by Charlotte Kilpatrick | Oct 24, 2024 | Global Health |
In October 2024 the International Finance Facility for Immunisation (IFFIm) priced a US$1 billion, 3-year fixed-rate bond to fund “critical vaccine research and immunisation programmes”. This is IFFIm’s largest single benchmark transaction in the primary market since its inaugural benchmark in 2006, with proceeds supporting Gavi and CEPI. The bond will mature on 29th October 2027 and carries a semi-annual coupon of 4.125% and a semi-annual re-offer yield of 4.222%.
“The success of this bond highlights the ongoing strength of IFFIm’s model, which leverages sovereign support and strong financial structuring to offer investment opportunities that make a positive impact on children’s health.”
The order book was IFFIm’s largest to date, exceeding US$4 billion. The bond drew interest from a diverse group of investors with geographic spread.
Support for vaccine programmes
IFFIm is an “important flexible tool” for organisations like Gavi; since 2006 it has provided Gavi with US$5.8 billion in financing, one sixth of its overall budget. It has been “critical” in enabling Gavi’s recent emergency responses as well as routine immunisation and health system resilience efforts. Dr Sania Nishtar, CEO of Gavi, reflected that IFFIm has been a “groundbreaking and indispensable tool”.
“Today’s bond issue provides us with vital flexibility in our mission to protect millions of children from preventable diseases and to protect our world from the threat of future pandemics.”
As Gavi nears the end of the 2021-2025 strategic period and prepares for the next phase, IFFIm states that the bond issue will play a “pivotal role” in supporting life-saving programmes.
IFFIm has also provided approximately US$272 million in past financing to CEPI in support of the research and development of new vaccines. Dr Richard Hatchett, CEO of CEPI, acknowledged the “serious threat to global health security” presented by epidemics and pandemics. He commented that these can be “mitigated through investment in vaccine R&D and manufacturing”.
“The IFFIm financing mechanism enables CEPI to access the critical funding it needs to accelerate the development of vaccines against emerging infectious disease threats, for the benefit of all.”
Offering opportunities
IFFIm Board Chair Ken Lay believes that the latest issue “highlights IFFIm’s unparalleled strengths”; it is “backed by sovereign donors, driven by a vital global mission, and structured to maximise impact”.
“IFFIm’s bonds continue to offer investors compelling opportunities to earn competitive returns with good secondary market liquidity and assured use of proceeds.”
Jorge Familiar, Vice President and Treasurer, World Bank commented that capital markets are a “powerful tool for connecting private investment with global public goods”.
“As IFFIm’s Treasury Manager, the World Bank is pleased to support IFFIm in accessing capital markets to provide a long-term and flexible funding source to Gavi to accelerate access to vaccines and vaccine development.”
Head of SSA and EMEA IG Syndicate, BofA Securities Adrien de Naurois congratulated the IFFIm team on a successful return to the USD market.
“Today’s transaction, the first USD benchmark in two years, is a clear demonstration of IFFIm’s loyal and diverse investor base, attracted by the importance of its mission to deliver immunisation programmes to those most vulnerable via the ongoing work of Gavi.”
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by Charlotte Kilpatrick | Oct 17, 2024 | Global Health |
A study in The Lancet Global Health estimates the impact that the 100 Days Mission could have had on the COVID-19 pandemic. The authors find that the implementation of non-pharmaceutical interventions (NPIs) within the 100 Days Mission could have averted around 8.33 million deaths, corresponding to a monetary saving of US$14.35 trillion. Investment in manufacturing and health systems contribute an increase to 11.01 million deaths averted. The researchers comment on the value of the 100 Days Mission but emphasise the importance of “prioritising a more equitable global vaccine distribution”.
In search of greater vaccine benefits
Although COVID-19 vaccines are estimated to have prevented almost 20 million deaths, the authors demand a better understanding of the “further health and economic benefits that could have been achieved” through shorter development times and “improved global equity in pandemic preparedness”. CEPI’s 100 Days Mission was proposed in 2021, establishing the ambition of cutting vaccine development time for new pathogens to 100 days. This about a third of the time taken to deliver the first COVID-19 vaccine.
“The availability of COVID-19 vaccines within 100 days would have substantially changed the pandemic; however, these benefits would be finite without enabling equitable access to vaccine products through system equity.”
Various efforts to encourage global vaccine distribution were “hampered” by inequities, and it is recognised that manufacturing capacity should be “expanded but also diversified” to “promote self-sufficiency and regional resilience”. Furthermore, supply chains and infrastructure must be scaled to enable the delivery of vaccines that rely on cold-chain infrastructure.
The study
The searchers hoped to quantify the potential impact of the 100 Days Mission by retrospectively estimating the effect it would have had on the COVID-19 pandemic, thus offering evidence to support decision making around future investments in research and development capabilities. They also aimed to quantify the impact of “additional investments”.
The analyses use an extended version of a previously published compartmental susceptible-exposed-infectious-recovered transmission model of COVID-19 vaccination with an explicit healthcare pathway. The vaccination pathway was expanded to include booster vaccination alongside waning efficacy, capturing the “restoration of immunity” through booster doses. The new vaccination pathway was parameterised to match platform-specific vaccine efficacy data and the duration of protection.
The authors modelled the impact of the 100 Days Mission by simulating a counterfactual scenario where the global vaccination campaign began on 20th April 2020, 100 days after the publication of the full SARS-CoV-2 genome. This scenario assumes that vaccinations in each country took the same roll-out process, but 232 days earlier. Two additional scenarios reflected “increased investment” in research and delivery infrastructure.
The Manufacturing scenario removed supply constraints, enabling the rollout of vaccination on 20th April 2020 in every country, without stockouts. The infrastructure-equity scenario enhanced both national health systems and global distribution networks so that all countries achieved 40% vaccine coverage in the first year and 40% booster coverage in the second year.
To account for the relaxing of non-pharmaceutical interventions (NPIs), the authors simulated three scenarios for NPI relaxation speeds as vaccination coverage improved. The History scenario assumed no changes, whereas the Target and Economic scenarios assumed earlier relaxing; the Target scenario lifted all restrictions over two months after reaching more than 80% adult coverage in high-income countries or more than 80% coverage in those older than 60 in other countries. The Economic scenario lifted NPIs more gradually after reaching the over-60 target, prioritising the reopening of schools.
Study findings
The results suggest that the 100 Days Mission could have averted an additional 8.33 million deaths due to COVID-19 by the end of 2021 when combined with the History NPI lifting scenario. In this scenario, an estimated 26.72 million severe cases of COVID-19 requiring hospitalisation and 1/44 billion infections would have been averted. Most of these averted deaths, hospitalisations, and infections would have occurred in low- and middle-income countries (LMICs).
The estimated VSLs (value of a statistical life) that could have been saved by the 100 Days Mission through the History scenario is US$22.61 trillion globally. As VSLs are “significantly higher” in HICs, 57% of the global value of statistical life averted occurred in HICs, even though most deaths would have been averted in LMICs. To estimate the monetary values associated with lives saved the authors multiplied the number of lives saved by the country-specific monetary VSL and by the value of a statistical life-year (VSLY).
“Increased investment in both global manufacturing and health systems infrastructure further increases the number of deaths that could be averted and the associated health-economic savings.”
In the 100 Days Mission with both manufacturing and health systems investments, an estimated 11.01 million deaths could have been averted and a value of $31.29 trillion in statistical lives saved. However, the authors describe this scenario as “unlikely”. In all scenarios involving the relaxing of NPIs thanks to earlier availability of vaccines, additional lives would have been saved.
In the Target NPI lifting scenario, an estimated 5.76 million deaths (100 Days Mission alone) to 9.20 million deaths (100 Days Mission with both manufacturing and infrastructure investments) could have been averted. In these scenarios, 12,600 and 23,900 fewer days of NPIs would have been implemented globally: 70 days and 133 days on average per country. Under the Economic scenario there were “similar trade-offs between public health and economic gains”. The public health and health economic outcomes would be greater than under the Target scenario, but still lower than the History scenarios.
Substantial benefits
“Earlier access to COVID-19 vaccines could have had substantial benefits.”
Most of the estimated averted deaths would have been concentrated in LMICs, but this demands investments in vaccine research, supported by “improvements to manufacturing and health system infrastructures”. With these investments, the authors estimate that 11 million deaths could have been prevented globally.
Although NPIs were effective at reducing transmission they incurred “significant economic and societal costs”, including consequences for education. Therefore, a major benefit of earlier access to vaccination is the reduction in school closures; in the Economic scenario, prioritising school opening could have averted 1,120 weeks of full school closures and 2,490 of partial school closures. This represents an average of 6 weeks of fully open schools and 14 weeks of partly open schools per country.
“Reopening schools and relaxing NPIs safely will crucially require scaling up both vaccine delivery infrastructure and manufacturing. Without addressing both aspects, advancements in vaccine development speed might not translate into equitable benefits globally.”
The results emphasise the importance of investments in support of the 100 Days Mission in controlling a future potential pandemic, with benefits for both health and economy.
“The 100 Days Mission is ambitious, requiring global innovation through creating vaccine libraries, clinical trial networks, accelerated immune response marker identification, rapid vaccine manufacturing, and strengthened global disease surveillance.”
CEO of CEPI, Dr Richard Hatchett, hopes that this research will encourage global commitment to the 100 Days Mission.
“This work shows in the starkest terms why the world needs to be prepared to move faster and more equitably when novel pandemic disease threats emerge. Investing in preparedness now to make the 100 Days Mission possible for future incipient pandemics will save millions upon millions of lives and protect the global economy against catastrophic losses.”
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by Charlotte Kilpatrick | Oct 16, 2024 | Global Health |
In October 2024, parliamentarians from across the world met at the UNITE Global Summit in Berlin to sign a statement in support of the WHO Pandemic Agreement. The statement was described by WHO as a “significant commitment” to “strengthen pandemic preparedness, response, and equitable access to health”. The Summit was held in collaboration with the World Health Summit (WHS), drawing global parliamentarians, civil society leaders, and health experts to “translate discussions into actionable policy priorities”.
Building trust for a healthier world
The World Health Summit 2024 was held under the theme “building trust for a healthier world”, focussing on inspiring “innovative solutions for better health and well-being for all”. The UNITE Global Summit agenda reflected key topics highlighted during WHS, divided into four pillars:
- Human rights and equitable access to health
- Global health architecture and security
- Strengthening of healthcare systems
- Sustainable financing for health
Support for the Pandemic Agreement
The Pandemic Agreement is under negotiation by WHO Member States as an attempt to address the “gaps” exposed by the COVID-19 pandemic and the threats presented by mpox and other disease outbreaks. It also seeks to “strengthen global collaboration pandemic prevention, preparedness, and response”.
A critical moment during the summit was the signing of the Global Parliamentary Statement in Support of the Pandemic Agreement, which demonstrated the importance of parliamentarians in “ensuring global health security and safeguarding populations against future pandemics”. The statement emphasised their commitment to ensuring that “all countries, regardless of resources, have access to the tools, capacities, resources, and healthcare required” during a pandemic.
Dr Ricardo Baptista Leite, President of UNITE, commented that parliamentarians are the “voice of the people” and carry a “crucial responsibility in safeguarding public health”.
“The WHO Pandemic Agreement represents a historic opportunity to prevent pandemics and strengthen our global preparedness and response capabilities. By signing this statement, we are not only showing our support for the agreement but also pledging to ensure that its principles of equity, solidarity, and global cooperation are fully realised in every nation.”
WHO Director-General Dr Tedros Adhanom Ghebreyesus welcomed the support for the “once-in-a-generation opportunity to build a stronger, fairer, and more prepared global health system”.
“By signing this statement, parliamentarians from around the world are showing their commitment to protecting lives from future pandemics and ensuring equitable access to vaccines, treatments, diagnostics, and other health tools for every country, particularly those with fewer resources.”
Key commitments
The Global Parliamentary Statement emphasises four “key commitments”:
- Equity at the core – ensuring equitable access to pandemic-related health tools based on public health need for everyone, especially countries with fewer resources
- Global solidarity – strengthening international cooperation to build resilient health systems that can prevent and respond to pandemics
- Legislative action – advocating for the ratification and implementation of the Pandemic Agreement within national legislatures, as appropriate
- Combating misinformation – providing communities with evidence-based health information to counter the spread of harmful misinformation
Dr Baptista Leite reflected that “the challenges we face today demand a global response”.
“No single country can prevent or combat pandemics alone. The WHO Pandemic Agreement is an essential step forward in ensuring that every nation has the tools, resources, and capabilities to respond to future health threats.”
More work to be done
WHO states that the Pandemic Agreement “needs to continue to garner broad international support”. Within the latest commitment, parliamentarians are to work with WHO and other international organisations to ensure the Pandemic Agreement is implemented in a way that “benefits all countries”, particularly those with “limited resources”.
“The statement signed in Berlin is expected to act as a catalyst for global parliamentary action, fostering collaboration and solidarity among nations.”
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by Charlotte Kilpatrick | Oct 10, 2024 | Global Health |
In October 2024, WHO announced an agreement with the International Monetary Fund (IMF) and the World Bank Group (WBG) on “broad principles for cooperation on pandemic preparedness”. The cooperation is intended to enable scaling up of support to countries to prevent, detect, and respond to public health threats through the IMF’s Resilience and Sustainably Trust (RST), WBG’s financial and technical support, and WHO’s technical expertise and in-country capabilities. The organisations will “leverage their experience to enhance pandemic preparedness”, working on the “synergies and complementarity” of each institution’s in-country analysis and operations.
Principles of coordination
Under the Broad Principles of Coordination:
- WHO and the WBG will continue to lead on health-related development policies and, with other multilateral development banks and The Pandemic Fund, on specific project investments for pandemic preparedness. RST financing will not be earmarked for specific projects.
- Pandemic preparedness policy reform measures supported by RSF arrangements will be informed by existing data, analytics, and operational engagement of WHO, the WBG, and country authorities.
- Pandemic preparedness reforms will build on each institution’s area of expertise. RSF programmes will focus on macro-critical policy reforms within the IMF’s expertise and complement the work carried out by the WBG and WHO to maximise both the financial resources and technical expertise available to countries. RSF Reform measures can include policy actions aimed at enhancing the readiness of finance and health systems to respond effectively to future health emergencies.
The cooperation will enable all three institutions to better serve countries’ efforts on pandemic preparedness.
Working for a safer world
Kristalina Georgieva, Managing Director of the IMF commented that the “stepped-up collaboration” will help the organisations to “complement and leverage each other’s expertise” to support members’ pandemic preparedness and resilience efforts.
“The IMF’s Resilience and Sustainability Trust allows eligible member countries to access affordable, long-term financing to address structural challenges that threaten their macroeconomic stability.”
WHO Director-General Dr Tedros Adhanom Ghebreyesus reflected on the need for “new sources of financing to bolster health systems”, making them “more able to prevent and detect” health threats and to “respond and withstand them when they strike”.
“WHO is proud to be working with the IMF and the World Bank to unlock financing from the Resilience and Sustainability Trust, and support countries to put it to work for a safe world.”
World Bank Group President Ajay Banga suggested that the “deepened collaboration” will focus efforts to help countries prepare for and respond to health threats.
“We must aggressively be planning and preparing for the next global health crisis, so that when the battle comes – and we know it will – we will have the health workforce that can be rapidly deployed in the face of a crisis, laboratories that can quickly ramp up testing, and surge capacity that can be called upon to respond.”
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by Charlotte Kilpatrick | Oct 7, 2024 | Global Health |
Gavi shared the 2023 Annual Progress Report in October 2024, highlighting that more than 1.3 million future deaths were averted in 2023 through Gavi-supported vaccination programmes. The report details progress on strategic goals and reveals that the number of children protected with routine childhood vaccines since 2000 has exceeded 1.1 billion. These milestones also have economic benefits for Gavi-supported countries; the report suggests that this totals US$ 52 billion since 2021.
Chair of the Gavi Board, José Manuel Barroso, emphasised the importance of vaccinating children and vulnerable populations.
“We not only enable millions of people to lead healthier, more fulfilled lives [but we also] contribute to families’ prosperity, to strong and more stable communities, and to economic development that is already translating into countries’ paying more towards their immunisation programmes than ever before.”
Dr Sania Nishtar, Gavi’s CEO, commented that many Gavi countries are “on the front line of climate change, with many vulnerable to economic instability and geopolitical tension”.
“For them to be able to immunise more children, not to mention expand important programmes such as HPV, deserves recognition. Fully funding Gavi for its next five-year period will be crucial in expanding these hard-won gains and helping countries further along the pathway to fully sustaining their own immunisation programmes.”
Indicators and goals
Gavi partners and countries are “on track” to achieve most of the six mission indicators of the 2021-2025 strategic period:
- Under-five mortality rate
- Future deaths averted with Gavi support
- Future DALYs averted
- Reduction in number of zero-dose children
- Unique children immunised through routine immunisation with Gavi support
- Economic benefits generated through Gavi-supported immunisations
The mission is supported by four strategic goals
- Introduce and scale up vaccines
- Strengthen health systems to increase equity in immunisation
- Improve sustainability of immunisation programmes
- Ensure healthy markets for vaccines and related products
Vaccines
National Immunisation Coverage estimates in July 2024 confirmed that Gavi is on track in reaching children with new vaccines but must increase efforts to reach zero-dose and under-immunised children. At the end of 2023, Gavi had helped countries reach more than 1.1 billion children with routine immunisations since 2000. This means that the Investment Opportunity 2021-2025 commitment was achieved two years early. Gavi-supported countries completed a total of 13 routine introductions, taking the total introductions from 2021-2023 to 42.
Coverage of the third dose of diphtheria, tetanus, and pertussis-containing vaccine (DTP3) in 57 lower-income Gavi-supported countries remained “stable” at 80%. Apart from the pentavalent vaccine, Gavi-supported vaccines had higher coverage in 2023 than before the pandemic in 2019. After the opening of the support window for the second dose of inactivated polio vaccine (IPV2) in 2021, overall coverage in Gavi-supported countries increased rapidly to 27% by the end of 2023. The revitalisation of the HPV vaccine programme had “significant” effects: countries fully immunised more than 14 million girls with Gavi support in 2023.
Gavi’s vaccine portfolio has “grown significantly” over time; Gavi now supports vaccines against 20 infectious diseases through 53 product presentations.
Strategy indicators
Breadth of protection: In 2023 the 57 Gavi-supported countries (Gavi57) increased breadth of protection by 3 percentage points to 56%, against an implied target of 60% by 2025.
Coverage: Across the four vaccines included in the Sustainable Development Goal (SDG) indicator 3.b.1, the third dose of pneumococcal conjugate vaccine (PCV3) and the last dose in the schedule of human papillomavirus vaccine (HPVC) were trending higher in 2023 than originally projected. However, coverage of the second dose of measles-containing vaccine (MCV2) was “slightly behind but improving” and coverage of the third dose of DTP3 is “off track”.
Rate of scale up of new vaccines: Coverage of three vaccines (yellow fever: 97%, PCV: 93%, and rotaC: 93%) exceeded the benchmark. RotaC recovered from 2022 supply disruptions. Coverage of MCV2 remained under the 90% relative coverage target.
Introductions: 13 new routine introductions took place in 2023 against a milestone of 21. The cumulative total for introductions in 2021-2023 is 42, just “moderately delayed” against the target of 82 by 2025.
Country prioritisation: Gavi Secretariat considered if funding applications presented the three criteria (disease burden, effectiveness of vaccination, accounting for budget to meet requirements for vaccine procurement and sustain immunisation levels after transition from Gavi support). 93% of applications considered disease burden and increase in budget needed; 76% considered effectiveness of vaccination. 41 applications were reviewed from 2021 to 2023, increasing as countries submitted malaria vaccine applications.
Measles: 75% of children aged under five who were previously unvaccinated against measles received an MCV dose among countries conducting a Gavi-supported preventing MCV campaign.
Timely detection and response: Detection and response challenges, including “suboptimal surveillance” and lack of “robust” preparedness plans and locally available resources “persisted” in 2023. However, 5 out of 28 Gavi-supported outbreak responses with timeliness data met the disease-specific timeliness threshold in 2023. Measles-containing and yellow fever vaccines achieved higher rates of timely response than cholera, Ebola, and meningitis vaccines.
The future
Commenting on the progress presented in the report, UNICEF Executive Director Catherine Russell affirmed that “no child should die from vaccine-preventable diseases”.
“Through Gavi, the Vaccine Alliance we continue to bridge the gap between life-saving vaccines and the children who need them.”
To achieve the goals of the next strategic period, 2026-2030, Gavi needs to meet the funding target of US$9 billion. This will enable the organisation to expand protection against more diseases, ensure that the most vulnerable populations are “not left behind”, and protect the world against disease outbreaks. WHO Director-General Dr Tedros Adhanom Ghebreyesus stated that “vaccines are among the most powerful inventions in history”.
“With continued and increased investment in Gavi, we can harness their power, saving millions of lives in the coming decades.”
How do you think Gavi can continue to make immunisation progress into its next strategic period? What are the key challenges it faces? For more on the biggest vaccine challenges and opportunities to overcome them, join us at the Congress in Barcelona this month or subscribe to our weekly newsletters here.
by Charlotte Kilpatrick | Oct 3, 2024 | Global Health |
WHO announced in October 2024 that it is launching the Global Strategic Preparedness, Readiness, and Response Plan (SPRP) to tackle dengue and other Aedes-borne arboviruses. The Plan is intended to reduce the burden of disease, suffering, and deaths from dengue and other Aedes-borne arboviral diseases, like Zika and chikungunya, by “fostering a global coordinated response”. It presents priority actions to control transmission and offers recommendations to affected countries across various sectors. With five “key components”, the Plan is to be implemented over one year until September 2025, demanding US$ 55 million.
“The SPRP is a call to action for all stakeholders – from government agencies and health-care providers to communities and individuals – to join forces in the fight against dengue and other Aedes-borne arboviruses, through innovation, new technologies, and improved vector control strategies.”
Turning the tide
In the foreword by WHO Director-General Dr Tedros Adhanom Ghebreyesus we learn that dengue has “afflicted humanity for centuries, and possibly longer”; the first report of a clinically compatible case is recorded in a Chinese medical encyclopaedia in 992. From a much more contemporary perspective, dengue has spread “rapidly” in the past 20 years, enabled by “increased global travel and the effects of climate change”. Between 2000 and 2019, WHO documented a “tenfold surge” in reported cases, to 5.2 million. Since then, the surge has continued; over 12.3 million cases were reported by the end of August 2024.
The global prevalence and effects of arboviruses like dengue are a “significant threat to public health”, particularly in tropical areas where they are endemic. Addressing this threat demands a “concerted, strategic, and informed response”, which the Director-General hopes to achieve with the SPRP, a “comprehensive plan” to outline ways of controlling Aedes-borne arbovirus transmission in affected countries.
“Our multifaceted approach emphasises integrated surveillance, laboratory diagnosis, vector control, community engagement, clinical management, and research and development.”
This approach should reduce the burden of disease, save lives, and minimise the socioeconomic consequences of these diseases. Furthermore, the Plan includes measures for “safe programming” to ensure interventions are “secure and do not exacerbate the risk” for those who are already vulnerable to disease or those involved in responding to the crisis. Dr Tedros states that prevention and control is a “shared responsibility”.
“Together, we can turn the tide against this disease, protect vulnerable populations, and pave the way for a healthier future.”
Understanding the threat
Dengue is a challenge across all of WHO’s regions, endemic in more than 100 countries. Various factors, such as unplanned urbanisation and the effects of climate change, fuel the spread of dengue and other Aedes-borne arboviruses, such as Zika and chikungunya, putting more than four billion people at risk. The growing threat must be addressed with a “robust and dynamic strategy” that accounts for the current global epidemiological landscape. This is complicated by the “still developing” global surveillance system.
Transmission drivers like the effects of climate change and population growth can explain the increase of these infections in some areas, but they also point to the need for a multisectoral approach to prevent and respond to outbreaks.
The Plan
The Plan is intended to “reduce the burden of disease and deaths from dengue and other Aedes-borne arbovirus diseases in all affected WHO regions”. The strategic objective is “to accelerate progress in preventing and controlling dengue and other Aedes-borne arboviral disease outbreaks worldwide”, with the following specific objectives:
- Strengthen global multisectoral coordination and collaboration among stakeholders and partners in preparedness, response, and resilience to dengue and other Aedes-borne arbovirus diseases
- Enhance the capacity of Member States in early detection, reporting, confirmation, and response to outbreaks of dengue and other Aedes-borne arboviruses
- Strengthen the capacity of Member States to implement effective vaccination and integrated vector management strategies for mitigating the transmission of dengue and other Aedes-borne arboviruses
The SPRP combines strategic interventions tailored to local contexts and leverages inter-stakeholder synergies to “confront the challenges” posed by these diseases and move closer to controlling them. The following “interconnected pillars” are included in the multidisciplinary approach:
- Leadership, coordination, planning, monitoring, and prevention of sexual misconduct
- Risk communication and community engagement (RCCE) and infodemic management
- Surveillance, case investigation, and contact tracing
- Travel, trade, and points of entry surveillance and control
- Laboratory and diagnostics
- Integrated vector management and WASH & IPC
- Clinical management and therapeutics
- Operational support and logistics
- Essential health services and systems
- Vaccination
- Research, innovation, and evidence
The 5Cs
The SPRP aligns with WHO’s 2023 Framework for Health Emergency Prevention, Preparedness, Response, and Resilience (HEPR) with a focus on five “core health emergency components”:
- Collaborative surveillance
- Strong national integrated disease, threat, and vulnerability surveillance,
- Effective diagnostics and laboratory capacity for pathogen and genomic surveillance
- Collaborative approaches for event detection, risk assessment, and response monitoring
- Community protection
- Community engagement, risk communication, and infodemic management
- Population and environmental public health interventions
- Multisectoral action for social and economic protection
- Access to countermeasures
- Fast tracked research and development
- Scalable manufacturing platforms
- Coordinated supply chains and emergency
- Emergency coordination
- Strengthened workforce capacity for health emergencies
- Strengthening health emergency preparedness, readiness, and resilience
- Health emergency alert and response coordination
- Safe and scalable care
- Scalable clinical care during emergencies
- Protection of health workers and patients
- Maintenance of essential health services
How do you think the SPRP can be effectively translated into specific contexts and implemented sustainably?
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by Charlotte Kilpatrick | Sep 30, 2024 | Global Health |
Gavi announced two major funding updates at the United Nations General Assembly High-level week 2024, revealing that it is making progress in its fundraising efforts for the upcoming strategic period. The first of these updates is that the European Commission has pledged funding for the first two years of Gavi 6.0, complementing “strong support” from Team Europe and contributing to Gavi’s goal of helping to protect 500 million more children around the world. Gavi also announced an expanded collaboration with the United States International Development Finance Corporation (DFC), focussed on donor liquidity.
European support
The President of the European Commission, Ursula von der Leyen, addressed a crowd at the Global Citizen Festival on Saturday 28th September, revealing a funding pledge of €260 million for 2026-2027 and promising more to follow. The funds will support Gavi’s 2030 ambition of providing protection to 500 million more children, strengthening immunisation systems, and boosting global health security by “increasing readiness to respond to disease outbreaks”.
Added to the money pledged so far by the United States, France, Spain, and others in June 2024, this pledge takes Gavi’s total for the next strategic period to US$2.7 billion. The target is at least US$9 billion, which would enable Gavi to protect more children against more diseases, faster, and protect the world from outbreaks of disease when they occur. The €260 million pledge is for the first two years of Gavi’s upcoming strategic cycle, which coincide with the last two years of the EU’s 2021-2027 Multiannual Financial Framework (MFF). The European Commission is expected to remain committed to a “high level of ambition in supporting Gavi” as it prepares for the next MFF.
President von der Leyen reflected that “a healthier world is a better world”, with vaccination “one of our best chances for this”.
“Right now, millions of children are still at risk. We must continue to support vaccination around the world to save lives. So today I am proud to pledge 260 million euros for Gavi, the Vaccine Alliance. And more will come.”
DFC collaboration
The DFC and Gavi will expand their partnership with a focus on donor liquidity. This builds on support established during COVID-19, with the US$1 billion Rapid Financing Facility allowing Gavi to access funds quickly in the event of new donor pledges for pandemic response or routine immunisation. The mechanism is also central to Gavi’s Day Zero Financing Facility.
Nisha Biswal, DFC Deputy CEO, recognised that “global health security is economic and national security”. DFC invests in healthcare services, supply chains, and technology to strengthen pandemic preparedness and health system resilience, including over US$3 billion in health-related projects to enable over 50 million patients access healthcare.
“With the new Surge Financing Initiative, the expanded Gavi liquidity facility, and investments in regional manufacturing, we will be able to do far more to expand access to life-saving healthcare products, especially during health emergencies.”
Still on track
Dr Sania Nishtar, CEO of Gavi, expressed gratitude to the European Commission, recognising President von der Leyen’s “leadership in advancing global health outcomes” and DFC.
“Thanks to the European Commission and DFC, we remain on track to meet our target of protecting people, communities, even our entire world through immunisation.”
For more on global health investments at the Congress in Barcelona next month, get your tickets to join us here. Don’t forget to subscribe to our weekly newsletters for the latest vaccine news.
by Charlotte Kilpatrick | Sep 26, 2024 | Global Health |
In September 2024 Africa CDC and IAVI announced the signing of a Memorandum of Understanding (MoU) to enhance the continent’s capacity to fight disease, pandemic readiness, and supply resilience. This will involve expanding capabilities for locally driven research, development, manufacturing, and supply of priority vaccines and antibodies as well as strengthening Africa CDC-led initiatives. The partnership will combine IAVI’s “expertise in vaccine and antibody development and access” and the “extensive network and Africa CDC”.
Initiatives under the MoU
The MoU is intended to tackle pressing public health challenges and promote long-term health security. Some of the key initiatives under the MoU include:
- Supporting the development of vaccines and antibodies for regional health priorities (like Lassa fever and HIV)
- Fostering a sustainable supply and demand ecosystem for priority products in the region (including monoclonal antibodies)
- Strengthening African research and development capacity
- Exploring regional stockpile strategies for licensed and investigational products to ensure rapid responses during health crises
The MoU exemplifies the “action-oriented partnerships” that Africa CDC’s New Public Health Order demands as the organisation drives its vision for “redefining global health architecture” and ensuring that Africa and the world are better prepared for future health threats. IAVI recognises the support of funders and partners, including Wellcome, CEPI, the European and Developing Countries Clinical Trials Partnership (EDCTP), the United States Agency for International Development (USAID) and the United States President’s Emergency Plan for AIDS Relief (PEPFAR) through the Accelerate the Development of Vaccines and New Technologies to Combat the AIDS Epidemic (ADVANCE) programme.
Dr Mark Feinberg, IAVI President and CEO, described the cooperation as a “key step” in IAVI’s mission to “improve global access to biomedical innovations and safeguard public health”.
“It goes beyond R&D; it’s about creating a vibrant health innovation ecosystem that meets current and future needs across Africa.”
We look forward to welcoming senior representatives of IAVI back to the Congress in Barcelona next month to learn more about the various efforts and initiatives they are enabling in pursuit of global health goals. Get your tickets to join us there and don’t forget to subscribe to our weekly newsletters here.
by Charlotte Kilpatrick | Sep 25, 2024 | Global Health |
At the United Nations General Assembly High-Level Week in September 2024, CEPI launched a new Biosecurity Strategy to bolster global health security and emphasise its commitment to addressing emerging epidemic threats. The strategy draws on the latest technologies and encourages international collaboration to mitigate the risks presented by emerging pathogens. This is a “significant step” in the “evolution” of CEPI, positioning it as a “though leader in the rapidly developing fields of biosafety and biosecurity”. Chair of CEPI’s Board, Professor Jane Halton, positioned the 100 Days Mission at the centre of this strategy and highlighted the significance of “security and equity” in this effort.
“To underpin that strategy, and to ensure the world can achieve the 100 Days Mission goal safely and securely, we need a robust, collaborative approach to maximising the benefits of new technologies and reducing their potential threats to human health.”
Remaining vigilant and stepping up
Dr Richard Hatchett, CEO of CEPI, writes in the foreword of the importance of remaining “vigilant” and being able to respond quickly to infectious disease outbreaks in an era of “heightened epidemic and pandemic risk”. He reflects that COVID-19 demonstrated the “devastating global consequences” of a pandemic and, through the “persistent controversy” over the origins of the pandemic, heightened awareness of the risk of accidental release and deliberate misuse of science.
“Most risk created by advances in the biological sciences derives from the fungibility of the tools designed to solve specific problems. The tools that will solve a pressing problem are empowering – but there is no intrinsic limit to their application.”
Dr Hatchett acknowledges the problem of “dual use” in the way that biologists tackle problems. However, he warns against imposing limits on scientists, suggesting that this could present “practical challenges” and “impede our progress towards legitimate and worthy goals”, among which is the 100 Days Mission.
“Global scientific participation is critical to the success of the 100 Days Mission and will enable vaccine research, development, and manufacturing to take place in communities that need it, led by those who will benefit from it, and informed by the priorities of the vulnerable communities that are disproportionately impacted by epidemics and pandemics.”
To address the risk of accidents or misuse, Dr Hatchett highlights the importance of mechanisms to “ensure that the highest, most current standards of biosecurity and biosafety are practiced and maintained”. CEPI’s “highly diverse” research portfolio includes more than 50 countries, each with “highly variable” oversight practices. The need for a biosecurity strategy is directed by a recognition that “as a steward of global funds, no matter where those funds are deployed, we have a critical responsibility to ensure that the research we fund does not lead to the next accident or deliberate incident”.
‘Beyond this threshold obligation, CEPI also has an opportunity to step-up as a thought leader in this emerging area.”
In developing the strategy, CEPI engaged more than 150 entities in the global health and security ecosystems in a consultative process and sought advice from a Biosecurity Strategy Group. Although technological capabilities will evolve and “boundaries blur between disciplines”, the strategy anticipates that “traditional approaches” may prove “inadequate” in the face of emerging threats. Thus, stakeholders must collaborate and develop mechanisms to encourage responsible use, supported by CEPI.
Biosafety and biosecurity
The strategy acknowledges the evolution of the terms biosafety and biosecurity, comparing the WHO (2024) definition of biosecurity with FAO’s (2007) understanding of the term. CEPI’s biosecurity and biosafety priorities must align with its mission to accelerate vaccine development towards the 100 Days Mission. The strategy outlines how an “innovative approach…frontloaded towards preparedness”, can enable the safe and secure delivery of this goal.
Top vulnerabilities
Several biosecurity and biosafety vulnerabilities are identified and considered relevant to the strategy:
- Variable biosafety and biosecurity oversight, risk identification, and management practices among life science funders for research involving high consequence pathogens, including CEPI.
- Substantial variations in biosafety and biosecurity policies, regulations, practices, and competencies where CEPI-funded research takes place, and insufficient health and security collaboration.
- The intersection between biosecurity and equity is insufficiently recognised, which threatens progress towards the 100 Days Mission and future responses to epidemic and pandemic threats.
- Emerging biotechnology and converging technologies present dynamic and evolving biosecurity risks that threaten 100 Days Mission progress.
- The world is insufficiently harnessing technological innovation to reduce safety and security vulnerabilities of the 100 Days Mission.
Focus and priorities
CEPI’s biosecurity focus is to “protect society from epidemic and pandemic threats, with an emphasis on preventing accidental and deliberate misuse of pathogens associated with CEPI-sponsored research”. The strategy therefore addresses global biosecurity vulnerabilities to accelerate current strategic goals with the following priorities:
- Strengthen biosafety and biosecurity risk identification, mitigation, and oversight by CEPI and encourage similar efforts by other life science research funders.
- Enhance global biosafety and biosecurity capabilities of CEPI partners for achieving the 100 Days Mission safely and securely and promote health-security partnerships.
- Drive biosecurity and biosafety in support of equity.
- Monitor and reduce emerging biotechnology and converging technology risks across CEPI’s vaccine research, development, and manufacturing portfolio.
- Accelerate biosafety and biosecurity innovation for vaccine research, development, and manufacturing.
More to come
An implementation plan of activities, goals, and timelines will follow the strategy. It will explore how priorities can be integrated into the wider mission and mandate in three major categories:
- Catalysing strategic partnerships and coalitions
- Advocacy and coordination
- Supporting biosafety and biosecurity capabilities development
Director General of Africa CDC, Dr Jean Kaseya, expressed enthusiasm at the strategy launch and its support of Africa CDC’s efforts.
“With a focus on laboratory systems strengthening, training and infrastructure development, and reducing risks of artificial intelligence and other innovations, the strategy is informed by vulnerabilities across a wide range of resource settings and will help galvanise global progress toward safely and securely achieving the 100 Days Mission.”
Trevor Smith, Deputy Director at Global Affairs Canada and member of the CEPI Biosecurity Strategy Group, welcomed the focus on “effective collaboration between the health and security sectors”.
“The strategy articulates an ambitious vision for reducing vulnerabilities and strengthening global health security.”
For insights from senior representatives of CEPI at the Congress in Barcelona next month, get your tickets to join us here. Don’t forget to subscribe to our weekly newsletters here.
by Charlotte Kilpatrick | Sep 17, 2024 | Technology |
Albert Einstein College of Medicine announced receipt of a five-year grant worth $14 million a year from the National Institute of Allergy and Infectious Diseases (NIAID). The grant is part of NIAID’s ReVAMPP (Research and Development of Vaccines and Monoclonal Antibodies for Pandemic Preparedness) Network. The funding will enable participation in a national effort to develop “plug-and-play” vaccines and antibody-based therapies against various emerging viruses. Albert Einstein College of Medicine will lead a consortium, called PROVIDENT (Prepositioning Optimised Strategies for Vaccines and Immunotherapies Against Diverse Emerging Infectious Threats).
PROVIDENT
The PROVIDENT consortium links 13 teams from academia, government, and industry on four projects to:
- Discover and analyse virus-host interactions and the molecular mechanisms involved in viral disease
- Design proteins to elicit antiviral immune responses and then evaluate and optimise those responses
- Create “road maps” for quick development of RNA vaccines against microbes with pandemic potential
- Map the antibody response observed in people infected with viruses for use in vaccine and therapeutic design
The project builds on NIAID’s 2021 Pandemic Preparedness Plan, which “leverages its broad research portfolio, long-standing expertise in product development, capacity to engage both domestic and international partners, and flexible infrastructure”. The plan addresses both “priority pathogens” and “prototype pathogens”.
Prototype pathogens will be PROVIDENT’s focus; these are “representative viruses” in families with potential to cause “significant human disease”. The research will concentrate on three virus families:
- Nairoviruses – transmitted by ticks
- Hantaviruses – borne by rodents and other small mammals
- Paramyxoviruses – borne by bats and other mammals
A sprint strategy
Dr Kartik Chandran, principal investigator on the grant, professor of microbiology and immunology, Gertrude and David Feinson Chair in Medicine, and Harold and Muriel Block Faculty Scholar in Virology, reflected on the importance of pandemic preparedness as revealed during COVID-19.
“One of the key lessons from the COVID pandemic is that having existing research on a viral family allows scientists to develop vaccines and therapeutics for a particular virus much more quickly. In our project, we plan to create a base of critical knowledge about a group of similar viruses and then – should a related ‘virus X’ pose a health threat – develop specific countermeasures as quickly as possible to save as many lives as possible.”
Dr Chandran explained that the researchers will select and study one or two prototype viruses from each family, developing countermeasures that will work against “as many viruses within that family as possible”.
“That strategy of quickly responding to an emerging virus with an approach and tools that have already been developed is what we mean by ‘plug and play’. A part of PROVIDENT’s strategy will be to carry out ‘sprints’ in which countermeasures that are developed for the prototype pathogens will be tested against other viruses in the same family to see how well they work and to improve them.”
The approach enabled faster development during the COVID-19 pandemic, and Dr Chandran emphasised the importance of coordinating efforts to “increase our odds of mounting a timely and effective response”. Dr Eva Mittler, research assistant professor and leader of a PROVIDENT component, warned that “we don’t know what virus will cause the next pandemic”.
“Recent outbreaks of mpox, Nipah virus, and Eastern equine encephalitis, among other viral infections, underscore the need for an even broader preparedness programme.”
To join your colleagues at the Congress in Barcelona next month and share perspectives on pandemic preparedness and innovative vaccine development, get your tickets now. Don’t forget to subscribe to our weekly newsletters here.
by Charlotte Kilpatrick | Sep 5, 2024 | Global Health |
In response to the mpox outbreak, declared a PHEIC by WHO and a PHECS by Africa CDC, the two organisations announced that they are co-leading a “coordinated, continent-wide response”. The Mpox Continental Preparedness and Response Plan for Africa describes “essential priorities” to control the current outbreak, focusing on ten pillars. The plan categorises Member States into four risk-based groups to ensure efforts and resource allocation are targeted. The estimated budget for September 2024 to February 2025, excluding the cost of vaccines, is US$599,153,498
Collective commitment
In the foreword by Africa CDC Director General Dr Jean Kaseya and WHO Africa Regional Director Dr Matshidiso Moeti, the declaration of mpox as a PHECS is described as a “bold move”. This was followed by WHO’s declaration, reflecting “alignment” and “collective commitment to raising awareness, mobilising resources, and galvanising action at all levels”. Drs Kaseya and Moeti state that current “battle” against mpox has been shaped by “hard-earned lessons” from the COVID-19 pandemic.
“The experience of COVID-19 exposed vulnerabilities in our health systems, showed Africa’s inequity and unfair treatment in terms of access to medical countermeasures, highlighted the urgent need for enhanced preparedness, and underscored the importance of swift, coordinated action in the face of emerging health threats.”
The “foundation” of the mpox response is built on lessons of “solidarity, resilience, and collaboration”.
4-ONE
A new approach is outlined: a “4-ONE APPROACH”:
- ONE coordination mechanism
- ONE continental response plan
- ONE budget
- ONE monitoring and evaluation mechanism
Africa CDC and WHO will lead efforts to implement the “unified approach” with global and continental stakeholders. The plan is a “roadmap” to facilitate a “coordinated, comprehensive, and evidence-based response” that puts the principles of “equity, inclusivity, and accountability” at the centre.
“As we move forward, we are guided by our strong commitment to protecting the health of all Africans, enhancing our collective resilience, and securing a healthier future for our continent. Together, we will overcome this challenge and build a stronger and resilient Africa.”
Mpox: then and now
Mpox was first described in the Democratic Republic of Congo (DRC) in 1970. It is a viral zoonotic illness that has caused “numerous outbreaks” since its identification. Although early outbreaks tended to be associated with zoonotic transmission from wildlife to humans, recent cases in urban settings have suggested changes in transmission dynamics.
“The emergence of zoonotic diseases is driven by complex ecological, climatic, political, economic, security, and social factors, some of which are becoming further exacerbated on the continent.”
However, the “warning signs” of local outbreaks are often “neglected” with “limited investigation, surveillance, diagnosis, and response”. Despite improvements in surveillance and reporting systems to enhance the understanding of mpox’s epidemiological patterns, “significant gaps” remain. Mpox virus has two variants: clade I and clade II. Clade I is geographically concentrated around the Central and Eastern Africa region and is considered “more virulent”; Clade II is found in Western Africa and other regions.
In the global outbreak of 2022-2023, the disease spread drew “renewed focus” on medical countermeasures. While many countries outside Africa were “quick to respond”, Africa faced “significant challenges in accessing these crucial tools”. Despite the high burden of mpox in several countries in Africa, access to vaccines and other medical countermeasures was inequitable.
“This lack of access was due to multiple factors, including limited global production capacity, unequal distribution agreements, and a lack of investment in public health infrastructure in Africa.”
Vaccines like JYNNEOS (MVA-BN) and ACAM2000 were widely authorised for emergency use but were “largely unavailable to African countries”. The authors of the plan attribute this to pre-existing contracts between manufacturers and high-income countries. Furthermore, logistical challenges exacerbated the disparity; “inadequate” cold chain storage facilities and distribution networks” created obstacles to the delivery of countermeasures.
“This inequity underscored the urgent need for Africa to develop self-reliance in manufacturing and distributing medical countermeasures to avoid similar scenarios.”
The current situation is concerning; reported cases are increasing in number across the continent. In comparison with 2022, there was a 79% increase in reported cases in 2023. By 3rd September 2024, confirmed cases have exceeded the number reported in 2023 by over 3,700. Furthermore, the recent outbreak has “dramatically” affect children under 15 years (60%). In 2024, 13 countries have reported cases, with a new subvariant of mpox clade I (clade Ib) identified since September 2023. This has been ‘widely circulating” among commercial sex workers and their sexual contacts.
While the increasing cases are worrying, the “true burden” is uncertain. Thus, the authors demand enhanced surveillance and detection. They also highlight the need for vaccination of both targeted and expanded priority population groups, particularly in the context of Africa’s “weaker surveillance systems and limited diagnostic capacity”.
“The Mpox Continental Preparedness and Response Plan for Africa (MCPRPA) seeks to build a stronger foundation for health security in Africa through a country-driven unified approach, prioritising prevention, enhancing immunity at community level, and promoting the continent’s self-reliance.”
Risk categories
The plan classifies African Union Member States according to their mpox status and risk level. The risk level is for “planning and resource optimisation”.
- Experiencing sustained human-to-human transmission: DRC, Burundi, Nigeria, South Africa, Côte d’Ivoire, Central Africa Republic
- Not already falling into category 1 but experiencing sporadic human cases since 1st January 2022 and/or countries that are assessed as having endemic zoonotic reservoirs for mpox: Rwanda, Kenya, Uganda, Sierra Leone, Libera, Ghana, Cameroon, Gabon, Republic of Congo, Morocco, Egypt, Benin, Mozambique, Sudan
- Not already falling into the first two categories that are assessed as requiring readiness including due to proximity to category 1 countries by land, air, or sea: Angola, Zambia, Eswatini, Lesotho, Ethiopia, South Sudan, Tanzania, Malawi, Republic of Guinea
- All other countries
Guiding principles
The plan relies on guiding principles from lessons learnt during the COVID-19 pandemic; the align with the 2023 Lusaka Agenda, which emphasises “strengthening joint approaches for achieving equity in health outcomes, operational coherence, and a coordinate approach to product development and research”.
- Country-driven: The plan focuses on mpox preparedness and response interventions based on priorities identified by affected countries to ensure that the response is tailored to the needs of each country.
- Science-driven: The strategic approaches and key interventions are grounded in the best available scientific evidence, ensuring that the response is effective and adaptive to the evolving understanding of the virus and its transmission.
- Equity and solidarity: Prioritisation of issues and resource allocation should be sensitive to the needs of the most affected regions/provinces, vulnerable groups, and countries most in need. This is supported by global solidarity, ensuring that medical countermeasures are made available to African Member States equitably.
- Unified: Align all partners around a single cohesive plan, ensuring that all stakeholders work toward common objectives, minimising duplication and maximising impact.
- Single collaboration mechanisms: Streamline efforts through coordinated leadership.
- Sustainability: Focus on developing sustainable, long-term solutions that can be scaled and maintained over time, ensuring that countries are better prepared for future outbreaks and that response efforts have a lasting impact.
10 pillars
The plan has 10 pillars, each with a strategic objective and actions.
- Coordination and leadership
- Strategic objective – establish one functional coordination mechanism with one team, one plan, one budget, and one monitoring and evaluation (M&E) framework at continental, national, and subnational levels.
- Actions – enhance harmonised coordination and collaboration between relevant stakeholders including resource mobilisation.
- Risk communication and community engagement (RCCE)
- Strategic objective – support and engage communities, particularly the most vulnerable members, so that they practice key public health recommendations and access the needed services to reduce transmission, morbidity, mortality, and secondary impacts.
- Actions – engage communities in public health response and ensure their perspective and realities drive the mpox response interventions.
- Surveillance
- Strategic objective – establish/enhance functional event-, community-based-, and cross-border mpox surveillance systems at continental, national, subnational levels.
- Actions – strengthen mpox surveillance through event/community-based surveillance, contact tracing, point of entry, and cross-border information sharing.
- Laboratory capacity
- Strategic objective – strengthen mpox laboratory testing and sequencing capacity to confirm at least 80% of suspected mpox cases and sequence at least 5% of epidemiologic and geographic representative confirmed mpox cases.
- Actions – strengthen laboratory testing for diagnostic and sequencing through training and provision of equipment and reagents.
- Case management
- Strategic objective – support comprehensive case management for mpox, including medical, nutritional, and psychosocial care, to reduce the case fatality rate to below 1% (0.5%).
- Actions – strengthen case management for mpox.
- Infection prevention and control
- Strategic objective – strengthen infection prevention and control measures at 80% of health facilities and schools in hotspots of mpox-affected and at-risk Member States to minimise the risk of mpox transmission.
- Actions – strengthen infection and prevention control measures at households, schools, health facilities, and communities.
- Vaccination
- Strategic objective – support the administration of mpox vaccination to 80% of the targeted population.
- Actions – vaccination of targeted and expanded high-risk population groups is a proactive measure to address the delayed responses that can occur due to weaker health systems, weaker surveillance systems, and limited diagnostic capacity. This would build population resilience, reduce the public health impact of mpox, and prevent healthcare systems from becoming overwhelmed. Mpox vaccination will be implemented in two phases. In the first phase, vaccines will be administered to the exposed group of contacts and the contacts of contacts and the expanded group of those at risk. In the second phase, consideration could be given for affected communities, depending on progress in epidemiology and vaccine availability.
- Research and innovation
- Strategic objective – coordinate and conduct mpox operational and clinical research across the continent to address critical knowledge gaps and support response efforts, and coordinate and enhance research and development (R&D) for the manufacturing of countermeasures to ensure rapid deployment during outbreaks.
- Operations support and logistics
- Strategic objective – provide robust operational support, ensuring the safety and security of response staff, maintaining key infrastructure and ensuring the efficient procurement and distribution of essential supplies.
- Actions – ensure robust support by developing standards for mpox supplies, coordinating demand forecasts, enhancing supply transparency and implementing fair allocation, strengthening logistics, and maintaining supply chain integrity for equitable distribution.
- Continuity of essential services
- Strategic objective – advocate for and support Member States to monitor the implementation of basic services ensuring continuity to avert loss of gains.
Budget
The plan also details “key resource requirements” for the first six months of operations. The estimates assume an initial case load of 2,000 cases per week, which increases to 4,000 cases per week in the first two months of operations. This is expected to continue through the fourth month, after which cases might decrease. The total estimated number of suspected cases is 92,000 over the first six months. Vaccine procurement costs are excluded from budget estimates as these depend on the outcome of “ongoing negotiations” with manufacturers.
The overall estimated budget for the six-month plan is US$599,153,498. Of this, 53% (US$315,311,463) are assigned to mpox outbreak response effort in the 13 affected Member States. 2% (US$14,000,000) will support the 15 high risk, non-affect Member States with emergency preparedness and 45% (US$269,842,035) will go toward partners’ operational and technical support.
Monitoring and evaluation
The monitoring and evaluation of the plan are centred on a results-based management approach, ensuring capture and analysis of key performance results information and dissemination for management decision-making, reporting, and stakeholder use.
- Input and output monitoring will be ensured through reporting tools developed by the incident management system (IMS). Periodic and ad-hoc joint support supervision visits will take place and internal review mechanisms will be used to ensure the correctness, completeness, and timeliness of monitoring data.
- The Continental incident management team (IMT) will conduct periodic evaluations of the plan.
- Data collection will be shared with the Continental IMT, which has the primary mandate for its monitoring.
Will this approach be sufficient to control the outbreak and establish mechanisms for future health threats on the continent? For expert insights into equitable vaccine development and deployment, get your tickets to join us at the Congress in Barcelona this October, and don’t forget to subscribe to our weekly newsletters here.
by Charlotte Kilpatrick | Aug 27, 2024 | Technology |
Tonix Pharmaceuticals announced in August 2024 that it is collaborating with Bilthoven Biologics (BBio) to advance TNX-801. TNX-801 is Tonix’s mpox vaccine candidate, a live replicating, attenuated virus vaccine based on horsepox. It has demonstrated better tolerability than 20th century vaccinia viruses in animal models, and preclinical studies have shown “positive” efficacy data.
TNX-801
Tonix’s TNX-801 is in preclinical development for the prevention of mpox and smallpox. In preclinical studies, Tonix found that TNX-801 vaccination protected non-human primates against lethal challenge, prevented clinical disease and lesions, and decreased shedding in the mouth and lungs. It is delivered percutaneously as a single dose, which could enable “higher rates of community protection”.
“TNX-801 has the potential to make a global impact on mpox and the risk of smallpox because of its durable T-cell immune response, the potential to manufacture at scale, and the use of a lower dose than non-replicating vaccines.”
Bolstering preparedness and response
Jurgen Kwik, Chief Executive Officer at Bilthoven Biologicals, believes that the current mpox outbreak “exemplifies precisely why we built the pandemic preparedness facility at BBio”.
“The establishment of the ‘ever-warm’ facility for pandemic preparedness underscores the critical importance of readiness in the face of global health emergencies, such as mpox. This collaboration encapsulates the essential role of the facility in bolstering pandemic preparedness and response capabilities.”
Dr Seth Lederman, Chief Executive Officer of Tonix Pharmaceuticals, looks forward to collaborating with BBio and “accelerating the development of our vaccine candidate to prevent mpox”. Dr Lederman believes that the single dose administration will “improve acceptance and eliminate partial vaccination” when compared to the current two-dose regimens.
“We believe TNX-801 can be rapidly scaled up for manufacturing and can be distributed and stored without a costly and cumbersome ultra-cold supply chain.”
Dr Lederman highlighted that the “worldwide availability of an affordable, safe, and effective single dose” vaccine against mpox is “essential given the pandemic potential of the disease”. Furthermore, successful development of TNX-801 would “establish the foundation” for potential expansion of the viral vector platform.
We look forward to learning more about this vaccine at the Congress in Barcelona this October; get your tickets to join us there and don’t forget to subscribe for more vaccine updates here.
by Charlotte Kilpatrick | Aug 27, 2024 | Global Health |
In August 2024 WHO launched a Global Strategic Preparedness and Response Plan (SPRP) to address the mpox public health emergency of international concern (PHEIC), declared on 14th August. The plan, subject to input from Member States, is intended to stop outbreaks of human-to-human transmission of mpox through “coordinated global, regional, and national efforts”. It covers the period September 2024 to February 2025 and is expected to involve a US$135 million funding need; WHO will follow with a funding appeal.
Outbreaks can be controlled
In the foreword, WHO Director-General Dr Tedros Adhanom Ghebreyesus states that the new mpox outbreaks “can be controlled” through “connected action”. The plan provides a “comprehensive approach” and emphasises “surveillance, research, equitable access to medical countermeasures, and community empowerment”.
“Our approach must uphold the principles of equity, global solidarity, community empowerment, human rights, and cross-sector coordination.”
Dr Tedros urges countries to use the plan to “guide their efforts” against the outbreak and “protecting the health and dignity of all”. The Executive Summary describes the need for “substantial resources” and “operational support” and calls for an estimated budget of US$135 million, excluding the cost of procuring around 2 million vaccine doses.
Temporary recommendations
In response to the “escalating” outbreak of different strains of mpox, a Public Health Emergency of International Concern (PHEIC) was declared on 14th August 2024.
“This declaration underscores the severity of the current situation and highlights the urgent need for intensified international collaboration to control the outbreak.”
The existing Standing Recommendations for mpox, issued in August 2023, were set to expire on 20th August 2024. However, the Emergency Committee proposed new Temporary Recommendations in the following areas:
- Strengthened coordination
- Enhanced surveillance and laboratory diagnostics
- Improved clinical care
- International traffic
- Vaccination
- Risk communication and community engagement
- Governance and financing
- Reporting
Strategic objectives
The mpox SPRP is intended to stop outbreaks of human-to-human transmission of mpox and “mitigate its impact on human health”. To achieve this, it sets out three strategic objectives:
- Rapidly detect and control outbreaks
- Advance research and ensure equitable access to medical countermeasures
- Minimise transmission between humans and animals
Vaccines to interrupt transmission
“Enhancing control strategies through strategic vaccination is crucial. Implementing targeted vaccination approaches can help reduce the spread of the virus by focusing on those at the highest risk of infection, thereby reducing overall transmission.”
The vaccination strategy prioritises individuals who are at “substantially higher risk of exposure”. Key considerations include:
- Access and delivery – the plan highlights an “urgent need” to increase access to and delivery of mpox vaccines, particularly in areas with active cases. WHO encourages countries with vaccine stockpiles to make doses available to affected regions and manufacturers to review access and pricing policies to ensure vaccines are affordable and accessible in low- and middle-income countries.
- Security and community engagement – effective strategies should consider the security challenges faced by vaccination teams and communities, especially in areas with “complex socio-political factors and ongoing conflicts”. WHO demands “strong community engagement and risk communication efforts”.
The plan proposes a phased vaccination strategy:
- Phase 1: Stop outbreaks. This phase is intended to interrupt known chains of transmission by targeting contacts of incident cases with onset in the previous 2-4 weeks and healthcare workers/frontline workers (HCWs/FLWs) in areas with active cases. This is a targeted approach that focuses on individuals most likely to transmit disease and uses fewer resources to efficiently reduce transmission by breaking chains of infection.
- Phase 2: Expand protection. This phase seeks to limit further spread in affected communities if additional doses are available. It targets individuals at high risk of severe disease – based on local epidemiology – in affected areas. This approach aims to provide broader community protection but does require additional doses, resources, and logistics.
- Phase 3: Protect for the future. The final phase focuses on increasing population immunity in areas at risk of outbreak expansion of future outbreaks. It targets all populations recommended by the Strategic Advisory Group of Experts on Immunisation (SAGE) as more doses become available. The goal is to achieve herd immunity to provide community-wide protection. Although it is resource-intensive, it is effective in reducing overall transmission.
The phased approach ensure that vaccination efforts are “prioritised and tailored to stopping the outbreak, guided by improved surveillance data, with the flexibility to scale up as vaccine availability increases”. The SPRP focuses on Phase 1 of the strategy.
The vaccine landscape
The SPRP presents a brief review of potential vaccine candidates under consideration:
- MVA-BN – A non-replicating vaccine, indicated for smallpox, and authorised in several countries for mpox prevention.
- LC16m8 – A minimally replicating vaccine, authorised in Japan for smallpox and mpox prevention.
- ACAM2000 – A replicating vaccine indicated for smallpox, with emergency use authorisation for mpox in the US.
Vaccines in preclinical studies include BNT166a and BNT166c; these are next-generation mRNA vaccines designed to provide “broad protection” against MPXV and related orthopoxviruses. These are showing “promising” preclinical results and research is focused on evaluating their efficacy and safety in “diverse groups”.
“The current outbreak presents an opportunity to evaluate new vaccines, which, if proven effective and safe, could expand vaccination efforts and help control the outbreak.”
Scale up of global production and distribution is “vital” to meet demand, particularly in low- and middle-income countries. Furthermore, accelerating regulatory evaluations for new and existing vaccines is “essential” to ensure availability.
For insights into a novel mpox vaccine from Tonix Pharma, join us at the Congress in Barcelona this October, or get your tickets to the Congress in Washington next April for more on mpox preparedness and response; don’t forget to subscribe to our weekly newsletters here.
by Charlotte Kilpatrick | Aug 23, 2024 | Infection |
In August 2024 WHO shared a disease outbreak update on the mpox situation in Africa, presenting information on the latest countries that are reporting cases. The outbreak was declared a PHEIC by WHO and PHECS by Africa CDC, prompting efforts to secure vaccines for the continent. In the update, WHO states that epidemiological data reveal that clade Ib has been spreading “rapidly” through close physical contact; this includes sexual contact identified within “networks of sex workers and their clients”. However, the affected groups are changing as the virus spreads.
Newly affected countries
The following countries are the latest in the African Region to report cases of mpox, either clade I or clade II, since the multi-country outbreak began in 2022.
- Burundi – an outbreak was declared on 25th July 2024 after confirmation of three cases. These are the first confirmed mpox cases identified in Burundi. By 17th August, there were 545 alerts of mpox cases, of which 474 suspected cases were investigated and validated. Of 358 suspected cases tested, 142 tested positive for MPXV and genomic sequencing analysis has confirmed clade Ib. No deaths had been reported as of 17th August. Confirmed cases were reported from 26 of 49 districts. Males account for 55.6% of cases and females 44.4%. Children under 5 years were 60.3% of cases, followed by those aged 11 to 20 (42.6%) and those aged 21 to 30 (38.2%).
- Kenya – on 29th July a confirmed case of mpox was identified in Taita Taveta County; the patient is a 42-year-old male with a history of travel from Uganda to Kenya. At the time of identification, he was travelling to Rwanda through Tanzania. By 13th August, a total of 14 suspected cases had been identified; one case tested positive for MPXV clade Ib. 12 of the suspected cases tested negative with one outstanding result. No deaths had been reported as of 13th August. This is the first mpox case identified in Kenya.
- Rwanda – on 24th July WHO was notified of two laboratory-confirmed mpox cases and an outbreak was declared on 27th July. The cases included a 33-year-old female and a 34-year-old male, both with travel history to the Democratic Republic of the Congo. They are the first confirmed mpox cases identified in Rwanda. By 7th August, four confirmed mpox cases and zero deaths had been reported with close contacts of the cases under follow up. Sequencing analysis confirmed MPXV clade Ib.
- Uganda – after enhanced surveillance for mpox disease was initiated in June and early July in response to reported cases in the Democratic Republic of the Congo, six suspected cases were identified on 11th July. Two samples tested positive for MPXV clade Ib on 15th July. These are the first mpox cases identified in the country, but investigations suggest that transmission occurred outside Uganda. By 12th August, 39 suspected cases had been reported. No deaths have been reported.
- Côte d’Ivoire – in July 2024, Côte d’Ivoire confirmed two non-fatal cases of mpox with no epidemiological link. By 7th August, seven mpox cases had been confirmed in three health districts. Four of the confirmed cases (57%) are male, and all seven cases are above 15 years old. Forty contacts are being followed up. Although the country has previously reported mpox, no cases had been notified since the start of the multi-country outbreak in 2022. The latest cases belong to clade II.
Risk of outbreak evolution
WHO assessed the risk of mpox separately; the risk in the eastern Democratic Republic of the Congo and neighbouring countries is “high” and in Côte d’Ivoire and other West African countries it is “moderate”. However, there is “concern” that the outbreak in Africa will continue to evolve as:
- There is evidence of possible under-detection and under-reporting.
- Although governments have activated emergency responses, resources to respond remain limited in some countries.
- Measures to support adequate patient care and introduce vaccines for people at risk are not currently in place in most countries. Acquisition and roll-out will require time before implementation.
- Some of the countries have not reported mpox before, which means public awareness and knowledge and capacity for identifying the disease remains limited.
- The global multi-country outbreak of mpox is ongoing. Countries outside Africa are still detecting sporadic cases and the unprecedented increase of cases in the African Region increases the risk of further transmission.
To join colleagues in considering the role of vaccines in better outbreak preparedness and response at the Congress in Barcelona, get your tickets here, and don’t forget to subscribe to our weekly newsletters for the latest infectious disease updates.
by Charlotte Kilpatrick | Aug 22, 2024 | Technology |
The Pandemic Institute announced in August 2024 that it has signed a Memorandum of Understanding (MoU) with Pharma Latch after attending the Congress in Washington this April. The collaboration will pursue several projects focused on optimising technology for safe, effective, and acceptable vaccines. Pharma Latch’s “unique” technology allows simple and efficient intradermal vaccine delivery and a “near pain free solution”. This has been identified by The Pandemic Institute as a promising avenue to encourage vaccine uptake.
Pharma Latch devices
Pharma Latch states that intradermal delivery can “enhance the efficacy” of various vaccine platforms. The technology “eliminates” user-dependency and variability associated with traditional intradermal injection techniques. The “Latch” platform uses opposing arrays of hypodermic needles of fixed length and angles. They work in pairs when deployed to establish a “slight stretching” of the skin, enabling full penetration of the needles to a predetermined depth.
Benefits include:
- Improved immune response
- Dose sparing
- Improved patient compliance and experience
- Complete dose delivery
- Simple to use devices
- High payload capability
- Low-cost, highly scalable device
Prevent and respond
The Pandemic Institute has five major research themes: Predict, Prepare, Prevent, Respond, and Recover. Central to these efforts is the development of new vaccines and community engagement to understand how to increase their acceptability. Some of the projects the collaboration will progress include:
- Patient acceptability of intradermal injection technology
- Assess the immune response when using the new technology in pre-clinical trials
- Assess how the technology works in delivering vaccines in a clinical trial
Professor Cathy Montgomery, Professor of Psychopharmacology and Health Inequalities at Liverpool John Moores University is “excited to be working with Pharma Latch to explore this new device” and uncovering the “benefits it could bring” to increasing uptake.
“Vaccine hesitancy is a rising concern in controlling infectious diseases, and anxiety around perceived pain and blood injection injury phobia (needle phobia) can be strong factors to hesitancy.”
Professor Tom Solomon CBE, University of Liverpool’s Infection, Veterinary, and Ecological Sciences Institute and Director of The Pandemic Institute is also “excited to be working with Pharma Latch going forward”.
“This new collaboration showcases what The Pandemic Institute does best – bringing together key people from across our partnership with external partners to ensure that we are putting things in place now for when the next pandemic emerges.”
Pharma Latch’s CEO, Ronan Byrne, is “delighted” with the partnership.
“We are impressed with both the breadth of ability and resources available and excited about the planned projects we will be looking to progress together.”
VaccineNation is thrilled to see the Washington Congress mentioned by The Pandemic Institute, particularly as Pharma Latch joined us in the start-up zone this year, and we look forward to following the progress made by this collaboration. For your chance to meet potential partners at the Congress in Europe this October get your tickets here, and don’t forget to subscribe to our weekly newsletters here.
by Charlotte Kilpatrick | Aug 20, 2024 | Technology |
Emergent BioSolutions announced in August 2024 that it is “proactively” working with WHO and the US government in response to the outbreak of mpox in Africa and has pledged to donate 50,000 doses of ACAM2000. The donation will be delivered with Direct Relief, a humanitarian relief organisation that has a “long history” of providing medical interventions to the Democratic Republic of the Congo (DRC) and other affected countries.
ACAM2000
ACAM2000 (Smallpox (Vaccinia) Vaccine, Live) is the primary smallpox vaccine designated for use in a “bioterrorism emergency”. Doses have been supplied to the US Strategic National Stockpile. It is indicated for active immunisation against smallpox disease for persons determined to be at high risk for infection. It is a single-dose vaccine administered via a bifurcated needle.
Emergent filed a supplemental Biologics License Application (sBLA) to the US FDA in 2023 to seek an expanded indication for ACAM2000 vaccine to include immunisation against mpox virus. This application includes human safety data and animal study data showing that ACAM2000 was effective in protecting against mpox virus exposure. Emergent has also responded to WHO’s invitation for an Expression of Interest for Emergency Use Listing.
Meeting demand
Dr Raina McIntyre, Professor of Global Biosecurity, NHMRC L3 Research Fellow, Head Biosecurity Programme, Kirby Institute, University of New South Wales Sydney, believes it will be “unlikely” that there will be enough supply of 3rd generation vaccines to control the epidemic in Africa, “given the demand in other countries”.
President and CEO, Emergent BioSolutions, emphasised that Emergent is “ready to scale up response efforts and partner with US and global public health leaders”. He reflected that “for years” the company has supplied ACAM2000 to the US and allied governments in “support of preparedness and stockpiling initiatives”.
“Currently, we have additional product already in inventory, with the ability to increase supply by approximately 40 million doses, if and potentially when needed. In the meantime, 50,000 doses of ACAM2000 vaccine will be donated to help control the outbreak across the African continent.”
Mr Papa concluded that increasing outbreaks of mpox around the world “should raise concerns and spur ongoing efforts” to produce and stockpile vaccines and other interventions to address all orthopoxviruses.
For the latest vaccine updates, don’t forget to get your tickets to the Congress in Barcelona this October, and subscribe to our weekly newsletters here!
by Charlotte Kilpatrick | Aug 8, 2024 | Technology |
Bavarian Nordic announced in August 2024 that the US Biomedical Advanced Research and Development Authority (BARDA), part of the Administration for Strategic Preparedness and Respond in the Department of Health and Human Services, has placed an order valued at US$156.8 million. The order concerns additional bulk product for the company’s smallpox/mpox vaccine, JYNNEOS. The bulk product represents $139.7 million of the contract value and will be manufactured and invoiced in 2024. This will “partly replenish” the inventory used to manufacture vaccines in response to the mpox outbreak in 2022. Around $17 million in the contract covers “additional services” in the 2025-2027 period, including storage of vaccine doses in the US.
MVA-BN
Modified Vaccinia Ankara-Bavarian Nordic (MVA-BN) is a non-replicating smallpox and mpox vaccine that has been approved by the FDA, EC, Health Canada, MHRA, and Swissmedic. It also obtained emergency use authorisation in other areas for use in the mpox outbreak.
Preparedness efforts
To fulfil the company’s existing contract to supply a next-generation, freeze-dried version of the vaccine for US smallpox preparedness, the bulk inventory must be replenished. Bavarian Nordic’s President and CEO, Dr Paul Chaplin describes the smallpox/mpox vaccine as a “key component” in the US biological preparedness, which was demonstrated in the 2022 mpox outbreak.
“JYNNEOS was also the first smallpox vaccine successfully developed under Project BioShield, a programme created by the US Congress in 2004 to accelerate the research, development, procurement, and availability of medical countermeasures against biological, chemical, radiological, and nuclear (CBRN) agents through public-private partnerships.”
Dr Chaplin is “proud” to continue providing vaccines to protect US citizens against “current and future public health threats”.
“We applaud the US government’s steadfast commitment to maintaining a robust preparedness.”
A longstanding relationship
Bavarian Nordic states that it has worked with the US since 2003 on the development, manufacturing, and supply of a non-replicating smallpox vaccine. Before the vaccine was approved by the FDA in 2019, Bavarian Nordic had supplied nearly 30 million doses of the liquid-frozen version; most of these were delivered for emergency use and have now expired. BARDA supported the development of a freeze-dried version with a longer shelf-life.
We look forward to welcoming Bavarian Nordic as Diamond Sponsors to the Congress in Washington in 2025. Get your tickets to hear from and network with senior representatives there, and don’t forget to subscribe to our weekly newsletters.
by Charlotte Kilpatrick | Aug 2, 2024 | Global Health |
In August 2024 WHO and CEPI shared a joint release calling on researchers and governments to “strengthen and accelerate” global research in preparation for the next pandemic. The statement highlights the importance of extensive research across “entire families” of pathogens that can infect humans, regardless of perceived pandemic risk, as well as a focus on individual pathogens. A report issued at the Global Pandemic Preparedness Summit 2024 in Brazil encourages the development of broad capabilities for rapid adaptation to emerging threats.
Pathogen prioritisation: a framework
The WHO R&D Blueprint for Epidemics’ primary goal is the accelerated development of medical countermeasures (MCM) and making these countermeasures available for diseases with epidemic and pandemic potential. It serves as a “global platform for research and development collaboration”. Central to the efforts is the concept of “pathogen prioritisation”.
The latest report outlines the results of a global pathogen prioritisation process with over 200 scientists from more than 50 countries. They evaluated the evidence related to 28 viral families and one core group of bacteria; this encompassed 1,652 pathogens.
“This process emphasised the imperative nature of collaborative efforts to attain global resilience against epidemics and pandemics.”
The report states that the approach encourages a focus on research of viral and bacterial families, rather than “isolated pathogens”, and emphasises the “critical necessity for investments in research, development, and innovation on an international scale”.
The ‘streetlight effect’
The report introduces a metaphor known as the ‘streetlight effect’, which describes looking for lost keys under a streetlamp to illustrate natural biases in research; this implies that we tend to search “where it is easiest”, rather than where the “actual answers might lie”. In this context, the area that is lit by the streetlamp represents Priority Pathogens, which are well-studied with plenty of data. The light area can be expanded by researching the Prototype Pathogens, representative viruses within a viral family that can be used as “pathfinders” to generate evidence and fill knowledge gaps with applications across the family.
Outside the illuminated area are the “Dark Areas”, including “under-monitored and under-studied” regions. These areas could harbour novel pathogens, but a lack of infrastructure and resources hinders comprehensive research. Thus, the proposed approach of research across all families, regardless of pandemic potential, could mitigate the risk of overlooking potential pandemic pathogens.
CORC
WHO is engaging research institutions across the world to establish a Collaborative Open Research Consortium (CORC) for pathogen families. Each family will have a WHO Collaborating Centre acting as a research hub. These CORCs will engage researchers, developers, funders, regulators, trial experts, and other stakeholders to promote “greater research collaboration and equitable participation”, especially in places where the pathogens are known to or highly likely to circulate.
Not if, but when
Dr Richard Hatchett, CEO of CEPI, described the scientific framework for epidemic and pandemic research preparedness as a “vital shift in how the world approaches countermeasure development”. He emphasised that CEPI “strongly” supports this step.
“This framework will help steer and coordinate research into entire pathogen families, a strategy that aims to bolster the world’s ability to swiftly respond to unforeseen variants, emerging pathogens, zoonotic spillover, and unknown threats referred to as pathogen X.”
WHO Director-General, Dr Tedros Adhanom Ghebreyesus, demands a “combination of science and political resolve” in preparation for the next pandemic.
“History teaches us that the next pandemic is a matter of when, not if. It also teaches us the importance of science and political resolve in blunting its impact.”
The efforts to advance pathogen knowledge require participation of “scientists from every country”.
Pandemic preparedness and pathogen research remain central to discussions at the Congress in Barcelona, so do get your tickets to join us for these sessions in October, and don’t forget to subscribe to our weekly newsletters for global health insights.
by Charlotte Kilpatrick | Jul 31, 2024 | Infection |
Africa CDC shared a situation update on mpox on the African continent in July 2024. This reveals that between January 2022 and July 2024 a total of 37,583 cases and 1,451 deaths have been reported. The Case Fatality Rate (CFR) is 3.9%. 15 African Union Member States have reported these cases. In 2024 alone (until July 2024), a total of 14,250 cases and 456 deaths (CFR of 3.2%) have been reported from 10 Member States. This represents a 160% increase in cases and a 19% increase in deaths compared to the same period in 2023.
A worrying increase
Over the past two years the 15 Member States that have reported mpox cases are: Benin, Burundi, Cameroon, Central African Republic (CAR), Congo, Democratic Republic of Congo (DRC), Egypt, Ghana, Liberia, Morocco, Mozambique, Nigeria, Rwanda, Sudan, and South Africa. In 2024 the following countries have reported cases:
- Burundi – 8 cases, 0 deaths
- Cameroon – 35 cases, 2 deaths
- CAR – 213 cases, 0 deaths
- Congo – 146 cases, 1 death
- DRC – 13,791 cases, 450 deaths
- Ghana – 4 cases, 0 deaths
- Liberia – 5 cases, 0 deaths
- Nigeria – 24 cases, 0 deaths
- Rwanda – 2 cases, 0 deaths
- South Africa – 22 cases, 3 deaths
Further to these cases, Chad has reported 24 suspected cases but no confirmed cases. DRC accounts for 96.3% of all cases and 97% of all deaths in 2024.
High geoscope and risk
Africa CDC ranks the geographic scope (geoscope) for mpox in Africa as “high”. Considering the morbidity and mortality, probability of spread, and availability of effective control measures, the risk assessment is also “high”.
“While mpox is moderately transmissible and usually self-limiting, the case fatality rate has been much higher on the African continent compared to the rest of the world. Despite a safe and effective vaccine and antiviral treatment against mpox, these are not readily available.”
Africa CDC’s response
The update concludes with a few “key ongoing activities” contributing to Africa CDC’s participation in mpox preparedness and response:
- Activation of the Emergency Operations Centre (EOC) to enhance coordination and provide technical support to Member States
- High-level political advocacy and agenda setting
- Deployment of the Africa CDC Rapid Response Team to DRC to support response efforts including coordination, surveillance and contact tracing, field investigation, and strategy development
- Laboratory support – providing RT-PCR test kits and ancillary supplies and training participants in sample processing, RT-PCR-based detection, sequencing, and molecular diagnosis
- Training and resources – a four-module animated course for public health professionals, policymakers, and health workers in endemic areas with information on mpox prevention, detection, treatment, patient care, infection control, and outbreak investigation
- Collaboration with partners
- Advocating for strengthened surveillance, diagnostic capacities, and access to vaccines and medical drugs
For more on using available vaccines to control outbreaks across the world, why not join us in Barcelona for the Congress this October? Don’t forget to subscribe to our weekly newsletters here for infectious disease insights.
by Charlotte Kilpatrick | Jul 29, 2024 | Technology |
In July 2024, WHO announced that Argentine manufacturer Sinergium Biotech is to lead a new project that aims to accelerate the development and accessibility of human avian influenza (H5N1) mRNA vaccine candidates for manufacturers in low- and middle-income countries (LMICs). The project will leverage the WHO and Medicines Patent Pool (MPP) mRNA Technology Transfer Programme, which was launched in July 2021 to build capacity in LMICs for the development and production of mRNA-based vaccines. Sinergium is a partner in the Programme and has developed candidate H5N1 vaccines. If it establishes preclinical proof-of-concept the technology, materials, and expertise will be shared with partners, “aiding the acceleration” of the development of these candidates and “bolstering pandemic preparedness efforts”.
The mRNA Technology Transfer Programme
Since its inception, the mRNA Technology Transfer Programme has already developed and implemented a platform that has been used to establish the immunogencity, efficacy, and safety of a COVID-19 vaccine candidate in preclinical models. The platform was created and validated at Afrigen and is now being shared with partners for applications against “other critical disease targets”.
WHO Director General Dr Tedros Adhanom Ghebreyesus, states that the initiative “exemplifies” why WHO established the Programme to “foster great research, development, and production”.
“When the next pandemic arrives, the world will be better prepared to mount a more effective and more equitable response.”
Charles Gore, MPP’s Executive Director, reflected that the goal of the Programme is to “enable low- and middle-income countries to lead development efforts, foster collaboration, share resources, and disseminate knowledge”.
“This project embodies our vision and demonstrates a strong commitment to future pandemic preparedness and response.”
Rising to the avian influenza challenge
WHO states that avian influenza viruses are a “significant public health risk” due to “widespread circulation in animals” and “potential to cause a future pandemic”. Thus, the latest project complements work to improve and strengthen the sharing of influenza viruses with human pandemic potential and increase LMIC access to vaccines. Dr Jarbas Barbosa, Director of the Pan American Health Organisation (PAHO), is pleased with the news.
“This announcement underscores the importance of not only geographically diversifying the innovation and production of health technologies including and recognising the capacities in Latin America and the Caribbean, but also the importance of early planning for access and the sharing of knowledge and technologies during the research and development processes.”
Chief Executive Officer at Sinergium is “excited to tackle this public health challenge” in collaboration with partners.
“Sinergium’s enhanced capacity and readiness to apply our expertise to H5N1 will play a vital role in this effort towards global pandemic preparedness. I would also like to thank PAHO who have also been instrumental through the strong support it offers to regional manufacturers in the Americas.”
The importance of technology transfers in building regional capacity and facilitating equitable vaccine distribution will be discussed in a panel at the Congress in Barcelona this October; get your tickets to join us here and don’t forget to subscribe to our weekly newsletters here.
