The UN World Health Organization (WHO) on Thursday unveiled an $8 billion pathway out of the COVID-19 pandemic, in a bid to make vaccines accessible to everyone, everywhere.
The Global COVID-19 Vaccination Strategy aims to inoculate 40 percent of people in all countries by the end of the year, and 70 percent by the middle of 2022.
WHO had previously pressed governments to vaccinate 10 per cent of the world’s people by the end of last month. However, more than 55 countries, mainly in Africa and the Middle East, missed the target.
In remarks to the virtual launch, UN Secretary-General António Guterres, who has been strongly advocating for a global plan, urged nations to unite and make it a success.
“Without a coordinated, equitable approach, a reduction of cases in any one country will not be sustained over time. For everyone’s sake, we must urgently bring all countries to a high level of vaccination coverage,” he said, speaking from New York.
A ‘two-track pandemic’
As of Thursday, there more than 235.6 million confirmed COVID-19 cases worldwide, and close to five million deaths, according to latest WHO data.
The new strategy requires 11 billion vaccines to be made available, to defeat what the UN agency has labelled “a two-track pandemic”.
Even though nearly 6.5 billion doses have been administered globally as of the end of September, and almost one-third of the world’s population is fully inoculated, vaccine inequity persists.
“High and upper-middle income countries have used 75 per cent of all vaccines produced so far,” said WHO chief Tedros Adhanom Ghebreyesus, speaking from its headquarters in Geneva.
Meanwhile, less than half of one per cent of doses have gone to low-income countries. “In Africa, less than five per cent of people are fully vaccinated,” he added.
Vaccines for all
Global vaccine production currently stands at 1.5 billion doses per month, meaning “there is enough supply to achieve our targets, provided they are distributed equitably,” said Tedros.
“This is not a supply problem; it’s an allocation problem,” he added.
The strategy calls for a three-step approach to vaccination, starting with protecting older people, health workers and high-risk groups of all ages. All adults in every country would be next, followed by adolescents.
While financing has been secured to procure most of the required vaccines for poorer countries, including through the COVAX solidarity initiative and the African Vaccine Acquisition Trust (AVAT), additional investment is needed.
‘We have the tools’
“We call on vaccine manufacturers to prioritize and fulfil contracts with COVAX and AVAT as a matter of urgency, to be more transparent on what is going where, and to share know-how and non-exclusive licenses to enable all regions to increase manufacturing capacity,” said Tedros.
Countries that produce vaccines should allow for cross-border flow of finished vaccines and raw materials, and facilitate sharing of knowledge, technology and licenses. Governments were also urged to update their national vaccine targets and plans “to guide manufacturing investment and vaccine distribution”.
Tedros said the strategy can be achieved if the countries and companies that control vaccine supply prioritize COVAX and the AVAT, both for vaccine delivery and donations.
“We have the tools to bring the pandemic under control, if we use them properly and share them fairly,” he said.
UN-backed COVAX mechanism delivers its 1 billionth COVID-19 vaccine dose
With a 1.1 million jab delivery in Rwanda this weekend, the World Health Organization’s multilateral initiative to provide equal access to vaccines for all reached the one billion milestone.
Along with the Coalition for Epidemic Preparedness Innovations (CEPI), the Vaccine Alliance GAVI, and partners, WHO has led the largest vaccine procurement and supply operation in history with deliveries to 144 countries to date.
According to a press release published on Sunday, as of 13 January 2022, out of 194 countries members of WHO, 36 have vaccinated less than 10% of their population, and 88 less than 40%.
“COVAX’s ambition was compromised by hoarding/stockpiling in rich countries, catastrophic outbreaks leading to borders and supply being locked. And a lack of sharing of licenses, technology, and know-how by pharmaceutical companies meant manufacturing capacity went unused”, the agency explained.
On 24 February 2021, Ghana became the first country in the world to receive vaccines through COVAX when 600,000 doses of the Oxford–AstraZeneca vaccine were delivered to Accra.
The work that remains
COVAX is currently working with governments, manufacturers and partners to ensure that when countries receive vaccines, they can get them to people quickly.
“The work that has gone into this (1 billion) milestone is only a reminder of the work that remains”, the UN’s health agency underscored.
They added that with updated vaccines in the pipeline, citizens should demand that governments and pharmaceutical companies share health tools globally and “bring an end to the death and destruction cycles of this pandemic, limit new variants and drive a global economic recovery”.
COVAX is one of three pillars of the Access to COVID-19 Tools (ACT) Accelerator, which was launched by WHO in April 2020 in response to the pandemic.
The ACT Accelerator is a ground-breaking global collaboration to accelerate the development, production, and equitable access to COVID-19 tests, treatments, and vaccines.
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.
Omicron fuels record weekly COVID-19 cases, but deaths ‘stable’
Fuelled by Omicron, more than 15 million new cases of COVID-19 were reported around the world last week, by far the most cases reported in a single seven day period, the World Health Organization (WHO) informed on Wednesday.
Briefing reporters in Geneva, the UN health agency chief, Tedros Adhanom Ghebreyesus, said the “huge spike” is being driven by the Omicron variant, which is rapidly replacing Delta in almost all countries.
Despite the number of cases, the weekly reported deaths have “remained stable” since October last year, Tedros added, at an average of 48,000. The number of patients being hospitalized is also increasing in most countries, but it is not at the level seen in previous waves.
He told reporters this is possibly due to the reduced severity of Omicron, and widespread immunity from vaccination or previous infection.
‘50 thousand deaths too many’
For the WHO chief, while Omicron causes less severe disease than Delta, it remains a dangerous virus, particularly for those who are unvaccinated.
“Almost 50 thousand deaths a week is 50 thousand deaths too many”, Tedros said. “Learning to live with this virus does not mean we can, or should, accept this number of deaths.”
For him, the world cannot “allow this virus a free ride” when so many people around the world remain unvaccinated.
In Africa, for example, more than 85 per cent of people are yet to receive a single dose of vaccine.
“We cannot end the acute phase of the pandemic unless we close this gap”, he said.
Tedros then listed some progress towards reaching the target of vaccinating 70 per cent of the population of every country by the middle of this year.
In December, COVAX shipped more than double the number of doses it distributed in November. In the coming days, the initiative should ship its one billionth vaccine dose.
Some of the supply constraints from last year are also starting to ease, Tedros said, but there’s still have a long way to go.
So far, 90 countries have still not reached the 40 per cent target, and 36 of those countries have vaccinated less than 10 per cent of their populations.
Tedros also highlighted an interim statement from the WHO Technical Advisory Group on COVID-19 Vaccine Composition, released on Tuesday, stressing that further vaccines are needed that have a greater impact on preventing infection.
Until such vaccines are developed, the experts explained, the composition of current vaccines may need to be updated.
The Group also said that a vaccination strategy based on repeated booster doses is “unlikely to be sustainable.”
A heavy toll
According to Tedros, the overwhelming majority of people admitted to hospitals around the world are unvaccinated.
At the same time, while the immunizations remain very effective at preventing severe disease and death, they do not fully prevent transmission.
“More transmission means more hospitalizations, more deaths, more people off work, including teachers and health workers, and more risk of another variant emerging that is even more transmissible and more deadly than Omicron”, Tedros explained.
The sheer number of cases also means more pressure on already overburdened and exhausted health workers.
A study published last year showed that more than one in four health workers have experienced mental health issues during the pandemic. Data from several countries also show that many have considered leaving or have left their jobs.
On Tuesday, WHO hosted a global webinar, attended by clinicians from around the world, on the clinical management of the virus during pregnancy, childbirth and the early postnatal period.
As stated earlier in the pandemic, pregnant women are not at higher risk of contracting COVID-19, but if they are infected, they are at higher risk for severe disease.
“That’s why it’s vital that pregnant women in all countries have access to vaccines to protect their own lives, and those of their babies”, Tedros said.
The agency chief also called for pregnant women to be included in clinical trials for new treatments and vaccines.
He also stressed that, fortunately, mother to baby transmission in utero or during birth is very rare, and no active virus has been identified in breast milk.
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