π Mpox gets an official vaccine; Profits over people, always; Google's new drug designer
#534 | Bird flu is still making moves; Wildfires aren't good news; Ageing? What ageing?
Hello, and welcome back to The Kable for a fairly short read this week, a week in which, once again, mpox continues to dominate the news cycle.
First up, though, the Africa CDC has released its landmark report on antimicrobial resistance (AMR), highlighting a lack of access to common antibiotics as one of the key drivers of AMR on the continent.
The WHO has started polio vaccination campaigns in North Gaza, even as hostilities seem to be escalating. In a new release, the WHO lays bare the devastating effect of Israel's war on Palestine, with at least 25% of injured Gazans looking at life-changing injuries. In a teeny-tiny ray of sunshine, the WHO also reported being able to evacuate 97 people from Gaza to the UAE for medical treatment.
A warning letter posted by the US FDA highlights all the issues that led to the latest agency censure for Indian drugmaker Zydus Lifesciences. And it doesn't make for pretty reading.
Elsewhere in India, new hope against the Zika virus in the form of an announcement from Indian Immunologicals that it is partnering with the Indian Council of Medical Research (ICMR) to develop a vaccine.
An unknown illness in Vietnam has seen one student die, with many more hospitalised.
In the US, authorities began the week with the report of the first human bird flu case with no contact with animals. As the week ended, officials were no closer to identifying the cause of this infection, only saying it was likely a one-off.
And finally, in a stark reversal of decades-long messaging, China's apex health agency is asking citizens to get married and have babies.
Stories Of The Week
Africa's mpox moves. In a week where mpox continued its African march unimpeded, the Africa CDC continued to claim its place at the forefront of the response. Most notable, the agency, in cahoots with the WHO, launched a joint continental response plan for mpox. The plan calls for a single coordination mechanism, response plan, budget, and monitoring system for mpox. It classifies African nations into four risk categories: countries with sustained human-to-human transmission, those with sporadic human cases since January 2022 or endemic zoonotic reservoirs, nations needing enhanced readiness due to proximity to transmission, and countries with no current outbreak or risk. The plan aims to improve surveillance, lab detection, case management, infection prevention, vaccination, risk communication, and research.
In the Democratic Republic of the Congo, supplies continue to be received. First, the WHO delivered emergency supplies. Then, the country received 50,000 vaccine doses from the US and another 15,000 from Bavarian Nordic. As a consequence, the country has brought ahead its vaccination launch, now aiming to begin in the first week of October.
Elsewhere, India reported its first case of mpox in the current outbreak. Later in the week, authorities confirmed that this case is not of the new Clade 1b variant.
The week ended with the excellent news that Bavarian Nordic's vaccine has been prequalified by the WHO. This should now make it even easier for the vaccine to reach African arms.
(Africa CDC, WHO, USAID, Gavi, Reuters, The Hindu, Reuters, WHO)
Once again, money trumps reason. Targets to reduce antimicrobial use in livestock were dropped from the latest UN Political Declaration on Antimicrobial Resistance (AMR), reportedly due to pressure from major meat-producing nations and the veterinary drug industry. The draft, released ahead of the UN's High-Level Meeting on AMR, once proposed a 30% reduction in antimicrobial use by 2030 but now only "strives" to reduce it. With 80% of antibiotics in agriculture, drug-resistant pathogens claim nearly 5 million lives annually. Despite this, countries will set their own targets, guided by a new global animal vaccination plan and AMR guidelines for agriculture. Key commitments to reduce AMR deaths by 10% and raise $100 million for action plans remain, but the overall response still faces challenges.
(Health Policy Watch)
Breakthroughs
The new drug designer. AI's role in drug discovery is rapidly expanding, with systems like Google DeepMind's recently launched AlphaProteo leading the way. AlphaProteo is designed to create novel protein binders that target molecules with high precision, a critical advancement for drug development and biosensors. Trained on the Protein Data Bank, AlphaProteo has already successfully designed binders for proteins associated with cancer and viral infections, including SARS-CoV-2.
(Google DeepMind)
New hope against cholera? Despite having a cure for decades, cholera remains one of the leading killers worldwide, responsible for up to 143,000 deaths annually. Antimicrobial resistance compounds this issue, with over a million deaths each year due to resistant infections. Researchers at The University of Texas at Austin see promise in microcins, natural antimicrobials produced by gut bacteria. These highly selective compounds could target pathogens like cholera without disrupting the gut microbiome. A recent study identified MvcC, a microcin that kills cholera-causing bacteria. Using AI, the researchers are finding more microcins to combat resistant pathogens.
(Cell Host & Microbe)
Monkey see, monkey do. Despite being around for decades as a diabetes drug, metformin might also be a secret weapon against ageing, according to a new study on male monkeys. The primates treated with the drug showed slower brain ageing, with cognitive function and neuronal activity resembling those of much younger animals. Metformin also helped preserve liver function and reduce inflammation, a key marker of ageing. While more research is neededβespecially in humansβthe study hints at the possibility that this low-cost drug could one day help delay ageing itself, keeping us healthier longer.
(Nature)
Bottom line
The world is on fire. Wildfires, fueled by climate change, are creating a global air quality crisis, with emissions crossing continents and threatening human health, ecosystems, and agriculture, according to the latest World Meteorological Organization (WMO) bulletin. Fine particulate matter (PM2.5) from fires, fossil fuels, and other sources is particularly hazardous, penetrating deep into the lungs and contributing to over four million premature deaths annually. In 2023, wildfires in Canada, Algeria, and Chile underscored the international scope of this threat, with smoke spreading across borders and even oceans. The report highlights how pollution not only harms human health but also disrupts agriculture, reducing crop yields and threatening food security, as rising temperatures and droughts make intense wildfires more frequent.
(WMO)
Mind the health gap. Pharmaceutical companies must prioritise reaching underserved populations with essential medicines like insulin while also measuring the effectiveness of these efforts, says the Access to Medicine Foundation. Though many big pharma companies claim to have strategies in place, the foundation's latest report highlights gaps in comprehensive, measurable goals, particularly for diseases like diabetes and cancer in low- and middle-income countries. Without clear targets and data on patient reach and adherence, the disparity between production and actual healthcare needs will persist. Addressing this is crucial to ensuring global health equity and making medicines accessible to all, regardless of location.
(Access to Medicine Foundation)
Long reads
The AVMA agenda. Despite the urgent need for vaccines in Africa, the continent remains reliant on donations from wealthier nations, as highlighted by the mpox and cholera outbreaks. The African Vaccine Manufacturing Accelerator (AVMA), launched by Gavi, aims to change this by investing $1.2 billion over 10 years to boost local vaccine production. However, critics argue the initiative favours international manufacturers over truly local efforts. Read Health Policy Watch's deep dive on the AVMA's impact and the challenges of ensuring equitable vaccine access.
(Health Policy Watch)
The train that can. Not a long read really but a fascinating story nevertheless about the trains that serve as the nodal healthcare centres in South Africa's fast-growing suburban epicentres. This is a story that deserves great long-form writing.
(AP)
Oh, and Gopal Nair doesn't want you to see this.