do to blunt the effects with the new generation of vaccines that target Omicron…..”
See also Stat News - From BQ.1.1 to XBB and beyond: How the splintering of Omicron variants could shape Covid’s next phase
“…. What’s different, at least for now, is that there’s not one variant pushing the wave. Rather, scientists are tracking a bevy of new forms of Omicron, which are jockeying with each other as they compete to become the next dominant strain. Scientists are monitoring more than 300 sublineages of Omicron, World Health Organization officials said this week. To get a sense of what’s happening right now with the evolution of the SARS-CoV-2 virus, STAT spoke with Tom Peacock, a virologist at Imperial College London….”
“ A rebound of COVID-19 symptoms in some patients after taking Pfizer's antiviral Paxlovid may be related to a robust immune response rather than a weak one, U.S. government researchers reported on Thursday.”
https://www.ft.com/content/c3fe4791-72fb-4d01-ac59-707b39baa0b6
“UK trial shows ‘no difference’ between taking molnupiravir or placebo in reducing clinical admissions during Omicron wave.”
https://www.nature.com/articles/s41467-022-33549-6
“Currently approved COVID vaccines are designed using the spike antigen derived from the ancestral strain, but health authorities are recommending changes to the vaccine strain to combat emerging variants. The goal is to ensure that next generation vaccines can tackle multiple variants of concern including the most prevalent variant for the coming season. We here discuss recent preclinical and clinical data on COVID vaccine antigens that are potential candidates for an updated vaccine.”
https://link.springer.com/chapter/10.1007/978-3-031-09432-3_15
Paper by S Okafor et al.
“….mathematical models indicate overall underreporting of cases ranging from 1 in 1.2 to 1 in 4.7, investigators report in the journal Current Science. That underreporting translates to global pandemic estimates between 600 million and 2.4 billion cases…..”
“Research suggests immune response may be cause of delirium and brain fog in Covid patients.”
“Severe Covid infections can cause immune reactions that damage nerve cells in the brain, causing memory problems and confusion, and potentially raising the risk of long-term health issues, research suggests. Scientists at King’s College London found that a wayward immune response to the virus increased the death rate of neurons and had a “profound” impact on regeneration in the hippocampus region of the brain, which is crucial for learning and memory. The findings are preliminary but suggest Covid can trigger neurological problems in patients without the virus having to infect the brain itself. The process is believed to underpin delirium in Covid patients, but may also contribute to brain fog and other problems experienced by people with long Covid…..”
M Pincombe et al ; https://www.cgdev.org/blog/monkeypox-infectious-disease-response-deja-vu
“In this blog, we reflect on the status of equitable access to safe and effective diagnostics, vaccines, and treatments in the global response to the ongoing monkeypox outbreak, similarities to the COVID-19 response, and accountability during health emergencies…..”
(5 Oct) “The Monkeypox Strategic Preparedness, Readiness, and Response Plan (SPRP) outlines a framework of priorities for aligning collective efforts towards the goal of stopping the monkeypox outbreak. WHO invites countries to develop their own context specific approach to prepare for and respond to the current monkeypox outbreak guided by the SPRP, with a specific focus on three strategic objectives: interrupt human-human transmission, protect vulnerable groups at risk, and minimize zoonotic transmission. To achieve this requires implementing effective public health measures within emergency coordination, collaborative intelligence; community protection; safe and scalable care; as well as countermeasures and research. Confronting this global outbreak demands swift action, whilst upholding inclusiveness and respect for human rights.”
“Monkeypox rampant in wildlife would make the virus impossible to control, warn scientists.”
“Monkeypox is known to infect more than 50 species of mammal, according to data compiled by researchers at the University of Liverpool, UK. But scientists don’t know the virus’s exact reservoir — the animal or animals that continuously carry and spread the virus without becoming ill from it. The evidence so far indicates that rodents and other small mammals in Africa — including Gambian pouched rats, tree squirrels, rope squirrels and target rats — are responsible for keeping the virus circulating in the wild there. Monkeypox outbreaks in people have been cropping up in parts of Africa for decades.”
G Poland et al ; https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00574-6/fulltext
“…The purpose of this Review is to briefly describe human immune responses to orthopoxviruses; provide an overview of the vaccines available to combat this outbreak; and discuss the various clinical data and animal studies evaluating protective immunity to monkeypox elicited by vaccinia virus-based smallpox vaccines, address ongoing concerns regarding the outbreak, and provide suggestions for the appropriate use of vaccines as an outbreak control measure….”
https://www.cidrap.umn.edu/news-perspective/2022/09/studies-detail-monkeypox-transmission-risks
“A study of almost 400 samples taken from men with monkeypox reveals a high prevalence of the virus on skin, throat, and anus swabs compared to in blood or urine—with detections in semen in the midrange—and high viral loads in skin and anal swabs. Two other new studies detail transmission risk in a tattoo parlor and in healthcare settings, and in US news, officials report a monkeypox-related death in Ohio…..”
There are several new studies in The Lancet Infectious Diseases that aim to describe real-world transmission risks of the poxvirus.
Coverage via Stat News: “…. Last week the CDC released heartening preliminary data on how much protection people who have had a single dose of monkeypox vaccine may have. But new data published in JAMA strike a more cautionary tone. ….”
See also Cidrap News - Study prompts more monkeypox vaccine efficacy questions
PS: “….The researchers didn't adjust for risk factors like the number of sex partners” though.
https://www.nature.com/articles/d41586-022-03171-z
“In some samples, large chunks of the virus’s genome have disappeared — but understanding whether the mutations affect its behaviour will be difficult.”
https://healthpolicy-watch.news/who-malaria-control-and-elimination-africa/
From late last week. “The World Health Organization (WHO) has launched a new initiative to counter the added malaria threat posed by the rapid expansion on the African continent of the mosquito Anopheles stephensi — native to parts of South Asia and the Arabian Peninsula, the organization said this week. …. with detections of the new vector already reported in several African countries including Djibouti, Ethiopia, Sudan, Somalia and Nigeria, WHO is sounding the alarm bell to Africa’s national malaria programmes. This is particularly the case because of the vector’s ability to thrive in urban settings – unlike An. gambiae. Moreover, the vector has been found to be resistant to many of the insecticides used today for malaria control – thus posing an added challenge. ….”
“… For Africa then, the new WHO initiative, described in detail in a new policy brief, could be decisive in the battle to halt further spread of An. stephensi in the region, as well as determining whether it can be eliminated from areas that have already been invaded. ….”
https://www.nytimes.com/2022/10/04/health/malaria-vaccines.html
“Two new vaccines may finally turn back an ancient plague. But in unexpected ways, their arrival also complicates the path to ending the disease.”
https://www.voanews.com/a/uganda-seeks-ebola-funding-amid-exposure-of-health-workers/6771762.html
“The World Health Organization and Ugandan authorities are seeking nearly $18 million to help contain the Ebola outbreak in the country for the next three months. The initiative comes as Uganda registers the death of the first health worker in the current Ebola outbreak and brings the total number of confirmed cases to 35, with seven deaths…..”
See also Cidrap News - Ebola sickens 8 more in Uganda; doctor among latest deaths
And via Cidap News - Ebola kills another health worker in Uganda outbreak
Meanwhile, (Stat) - Citing Ebola outbreak in Uganda, U.S. to screen all passengers arriving from there
“The United States is going to direct travelers arriving from Uganda, where a fast-growing Ebola outbreak arose in recent weeks, to five airports where they can be screened for possible infection…..”
S-J Park et al; https://www.tandfonline.com/doi/full/10.1080/09581596.2022.2128990
“This paper examines the atmosphere of mistrust that permeated the response to the tenth Ebola epidemic in Eastern DRC (2018–2020). The concept of an ‘atmosphere of mistrust’ that we develop in this article directs attention to the elusive-yet-pervasive presence of mistrust in interactions between responders and communities during the Ebola epidemic. This analysis focuses on the popular notion that ‘Ebola is a business’…..”
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00647-8/fulltext (By K Schneider et al. )
“ CARB-X (the Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator), which since its founding in 2016 has provided $396 million in funding to 92 pre-clinical projects aimed at fighting drug-resistant infections, says that for this next round of awards, it's seeking to fill "major gaps" in the global pipeline of new antibiotics, diagnostics, vaccines, and alternative therapies that can address the growing public health threat posed by antimicrobial resistance (AMR). Specifically, CARB-X is seeking products in three distinct areas or product "themes": oral therapeutics for common syndromes like respiratory and urinary tract infections caused by gram-positive pathogens, vaccines for neonatal sepsis, and antibiotics, vaccines, and diagnostics for gonorrhea.”
“….The new round of funding that CARB-X will award to companies with promising products in these areas is made possible by renewed funding the group received in May from its partners—the US Department of Health and Human Services Biomedical Advanced Research and Development Authority (BARDA) and global charitable foundation Wellcome. Under the renewed agreement, BARDA and Wellcome are providing an additional $370 million in funding.”
“a new international survey of people's perceptions of NCDs and their risk factors, which was conducted in late 2021 and early 2022 by Gallup in collaboration with Bloomberg Philanthropies and the World Health Organization (WHO). The respondent-level data are now available for independent research. …. Though most see cancer as "very harmful," many underestimate the harmfulness of other NCDs…..”
https://www.washingtonpost.com/health/2022/10/03/diabetes-type-one-surge/
“Using a new model for projecting the number of people with Type 1 diabetes worldwide, members of an international team of researchers estimate up to 17.4 million cases by 2040, double the number of people known to have the disease today. A study published in the Lancet Diabetes & Endocrinology says 8.4 million people now live with Type 1 diabetes, which occurs when the pancreas produces little or no insulin, leading to a buildup in blood sugar that can be disabling or fatal. …..”
https://www.ijhpm.com/article_4322.html?utm_source=dlvr.it&utm_medium=twitter
By L Chen et al.
https://www.afro.who.int/news/reversing-suicide-mental-health-crisis-africa
“World Health Organization (WHO) today launched a campaign to raise awareness and spur action for suicide prevention in the African region, which has the world’s highest rates of death by suicide. Around 11 people per 100 000 per year die by suicide in the African region, higher than the global average of nine per 100 000 people. This is due in part to insufficient action to address and prevent the risk factors, including mental health conditions which currently affect 116 million people, up from 53 million in 1990. The social media campaign, launched ahead of World Mental Health Day, aims to reach 10 million people across the region to raise public awareness and galvanize the support of governments and policymakers to increase focus and funding for mental health programming, including suicide prevention efforts…..”
See also UN News - Make suicide prevention in Africa a priority, UN health agency urges governments
https://www.tandfonline.com/doi/full/10.1080/09540261.2022.2097005
By C Li, R Guinto et al.
https://movendi.ngo/news/2022/07/19/fifa-and-big-alcohol-alcohol-sales-during-world-cup-in-qatar/
“FIFA doing the dirty work for alcohol giant AB InBev pushed Qatari officials to weaken their alcohol laws just for the FIFA World Cup. Qatar was initially going to prohibit all alcohol sales during the World Cup. While the football arenas will remain alcohol-free, alcohol will be available in other public areas. After FIFA and AB InBev’s intense lobbying alcohol will be made available in certain spaces. This is not the first time AB InBev and FIFA have forced a country to make alcohol widely and easily available ignoring the public interest and laws of that country…..”
“The announcement by Egypt’s Ministry of Foreign Affairs that Coca-Cola will sponsor the 27th Annual United Nations Climate Change Conference of the Parties (COP27) has been widely condemned by climate and health activists…..”
And a link:
· Stat News - The U.S. is terrible at keeping businesses from worsening public health, experts say
“….There’s only one university in the U.S. with a program dedicated to Commercial Determinants of Health. You can literally count the number of U.S.-based experts on one hand. And there isn’t a single mention of the commercial determinants of health on the federal health department’s website, according to Google. That’s a shame, because experts in the field agree: The U.S. is doing a terrible job of addressing this very topic…..”
“Particles breathed by mothers pass to their vulnerable foetuses, with potentially lifelong consequences.”
“India is investigating the deaths of dozens of children in Gambia that the WHO said may be linked to a cough syrup made in the south Asian nation. ….”
“The deaths of dozens of young children in Gambia from acute kidney injuries may be linked to contaminated cough and cold syrups made by an Indian drug manufacturer, the WHO said…..”
https://www.devex.com/news/givewell-drops-four-deworming-programs-are-the-worm-wars-back-104076
(gated) “Observers say the charity's decision to drop the deworming programs is certain to have financial implications and to potentially resurrect the battle of how effective the intervention actually is.”
C Kenney & R Silverman; https://www.cgdev.org/blog/biomedical-innovation-agenda-our-shared-global-health-future
“In our new policy paper, we share findings from a horizon-scanning exercise in late 2021 to source ideas for biomedical innovations with significant potential to transform health, quality of life, and health security. Our paper has two goals: (1) clarifying the global health innovation agenda; and (2) motivating further investments in the health technologies that could be transformative for the world’s poor and vulnerable…..”
O Wouters et al ; https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2796669
“Is there an association between how much drug companies spend on the research and development of new drugs and how much they charge for these drugs? Findings In this cross-sectional study of 60 new therapeutic agents approved by the US Food and Drug Administration from 2009 to 2018, there was no association between estimated research and development investments and treatment costs based on list prices at the launch of the product or based on net prices a year after launch. …. Findings of this study suggest that variation in drug prices could not be explained by research and development investments; drug companies should make further data available if they want to use this argument to justify high prices.”
Els Torreele; https://www.pestemag.com/third-row/blog-post-title-one-7l87x-xJTdJ-97sth
Els Torreele’s contribution to the inaugural issue of @PesteMagazine on the absurdity and greed behind @moderna_tx 's patent wars. “The covid vaccines are the result of collective efforts and must be considered global commons, not private property or financial assets. “
Amy Kapcinszky; Dukepress;
“The pharmaceutical industry is among the most politically powerful in the US today. This article describes how industry successfully has entrenched its power, with attention to four sources of power: property power, vertical power over politics, ideational power, and material power. Attempts to reform the industry must grapple with these forms of power, which are not easily separated and in the current environment tend to reinforce one another.”
https://www.who.int/publications/i/item/9789240055940
“The Human Resources for Health (HRH) curricula package structures three curricula to recognize, formalize and build a critical mass of leaders and managers in the much needed area of HRH. The courses address the leadership of HRH around the dynamics of the health labour market, and aim to develop competencies to strengthen leadership in HRH development in the following domains: policy and planning; management; communication; information and communication technology; data management, analysis and intelligence; and research….”
“With rigorous science and good-humored braggadocio, Tulio de Oliveira champions coronavirus research from the Global South.”
B Nkosi et al ; https://www.tandfonline.com/doi/full/10.1080/17441692.2022.2124300
« Drawing on the reflections and discussions from a special session at the 2021 Global Health Bioethics Network summer school, this paper has summarised the key challenges faced by Frontline Workers (FWs) across research sites in Africa and Asia in performing the everyday ‘body work’ entailed in operationalising global health research. Using a ‘body work’ lens, we specifically explore and map key challenges that FWs face in Africa and Asia and the physical, social, ethical, emotional, and political labour involved in operationalising global health in these settings. The research encounter links with wider social and economic structures, and spatial dimensions and impacts on the FWs’ performance and well-being. Yet, FWs’ ‘body-work’ and the embedded emotions during the research encounter remain hidden and undervalued. »
“….The 2022 Poverty and Prosperity Report provides the first comprehensive analysis of the pandemic’s toll on poverty in developing countries and of the role of fiscal policy in protecting vulnerable groups. It also finds that global progress in poverty reduction has ground to a halt and calls for an urgent course correction by policymakers…..”
“The global goal of ending extreme poverty by 2030 is likely to be missed: by then, about 600 million people will remain in abject poverty. A major course correction is needed….”
“…. countries are coming together to share common approaches to building trusted, safe, and inclusive digital public infrastructure, or DPI. They’re also sharing knowledge around so-called digital public goods so that governments can adopt them and scale up their DPI much more quickly — which will in turn help them reach more people with services ranging from health care to food distribution to cash transfers. …. …. Donors committed a total of $295 million to the cause during the 77th United Nations General Assembly. Big donors included the Bill & Melinda Gates Foundation, which committed $200 million; Norway, which committed $50 million; Germany with nearly $35 million; and the EU’s Horn of Africa Initiative, with nearly $10 million. Leaders from 15 countries committed to sharing digital public goods as well as their knowledge to help other countries build this infrastructure…..”
PS: “ …. The U.N. defines digital public goods as “open-source software, open data, open artificial intelligence models, open standards and open content that adhere to privacy and other applicable international and domestic laws, standards and best practices and do no harm.” They’re key to achieving the U.N. Sustainable Development Goals, particularly for low- and middle-income countries. And many lower-income countries are leading the way in developing and sharing these goods…..”
“Japan has been investing in the continent for longer than China and applies international standards to its infrastructure financing, analysts said; Its pockets may not be as deep, but its support of good governance and democratic principles makes it a tempting development partner for African states.”
https://www.devex.com/news/the-radical-plan-to-honor-dr-paul-farmer-by-remaking-global-health-104092
Withsome info on “….the Dr. Paul Farmer Memorial Resolution, which Schakowsky introduced in Congress last month alongside Rep. Raul Ruiz, a Democrat from Maryland, and Rep. Barbara Lee, a Democrat from California…. The resolution sets out a three-part strategy for the future of U.S. global health efforts. If the U.S. government were to pursue the agenda outlined in the resolution, it would completely transform America’s role as a global health leader, massively increase the amount of funding available for these programs, and require a fundamental rethink of fairness in the global economy…..”
Including: a $125 billion U.S. global health budget…
https://www.ncbi.nlm.nih.gov/pmc/issues/417951/
“In editorials this month, Kapil Narain et al. discuss strategies for malaria vaccination during the COVID-19 pandemic in African countries. Dévora Kestel et al. present a WHO report on the transformation needed in mental health care…..” Check out also the rest of the issue.
Make sure you also check out this WHO Bulletin Perspective - Inequalities in COVID-19 mortality: defining a global research agenda (by J Friedman et al).
D L Strachan et al ;https://academic.oup.com/heapol/advance-article/doi/10.1093/heapol/czac083/6743163?searchresult=1
“….. We investigated the varied experiences of HPSR in Mexico, Cambodia and Ghana (each selected purposively as a strong example reflecting important lessons under varying conditions) to illustrate the ways in which HPSR is used to influence health policy……”
E Banerjee et al ; https://economics.mit.edu/sites/default/files/2022-09/220919%20social%20protection%20review%20manuscript.pdf
“Social protection programs have become increasingly widespread in low- and middle-income countries, with their own distinct characteristics to match the environments in which they are operating. This paper reviews the growing literature on the design and impact of these programs. We review how to identify potential beneficiaries given the large informal sector, the design and implementation of redistribution and income support programs, and the challenges and potential of social insurance. …”
R Marten et al ; https://gh.bmj.com/content/7/10/e010709
“….. the Alliance for Health Policy and Systems Research, in collaboration with WHO Departments and the Inter-Agency Working Group on Health Taxes, is supporting the development of a series of analytical country case studies to better understand the political economy of advancing health taxes in eight countries (namely, Bangladesh, Ethiopia, Ghana, Indonesia, Nepal, Pakistan, Peru and Vietnam). To complement this work and advance the field, we are now issuing an open call for papers for a special issue of BMJ Global Health on health taxes. We are interested in papers that focus on political economy and policy analysis as well as consider how framing can be used to advance health taxes; we are interested in health taxes on products including, but not limited to, tobacco, alcohol, sugar, fossil fuels, meat and salt. ….”
Jim Campbell et al ; https://cdn.who.int/media/docs/default-source/bulletin/online-first/blt.22.289032.pdf?sfvrsn=f0cd1b2a_1
“…. Here we present several reasons why the rehabilitation workforce has been largely neglected in health system strengthening efforts to date and suggest three health policy and systems research questions that need to be explored to inform policy actions…..”
And a link: Plos GPH - Prioritizing gender equity and intersectionality in Canadian global health institutions and partnerships
https://tdr.who.int/publications/i/item/9789240058675
“In this guide, institutionalizing research mentorship is defined as the nurturing of research capacity in organizations (e.g., universities, professional associations, or research institutes) to improve research effectiveness and health equity. …. The guide is aimed at institutional leaders, funders, and others interested in institutionalizing research mentorship in LMICs or other resource-constrained settings.”
“The @WorldBank 's new poverty report feels like a watershed moment. At the halfway point of the SDGs, the Bank has declared the banner goal - ending extreme poverty by 2030 - no longer achievable. Why? The COVID shock and slow recovery have set back progress by at least 4 years.”
“There is a global movement to advocate for 0.7 GDP for ODA, it might be time for a global movement that calls for a minimum many 5% of health budgets for #healthpromotion and #prevention. All the issue based advocacy groups could finally band together and call for #5%forhealth.”
(quoting Peter Piot at the ‘Investment for Health for All’ event)
“One of the silverlining of the COVID-19 epidemic is that the African Union and the Africa Centers for Disease Control have taken things in hand. ….”
“Twitter is where #globalhealth & development organizations & initiatives celebrate themselves. LinkedIn is where you can see them hollow out and sink, as staff start leaving in large numbers…”
“In May of this year, WHO member states agreed to triple the size of its regular budget from 16% to 50% by 2028 – a big departure from the near-zero growth budgets that had previously been in place since the 1980s. Is this just a sign that these member states realise they can no longer starve a global technical body at the centre of the Covid-19 pandemic response? Or is it something more significant, a vote of confidence in the United Nations that bodes well for broader reforms and gives it access to predictable and flexible sources of finance? This ODI Bites episode discusses the implications this historic decision will have on UN reform and multilateral finance.”