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ngq, you sexy beast! Here is a sanity check for that clean meta. ;)

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Last week, the Global Pandemic Monitoring Board published its second annual report calling for multilateral systems to strengthen global pandemic preparedness and response capacity. The independent body, convened by the WHO and the World Bank, noted that the COVID-19 pandemic has been exacerbated by a “failure of governance in global collective action, including coordination and engagement with multilateral systems” as well as financing gaps in global health security, including “chronic underinvestment in preparedness as well as states withdrawing financial support.”

The report calls for a re-centering of governance across multilateral systems, including in the following areas: (a) global and regional mechanisms to track pathogens, (b) strengthen early warning and information sharing, (c) intermediate grading of health emergencies, (d) evidence-based policy formulation on travel and trade restrictions, (e) collaborative mechanisms for research and regulatory harmonization, as well as (f) strengthening IHR compliance assessment and enforcement mechanisms.

Global health security presents distinct challenges in low- and middle-income countries, according to the Centre for Global Development, requiring policy restructuring to ensure development gains. In the article, the President of CGD outlines three key problem areas that require coordinated global action: (1) reversing decades of underinvestment in global health security, (2) ensuring the continuity of developmental programs, and (3) expanding funding for these programs to reflect the disproportionate impact of the looming economic crisis on vulnerable populations.

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Countries will meet for the 75th UN General Assembly this coming week where they will adopt two resolutions on the Global Response to COVID-19. Acknowledging the key leadership role of the WHO and the UN system more broadly, the all-encompassing resolutions call for intensified international cooperation and solidarity to contain, mitigate and overcome the pandemic and its consequences through responses that are people-centred and gender-responsive, with full respect for human rights. It also encourages countries to partner with relevant stakeholders in order to increase R&D funding for diagnostics, treatment and vaccines, leverage digital technologies, and strengthen scientific cooperation. The resolution moreover urges climate- and environment-sensitive approaches to drive the recovery, reflecting growing support and recognition within the UN of the importance of combatting the threat of climate change.

Two countries voted against the UN resolution in a break from multilateralism: the U.S. launching renewed attacks against China in rejecting the expressions of support for the WHO, while Israel objected to an amendment that discouraged countries from enacting unilateral sanctions on states that were not in accordance with international law. The last-minute amendment was introduced by Cuba and supported by 84 countries, claiming the original text failed to reflect concerns on national efforts to deal with the COVID-19 crisis.

In a second resolution that was adopted unanimously, the UN General Assembly called for intensified international cooperation and multilateral efforts in addressing current and future disease outbreaks. That includes sharing timely, accurate and transparent information, exchanging epidemiological and clinical data, sharing materials necessary for R&D, and implementing relevant guidance, including the International Health Regulations. The resolution also stressed the importance of expanding global efforts to fight health crises in order to maintain economic stability by supporting economies, protect workers and businesses as well as shielding the vulnerable through adequate social protection.

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The WHO Weekly Epidemiological Update reported that the pandemic has surpassed 30 million confirmed cases, and that the number of confirmed COVID-19-related deaths approach one million globally. Many regions are reporting a resurgence in cases, as countries experiment with different strategies for reopening schools and businesses, as the International Monetary Fund last month estimated the pandemic is costing the global economy US$375 billion a month.

With more than 15 million confirmed cases, the region of the Americas represents over half the global burden of the pandemic. The U.S. and Brazil remain among the top three countries, while Venezuela is approaching a humanitarian catastrophe as outbreaks in the capital have exacerbated existing food shortages and economic crisis. Public health experts are also warning that the virus is spreading from major cities to less populated areas of Latin America where health systems are weaker. A quarter of the countries in the region have suspended routine vaccination, at least 25 countries have suspended primary care programs for diabetes and hypertension – notable risk factors for COVID-19 – while pregnancy-related health services have dropped by nearly 40% in the region. The WHO Director for the Americas region urged countries to sustain essential health services, as well as scaling up alternative approaches such as telemedicine, home visits, and community outreach.

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  • Over 150 efforts are currently underway around the world to develop COVID-19 vaccines and therapeutics, according to the WHO, with 23 vaccine candidates currently in human trials. Most of these studies are in Phase 1 trials that typically include a small number of healthy people where the goal is to determine safety and whether an immune response is observed. A small number of Phase 2 trials are also underway that include a larger and more diverse population, while none of the vaccine candidates have entered Phase 3 trials that focus on balancing efficacy (i.e. vaccine dosage to elicit immune response against SARS-Cov-2) and safety (i.e. minimizing adverse side effects). A number of papers over the past week reported on promising developments in three leading vaccine trials currently underway in the U.S., the U.K. and China.
  • A paper in the New England Journal of Medicine last week shows encouraging interim results for Moderna’s mRNA-1273 that targets the “spike” protein used by SARS-Cov-2 to enter cells. The Phase 1 clinical trials conducted by the U.S. National Institutes of Health confirmed that 45 health adults who received two doses of the vaccine 28 days apart had higher levels of antibodies than those who had recovered from being infected by COVID-19 (with the peak in antibody production coming only after the second dose). Moderna will begin Phase 2 trials on July 27, while mRNA-1273 is also expected to be the first vaccine candidate to enter Phase 3 efficacy trials later this year, with efforts underway to recruit over 30,000 people.
  • The Lancet this week also published encouraging results for another leading vaccine candidate from the U.K., AZD1222, developed by Oxford University and AstraZeneca. The interim findings show the vaccine continues to induce antibody and T-Cell immune responses up to day 56 of the ongoing Phase 1/2 trials that involve 1,077 health adults. A sub-group study of 10 patients receiving a second dose showed an even greater immune response to SARS-Cov-2. While no major adverse events were observed, 60% of patients did report mild side effects (fever, headaches, muscle aches, and injection site reactions) compared to the control group, a meningitis vaccine. AZD1222 is expected to advance to Phase 2 trials this month of a diverse patient population.
  • A research team from China also published results in the Lancet this week on Phase 2 trials for a vaccine candidate developed by CanSino. The latest findings validate previous Phase 1 data that show the vaccine induces an immune response to SARS-Cov-2, but that the neutralizing antibody response is not as strong in some key demographics, including people over the age of 55.
  • While these early results are promising, Merck’s CEO in the Harvard Business Review claimed it would be a “great disservice” to raise hopes that a vaccine would be available to the public by the end of the year. Novel vaccines often take years or decades to develop, due to established research protocols to ensure safety and efficacy. Vaccines also present unique manufacturing and distribution challenges that often limit production capacity while requiring complex logistical efforts. This is further strained by the global demand for a COVID-19 vaccine, as civil society groups have urged the international community to establish vaccine distribution agreements to prevent hoarding by wealthier countries.
  • The WHOhas confirmed that 165 countries representing 60% of the world’s population have engaged in COVAX, the COVID-19 vaccine global access facility that is designed to promote rapid, fair and equitable access. As part of the mechanism, 75 countries would finance the vaccines using domestic budgets, while partnering with up to 90 lower income countries that would be supported through voluntary donations to the COVAX Advance Market Commitment coordinated by GAVI. Other regions like PAHO announced parallel pooled procurement plans to ensure countries receive vaccines at subsidized, affordable prices.
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Last week, the Global Pandemic Monitoring Board published its second annual report calling for multilateral systems to strengthen global pandemic preparedness and response capacity. The independent body, convened by the WHO and the World Bank, noted that the COVID-19 pandemic has been exacerbated by a “failure of governance in global collective action, including coordination and engagement with multilateral systems” as well as financing gaps in global health security, including “chronic underinvestment in preparedness as well as states withdrawing financial support.”

The report calls for a re-centering of governance across multilateral systems, including in the following areas: (a) global and regional mechanisms to track pathogens, (b) strengthen early warning and information sharing, (c) intermediate grading of health emergencies, (d) evidence-based policy formulation on travel and trade restrictions, (e) collaborative mechanisms for research and regulatory harmonization, as well as (f) strengthening IHR compliance assessment and enforcement mechanisms.

Global health security presents distinct challenges in low- and middle-income countries, according to the Centre for Global Development, requiring policy restructuring to ensure development gains. In the article, the President of CGD outlines three key problem areas that require coordinated global action: (1) reversing decades of underinvestment in global health security, (2) ensuring the continuity of developmental programs, and (3) expanding funding for these programs to reflect the disproportionate impact of the looming economic crisis on vulnerable populations.

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