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China shows COVID-19 Coronavirus can be ‘stopped in its tracks’

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Medical equipment supplied by the World Food Programme (WFP) arrives in Beijing. Photo courtesy of Yingshi Zhang

China’s experience in containing the spread of the new coronavirus could serve as a lesson for other countries now facing the COVID-19 pandemic, a senior official with the World Health Organization (WHO) has told UN News in an in-depth interview. 

While more than 153,00 cases of the respiratory illness have been recorded globally as of Sunday, it is on the decline in China, demonstrating that the course of the outbreak there has been altered, according to WHO Representative in the country, Dr. Gauden Galea. 

 “It is an epidemic that has been nipped as it was growing and stopped in its tracks. This is very clear from the data that we have, as well as the observations that we can see in society in general”, he told UN News in the capital, Beijing, on Saturday.  

“So that’s a big lesson: that the natural course of the outbreak does not need to be a very high peak that overwhelms health services. This lesson in containment, therefore, is a lesson that other countries can learn from and adapt for their own circumstances”. 

Understanding ‘a pneumonia of unknown cause’ 

COVID-19 is the most recently discovered of the coronaviruses which are known to cause respiratory infections such as MERS and SARS. 

WHO has been on the case since 31 December, when it was first informed that “a pneumonia of unknown cause” had been detected in Wuhan, the largest city in Hubei province in central China.   

Dr. Galea reported that there were three main questions to understand during this initial phase: How the virus was being transmitted, its severity, and control measures. 

“In a way, the first three weeks were very deeply involved in looking into the local epidemiological investigation, in asking questions of the national investigators, seeking interpretation by international networks of experts, developing risk communications around the information that we had, sending out the message across the media, reaching out to partners in the UN and in the missions in China based in Beijing”, he said. 

Dr. Galea and colleagues travelled to Wuhan from 20-21 January, just days before the city was subjected to a lockdown.  At the time, there was no overwhelming demand on the health services, though the situation had changed when Chinese and international health experts conducted a joint mission a month later. 

Dr. Galea understood that while there were shortcomings at the time, and allegations of cover-ups, creating an “alternative history” would have been difficult.   

He highlighted the “high price” paid by Wuhan’s citizens with the lockdown, thus “buying time” for the rest of China and the world. 

“But that containment was effective and did allow the rest of China to be able to contain the outbreak in a very effective manner. The shape of the epidemic and the small number of cases that were seen outside Hubei are a testimony to the success and the effectiveness”, he said.  

“It’s very important to realise that such shortcomings are not unique to China, and that very few countries are manifesting any greater speed in action”.  

From international emergency to pandemic 

Following two meetings of its Emergency Committee, WHO chief Tedros Adhanom Ghebreyesus on 30 January declared the new disease a public health emergency of international concern: the agency’s highest ranking of risk assessment.   

WHO then set up what Dr. Galea described as a “research blueprint” and began shipping testing kits and personal protective equipment to other countries. 

Last week, WHO announced that COVID-19 could be characterized as a pandemic: the first to be sparked by a coronavirus

“When you realise that a public health emergency of international concern was declared on January 30, and as we speak, we are now mid-March, it’s very important to understand that any country that still has not heeded the call needs to be acting and acting fast: not least preparing the population through appropriate risk communication”, said Dr. Galea. 

Sharing lessons learned 

With the caseload in China on the decline, WHO is working to share lessons learned there for the benefit of other countries now facing COVID-19. 

Dr. Galea praised the timely cooperation with the National Health Commission, its counterpart in the country. Early and frequent exchanges resulted in sharing of the genetic sequence of the virus, as well as the specifications for designing tests so other countries would be able to identify it.  

“The biggest conclusion is that China has demonstrated that the course of the outbreak can be altered. Normally, an outbreak of this nature would have exponential growth, would reach a high peak, and would then decline naturally once all susceptible people have been infected, or developed the disease.  This has not happened in China in a number of ways,” he said.  

“One: the shape of the course of the events – the graph, the epidemic curve, as we call it, of the numbers of cases over time – appears very unnatural. It is an epidemic that has been nipped as it was growing and stopped in its tracks. This is very clear from the data that we have, as well as the observations that we can see in society in general.

“So, that’s a big lesson that the natural course of the outbreak does not need to be a very high peak that overrwhelms health services.  This lesson in containment, therefore, is a lesson that other countries can learn from and adapt for their own circumstances”.

Use the tools 

One lesson so far has been the importance of having strong national public health systems. Dr. Galea underlined the need for preparation, and the value of providing all citizens with access to health care. 

At the individual level, he urged people not to panic and to follow procedures for reducing the risk of spread, such as proper hand-washing, covering your nose when sneezing, coughing into your elbow, and working from home where possible. 

Said Dr. Galea: “People would have heard these things  many times, but one can never repeat them enough or with enough force. This is the way. These are the tools we have now. Use them.” 

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Human Rights

Millions in Yemen ‘a step away from starvation’

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Mobile health clinics are distributing nutritional supplements to children in Yemen. WFP/Saleh Bin Haiyan

The crisis in Yemen, now in its seventh year of war, continues unabated, with thousands of people displaced and millions “a step away from starvation”, the UN Humanitarian Relief Coordinator said on Wednesday during a high-level side event on the margins of the 76th General Assembly.

“The country’s economy has reached new depths of collapse, and a third wave of the pandemic is threatening to crash the country’s already fragile health-care system”, Humanitarian Affairs chief Martin Griffiths told world leaders at the meeting: Yemen: Responding to the crises within the world’s largest humanitarian crisis.

Underscoring that the most vulnerable always “bear the highest cost” of the crisis, he said that females were more likely to be hungry, sick or exposed to gender-based violence and, with little access to essential services, millions of internally displaced people face “a daily struggle to survive”.

Cause for hope

In a positive development, the UN official credited the international community for stepping up support to the country’s humanitarian aid operation.

Thanking the world leaders, he said that Yemen’s Humanitarian Response Plan is “among the most well-funded”, with 98 per cent of the pledges made at an event in March fulfilled.

With over $2 billion received, the UN and its partners were able to “prevent famine and pull people back from the brink of despair”, delivering assistance to “every single one of the country’s 333 districts”.

‘Far from done’

Despite these important achievements, Mr. Griffiths acknowledged that the work there is “far from done”, as many sectors still face “alarming funding gaps” and humanitarians are working with less than one-fifth of the money needed to provide health care, sanitation, and shelter.

“Without additional funding, these and other forms of critical life-saving support – including food assistance – will have to be reduced in the coming weeks and months”, he warned.

Three requests

The UN relief chief asked global leaders to continue generously supporting Yemen’s humanitarian operation; respect international humanitarian law and protect civilians; and address the root drivers of the crisis, including restrictions on imports, which elevate the prices of essential goods.

He urged them to do “everything in our collective power to stop this war”, saying, “at the end of the day, peace is what will provide Yemenis the most sustainable form of relief”.

Children robbed

The war has robbed too many of Yemen’s children of safety, education and opportunities.

“Each day, the violence and destruction wreak havoc on the lives of children and their families”, Henrietta Fore, Executive Director of the UN Children’s Fund (UNICEF), told the meeting.

She painted a grim picture of 1.7 million displaced youth, 11.3 million youngsters depending on humanitarian assistance to survive and 2.3 million under-five “acutely malnourished” – nearly 400,000 of whom are at “imminent risk of death”.

“Being a child in Yemen means you have probably either experienced or witnessed horrific violence that no child should ever face”, said the UNICEF chief.

“Quite simply, Yemen is one of the most difficult places in the world to be a child”.

Millions ‘marching towards starvation’

In his address, World Food Programme (WFP) chief David Beasley said that in a nation of 30 million people, food rations are needed by 12.9 million; while 3.3 million children and women need special nutrition, together with 1.6 million school children.

“We’re literally looking at 16 million people marching towards starvation”, he said.

With one thousand people a week dying from a lack of food and nutrition, the senior WFP official warned that if $800 million is not received in the next six months, the need to cut rations could lead to the death of 400,000 children under the age of five next year.

We have a moral, obligation, to speak out and step up”, he stated, appealing to the world leaders to “put the pressure on all parties…to end this conflict”.

“These are our children; these are our brothers and sisters we need the donors to step up immediately otherwise children are going to die. Let’s not let them down. Let’s do what we need to do”, concluded Mr. Beasley.

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Africa Today

South Sudan ‘determined to never go back to war’

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Rebecca Nyandeng De Mabior, Vice-President of the Republic of South Sudan, addresses the general debate of the UN General Assembly’s 76th session. UN Photo/Cia Pak

South Sudan is “ready to turn a new page” towards greater peace, development and prosperity, Vice-President Rebecca Nyandeng de Mabior said in her speech in the UN General Assembly on Friday. 

A decade after gaining independence from Sudan, the country remains “on a path of nation-building” and is working to implement a 2018 revitalized peace deal which led to the formation of a unity government last year.

 “I want to assure our friends and partners that we are determined to never go back to war,” said Ms. De Mabior.

“We must replace the destruction of war with the productive use of our vast natural resources and national assets for the good of our people.”

Prioritize nation-building

The Vice-President recalled that when South Sudan became independent, the international community pledged to build capacity in nation-building, establishing a UN mission in the country, UNMISS, to support this process.

“However, after the outbreak of the war, that vision was abandoned, and priority was placed on protecting civilians and providing humanitarian assistance. As a result, support for capacity building of the State was terminated,” she said.

Ms. De Mabior stressed that supporting a State’s ability to govern responsibly and effectively is essential.  It is also necessary to guard against what she called “the unintended consequences of dependency on humanitarian assistance.”

Given improvements in peace and security, she said it was now time to transition from emergency towards sustainable development.

“It is a painful and shameful situation for a country endowed with vast fertile land to be regarded as poor,” she added.  

“We must ensure peace and security in the country and double our efforts to support our people who want to return, and are returning, to their areas of origin, for them to participate fully in nation-building and contribute to building food security in the country.”

Support youth and women

South Sudan is also “a youthful country”, and the Vice-President called for continued efforts to develop the skills of its youth and women “to provide an alternative to picking up the gun again and engaging in destructive behavior.”

Encouraging developments have included joint efforts by the national security forces and their UNMISS counterparts to promote rural peace and security, while the Government is set to unveil a national youth service programme.

“To fulfill the vision of our liberation struggle, we must use our oil revenues to fuel economic growth through investment in agriculture,” she said.  

“We will invest in infrastructure to connect our rural communities to the markets. We need the public and private sectors, including foreign investors, to join hands in turning South Sudan’s potential wealth into a reality.”

Glass ‘half-empty’

Ms. De Mabior reported progress in implementing aspects of the Revitalized Peace Agreement, particularly in the creation of state and national bodies and public financial management reforms

However, “the glass remains half-empty” in implementing a permanent ceasefire and transitional security arrangements, she said, noting the urgency for a unified army.

“The security sector reform is the most challenging part of the Agreement as it contains elements at the center of the violent conflicts in the country,” she said, calling for continued dialogue.

“Building sustainable peace requires inclusivity, collective investment, determination, diligence, and patience.”

Meanwhile, relations with Sudan have also improved, though outstanding issues remain over the oil-rich Abyei border area.

Ms. De Mabior stressed her country is determined to learn from the past.

 “We must make the Revitalized Peace Agreement succeed, and we can only do that with the support of our regional and international partners. Simply stated, South Sudan desires and is ready to turn a new page,” she said.

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Health & Wellness

WHO backs Regeneron COVID-19 drug cocktail – with equal access, price cut

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A technician carries out an experiment in the Regeneron laboratory. © Regeneron

The Regeneron antibody drug cocktail – casirivimab and imdevimab – has been added to the World Health Organization’s (WHO) list of treatments for COVID-19 patients, the UN agency said on Friday, before underscoring the need for lower prices and equitable distribution. 

“This is a major breakthrough in the care of COVID-19 patients”, said Dr. Janet Diaz, WHO head of clinical care. “This is our first recommendation for a therapeutic for those patients with mild, moderate disease,” she said, because it reduces “the need for hospitalisation if they are at high risk”. 

Effective ‘reduction in mortality’  

WHO’s conditional recommendations are for use of the drug combination on patients who are not severely ill, but at high risk of being admitted to hospital with COVID-19, or those with severe cases of the disease and no existing antibodies.  

“Giving them this additional antibody seems to show an effect. And what effect is that? A reduction in mortality” Dr. Diaz told a briefing in Geneva. 

The antibody therapy was granted emergency use authorization in the United States November last year after it was used to treat former President Donald Trump when he was admitted to hospital with the virus. The United Kingdom has also approved Regeneron, while it is under review in Europe. 

‘Meaningful’ benefit 

The WHO recommendations were largely based on data from a British study of 9,000 patients in June which found that the therapy reduced deaths in hospitalised patients whose own immune systems had failed to produce a response. 

“We are taking the information (from the UK study) and generalizing it to other persons,” said Dr. Diaz. “We saw there was a benefit we thought was meaningful.” 

The treatment has been on the market for decades to treat many other diseases, including cancers. It is based on a class of drugs called monoclonal antibodies which mimic natural antibodies produced by the human body to fight off infections. 

Equity, price cut call 

Swiss drugmaker Roche, has been working in partnership with Regeneron, which holds the patent, to produce the antibody treatment. 

Dr. Diaz urged Regeneron to lower the drug’s price and work on equitable distribution worldwide: “We know that the life-saving benefits and the benefits for patients with COVID-19 is significant and requires action.” 

She added that WHO-hosted health agency UNITAID, has been negotiating directly with Roche for lower prices and equitable distribution across all parts of the world, “including low and middle-income countries”. 

WHO has also been in discussions with the company for a donation and distribution of the drug through UN Children’s Fund UNICEF, following an allocation criteria set by the health agency. “We are working together with the company so we can address these very important issues so we can have equitable access” she said. 

Call to manufacturers 

In a statement, WHO said in parallel it had “launched a call to manufacturers who may wish to submit their products for pre-qualification, which would allow for a ramping-up of production and therefore greater availability of the treatment and expanded access. 

ACT-A partners are also working with WHO on an equitable access framework for recommended COVID-19 therapeutics”. On that subject, Dr Diaz added that “there are bottlenecks and we are aware of those. 

WHO has launched the pre-qualification expression of interest call so that the manufacturing companies can start to submit their dossiers to WHO”. 

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