💉 The US doesn't get its way at UN Women; The WFP says war on Iran could make the world hungry; Antibiotics mess your gut up almost forever
#596 | The WHO says we need new antibiotics; Researchers almost ready new antibiotics; Climate change gets into the fast lane
Hello, and welcome back to yet another Friday the 13th. The way things are going with the world, it’s not like we need a day to remind us of all the things that are scary. But in case you did, cast your eye back to March 2020, the second Friday of which too was Friday the 13th. And it was just two days after the WHO had declared Covid a global pandemic. And for further scary reading, just remember, the WHO has never declared the pandemic over. It only declared the emergency phase of it over. For the post-pandemic folks, back-to-normal folks hiding among you.
But if the past 30 months or so have taught us anything, it is that pandemics can’t scare us, when Israel is around. Beaches, healthcare facilities, schools, residential facilities, medical workers... nothing and no one is safe. Yeah, Israel, with the US, is waging a war on Iran, and causing black, acid rain to pour down on people while bombing schoolgirls. Also, probably envious of the fact that they have no cultural heritage of their own to speak of, Israel is bombing historical monuments, some going as far back as the 14th century. In the ongoing “excursion” as a certain orange someone likes to call it, Israel and the US have bombed over 20,000 non-military buildings, including over 17,000 that were residential. As per tradition, healthcare facilities aren’t safe either. While all this is happening though, the people of Palestine are still besieged and attacked on the daily and now the Gaza playbook is being exported by Israel to Lebanon as well. Those beaches, healthcare facilities, schools, residential facilities, medical workers that we mentioned above? Yeah, all in Lebanon. Hey, they aren’t Hamas over there. Maybe the beaches were Hezbollah. Also, children. Can’t forget the children. Not that one can find silver linings in war, but if one were so inclined - it might be early days yet - but it looks like the RSF might be exiting Sudan because their armourer is otherwise occupied, thanks to Iran.
Alright, on with The Kable then.
The Africa CDC has signed up yet another ally in its quest for African sovereignty. This week’s partnership is with the European Centre for Disease Prevention and Control (ECDC), a union that will see the agencies work together on disease surveillance and emergency preparedness, among other things. One can’t help but think that this is also a counter to the US spree of signing bilateral health agreements with African nations. Sure, there is no money on the table but neither is public health data being given away.
A little over a decade ago, the popular discourse all centred around how only some 80-odd% of India had access to a toilet but mobile penetration in India was at some 125+%. In the last maybe five years or so, the popular discourse has shifted to how Africa contributes the least to climate change but bears the biggest burden of it. Unfortunately, the biggest contributors are still only talking. As is only apt then, a couple of African universities have stepped into the breach, setting up climate change hubs under an initiative by the UK’s Wellcome trust. These hubs in Ghana and South Africa are the first two, to be joined later by an as-yet-undetermined hub in East Africa, that will generate continent-specific data to help policymakers create plans to mitigate the effects of escalating climate change.
In Africa, especially West and Central Africa, the hunger crisis is not going away anytime soon. The WFP prediction for the June-August season this year is that nearly 55 million people in the region will be at crisis levels of hunger. Cameroon, especially, has it really, really bad.
In the UK, Wellcome is partnering with the National Institute for Health and Care Research (NIHR) and the Foreign Commonwealth Development Office (FCDO) to work together on infectious disease trials in Africa, South Asia, and Southeast Asia. At The Kable, we don’t usually compliment initiatives from the Global North but this trial application from Wellcome looks totally legit. If you’re a researcher in any of the regions mentioned above working on vaccines for TB, dengue or invasive fungal and lower respiratory and bloodstream infections, you should consider applying.
The US, meanwhile, has launched a new platform for funding global health projects and it is inviting all comers to apply. Just remember, in the US, more than half of their states don’t trust their federal health agency when it comes to vaccine recommendations. But sure, their global health plans are rock-solid. Just ask Guinea-Bissau.
Just a slight segue here because this is not a typical Kable story. But there have been umpteen reports we’ve all read about how companies have fired tens and hundreds and thousands of people and seen their stock prices go up. Turns out all they need to is to let a CEO go instead. All the power to all the people. 👊🏽
In the most ridiculous waste of time, the UN passed a resolution this week instituting International Coffee Day. Every freaking day is International Coffee Day. The draft resolution for this was introduced by Brazil and it was passed with one country saying no. No prizes if you guessed the country was the USA. At the same assembly, the UN also passed resolutions on road safety and International Wellness Day, both of which also had the same naysayer.
And finally, if you’re doom-scrolling while on the toilet, you may want to pack that shit up. Seriously.
Stories Of The Week
US 0; UN won. The week began with the opening of the 70th session of the UN Commission on the Status of Women in New York. The US came ready to fight, demanding the removal of references to gender ideology, sexual and reproductive health rights, and provisions calling for reparations funds for women targeted with violence. Such a pity that the US failed in its attempt and the delegates at the commission adopted the outcome document by a vote of 37-1, with six abstentions. Devex reports that the General Assembly erupted into “shouts, applause, and even tears” as the US was defeated, marking the first time in the commission’s 80-year history that an outcome document was adopted by vote rather than consensus. Honestly, if we were present there, we would’ve been hooting and hollering right alongside. Also, it’s a good thing this session was in New York. If it was in Iran or elsewhere in the Global South, the US would’ve probably bombed it to liberate the women.
(Health Policy Watch, UN Women, Devex)
What happens in Iran... doesn’t stay in Iran. The WFP is warning that surging food and fuel prices driven by the conflict could push global hunger higher, with ripple effects that will worsen food insecurity for vulnerable populations far beyond the region. Because apparently, when you’re busy bombing civilians and destroying infrastructure, you also need to make sure the rest of the world can’t afford to eat either. The conflict is already having immediate impacts: Lebanon faces “significant internal displacement.” In Gaza, border closures triggered “sharp food price increases” that remain elevated. The real global threat, however, comes from supply chain disruptions, especially a chokepoint that affects shipping, energy, and fertiliser markets. The Strait of Hormuz handles a bulk of the world’s fertiliser supply and any disruption there means fewer fertilisers, lower crop yields, and soon, higher global food prices. We’re not even talking about oil and gas shortages yet. But hey, let’s bomb a school filled with young girls so they can feel the freedom.
(WFP)
Everlasting gut disorder. A new study says antibiotics kill the infection. Yay. But they also massacre your gut microbiome for years. Oh no. Yup. People who hadn’t taken antibiotics in eight years had about 350 unique bacterial species in their guts, while those who had taken antibiotics, any antibiotics, had fewer. The most disruptive was clindamycin. Each course taken in the year before stool sampling was linked to an average of 47 fewer detected species and changes in abundance in almost 300 of the 1,340 species analysed. Fluoroquinolones and flucloxacillin both corresponded to about 20 fewer species each. The effects were strongest in the year immediately after taking antibiotics, and while diversity recovered fastest in the first two years, complete recovery of the gut microbiome never happens. Even a single course taken up to eight years earlier had an effect. The researchers note this could be related to “variable bioavailability and only partial bile excretion”, which in plain speak means these drugs keep messing up your gut long after you stop taking them. Okay. So why does it even matter how diverse the bacteria in the lower gut is? Well, the same study says lower gut diversity is linked to obesity, type 2 diabetes, and inflammatory bowel disease, and there’s “no evidence that probiotics are the answer” for recovery.
(Nature Medicine)
Needed: New antibiotics. The WHO has published three new Target Product Profiles for desperately needed antibiotics, focusing on severe multidrug-resistant Gram-negative infections, antibiotic-resistant Gram-positive infections in immunosuppressed patients, and bacterial meningitis. The three priorities address critical gaps: MDR Gram-negative infections causing increased deaths and ICU strain; Gram-positive infections in immunosuppressed patients where bloodstream complications are leading ICU concerns; and bacterial meningitis with one in six fatalities and one in five survivors facing long-term disabilities. Each TPP provides specific guidance for developing treatments aligned with WHO bacterial priority pathogens. Why now though? Don’t we have enough antibiotics? Well, yeah but each of these targeted infection types are currently treated with antibiotics that are becoming less effective as drug resistance rises, and there are few candidates in the antibiotic pipeline to provide new treatment options. What is Big Pharma making though? GLP-1s. Maybe if the WHO went with an exaggerated dollar amount for each of these TPPs, we might see some development happen because otherwise antibiotic development will always remain economically unattractive compared to chronic disease medications. And then, we will all die.
(WHO)
Why no drugs for kids? We’re not done talking about antibiotics just yet. In fact, we’re here to say the antibiotic crisis is getting worse as big pharmaceutical companies slow production, leaving children in LMICs particularly exposed to drug-resistant infections. The Access to Medicine Foundation reports that the number of candidate antimicrobial drugs in the pipeline has shrunk by 35% since 2021, even though AMR contributes to more than four million deaths annually and is expected to rise to eight million by 2050. The situation is particularly dire for children - only 14% of medicines under development are for those aged under five, and 17 countries in Sub-Saharan Africa have no children’s antibiotics available from major pharmaceutical companies. While seven drugs in late-stage development promise to treat resistant infections from gonorrhea to drug-resistant tuberculosis, only two are expected to be affordable in LMICs. The rest will likely remain out of reach for the populations who need them most because of course.
(Access to Medicine Foundation)
Breakthroughs
Supersize it. Yup, we’re still on antibiotics but this time, we’re making it super with the undies on outside and all. Scientists in Leiden have developed EVG7, a new antibiotic that can combat dangerous C. difficile infections using only a very small dose while sparing beneficial gut bacteria. Unlike current antibiotics that, you know, wipe out large portions of the gut microbiome, EVG7 appears to preserve protective bacteria like those in the Lachnospiraceae family that naturally help keep C. difficile in check. In mouse studies, even a very small dose of EVG7 was highly effective at clearing the infection and preventing it from coming back. The researchers found that using a low dose actually worked better than higher doses, suggesting the drug’s potency allows for targeted treatment without collateral damage to the microbiome. Early findings also suggest EVG7 is less likely to drive antibiotic resistance, as it’s powerful enough to effectively eliminate C. difficile rather than merely irritating the bacteria. Wow, send it to the clinic already, right? Yeah, except the researchers say pharma will ask where is the money?
(Nature Communications)
Bottom line
Hurtling towards hell in a handbasket. You think the world is moving far too fast lately? Climate change agrees. Global warming has picked up speed in the past decade, with temperatures climbing at an estimated rate of about 0.35°C per decade, nearly double the 0.2°C per decade increase from 1970 through 2015. In a new study, The Potsdam Institute for Climate Impact Research found this acceleration to be “statistically significant with a statistical certainty of over 98%” after removing natural influences like El Niño events, volcanic eruptions, and solar cycles from temperature records. The study analyzed five major global temperature datasets and found the faster warming trend becomes visible around 2013-2014, representing the fastest warming observed in any decade since record-keeping began. Even after adjusting for natural factors, 2023 and 2024 still rank as the two warmest years on record. And if this rate of warming continues, that 1.5°C limit that policymakers have been talking about will be exceeded well before 2030. The only off-ramp is if we reduce global CO2 emissions from fossil fuels to zero. But that ain’t happening. So eat, drink, and be merry. Unless you’re in West or Central Africa, or anywhere close to Israel.
(Geophysical Research Letters)
Long reads
Get your health on. Health Policy Watch with a wonderful read on how public health no longer has control of the mainstream health discourse, and possible suggestions on how to reclaim it.
(Health Policy Watch)
Beware bilateral backstabbing. Yet another piece in The Conversation about what African nations stand to lose in the bilateral health deals they’re signing with the great imperialist of our times.
(The Conversation)
First and foremost. Africa has been a spectator to climate change and adaptation discussions for far too long. SciDev contends it is now time for Africa to take the lead. We agree.
(SciDev)
Making it local. A year and a half ago, Gilead granted six voluntary licenses to generic manufacturers across Egypt, India, and Pakistan, to produce and supply generic lenacapavir to 120 LMICs. Now, South Africa is looking to expand that by at least one, seeking homegrown pharma manufacturers. Bhekisisa has the complete rundown.
(Bhekisisa)
Oh, and Gopal Nair doesn’t want you to see this.
Excellent review of world health situation as usual
Thanks