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COVID-19: Consequences of ‘chronic under-investment in public health’ laid bare

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A nurse who recovered from COVID-19 is back at work helping patients at a hospital in Malawi. © UNICEF

A global chronic under-investment in public health has been exposed by the coronavirus pandemic, which must now lead to a major re-think in how all societies value health, said the head of the World Health Organization (WHO) on Friday.

Tedros Adhanom Ghebreyesus was making closing remarks at the closing of WHO’s governing body, the World Health Assembly, which finalized its annual session this week after its regular May meeting was cut short by COVID-19 safety requirements.

Historic vaccine advances

The WHO chief highlighted the Pfizer/BioNTech vaccine breakthrough announced this week, which results indicate could be around 90 per cent effective, saying he had “no doubt” that vaccines were a vital tool for controlling the on-going pandemic.

“Never in history has vaccine research progressed so quickly. We must apply the same urgency and innovation to ensuring that all countries benefit from this scientific achievement.

“But we have a long way to go. The world cannot put all its eggs in one basket and neglect the many other tools at our disposal, that countries like Thailand have shown are effective, for bringing this virus under control.”

What works against the virus before inoculation, are isolation, testing and treatment programmes, where the contacts of those infected are traced and then quarantine.

Chronic weakness

The COVID-19 pandemic has “demonstrated the consequences of chronic under-investment in public health”, said Tedros, and the health crisis, “has ignited a socio-economic crisis that has impacted billions of lives and livelihoods and undermined global stability and solidarity. Returning to the status quo is not an option.”

The WHO chief said it wasn’t just more investment that was needed in public health infrastructure, “we must also rethink how we value health.”

New brains trust on health economics

Tedros told the Assembly that that time has now come to think of healthcare as an investment, not a cost, “that is the foundation of productive, resilient and stable economies.”

“To start building that narrative, today I am proud to announce that we are establishing a new Council on the Economics of Health for All, to focus on the links between health and sustainable, inclusive and innovation-led economic growth.”

He said the first virtual session of the Council, which will bring together leading economists and health experts, will likely hold its first virtual session in the coming weeks, to set out its work plan and best way of working.

“The pandemic has also shown that there is an urgent need for a globally agreed system for sharing pathogen materials and clinical samples”, he added, “to facilitate the rapid development of medical countermeasures as global public goods.”

Productive session

Among the Assembly’s achievements through the week were a new roadmap to defeat meningitis by 2030; a new roadmap for neglected tropical diseases; a resolution on scaled-up action on epilepsy and other neurological disorders; the adoption of the Immunization Agenda 2030; the Global Strategy to Accelerate the Elimination of Cervical Cancer as a public health problem; and the Global Strategy for TB Research and Innovation.

“Each of these represents an urgent health priority that affects the lives of millions of people, and which increases the demands on, and expectations of, WHO”, said Tedros.

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Landmark G7 agreement pledges 870 million COVID-19 vaccine doses

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G7 leaders plenary: Building back better from COVID19, Cornwall, UK. ©Karwai Tang/G7 Cornwall 2021

A senior UN official welcomed on Sunday, the Group of Seven (G7) leading industrialized nations’ commitment to immediately share at least 870 million doses of COVID-19 vaccines, supporting global access and helping to end the acute phase of the pandemic. 

“Equitable access to COVID-19 vaccines represents the clearest pathway out of this pandemic for all of us — children included, and commitments announced by G7 members…are an important step in this direction”, the Executive Director of the UN Children’s Fund (UNICEF), Henrietta Fore, said in a statement

Building on the momentum of the G20 Global Health Summit and the Gavi COVAX AMC Summit, in a landmark agreement at the G7 Summit – underway in Cornwall, United Kingdom – the global leaders made the pledge, with the aim of delivering at least half by the end of 2021  

Secretary-General António Guterres had previously said that despite “unequal and very unfair” access to inoculations, “it is in the interest of everybody that everybody gets vaccinated sooner rather than later”.  

The G-7 leaders also reaffirmed their support for the UN-led equitable vaccine distribution initiative COVAX, calling it “the primary route for providing vaccines to the poorest countries”. 

Prompt action, please 

The COVAX alliance, meanwhile, welcomed the G7’s commitment, including their continued support for exporting in significant proportions and for promoting voluntary licensing and not-for-profit global production. 

The partners look forward to “seeing doses flowing to countries” as soon as possible.  

COVAX will work with the G7 and other countries that have stepped up to share doses as rapidly and equitably as possible to help address short-term supply constraints currently impacting the global response to COVID-19 and minimize the prospect of future deadly variants. 

“We have reached a grim milestone in this pandemic: There are already more dead from COVID-19 in 2021 than in all of last year”, lamented Ms. Fore. “Without urgent action, this devastation will continue”. 

Aligning interests 

Noting the need for a “ramp up”, in both the amount and pace of supply, the top UNICEF official attested that when it comes to ending the COVID-19 pandemic, “our best interests and our best natures align. This crisis will not be over until it is over for everyone.” 

The Director General of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, underscored that many countries are facing a surge in cases, without vaccines.  

“We are in the race of our lives, but it’s not a fair race, and most countries have barely left the starting line”, he said.  

While grateful for the generous announcements of vaccine donations, he stressed, that “we need more, and we need them faster”. 

Time of the essence 

As many high-income countries begin to contemplate post-vaccination life, the future in low-income countries appears quite bleak.  

“We are particularly worried about the surges in South America, Asia and Africa”, said the UNICEF chief. 

Moreover, as the pandemic rages, the virus mutates and produces new variants that could potentially threaten the vaccinated and unvaccinated alike.  

“Donating doses now is smart policy that speaks to our collective best interests”, she continued, adding that in addition to vaccine pledges, “distribution and readiness need clear timelines” as to when they will be available, particularly in countries with poor health infrastructure. 

“The COVID-19 pandemic has upended the lives of children, affecting every aspect of their lives: their health, education, protection and future prosperity. Now, more than ever, what we do today will have significant and lasting impact on our collective tomorrows. There is no time to waste”, she concluded. 

Explanations 

The G7 is made up of Canada, France, Germany, Japan, Italy, UK and United States. 

COVAX was set up by WHO, GAVI the vaccine alliance and the Coalition for Epidemic Preparedness Innovations (CEPI). It is part of the Access to COVID-19 Tools (ACT) Accelerator to equitably provide COVID-19 diagnostics, treatments and vaccines to all people globally, regardless of their wealth. 

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Vaccine inequity triggers ‘huge disconnect’ between countries

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Although COVID-19 cases and deaths continue to decline globally for a second consecutive week, the UN health agency chief said on Monday that “a huge disconnect” is mounting between some highly vaccinated countries, which see the pandemic as largely resolved, while huge waves of infection continue to grip others where shots are scarce. 

“The pandemic is a long way from over, and it will not be over anywhere until it’s over everywhere”, Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO) told journalists once more, at the regular press briefing in Geneva. 

Still under threat 

Tedros pointed to “dramatic increases” in cases, hospitalizations and deaths, in places where the coronavirus had previously been contained and added that new variants, fragile health systems, relaxed public health measures – and shortages of oxygen, dexamethasone and vaccines – were compounding the problem. 

“But there are solutions”, he said, urging people to adhere to physical distancing, continue to wear masks and avoid large gatherings. “Even where cases have dropped, genetic sequencing is critical so that variants can be tracked and measures are not eased prematurely”. 

Urgent financial support needed 

Although WHO has been responding to the surge in India and other flashpoints, immediate additional funding is required to sustain support in all countries experiencing new waves of cases. 

The 2021 response plan is already underfunded, and the vast majority of it is “ring fenced” by donors for specific countries or activities, which is constraining WHO’s ability to provide “an adaptable and scalable response in emerging hotspots”, Tedros said. 

Urgent and flexible funding would allow the UN health agency to scale up support for countries and the ACT Accelerator.  

Set ambitious goals ‘collectively’ 

Meanwhile, the UN Children’s Fund (UNICEF) outlined a 190 million dose shortfall in the UN-backed COVAX vaccine initiative for equitable COVID inoculations. 

While COVAX has delivered 65 million doses to 124 countries and economies to date, the WHO chief called on manufacturers to publicly commit to sharing their vaccines with COVAX by lifting contractual barriers “within days not months”. 

He also pressed manufacturers to give the right of first refusal to COVAX on any additional doses and encouraged them to make deals with companies willing to use their facilities to produce COVID-19 vaccines. 

“We need to collectively set ambitious goals to at least vaccinate the world’s adult population as quickly as possible”, Tedros underscored. 

Road safety priorities 

Although pandemic lockdowns and telecommuting has led to fewer car journeys and road crashes, the WHO chief pointed to a converse problem caused by drivers’ speeding. This has meant the number of deaths had not decreased proportionately.  

Kicking off UN Road Safety Week, Tedros asked for national and local policy commitments “to deliver 30 kilometre per hour speed limits in urban areas and generate local support for low speed measures overall”. 

Addressing the risk of road traffic deaths is also fundamental to achieve the Sustainable Development Goals (SDGs), specifically those affecting health security, sustainable cities and reducing inequalities among and within countries.  

And policies that tackle the of impact road traffic, and create environments for safe, sustainable and inclusive transport options, also unlock action for protecting the climate and gender equality.  

A paradigm shift in how streets are designed can make streets safe, accessible and equitable for all road users – delivering multiple benefits while accelerating action across interlinking SDGs, according to WHO.

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WHO approves Chinese COVID-19 vaccine for emergency use

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A COVID-19 vaccine produced in China has been given the green light for global rollout, potentially paving the way for its use in underserved countries, the World Health Organization (WHO) announced on Friday. 

The UN agency has approved the Sinopharm vaccine for emergency use, which is a prerequisite for inclusion in the global vaccine solidarity initiative, COVAX.  

The vaccine is easy to store, making it suitable for locations with limited resources, and proved 79 per cent effective in clinical trials. 

“The addition of this vaccine has the potential to rapidly accelerate COVID-19 vaccine access for countries seeking to protect health workers and populations at risk”, said Dr Mariângela Simão, WHO Assistant-Director General for Access to Health Products.  

“We urge the manufacturer to participate in the COVAX Facility and contribute to the goal of more equitable vaccine distribution.” 

A vaccine first 

The Sinopharm vaccine is produced by Beijing Bio-Institute of Biological Products Co Ltd, a subsidiary of China National Biotec Group (CNBG).   

It is the first vaccine to carry a vaccine vial monitor. The vials have a small sticker that changes colour as the vaccine is exposed to heat, so health workers know whether it can be safely used. 

The vaccine is recommended for adults 18 and older, with a two-dose schedule spaced over a period of three to four weeks. 

Although few people over 60 participated in the clinical trials, WHO did not recommend an upper age limit for use as data suggests the vaccine is likely to have a protective effect in older persons.   

Safely expediting vaccines 

WHO emergency use listing (EUL) allows countries to expedite their own regulatory approval to import and administer COVID-19 vaccines. 

The EUL process assesses the suitability of new medicines, vaccines and diagnostics during public health emergencies.  

The goal is to make them available as rapidly as possible, while maintaining strict criteria of safety, efficacy and quality. 

The Sinopharm vaccine is the sixth to receive the EUL approval.  The others are by Pfizer/BioNTech, Astrazeneca-SK Bio, Serum Institute of India, Janssen (Johnson & Johnson) and Moderna.

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