💉 WHO says no to e-cigarettes; Rwanda says yes to host APTF; COP28 says maybe to fossil fuels
#494 | German farms with bird flu; 16 US states with mystery dog illness; Dolphins with thumbs
Hello, and welcome to the free Friday Kable. What do you think Friday needs to be freed from? Well, drudgery. And you won't find any of that in here. Nor will you find any in this profile of one researcher from Burkina Faso whose work proved vital in bringing a new malaria vaccine to fruition.
Pretty much every pan-continent organisation in Africa has been setting up HQ in Rwanda lately. The African Pharmaceutical Technology Foundation is no exception, and here is an announcementof its host country agreement with Rwanda.
The Senegalese government and WHO inaugurated a regional health emergency hub in Dakar, aiming to enhance Africa's capacity for rapid and effective response to health crises, building on lessons from the pandemic. This Dakar hub, specialising in supply chain management and data analysis, is part of a transformative initiative, including hubs in Nairobi and a planned one in Pretoria, to drastically reduce response time to emergencies and train over 3000 African health experts.
The ongoing diphtheria outbreak in Nigeria is only part of a larger outbreak in West Africa, which is experiencing its worst diphtheria outbreak. Attributed to historically low vaccination rates exacerbated by the pandemic, this outbreak has seen Nigeria alone report over 12,000 cases and 570 deaths, figures likely underestimated. This situation highlights the urgent need for a massive vaccination scale-up, as the disease, preventable by routine childhood vaccination, has resurged due to inadequate health service delivery and global vaccine shortages.
In corporate news, more layoffs. Vir Biotechnology announced a restructuring plan involving a 12% workforce reduction and the closure of two R&D facilities, aiming to save at least $40 million annually. This move, following the failure of its experimental flu candidate and reduced potency of its Covid antibody treatment, refocuses the company on developing treatments for hepatitis B and D while also shifting research towards oncology and autoimmune diseases.
Novo Nordisk, meanwhile, continues to put more weight behind its oral GLP-1 manufacturing efforts with a new manufacturing plant acquisition in Ireland.
Something tells us dengue will become more talked about next year, thanks to an unprecedented outbreak in the Western Hemisphere, with over 4 million cases reported in the Americas and Caribbean this year, surpassing the 2019 record. Factors like rising temperatures, rapid urbanisation, and extended mosquito habitats are intensifying the spread of the disease, which is now being seen in regions like California and Florida, indicating a worrying global trend.
Close to 30,000 ducks in Germany won't be around to ring in Christmas this year because the farm they called home hosted a resident with bird flu.
Also, the mystery respiratory ailment affecting dogs in the US has now spread to 16 states. Maybe it's in the air.
And finally, it may be time for a change in the world order when it comes to which mammals reign supreme. Scientists have just discovered dolphins with thumbs. 😳
The Week That Was
What's more appropriate than kicking off a week for a life sciences newsletter with news of disease outbreaks? The Democratic Republic of Congo (DRC) has reported over 13,000 mpox cases in 2023; that is over twice as many as were recorded during the last peak in 2020. The WHO is “very worried” about the spread of this severe form of mpox that has already killed nearly 600 people, primarily children, in the country this year. Meanwhile, the number of countries in Africa reporting an anthrax outbreak has swelled to five, with Kenya, Malawi and Zimbabwe joining Uganda and Zambia.
New research, which pools the results of 25 studies from African countries, suggested that nearly half of Covid survivors in Africa are reporting at least one ongoing long Covid symptom. These symptoms are affecting people’s quality of life, their ability to work, and their productivity, consequently adding to economic costs in the region.
With a strong enabling infrastructure and holistic regulations, digital technologies present an opportunity to bridge gaps that have long plagued access to medicine in Africa. This piece in African Arguments highlighted the important role of robust regulations in the success of this transformation.
141 child deaths and a year and a half later, the Drugs Controller General of India (DCGI) last week issued a letter to state and regional authorities to inspect and verify, as “top priority,” the source and quality of propylene glycol (PG) used by cough syrups makers in India.
On Tuesday, we brought you a Bhekisisa update about all things AMA (African Medicines Agency). For its pilot phase, due to last for about a year, the AMA has already received more than 30 applications from pharma companies to approve medicines. The AMA’s focus is on conditions important within the African context – bilharzia, sleeping sickness, heart disease, diabetes, and more.
In an open letter, activist groups called on the Coalition for Epidemic Preparedness Innovations (CEPI) for greater transparency in the organisation’s partnership agreements. They encouraged CEPI to publish the terms of its agreements, including those relating to pricing, CEPI’s measures to ensure affordability, supply and delivery of products to LMICs, licensing, and tech transfer of products that result from CEPI R&D funding.
A new Global Burden of Disease (GBD) special report was published in the Journal of the American College of Cardiology. Spanning 21 global regions, the assessment found that global death counts due to cardiovascular disease (CVD) increased from 12.4 million in 1990 to 19.8 million in 2022.
Wednesday, meanwhile, brought the European Commission (EC) to release its first list of critical medicines for which continuity of supply is a priority. As part of its wider overhaul of legislation concerning the €136 billion ($148 billion) pharmaceuticals industry in Europe, the list comprises over 200 active substances of medicines, including antibiotics like amoxicillin, painkillers like paracetamol and morphine, insulin, and vaccines for measles, rabies, hepatitis A and B, and tetanus. The listed medicines will be closely monitored, with the EC analysing each of their supply chains.
Yesterday, Gavi outlined the measures adopted and the progress achieved so far in generating awareness about zoonoses in Africa. It described the efforts of the Transnational African Zoonosis Education Campaign across Cameroon, Nigeria, Liberia, and Zambia.
Taking its cue from the widespread adoption of mRNA vaccine tech since the Covid pandemic, the WHO Science Council released a report reviewing the potential benefits and limitations of mRNA vaccine tech.
And finally, we maybe possibly got an inkling of the beginning of the end of the oil age, maybe? After a day of overtime at COP28, representatives from nearly 200 countries agreed to begin “transitioning away from fossil fuels in energy systems, in a just, orderly and equitable manner ... so as to achieve net zero by 2050 in keeping with the science.” While the deal stops short of an outright “phaseout” of oil, coal, and gas, this is the first time that countries across the world have united on a clear text to reduce fossil fuel consumption.
Drug prices in Nigeria stay sky-high. In the past few months, everything from painkillers and asthma inhalers to antibiotics, cancer drugs, anti-hypertensives, and diabetes drugs has seen astronomical price increases in Nigeria. The price of some medicines in Nigeria has risen nearly tenfold. This can be attributed to a number of factors. In June, the removal of currency controls sent the value of the naira plunging. While GSK’s shift to a third-party distribution model in the country is also being blamed, GSK says that the price rises are not a result of their decision but rather the fault of “market forces outside [their] control”. This has had a significant effect on people’s access to essential medicines – people are either not purchasing all the meds they need or are turning to traditional cures instead.
Say no to e-ciggies. E-cigarettes have adverse population health effects. They are addictive, generate toxic substances linked to cancer, heart, and lung disorders, and affect brain development. Still, e-cigarettes have been allowed on the open market, where they are aggressively marketed to young people using social media and sleek designs. In many countries, e-cigarette use among children and young people exceeds usage rates in adults. E-cigarettes are not even effective transitions away from tobacco use. In fact, studies have shown that young people who use e-cigarettes are almost thrice as likely to use cigarettes later in life.
While 34 countries ban their sale, 88 have no minimum age for purchase, and 74 don’t have any regulations at all. The WHO Director-General has urged countries to implement strict measures to prevent e-cigarette uptake among their citizens, especially children and young people. In countries where e-cigarette sale is banned, implementation, monitoring, and surveillance should be strengthened. In other countries, stronger regulations are needed to reduce their appeal. Based on current evidence, the WHO does not recommend that governments allow the sale of e-cigarettes as consumer products at all if they are working towards a cessation objective.
Naturally, not everyone is happy. With tobacco-style controls being recommended for vapes, things don’t look good for big tobacco firms like Philip Morris International and British American Tobacco, which are shifting to new nicotine products. Imperial Tobacco and the UK Vaping Industry Association say that e-cigarette flavours – which the WHO recommends be banned – help smokers transition away from cigarettes, compared to which vapes pose much lower health risks. And while Cancer Research UK contests the cancer claim, vaping firm ANDS called the WHO’s position “detached from reality”. Ouch.
Llama drama. Noroviruses. Those pesky little pathogens responsible for foodborne illnesses. Infections with noroviruses are very contagious and have no specific treatment. They make millions sick and kill over 200,000 annually. But now Baylor College of Medicine researchers may have found an answer to the norovirus problem in an unlikely place: llamas. Members of the camel family, llamas produce tiny antibodies called nanobodies to fight infections. The researchers discovered that, when tested in lab-grown mini-guts, the nanobody M4 bound to the GII.4 norovirus strain, which is most common in people. M4 identified a hidden pocket in the norovirus which is only exposed when the virus is in a certain state. Unable to recover when attacked by nanobodies, the viruses cannot transmit. Hopefully, these findings will contribute to vaccine development as well as understanding new norovirus strains.
Resistant by association. Humans can be like cockroaches – living in dense groups, having frequent contact. So to understand antimicrobial resistance (AMR) in humans, what better way than to study it in a model of gregarious cockroaches?
Tetracycline is a class of antibiotics used to treat many kinds of bacterial infections. Researchers at the Technical University of Denmark added tetracycline to the diet of a group of these socially interactive cockroaches. Subsequently, they detected a greater abundance of tetracycline resistance genes in the cockroaches’ gut microbiomes. When an untreated group of cockroaches hung out with the tetracycline-treated guys, they also developed elevated tetracycline resistance, depending on how closely and how long they interacted. What’s more, the environment they lived in, the soil substrate, also saw a similar effect.
What’s the lesson here? That the direct overuse or misuse of antibiotics isn’t necessarily the only way in which AMR spreads. A microbiome rich with AMR genes can do the job just through interactions with friends who haven’t yet been affected. More research is needed in mammals before we can be sure this is how it works in humans as well. Just so we’re clear, this isn’t a recommendation to stop hanging out with friends who are on antibiotics.
Climate loopholes. Did you think we were done discussing the climate deal that came out of COP28? Well, we’re not. This last story today from New Scientist highlights the weak points of the agreement, which will most likely keep us from preventing warming beyond 1.5°C. It was the first-ever COP agreement that explicitly stated a transition away from fossil fuels, yet some unhelpful language was plugged in there by oil and gas producers. The deal leaves open possibilities for countries to use more gas as a transition fuel. It references the use of carbon capture and storage technology to prevent CO2 emissions from reaching the atmosphere – even though such tech is still unproven, expensive, and doesn’t capture all emissions. Despite mentions of a phase down of fossil fuels, there is no commitment to reach peak emissions before 2025, which is necessary to meet our Paris Agreement goal. Overall, many agree that the agreement is weak, but it’s the strongest we’ve had so far and the best option, for now, to keep the Paris goal somewhat alive.