💉 Mpox: it's an emergency (again); Bavarian Nordic says no to making in (or selling to) Africa; Smart insulin to the fore

#530 | Extreme heat doubles, the world boils and bubbles; Safe water? Not for half the planet; Time to rename bird flu?

Aug 16, 2024

Hello, and welcome back to The Kable, where we're confirming that mpox has achieved global emergency status for the second time in recent memory. However, more on that later.

In what was anyway a big week for the Africa CDC, the fledgling agency also launched its much-anticipated Antimicrobial Resistance (AMR) Landmark Report. Developed in partnership with the African Society for Laboratory Medicine (ASLM), the report says AMR is a much bigger threat to health security in Africa than the trifecta of AIDS, TB and malaria.

In India, the country's first home-grown dengue vaccine is entering Phase 3 trials.

Also in India, two drug makers - Dr. Reddy's and Aurobindo Pharma - received different but anti-positive reports from the US FDA.

In bird flu news, France has reported the first farm infection since January this year and a study in the US says bird flu has now spread to 23 mammal species, with a spread to cats being the most worrisome.

In South Korea, authorities are resuming Covid vaccinations after cases surged in the country, thanks to KP.3. Mass immunisations are scheduled for October.

And finally, UN labour agency - the International Labour Organization (ILO) - says youth around the world aren't working. Not by choice. There just aren't enough jobs, according to the ILO's latest Global Employment Trends for Youth 2024 report. The report does say that joblessness among youth has fallen to a 15-year low with further dips expected in 2024 and 2025 as the global economy continues its recovery from Covid. However, this recovery hasn't resulted in uniform employment benefits around the world, with youth in Asia, the Pacific region and Arab States - women in particular - lagging behind.

Stories Of The Week

It's official. What is? Well, mpox is now a public health emergency around the world. After the Africa CDC first declared a pan-continent emergency, the first such proclamation from the agency, the WHO too got in on the act and declared mpox a public health emergency, exactly like it had done in 2022. Unlike last time though, the emergency declaration this time has been mainly prompted by the emergence of a new clade called clade Ib that seems to spread more quickly and has a higher mortality rate. First identified in the Democratic Republic of Congo, this new clade has spread very, very rapidly to several nations in Africa. And now, it has crossed Africa too with Sweden and Pakistan reporting cases. What was that? Vaccines? There still aren't any that are prequalified by the WHO although it has now asked vaccine makers for submissions.

During the last emergency outbreak of mpox in 2022-23, Europe and the US hoarded most of all the available vaccines from drugmaker Bavarian Nordic. Hopefully, that won't be the case this time. Gavi has said it has $500 million readily available for mpox shots. Bavarian Nordic, however, has said it has no plans to sell to Africa, much less manufacture in Africa, leaving donations as the only means for the continent to avail its shots. The EU has stepped up with a donation of 215,000 doses, the first time in the 70-odd years of mpox's existence that Africa has received any vaccines. What makes this even more critical is that another antiviral - Siga's Tpoxx - that was in trials in the DRC since 2022 has failed its primary endpoint.

Experts are concerned about the spread of this new mpox clade, believing it to be up to 10 times more fatal. Countries around the world have ramped up preparatory measures to curb the outbreak. What makes us hopeful this time around is that the focus is rightfully on Africa. Here's hoping the Africa CDC and other agencies can curtail this before it becomes the p-word we all dread.
(Africa CDC, WHO, Reuters, MoneyControl, WHO, Gavi, Health Policy Watch, Africa CDC, Siga, Wired)

Breakthroughs

Smart insulin. Scientists have developed a potentially groundbreaking type of "glucose-responsive" insulin, designed to mimic the body's natural response to changing blood sugar levels. This "smart" insulin, developed by research teams in the US, Australia, and China, activates when blood sugar rises and deactivates once levels stabilise, potentially reducing the frequency of injections for diabetics to just once a week. While this innovation is rightly seen as a significant advancement towards managing type 1 diabetes, further research is nevertheless needed to address current delays in insulin activation to ensure safety and effectiveness.
(The Guardian)

Bottom line

Suffer the little children. A new UNICEF analysis reveals that one in five children globally now lives in areas experiencing double the number of extremely hot days compared to six decades ago. This alarming trend, driven by (what else?) climate change, shows a significant rise in heatwaves, particularly affecting children in regions like West and Central Africa, where two-thirds of kids now endure triple the number of heatwaves. The report highlights the severe impact of extreme heat on children's health, contributing to issues like malnutrition, heat-related illnesses, and increased vulnerability to infectious diseases.
(UNICEF)

Water, water everywhere... A new study published in Science reveals that approximately 4.4 billion people, or more than half of the world's population, drink unsafe water - double the previous estimate by the UN’s Joint Monitoring Programme (JMP), which reported 2.2 billion without access to safe water. This stark difference arises from the study's use of machine-learning algorithms and geospatial data to assess water quality, contrasting with the JMP's aggregation of data from various sources. The findings highlight significant gaps in global health data and underscore the urgent need for improved monitoring and access to clean water, especially in regions like South Asia and sub-Saharan Africa.
(Science)

Long reads

Viva la resistance. It is commonly accepted that antibiotic resistance will, at some time, spark an unprecedented health crisis around the world. This piece in Nature takes a look at how science is using a multi-pronged approach to hopefully nip this emerging crisis in the bud.
(Nature)

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