💉 AstraZeneca withdraws a vaccine; Sanofi lines up to make another; Scientists say we need just one

#516 | Heating up the record books; No pact for pandemics; Bird flu hogs the limelight again

May 10, 2024

Hello, and welcome back to The Kable to wrap up the week that was in life sciences.

The week began with the WHO chief exhorting all participants to endorse the pandemic treaty and not hold it up. Then, reports emerged that the UK won't be signing the treaty because it called for setting “pandemic-related health products” aside for low- and middle-income countries (LMICs). This portion of the agreement would've prevented countries from stockpiling pandemic supplies as they did in the pandemic just past but we guess consideration is too much to expect from 'the developed world.' As of the time of writing, it looks like pandemic pact discussions will go into overtime. Health Policy Watch takes a deep dive into options.

In what promises to be excellent news, Afro-Swiss health-tech marketplace Axmed has raised fresh funding in its effort to speed up the pricing, accessibility, and delivery of cutting-edge and essential drugs to LMICs.

Elsewhere in Africa, a story we will be tracking. A child has died in Burundi from a haemorrhagic fever that appears similar to Ebola. Fingers crossed it's not Ebola.

In Nigeria, a measles outbreak has seen at least 42 deaths in a little over a week. The northeastern state of Adamawa has shut schools in response.

In Zimbabwe, it is cholera that is resurgent. And so too in Kenya.

The south Indian state of Kerala reported an outbreak of West Nile fever with cases being reported from three districts. Which reaffirms for us how strong the monitoring network in this state is. Time and time again, they've caught (and stopped) outbreaks, with this latest incident being one in a long line of outbreaks.

Since the conversation has veered to India, we can't help but segue into talking about manufacturing issues with Zydus Lifesciences receiving its second reprimand in a month, this time with 10 observations from the US FDA.

Last week, we had a lot of reporting around bird flu, enough to feature it in our top stories of the week. This week too, there is a lot of reporting around. However, we are summarising it here this week because there is a lot of nebulousness and conjecture on this topic. The US CDC, according to a recently published study, says dairy workers are at risk from bird flu and need full PPE. Scientists in Germany plan to infect dairy cows with the same virus infecting cows in the US. This lab exercise, the scientists say, will help better identify the risk of the virus mutating to affect humans. In good news, the WHO says there isn't yet any evidence of bird flu spreading between humans. In not-so-good news, one state in the US is reported to be monitoring 70 peopleexposed to H5N1. A study from Japan says blowflies can be a vector for this virus. And Stat has the lowdown on why scientists are right to be concerned about bird flu. TL;DR: It has done lots of unexpected things in its 27 years on this planet.

Apart from its exhortations on a pandemic pact, the WHO has had a busy week of it. Some of the highlights: The launch of the WHO Alliance for Food Safety, a collaboration that will further food-borne disease surveillance as envisioned in the WHO Global Strategy for Food Safety 2022–2030. The agency also released a report on the progress made in neglected tropical diseases (NTDs). To no one's surprise, the progress is not on track for us to meet the NTD roadmap of a 90% reduction in NTD interventions by 2030. Perhaps the most significant production from the WHO this week was the release of its report on how it fared in 2023. Releasing the report, the WHO chief said "The world is off track to reach most of the Triple Billion targets and the health-related Sustainable Development Goals...” Well, one lives in hope.

In another bit of significant news this week, AstraZeneca withdrew its Covid vaccine from all markets, citing a decline in worldwide demand and availability of other, better vaccines. The vaccine, developed with scientists from Oxford University, never received an update for newer Covid variants. However, since the withdrawal came just days after an admission of side effects, conspiracy theorists had a field day on social media. Gotta find joy where one can find it, eh?

In good Covid vaccine news, Sanofi has tied up with Novavax to commercialise Covid vaccine development. The deal, worth $1.2 billion, also sees Sanofi taking a stake in Novavax, which should go a long way towards ensuring Novavax's recently-questioned sustainability.

Let's circle back to India where a new TB vaccine has got the nod from regulators to proceed to Phase 2 trials.

Also in India, there were concerns raised last week about the excessive presence of certain chemicals in spice mixes made in the country. Indian regulators were reported to be looking into those concerns. For now, food inspectors have increased permissible pesticide limits in spices tenfold. That should allay all concerns surely.

Speaking of food in India, researchers are prescribing a diet low in processed foods for Indians, attributing more than half of the disease burden in the country to unhealthy diets. And if you really want to know which processed foods to avoid the most, there is a recent study for that.

Google's Deep Mind and Isomorphic Labs this week unveiled AlphaFold 3, a more accurate biomolecular structure prediction tool than AlphaFold 2. The new model boasts a 50% increase in accuracy over prior methods, with some assessments even doubling previous accuracies. And AlphaFold 3 is now accessible via the AlphaFold Server, offering most of its advanced features for free to the scientific community. Even if, with Google, free often doesn't mean free. IYKYK.

And finally, something shady to wrap up this section with. If you guessed something Elon Musk-related when you heard shady, you're absolutely right. Neuralink, Space Karen's brain implant company, has run into some trouble with its first implant malfunctioning. Great reading for body horror fans.

Stories Of The Week

Who needs a vaccine? WHO? Ah, you thought we were done talking about bird flu this week, didn't you? But no. The spread of bird flu to mammals has prompted global concern and calls for vigilance from senior WHO officials. There may not (yet) be any mutations that could pose a direct threat to humans but scientists are proactively developing vaccines to be ready if a pandemic arises. Gavi details where on this vaccine development we stand right now and how soon a vaccine could be made. What Gavi doesn't have an answer for though is what to do about those pesky anti-vaxxers.
(Gavi)

Insulin injustice. A recent report from Doctors Without Borders/Médecins Sans Frontières (MSF) and T1International casts a harsh light on the stark price disparities and market monopolies in diabetes treatment. The villains? High markups on insulin pens and newer diabetes medications like GLP-1 receptor agonists that severely restrict access in LMICs. The report calls for an urgent policy intervention to combat these exorbitant prices set by Big Pharma. Highlighting the dire situation, the report points out that only a fraction of those needing insulin worldwide can obtain it, with insulin pens—deemed essential by the WHO—markedly underused outside high-income settings due to cost. The report itself ought to be a clarion call for more equitable access to diabetes treatments globally but one suspects it will quickly turn into last week's news with no one to advocate for its findings. Bleak, we know, but did you read what we had to say about the pandemic pact at the beginning of this issue?
(DWB/MSF)

Opportunity knocks. The WHO has just released six case studies on the local production of pharmaceuticals, vaccines, and biologicals in Bangladesh, Kenya, Nigeria, Pakistan, Senegal, and Tunisia. Conducted by the Local Production and Assistance (LPA) Unit of the WHO's Innovation and Emerging Technologies Department, these studies shine a light on the ecosystems supporting medicine production in LMICs and can easily become the framework for similar undertakings in other countries. The studies detail the unique challenges and opportunities each country faces, including aspects like policy environments, regulatory systems, and local production capacities. These insights aim to bolster local manufacturing capabilities, enhancing access to essential medical products. And for someone with the right idea, these insights are a blueprint for an opportunity that is begging to be seized. Go ahead, download those case studies ASAP!
(WHO)

Agency Observer

Stronger together. The Novo Nordisk Foundation, Bill & Melinda Gates Foundation, and Wellcome Trust have committed $300 million over three years to energise research in developing countries, targeting pivotal challenges like climate change, infectious diseases, and antimicrobial resistance (AMR). This alliance not only aims to deepen the understanding of how nutrition influences immunity and disease outcomes but also seeks to empower LMICs by enhancing their research capabilities and providing equitable access to existing health technologies.
(Gates Foundation)

Breakthroughs

One shot to fight them all. Research against the flu has received a new shot in the arm (hehe) with a newly published study about a vaccine that targets the less variable stalk portion of the virus' hemagglutinin protein, rather than the rapidly mutating head portion. This new approach, which showed promising results in experiments with mice and ferrets, could potentially lead to a universal flu vaccine, reducing the need for annual vaccinations tailored to specific viral strains. This vaccine design is part of an ongoing project to create a long-lasting solution that could effectively combat all variations of the influenza virus. The next phase of research will explore whether similar immunity levels can be achieved with fewer variants, potentially streamlining this breakthrough approach. Can't come soon enough, we think.
(Science Translational Medicine)

Pandemic begone! If a potential universal flu vaccine wasn't quite the jab you expected, how about a pan-coronavirus vaccine? Researchers - other researchers - have made a significant breakthrough with a new vaccine technology, designed to preemptively combat a wide spectrum of current and future coronaviruses, some of which are yet to be discovered. This strategy involves creating a vaccine that can recognise and initiate an immune response to specific regions common across multiple coronaviruses, including variants that have historically caused outbreaks and those potentially transmissible from animals to humans. Interestingly, this vaccine can even prompt an immune response to viruses not specifically included in its design, such as the virus responsible for the 2003 SARS outbreak. This recently published study highlights the vaccine's capacity to generate broad immune responses, even in subjects previously immunised, showcasing a simpler design that could fast-track clinical trials. This innovative approach could significantly enhance our preparedness for future pandemics by developing vaccines in advance, potentially mitigating the global impact of novel viruses.
(Nature Nanotechnology)

Bottom line

Records, they're meant to be broken. And each month since June 2023 has shattered historical temperature records, pushing the global average temperature 1.61°C above pre-industrial levels. Thankfully, April continued that trend, making it 11 months in a row of records being shattered. This latest spike brings us to the warmest 12-month period ever recorded, prompting scientists to wonder whether human activities, particularly fossil fuel combustion, along with natural factors like El Niño, have pushed our climate to a tipping point.
(Reuters)

Long reads

One for the provaxxers. The recent withdrawal of AstraZeneca's Covid vaccine and the earlier news about its side effects saw a lot of "I told you so's" being bandied about by vaccine ditherers. But this piece in The Economic Times talks about how the benefits outweighing the concerns are the only point worth discussing in any vaccine conversation. Not a long read but an important one nevertheless.
(ET)

Learning from pandemics past. Curious about the evolving patterns of infectious diseases and their deep-rooted causes? This piece in The Conversation provides a compelling exploration, tracing the emergence of diseases from the Neolithic revolution to the present, illustrating how human practices like agriculture, urbanisation, and economic disparities continue to shape disease dynamics. An essential read for anyone looking to understand not just the how, but the why behind the recurring outbreaks that challenge global health.
(The Conversation)

Oh, and Gopal Nair doesn't want you to see this.