💉 Gavi places an mpox vaccine order; Antibiotic resistance is the new world order; The Global Fund makes sense out of disorder
#535 | A new blood group emerges; Wastewater to the rescue; An Arctic pandemic?
Hello, and welcome back to The Kable this fine Friday. Even as mpox continues to rage on in Africa, this still-developing outbreak seems to have been relegated to the back pages in much of the Western world. We hope this is a portent indicating that mpox will not remain a scourge much longer but it is more likely a continuing trend of ignoring Africa's issues till they manifest outside the continent.
Anyway, the WHO kicked off the week setting up a plan for access to mpox vaccines and tests that will ostensibly allow countries with the greatest need to fulfil their requirements first.
Elsewhere, a new pandemic agreement continues to drag on, with the most critical point of Pathogen Access and Benefit Sharing (PABS) access being deferred to later.
CEPI shared takeaways from the Global Pandemic Preparedness Summit it had organised in Brazil last weekend. Among these takeaways - "achieving equity remains a fundamental challenge and addressing it must be a political, financial and technical priority."
For the editors at The Kable, leprosy is one of those personal bugbears we can't stop thinking about. And there hasn't been much good news on the leprosy front since the inception of The Kable. But now there is, with Jordan becoming the first country verified by the WHO as having eliminated leprosy.
Great news on the CSR front. Japan's Takeda is investing over $32 million in five different organisations working on different aspects of healthcare across Africa. The investment will go towards expanding vaccine access across Ethiopia, Kenya and Nigeria, integrating community health with the national health system in South Africa’s remote Xhorha Mouth Administrative Area, increasing access to care and psychosocial support for women and girls in Cameroon, Democratic Republic of Congo and Nigeria, building a skilled health workforce in Malawi, Sierra Leone, Uganda and Zambia, and strengthening national health systems in Democratic Republic of Congo, Guinea, Malawi, Tanzania and Uganda.
On the corporate malfeasance front, trucks overloaded with torn manufacturing documents and birds inside the production facility are just some of the issues the US FDA identified in a recent inspection of India's Granules Telangana facility.
In India's southernmost state of Kerala, the Nipah virus rears its ugly head again with one death. Samples of individuals in contact with the deceased person have thankfully returned negative.
In the US, a follow-up on the mystery case of a human infected with bird flu reveals that one of their contacts, too, had symptoms but they didn't get tested. Murica!
And finally, a new blood group has entered the chat. The research documenting this discovery has been, unsurprisingly, published in Blood.
Stories Of The Week
Gavi makes a deal. Let's begin with the good news. The WHO's pre-licensing of Bavarian Nordic's mpox vaccine has finally made it possible for Gavi to place an order - 500,000 doses - for Africa. This number is well short of what the continent needs but is still 500,000 doses more than were ever secured specifically for Africa. The deal says doses will be ready this year but doesn't really specify when. Gavi wasn't the only one stocking up on mpox vaccines this week. The UK also decided to buy 150,000 doses more, probably to replenish the stockpile when they donated zero (0) doses to Africa.
UNICEF began the week by asking for $58.8 million to respond to the mpox outbreak, stating children are disproportionately affected in this outbreak. A claim that was immediately validated with data showing nearly a third of the cases in Burundi are among children.
In disease news, Malaysia has reported its second case of mpox in this outbreak, once again the less severe Clade 2 variant. Morocco becomes the first country from North Africa to report a case. Infections in Uganda have inched up into double digits and India has reported its second case in the current outbreak, variant unknown.
In Rwanda, thanks to 1,000 vaccine doses received from Nigeria, authorities have begun mpox vaccinations.
However, Africa's nodal health agency, the Africa CDC says mpox is nowhere near being under control on the continent.
(Gavi, Reuters, UNICEF, UNICEF, Reuters, Arab News, Reuters, The Hindu, AP, Reuters)
Some you win. The Global Fund released its 2024 report this week. And it makes for good reading. In its fight against HIV, tuberculosis, and malaria, the Global Fund reports a reduction in deaths by 61% and 65 million lives saved since 2002. Last year's wins for the Fund included price cuts on key HIV and TB treatments and introducing more effective mosquito nets against malaria. However, the prognosis isn't all rosy. Because climate change with conflict thrown into the mix. And the poor will bear the burden. Of course.
(The Global Fund)
The rise of the superbug. If you needed a new villain, drug resistance is right here, staking its claim to the position. A new report released in The Lancet predicts the toll of drug-resistant infections rising by 70% to 40 million by 2050. But that's only the direct deaths due to antibiotic-resistant bacterial infections. The study says it will also lead to an additional 169 million deaths through indirectly related causes. And it further estimates 10 million deaths every year from 2050, directly or indirectly. Unsurprisingly, low- and middle-income countries (LMICs), especially in sub-Saharan Africa and South Asia, will bear the brunt of this burden. Unless we come up with enhanced care regimens and new vaccines and incorporate careful antibiotic use in our treatment schedules.
(The Lancet)
Breakthroughs
The poop potion. Welcome to a world where poop might save lives. Scientists have discovered 18 strains of bacteria from healthy human stool that could help tackle those pesky antibiotic-resistant gut infections. These "good guys" outcompete the bad bacteria for carbs in the gut, stopping them from colonising and reducing inflammation. Imagine a future where a poop transplant does more than just, well, get you regular — it could actually outsmart nasty infections! So, the next time someone says you’re full of it, maybe that’s not such a bad thing after all.
(Nature)
Bottom line
The kids aren't feeling alright. The Gates Foundation is sounding the alarm on malnutrition, calling it the world’s worst child health crisis and warning that climate change will make it worse. By 2050, 40 million more children could face stunted growth, and 28 million more could suffer from wasting, the most severe form of malnutrition, according to the foundation’s latest Goalkeepers report. The report stressed the importance of good nutrition in early years for physical and mental development and highlighted the devastating impact of climate change on food systems while calling for more funding and research into nutrition solutions.
(The Gates Foundation)
The pathology of poop. One of the very few plusses of the Covid pandemic is the recognition of how important wastewater tracking is in disease management. Turns out, analysing what gets flushed down the toilet can help scientists detect thousands of health threats at once — everything from antibiotic resistance to cholera. A team of researchers figured out a way to decode the DNA puzzle pieces in sewage, uncovering previously unknown bacteria and grouping them by their source: humans, animals, or even biofilms growing in pipes. So, while wastewater may sound gross, it’s actually a goldmine for tracking bacteria and stopping outbreaks before they turn into something worse... like a literal crapstorm.
(Nature Communications)
Long reads
The eye of the storm. Based on some of their recent reporting, it would appear AP has hired some new quality writers out of Africa. Following on from their reporting last week about South Africa's healthcare trains comes this very good, albeit not complete enough, piece on how the new mpox clade took the epicentre of the outbreak in the Democratic Republic of Congo by storm.
(AP)
No money, more problems. A piece in Stat about how drugs and treatments for HIV keep getting trialled in Africa but are never made accessible to the African patient population after successful trials. Case in point: Gilead's recently announced results from its trial of Lenacapavir in women in South Africa and Uganda.
(Stat)
Eyes up north. Another of the few upsides of the Covid pandemic is that we’re finally paying more attention to how the Arctic could be the next big health crisis. New research reveals that as the region warms and its environment degrades, the risk of zoonotic diseases is growing. Nature has an opinion piece for you to understand how climate change, pollution, and biodiversity loss are creating a "quadruple" planetary crisis. Thawing ice is releasing ancient microbes, and invasive species are bringing new diseases, making it clear we need better surveillance and action before the next pandemic inevitably emerges from the Arctic.
(Nature)
Oh, and Gopal Nair doesn't want you to see this.