💊 A historic Declaration of Climate and Health; A global dengue fever nightmare; The epidemic of autoimmunity

#485 | More questions for GLP-1 makers; Human drugs for rare birds; No learning for India's cough syrup makers

Hello, and welcome back to a brand new week with The Kable. First things first: do we have a new infectious disease to worry about? Thankfully, no. The recent surge in respiratory illnesses in China has been caused by known pathogens, according to a health official. There is no sign of new infectious diseases, and experts within and outside China have not expressed alarm.

Now for Africa. At the recently concluded CPHIA, the Africa CDC and its strategic partners announced the Trusted Health Initiative to digitise Africa’s health systems. Part of the 4D Initiativeand building on the success of the Panabios Trusted Travel platform, Trusted Health and its AI-enabled health wallet will facilitate integration between public health systems and private health innovations. It will combine e-genomics, e-diagnostics, and e-therapeutics. With an investment of $100 million, the initiative will extend to 22 African Union Member States. Overall, the goal is to reduce public health incidents and improve response times via strategic technology use.

Meanwhile, at the other big event that’s been crowding the news, COP28, Kenya announced its inaugural Climate Change and Health Strategy for the years 2023 to 2027. This strategy harmonises climate action with health goals, emphasising the need for collaboration across the sectors of environment, energy, water, and agriculture.

Since we’re already talking about Kenya – the US-based pharma firm Human Biosciences has revealed its plans to establish a plant to produce collagen products to treat wounds in Kenya. Human Biosciences has partnered up with Kenya’s Skintech Green for the multi-million shilling plant, which will either come up in Nairobi or Eldoret within the next couple of years. Once established, the plant will employ hundreds of health experts, directly and indirectly. The partners have already started training doctors in the country. Kenya is the first African country to get a Human Biosciences plant.

Also in Kenya, the Chinese traditional medicine giant For Our Health Our Wealth, or FOHOW, has launched its operations in Kenya. FOHOW’s long-term view for the country is to set up a pharma industry which offers job opportunities to locals in line with the One Belt One Road blueprint. In fact, FOHOW claims its unique feature is its training and skill development programme.

Meanwhile, the medical professional scarcity in Nigeria has reached a critical point. Major teaching and general hospitals are struggling with personnel shortages. At the Obafemi Awolowo University Teaching Hospital (OAUTH) in Osun State, the Behavioural Science/Psychiatry section has shut down a ward because there are no professionals to service it, while three wards had stopped admitting patients as 65 doctors left last year. At the Lagos University Teaching Hospital (LUTH), five wards, accounting for 150 beds, have been closed. Institutions like the Federal Medical Centre (FMC) have also been forced to reduce the number of outpatients attended to and the number of elective surgeries conducted. From 29 May to date this year, an estimated 1,197 Nigerian-trained doctors have moved to the UK. Reports have shown that specialists are leaving Nigeria for other African countries like Sierra Leone and the Gambia as well.

While healthcare institutions in Nigeria remain understaffed, prescription and OTC medications have become scarce. Where available, prices are soaring – some as high as 300%. As these drugs move beyond the reach of ordinary people, some residents of the Federal Capital Territory have resorted to herbal concoctions, referred to as “agbo,” to meet their health needs. Meanwhile, the Association of Alternative Medicine Practitioners of Nigeria is urging the Federal Ministry of Health to create an agency for traditional, complementary, and alternative medicine.

And for our final Nigeria story for today, the Federal Government has pledged a robust health sector transformation, emphasising diagnostic medicine and collaborative pathology advances. This move is in keeping with the government’s four-point agenda of governance, population health outcomes, the healthcare value chain, and health security.

The WHO and the Korea International Cooperation Agency (KOICA) are collaborating to bring healthcare services – including cervical cancer screening for women, medical services, optometry services, and pediatric services – to targeted communities in Tanzania. This health outreach programme was part of an overall initiative targeting hard-to-reach areas across the country.

Coming to the Middle East…

The Dutch company DEBx Medical, focused on advanced wound care, has established a new regional headquarters in the Middle East. It has entered a strategic partnership with the region’s healthcare distribution leader Sarabeel Medical to distribute its wound care solution Debrichem.

In Saudi Arabia, the Health Ministry has mobilised 100 hospitals and healthcare centres to monitor respiratory infections. Their work will include collecting data on respiratory infections, with respiratory samples being tested at two levels – monitoring centres will take charge of flu, coronavirus, and RSV cases, while the Public Health Authority laboratory will examine samples from other infections and genetically sequence viruses.

And now for Asia…

Global healthcare leaders – including AstraZeneca, GSK, Novo Nordisk, and Roche – are leading the charge to decarbonize the health sector. As part of the Sustainable Markets Initiative Health Systems Task Force, they are in advanced discussions with energy providers in China and India to scale renewable power across their supply chains. In China, the power agreements will focus on renewable energy in Jiangsu, Guangdong, Shanghai, and Beijing. In India, they will span the states of Gujarat, Karnataka, Madhya Pradesh, Maharashtra, and Tamil Nadu. 2024 onwards, the agreements will bring about 70MW of renewable energy to the grid. This would result in annual emissions savings equivalent to taking 25,000 cars off the road.

Globally, 1 in 12 hospitals are at risk of total or partial shutdowns by 2100 from climate change-linked extreme weather events. According to a report by XDI, Bangladesh is home to 183 such hospitals that will face shutdown if fossil fuels aren’t phased out by the end of the century.

The Nepal government and USAID have launched a strategic partnership to strengthen Nepal’s capacity to prevent, detect, and rapidly respond to emerging infectious diseases. This USAID Global Health Security programme will take a One Health approach.

In Singapore, there has been a large rise in Covid infections. The number of estimated Covid cases doubled to over 22,000 between 19 and 25 November, compared to the week prior. Nonetheless, the average number of daily Covid hospitalisations and ICU cases has remained stable.

Why should humans monopolise the benefits of modern medicine? Researchers in Japan are exploring the use of human flu medicine to protect rare and endangered bird species from avian influenza, aka bird flu. Antivirals have done well in experiments so far.

The pharma e-commerce company BlueMTech will begin co-marketing two of MSD’s vaccines – one for hep A, and another for measles, mumps, and rubella (MMR) – in Korea, starting 1 January 2024. This will be the first joint vaccine sale between a local distributor and a global pharma player. The vaccines will be supplied through the BlueMTech-operated e-commerce platform BluePharm Korea.

At COP 28, the Hong Kong Jockey Club’s new Institute of Philanthropy inked a formal statement of collaboration with the Rockefeller Foundation to boost public health globally and protect some of the most vulnerable groups from the impacts of climate change. 

Meanwhile, in South America, the Pan-American Health Organisation (PAHO) recently issued an epidemiological alert concerning increased cases of invasive group A streptococcal (iGAS) infections, especially in children. As of 28 November, Argentina had reported 93 fatalities. PAHO recommends that Member States conduct clinical and genomic surveillance and ensure timely diagnosis and treatment of invasive group A streptococcal disease.

In the latest big Big Pharma investment, Novartis is building a new radiotherapy production facility in China. This will involve shelling out over 600 million Chinese yuan (~$85 million). Located about 60 miles from Shanghai, the plant will expand manufacturing capacity for Lutathera and Pluvicto. If regulatory approvals come through as planned, the plant could be up and running in 2026.

Not all is looking rosy for Pfizer, which doesn’t intend to continue into phase 3 with its twice-daily dose of the experimental obesity drug Danuglipron. This decision comes as mid-stage study data revealed high rates of gastrointestinal side effects and participant dropout even as the treatment did lead to significant weight loss compared to placebo.

Speaking of obesity drugs, the European Medicines Agency’s safety committee continues to be concerned about reported cases of suicidal ideation and self-harm in GLP-1 users. The agency has more questions in store for GLP-1 makers, saying that many issues still need to be clarified.

AstraZeneca has inked a deal worth up to $247 million with the US-based AI biologics firm Absci. The partners will design a cancer-fighting antibody, though they haven’t specified what type of cancer.

In Uzbekistan, the Tashkent city court has suspended the trial of 21 people over 65 child deaths associated with the consumption of cough syrup made by India’s Marion Biotech. The case was sent back to investigators to identify more suspects.

Meanwhile, in India, cough syrup makers have refused to learn. Lab tests have shown that over 50 companies manufacturing cough syrups in India have failed quality tests, according to the Central Drugs Standard Control Organisation (CDSCO).

And finally, climate change is finally informing public health decisions. For the first time ever, in 2024, climate change risk will be among the criteria used by Gavi’s Vaccine Investment Strategyto decide which vaccines will join the Gavi portfolio.