Four in five children living with HIV in West and Central Africa are still not receiving life-saving antiretroviral therapy and AIDS-related deaths among adolescents aged 15-19 are on the rise, the United Nations Children’s Fund (UNICEF) has warned.
“It is tragic that so many children and adolescents today are not receiving the treatment they need just because they have not been tested,” said Marie-Pierre Poirier, the UNICEF Director for the region, in a news release, Tuesday, calling for improvement of early diagnosis and access to HIV treatment and care for children.
According to UNICEF, West and Central Africa has the lowest paediatric antiretroviral treatment coverage in the world, with only 21 per cent of the 540,000 children (aged 0-14) living with HIV receiving antiretroviral treatment in 2016 – compared to 43 per cent globally.
A major cause behind this is the limited capacity of the countries to perform the tests needed for early infant diagnosis of HIV.
“Without knowing a child’s HIV status, his or her family is less likely to seek the treatment that could prevent the tragedy of a child’s death from AIDS-related illnesses,” said UNICEF.
The situation is worse among adolescents: the annual number of new HIV infections among those aged 15-19 years in the region now exceeds that of children aged 0-14 years. These new infections occur mostly through unprotected sexual contact and among adolescent girls.
Equally concerning, according to Step Up the Pace: Towards an AIDS-free, a recently released UNICEF report, is that the region has seen a 35 per cent rise in the annual number of AIDS-related deaths among adolescents aged 15-19 years – the only age group in which the number of AIDS-related deaths increased between 2010 and 2016.
With the region’s youth population expected to grow significantly within the coming decades, especially in countries like the Democratic Republic of the Congo (DRC) and Nigeria, the numbers of children and adolescents becoming infected with HIV and dying from AIDS is likely to remain high, unless the HIV response – both prevention and treatment – improves dramatically, the report warns.
To overcome these hurdles, the report calls for key strategies to enable countries accelerate efforts to curb the spread of disease.
In particular, it proposes a differentiated HIV response focusing on unique epidemiological and local contexts in each country and community; integration of HIV services into key social services including health, education and protection; community ownership and local governance of the HIV response including working with families to help reduce stigma, access prevention and treatment; and investment in innovations to remove barriers to diagnostic and biomedical approaches such as point of care diagnostics, HIV self-testing and pre-exposure prophylaxis.
“Leaders of the region have endorsed a Catch-Up plan aiming to triple the number of people on treatment in the region – including children – by the end of 2018, the key issue now is to accelerate implementation,” said Luiz Loures, the Deputy Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS).
“Countries should urgently put in place more effective strategies for early infant diagnosis of HIV, and start reducing inequity in children’s access to treatment.”
Competition to Find Solutions to Reduce Overfishing in Coastal Fisheries
The World Bank Coastal Fisheries Initiative – Challenge Fund (CFI-CF) is launching a competition to seek collaborative solutions to reduce overfishing by supporting coordination among fishers and collaboration across seafood value chains. The competition seeks innovative solutions that promote the productive and sustainable use and management of coastal fish stocks in Cabo Verde, Ecuador, Indonesia, and Peru. Both new and established coalitions of fishing and coastal communities, businesses, and/or nonprofit organizations are invited to apply.
Overfishing is among the biggest challenges threatening the health of the world’s oceans, the livelihoods of millions living in coastal communities, and the business opportunities of seafood and related industries. Each year, global fisheries lose out on US$83 billion in economic benefits due to overfishing (World Bank “The Sunken Billions Revisited”), a sum that could instead be productively reinvested in people, communities, and economies. Limited coordination among fishers and seafood stakeholders has blocked the development of viable solutions to overfishing, resulting in the continued loss of natural resources and economic benefits.
“The Coastal Fisheries Initiative – Challenge Fund is committed to improving coastal fisheries, which are important sources of food and livelihoods for local communities. This competition is a call to action to bring together all of the actors in the seafood industry to tackle this perennial problem of overfishing,” said Mimi Kobayashi, Senior Environmental Economist at the World Bank and team leader of the CFI-CF. “Although this issue remains challenging, we are confident that we will receive some innovative and game-changing solutions.”
This competition aims to mobilize the collective power of fisheries and seafood stakeholders to design and implement solutions that systematically reduce overfishing in a self-sustained way by effectively engaging stakeholders. Solutions should address the restoration of already degraded fish stocks, while protecting people who are impacted when fishing is reduced.
Eligible applicants will receive mentoring and coaching support to improve their approaches and then can re-apply to increase their chances of winning.
One winner and one runner up will be selected in Cabo Verde, Ecuador, Indonesia, and Peru and announced at a virtual Knowledge Sharing Event in Spring 2022. Winners and runners up will participate in a week-long series of virtual events designed to share knowledge and experience in advancing productive and sustainable coastal fisheries. They will also receive dissemination support from the World Bank and acceleration services to improve and implement their solutions from competition partners.
Canada’s bold policies can underpin a successful energy transition
Canada has embarked on an ambitious transformation of its energy system, and clear policy signals will be important to expand energy sector investments in clean and sustainable energy sources, according to a policy review by the International Energy Agency.
Since the IEA’s last in-depth review in 2015, Canada has made a series of international and domestic climate change commitments, notably setting a target to cut greenhouse gas emissions by 40-45% from 2005 levels by 2030 and a commitment to reach net zero emissions by 2050.
To support those climate and energy targets, governments in Canada have in recent years worked on a number of policy measures, including an ambitious carbon-pricing system, a clean fuels standard, a commitment to phase out unabated coal-fired electricity by 2030, nuclear plant extensions, methane regulations in the oil and gas sector, energy efficiency programmes and measures to decarbonise the transport sector.
“Canada has shown impressive leadership, both at home and abroad, on clean and equitable energy transitions,” said IEA Executive Director Fatih Birol, who is launching the report today with Jonathan Wilkinson, Canada’s Minister of Natural Resources. “Canada’s wealth of clean electricity and its innovative spirit can help drive a secure and affordable transformation of its energy system and help realise its ambitious goals. Equally important, Canada’s efforts to reduce emissions – of both carbon dioxide and methane – from its oil and gas production can help ensure its continued place as a reliable supplier of energy to the world.”
Canada’s profile as a major producer, consumer and exporter of energy presents both challenges and opportunities for reaching the country’s enhanced targets. Energy makes up 10% of gross domestic product and is a major source of capital investment, export revenue and jobs. Moreover, Canada’s highly decentralised system of government means that close coordination between federal, provincial and territorial governments is essential for a successful energy transition.
“This report acknowledges Canada’s ambitious efforts and historic investments to develop pathways to achieve net-zero emissions by 2050 and ensure a transition that aligns with our shared objective of limiting global warming to 1.5 degrees Celsius, “ said Minister Wilkinson. “These are pathways that make the most sense for our people, our economy and our country and will also yield technology, products and know-how that can be exported and applied around the world.”
The IEA finds that emissions intensity from Canada’s oil and gas production has declined in recent years, but the sector remains a major source of greenhouse gases, accounting for about a quarter of the country’s GHG emissions. Along with strong action to curb methane emissions, improving the rate of energy technology innovation will be essential for the deep decarbonisation that is needed in oil and gas production, as well as in the transport and industry sectors. Canada is actively advancing innovation in a number of key fields, including carbon capture, utilisation and storage; clean hydrogen; and small modular nuclear reactors, with a view to serving as a supplier of energy and climate solutions to the world. The IEA notes that further federal support for research, development and demonstration would help accelerate progress towards these goals.
The IEA is also recommending that Canada’s federal government promote a comprehensive energy efficiency strategy in consultation with provinces and territories that sets clear targets for energy efficiency in the buildings, industry and transport sectors
The IEA report highlights that Canada’s electricity supply is among the cleanest in the world, with over 80% of supply coming from non-emitting sources, thanks to the dominance of hydro and the important role of nuclear. To further support the expansion of clean power and electrification, the report encourages increased interconnections among provinces and territories to ensure balanced decarbonisation progress across the country.
The IEA commends Canada on its efforts to advance a people-centred approach to its clean energy transition, including initiatives to promote diversity and inclusion in clean energy sectors; programmes to increase access to clean energy in northern, remote and Indigenous communities; and actions to enable just transitions for coal workers and their communities.
“Canada has laid out a comprehensive set of policy measures and investments across sectors to meet its climate targets, including a strong clean energy component to its Covid-19 economic recovery efforts,” said Dr Birol. “I hope this report will help Canada navigate its path toward economy-wide emissions reductions and a net zero future.”
WHO recommends two new drugs to treat patients with COVID-19
The World Health Organization (WHO) on Thursday reccommended two new drugs to treat patients with COVID-19, one for patients with critical disease, and another deemed effective for non-severe cases.
The first drug, baricitinib, is a Janus kinase (JAK) inhibitor- a class of drugs used to treat autoimmune conditions, blood and bone marrow cancers, and rheumatoid arthritis.
According to the WHO Guideline Development Group, it is “strongly recommended” for patients with severe or critical disease in combination with corticosteroids.
The group of international experts based their recommendation on “moderate certainty evidence” that it improves survival and reduces the need for ventilation.
There was no observed increase in adverse effects.
The experts note that it has a similar effectas other arthritis drugs called interleukin-6 (IL-6) inhibitors. Because of that, when both drugs are available, they suggest choosing the best option based on cost, availability, and clinician experience.
It is not recommended to use both drugs at the same time.
The experts also advise against the use of two other JAK inhibitors (ruxolitinib and tofacitinib) for patients with severe or critical cases of COVID-19 infection.
According to them, trials undergone using these drugs failed to show any benefits arising using either drug,and suggested a possible increase in serious side effects with tofacitinib.
In the same update, WHO makes a conditional recommendation for the use of a monoclonal antibody known as sotrovimab in patients with non-severe cases.
According to them, the drug should only be administered to patients at the highest risk of hospitalisation. In those at lower risk, it onlyshowed “trivial benefits”.
A similar recommendation has been madepreviously, for another monoclonal antibody drug, casirivimab-imdevimab, and the experts say there is insufficient data to recommend one over the other.
For both, the effectiveness against new variants, like Omicron, is still uncertain.
The group will update their guidelines for monoclonal antibodies when more data becomes available.
These recommendations are based on new evidence from seven trials involving over 4,000 patients with non-severe, severe, and critical infections.
Developed by WHO with the methodological support of MAGIC Evidence Ecosystem Foundation, the guidelinesprovide trustworthy guidance and help doctors make better decisions with their patients.
According to the agency, the guidelines are useful in fast moving research areas, because they allow researchers to update evidence summaries as new information becomes available.
The latest guidance also updates recommendations for the use of interleukin-6 receptor blockers and systemic corticosteroids for patients with severe or critical COVID-19; conditional recommendations for the use of casirivimab-imdevimab (another monoclonal antibody treatment) in selected patients; and against the use of convalescent plasma, ivermectin and hydroxychloroquine, regardless of disease severity.
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