Tuesday’s Weekly Primer: Curated Global Health News

POLICY UPDATES

Image credit: ©WTO/Bryan Lehmann

“What we are proposing is a limited scope and a temporary Waiver that would provide countries with the policy space needed to collaborate in research and development (R&D), manufacturing, scaling up, and supplying COVID-19 tools which are currently in short-supply. The Waiver is an instrument that is provided for in the WTO legal framework in exceptional circumstances. No one can dispute that COVID-19 is an unprecedented crisis facing the global economy today. We have indicated our flexibility to engage on the scope and timeframe for the application of the Waiver and we are ready to engage in constructive text-based discussions with Members towards a solution. The world cannot afford anymore delays. This should be the most urgent priority for the WTO. History will judge us harshly should we fail to provide a credible response to this crisis. The time to act is now.”

“Permit me Ladies and Gentlemen to spend just a little time on COVID-19. We have a demand for a TRIPS waiver by a growing number of developing countries and the dialogue is intensifying. Whilst this is happening, I propose that we “walk and chew gum” by also focusing on the immediate needs of dozens of poor countries that have yet to vaccinate a single person. People are dying in poor countries. We just had our first COVAX shipment to Ghana last week and others will follow but it will not be enough. There is serious supply scarcity and some countries are out bidding COVAX and diverting supplies. The world has a normal capacity of production of 3.5 billion doses of vaccines and we now seek to manufacture 10 billion doses. This is just very difficult, so we must focus on working with companies to open up and license more viable manufacturing sites now in emerging markets and developing countries. We must get them to work with us on know how and technology transfer now. There will soon be a world manufacturing convention where we can seek to build this partnership. I also hope we can initiate a dialogue and information exchange between us and representatives of manufacturers associations from developing and developed countries. Excellencies, this should happen soon so we can save lives. As I said at the beginning, this will be an interim solution whilst we continue the dialogue on the TRIPS waiver.”

WHAT WE FOUND INTERESTING

“On 18 February 2021, the National IHR Focal Point for the Russian Federation notified WHO of detection of avian influenza A(H5N8) in seven human clinical specimens. These are the first reported detection of avian influenza A(H5N8) in humans.”

WHO

“Test samples had to be sent more than 1,500 kilometres from remote hospitals to the capital Kinshasa. Results took weeks to come back. Some of the infected returned home, spreading the virus. In Bukavu, the capital of South Kivu province, bodies piled up in the morgue. Senior doctors described total confusion. Five doctors and 10 nurses were among those who died, according to one medic who spoke on condition of anonymity.”

It needn’t have been this way. Bukavu’s Provincial General Reference Hospital, like dozens of others across Congo, had access to a machine that could have processed around 100 COVID-19 tests a day, if only it had the right chemical kits, doctors there told Reuters.

Reuters Investigates

“A team of leading Finnish researchers had a patent-free COVID-19 vaccine ready last May, which could have allowed countries all over the world to inoculate their populations without paying top dollar. Yet rather than help the initiative, Finland’s government sided with Big Pharma — showing how a patent-based funding model puts profit over public health….

…In the mainstream narrative, the first-generation COVID-19 vaccines from Pfizer, Moderna, and AstraZeneca are typically presented as an illustration of how markets incentivize and accelerate vital innovation. In reality, the fact that the profit motive is the overriding force shaping medical research has been devastating — particularly in a global pandemic. The Finnish vaccine provides a striking case study of the many ways in which the contemporary patent-based funding model has slowed down vaccine development, and how it currently hampers the possibility of conducting effective mass-inoculation campaigns.”

Jacobin Mag

“Vaccinating over 210 million people may sound daunting, but for Brazil it really shouldn’t be. With one of the largest universal, free-of-charge public health systems in the world, the country has a distinguished track record of vaccinations and disease control. The National Immunization Program, founded in 1973, helped to eradicate polio and rubella in the country and currently offers more than 20 vaccines free in every municipality.

…We take immunization so seriously here that we even have a mascot for vaccination campaigns, an adorable six-foot smiling white blob named “Zé Gotinha,” Joe Droplet. (This glorious national hero apparently refused to shake hands with President Jair Bolsonaro during an official event in December.)…”

New York Times Opinion

“The African Union will pay three times more for Russia’s Sputnik V jab than it is paying for the Oxford/AstraZeneca and Novavax vaccines, according to people familiar with the procurement process.

The $9.75 price per dose for 300m shots of the Russian vaccine, developed by the state-run Gamaleya Institute, undermines Moscow’s argument that it is offering affordable jabs to countries priced out of deals with western pharmaceutical groups.”

Financial Times

“For now, then, the African paradox persists. “We don’t have an explanation for why the impact has been lower,” says Karim. “It remains for me an unanswered question.” Nkengasong says that answers may not be forthcoming for years, and until then most theories remain on the table. One early prediction has already been disproved, however: that many Africans whose immune systems were weakened by HIV/Aids infection would die of Covid-19. Thankfully it didn’t happen, says Karim, for a reason that, in hindsight, appears obvious. The two diseases don’t affect the same age groups, since HIV is mainly a disease of the young in Africa. There is, however, some evidence that when those infected with HIV do catch Covid-19, their Covid-19 can be more severe.”

“In the present paper we discussed the scientific foundation of these ‘social distancing’ measures, which touches several billion individuals globally. Our simulations demonstrate that currently available information is inadequate to design social distancing recommendations on a solid scientific basis….

…Our findings call for novel experimental efforts to address two key issues that cause uncertainty in predictions: the determination of droplet size distributions at emission and the infection potential of viral load carried on dry versus wet nuclei..”

“..There are two broad approaches to valuing a human life. The first is known as the value of a prevented fatality (VPF), and it’s the one applied in the first scenario above. How much would you pay for, say, improving road safety to reduce the risk of premature deaths? It’s an average measure applied across the population as a whole.

The second approach applies when you have more information about the individuals concerned, as in the lifeboat example above, and it’s called the quality-adjusted life year (QALY). A QALY is one year in full health, whatever that means for the individual in question. That’s an important detail, because the value of a QALY is the same for a person born deaf as one born hearing, but less for a “sickly old” man than for a “healthy young” child. Age and health are taken into account, but that’s all. “This is nothing to do with economic importance,” Jessop explains. “A rich person’s QALY is the same as a poor person’s.”

The Guardian

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