💉 CEPI does a lot of work; BioNTech gets money to build in Africa; New hope for birth control

#519 | The heat is on; Bird flu still occupies newsprint; Climate change spells bad news all around

May 31, 2024

Hello, and welcome back to The Kable for a scorcher of an edition. By scorcher, we mean it quite literally. It has been a week of extremely hot weather in our neck of the woods. Temperatures across different parts of India crossed 50°C with capital New Delhi touching record highs. Neighbouring Pakistan too has seen temps cross the 50°C mark in a heatwave that shows no signs of abating. Heat-related deaths have begun in earnest in India with two states reporting 15 deaths in a 24-hour period while a Hindi-language media outlet claims India's most-populous state, Uttar Pradesh, saw 166 deaths in a single day. The future world where we've breached the 1.5°C mark? It is here. And it is not a pretty sight. And with climate change, India especially, is predicted to see even more heatwaves.

Moving on to slightly better news, Africa finally has a shot at securing some mpox vaccines for itself, thanks to a deal CEPI made with Bavarian Nordic. It only took some 50-odd years!

The Medicines Patent Pool (MPP) has signed an agreement with Indonesia's Ministry of Health to advance public health outcomes in the country by improving access to medicines and vaccines. As part of the agreement, the MPP will provide tech know-how for local manufacturing and also provide skilling and capacity-building opportunities to healthcare workers in Indonesia.

South Korea has reported its first case of swine fever since September last year. Affected pigs are being prepped for culling. No more Samgyeopsal for the people of Hwacheon for a while, we guess.

Yet another frequent reminder that Covid isn't over. Singapore has added a new vaccine, Novavax's jab, to its Covid vaccination program. And yes, it still has a Covid vaccination program.

In continuing news from Asia, Germany's Merck has planned its largest-ever investment in Asia, a $315 million production plant in Daejeon, South Korea. Merck also partnered with the Korea Advanced Institute of Science and Technology (KAIST) to boost the country's R&D ecosystem.

And finally, a recently published study in Nature Mental Health says one in two children with ADHD have trouble regulating emotions, with these dysregulations often manifesting as depression, anxiety and explosive outbursts.

Stories Of The Week

Lots of talk, little action. As we all know, the World Health Assembly (WHA) is in session this week. Naturally, we're beginning this section with a recap of what happened at WHA77. The latest update is that WHO members have a new resolution on improving access to transplantation. Delegates have also put in place a new global action plan for infection prevention and control. Apparently, member states in attendance at the WHA were "alarmed" at the backsliding numbers in maternal and child mortality and have therefore recommitted to making progress. In more word salad, there was also a new resolution on AMR and a discussion on how AI is transforming healthcare. And the WHO reaffirmed that addressing sexual misconduct is a priority for it. But did they agree on a new pandemic pact? Ummm, no, but they've agreed on a way forward for it. On the eve of the WHA, the WHO launched its first investment round to sustainably finance its 'Health for All' mandate and mobilise funds for the agency's operations for the next four years with an ask of $11 billion. And yes, climate change will deservedly be a major focus area. Separately, the Pandemic Fund is targeting $2 billion to launch a new strategic plan. Why do we need a Pandemic Fund though? The pandemic is over, no? It actually isn't. Also, another pandemic is "inevitable." And here's how the WHO can/should deal with future pandemics.
(WHO, Devex, The Guardian, Reuters)

A small step forward for making in Africa. BioNTech might finally be ready to take its mRNA facility in Rwanda places. Struggling as it ostensibly was with a funds crunch, the drugmaker has secured funding of up to $145 million from CEPI to establish Africa's first commercial-scale mRNA vaccine plant. This Rwanda facility, which opened in December last year, uses BioNTech's modular BioNTainers to produce a variety of mRNA-based vaccines targeting diseases such as malaria, mpox, and tuberculosis. This collab with CEPI is part of a broader effort to create an "end-to-end vaccine ecosystem" on the continent, enhancing Africa's capacity to respond to future epidemics and pandemics. Part of the investment will also support clinical trials and manufacturing for third-party projects by African researchers and organizations.
(CEPI)

Breaking records all around. Last year was a record-breaking year for the Americas when it came to dengue with 4.6 million cases. Well, 2023 no longer holds the record because 2024 has already crossed last year's highs with peak dengue season yet to arrive in many places. PAHO reported that dengue cases in the Americas exceeded 7 million by the end of April. Globally, there were over 7.6 million dengue cases and about 3,000 deaths during the same period. Brazil, Argentina, and Paraguay were the hardest hit among all the 46 countries in the region.
(PAHO)

Once again, bird flu. Just like last week, this week too we hoped to only make a passing mention of bird flu. Just like last week, however, the sheer deluge of information, some of it concerning, means we have to devote a lot more space to bird flu than we originally planned. Let's get the concerning news out of the way first. The US has reported its third human case of bird flu this year. What is concerning is that this case is the first one to show respiratory symptoms. China reported a death due to bird flu, but this one was the H5N6 variety. What is concerning is another case from China, reported in a recently published paper, where a human was infected with H5N1 while still carrying remnants of Covid within them. Back in the US, regulators say they detected bird flu in tissue samples of a dairy cow. And another study says raw milk containing bird flu infected mice. No word on whether the mice were willing participants. For the first time, alpacas too were infected with bird flu. In fact, here is a helpful list of all the mammals that have contracted bird flu around the world. In conventional bird flu news, half a million chickens were involuntarily culled in Australia thanks to an outbreak. Asking this Australian farm to hold its beer is a farm in Iowa, US, where a bird flu outbreak led to 4 million chickens giving up their life for the good cause. In hopeful news, at least for some parts of the world, the US government has awarded a 4th contract to CSL Seqirus to be prepared with 4.8 million vaccine doses. The US is also reportedly close to funding Moderna's vaccine trial. Drugmakers in Canada are propositioning the government to be prepared as well. Another study says we will need a range of vaccine platforms to be fully prepared for a human pandemic. Well, duh!
(US CDC, Hindawi, NEJM, CIDRAP, Reuters, ABC, MSN, CSL Seqirus, FT, Ottawa Citizen, Human Vaccines & Immunotherapeutics)

Agency Observer

Africa CDC and CEPI pave the way. In what has been a busy week for CEPI anyway, it also found time to sign two agreements with the Africa CDC. The first agreement sees the two bodies collaborate on health research while the second agreement hopes to make Africa more prepared for future disease outbreaks. CEPI also extended its partnership with Gavi and tied up with South Korea's pandemic agency - the Korea Disease Control and Prevention Agency (KDCA) - on the sidelines of the WHA.
(Africa CDC, Africa CDC, CEPI, CEPI)

Breakthroughs

Evening the odds. A new non-hormonal male contraceptive, CDD-2807, has shown promising results in mice, effectively reducing fertility without toxicity. Developed by researchers from Baylor College of Medicine and Lawrence Berkeley National Laboratory, this small molecule inhibitor targets an enzyme linked to male sterility. When male mice were treated with CDD-2807, their fertility dropped significantly, but it returned after stopping the drug, indicating reversibility. This approach contrasts with current hormone-based male contraceptives that have notable side effects. While these findings are encouraging, human trials are necessary to determine if the drug is viable for male contraception.
(Science)

Killing bacteria, keeping the gut safe. Researchers have developed a new antibiotic called lolamicin that effectively reduces or eliminates drug-resistant bacterial infections in mouse models of acute pneumonia and sepsis while preserving healthy gut microbes. This drug also prevents secondary infections with a common and dangerous hospital-associated bacterium and has shown effectiveness against over 130 multidrug-resistant bacterial strains in cell culture. Unlike most antibiotics, lolamicin selectively targets gram-negative pathogens without affecting beneficial bacteria. In mouse experiments, it successfully treated drug-resistant septicemia and pneumonia without disrupting the gut microbiome. The findings suggest a promising future for antibiotics that can differentiate between harmful and beneficial bacteria, though more research is needed to confirm these results and evaluate potential toxicity and resistance development.
(Nature)

Bottom line

Counting down fast! A new analysis suggests that if global average temperatures exceed 1.5°C above pre-industrial levels for three individual years, that's all it will take to signal the loss of the 1.5°C climate goal established by the Paris Agreement. Current data shows that human activities have already increased temperatures by 1.26°C, and recent years have come close to the 1.5°C mark. The study uses historical and modelling data to make its predictions. And if you read our opening paragraph to this week's Kable, those predictions might already seem dated.
(Research Square)

Long reads

What is everybody eating? Weekend reading? We've got you sorted. With what? With the 2024 Global Food Policy Report. In what should not come as a surprise, the report says progress in reducing undernutrition has stalled in LMICs while obesity is surging worldwide.
(IFPRI)

Too hot to give birth. Since climate change and worsening heat is what we began this issue with, that is what we chose to end with as well. With this series from Grist on what a heating planet means for pregnancy and giving birth. Compelling reading.
(Grist)

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