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‘Three major threats’ to inoculating the world

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A pharmacy at Fasham Urban Comprehensive Health Centre, Shemiranat District Tehran, Iran. Photo: WHO

Amidst some positive news from the World Health Organization (WHO) that both COVID-19 deaths and new cases have recently been on the wane, there are “three major threats” to the UN-led international equitable vaccine initiative, COVAX, that require urgent attention. 

Briefing UN Member States on Thursday, WHO chief Tedros Adhanom Ghebreyesus drew attention to a $27 billion financing gap in the ACT Accelerator, which supports the development and equitable distribution of coronavirus tests, treatments and vaccines globally. 

“The longer this gap goes unmet, the harder it becomes to understand why, given this is a tiny fraction of the trillions of dollars that have been mobilized for stimulus packages in G20 countries”, he said. 

Secondly, noting some bilateral deals, he called on all States “to respect COVAX contracts and not compete with them”. 

And third, Tedros underscored the need for “an urgent scale-up in manufacturing to increase the volume of vaccines” with “innovative partnerships” to include tech transfer, licensing and “other mechanisms to address production bottlenecks”. 

COVID swells in Africa  

Meanwhile, as Africa marks one year since its first COVID-19 case, on 14 February, WHO revealed that last month, the continent had witnessed a 40 per cent surge in COVID fatalities – pushing the death toll there towards 100,000. 

“The increasing deaths from COVID-19 we are seeing are tragic, but are also disturbing warning signs that health workers and health systems in Africa are dangerously overstretched”, WHO Regional Director for Africa Matshidiso Moeti said at a virtual press conference. 

‘Grim milestone’ 

At the same time, in the last 28 days, over 22,300 deaths were reported on the continent – a 3.7 per cent fatality rise – compared with nearly 16,000 deaths in the previous 28 days, which reflected a 2.4 per cent increase, according to WHO.  

This mortality spike comes as Africa’s second wave which began in October, seems to have peaked on 6 January, having spread significantly faster and proven far more lethal. 

WHO maintained that second wave cases surged far beyond the peak experienced in the first wave and health facilities have become overwhelmed. 

“This grim milestone must refocus everyone on stamping out the virus”, said Dr. Moeti. 

New strain, new challenges 

At the same time, new contagious COVID-19 strains are spreading rapidly as Africa gears up for its largest-ever vaccination drive. 

The variant known as B1.351, which was first identified in South Africa, has now been detected in eight African States, while the mutation initially identified in the United Kingdom, called B1.1.7, has been found in six countries on the continent. 

“This is obviously very disappointing news, but the situation is very dynamic”, said Dr. Moeti. “While a vaccine that protects against all forms of COVID-19 is our biggest hope, preventing severe cases which overwhelm hospitals is crucial”. 

This week South Africa said it would pause the roll-out of the Oxford/AstraZeneca vaccine citing a study indicating that it is less effective in battling the country’s dominant B1.351 strain. 

Coordinated approach needed 

WHO says there is an “urgent need” for a coordinated approach to variant surveillance and more evaluation to help decipher the potential impact they may have on vaccine effectiveness.  

“The pandemic is far from over, and vaccines are just one crucial tool in our fight against the virus. We must boost investments and support for our health workers and health systems by sticking to mask wearing, regular hand cleaning and safe social distancing”, said Dr Moeti.

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Health & Wellness

COVAX and World Bank to Accelerate Vaccine Access for Developing Countries

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COVAX and the World Bank will accelerate COVID-19 vaccine supply for developing countries through a new financing mechanism that builds on Gavi’s newly designed AMC cost-sharing arrangement. This allows AMC countries to purchase doses beyond the fully donor-subsidized doses they are already receiving from COVAX.

COVAX will now be able to make advance purchases from vaccine manufacturers based on aggregated demand across countries, using financing from the World Bank and other multilateral development banks. Participating developing countries will have greater visibility of available vaccines, quantities available, and future delivery schedules, enabling them to secure doses earlier, and prepare and implement vaccination plans more effectively.

This important and timely financing mechanism, made possible now by the World Bank and Gavi teaming up on the AMC cost-sharing arrangement, will allow COVAX to unlock additional doses for low- and middle-income countries,” said Dr. Seth Berkley, CEO, Gavi, the Vaccine Alliance. “As we move beyond initial targets and work to support countries’ efforts to protect increasingly large portions of their populations, World Bank financing will help us advance further towards our goal of bringing COVID-19 under control.”

The scalable mechanism brings together COVAX’s ability to negotiate advance purchase agreements with vaccine manufacturers with the World Bank’s ability to provide predictable financing to countries for vaccine purchase, deployment and broader health systems investments. The new mechanism will mitigate risks and uncertainties in country demand and financing ability.

Accessing vaccines remains the single greatest challenge that developing countries face in protecting their people from the health, social, and economic impacts of the COVID-19 pandemic,” said World Bank Group President David Malpass. “This mechanism will enable new supplies and allow countries to speed up the purchase of vaccines. It will also provide transparency about vaccine availability, prices, and delivery schedules. This is crucial information as governments implement their vaccination plans.”

Countries with approved World Bank vaccine projects that confirm the purchase of additional doses through COVAX will agree with COVAX on the number of doses of a specific vaccine as well as related windows of delivery. On receiving a request from the country, the World Bank will provide COVAX a payment confirmation, allowing COVAX to make advance purchases of large amounts of vaccine doses with manufacturers at competitive prices.

Under the cost-sharing arrangement for AMC countries (92 low- and middle-income countries), COVAX plans to make available up to 430 million additional doses, or enough to fully vaccinate 250 million people, for delivery between late 2021 and mid-2022. There will be several supply offerings where countries will have the opportunity to select and commit to procuring specific vaccines that align with their preferences.

COVAX is co-led by the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance and the World Health Organization (WHO). The World Bank and COVAX will work in partnership with UNICEF and the PAHO Revolving Fund as key implementing partners to ensure safe vaccine delivery and supply of materials such as syringes, safety boxes and other items essential for vaccination campaigns.

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Study Finds That India Might Have Half Of All Covid-19 Deaths Worldwide

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© UNICEF/Vinay

On July 20th, an analysis that was published of India’s “excess mortality estimates from three different data sources from the pandemic’s start through June 2021 … yields an estimate of 4.9 million excess deaths.” As-of July 20th, the total number of deaths that had been officially reported worldwide from Covid-19 was 4,115,391, and only 414,513 (10%) of those were in India. If this new study is correct, then the possibility exists that around half of all deaths that have occurred, thus far, from Covid-19, could be in India, not merely the currently existing 10% that’s shown in the official figures.

This study doesn’t discuss why the actual number of deaths in India from Covid-19 might be around ten times higher than the official Indian figures, but one reason might be a false attribution of India’s greatly increased death-rate from the Covid-19 epidemic not to Covid-19 but to other causes, such as to Covid-19-related illnesses.

The new study is titled “Three New Estimates of India’s All-Cause Excess Mortality during the COVID-19 Pandemic”, and the detailed version of it can be downloaded here.   The study was funded by U.S.-and-allied billionaires and their foundations and corporations, and by governments that those billionaires also might control. However, this doesn’t necessarily mean that its methodology is in any way unscientific or otherwise dubious. The study raises serious questions — it does not, in and of itself, answer any. It’s a serious scientific study.

On 1 August 2020, I headlined “India and Brazil Are Now the Global Worst Coronavirus Nations”, and reported that, “India and Brazil have now overtaken the United States as the world’s worst performers at controlling the cononavirus-19 plague. The chart of the numbers of daily new cases in India shows the daily count soaring more than in any other country except Brazil, whereas in the United States, the daily number of new cases has plateaued ever since it hit 72,278 on July 10th, three weeks ago.” At that time, there was great pressure upon India’s Government to stop the alarming acceleration in the daily numbers of people who were officially counted as being patients (active cases) from the disease, and of dying from it. One way that a government can deal with such pressures is by mis-classifying cases, and deaths, from a disease, as being due to other causes, instead.

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Sharp rise in Africa COVID-19 deaths

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A volunteer carer called Trinity is working in a COVID-19 field hospital in Nasrec, Johannesburg. IMF/James Oatway

COVID-19 deaths in Africa have risen sharply in recent weeks, amid the fastest surge in cases the continent has seen so far in the pandemic, the regional office for the World Health Organization (WHO) said on Thursday. 

Fatalities are rising as hospital admissions increase rapidly as countries face shortages in oxygen and intensive care beds. 

COVID-19 deaths rose by more than 40 per cent last week, reaching 6,273, or nearly 1,900 more than the previous week. 

The number is just shy of the 6,294 peak, recorded in January. 

Reaching ‘breaking point’ 

“Deaths have climbed steeply for the past five weeks. This is a clear warning sign that hospitals in the most impacted countries are reaching a breaking point,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.  

“Under-resourced health systems in countries are facing dire shortages of the health workers, supplies, equipment and infrastructure needed to provide care to severely ill COVID-19 patients.” 

Africa’s case fatality rate, which is the proportion of deaths among confirmed cases, stands at 2.6 per cent compared to the global average of 2.2 per cent.  

Most of the recent deaths, or 83 per cent, occurred in Namibia, South Africa, Tunisia, Uganda and Zambia. 

Six million cases 

COVID-19 cases on the continent have risen for eight consecutive weeks, topping six million on Tuesday, WHO reported. 

An additional one million cases were recorded over the past month, marking the shortest time to reach this grim milestone. Comparatively, it took roughly three months for cases to jump from four million to five million. 

Delta, variants drive surge 

The surge is being driven by public fatigue with key health measures and an increased spread of virus variants.  

The Delta variant, the most transmissible, has been detected in 21 countries, while the Alpha and Beta variants have been found in more than 30 countries each. 

Globally, there are four COVID-19 virus variants of concern.  On Wednesday, a WHO emergency committee meeting in Geneva warned of the “strong likelihood” of new and possibly more dangerous variants emerging and spreading. 

Delivering effective treatment

WHO is working with African countries to improve COVID-19 treatment and critical care capacities.  

The UN agency and partners are also delivering oxygen cylinders and other essential medical supplies, and have supported the manufacture and repair of oxygen production plants. 

“The number one priority for African countries is boosting oxygen production to give critically ill patients a fighting chance,” Dr Moeti said. “Effective treatment is the last line of defence against COVID-19 and it must not crumble.” 

The rising caseload comes amid inadequate vaccine supplies. So far, 52 million people in Africa have been inoculated, which is just 1.6 per cent of total COVID-19 vaccinations worldwide.  

Meanwhile, roughly 1.5 per cent of the continent’s population, or 18 million people, are fully vaccinated, compared with over 50 per cent in some high-income countries. 

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