💊 CHAI’s vaccine market-shaping strategy for Africa; BMS expands its Avidity partnership; Boehringer, Amgen get in on genAI

#482 | Indian pharma MSMEs not up to snuff; CAR-Ts cure some cancers, cause others; Reducing GLP-1 dosing

Hello, and welcome back to The Kable for what is a busy day, with CPHIA and the lead up to COP28 in full swing.

Coming first to CPHIA 2023, or the Third International Conference on Public Health in Africa, which is currently in progress in Lusaka, Zambia. While Director-General of the Africa CDC, Dr Jean Kaseya highlighted the importance of the five Cs - community, connectivity, capacity, collaboration, and climate - in guiding leaders to reposition Africa in global health architecture, the CPHIA Co-Chair highlighted important innovations in health tech - particularly the CDC’s Digital Disease Surveillance, piloted in 6 countries - that have improved healthcare access, delivery, and disease surveillance. Also, the Zambian President appealed to the Africa CDC to establish the region’s indigenous cholera vaccine production hub in the country, with its strategic location and commitment to health equity making it an ideal candidate.

On the sidelines of the event, the Africa CDC and the US government have announced a Joint Action Plan in support of their “shared vision to strengthen public health systems and deliver improved health outcomes in Africa”. The Plan outlines key activities between the Africa CDC and the US government to achieve the objectives that had been laid out in March 2022, when a Memorandum of Cooperation was inked to promote public health partnership.

Additionally, the Africa CDC and the Mastercard Foundation have launched phase two of their Saving Lives and Livelihoods (SLL) initiative to strengthen Africa’s public health systems. This second phase will focus on completing the vaccination of healthcare workers and vulnerable groups, building a robust workforce of community health workers, ensuring pandemic preparedness by bolstering national public health institutions, laboratory capacities, data access and quality, local manufacturing of vaccines, therapeutics and diagnostics, and continuing strengthening of Africa CDC.

Meanwhile, starting tomorrow, policymakers from around the world will gather in Dubai for COP28 which, for the first time in its almost three-decade history, will put health issues in the spotlight. With 65 countries’ health ministers attending the event, the WHO is encouraging them to get their governments to endorse a declaration to commit to dealing with the effects of changing weather patterns on people’s health. This would mean not only financing climate-resilient health systems but also the lowering of the health sector’s carbon footprint. An advisory panel to the conference also recommends taxing the bad i.e. increasing taxes on polluting activities and cutting fossil fuel subsidies to generate trillions of dollars to fight climate change.

While conferences outline plans and make declarations, in Gaza, the pause in strikes appears to be entering a fifth day. But as essential infrastructure lay damaged, the WHO fears more people could now die from disease than from bombings. About three-quarters of hospitals have shut down completely. With a dearth of clean water, food and difficulties in maintaining hygiene, infectious diseases are likely to spike. Child diarrhoea cases are already about 100x normal levels. With doctors terrified of the risk of a deadly disease outbreak, UN humanitarians warn that aid deliveries need to multiply immediately.

In Malawi, the first case of anthrax has been detected in a person in an area bordering Zambia, where four deaths and 335 cases of the zoonotic disease have been recorded this year.

Meanwhile, Morocco is on a path towards achieving national medicine sovereignty. The country is reducing its import reliance by developing capacity to guarantee that its national strategic stock of medicines and health products meets 70% of national needs. The government is also working to establish the Moroccan Agency for Medicines and Health Products.

In Kenya, severe flooding - courtesy of El Niño - has killed 120 people. Almost 90,000 households have been forced to leave their homes, which have either been washed away or are marooned. Farmland has been submerged, tens of thousands of livestock have drowned. This heavy rainfall, which is forecasted to continue till January 2024, follows the worst drought in 40 years in the Horn of Africa. In neighbouring Somalia, the floods have killed at least 96 and displaced about 700,000.

In Burkina Faso, UNICEF warns that insecurity is pushing over 10% of children into acute malnutrition in heavily conflict-affected regions.

As the market for GLP-1s expands, counterfeits of the diabetes and weight loss drugs continue to proliferate. In Lebanon, suspected fake versions of Novo Nordisk’s Ozempic have resulted in 11 people suffering from dangerously low blood sugar, one of whom required hospitalisation. Lebanon is one of at least 17 countries dealing with such counterfeits.

For $1.01 billion, UAE’s Aster DM Healthcare is ready to divest a majority stake in its Gulf businessto a consortium led by private equity firm Fajr Capital Advisors. Its subsidiary Affinity Holdings, which operates Aster’s business in the GCC, will be selling its shares in Aster to Alpha GCC Holdings. Once the transaction is completed, the funds managed by Fajr will hold a 65% stake in the business. The rest will remain with the promoters of Aster India.

Over in Colombia, the government wants to rein in healthcare spending by curbing prices of some high-cost medicines.

In Cambodia, bird flu has once again jumped from birds to humans. Health officials are investigating two new severe human H5N1 avian influenza infections. This brings Cambodia’s total to 6 cases this year. Genomic sequences have been posted to the GISAID database, and analysis seeks to find if these new cases were caused by the same clade as the four earlier ones.

India’s Bharat Biotech and Australia’s University of Sydney Infectious Diseases Institute (Sydney ID) have inked an MoU to advance vaccine research initiatives and fortify academia-industry partnerships to tackle future disease outbreaks.

In 2022-23, India’s pharma business stood at over $50 billion. The Chairman of Pharmexcil, or the Pharmaceuticals Export Promotion Council of India, is confident that India’s pharma industry will touch the $130 billion mark by 2030. These forecasts were made on the back of a strong 8% year-to-date increase in exports, with a 29% surge in October alone.

Time for Big Pharma. First, new phase 3 results show that Merck’s experimental 21-valent pneumococcal vaccine V116 has won the latest battle against Pfizer’s Prevnar 20 (PCV20) for 10 out of 11 unique serotypes in adults aged 50 and over. The 21 serotypes covered by V116 account for approximately 83% of invasive pneumococcal disease in people 65 years and over.

Bristol Myers Squibb is shelling out $100 million upfront to expand its 2020 partnership with Avidity Biosciences to create RNA-based meds for up to five cardiovascular targets. Avidity’s focus lies in creating AOCs, or antibody oligonucleotide conjugates, which combine elements from monoclonal antibodies and oligonucleotide therapies.

While Boehringer Ingelheim collaborates with IBM to advance generative AI and foundation models to discover novel candidate antibodies, Amgen is working with Amazon Web Services to design generative AI-based solutions to discover and develop drugs and increase manufacturing throughput.

Eli Lilly will be using PRISM BioLab’s PepMetics platform to discover oral inhibitors of protein-protein interaction (PPI) targets. PRISM claims that its tech can render previously undruggable PPIs into targets readily druggable with small molecules.

In another expanding partnership, Thermo Fisher Scientific and Flagship Pioneering have plans to jointly create new platform companies focusing on novel tools and capabilities to power the biotech ecosystem and accelerate the development of first-in-class therapies.

For four years, Emergent BioSolutions has been supplying its post-exposure prophylaxis anthrax vaccine under a pre-emergency use authorisation. Now, armed with full FDA approval, the company is expanding its supply pact with the US. BARDA, the Biomedical Advanced Research and Development Authority, is shelling out $75 million to exercise an option on an existing deal for additional doses of the two-dose Cyfendus.

As part of $60 million budget cuts, Switzerland-headquartered oncology company Novocure is laying off 13% of its global workforce, which amounts to about 200 workers.

The WHO has granted emergency-use authorisation to Novavax’s XBB-updated Covid vaccine for use in individuals 12 years of age and older.

Amidst widespread drug shortages, the US President has invoked the Cold War-era Defense Production Act to boost investment in local manufacturing of essential medicines and medical countermeasures, including supplies to diagnose, prevent, and treat diseases linked to chemical, biological, radiological, or nuclear attacks. This is one of a series of 30 measures the US government has announced to help industrial supply chains and counter inflation.

And finally, while China’s mysterious wave of childhood pneumonia raises concerns about the country’s surge in respiratory illnesses, the Netherlands is also experiencing a 25% increase in mysterious pneumonia cases in children.