IHP news 625 : All eyes on the G7 summit
( 11 June 2021)
The weekly International Health Policies (IHP) newsletter is an initiative of the Health Policy unit at the Institute of Tropical Medicine in Antwerp, Belgium.
Dear Colleagues,
I’m sure, given the size of this “comprehensive” newsletter, you won’t mind if this week’s intro is rather short. Among the reasons: we have three (!) (timely) editorials this week, plus the fact that “the Powers that be” have decided that after one and a half years of Covid, with summer in the air ànd with the European Championship football starting this very evening, now is the dreadful season for writing proposals: enter fancy Theories of Change, ticking relevant (and irrelevant) OECD-DAC criteria boxes and let’s not forget the lovely logframes. Looking forward to the days Bill, Elon & Jeff will have to do the same for their billion-dollar space, divorce and other projects. Anyway, just to say my ‘bandwidth’ is a bit constrained these days .
So let me just flag here that in this issue, we will obviously pay attention to the UN High Level meeting on AIDS (including a quote by Winnie Byanyima that rang true not just for HIV/AIDS but global health in general: “Inequalities in power, status, rights and voice are driving the HIV pandemic. Inequalities kill. To end AIDS, we have to end the inequalities which perpetuate it.””), including the celebration of 20 years Global Fund.
We also provide the usual updates on COVAX, ACT-A, Trips Waiver discussions, donation of doses & tech transfer. With respect to these, a lot already happened this week, ahead of the G7 summit in Cornwall. Still, all eyes will be on Biden, Johnson & co this weekend, given the current two-track pandemic. Jeremy Farrar argued “global vaccination must be the top priority at the G7 meeting”, and we obviously agree (even if we’re not in the year 2005 anymore, geopolitically). As a reminder: WHO says 11 billion doses are necessary to immunize the globe. Hope this weekend brings some real change, certainly something more “comprehensive” than the trickle-down solidarity we’ve seen so far. At least Joe seems to have “a plan” for vaccinating the world and as we recall from the 80s when we used to watch “The A-Team”, everything starts with a “good plan” . We’re not the only ones wondering whether that’s the case, though. It rather sounds like a “good start”.
Enjoy your reading.
Kristof Decoster
1
Featured Articles
How community-based youth researchers are shaping national policy in Sudan
Ahmed Tom Hemedan (COVID-19 Research Coordinator in North Kordufan), Isra Zain Alabdeen (Former National Coordinator of Y-PEERs Sudan, member of Y-PEER Sudan Alumni Board), Rahaf Abu Koura (Research Fellow, London School of Hygiene and Tropical Medicine) & Reem Gaafar (Communications Consultant, Sudan COVID-19 Research Group)
Acknowledgements: Maysoon Dahab, London School of Hygiene and Tropical Medicine & Duriya Awad, Y-PEERs Sudan
COVID-19 has impacted the lives and livelihoods of communities across Sudan, like in much of the rest of the world. However, the impact in Sudan has been aggravated by the already crumbling healthcare infrastructure and deteriorating economy, on top of the uncertain political transition the country is going through. A recent analysis suggests that the rates of COVID-19 infections and deaths have been vastly underreported, giving people a false sense of security due to the belief that the hot weather conditions in the country and some form of “natural immunity” are protective against the virus, as well as widespread disbelief in its existence in the first place.
Duriya and Ahmed are community COVID-19 first responders where there are no responders, facing off the pandemic with a dwindling supply of ammunition. Their job - and that of the community Youth- Peer Electronic Education Resources (Y-PEER) volunteers across the country - is a challenge difficult to face, let alone accomplish. Still they respond, against many odds, spurred on by the sense of responsibility to their families and communities, and the strong conviction that their actions could yet make a difference in an otherwise desperate situation.
The Y-PEERs Sudan is a branch of the global Y-PEERs network that works within communities to change behaviours for the better, using different educational methods including direct dialogue with youth peers from both genders, and raising awareness. The network was established by UNFPA (in partnership with UNICEF) in 1999, and originally focused on gender-based violence, reproductive health, education, and supporting peace movements in Sudan. With COVID-19 increasingly wreaking havoc in their communities, however, the network caught that ball mid-air and hit the ground running.
Duriya and Ahmed didn’t wait for the official government response which they knew may never come. Instead, they started working with their peers to crowdsource ideas for locally appropriate prevention methods, raised awareness about what could work to mitigate the impact of the virus on health and wealth of community members, and led initiatives to support the most vulnerable in coping with the need to shield themselves. They have been doing all this through community-led, community- conducted research that generates much needed contextualized, real-time and relevant evidence.
Action based on research is new to the network, and this is where the partnership with a group of humanitarian and public health experts based in the London School of Hygiene and Tropical Medicine
2
and the University of Khartoum has come in, supported by UK Aid. The partnership was named the Sudan COVID-19 Research Group, and together they have been navigating the impact of COVID-19 in Sudan from the community level upwards through mitigation practices tailored to the local context.
Of course, the process has not been easy. Research and training face many challenges in the country, starting with a very basic one: communication. Internet and phone coverage issues form some of the biggest obstacles for researchers especially at the data collection phase, causing members to miss out on meetings and forcing them to shift strategies several times (including recording meetings and uploading them to a private channel and sharing links with the team).
Cooperation at the community level has also been a challenge with wide-spread skepticism of the existence of COVID-19, stigma surrounding the disease and all those who contract it, and hesitancy of research participants to engage in unfamiliar remote data collection methods. But as the Y-PEERs are trained to mobilize the communities they work and live in, they have been able to overcome most of these difficulties through their extensive networks. Targeting community influencers and gate keepers, they managed to unlock doors that would have otherwise remained firmly shut.
Challenges also exist at the policy level. The insanely high turnover rate at the Federal Ministry of Health makes getting to (and holding onto) policy makers a near impossible feat. This has been a longstanding challenge in Sudan which jeopardizes sustainable health policy development and the maintenance of any kind of institutional memory. Still, the recent economic and political deterioration in the country, in addition to the constant change of leadership following ever-shifting political alliances, further exacerbated the massive brain drain and turnover. Nevertheless, Y-PEERs Sudan has also been able to overcome this challenge by leveraging their networks within the ministry starting at the most junior level, in order to get their voices heard higher up.
The high level of community engagement in all aspects of the study has been crucial to the project’s success. The study teams and data collectors include members who live and work in each of the study sites, and all members are heavily involved in the data management and analysis. This contextuality provides valuable depth and strength to the qualitative component of the studies in particular, providing a wealth of data that extends well beyond COVID-19.
These results have been translated into targeted advocacy campaigns at community and national levels, and policy briefs delivered to and discussed with policymakers at the highest level – including the High Commission for Emergencies which is tasked with leading the country through the COVID-19 crisis. These briefs have provided evidence-based advice on easing lockdown regulations and navigating the second COVID-19 wave, and most importantly have provided evidence supporting shielding high-risk populations as a locally-appropriate mitigation method. Based on the teams’ recommendations, the shielding concept was introduced into the national COVID-19 guidelines for the first time.
A small victory for Ahmed and Duriya, but their fight is far from over. They and their fellow Y-PEERs continue to mobilize their communities, supporting families affected by the pandemic and resulting economic impact, shooting down rumours and fake news around the virus, and expanding their research agenda across the country so that no one is left behind – and all this despite the difficulties they themselves face in their daily lives. Moreover, the partnership is well-chosen, with the youth being both players and beneficiaries from what is sown today and harvested tomorrow.
3
Men’s health: lessons from the pandemic
Peter Baker, Director, Global Action on Men’s Health [email protected]
Over two million men have already died from COVID-19 worldwide. They account for around 60% of deaths and there is a higher ratio of male:female deaths in all but seven of 193 countries for which there is data. Women are much more affected by the secondary impacts of the pandemic, including employment and gender-based violence, but men have without doubt taken the biggest hit in terms of mortality. Low-income and racial minority men have fared particularly badly.
The reasons for men’s vulnerability are not yet fully understood but are most likely linked to a mix of a weaker immune system, higher rates of a range of underlying conditions (including hypertension, diabetes and lung disease), and lower levels of preventive self-care (mask-wearing, handwashing and social distancing). Many men also have jobs, such as transportation, more likely to expose them to infection.
International Men’s Health Week (14-20 June) provides an opportunity, 18 months or so since the start of the pandemic, to reflect on whether it was inevitable that men’s health outcomes would be this bad and what lessons can be learned for the future so that the same disaster need never happen again.
Despite men’s dominance in global health leadership and clear evidence of men’s poor outcomes, including life expectancy and premature mortality, men’s health has not received systematic attention. An analysis of 35 national health policies in the WHO European Region’s member states found that the term ‘men’s health’ appeared just once. A review of national policies on health, HIV, sexual and reproductive health and mental health in 14 countries in eastern and southern Africa found that the health of men and boys was well addressed in the health policy of just one country, eSwatini.
Had comprehensive action to improve men’s health been taken before the pandemic struck, COVID- 19’s impact on men would almost certainly have been far smaller. Fewer men would have had an underlying condition that put them at greater risk. Pandemic-response policies could have been informed from the outset by an understanding of sex and gender that recognized men’s specific needs. Health promotion campaigns could have drawn on past experience of targeting men successfully.
A new approach to gender and health is now needed for the benefit of everyone. For men, policymakers and service providers must take these five key steps:
1. Collect, analyse and publish data on men’s health to provide a guide to where action is needed and to judge its effectiveness. 2. Recognise the inequalities between men and target action on those groups in the greatest need. 3. Introduce health policies that address men specifically and also include men in all relevant health policies (eg. on cancer, mental health, COVID-19). 4. Address the practical barriers, such as opening hours, that make it harder for men to access mainstream primary care services. Meeting men ‘where they are’, with services provided in workplaces, sports clubs, communities and online, can also help. 5. Take account of male gender norms when designing services and health campaigns, eg. reframing ‘mental health’ as being about ‘stress’ or ‘losing weight’ as ‘getting fit’.
4
Over the past decade, there has been a growing volume of men’s health scholarship complemented by the practical expertise of men’s health organisations around the world. We now know what works. There is no longer any excuse for failing to take action that would benefit men as well as their partners, families, communities and workplaces.
The G7 is set to miss another opportunity for global health leadership
Professor Garrett Wallace Brown is Chair of Global Health Policy and Co-Lead of the Global Health Research Theme at the University of Leeds, United Kingdom.
On June 11th the leaders of the G7 will meet in Cornwall to ‘build back better’ from coronavirus. As would be expected, global health security is high on the political agenda, and Boris Johnson, who holds the G7 Presidency, has started to roll out his initiatives. This is not unusual, since the G7 has traditionally played an important role in global health policy, both for better and worse.
For better, at the Japanese Summit in 2000, the members of the G8 (before Russia was expelled for invading Crimea) committed $10 billion to launch both the Global Fund to Fight, AIDS Malaria and Tuberculosis (GFATM) and the GAVI Alliance. Although these institutions have been far from perfect, it would be churlish to dismiss their positive impact on global health security, since they are estimated to have saved millions of lives.
Yet, for worse, the G7 also has a history of being big on words and light on follow-through and well- integrated policies. For example, in 2015, the leaders of the G7 in Germany declared that Ebola had been ‘a global wakeup call’ for better pandemic cooperation. In response, the G7 backed the establishment of the Global Health Security Agenda (GHSA) and underwrote the World Bank’s Pandemic Emergency Financing Facility (PEF). Both initiatives were not fit-for-purpose and were nowhere to be seen during the pandemic.
In the case of the GHSA it has struggled to get members (only 69 countries), is poorly integrated with other global policies, and lacks funding and political commitment, particularly from G7 countries. PEF, which was meant to deliver $500 million within 72 hours of a pandemic threat, sat idle, and has now been terminated. As the former Chief Economist of the World Bank lamented, PEF was an ‘embarrassing mistake’, created by ‘goofy governments who wanted to have an initiative for the G-7’ and ‘officials who loved the phrase “private sector involvement”’.
The recently published 2021 Carbis Bay Progress Report, a G7 progress report on development commitments, focused heavily on how the G7 has helped to strengthen health systems, expand access to vaccines, to advance universal health coverage (UHC), while also promoting health security. However, when examined in detail, the report shows only minor gains and seemingly counts everything the G7 does as somehow advancing health security. This inflates the positive narrative while shifting the blame for emerging health risks on low-to-middle income countries.
5
That said, what is promising about the progress report is that it does recognise key shortcomings in current global health security policy, which has tended to narrowly focus on surveillance, vaccine discovery, and countermeasures, with little attention given to upstream determinants, prevention or preparedness. As the report suggests, ‘the foundational role of strengthening health systems to the goals of UHC and Global Health Security (GHS) has only become clearer, not least in the face of the COVID-19 pandemic that has challenged health systems across the globe. The case to look at UHC, GHS and health system strengthening together is clear, as is the need for continued leadership by the G7 and other partners in these priority areas’.
Nevertheless, there are worrying signs that key lessons learned from the 2021 Carbis Bay Report and from COVID-19 are being missed at this G7 Summit. Two stand out.
First, a major initiative by Johnson is the Pandemic Preparedness Partnership (PPP). This initiative aims to establish a public-private partnership that includes industry, international organisations and experts to help deliver vaccines, therapeutics and diagnostics more quickly, via co-operation on research and development, manufacturing, clinical trials and data-sharing. The ultimate aim, according to Johnson, is to ‘slash the time to develop vaccines for new diseases to 100 days’.
The problem with the PPP is that it merely continues our current obsession with vaccine discovery and immunisation as the primary means for health security. This approach got us here in the first place and often comes at the expense of other preventative and preparedness measures (as highlighted in the 2021 Carbis Bay Report).
This is concerning since an overreliance on immunization for health security does not appropriately reflect the empirical evidence, both in terms of general public health and, particularly, in the case of Covid-19, in which social determinants, age, comorbidities, and previous exposure to infections play a determining role in explaining the ‘transition’ from SARS-CoV-2 infection to severe forms of Covid- 19. Given the epidemiological complexities, vaccine dominant strategies risk being suboptimal, when not strongly coupled with more ambitious preventative public health policies and investments in population health. If the lessons of COVID-19 taught us one thing, it was confirmation of the principle that ‘an ounce of prevention is worth a pound of cure’.
Moreover, it is not clear how the PPP’s 100-day target was selected and whether it is a case of putting the cart before the horse. At the moment, it looks arbitrary, better suited for political slogans and G7 speeches, than rooted in science. This raises several quality and control concerns, particularly if clinical trials and government approvals will be fast tracked in order to meet the target. As the lessons from COVID-19 demonstrate, hurried processes and speedy trails can restrict our evidence-base, which can leave significant gaps in our knowledge about who can receive the vaccine, how long the vaccine generates immunity, whether it reduces transmission, while also fuelling vaccine hesitancy and mistrust. Lastly, overreliance on vaccine strategies assumes that we can find an effective vaccine to future pathogens. This is not a given, since there are many diseases where vaccines remain elusive.
Second, although the G7 Health Minister’s communiqué on June 4th 2021 provided some positive words on revamping global health policy (whole-of society approach; One Health; intersectoral, health system strengthening, and gender), the communiqué was light on detail, and much of the language used could have been cut and pasted from the 2015 G7 communiqué. This is troubling if not backed with appropriate mechanisms, since historically the problem with G7 global health policies is that they are disjointed, increasing governance fragmentation, where financial commitments are scarce, coordination between institutions limited, and political leadership wanting.
6
Beside a few promises to establish expert committees (e.g. the Zoonoses Community of Experts & the New Variant Assessment Programme) there is little in the PPP or the Health Minister’s Communiqué that indicates real commitment to the political and financial reform mechanisms needed to address the counterproductive public health effects of ‘vaccine nationalism’, ongoing violations of the International Health Regulations, uncoordinated pandemic travel policies, meaningful attention to upstream zoonotic and environmental determinants, global health system strengthening, and/or the lack of political will and investment required to seriously reboot global health governance. In the case of finance, the numbers being discussed look meagre, and hardly an investment in global health, particularly when compared to the estimated $25 trillion COVID-19 has cost the planet in stimulus packages and lost GDP.
Furthermore, like the PPP, the Minister’s Communiqué again overemphasises surveillance, data sharing and immunisation as the mainstay of global health security. This symptom approach becomes precarious as the risks from emerging epidemics and syndemics are estimated to intensify with increased habitat encroachment, increased social inequality, degradation of living conditions, social environments and ecologies, urban density, and climate change. These upstream determinants require a much stronger focus on prevention and preparedness. Otherwise, we simply let pathogens emerge and lockdown until vaccines can be discovered, produced and globally distributed.
As an alternative Britain should be more ambitious with its G7 Presidency to push a broader continuum of strategies that includes vaccine discovery and equitable immunization, but also strategies promoting better global population health and healthy lifestyles, targeted prevention on other determinants of health, adequate primary care and monitoring, early treatment, health system strengthening, enhanced health regulations, and sufficient national, regional and global system policy preparedness for emerging epidemics.
These reforms will require a paradigm shift in our thinking about global health, where health becomes an investment, not a line-item expense, and where preventive measures beyond siloed vaccine strategies are taken seriously – and there are already frameworks being developed elsewhere that can promote this approach, such as the Health Systems for Health Security framework being finalised at the World Health Organisation. Without this more holistic approach we are doomed to repeat the failed lessons from the G7 Summit in 2015 and COVID-19. Thus, merely elevating yet another set of misaligned, uncoordinated, half-hearted, and under-resourced global health and pandemic preparedness partnerships and policies. We must ‘build back better’ than that.
Highlights of the week
High-Level meeting on AIDS (8-10 June) https://hlm2021aids.unaids.org/
Check out the political declaration: https://www.unaids.org/en/resources/documents/2021/2021_political-declaration-on-hiv-and-aids
7
UNAIDS (press statement)- New global pledge to end all inequalities faced by communities and people affected by HIV towards ending AIDS https://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2021/june/20 210608_hlm-opens
“World leaders agree[d] to reduce the annual number of new HIV infections to under 370 000 and AIDS-related deaths to 250 000, eliminate new HIV infections among children, end paediatric AIDS and eliminate all forms of HIV-related discrimination by 2025. They also committed to providing life-saving HIV treatment to 34 million people by 2025. United Nations Member States adopted a set of new and ambitious targets in a political declaration at the United Nations General Assembly High-Level Meeting on AIDS, taking place in New York. If the international community reaches the targets, 3.6 million new HIV-infections and 1.7 million AIDS-related deaths will be prevented by 2030….
….The political declaration calls on countries to provide 95% of all people at risk of acquiring HIV within all epidemiologically relevant groups, age groups and geographic settings with access to people-centred and effective HIV combination prevention options. It also calls on countries to ensure that 95% of people living with HIV know their HIV status, 95% of people who know their status to be on HIV treatment and 95% of people on HIV treatment to be virally suppressed….
… Member States agreed to a target of ensuring that less than 10% of countries have restrictive legal and policy frameworks that lead to the denial or limitation of access to services by 2025. They also committed to ensure that less than 10% of people living with, at risk of or affected by HIV face stigma and discrimination by 2025, including by leveraging the concept of undetectable = untransmittable (people living with HIV who have achieved viral suppression do not transmit HIV)….”
HPW - Russia Stuns UN High-Level Meeting on AIDS by Refusing to Support Consensus Declaration https://healthpolicy-watch.news/87348-2/
“Russia stunned the United Nations High-Level Meeting on AIDS on Tuesday when it proposed a series of last-minute oral amendments to the political declaration which would have removed references to “rights”, and the decriminalisation of sex work and injecting drug use. The declaration has been negotiated over the past two months under the leadership of Australia’s Mich Fifield and Namibia’s Neville Gertze… However, the watered-down resolution was not adopted by consensus but put to a vote after the vast majority of delegates voted against the Russian amendments. The declaration was carried by 162 countries in favour with four against, with Belarus and Qatar siding with Russia. After the vote, however, a number of countries that supported the declaration made it clear that their support was qualified. Countries including Bahrain, Egypt and Libya disassociated themselves in particular from references to “key populations” – those groups considered particularly vulnerable to HIV, including sex workers, men who have sex with men and injecting drug users. …”
“… Meanwhile, African countries including South Africa, Rwanda and Cameroon expressed disappointment that the declaration to guide the global campaign against HIV had not been adopted by consensus…”
8
As a reminder: UNAIDS 2025 “10-10-10 targets” are: Less than 10% of countries with punitive legal and policy environments; less than 10% of people living with HIV and key populations experiencing stigma and discrimination, and less than 10% of women, girls, people living with HIV and key populations experience gender inequality and violence.
Link to some coverage of the meeting (with key speakers like W Byanyima et al):
UN News - Step up HIV fight, to end AIDS ‘epidemic of inequalities’ by 2030
NYT - U.N. Declaration on Ending AIDS Should Have Been Easy. It Wasn’t. https://www.nytimes.com/2021/06/08/health/unaids-declaration-patents.html
Must-read analysis on the diplomatic negotiations behind the Declaration.
“Even with U.N.’s previous goals unmet, delegates tried to water down provisions regarding protections for vulnerable populations and patents for essential drugs….”
“…On Tuesday, the United Nations is predicted to undertake new targets for ending AIDS as a public well being menace by 2030, seemingly a aim most international locations may simply have agreed to. But consensus has been elusive. In early negotiations over the settlement, known as a political declaration, the United States and the European Union fought to ban insurance policies and legal guidelines that stigmatize, and even criminalize, high-risk teams — and drastically scaled again strikes to chill out patent protections for H.I.V. medication. …. … Included within the closing draft is a crucial new aim of getting most nations reform discriminatory legal guidelines, in order that lower than 10 p.c of the world’s international locations would have measures that unfairly goal folks prone to, or dwelling with, H.I.V….”
“… But the declaration doesn’t transfer the needle on patent protections. The United States was amongst these nations whose delegates considerably watered down — or moved to chop — language to chill out patents to permit for better entry to inexpensive H.I.V. medication in low- and middle-income international locations, a stance at direct odds with the Biden administration’s help of patent waivers for Covid vaccines….”
Plos Med (Perspective) - Ending AIDS as a public health threat by 2030: Time to reset targets for 2025 P De Lay, M Dybul et al ; https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003649
« In 2015, the United Nations’ (UN) Sustainable Development Goal (SDG) 3 established that by 2030, the world would “end the epidemics of AIDS, tuberculosis, malaria …”. As part of the SDG strategy, UNAIDS and partners developed the “Fast Track Response Strategy” in 2016 and, using standardized epidemiologic guidelines, defined “ending AIDS as a public health threat” as a 90% reduction in HIV incidence and mortality by the year 2030, compared to a baseline year of 2010…”
9
“… in light of all of the [current] challenges, is it still realistic to end AIDS as a public health threat by 2030? Recognizing the challenges and to ensure that we do not reverse the gains made to date, what do we need to do to get back on track to meet the UN 2030 goal to end AIDS as a public health threat? »
« … In 2018, UNAIDS and partners initiated a new strategic planning process, which would examine progress thus far and determine where the global community has succeeded and where we are falling behind. For this process, the most current and comprehensive evidence base was elicited to identify the most effective interventions that can contribute to achieving impact over the next 5 years. … The primary goal for this multiyear endeavor was to reexamine the range of critical targets that needed to be achieved and to assess the impact of a more comprehensive and differentiated approach to addressing the HIV epidemic that would efficiently achieve the 2030 goal. One primary output of this process was to describe a new set of interim targets for 2025, which would recalibrate the global response and assure that the 2030 goals could be achieved. We are therefore announcing a PLOS Collection in which articles will include a more detailed description of the process and present some of the conclusions…”
« … The new set of 2025 targets, including those addressing financial needs and societal enablers, has been incorporated in the UNAIDS Strategy for 2021 to 2026, which was approved by the UNAIDS Programme Coordinating Board in March 2021, and which is expected to guide and influence countries, major donors, and implementing organizations. …”
HIV Policy lab - UN High-Level Meeting on HIV/AIDS 2021: HIVPL Data and Analysis on the 10-10-10 Targets https://hivpolicylab.org/hlm2021
From late last week. “At the High-Level Meeting on HIV/AIDS (June 8-10, 2021), UN member states [will] recommit to the goal of ending AIDS by 2030. The Political Declaration is expected to recognize the central role that inequalities, stigma and discrimination, and violence play in fueling the HIV pandemic and the necessity of reforming laws and policies that drive discrimination and undermine access to HIV prevention and treatment. The Political Declaration follows on UNAIDS’ release of the Global AIDS Strategy 2021-2026: End Inequalities. End AIDS. At the core of the strategy, an ambitious new set of targets, the 10-10-10 targets, call on countries to repeal punitive laws/policies that target key populations and to implement supportive laws/policies that combat stigma, discrimination, and gender-based violence. “
“The HIV Policy Lab has developed a set of analyses to support advocacy around the High-Level Meeting and 10-10-10 targets. … These policy briefs highlight the progress countries have made towards adopting the laws/policies called for in the 10-10-10 targets, globally and in each UNAIDS region….”
And a few links:
Think Global Health - Criminalizing HIV Slows Progress (by D Jahagirdar)
MSF - HIV/Aids: A disappointing last final political declaration
10
HPW - Ambitious Goal to End HIV/AIDS By 2030 Endorsed by UN – But Targets Threatened By Realities on the Ground
“ UNAIDS hailed a new political roadmap to end HIV/AIDS by 2030 as a “major feat”, but admitted that its implementation would remain a challenge – along with devising ways to measure how inequalities in access to prevention and treatment are reduced for people and groups most at risk….”
G7 Health Ministers’ meeting (Oxford, 4 June)
Kicked off a G7 week, together with the G7 Finance Ministers’ & Central Bankers meeting (see below).
G7 Health Ministers’ Meeting, communique https://www.g7uk.org/g7-health-ministers-meeting-communique-oxford-4-june-2021/
“We therefore commit to take the following strategic actions as G7 Health Ministers across 4 areas: global health security; antimicrobial resistance; clinical trials; digital health.”
See tweet Kent Buse: “Health Minister communique *touches* huge range of key issues ;but a real frustrating lack of specific, deep & strong commitments ;'equitable access' to #CovidVaccine sharing qualifier: 'working with #COVAX when domestic situations permit'. !!
PS: “when situations allow”, that didn’t sound promising….
Reuters - Britain says G7 countries in health agreement for clinical trials boost Reuters;
“Britain said that the G7 group of advanced economies agreed on Friday to speed up and share results from clinical trials on, for instance, vaccines to better tackle the COVID-19 pandemic and future threats to global health. The G7 Therapeutics and Vaccines Clinical Trials charter sets out shared principles to accelerate the speed with which clinical trials generate evidence to enable timely and decisive action on findings, said Britain's health ministry….”
Related Stat op-ed - The future of pandemic preparedness: agile coordination around clinical trials (by John Tsai - member of the Pandemic Preparedness Partnership steering group.)
G7 Finance Ministers and Central Bank meeting (4 June)
Some encouraging news for global tax justice, although a lot more will be needed still. But a potential milestone, in principle at least, on the (difficult) journey towards a social contract for the 21st century.
11
G7 Finance Ministers and Central Bank Governors Communiqué https://www.g7uk.org/g7-finance-ministers-and-central-bank-governors-communique/
“Today #G7 Finance Ministers & Central Bank Governors chaired by Chancellor @RishiSunak agreed a landmark deal on global tax, and ways to build a strong, sustainable, balanced and inclusive global economic recovery.”
You probably also saw this tweet by Gabriel Zucman: “The G7 deal on corporate tax is historic, inadequate & promising — yes all of that at the same time! Historic because it's the first time that countries agree to a minimum *rate* Inadequate because 15% is way too low Promising because there's no obstacle to reaching 25% soon”.
Some analysis:
• Economist - Fighting for the scraps: Will poorer countries benefit from international tax reform? Yes, but a lot less than rich countries, it appears…. Read why. “…Perhaps the biggest complaint is that rich countries may get the bulk of taxable profits being grabbed back from havens, while poor ones are left with the scraps….”
• Foreign Policy - Big Tech and Other Multinationals Are About to Pay a Lot More in Taxes
“Biden and the Europeans are close to agreement on a virtual revolution in international corporate tax policies. … Biden is expected to sign off on the deal at his summit next week in Cornwall, England. If an agreement is then reached by the G-20 finance ministers at their meeting in July—and finally by leaders at the G-20 summit in October—the changes could amount to a virtual revolution in international corporate tax policies. …”
International Centre for Tax & Development - The G7 tax deal: ‘historic’ and ‘global’? https://www.ictd.ac/blog/g7-tax-deal-historic-global/
Excellent analysis by R C Christensen. “…the significance of the G7 announcement has been massively overblown and oversold, in both political and normative terms. There are at least four parts to this argument worth highlighting….”
G7 Leaders’ summit: Advocacy & analysis ahead of the meeting
As you can imagine, there was plenty of high-level advocacy (and analysis of what needs to be done) ahead of the G7 summit in Cornwall.
12
HPW - WHO Calls On G7 to Donate 100 Million More Vaccines by End July; New COVID Cases Decline Globally https://healthpolicy-watch.news/global-decline-in-new-covid-cases-but-deaths-still-rising-in- americas-africa-western-pacific/
“WHO’s Director General Dr Tedros Adhanom Ghebryesus called on leaders of the G7 Group of the world’s most industrialized nations to share at least 100 million more COVID-19 vaccine doses with low- and middle-income countries in June and July and 250 million doses by September. His appeal, at a WHO press conference Monday, added to the growing chorus of voices being directed at G7 leaders to step up donations of vaccines and funding – when they meet this coming weekend in Cornwall, England for the first face-to-face meeting since the pandemic began. … … He also called upon vaccine manufacturers to commit 50% of any new volumes of vaccines produced to the WHO co-sponsored global COVAX facility – or at the least give COVAX the first right of refusal to those new vaccine volumes. …”
See also Reuters - Funding and vaccines sought from G20 nations for COVAX, says WHO
“Emerging powers among G20 countries including China, Brazil and India are being pressed to contribute urgent financing and COVID-19 vaccines for the COVAX dose-sharing facility, the World Health Organization and a Norwegian official said on Monday. Ahead of the G7 summit this week, wealthy countries have also been pushed to follow the United States in making doses available immediately to cover a 200 million dose gap caused by Indian supply disruptions and manufacturing delays. read more So far some 150 million doses have been pledged to COVAX, far short of the 250 million needed by the end of September, and 1 billion target by year-end, the officials said….”
“Bruce Aylward, senior adviser to the WHO director-general and its coordinator of the ACT (Access to COVID-19 Tools) Accelerator, and Norway, which co-leads the COVAX Facilitation Council with South Africa, said more investments were needed. "We still need more contributions from G7 but are also calling for wider investments from the G20," John-Arne Røttingen, Norway's ambassador for global health, told reporters. "We must be frank to say that currently several of the larger emerging economies constituting an important part of the G20, they have still not contributed financially to the ACT-Accelerator. So this is of course countries like China, Brazil, to mention a few," he added. Aylward said that discussions were being held with China and India but gave no details. … "We are not restricting our gaze to the G7," he said.”
Devex - ACT-Accelerator calls on G-7 to pay their fair share https://www.devex.com/news/act-accelerator-calls-on-g-7-to-pay-their-fair-share-100088
“In the lead-up to the G-7 Cornwall Summit, members of the ACT-Accelerator are calling on the world’s richest nations to contribute their ‘fair share’ in financing efforts to increase equitable access to COVID-19 tests, treatments, and vaccines by the end of this month. The ACT-Accelerator is currently $18.1 billion underfunded which is hindering the distribution of personal protective equipment, diagnostics, therapeutics, and oxygen needed to control the COVID-19 pandemic as vaccines slowly trickle into countries. … The ACT-Accelerator’s Financing Working Group has developed a burden-sharing framework for governments as a way to “split the bill” on efforts to manage the pandemic. It is based on countries contributing on their gross national product, income per capita, with an adjustment on how dependent economies are to global trade, said John-Arne
13
Røttingen, the ambassador for global health for Norway, which is co-chair of the ACT-Accelerator Facilitation Council, during a press conference on Monday….”
“Only two countries in the G-7— Germany, and Canada — have contributed their share of funding based on the shared burden structure, while Italy, the United Kingdom, and the United States have contributed more than half of their determined contribution. The remaining countries in the G-7 include Japan, which has contributed 16%, and France, which has contributed 15%. The ACT- Accelerator is also calling for wider contributions from the G-20, with hopes to receive these funds by the middle of this year, Røttingen said. Key larger emerging countries — including China, Brazil, and Russia — have still not contributed financially to the ACT-Accelerator, he said….”
“… But financing is not going to solve the problem, because of the limited production of vaccines, he said. Because of this, the ACT-Accelerator is also calling on the G-7 countries to donate 1 billion doses by the end of the year with an initial 250 million doses to be donated by the end of September. …”
HPW - Public Support for G7 Investment in Vaccine Rollout and Sharing of Doses and Know-how https://healthpolicy-watch.news/boris-johnson-calls-for-global-vaccination-by-end-of-2022-while- former-world-leaders-urge-g7-to-fund-vaccinations-in-low-income-countries/
“… a poll conducted by Save the Children, which found that support for G7 countries paying for global vaccinations was overwhelming among respondents across the G7’s European and American members. Japan, the G7’s only Asian member, was not included in the poll. In the UK, 79% of respondents were in favour of such a policy, 76% supported it in the US, 73% in Canada, 71% in Germany, and 63% in France. Some 80% of the respondents backed both the sharing of doses and intellectual property for vaccines by G7 countries. …”
Telegraph - Covid could wipe out ‘generation of healthcare workers’ in poorest nations as just 10pc vaccinated https://www.telegraph.co.uk/global-health/science-and-disease/covid-could-wipe-generation- healthcare-workers-poorest-nations/
“Fewer than 10 per cent of healthcare workers have been vaccinated in the world’s poorest countries, the World Health Organization has warned, amid mounting concerns that Covid still has the potential to wipe out a generation of medics. The stark warning comes as calls for wealthy countries to donate available shots become more urgent. The WHO says that – at a minimum – 250 million doses need to be shared by September, rising to one billion by the end of the year, to begin to tackle the vaccine “equity gap”….”
Quotes:
“… In most African countries political leaders and those in public office were vaccinated first – as the supply of vaccines has stalled, [the] majority of health care workers remain unvaccinated,” Dr Ayoade Alakija, co-chair of the Africa Union Vaccine Delivery Alliance, told The Telegraph. “With
14
the looming third wave in Africa we risk losing not just a generation of healthcare workers, but a collapse of a continent's health infrastructure – because rich countries insist on hoarding vaccines.”
“…as well as the risk of catching, and possibly dying, from coronavirus, there is evidence that the pandemic experience is pushing people away from working in the healthcare sector in countries including the UK, United States and China. “So we can imagine that this would be true globally,” said Clare Wenham, a professor of global health policy at the London School of Economics. “But with the added kick in the face of being unvaccinated when we a) have vaccines b) are 18 months plus into this.” She added that “the mental anguish of having to go to work unprotected” will have ramifications for years, as it will mean people drop out of the profession and it is harder to recruit into. …”
Guardian - Covid: more than 200 leaders urge G7 to help vaccinate world’s poorest https://www.theguardian.com/world/2021/jun/06/covid-global-leaders-urge-g7-to-help-vaccinate- worlds-poorest
As already reported in previous newsletters. “Former PMs, presidents and ministers sign letter saying richest should pay two-thirds of $66bn needed.”
And via WEF: IMF and World Bank urge G7 to release surplus vaccines
“The heads of the International Monetary Fund and World Bank on Thursday urged the Group of Seven advanced economies to release any excess COVID-19 vaccines to developing countries as soon as possible, and called on manufacturers to ramp up production. In a joint statement to the G7, IMF Managing Director Kristalina Georgieva and World Bank President David Malpass also called on governments, pharmaceutical companies and groups involved in vaccine procurement to boost transparency about contracting, financing and deliveries….”
AP – ‘This IS INSANE’: Africa desperately short of COVID vaccine AP;
“… In an interview, John Nkengasong [African CDC] called on the leaders of wealthy nations meeting this week at the G-7 summit to share spare vaccines — something the United States has already agreed to do — and avert a “moral catastrophe.” “I’d like to believe that the G-7 countries, most of them having kept excess doses of vaccines, want to be on the right side of history,” Nkengasong said. “Distribute those vaccines. We need to actually see these vaccines, not just ... promises and goodwill.” Others are not so patient, nor so diplomatic. “People are dying. Time is against us. This IS INSANE,” South African human rights lawyer Fatima Hasan, an activist for equal access to health care, wrote in a series of text messages….”
“Africa alone is facing a shortfall of around 700 million doses, even after taking into account those secured through WHO’s vaccine program for poorer countries, COVAX, and a deal with Johnson & Johnson, which comes through in August, two long months away….”
15
Lancet Perspective - Epidemiology, not geopolitics, should guide COVID-19 vaccine donations T Bollyky, C Murray et al ; https://www.thelancet.com/journals/lancet/article/PIIS0140- 6736(21)01323-4/fulltext
« Maximising the potential of vaccine donations in this pandemic depends on vaccine doses going where they can do the most good. But there is currently no consensus on where that would be. … Without a compelling metric of where the greatest public health benefit will be gained from vaccine donations, G7 policy makers are likely to split the difference between these paths and direct some spare vaccine doses to COVAX's population-based allocation scheme while sending the remaining doses to allies, economic partners, and countries where they have strategic interests.
… Whether donated through COVAX or bilaterally, spare COVID-19 vaccine doses should be allocated to reduce the most premature deaths. Although it is impossible to know for certain where future COVID-19 deaths will occur, it is possible to anticipate impending needs in this pandemic. …. … On the basis of the estimates in the figure, the areas of greatest need, taking into account the available data on secured vaccines and likely SARS-CoV-2 variants, are in Latin America, central and eastern Europe, central Asia, and South Africa—settings that have received among the fewest COVID-19 vaccine donations to date….” « … Within Latin America, countries expected to have high COVID-19 death rates in the next 3 months but that have received few or no vaccine donations to date include Bolivia, Colombia, Peru, and Uruguay. COVID-19 crises are also likely to loom throughout central Asia, but only two countries in that region (Kyrgyzstan and Uzbekistan) have received vaccine donations. By contrast, most countries in the Asia-Pacific region are projected to have lower COVID-19 death rates than in other regions, but have received nearly 60% of all vaccine donations so far…”
Guardian - Share vaccines or climate deal will fail, rich countries are told https://www.theguardian.com/society/2021/jun/05/share-vaccines-or-climate-deal-will-fail-rich- countries-are-told?CMP=Share_iOSApp_Other
Making the link between global vaccine equity & the climate negotiations. “Progress on climate change could be scuppered by developing nations if they are not given equitable access to vaccines, Boris Johnson has been warned, as rich nations come under new pressure to donate more doses. … Before a three-day G7 summit beginning in Cornwall on Friday, a growing number of influential figures believe failure to agree a vaccination plan for poorer countries could lead to them refusing, or being unable, to work with rich countries in the battle against the climate crisis….”
“… In a key week for UK diplomacy, Johnson is hoping to use the G7 gathering to lay the groundwork for Cop26, the vital UN climate summit being held in Glasgow in November, to which it is hoped rich and developing nations will send delegations. But as rich nations face accusations of stockpiling vaccines, Paul Polman, the former chief executive of Unilever and chair of the International Chamber of Commerce, said the two biggest global challenges were becoming increasingly, and dangerously, linked. “We can’t have global solidarity and trust around tackling climate change if we do not show solidarity around vaccines,” Polman said. “Developing countries will not come with more ambitious targets [on emissions] if they do not see developed countries
16
showing some solidarity on vaccines, and climate funding.” The chances of success at Cop26, Polman said, “will be significantly higher if we address this vaccine issue.” ..”
WP - Biden’s global vaccine strategy draws scrutiny ahead of G-7 pandemic talks https://www.washingtonpost.com/health/2021/06/08/biden-g7-vaccine-sharing-strategy-under- scrutiny/
View from the US, as Biden heads into the G7 meeting. Listing diplomatic, advocacy & domestic pressures.
Excerpt: “With the gap between vaccine “haves” and “have-nots” widening, the world wants and needs them to deliver big, said J. Stephen Morrison, director of the Global Health Policy Center at the Center for Strategic and International Studies. “The argument is being won at a conceptual level,” Morrison said. “But beyond winning the argument and having a conceptual agreement is the question, ‘Who does what?’” Days before the summit, all that still seemed up in the air. “The G-7 is on the spot because these are the countries that have surplus vaccine,” said Mara Pillinger, a senior associate in global health policy and governance at Georgetown University’s O’Neill Institute for National and Global Health Law. However, it is not clear the group shares a common vision for what to do next. Part of the problem is that members are at different stages of their own vaccination efforts …”
Chatham House (Expert Comment) - Boris Johnson the superhero is needed, not the showman R Yates; https://www.chathamhouse.org/2021/06/boris-johnson-superhero-needed-not-showman
“With potential conflict among G7 leaders and criticism over lack of ambition, there is a risk the UK prime minister may change the focus of the Cornwall summit.”
Rob’s conclusion: “…If Boris Johnson and the G7 team of 2021 are to go down in history as superheroes rather than villains, they need to follow the script – donate vaccines, fund COVID-19 commodities and health systems, and speed up technology transfers. “
G7 Research Group - UK -The Cornwall Summit G7 research group
Report. Lots of ‘Building back better bla bla” (BBBBB) from our leaders, obviously, but do check some of the more (global) health related analysis sections by experts. Including Kickbush on (5) systemic failures that need to be addressed.
Links:
17
• Rockefeller Foundation - One for All: An Updated Action Plan for Global Covid-19 Vaccination (new report) • Op-ed - G7 leaders should end not just coal, but also oil and gas finance in 2021
“Ahead of summit, more than 100 economists (including Kate Raworth) call on G7 countries to commit to shift their finance out of all fossil fuels this year, to enable a green pandemic recovery…”
G7 Leaders’ summit (11-13 June)
On June 11-13, world leaders will gather at the G7 summit in Cornwall, UK. There, they plan to adopt an agenda to “build back better from coronavirus and create a greener, more prosperous future”.
Let’s see what the summit “delivers” over the weekend. The world is certainly looking to the G7 for a detailed, funded global vaccination plan (as the Guardian put it). Or in the words of Politico, “This G-7 meeting might be the last chance for rich countries to take decisive action to control the coronavirus pandemic all over the world…”
Some early hints:
Guardian - G7 leaders will call for fresh WHO inquiry into Covid origins, leaked communique suggests https://www.theguardian.com/world/2021/jun/10/g7-communique-leak-covid-origins-inquiry- vaccines-forced-labour
“Leaders at the G7 summit will call for a new, transparent investigation by the World Health Organization into the origins of the coronavirus, according to a leaked draft communique for the meeting. The call was initiated by Joe Biden’s administration and follows the US president’s decision to expand the American investigation into the origins of the pandemic, with one intelligence agency leaning towards the theory that it escaped from a Wuhan laboratory. …. … According to Bloomberg News, which said it had sight of the communique draft, the G7 will also commit to deliver a billion extra doses of the Covid-19 vaccine over the next year to accelerate global protection against the disease….”
FT - G7 leaders to pledge 1bn Covid-19 vaccine doses for poorer countries https://www.ft.com/content/000e6968-8ae4-4f00-9cb5-324b98aa779b
“Initiative to be unveiled at Cornwall summit to address criticism wealthy nations have taken bulk of supplies…”
As part of a plan to vaccinate the world by end of 2022.
“…Speaking at the Elysée Palace on Thursday, France’s president Emmanuel Macron said he would push for the G7 to “lift obstacles” to speed up vaccination in Africa to reach a 40 per cent immunisation rate by the end of 2021 and 60 per cent by the end of the first quarter next year. Jabs
18
donated by the US and other G7 members would need to be “matched” by an additional pledge by drugmakers to give away the equivalent of 10 per cent of their dose production, Macron added….”
“…Johnson, the summit host, will ask G7 leaders to encourage pharmaceutical companies to adopt the Oxford/AstraZeneca model of providing vaccines on a not-for-profit basis during the pandemic….”
“…The summit will also try to agree a joint approach to fighting future pandemics, with Johnson keen to avoid what Downing Street called an “every man for himself” approach in which countries scrambled to secure vital supplies….”
WP - Biden administration to buy 500 million Pfizer coronavirus vaccine doses to donate to the world https://www.washingtonpost.com/politics/biden-vaccine-donate/2021/06/09/c2744674-c934-11eb- 93fa-9053a95eb9f2_story.html
“The Biden administration is buying 500 million doses of Pfizer’s coronavirus vaccine to donate to the world, as the United States dramatically increases its efforts to help vaccinate the global population, according to three people familiar with the plans….”
See also NYT - US agrees to buy 500m Pfizer vaccine doses to distribute to 100 countries
“…According to reports, the vaccines will be donated through Covax, the global initiative to help developing countries face the pandemic, and would go to 92 lower-income countries and the African Union….”
Though that might have to be qualified, cfr Twitter (Josh Wingrove):
“Biden is redirecting half of the U.S. cash pledge to Covax - $2 billion - to help pay for the 500 million Pfizer doses that the U.S. will instead send to countries directly. Total estimated cost is $3.5b. Initial Covax pledge was $2b & up to $2b more; now it's $2b & doses.”
“the doses themselves won't actually go straight to Covax. The U.S. will donate them to the 92 low- income countries that Covax deems eligible, and will work "through Covax" to deliver them, but the U.S. will be the entity allocating them.”
See also HPW - US Poised for New Donation of 500 Million Pfizer Vaccines as World Trade Organization Agrees to Text-Based Discussions’ Over IP Waiver for COVID Tools
“…Such a massive donation by the United States would be a game-changer for LMICs that have suffered massive shortfalls of vaccines – effectively reaching WHO’s recent target for developed countries to share 250 million doses by September. But it also might deflate some of the building pressures on WTO members to agree to a sweeping text on an IP waiver….”
And Reuters – Pfizer to provide U.S. with 500 million COVID-19 vaccines to donate to world
19
“The two drugmakers will provide 200 million doses in 2021 and 300 million doses in the first half of 2022, which the United States will then distribute to 92 lower-income countries and the African Union, they said. The shots, which will be produced at Pfizer's U.S. production sites, will be provided at a not-for-profit price. … Pfizer and Biontech said the doses are part of a previously announced pledge to provide two billion doses of the COVID-19 vaccine to low- and middle-income countries over the next 18 months….”
Bloomberg – G-7 Plans 1 Billion Extra Covid Shots to End Pandemic Next Year https://news.yahoo.com/g-7-plans-1-billion-210415014.html
“Group of Seven leaders are set to vow to deliver at least 1 billion extra doses of vaccines over the next year to help cover 80% of the world’s adult population, according to a draft communique seen by Bloomberg News. Ahead of the G-7 summit in the U.K., officials are putting together a document that outlines a plan to end the pandemic by December 2022….”
Guardian – UK to give 100m Covid vaccine doses to poorer countries within a year https://www.theguardian.com/world/2021/jun/10/uk-to-give-100m-covid-vaccine-doses-to-poorer- countries-within-a-year
“The UK will donate 100m surplus coronavirus vaccine doses within the next year to low-income countries as part of at least 1bn doses due from the G7.”
And related link – Devex - UK’s 100M COVID-19 vaccine donation will be additional to [0.5%] aid budget
“…80% of which will be given through the COVAX initiative and the rest bilaterally. Five million of the surplus U.K. doses will be distributed by the end of September “primarily for use in the world’s poorest countries,” said the government statement. It added that 25 million more doses would be sent out by the end of 2021 and the remaining doses within the next year….”
Reuters - UK's Johnson calls on G7 to vaccinate world by end of 2022
Reuters;
From last weekend already: “British Prime Minister Boris Johnson [last week] on Saturday called for leaders of the Group of Seven (G7) rich nations to make a commitment to vaccinate the entire world against COVID-19 by the end of 2022 when they meet in Britain next week. Johnson will host the first in-person summit in almost two years of G7 leaders - which follows a meeting of the group's finance ministers which wrapped up earlier in the day - and said he would seek a pledge to hit the global vaccination goal. … "Vaccinating the world by the end of next year would be the single greatest feat in medical history," Johnson said in a statement. " “
20
UK and US agree new partnership to fight future pandemics and tackle health inequalities https://www.gov.uk/government/news/uk-and-us-agree-new-partnership-to-fight-future- pandemics-and-tackle-health-inequalities
“UK Government confirms launch of new Centre for Pandemic Preparedness which will spearhead UK’s work to develop a global early warning system to detect new infectious disease threats; UK–US joint commitment to tackling health inequalities reaffirmed as part of levelling up agenda. The UK and the US governments have agreed a new landmark partnership between the UK Health Security Agency (UKHSA) and the US National Centre for Epidemic Forecasting and Outbreak Analysis, run by the US Centers for Disease Control and Prevention (CDC), to turbocharge efforts to combat global pandemics and emerging health threats….”
Coverage via Reuters - Britain and U.S. agree partnership to tackle new pandemics
“Britain said it agreed a partnership with the United States on Thursday to tackle new pandemics by bolstering disease surveillance and genomic sequencing worldwide, on the eve of a G7 leaders' summit….”
C-TAP, tech transfer & Trips Waiver
Progress this week in the Trips waiver discussions, both in WTO and in the European parliament, among others.
Meanwhile, (see Reuters ) “The Biden administration is committed to efforts to waive intellectual property rights for COVID-19 vaccines and will raise the issue with the World Trade Organization (WTO), but it may take time, U.S. Trade Representative Katherine Tai said on Thursday.”
HPW -World Trade Organization TRIPS Council Agrees To Advance ‘Text-Based Discussions’ Over IP Waiver on COVID Medicines and Vaccines https://healthpolicy-watch.news/world-trade-organization-agrees-to-text-based-discussions-over- ip-waiver-on-covid-medicines-and-vaccines/
“The World Trade Organization’s TRIPS Council agreed on Wednesday to move ahead with a “text- based process” – effectively greenlighting negotiations over a proposal to waive intellectual property associated with COVID tests, treatments and vaccines, Geneva-based trade officials said. … But the agreement reached by the TRIPS Council members Wednesday after a two-day meeting does not mean that European Union bloc, also backed by the United Kingdom, Republic of Korea and Switzerland, have acceded to the proposal for a blanket waiver, other sources told Health Policy Watch. Rather, an alternative EU proposal – which has proposed alternative measures to expand medicines and vaccines production – would remain on the table side by side with the waiver proposal as part of the overall negotiations, the sources said. …”
21
“…. TRIPS Council members were reportedly set to resume informal talks about the waiver on 17 June. A statement by India to the WTO meeting, reportedly set forward a target for concluding talks by end July. …” (“given the severity of the 2nd and 3rd wave hitting different parts of the world we have no time to lose”).
“… Typically, TRIPS Council members would need to reach agreement by consensus on a final draft text before submitting it to the WTO General Council – which includes all member states. … … The two day TRIPS Council meeting, presided over by Ambassador Dagfinn Sørli of Norway, saw a centrist bloc, led by the United States, Australia, Canada, New Zealand, Brazil, Norway, China and Chinese Taipei, seek a middle ground between the staunch supporters of the IP waiver – and opponents. …”
See also Reuters – WTO to start vaccine supply negotiations amid clash on patents
“World Trade Organization members agreed on Wednesday to start formal negotiations on a plan to boost COVID-19 vaccine supply to developing countries, but face rival proposals - one with and one without a waiver of intellectual property rights….” “ … WTO members agreed to begin discussions on June 17 to determine the format of negotiations and to produce a report outlining their progress on the vaccine supply plan by July 21-22, when the WTO's general council convenes, a Geneva trade official said….”
And Devex - WTO council offers hope for TRIPS vaccine proposal Good overview of where things stand now, current positions & blocks; and how the EU is increasingly isolated.
HPW - Is European Union on Collision Course With European Parliament on COVID IP Waiver? https://healthpolicy-watch.news/eu-may-be-at-odds-with-european-parliament-over-trips-waiver/
Analysis ahead of a EP vote on Wednesday. A vote, which turned out – hopefully – a gamechanger, raising further pression on the European Commission to change its stance.
“While European Union (EU) member states continue to oppose a waiver on intellectual property rights for COVID-19 vaccines and medicines, it may soon find itself at odds with the European Parliament, which is expected to pass a resolution in support of the waiver on Wednesday. … … a groundswell of support for the broader waiver initiative is emerging among European parliamentarians. The draft resolution due to go to the plenary on Wednesday calls for “a temporary TRIPS waiver for COVID-19 vaccines and related health technologies, and for the EU to actively participate in text-based negotiations at the World Trade Organization (WTO) to achieve this”.
PS: “… In the wake of the United States announcement on 5 May that it would support an IP waiver, at least for COVID vaccines, waiver advocates have turned up the heat on the EU, whose member states are now widely perceived as the key remaining barrier to some kind of compromise text on the IP waiver initiative. They also stress that time is of the essence. “In addition to muddying the water and diverting attention, the EU is also hoping that its empty-package compulsory licensing proposals will delay text-based negotiations of a waiver agreement so long that implementing the
22
waiver would be economically impractical for alternative producers and countries,” said Professor Brook Baker, Senior Policy Analyst for Health GAP….”
Via HPW – “On Wednesday evening, Parliamentarians voted for a resolution effectively supporting the WTO IP waiver initiative by a one-vote majority.” Very close….
See also Reuters - Lawmakers urge EU U-turn to back vaccine patent waiver “ The European Parliament urged the European Union to reverse its position and support a proposed temporary lifting of intellectual property (IP) rights for COVID-19 vaccines, backing a push by many developing nations to allow more production.”
HPW - MSF Slams EU Counter-Proposal To TRIPS Waiver https://healthpolicy-watch.news/msf-slams-eu/
Last weekend, “Humanitarian organisation Médecins Sans Frontières (MSF) … criticised the European Union’s (EU) opposition to the TRIPS waiver, labelling its counter-proposal published on Friday as a “manoeuvre” to replace a concrete legal solution to COVID-19 vaccine manufacturing. …. Ahead of next week’s TRIPS council meeting scheduled for 8-9 June, Senior Legal and Policy Advisor at MSF’s Access Campaign, Yuanqiong Hu, said the EU’s counter proposal not only ignored critical corrections needed to overcome the shortcomings of existing rules, but also failed to address access to a sustainable supply of tests and other life saving devices beyond vaccines and therapeutics….”
For the EU proposal, see Communication from the European Union to the WTO General Council – Urgent Trade Policy responses to the Covid-19 crisis And KEI - The European Union’s riposte to the WTO TRIPS waiver With some analysis of the EU’s counter-proposal to the proposed TRIPS waiver.
Plus a link:
MSF - EU, UK, Switzerland, Norway must stop blocking negotiations on landmark pandemic monopoly waiver
Reuters - U.S. encouraged by progress toward vaccine patent waiver Reuters;
“Progress is being made towards a deal on an intellectual property waiver for COVID-19 vaccines at the World Trade Organization (WTO), U.S. Trade Representative Katherine Tai said [last week] on Saturday. Tai pointed to a revised proposal from the original proponents of the waiver, led by India and South Africa, as well as principles the European Union has come up with to guide how they would like to negotiate the issues….”
23
Politico - Macron backs waiving COVID-19 vaccine patents ahead of G7 summit https://www.politico.eu/article/macron-backs-waiving-covid-19-vaccine-patents-ahead-of-g7- summit/
“French President Emmanuel Macron expressed support late Wednesday for waiving patents for vaccines to help end the coronavirus pandemic, putting France on a collision course with the U.K. and Germany ahead of the G7 summit in England. …”
Politico - APEC members back calls for Covid-19 vaccine IP waiver https://www.politico.com/newsletters/weekly-trade/2021/06/07/apec-members-back-calls-for- covid-19-vaccine-ip-waiver-795772
“APEC members agreed Saturday on the need to waive intellectual property protections on Covid- 19 vaccines as part of a bigger trade policy effort to help fight the pandemic. They also reaffirmed the group’s long-term goal of creating a Free Trade Area of the Asia-Pacific….”
Reuters - World Bank chief says does not support vaccine intellectual property waiver at WTO Reuters;
“World Bank President David Malpass said on Tuesday that the bank does not support waiving intellectual property rights for COVID-19 vaccines, out of concern that it would hamper innovation in the pharmaceuticals sector. Malpass, asked during a media call about new World Bank economic forecasts whether he supports WTO negotiations for a vaccine waiver, said: "We don't support that, for the reason that it would run the risk of reducing the innovation and the R&D in that sector."
HPW: With or Without Waiver – WHO Pushes Ahead on Vaccine Technology Transfers https://healthpolicy-watch.news/eu-may-be-at-odds-with-european-parliament-over-trips-waiver/
“Meanwhile, said Tedros at Monday’s WHO press briefing, WHO is also moving ahead on measures that aim to build longer-term capacity for technology transfer to developing countries, including an “mRNA Vaccine Technology Transfer Hub”. “Two months ago, WHO also issued a call for expressions of interest to establish an mRNA technology transfer hub to facilitate increased global production of mRNA vaccines,” said Tedros, who added that a technical review of expressions of interest from companies interested in transferring their technology, and countries wanting to receive the technology was being conducted. “We continue to call on companies with mRNA technology to share it through the COVID 19 technology access pool. The result can be a win-win for both the owner of the know-how as well as for public health,” added Tedros. …”
24
Devex - WHA passed resolution strengthening local medicine production. Now what? https://www.devex.com/news/wha-passed-resolution-strengthening-local-medicine-production- now-what-100062
Some more analysis of this (important) WHA resolution.
“Advocates welcomed a resolution passed in the 74th World Health Assembly calling for strengthening local production of medical technologies led by Ethiopia. But its success will depend on a number of factors, and there remain questions on some of the aims of the resolution. … “It’s a landmark resolution for a number of reasons,” said Jaume Vidal, senior policy adviser for Health Action International. The resolution responds to global “structural imbalances” in pharmaceutical manufacturing and includes “explicit references” to use the COVID-19 Technologies Access Pool or C-TAP as a “valid instrument to enhance technology transfer and scale-up production of vaccines, diagnostics and therapeutics,” he said. … The resolution would also strengthen the World Health Organization’s role in helping countries improve their regulatory systems and facilitate WHO prequalification, said Thiru Balasubramaniam, Geneva representative for Knowledge Ecology International. … But the resolution itself will depend on WHO member states’ political will — particularly large donors, as it may need extra-budgetary spending to implement — and the regulatory capabilities of regional and sub-regional entities to be effective, said Vidal. He added that its success or failure would also depend on how the resolution will combine with WHO-led initiatives such as C-TAP or initiatives in which WHO plays a role, such as Access to COVID-19 Tools Accelerator, or ACT-A. …” … WHO will need $69.54 million to implement the resolution from now to 2030….”
On the WHA resolution, see also Swissinfo - WHO aims to boost global vaccine production, but no agreement on patents
“A resolution approved at this year’s World Health Assembly to strengthen local production of medicines and other technologies acknowledges the current unequal distribution of vaccines but the plan fell short of agreement on how to boost vaccine access. …. … while the decision was widely applauded for its recognition of a failed system, it also showed a lack of agreement on how to increase vaccine production. The resolution, for instance, does not mention the possibility of a patent waiver, a proposal supported by 63 developing countries and which many argue could help to end the pandemic. … … Despite the stalemate at the WTO, observers insist that the resolution at the World Health Assembly is significant, since it recognizes the importance of enhancing local production to achieve other development goals, as well as addressing the immediate health emergency. It is also considered a step in the right direction towards price transparency, which has been a source of disagreement over the last decades between the private sector and governments….”
Reuters - EU, U.S. to agree reduction of vaccine export barriers, summit draft says Reuters;
“ The European Union and the United States are set to agree at a summit on Tuesday to reduce export restrictions on COVID-19 vaccines and drugs, a draft joint text says, arguing that voluntary sharing of technology is the key to boosting output. The document, seen by Reuters and still subject
25
to changes, makes no mention of mandatory waivers on vaccine patents, which U.S. President Joe Biden has endorsed as a temporary solution to the global shortage of COVID-19 shots. … At a EU- U.S. summit in Brussels on Tuesday, the two parties are set to agree to establish a joint taskforce to boost vaccine and drugs production capacity that will aim at "maintaining open and secure supply chains, avoiding any unnecessary export restrictions"….” “…The draft also says the taskforce will try to expand global production of vaccines and drugs by "encouraging voluntary sharing of knowhow and technology on mutually-determined terms" - a far remove from forcing pharmaceutical companies to give away their patents to competitors.”
See also Politico:” EU and US set to launch coronavirus manufacturing task force, aiming to vaccinate two thirds of the world’s population by the end of 2022.”
More Covax & ACT-A updates
See also above – in the G7 related HL Advocacy section.
Dr Aylward (WHO) estimates that the (Covax) scheme is roughly 200 million doses behind where it expected to be at this point in time. Ahead of the G7 summit, that is.
WHO - Access to COVID-19 tools funding commitment tracker https://www.who.int/publications/m/item/access-to-covid-19-tools-tracker
Regularly updated.
“As of 4 June 2021, an unprecedented mobilization of sovereign funders and private sector, philanthropic and multilateral contributors has galvanized commitments of USD 15.1 billion. The ACT Accelerator Commitment Tracker provides details of this funding. These pledges, together with cost adjustments since September 2020, bring the remaining funding gap for 2021 to USD 18.1 billion. Of note, the United States will release an additional USD 1.5 billion to Gavi through 2021 and 2022. A substantial amount of this funding is expected to further reduce the 2021 gap. The Commitment Tracker now provides an overview of vaccine dose-sharing through COVAX….”
Reuters - Funding and vaccines sought from G20 nations for COVAX, says WHO Reuters;
“A senior World Health Organization (WHO) official (i.e. Bruce Aylward) said on Monday that talks were being held with G20 countries, including China and India, regarding financial and COVID-19 vaccine donations to the COVAX dose-sharing facility.
PS: “Aylward said that a proposal submitted last Friday by the EU to the World Trade Organization to widen COVID-19 vaccine access did not go far enough and said a waiver of patent rights "would add value".
26
SCMP - Coronavirus: China’s first Covax vaccines roll off Sinopharm factory lines https://www.scmp.com/news/china/science/article/3135660/coronavirus-chinas-first-covax- vaccines-roll-sinopharm-factory
“10 million doses made in initial batch for WHO-led global sharing scheme. Preparation of the doses welcomed by Gavi, scheme’s co-leader. “
Link:
The Conversation - COVAX is failing to halt the COVID-19 pandemic: here’s why, and how to fix it (by Monica de Bolle)
“…the facility suffers from two major flaws. Firstly, it primarily allocates vaccines in proportion to population sizes, which is not the best public health metric. Secondly, it does not consider countries’ capacities to roll out massive immunisation campaigns….”
“Vaccine allocation, whether done through COVAX or directly, should be based on public health metrics. …” Incidence rate, attack rate & health system capacity.
Other Global Health Governance & Financing news & analysis
The Nation - Despite the Headlines, the Gates Foundation Has Evaded Scrutiny
Tim Schwab; https://www.thenation.com/article/economy/gates-foundation-michael-larson/
“Allegations of financial misconduct against Michael Larson, who manages the foundation’s money as well as a portion of Bill and Melinda’s personal wealth, should prompt a closer look.”
“… The allegations against Michael Larson, which he denies, are both long-standing and long known to both Bill Gates and Melinda French Gates, according to the Times, and they contribute to a widening institutional crisis around the Gates Foundation, whose leadership is characterized as negligent, dysfunctional, and abusive. But buried in the Times story is also an allegation of financial misconduct that governance and tax experts say should trigger official investigations into the foundation, and prompt us to rethink governance rules over billionaire philanthropy….”
Vanity Fair – Bill and Melinda Gates’ epic divorce saga enters its next phase Vanity Fair; Vanity Fair is on it now. That doesn’t bode well. “The blowup of a billionaire duo’s 27-year marriage was always going to be rife with drama. Now come the private investigators, rumors of affairs, and former employees chafing at NDAs.”
Rumour has it that Gates Foundation employees fear the worst.
27
Think Global Health - A New Era in U.S. Global Health Leadership? What the World Health Assembly meeting revealed
David Fidler; Think Global Health;
Fidler’s final analysis of the World Health Assembly, focusing on the US role there.
“ the much-anticipated annual meeting of the World Health Assembly ended on May 31. At the event, member states of the World Health Organization (WHO) did not transform cooperation on the COVID-19 pandemic, agree on reforms for global health governance, or strengthen WHO through increased authority over, or mandatory funding from, member states. These results are disappointing for those who expected the pandemic-ravaged international community to chart bold, new directions for global health at the meeting. However, the outcomes align with the positions the United States took at the assembly, which makes the meeting important for what it reveals about U.S. foreign policy on global health at this point in the pandemic. “
Excerpts: “President Biden's decision to re-engage with WHO meant U.S. participation in the assembly meeting has heightened significance. But the meeting demonstrated that what the united States considers leadership in global health does not conform with what WHO officials, other influential member states, and health advocates want from the United States concerning this pandemic and beyond. The U.S. government's commitment to vaccine nationalism appears unmoved by rhetoric about vaccine apartheid. The Biden administration rebuffed the call by European allies to have the assembly authorize immediate negotiations on a pandemic treaty. Nor did the United States support making the WHO more independent through expanded powers or increased assessed contributions. The U.S. government confronted China, turning the search for the pandemic's origins into a zero-sum contest between the U.S. intelligence community and the Chinese communist party. “
“…The pandemic is not over, and the Biden administration's foreign policy on global health remains a work in progress. Even so, the assembly meeting revealed traditional patterns of U.S. foreign policy on global health converging with strong geopolitical incentives in ways that promise to make future U.S. interactions with WHO complicated, contested, and controversial. America is back at WHO, but that does not mean that WHO is, or will be, the epicenter of renewed U.S. engagement with global health. …”
Launch of GHWN Gender Equity Hub Policy Action Paper -Closing the Leadership Gap https://apps.who.int/iris/bitstream/handle/10665/341636/9789240025905-eng.pdf
Global Health Workforce Network’s Gender Equity Hub, in collaboration with Women in Global Health and World Health Organization launched its first in the series of policy action papers ''Closing the leadership gap: gender equity and leadership in the global health and care workforce'.
28
Other Global health security news
Telegraph - Covid is a 'wake-up' call for the world to improve health resilience
Telegraph;
“Leaders must use this month's G7 to build post-pandemic consensus, just as countries did after Second World War.”
“The world needs to forge a post-pandemic consensus around global health, just as leaders came together after the Second World War to build new international institutions, a new report has urged. The Reform for Resilience Policy Commission, made up of leaders from business, science and politics including the past Prime Ministers of Australia, Finland and Portugal, described Covid as a “wake-up call to the world”. It urges leaders to use this month’s G7 summit in the UK to establish the first integrated approach to global health, economics and the environment – similar to the Bretton Woods discussions that shaped global financial cooperation at the end of the Second World War. … It calls for a new global health architecture to support the World Health Organization to enable more timely disease surveillance and data sharing. And it urges G20 countries to establish an independent Office for Health Resilience, similar to the UK’s Office for Budgetary Responsibility, which would measure and monitor each country’s preparedness. …”
Guardian - World leaders ‘ignoring’ role of destruction of nature in causing pandemics https://www.theguardian.com/world/2021/jun/04/end-destruction-of-nature-to-stop-future- pandemics-say-scientists?CMP=Share_iOSApp_Other
“Ending the destruction of nature to stop outbreaks at source is more effective and cheaper than responding to them, scientists say.”
“The root cause of pandemics – the destruction of nature – is being ignored, scientists have warned. The focus of world leaders on responding to future outbreaks overlooks the far cheaper and more effective strategy of stopping the spillover of disease from animals to humans in the first place, they have said. … However, preventing this root cause of spillover is scarcely mentioned by leaders and authorities, said the scientists behind a new independent taskforce, which will report to the coalition on Preventing Pandemics at the Source. The PPS said the issue has been ignored by the World Health Assembly, and a recent report for the World Health Organization on the coronavirus pandemic. …. Recent research estimated the annual cost of preventing further pandemics over the next decade to be $26bn (£18bn), just 2% of the financial damage caused by Covid-19. The measures would include protecting forests, shutting down risky trade in wildlife, better protecting farm animals from infection and rapid disease detection in wildlife markets.
The new taskforce comprises experts from every region of the world and is hosted by Harvard University in the US. By the end of the summer, it will produce an action plan on preventing spillovers, which will then be championed by a group of high-level figures….”
29
FT - Scientists fear future leaks as top-level labs proliferate https://www.ft.com/content/a0badd5d-4d88-4a3b-b019-61c6d8275caa
“At least 59 facilities, like Wuhan Institute, are planned or in operation across world.”
“ Maximum security laboratories used to carry out the most dangerous biological research have proliferated in the past decade, scientists say, warning that lax controls at some locations could lead to another pandemic. At least 59 maximum biosafety level 4 labs (BSL-4) are planned, under construction or in operation across the world, spanning 23 countries including the UK, US, China, India, Gabon and Côte d’Ivoire. … . Gregory Koblentz, an associate professor of biodefence at George Mason University, and Filippa Lentzos at King’s College London, who mapped the facilities, found that of the 42 labs where planning data was available, half were built in the last decade. Three- quarters of all the BSL-4 labs were in urban centres. And only three of the 23 countries have national policies that provide oversight of so-called dual-use research, where experiments that are conducted for civilian purposes can also be adapted for military ends….”
Bulletin of the Atomic Scientists - The origin of COVID: Did people or nature open Pandora’s box at Wuhan? N Wade; https://thebulletin.org/2021/05/the-origin-of-covid-did-people-or-nature-open-pandoras- box-at-wuhan/
Nice analysis from a month ago (5 May). Worth a good read. No need to agree with the gist of the piece (hard to assess anyway, as obviously hard to distinguish some of the claims from conspiracy theories), but as a take-home message, regardless of what happened in the Wuhan lab, I think it’ s obvious ‘gain of function’ research should be much more regulated (than it is now). Needs to become a key GHS priority – see also the FT link mentioned above.
Even if the lab leak hypothesis remains very unlikely.
Excerpts “…. So it’s worth trying to assess responsibility for the pandemic, at least in a provisional way, because the paramount goal remains to prevent another one. Even those who aren’t persuaded that lab escape is the more likely origin of the SARS2 virus may see reason for concern about the present state of regulation governing gain-of-function research. …”
• For a very nuanced take, one month later (i.e. now), we recommend Vox - The lab leak hypothesis, explained. With various (scientific) sides on the hypothesis.
• See also Nature News – The COVID lab-leak hypothesis: what scientists do and don’t know
“ Nature examines arguments that the coronavirus SARS-CoV-2 escaped from a lab in China, and the science behind them.” (8 June)
• And Guardian - Leading biologist dampens his ‘smoking gun’ Covid lab leak theory
Plus a link:
30
Reuters - Explainer: China’s Mojiang mine and its role in the origins of COVID-19 “ Top U.S. infectious disease expert Dr. Anthony Fauci has urged China to release information about six labourers who fell ill after working in a mine in Yunnan province in 2012, and are now seen as a key part of efforts to find the origins of COVID-19….”
CGD (blog) - Biden’s First Budget: What the FY22 Request Could Mean for Development Policy https://www.cgdev.org/blog/bidens-first-budget-what-fy22-request-could-mean-development-policy
“The recently released FY22 budget request includes more than $63.6 billion in international affairs spending, a more than 10 percent increase over the FY21 level absent the emergency spending provided in the end-of-year consolidated appropriations bill and supplemental funding included in the American Rescue Plan, the massive COVID relief package signed into law in March. Here’s a rundown of some of what we’ve learned about the administration’s overarching ambition and plans for future US development policy.”
Including a section on global health programs: “The budget would provide an $855 million increase in global health funding, relative to last year’s non-emergency appropriations. The majority of this increase is earmarked for global health security, including $300 million for contributions to ACT- A—the multilateral COVID-19 response platform. … Notably, the budget also includes a down payment of $250 million to kick off a new health security financing mechanism to bolster countries’ preparedness to respond to future global health threats….”
Covid key news
With some key trends, WHO messages (not mentioned yet in above sections), …
Cidrap News - Uganda enters 2nd COVID-19 lockdown as surges noted elsewhere https://www.cidrap.umn.edu/news-perspective/2021/06/uganda-enters-2nd-covid-19-lockdown- surges-noted-elsewhere
“Amid a worrisome rise in cases in some African nations, Uganda's president yesterday reimposed a lockdown as part of an effort to prevent its COVID-19 surge from overwhelming the healthcare system.” Cases rise in 8 African nations : “Last week, the World Health Organization (WHO) African regional office warned of abrupt rises in eight countries, including Uganda, and urged nations to boost their intensive care unit (ICU) capacity. African countries are also falling behind the global pace of vaccination…”
See also Cidrap News - Africa surge continues
“Africa's COVID-19 cases have now risen for the fourth week in a row, up 19% from the previous week, according to a weekly outbreaks and health emergencies report from the World Health Organization (WHO) Africa regional office. Most cases, however, are concentrated in a few
31
countries experiencing sharp or steady rises, including South Africa, Uganda, Eritrea, Namibia, and Zambia….”
Guardian - Third wave sweeps across Africa as Covid vaccine imports dry up https://www.theguardian.com/world/2021/jun/07/third-wave-sweeps-across-africa-as-covid- vaccine-imports-dry-up
“WHO says continent urgently needs more jabs as eight countries report rise of 30% in cases in a week….”
“African countries face a last-ditch battle against a third wave of Covid infections, as the supply of vaccines to the continent “grinds to a halt”, top health officials have warned. “The threat of a third wave in Africa is real and rising. Our priority is clear – it’s crucial that we swiftly get vaccines into the arms of Africans at high risk of falling seriously ill and dying of Covid-19,” said Dr Matshidiso Moeti, the World Health Organization (WHO) regional director for Africa. The WHO said the pandemic was now trending upwards in 14 countries and in the past week alone, eight countries had witnessed an abrupt rise of over 30% in cases. However, vaccine shipments to African nations have ground to a near halt….”
HPW - Latin America Sees Continued COVID Surges – Despite Declines In North America And Globally https://healthpolicy-watch.news/latin-america-sees-continued-covid-surges/
“Although the pace of new COVID-19 infections is slowing down across North America, cases continue to rise in Latin America. Surges in COVID-related deaths and infections in some countries are even higher now than at any point during this pandemic, says the WHO Pan American Health Organization (PAHO). Last week, the region reported more than 1.2 million new COVID-19 cases and nearly 34,000 COVID related deaths. Four of the five countries with the highest death counts in the world were located in the Americas. … Globally, Latin America has become the world’s COVID hotspot, with a new wave of rising COVID cases peaking at 300 cases per million people this past weekend. This is currently more than three times the number of new cases being seen by hard- hit India, five times that of Europe and six times higher than the global average. …”
And Vaccination trickles down inequitably to high-risk countries in Latin America as well…
See also HPW - Amidst Global Declines in Cases, Latin America Remains Global Hotspot
“For the sixth week in a row, the world has witnessed sharp declines in new COVID cases. However, “a mixed picture” remains with more deaths reported last week than the week previous, in three WHO regions – Latin America, the African region and the Western Pacific, Tedros said. …”
Guardian - Covid: India posts global record deaths after state revises data https://www.theguardian.com/world/2021/jun/10/covid-india-posts-global-record-deaths-after- state-revises-data
32
“India has recorded a global record of more than 6,000 coronavirus deaths in 24 hours after one state [Bihar] dramatically revised upwards its data, stoking suspicions that the country’s toll is much higher than reported….”
Reuters - WHO's Tedros says COVID-19 vaccine inequity creates 'two-track pandemic' Reuters;
Coverage of Monday’s press conference. “Glaring COVID-19 vaccine inequality has created a "two- track pandemic" with Western countries protected and poorer nations still exposed, World Health Organization head Tedros Adhanom Ghebreyesus said on Monday, renewing pleas for shot donations. "Increasingly, we see a two-track pandemic," Tedros told reporters during a press conference from Geneva. "Six months since the first COVID-19 vaccines were administered, high- income countries have administered almost 44% of the world's doses. Low-income countries have administered just 0.4%. The most frustrating thing about this statistic is that it hasn't changed in months." Link – Reuters - WHO warns of 'failure' unless rich countries speed up vaccine sharing
“Warning of a "two-track recovery", the World Health Organization is urging wealthy countries to donate their surplus doses to poorer countries instead of giving them to less vulnerable groups, such as children. They have so far donated 150 million doses via the COVAX sharing scheme;
However, Bruce Aylward said on Friday that only a small portion of those doses will be available in the short-term in June, July and August when they can make a difference in slowing the pace of infections in the global pandemic. "We are going to need twice that much and it's got to be brought forward," he said…”
Independent - Global eradication of Covid ‘not a reasonable target’, says World Health Organisation expert https://www.independent.co.uk/news/health/covid-eradication-who-david-nabarro-b1860520.html
“‘This virus isn’t going away any time soon,’ Dr David Nabarro says.”
“The global eradication of Covid-19 is not currently a “reasonable target”, according to an expert from the World Health Organisation (WHO). Dr David Nabarro, the WHO’s special envoy on Covid-19, said the virus “isn’t going away any time soon”. “Humanity is going to have to learn how to co-exist with this virus, preventing it from spiking and then surging and causing hotspots …”
FT - Poorest countries are being ‘left behind’ in pandemic recovery FT;
“Efforts to support low-income economies with debt relief and vaccines must be accelerated, warns World Bank.”
33
“Developing countries are being left behind in the pandemic recovery and face the risk of a renewed economic downturn if vaccine supplies fail to materialise and global inflation rises, the World Bank warned on Tuesday. Emerging economies are particularly vulnerable, it said, as increasing prices and interest rates undermine their ability to deal with the high levels of debt accumulated during the coronavirus crisis. “While advanced economies are rebounding, many of the world’s poorest countries are being left behind, and much remains to be done to reverse the pandemic’s staggering human and economic costs,” the bank said in its twice-yearly Global Economic Prospects report. “Moreover,” it added, “the recovery is not assured: the possibility remains that additional Covid-19 waves, further vaccination delays, mounting debt levels or rising inflationary pressures deliver setbacks.” … Speaking to reporters, Malpass said the World Bank did not support the lifting of IP rights because to do so could jeopardise spending on research and development. “The World Bank supports the licensing and transfer of technology to developing countries to bolster global supply,” he said….”
UN News - Child labour figure rises to 160 million, as COVID puts many more at risk https://news.un.org/en/story/2021/06/1093682
“For the first time in two decades, the number of children being put to work has risen – to 160 million worldwide, representing an increase of 8.4 million over four years – while millions of other are at risk due to the COVID-19 pandemic, according to a new UN report launched on Thursday. New ILO/UNICEF report.”
UN News - UN experts to G7: Production of safe COVID-19 vaccines must outweigh profit https://news.un.org/en/story/2021/06/1093672
“A group of UN independent human rights experts called on Wednesday for the leaders of the world’s largest economies to ensure equal access to COVID-19 vaccines for people in the Global South, urging them not to allow the profit motive to undermine global health and equity. …”
“… The UN experts urged pharmaceutical companies to join WHO’s COVID-19 Technology Access Pool (C-TAP) for sharing know-how, data and intellectual property and recalled that while the TRIPs Agreement on intellectually property rights provides for certain flexibilities, including the possibility of compulsory licensing in cases of national emergency, they are insufficient to respond to the current pandemic. …”
Covid Science
Science - A ‘landmark’ trial to test mRNA vaccines against COVID-19 in Africa can’t get the coveted shots https://www.sciencemag.org/news/2021/06/landmark-trial-test-mrna-vaccines-against-covid-19- africa-can-t-get-coveted-shots
34
“Pfizer declined to participate in a study involving HIV-infected people and pregnant women and Moderna is balking.”
“… a highly anticipated, $130 million clinical trial, meant to test the efficacy of the novel messenger RNA (mRNA) vaccines for COVID-19 against a key variant of the pandemic coronavirus as well as in people living with HIV and pregnant women, is stalled. It is ready to launch in eight countries in sub- Saharan Africa, yet neither maker of the vaccines, Pfizer and Moderna, wants to participate—or even provide their vaccines….” Read why.
NYT - We’ll Probably Need Booster Shots for Covid-19. But When? And Which Ones? https://www.nytimes.com/2021/06/06/science/covid-vaccine-boosters.html
“Scientists are asking a lot of questions about Covid-19 booster shots, but they don’t yet have many answers. Here’s what they know so far.”
NPR - A New Type Of COVID-19 Vaccine Could Debut Soon https://www.npr.org/sections/health-shots/2021/06/06/1003328413/new-type-of-covid-vaccine- could-debut-soon?t=1623071935903
A protein subunit vaccine, that is.
Science (news) - Would you have your DNA tested to predict how hard COVID-19 would strike? Should you? https://www.sciencemag.org/news/2021/06/would-you-have-your-dna-tested-predict-how-hard- covid-19-would-strike-should-you
“Scientists question the usefulness and validation of a saliva-based genetic test now sold in the United States.”
Lancet Letter - Research collaboration is needed to inform quarantine policies for health-care workers Sarin KC et al ; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01224- 1/fulltext
“Evidence is weak on global policies and guidelines regarding quarantine and testing measures for vaccinated health-care workers (HCWs) who might have been exposed to patients with COVID-19. Recurring outbreaks have constrained the number of available HCWs, particularly in low-income and middle-income countries (LMICs). We urge the international community to support development of evidence and evidence-based recommendations on this issue….”
35
Nature (News) - Six months of COVID vaccines: what 1.7 billion doses have taught scientists https://www.nature.com/articles/d41586-021-01505-x
“At a pivotal moment in the pandemic, Nature explores key questions about the vaccines that countries are racing to deliver while viral variants spread around the globe.”
Preprint - Vaccine nationalism and the dynamics and control of SARS-CoV-2
C Wagner, J Farrar et al ; https://www.medrxiv.org/content/10.1101/2021.06.02.21258229v1
“… To examine the potential epidemiological and evolutionary impacts of ‘vaccine nationalism’, we extend previous models to include simple scenarios of stockpiling. In general, we find that stockpiling vaccines by countries with high availability leads to large increases in infections in countries with low vaccine availability, the magnitude of which depends on the strength and duration of natural and vaccinal immunity. Additionally, a number of subtleties arise when the populations and transmission rates in each country differ depending on evolutionary assumptions and vaccine availability. Furthermore, the movement of infected individuals between countries combined with the possibility of increases in viral transmissibility may greatly magnify local and combined infection numbers, suggesting that countries with high vaccine availability must invest in surveillance strategies to prevent case importation. Dose-sharing is likely a high-return strategy because equitable allocation brings non-linear benefits and also alleviates costs of surveillance (e.g. border testing, genomic surveillance) in settings where doses are sufficient to maintain cases at low numbers. Across a range of immunological scenarios, we find that vaccine sharing is also a powerful tool to decrease the potential for antigenic evolution, especially if infections after the waning of natural immunity contribute most to evolutionary potential. Overall, our results stress the importance of equitable global vaccine distribution.”
Science News - Mixing COVID-19 vaccines appears to boost immune responses https://www.sciencemag.org/news/2021/06/mixing-covid-19-vaccines-appears-boost-immune- responses
“Findings from combination studies support measures to stretch supplies, avoid side effects.”
“…if mixing vaccines proves safe and effective, it could speed the effort to protect billions of people. “This possibility opens new perspectives for many countries,” says Cristóbal Belda-Iniesta, a clinical research specialist at the Carlos III Health Institute. Governments, for example, could immediately distribute new doses without worrying about setting aside second shots of specific vaccines to give people weeks or months later….”
And a link:
Stat - More transmissible, wilier variant makes Covid-19 vaccinations even more crucial, experts say
On the implications of the Delta variant (with the current state of knowledge).
36
Other Covid vaccine access news
WHO Afro – Nine in 10 African countries set to miss urgent COVID-19 vaccination goal https://www.afro.who.int/news/nine-10-african-countries-set-miss-urgent-covid-19-vaccination- goal
Update on vaccine roll-out in Africa. “As COVID-19 cases in Africa rise for the third week running and vaccines are increasingly scarce, 47 of Africa’s 54 countries—nearly 90%—are set to miss the September target of vaccinating 10% of their people unless Africa receives 225 million more doses. The new global targets were announced recently at the World Health Assembly, the world’s highest health policy-setting body, and at today’s pace only seven African countries are set to meet them….”
See also HPW - US Donation of 500 Million Pfizer Vaccines Could Help ‘Turn Tide’ as Africa Runs Out of Doses, Says WHO (on media briefings Moeti & Nkengasong on Thursday)
“US President Joe Biden’s announcement today of some 500 million Pfizer doses to the African Union and 92 low- and middle-income countries elsewhere in the world could help begin to “turn the tide’’ on the continent’s pandemic battle, said WHO African Regional Director, Matshidiso Moeti.
“The tide is starting to turn. We are now seeing wealthy nations beginning to turn promises into action,” Moeti said, speaking at a WHO press briefing on Thursday….”
PS: “Even within Africa, there is inequality in access, a brief assessment by Health Policy Watch Reveals. A closer look at doses administered so far shows just five countries accounting for about 64% of all doses administered on the continent. Those include Morocco, having administered 15.8 million doses, followed by Egypt (3.1 million), Nigeria (2.1 million), Ethiopia (1.9 million), and South Africa, (1.4 million doses out of 2.4 million that it has available). On the other hand, Tanzania, the Saharawi Republic, Eritrea, and Burundi are yet to receive or administer any COVID- 19 vaccines. Along with the new US vaccine offers, some other fresh donations are finally beginning to trickle into some African countries, Nkkengasong said. “On 1 June 2021, Togo received 100,620 doses of the PfizerBioNTech vaccine from the COVAX facility making it the third country to receive such from the initiative. On 4 June 2021, Chad started vaccinating health personnel and the elderly with 400,000 doses of Sinopharm received on 3 June 2021,” he noted….”
Reuters - In boost for Africa, Senegal aims to make COVID shots next year https://www.reuters.com/world/africa/exclusive-boost-africa-senegal-aims-make-covid-shots-next- year-2021-06-06/
“Senegal could begin producing COVID-19 vaccines next year under an agreement with Belgian biotech group Univercells aimed at boosting Africa's drug-manufacturing ambitions, a source involved in funding the project told Reuters. … Univercells announced the signing of a letter of intent for collaboration with the Institut Pasteur in Senegal's capital Dakar in April. The source shared details of the proposal, which were not made public. .. Under the agreement, the Institut Pasteur would use vaccine production technology developed by Univercells to supply COVID-19
37
vaccine shots to countries across West Africa. The institute would initially begin packaging and distributing vaccines produced by Univercells in Belgium early next year, the source involved in securing financing for the collaboration told Reuters. … Univercells would transfer its full production line to Senegal in the second half of 2022, the source said, adding that the company would train local staff so they could eventually run the operation.”
“… It is not clear yet what vaccine will be supplied to Senegal, but Antrobus said the site in Belgium would be able to manufacture a class of so-called viral vector COVID-19 vaccine such as those developed by Johnson & Johnson (JNJ.N), AstraZeneca (AZN.L), Russia's Sputnik V and China's Cansino….”
Mastercard Foundation to deploy $1.3 billion in partnership with Africa CDC to save lives and livelihoods https://africacdc.org/news-item/mastercard-foundation-to-deploy-1-3-billion-in-partnership-with- africa-cdc-to-save-lives-and-livelihoods/
This new initiative was launched on Tuesday. “… the Mastercard Foundation has announced that it will deploy $1.3 billion over the next three years in partnership with the Africa Centres for Disease Control and Prevention (Africa CDC) to save the lives and livelihoods of millions of people in Africa and hasten the economic recovery of the continent. The Saving Lives and Livelihoods initiative will acquire vaccines for at least 50 million people, support the delivery of vaccinations to millions more across the continent, lay the groundwork for vaccine manufacturing in Africa through a focus on human capital development, and strengthen the Africa CDC….”
See also AP - Foundation to spend $1.3B to vaccinate Africans for COVID
“ One of the world’s largest foundations will spend $1.3 billion over the next three years to acquire and deliver COVID-19 vaccines for more than 50 million people in Africa. It’s a first-of-its-kind effort for a Western nonprofit to bolster Africa’s lagging vaccination campaign amid widespread fears of a third wave of infections on the continent. The Tuesday announcement came from the Toronto-based Mastercard Foundation, which has more than $39 billion in assets. …”
“... The foundation will purchase single-dose Johnson & Johnson vaccines at the discounted rate negotiated by the African Union during its 220 million dose deal with the vaccine manufacturer. Those vaccines will begin to be delivered to the AU’s 55 member states from July to September, with an option to purchase an additional 180 million doses through next year…. … The Africa Centers for Disease Control and Prevention is partnering with the foundation on the initiative, and will be consulting African government agencies and other institutions on how to best deploy the shots…. The foundation says the money will be used, in part, to help transport the vaccines, hold community engagement activities that address vaccine hesitancy, identify potential virus variants, train workers to improve the speed of vaccine deployments and help develop a skilled workforce that could expand vaccine manufacturing in Africa….”
FT - BioNTech prepares expansion into Africa alongside EU https://www.ft.com/content/2db9e21f-881d-4da2-8394-3ec732024581
38
“German biotech plans to build mRNA facilities on the continent in next four years.”
“BioNTech is planning a push into Africa, aiming to establish mRNA vaccine production facilities on the continent as part of a long-term effort to tackle diseases beyond Covid-19. The German biotech’s plans come as the EU moves to bolster vaccine manufacturing capacity in Africa, which imports more than 99 per cent of the jabs it uses. BioNTech co-founder and chief executive Ugur Sahin outlined the effort on a joint video call with Ursula von der Leyen, European Commission president, ahead of the G7 summit in Cornwall. … … All of BioNTech’s future facilities in Africa would produce treatments at non-profit rates, for middle and low-income countries, Sahin said. Von der Leyen, who last month announced a plan to invest €1bn in vaccine production in Africa, said she believed the African Union’s goal of producing 60 per cent of the continent’s vaccine consumption within the continent by 2040 was both do-able and realistic….”
… “We need to join forces here,” she said, adding that the EU was in discussions with countries including Senegal, South Africa, Rwanda and Ghana. Support from institutions such as the European Investment Bank would help incentivise investment as the EU took on some of the risk, she added. …”
Nature News - WHO approval of Chinese CoronaVac COVID vaccine will be crucial to curbing pandemic https://www.nature.com/articles/d41586-021-01497- 8?utm_source=twt_nat&utm_medium=social&utm_campaign=n
“CoronaVac is one of two Chinese vaccines already sustaining vaccination campaigns in more than 70 nations. Both should soon be much more widely available to low-income countries. … CoronaVac is sustaining vaccination campaigns in more than 40 countries, such as Chile and Botswana. Globally, more than 600 million doses have been delivered. Sinopharm's vaccine has been approved in many more nations. But WHO emergency approval could now facilitate the further distribution of both vaccines to low-income countries, through the COVID-19 Vaccines Global Access (COVAX) initiative….”
Nature News – China is vaccinating a staggering 20 million people a day https://www.nature.com/articles/d41586-021-01545- 3?utm_source=twt_nat&utm_medium=social&utm_campaign=nature
“Scientists are impressed by China’s juggernaut of a vaccination drive, through which it is currently administering nearly 60% of all COVID-19 vaccine doses globally….”
Politico - Europe’s moral dilemma — vaccinate its kids or donate the doses https://www.politico.eu/article/europe-coronavirus-moral-dilemma-vaccinate-kids-donate-doses/
Well worth a read. “Many European countries plan to open vaccinations to teens in June despite health workers elsewhere not being jabbed. Europe is grappling with one of the most ethically fraught decisions of the pandemic — expand vaccination to children or donate jabs to those who need them most in the rest of the world. … As yet, no EU country has pledged to delay jabs for kids
39
and send these vaccines elsewhere, despite the fact that the pandemic is still raging in many other parts of the world, including South Asia and South America. Instead, following approval from the European Medicines Agency of the BioNTech/Pfizer vaccine for children aged 12-16, countries across the bloc are preparing to begin vaccinating their adolescents, with several EU countries eyeing a start date this month. That move seems to contradict guidance from the European Centre for Disease Prevention and Control (ECDC), which stated Tuesday that "equity issues concerning vaccine availability and access need to be carefully considered when deciding on expansion of COVID- 19 vaccination to groups with lower individual risk of severe disease."
“…. others point out it’s not a simple matter of rerouting a jab meant to go into the arm of an American teen to the arm of a health care worker in Ghana. Logistics, the complexity of rolling out vaccination campaigns, expiry dates and the science all make things more complicated. “
Still, the “moral dilemma” is a no-brainer…. (if you ask us)
Wellcome (Tracker) - The road to 1 billion vaccines – what Covid-19 dose sharing commitments are needed from the G7 https://wellcome.org/news/road-1-billion-vaccines-what-covid-19-dose-sharing-commitments- are-needed-g7
New tracker, for all G7 countries – how many doses they’ve already contributed (to the 1 billion by end of 2021).
CGD - Can Serology Tests and Seroprevalence Surveys Inform a More Effective Vaccine Roll Out? Yi-Ling Chi et al ; https://www.cgdev.org/blog/can-serology-tests-and-seroprevalence-surveys- inform-more-effective-vaccine-roll-out#.YL-4O4NvxkI.twitter
Blog.
And a few links:
• Peterson Institute for International Economics - The US did not ban exports of vaccine supplies. But more help is needed. (by Chad Bown et al)
With some visualization of global vaccine manufacturing supply chains (of various vaccines).
• Impact Alpha - Linchpin of Gates Foundation’s health strategies, ‘global access agreements’ fail their COVID-19 test
(gated) “Legal agreements between the Bill and Melinda Gates Foundation and private biotechnology companies were supposed to be the great equalizer between rich and poor in the high- risk, high-cost world of drugs, vaccines and therapeutics. The Global Access Agreements require
40
recipients of Gates Foundation funding to provide low-income countries with affordable access to drugs, vaccines and other health innovations….” Didn’t happen with Covid vaccines.
Covid Analysis
Paper - COVID-19 vaccine equity: a health systems and policy perspective R van de Pas et al; https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3856949
“… . This perspective provides analyses on historical and contemporary policy trends of vaccine development and immunization programs, including the current COVID-19 vaccination drive, and governance challenges. Moreover, we also provide a comparative health system analysis of the COVID-19 vaccine deployment in some countries from different continents. It recommends that the international Access to COVID-19 Tools Accelerator (ACT-A) partnership requires a strong governance mechanism and urgent financial investment. All WHO member states should agree on technology transfer and voluntary license-sharing via a commonly governed technology access pool. Contextualized, dynamic understandings and country-specific versions of health systems strengthening are needed to improve vaccine equity in a sustainable matter.”
Preprint – What Could Explain the Lower COVID-19 Burden in Africa Despite Considerable Circulation of the SARS-CoV-2 Virus? R Wamai, J Hirsch, W van Damme et al; https://www.preprints.org/manuscript/202105.0549/v1
Review. “…while recent data from seroprevalence studies posit more extensive circulation of the virus, continuing low COVID-19 burden may be explained by the demographic pyramid, prevalence of pre-existing conditions, trained immunity, genetics, and broader sociocultural dynamics. Though all these prongs contribute to the observed profile of COVID-19 in Africa, some provide stronger evidence than others….”
CGD (blog) Should Donated COVID-19 Vaccines Count as ODA?
C Kenny; https://www.cgdev.org/blog/should-donated-covid-19-vaccines-count-oda
“The benefits to expanded vaccination programs in low- and middle-income countries (LMICs) simply dwarf the cost. Rich countries should be donating more vaccines faster to poorer countries. It is difficult to think of a more urgent global priority and it is surely a best buy in international development. But does that mean that these vaccine donations should count as official development assistance (ODA)? That’s an active debate in the halls of the Development Assistance Committee, which set the rules on what counts as ODA. And I think the short answer is “that depends.””
Kenny’s conclusion: “…rich countries should be donating surplus vaccines to poorer countries, preferably through COVAX. And it is positively obscene that some rich countries are sitting on stockpiles of vaccines that don’t have regulatory approval or aren’t being used that might expire but could be used today in other countries where they are approved. Charge the transport and
41
liability costs of sending those vaccines to developing countries as an ODA eligible expense. More important, send them today. But don’t make poor people pay twice for a rich country strategy of hogging the market for vaccines: first through delayed vaccine access and then through ODA diverted from other development priorities.”
Lancet Healthy Longevity (Editorial) - The second shadow pandemic: elder abuse https://www.thelancet.com/journals/lanhl/article/PIIS2666-7568(21)00122-7/fulltext
“… there is another, even less recognised, pandemic of violence which COVID-19 restrictions have worsened: the pandemic of elder abuse. Even before the pandemic, elder abuse has been found to be shockingly common worldwide, with an estimated one of six older adults (people aged 60 or older) the victim of abuse worldwide. Defined as “a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person”, elder abuse can take the form of physical, psychological, sexual, or neglectful abuse. June 15 marks World Elder Abuse Awareness Day 2021, and it has never been more important to shine a light onto this shameful occurrence. Risk factors for elder abuse include social isolation, cognitive impairment, physical frailty, and dependence on others for care (eg, living in a long-term care facility). Almost all these risk factors for elder abuse have been compounded by COVID-19 restrictions. …”
CGD –Shock to the System: Understanding Global Medical Supply, Shortages in COVID-19 Crisis and How to Prepare for Future Disruptions
A McDonnell et al ; https://www.cgdev.org/blog/shock-system-understanding-global-medical- supply-shortages-covid-19-crisis-and-how-prepare
“… . This included pharmaceutical production and distribution, where anecdotal evidence suggested production problems, export bans, and trade disruption could significantly impact vital medicines access in low- and middle-income countries. …. Shortly after the pandemic began, we at the Center for Global Development set out to work with analysts from a number of other organisations to understand what impact this had on the supply of pharmaceuticals. Our aim was to test how early shortages could be identified using the increasingly large amount of data on pharmaceutical supply chains that exists, and to identify ways of strengthening global procurement. Today we release a paper outlining our results.
For the CGD paper, see A Path to Resiliency: Mitigating the Impacts of COVID-19 on Essential Medicines Supply Chains.
Five reasons why the real number of COVID-19 deaths could be triple the official number Priya Joy; https://www.gavi.org/vaccineswork/five-reasons-why-real-number-covid-19-deaths- could-be-triple-official-number
“The death toll from the pandemic has been devastatingly high, with the official figure standing at 3.5 million people, but the World Health Organization estimates the real number could be up to three times higher. Here’s why.”
42
The 5 reasons: A significant proportion of deaths are not being attributed to Covid-19; a lack of capacity to count deaths accurately; people are dying at home instead of in hospital; social inequity is worsening access to health care; and Covid-19’s collateral damage.
Lancet (Comment) – From routine data collection to policy design: sex and gender both matter in COVID-19 M Evagora-Campbell et al ; https://www.thelancet.com/journals/lancet/article/PIIS0140- 6736(21)01326-X/fulltext
“Gender has a role in vaccine uptake but goes largely unrecognised in vaccine policies and programmes, undermining attempts to ensure equity. There is a wider gender blind spot that pervades national health responses to COVID-19 beyond vaccination, ranging from the way countries collect and report data to the commitments they make in pandemic health policies….” Comment based on the Global Health 50/50 (GH5050) COVID-19 Sex-Disaggregated Data Tracker.
Covid resources
World Pandemic Research Network https://wprn.org/
The World Pandemic Research Network (WPRN) platform maintains a searchable global directory of the scientific projects, initiatives and resources available on the societal and human impacts of the Covid-19 pandemic.
Think Global Health - The Inequity of Vaccine Passports https://www.thinkglobalhealth.org/article/inequity-vaccine-passports
“Tracking the global use of COVID-19 vaccine certificates.”
“… Based on government websites, official statements, and media reports Think Global Health has identified 88 countries, as of June 3, using or considering vaccine certificates for international travel. Twenty-four nations are also using or considering vaccine certificates to exempt individuals from domestic restrictions, such as limits on gatherings, indoor activities, and internal movement. A full database with sources is included below. This tracker will be updated regularly….”
Check out the trends so far.
IDS - New resource for policy, practice and research responding to Covid-19 https://www.ids.ac.uk/news/new-resource-for-policy-practice-and-research-responding-to-covid- 19/
43
“A new resource for policy actors and researchers seeking to respond more effectively to the Covid pandemic is now live. The COVID response for Equity Programme (CORE), supported by the International Development Research Centre (IDRC), is rapidly mobilising research evidence for the mitigation of the social and economic impacts of COVID and for promoting recovery from the pandemic in low-income countries….”
AMR
Cidrap News – WHO reveals new global antibiotic resistance data, more concerns https://www.cidrap.umn.edu/news-perspective/2021/06/who-reveals-new-global-antibiotic- resistance-data-more-concerns
“A new report from the World Health Organization (WHO) shows that an increasing amount of data is being reported on antimicrobial resistance (AMR) and use, and some of the data suggest troubling trends, particularly in low- and middle-income countries (LMICs). The WHO's fourth Global Antimicrobial Resistance and Use Surveillance System (GLASS) Report includes information on more than 3 million laboratory-confirmed bacterial infections caused by pathogens of concern in 70 countries in 2019. That's more than a sixfold increase in the number of infections reported to GLASS when sites first began reporting AMR surveillance data in 2017. Although WHO officials caution that the data are limited and more research is required to draw firm conclusions, among the findings are high rates of resistance in common pathogens to first-line antibiotics used to treat urinary tract infections (UTIs) and extremely high resistance to last-resort antibiotics in some healthcare- associated pathogens. The data also show higher rates of resistance in LMICs for the most common causes of bloodstream infections (BSIs)….”
WHO press release - Record response to WHO’s call for antimicrobial resistance surveillance reports in 2020
Guardian - More research funding needed to avoid drug-resistant pandemic, warns report https://www.theguardian.com/science/2021/jun/10/more-research-funding-needed-to-avoid- drug-resistant-pandemic-warns-report
“Small drugmakers and biotech firms that are developing the bulk of new antibiotics need far more financial support, according to a new report, which warned that without these life-saving medicines there could be a pandemic of drug-resistant infections, worse than Covid-19. The Access to Medicine Foundation, an Amsterdam-based non-profit group, said small and medium-sized firms, which account for three-quarters of all late-stage antibiotics in development, struggle to secure enough funding and are often at risk of bankruptcy, potentially leaving new medicines stranded on the lab bench. “If the loss of such promising products continues, the pandemic of drug-resistant infections will pose a bigger global health emergency than Covid-19,” the foundation’s report warned. Last year, 138 vaccines or drugs targeting 18 bacterial and fungal infections were in development worldwide, down from 175 projects two years earlier…”
44
“… To support such projects, Iyer called for subscription-based models, such as the UK’s – where governments make regular payments in return for on-demand supply of effective antibiotics – as well as international partnerships with bigger firms. Iyer said China’s role, as the world’s biggest producer and user of antibiotics, was key to the development of these life-saving medicines. Some small drugmakers work with partners in China and the report said: “There are compelling signs that China will become a global hub for the development, manufacturing and commercialisation of antibiotics and anti-fungals.”…”
See also the Access to Medicine Foundation news release - Biotech’s antibiotic warriors need new reward system in superbug fight
“…This report identifies how a crop of SMEs are now turning to partnerships with local companies in emerging economies such as China, India and South Africa to reach worldwide markets as they grapple with the so-called “valley of death”, when early research funding runs out before financial returns kick in….”
SRHR
Guardian - End all legal barriers to abortion, say leading European politicians https://www.theguardian.com/global-development/2021/jun/09/end-all-legal-barriers-to- abortion-say-leading-european-politicians
“Government ministers from five European countries, including Belgium’s prime minister, Alexander de Croo, are among 29 politicians, healthcare and women’s rights activists who have signed an open letter calling for the removal of all legal barriers to abortion….”
“The letter, signed by gender and equality ministers from France, Canada and Norway, and international development ministers from Sweden and the Netherlands, states that women’s right to safe, legal abortion is being eroded by misinformation and attacks on services. It calls for the reopening of abortion clinics closed during the pandemic. The signatories say abortion should be regarded as an essential healthcare service and call for a global campaign “of factual and unbiased information” so women and girls know their rights and understand their options. Published by the SheDecides movement on Wednesday, the letter calls for an end to mandatory counselling for abortion, the implementation of forthcoming revised World Health Organization guidelines, and for mifepristone, the abortion-inducing drug, to be approved for use in countries where it is not yet available….”
Aidspan – UN Special Rapporteur focus on Sexual and Reproductive Health challenges and opportunities during Covid-19 https://www.aidspan.org/en/c/article/5635
“The United Nations Special Rapporteur will focus her next thematic report to the General Assembly on "The right to sexual and reproductive health – challenges and opportunities during COVID-19".”
45
Link:
BMJ Global Health (Commentary)- Falling aid for reproductive, maternal, newborn and child health in the lead-up to the COVID-19 pandemic (by C Pitt et al)
NCDs
HPW - Community-Based Mental Health Care is Cost-Effective and Produces Good Outcomes, Says New WHO Guidance https://healthpolicy-watch.news/community-mental-health-cost-effective/
“Providing community-based mental health care that is respectful of human rights and recovery- focused has proven successful and cost-effective, according to a new report released by the World Health Organization. … WHO’s new “Guidance on community mental health service: promoting person-centered and rights-based approaches”, released today, includes examples from countries including Brazil, India, Kenya, Myanmar, New Zealand, Norway, and the United Kingdom of community-based mental health services that have demonstrated good practices that are non- coercive, incorporate the community, and respect people’s legal capacity, or their right to make decisions about their treatment and life. …”
See also WHO - New WHO guidance seeks to put an end to human rights violations in mental health care
Coverage via the Telegraph - Seclusion, restraint and coercion: abuse 'far too common' in mental health services across the world
“ The majority of psychiatric care is provided in hospitals and drugs are too readily prescribed, WHO says.”
Planetary Health
Nature Comment - Climate policy models need to get real about people — here’s how
Nature;
“ To predict how society and political systems might actually respond to warming, upgrade integrated assessment models.” “There is good news for decarbonizing the global economy: political support is at an all-time high, and most carbon emissions come from countries that have committed to reach ‘net zero’ by mid-century. But to plan how to get there, analysts use computer models that don’t recognize the difficult trade-offs faced by decision makers, argue ten
46
climate-policy experts. They outline exactly how insights from political economy lead to 11 ways that models can better reflect social realities and possibilities.”
“… To develop politically durable strategies, decision makers need to understand how climate policy creates winners and losers. This means moving IAMs away from jack-of-all-trades models and towards a suite of tailored ones, each tuned to a specific purpose and audience…. … As a first step, we — a group of political economists and IAM specialists — identified eight key areas in which insights from our disciplines can improve models’ relevance for real-world policy and investment choices (see ‘Eight political economy insights’). We also assessed numerous potential reforms (see ‘How to improve models’ and Supplementary information for a full list of 11 reforms), so that researchers can examine the trade-offs between making models tractable and making them more useful for real-world decisions.”
BMJ GH (blog) – Planetary health care and Barbara Starfield´s legacy
E Falcetta de Barroso et al ; https://blogs.bmj.com/bmjgh/2021/06/10/planetary-health-care/ “Barbara Starfield advanced academic scholarship on the role of primary care in health systems and universal health coverage. …. On June 10th 2021, we commemorate her 10th death anniversary. Starfield described four attributes of primary care- first contact, continuity of care, comprehensiveness, and coordination – and three derivative attributes – family centeredness, cultural competency and community orientation … …. Primary care tackles root causes of ill health by caring not only for patients but also for their families, communities and societies. Today in the era of Planetary Health, this commitment must be extended to include the care for the ecological systems that sustain humanity’s health. … To encompass this new role, it is time to consider adding an eighth attribute – Planetary Health Care (PLHC) – to Starfield’s primary care framework…” Check out what it involves.
Polio
NYT - A Multibillion-Dollar Plan to End Polio, and Soon https://www.nytimes.com/2021/06/09/health/polio-eradication-plan.html
“The Global Polio Eradication Initiative, a public-private partnership led by national governments and health groups, on Wednesday released a $5.1 billion plan to eradicate polio by 2026.”
Excerpts:
“Many countries were dealing with sporadic outbreaks of polio before the coronavirus emerged, but the pandemic brought some polio vaccination programs to a halt, at least for a few months, and worsened the trend. Last year, there were 1,226 cases of polio worldwide, compared with 138 in 2018. There was also some good news. In August, African countries were declared free of wild poliovirus, leaving Afghanistan and Pakistan as the only two countries where polio is endemic. And in November, the World Health Organization granted the first emergency authorization to a new vaccine that promises to minimize polio outbreaks. …. … The new strategy includes policies
47
intended to increase political commitment while taking the pandemic into account, Dr. Vertefeuille said. It embraces two key goals: integrating polio programs with other health care programs and focusing on areas with chronically low immunization rates. The plan also ensures vaccine supply and outlines a communication strategy to increase vaccine acceptance..”
“…The global initiative has set up two teams to respond to outbreaks within 72 hours: one in the eastern Mediterranean region (which comprises 21 countries, including Pakistan and Afghanistan), and the other in sub-Saharan Arica. This time, the strategy also involves health ministers in the eastern Mediterranean region, so that governments are urged to focus on polio by their peers, rather than by a global health organization….”
WHO – Countries reaffirm commitment to ending polio at launch of new eradication strategy https://www.who.int/news/item/10-06-2021-countries-reaffirm-commitment-to-ending-polio-at- launch-of-new-eradication-strategy
“… The 2022-2026 Strategy underscores the urgency of getting eradication efforts back on track and offers a comprehensive set of actions that will position the GPEI to achieve a polio-free world. These actions, many of which are underway in 2021, include:
• further integrating polio activities with essential health services—including routine immunization—and building closer partnerships with high-risk communities to co-design immunization events and better meet their health needs, particularly in Pakistan and Afghanistan; • applying a gender equality lens to the implementation of programme activities, recognizing the importance of female workers to build community trust and improve vaccine acceptance; • strengthening advocacy to urge greater accountability and ownership of the program at all levels, including enhanced performance measurement and engagement with new partners, such as the new Eastern Mediterranean Regional Subcommittee on Polio Eradication and Outbreaks; and, • implementing innovative new tools, such as digital payments to frontline health workers, to further improve the impact and efficiency of polio campaigns.
And a link:
Lancet Global Health Viewpoint – Polio eradication at the crossroads
By K Chumakov et al.
“The Global Polio Eradication Initiative, launched in 1988 with anticipated completion by 2000, has yet to reach its ultimate goal. … We propose that the sustainable protection of the world population against paralytic polio cannot be achieved simply by stopping the circulation of poliovirus but must also include maintaining high rates of population immunity indefinitely, which can be created and maintained by implementing global immunisation programmes with improved poliovirus vaccines that create comprehensive immunity without spawning new virulent viruses. The proposed new strategic goal of eradicating the disease rather than the virus would lead to a sustainable eradication
48
of poliomyelitis while simultaneously promoting immunisation against other vaccine-preventable diseases.”
Decolonize Global Health
Must-watch: Seye Abimbola’s Prince Claus Chair inaugural speech (starting from minute 53)
Starting from: “In love and war, not all is fair”. There’s still way too much ‘colonial love’ in global health. And much more in this lecture full of wisdom.
Some other news of the week
Devex - UK ends bilateral aid to more than 100 countries, territories https://www.devex.com/news/uk-ends-bilateral-aid-to-more-than-100-countries-territories-100087
“The British government has ended direct bilateral aid to more than 100 countries and territories, according to a Devex analysis of a letter written by Foreign Secretary Dominic Raab. The entirety of North Africa — including Libya — Central Asia, and Central America will no longer receive bilateral aid from the U.K., the letter indicated. Individual countries and territories that will apparently no longer receive development assistance directly from the U.K. include Iraq, Jordan, the Palestinian territories, and Lebanon — all of which are dealing with crippling humanitarian crises. African countries gripped by conflict, such as Cameroon, Mali — where the U.K. has deployed a peacekeeping mission — and the Central African Republic will also not be receiving any direct bilateral aid this year, the letter suggested. …”
In related news, see also Devex - UK government avoids vote on aid cuts — for now
“The United Kingdom’s Parliament will not be voting on the aid budget Monday, after a legal amendment designed to restore the country’s 0.7% aid spending target was ruled out on technical grounds….”
And see a Devex Op-ed - UK aid cuts will cause more damage than 'global gag rule' (on SRHR)
Devex - USAID hack is 'wakeup call' for aid industry on cybersecurity https://www.devex.com/news/usaid-hack-is-wakeup-call-for-aid-industry-on-cybersecurity-100028
“A cyberattack that mimicked the U.S. Agency for International Development’s email marketing account to target development and humanitarian organizations last week could be a “watershed moment” for the sector to prioritize information security, experts told Devex. While aid groups have been targeted in the past, this is the largest and most coordinated public attack on organizations in the sector. It raises questions about how prepared the aid industry is to respond and how it can mitigate risk, experts said. … “Even USAID got hacked and that is a wakeup call for all of
49
us,” said Dianna Langley, senior director of engagement at NetHope, a technology-focused global consortium of nonprofit organizations. That a large U.S. government agency with ample security resources can be subjected to this kind of attack shows just how vulnerable other aid organizations can be, she explained. … The attack, carried out by Russian hackers three weeks before President Joe Biden is set to meet Russian President Vladimir Putin in Geneva, sent organizations scrambling to determine their potential exposure. It has also illuminated the challenges the sector faces when it comes to cybersecurity….”
Unherd - Beijing’s useful idiots
Ian Birrell; https://unherd.com/2021/06/beijings-useful-idiots/
“Science journals have encouraged a false Covid narrative.” Hard to assess, and close to being a conspiracy theory, but an interesting read nevertheless with some speculation on (commercial) conflicts of interest. With the emphasis on “speculation”.
Guardian - Uganda’s ID scheme excludes nearly a third from healthcare, says report https://www.theguardian.com/global-development/2021/jun/09/ugandas-id-scheme-excludes- nearly-a-third-from-healthcare-says-report
“Up to a third of adults in Uganda have been excluded from vital healthcare and social services because they do not have national ID cards, according to a report. Women and elderly people have been particularly affected by the introduction of the digital identity cards, which are required to access government and private sector healthcare, to claim social benefits, to vote and to open bank accounts or buy sim cards. Many services that require IDs are funded by donors, including the UK and Ireland, which finance grants for older people, and the World Bank, which supports birth registrations. The report, published by three human rights organisations, estimates that between 23% and 33% of Uganda’s adult population do not have ID cards, which were introduced by the National Identification and Registration Authority (Nira) in 2015….”
Some papers, briefs & reports of the week
Lancet Editorial – We need a global conversation on the 2020 Olympic Games https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01293-9/fulltext
Concluding: “… Global health organisations have been largely silent on whether the Games should proceed. WHO refuses to be drawn on whether they should go ahead. The ECDC has told The Lancet it has not specifically performed or even discussed a risk evaluation for the Olympics. In 2016, amid Zika, US CDC director Tom Frieden, declared there was no public health reason to cancel or delay the Rio Games. The CDC has not responded to several requests from The Lancet to clarify its stance on Tokyo 2020. This silence is a deflection of responsibility. The risks of the Games, and how they are being managed, need wide scrutiny and approval. There needs to be a global conversation about the Games, and it needs to happen now.”
50
Council brief No. 1 - The WHO Council on Economics of Health for All https://www.who.int/publications/m/item/council-brief-no-1
First brief of the WHO Council on Economics of Health for All (the one headed by M Mazzucato).
“Governing health innovation for the common good is a key element towards creating a new political economy for Health for All, one that has the ambition of shaping the economy with the objective of building healthy societies that are just, inclusive, equitable and sustainable. The Council has written this brief to focus on the governance of innovation, a critical building block of healthy economies, and lays out the key problems with the health innovation ecosystem and why radical changes are needed to ensure it delivers Health for All.”
This brief makes the case for an inclusive and equitable end-to-end health innovation ecosystem able to deliver the appropriate medical technologies required to achieve Health for All, and outlines the key principles for pivoting towards the new ecosystem.
See also WHO - Council on the Economics of Health For All issues brief on equitable health innovation
“In the Council’s first brief, its members called on the public and private sectors to work collaboratively to deliver needed vaccines, therapeutics, diagnostics, and other essential health supplies that are available equitably to those who can benefit. The Council Brief recommends both immediate and long-term action, urging all stakeholders to work towards creating a health innovation ecosystem characterized by purpose-driven and symbiotic public-private partnerships that put the common good front and center….” “The Council’s brief came ahead of the G7 Leaders' Summit under the U.K.’s Presidency, which aims to build back better from the COVID-19 pandemic, including by strengthening resilience against future pandemics; and following the Seventy-fourth World Health Assembly and the G20 Global Health Summit co-hosted by Italy and the EU earlier this month….”
BMJ GH – Unravelling ‘low-resource settings’: a systematic scoping review with qualitative content analysis
C van Zyl et al; https://gh.bmj.com/content/6/6/e005190
“A systematic scoping review was undertaken to start unravelling the term ‘low-resource setting’…. … nine major themes were identified relating to the term ‘low-resource setting’. Themes that emerged relate to (1) financial pressure, (2) suboptimal healthcare service delivery, (3) underdeveloped infrastructure, (4) paucity of knowledge, (5) research challenges and considerations, (6) restricted social resources, (7) geographical and environmental factors, (8) human resource limitations and (9) the influence of beliefs and practices….”
BMJ GH Editorial - Harnessing the peace dividends of health A A Mandhari, A Ghaffar et al ; https://gh.bmj.com/content/6/6/e006287
51
“… Building on previous efforts and calls, the leadership of WHO EMRO, PAHO and the Alliance for Health Policy and Systems Research are together issuing a call for papers for a special issue of BMJ Global Health on Peace for Health. This special issue will focus broadly on themes and questions, like how can health, directly and indirectly, promote peace as well as mitigate and prevent conflict? Are there specific examples or case studies of where or when this has occurred? Have they been documented? Can they be replicated? What lessons do they offer? What are the fundamental principles of ‘health for peace’? How should it be conceptualised and assessed? What frameworks or methodologies should be applied and used? How might such considerations affect health policy and practice?...”
BMJ GH (Editorial) – Going beyond access to health information: a pandemic call to action S Baumik et al ; https://gh.bmj.com/content/6/6/e006472
Some “… have argued that access to health information is a key component of universal health coverage. In the backdrop of the COVID-19 pandemic, we have seen significant investments from multinational agencies, governments, non-profits and private actors to disseminate health information. However, a narrow focus on providing access to health information alone, without any investment or thought on how information can be translated by people to meaningful health outcomes, is proving to be counterproductive….”
“…We urge multinational agencies, governments, global health organisations and humanitarian crisis response groups to not limit themselves to generating health information products….”
Lancet – Parental education and inequalities in child mortality: a global systematic review and meta-analysis https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00534-1/fulltext
Authors aimed to estimate the total reductions in under-5 mortality that are associated with increased maternal and paternal education, during distinct age intervals.
“… The results showed that lower maternal and paternal education are both risk factors for child mortality, even after controlling for other markers of family socioeconomic status. This study provides robust evidence for universal quality education as a mechanism to achieve the Sustainable Development Goal target 3.2 of reducing neonatal and child mortality.”
Related Lancet Comment - Parental education's role in child survival.
CGD - The Multilateral Humanitarian System Needs Alternative Donorship Models https://www.cgdev.org/blog/multilateral-humanitarian-system-needs-alternative-donorship-models
“Humanitarian donor governments today spend roughly $25 billion every year, and approximately two-thirds of this is channeled through UN agencies and the international Red Cross/Red Crescent Movement.”
52
Blog linked to a new paper - Improving Performance in the Multilateral Humanitarian System: New Models of Donorship.
Links:
Global Public Health - Synthesising the shifting terminology of community health: A critiquing review of agent-based approaches (by L Peters et al)
Lancet Letter - Intersectionality in UHC: from blue-sky to day-to-day practice
Some blogs of the week
Why do we need to know about progress if we are concerned about the world’s large problems? The mission of Our World in Data M Roser; https://ourworldindata.org/problems-and-progress
Cfr tweet Steven Pinker: “In this important essay @maxcroser explains the mission of @ourworldindata & articulates a vision of moral purpose: Open-mindedly trying to understand the world's problems & seeking practicable solutions, confident some might work.”
Blog - Launch of the WHO Handbook on social participation in UHC https://www.pamojacommunications.co.uk/2021/06/04/launch-of-the-who-handbook-on-social- participation/
“In this blog Lynda Keeru reports back on the launch of the WHO Handbook on Social Participation in Universal Health Coverage. The webinar focused on educating participants about why social participation matters and presenting real life experiences of implementation. During the webinar, the tensions at play in the implementation processes also surfaced.”
Chapter in book “Words and Worlds: A lexicon for Dark Time” – Resilience Jonathan Pugh; https://apps.crossref.org/coaccess/coaccess.html?doi=10.2307%2Fj.ctv1mvw95b.15
See also https://www.academia.edu/49169394/Resilience
Via my colleague Werner Soors: “Probably the clearest synthesis of resilience’ shifting concept, discourse, uptake and its implications over the last three decades. In a relative short book chapter (17 pages + a wealth of references) the author substantiates his thesis that “resilience tends to shift the focus of attention away from the perpetrators to the victims of environmental precarity (…) rather than engaging in the more politically charged stakes, and deeper structural conditions, which brought about environmental precarity in the first place”. Recommended for all readers with a minimum of concern for humanity, and particularly relevant also for a decolonization perspective beyond sub-Saharan Africa.”
53
Tweets of the week
Tim Schwab “Twittersphere: what is the earliest use of the term #BillChill to describe a reluctance to criticize #BillGates and the #GatesFoundation? I'm seeing it as far back as 2008 (and I'm guessing that, like most critiques of Gates, it comes from activists).”
Larry Brilliant Re a WSJ piece - Millions of J&J Covid-19 Vaccines Are at Risk of Expiring in June
“If millions of vaccine doses expire and don’t get into arms it would be a tragedy. We need to find ways to surge vaccine to where it is needed —whether around the world or in local outbreaks. “
Global health events
HPW - New Food System is Needed Based on ‘Interconnectedness’ of Humans, Animals and the Planet https://healthpolicy-watch.news/growing-global-one-health-approach-ahead-of-un-food-summit/
Coverage of (last week) Friday’s Healthy Food Systems dialogue, co-hosted by the World Health Organization (WHO), EAT, and the Global Alliance for the Future of Food.
“…Opening Friday’s dialogue, WHO Director-General Dr Tedros Adhanom Ghebreyesus said that “we need a new food systems narrative that embraces the interconnectedness of humans, animals, and the planet that sustains us”. The dialogue marked the start of a week-long series of global conversations in preparation for the United Nations (UN) Food Systems Summit in September and the civil society “pre-summit” next month. UN Secretary-General Antonio Guterres has called the summit to address how to build healthier, more sustainable and equitable food systems to achieve the Sustainable Development Goals (SDGs) by 2030. Tedros told the dialogue that the WHO proposes a new food system based on five major pathways …”
Global governance of health
Devex - Guterres wins the election that never was https://www.devex.com/news/devex-newswire-guterres-wins-the-election-that-never-was-100100
“Just call him Two-Term Tony. The United Nations Security Council has recommended António Guterres for a second five-year term as U.N. secretary-general. … The General Assembly is set to vote next week to most likely officially approve Guterres. …”
54
TWN - Developing countries convey difficulties faced in virtual meetings https://www.twn.my/title2/climate/news/unfccc31may21/TWN_update5_2021_07%20June%20202 1.pdf
“Developing countries at the climate talks held under the UNFCCC’s Subsidiary Bodies (SBs) to take stock of the first week’s meetings, conveyed the challenges they faced with the virtual format…”
“The G77/China, as well as some of its sub-groups of developing countries, highlighted challenges dealing with internet connectivity, poor audio, power-cuts, as well as different time-zones and other problems in capitals, that hampered their effective participation and engagement….”
Devex - Exclusive: UK to charge Special Drawing Rights to aid budget — sources https://www.devex.com/news/exclusive-uk-to-charge-special-drawing-rights-to-aid-budget-sources- 100078
“While the new allocation of Special Drawing Rights expected later this year is seen as an opportunity to provide much-needed additional development assistance, the United Kingdom government may be looking to use the redistribution of those reserve assets as part of its 0.5% aid target, according to sources who have had conversations with U.K. officials. The move could mean even more strain to the already battered budget and could cause further program cuts, rather than providing additional aid, the sources told Devex…..”
Link:
Health Affairs (blog) - It’s Time For A Biden Plan To Help Vaccinate The World Against COVID—And End This Pandemic For Good. Here’s What It Should Include. (by P Suwondo et al)
Planetary health
Guardian - Global carbon dioxide levels continued to rise despite pandemic https://www.theguardian.com/environment/2021/jun/08/carbon-dioxide-levels-pandemic- emissions
“Emissions rose to 419 parts per million in May, the highest such measurement in the 63 years that the data has been recorded…”
Guardian - Wealthy nations breaking climate pledge with gas dash in global south https://www.theguardian.com/environment/2021/jun/07/wealthy-nations-breaking-climate- pledge-with-gas-dash-in-global-south
55
“Wealthy nations are breaking their climate commitments by funding a new dash for gas in the global south, according to a study. A week before the G7 summit begins in Cornwall, the report reveals low and middle-income nations received nearly $16bn a year between 2017 and 2019 to fund projects related to gas, a fossil fuel that worsens global heating. This was nearly four times more than international public finance for wind or solar projects, raising concerns that poorer nations are being locked into the old fossil fuel economy even though cleaner and increasingly cheap alternatives are available….”
“… Three governments – the US, Japan and China – provided 48% of the public funding for gas in the global south. The World Bank accounted for a further 12%. The authors of the study said this funding was being used to expand markets in Asia and Africa, which would benefit petroleum industries in wealthy nations….”
Guardian - We are running out of time to reach deal to save natural world, says UN talks chair https://www.theguardian.com/environment/2021/jun/07/age-of-extinction-running-out-of-time-to- reach-deal-to-save-natural-world-says-un-talks-chair
“Warning comes amid fears of further delays to Kunming summit, which aims to agree on curbing destruction of ecosystems…”
Guardian - Climate crisis to shrink G7 economies twice as much as Covid-19, says research
Guardian
“G7 countries will lose $5tn a year by 2050 if temperatures rise by 2.6C.”
“The economies of rich countries will shrink by twice as much as they did in the Covid-19 crisis if they fail to tackle rising greenhouse gas emissions, according to research. The G7 countries – the world’s biggest industrialised economies – will lose 8.5% of GDP a year, or nearly $5tn wiped off their economies, within 30 years if temperatures rise by 2.6C, as they are likely to on the basis of government pledges and policies around the world, according to research from Oxfam and the Swiss Re Institute. The economies of G7 nations contracted by about 4.2% on average in the coronavirus pandemic, and the economic losses from the climate crisis by 2050 would be roughly on the scale of suffering a similar crisis twice every year, according to the research….”
Guardian - World’s soils ‘under great pressure’, says UN pollution report https://www.theguardian.com/environment/2021/jun/04/soils-great-pressure-un-pollution-report- food-farming-mining
“The world’s soils, which provide 95% of humanity’s food, are “under great pressure”, according to a UN report on soil pollution. … the report said industrial pollution, mining, farming and poor waste management are poisoning soils, with the “polluter pays” principle absent in many countries….”
56
Infectious diseases & NTDs
Science News - Mosquitoes armed with virus-fighting bacteria sharply curb dengue infections, hospitalizations https://www.sciencemag.org/news/2021/06/mosquitoes-armed-virus-fighting-bacteria-sharply- curb-dengue-infections
“Trial of Wolbachia-infected insects draws praise for new disease control method.”
“A strategy for fighting dengue fever with bacteria-armed mosquitoes has passed its most rigorous test yet: a large, randomized, controlled trial. Researchers reported today dramatic reductions in rates of dengue infection and hospitalization in areas of an Indonesian city where the disease- fighting mosquitoes were released. The team expects the World Health Organization (WHO) to formally recommend the approach for broader use. …. The findings are a “breakthrough” that brings the approach “much closer to … being an official strategy to control dengue,” says Ewa Chrostek, an infection biologist at the University of Liverpool who was not involved with the work. WHO estimates there are 100 million to 400 million infections per year with dengue, which can cause high fever and severe joint pain….”
NCDs
HPW - Anti-Smoking Campaigns Launched In Eight Countries to Mark World No Tobacco Day https://healthpolicy-watch.news/anti-smoking-campaigns-launched-in-eight-countries-to-mark-no- tobacco-day/
“Eight campaigns and initiatives aimed at encouraging people to quit smoking were launched this week by Vital Strategies and partners to mark World No Tobacco Day on 31 May 2021. …”
Link:
SS&M - Implications of household tobacco and alcohol use on child health and women’s welfare in six low and middle-income countries: An analysis from a gender perspective
57
Human resources for health
Human Resources for Health - The regulation of healthcare professions and support workers in international context M Saks; https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-021-00618-8
“The objective of this paper is to outline and compare the regulation of paid healthcare professions and associated support workers in international context, bringing out the lessons to be learned as appropriate….”
Extra Covid section
FT - The next generation Covid-19 vaccines seeking a slice of the market https://www.ft.com/content/846c00e4-06ba-417d-978c-98caef7f605a
“Latecomers hope size, price or novel technology mean they can still play an important role in the pandemic.”
“… Yet the global need for coronavirus vaccines is so great that the pandemic’s next phase provides a chance for other players to break in. Large pharma companies like Sanofi and GSK are hoping to shake off their image as laggards, while start-ups such as Novavax, CureVac and Valneva see opportunities to satisfy unmet needs. …. … But the size of the opportunity to provide doses, both for initial inoculations and potential booster shots, makes it worthwhile. Indeed, newcomer Novavax is forecast to overtake Moderna as the second-largest Covid-19 vaccine maker by revenue next year, with estimated sales of $17.9bn in 2022, according to Airfinity, a London-based analytics company. And if their vaccines are approved, it predicts Sanofi, GSK, and CureVac will all book more than $6bn in sales next year, far more than the $1bn in annual revenue that typically defines a “blockbuster” drug….”
Nature (News) - The four most urgent questions about long COVID
News;
“ Scientists are starting to get insights into the lingering disorder that affects some people infected with SARS-CoV-2 — but many mysteries remain unsolved.”
“The number of confirmed COVID-19 cases has topped 170 million across the globe, and upwards of 10% of those people might be experiencing persistent symptoms. Among the questions that scientists are investigating: who is most at risk, what are the underlying mechanisms and how might long COVID offer insight into other post-viral problems? And, of course, how can it be treated?...”
58
The Verge – The pandemic showed that Big Tech isn’t a public health saviour https://www.theverge.com/2021/6/3/22514951/pandemic-public-health-solutions-google-apple- facebook
“Public health takes a village, not a tech campus.”
“… “What is really clear, and I think this was clear well prior to the pandemic, is that tech does not substitute for strong public institutions,” Schroeder says. “Public health investment needs to happen independently of what any tech company does.” “
NPR - Malaysia's Recent Surge In COVID Infections Leads To A New Lockdown And New Worries https://www.npr.org/2021/06/04/1002843927/malaysias-recent-surge-in-infections-leads-to-a- new-lockdown-and-new-worries
“In terms of new cases per million, Malaysia's infections are "higher than even India['s]."…”
“The current spike marks a dramatic shift for Malaysia. Kuala Lumpur-based political analyst James Chai says the country has gone from a "shining example of handling the pandemic and suppressing it to single digits on a daily basis" to now having the fastest-growing COVID-19 outbreak in all of Southeast Asia….”
AP - India to provide free vaccines to all in major policy shift AP;
“ India’s federal government will provide free coronavirus shots to any adult starting later this month and take back control of the country’s vaccination drive, marred by delays and shortages, Prime Minister Narendra Modi announced Monday. The changes reverse a policy launched in April which tasked states and the private sector with vaccinating those between the ages of 18 and 44. The federal government will now procure 75% of all vaccines directly from the manufacturers and provide them to the states for free, while the remaining 25% will be purchased by the private sector….”
Stat - Scientific publishing’s new weapon for the next crisis: the rapid correction https://www.statnews.com/2021/06/08/scientific-publishing-new-weapon-for-the-next-crisis-the- rapid-correction/
“…A big part of the problem has been the ever-widening mismatch between the speed of scientific publishing and error correction. …” The rapid correction aims to change that.
Links:
Global Public Health - Forty days of regulatory emergency use authorisation of COVID-19 vaccines: Interfacing efficacy, hesitancy and SDG target 3.8
59
Science News - Brazil gives Russian COVID-19 vaccine a chance, approving the import of limited doses
Economist - More evidence emerges of India’s true death toll from covid-19
“ New surveys corroborate earlier estimates that the number is some six times higher.”
60