As national health systems continue to reel from the pandemic, Jeremy Farrar said “there has got to be a mutual understanding” between countries to ensure better preparedness. “Don’t wait for a crisis to put in place better systems — by the time [of the next pandemic], you’ll only just be turning the key and that’s too late,” he added.

Farrar said experts must not “neglect the known pathogens for the sexy unknown ones”. The WHO has a research and development “roadmap” fully in place for Ebola, Marburg and the tick-borne Crimean-Congo haemorrhagic fever, but more work needs to be done on Zika, Rift Valley Fever and “Pathogen X” — an infectious disease yet to emerge that has the potential to cause a pandemic.

Farrar also called on pharmaceutical manufacturing to be shifted from populous countries, which “inevitably look after their own citizens first”. He cited smaller countries such as Denmark, Rwanda, Senegal or Denmark, which could provide for their own citizens “within a week” and then export spare output “in a time of crisis”.

In his first interview with a newspaper since he started in the job three months ago, Farrar said the world faced a number of health challenges, namely ageing and more unwell populations and a shrinking pool of health workers; conditions caused by climate change and the loss of biodiversity; and health crises stemming from economic trends such as youth unemployment and inequality.

“If we don’t address those key drivers in the 21st century, we’re going to face more,” said Farrar, who for a decade helmed Britain’s Wellcome Trust, a leading global health institution.

Another huge risk, he said, was that health workforces were “on the edge of collapse”, citing the UK’s National Heath Service, whose operational weaknesses had “been papered over by the workforce being willing to go beyond what’s normal”.

Debates about health sector reform and funding were obscuring the fact that “when you ask a workforce to go above and beyond, it collapses”, he said. “And the global health workforce is close to that point.”

Farrar said he was still open to all hypotheses on Covid’s origins, including an accidental laboratory leak from the Institute of Virology in Wuhan, China, or its transmission from animals being sold in the city’s wet markets. His interpretation of the evidence accumulated over three years suggested that it “is increasingly that actually the natural origin is much more likely”.

“But you can’t ignore the geography, you can’t ignore the centre,” he added, referring to the potential leak from labs in Wuhan.

Farrar is open to the idea of a WHO new mission to China to trace Covid’s origins, “if there was a willingness to share all information, and this could be done in a way that will actually shed light on it”. While the health body was criticised early in the pandemic for being too lenient on China, it has increasingly become more vocal in calling on Beijing to share all relevant coronavirus data.

“Every [piece of] information should be shared. And we should get to the bottom of it,” he said, referring to the origins of Covid. But he added: “I’m not sure we will.”

The WHO should be more of a public “conductor” of initiatives to improve global health rather than running them inside the organisation, Farrar said.

While coronavirus laid bare tensions over how governments handle global outbreaks of infectious disease, Farrar said the world was “converging in many ways”, citing the problems of drug resistance and non-communicable diseases such as heart disease and obesity. “The issues that affect one country are increasingly going to affect every country.”

This story originally appeared on: Financial Times - Author:Donato Paolo Mancini

A peer-reviewed study published in The Lancet Planetary Health on Monday found that antibiotic resistance increases in tandem with levels of small particulate matter, or PM2.5, which originates from engine combustion and can penetrate the lungs and bloodstream.

“The association has strengthened over time, with changes in PM2.5 levels leading to larger increases in antibiotic resistance in more recent years,” the researchers said. Especially high levels of both small particulate matter and antibiotic resistance were found in north Africa, the Middle East and south Asia.

The correlations were “consistent across the world in most antibiotic-resistant bacteria”, said the researchers.

The findings follow earlier discoveries of DNA from antibiotic-resistant organisms on particles polluting the air. Antimicrobial resistance is the emergence of bacteria impervious to existing antibiotics, which the World Health Organization has said is one of the top 10 global public health threats.

While the study suggests a correlation between pollution and antimicrobial resistance, it has not demonstrated that one causes the other.

Researchers said the results “provide new pathways for antibiotic-resistance control from an environmental perspective”. They analysed data from 116 countries between 2000 and 2018, but acknowledged limitations resulting from disparities in the figures available.

Hong Chen of Zhejiang University, China, a professor who led the research, said: “Antibiotic resistance and air pollution are each in their own right among the greatest threats to global health. Until now, we didn’t have a clear picture of the possible links between the two.”

“But this work suggests the benefits of controlling air pollution could be two-fold: not only will it reduce the harmful effects of poor air quality, it could also play a major role in combating the rise and spread of antibiotic-resistant bacteria.”

The main drivers of antimicrobial resistance are the misuse and overuse of antibiotics, not just in humans but also in the broader ecosystem, such as in animal farming.

About 1.27mn deaths were attributed to bacterial antimicrobial resistance in 2019 alone, according to a separate Lancet study. Estimates put the projected death toll at close to 10mn by 2050 if there is no substantial change before then.

Andrew Singer, principal scientist at the UK Centre for Ecology & Hydrology, who was not part of the study, noted that the research — as its authors acknowledged — was not experimental and did not offer data on the mechanism for any link.

But he added that the study “convincingly” raised PM2.5 “as an intriguing possible driver of [antimicrobial resistance] — one that hasn’t yet been examined in any great detail to date”.

“Like all good research, it raises more questions than it answers — but it will hopefully drive the research community to examine this in greater detail,” Singer said.

This story originally appeared on: Financial Times - Author:Donato Paolo Mancini

HIV diagnoses in inner Sydney plunged 88 per cent from the 2008-2012 average to just 11 cases last year, a decline on a scale never before recorded in a former AIDS hotspot.

The results are adding to evidence that existing prevention strategies, including testing and pre-exposure drugs, are highly effective when implemented correctly.

“Rapid progress towards ending AIDS is possible. If trends continue, several countries in several global regions will reach the [UN] goal of a 90 per cent HIV incidence reduction by 2030,” the researchers wrote.

While rates decreased in New South Wales and Australia overall, the decline was “extraordinary” in inner Sydney, where a large proportion of men who have sex with men resided, said Andrew Grulich, a professor of HIV epidemiology at the country’s Kirby Institute.

Darryl O’Donnell, chief executive of NSW-based HIV advocacy group Health Equity Matters, said the prospect of eliminating transmission was an “astonishing” one for anyone that lived through the “horror years” of the AIDS crisis. 

“What we are starting to grasp in Australia is that we could end this epidemic,” he said.

The reduction was achieved, Grulich said, because of a community-centred approach that included high rates of testing, prompt treatment of those who tested positive, and increased use of pre-exposure prophylaxis, a drug regimen that prevented the risk of contracting the virus by 99 per cent.

“People should be acting on [this evidence],” he said.

HIV treatment enables those living with the virus to lead long and healthy lives. But only a few instances of complete cure, or HIV eradication, have been documented in patients, and no vaccine is yet available.

Some countries in the world, such as Zimbabwe, Nepal, Lesotho, Rwanda, Eritrea and Malawi, have achieved a decline greater than 70 per cent, while declines of about half have been documented in the Netherlands, England, Singapore and US cities, such as New York and San Francisco.

But no locality had reported a decrease as large as that of inner-city Sydney, said Grulich, who led the study and warned health officials against complacency.

“Without a vaccine and a cure, elimination of HIV is impossible . . . One thing people shouldn’t think in reading this data is: ‘we can pack our bags and go home’. That’s not the case at all,” he said, urging “continued investment” in testing and treatment.

Meg Doherty, head of the HIV, hepatitis and STIs programmes at the World Health Organization, noted the strong public health programme was backed by a “government that put money behind this”.

O’Donnell, who was head of the NSW government’s HIV unit 20 years ago, said the progress made in the country dates to the 1980s, when Australian politicians took a non-ideological approach to the epidemic and opted to work closely with the gay and bisexual community, drug users and sex workers to get on top of the crisis.

“The ending of AIDS is not going to happen once, all in a big bang,” said the WHO’s Doherty. “It’s going to be Sydney, other localities, and then slowly over time we’ll see it more globally until we have a vaccine.”

This story originally appeared on: Financial Times - Author:Donato Paolo Mancini

The Food and Drug Administration on Thursday approved Opill, an oral contraceptive made by the Irish-American pharmaceutical group Perrigo, for non-prescription use. The pill will be available to purchase at pharmacies, convenience stores, grocery stores and online.

The decision is expected to improve access to contraceptives and has been welcomed by advocates of reproductive rights after many states moved to increase restrictions on abortion.

Patrizia Cavazzoni, director of the FDA’s drug evaluation and research centre, said the approval would make the pill “an available option for millions of people in the US”.

The move is a milestone in the fight for reproductive rights in the US, after the Supreme Court overturned Roe vs Wade last year, removing women’s constitutional right to abortion that had been in place since 1973.

The legality of the abortion pill mifepristone remains uncertain after the Supreme Court halted a ruling from a Texas federal judge to withdraw the FDA’s approval of the pill, which if upheld would restrict access to the drug even in states with abortion protections.

Democratic lawmakers had pressed the FDA to approve the over-the-counter drug but conservative religious groups have strongly opposed the measure.

The FDA’s Cavazzoni said: “When used as directed, daily oral contraception is safe and is expected to be more effective than currently available non-prescription contraceptive methods in preventing unintended pregnancy.”

Opill must be taken at the same time every day, the FDA said, and should not be used by those with a current or past diagnosis of breast cancer. It should also not be used with other hormonal birth control products.

The pill contains progestin, a hormone that helps regulate the menstrual cycle and pregnancy. It has been safely and effectively used for decades for birth control.

Ireland-based Perrigo said the pill would be available in-store and online at leading retailers across the US from the first quarter of 2024.

Frederique Welgryn, Perrigo’s global vice-president for women’s health, said the approval was a “groundbreaking expansion for women’s health in the US, and a significant milestone towards addressing a key unmet need for contraceptive access”.

She said the company was committed to making the pill “accessible and affordable to women and people of all ages”.

Perrigo said 45 per cent of 6mn yearly pregnancies in the US are unintended, and that one-third of adult US women who have ever tried to obtain a prescription or refill for birth control products, including the pill, have faced difficulties in doing so.

“Removing the prescription requirement for Opill improves access to a contraceptive method that is effective and well tolerated for all ages,” the company said.

This story originally appeared on: Financial Times - Author:Donato Paolo Mancini

The UK company said on Friday it had reached a settlement with James Goetz, who filed a suit in a California state court.

The settlement reflected its desire “to avoid distraction related to protracted litigation in this case”, GSK said, without providing details of the agreement.

“GSK does not admit any liability in this settlement and will continue to vigorously defend itself based on the facts and the science in all other Zantac cases,” it added.

This story originally appeared on: Financial Times - Author:Donato Paolo Mancini

The WHO had declared mpox, which peaked globally last summer, a public health emergency of international concern or PHEIC last July. It said on Thursday that it had received reports of more than 87,000 cases and 140 deaths from 111 countries. Most cases have been concentrated among men who have sex with men.

This story originally appeared on: Financial Times - Author:Donato Paolo Mancini

The UN body said it had called an end to the designation of Covid-19 as a “public health emergency of international concern”, or PHEIC — the highest possible under international health regulations.

This story originally appeared on: Financial Times - Author:Donato Paolo Mancini

In a paper seen by the Financial Times, Belgium and 18 other countries — including Germany and France — have gone further than Brussels’ recent proposals to overhaul the bloc’s pharmaceuticals laws, calling for a “last-resort” mechanism to swap medicines between member states and the establishment of a list of critical drugs whose supply chains must be monitored.

This story originally appeared on: Financial Times - Author:Donato Paolo Mancini

“Dr Temo Waqanivalu has been dismissed from WHO following findings of sexual misconduct against him and [the] corresponding disciplinary process,” the WHO told the Financial Times on Monday.

This story originally appeared on: Financial Times - Author:Donato Paolo Mancini

The Serum Institute of India, which manufactures the vaccine called R21, said on Thursday that the preventive had received “full national licensure” from Ghana’s Food and Drugs Authority. The institute said R21 could be rolled out at “mass scale and modest cost, enabling . . . hundreds of millions of doses to be supplied to African countries which are suffering a significant malaria burden”.

He also said it was “still uncertain” if R21 was value for money, “especially when compared to other cost-effective malaria interventions that have not been fully deployed across endemic countries, such as insecticide-treated nets or indoor residual spraying”.

This story originally appeared on: Financial Times - Author:Donato Paolo Mancini

The annotated “zero”, or early, draft of the intergovernmental group developing the treaty, seen by the Financial Times, shows a complex debate between countries about whether any outbreak deemed a “pandemic” would have to be viral, transmit from human to human, or affect populations with low immunity, among other points.

Nations are also torn on whether the director-general of the WHO would have the power to “trigger” a declaration of a pandemic, the diplomats said.

A proposal by the EU to cap pricing for vaccines, drugs and tests at not-for-profit levels and to tier pricing for poor and middle-income countries respectively has so far received a “lukewarm reception” from the global south, one of the two said.

Thiru Balasubramaniam, Geneva representative of Knowledge Ecology International, a patent advocacy group, said the “clock was ticking”.

This story originally appeared on: Financial Times - Author:Donato Paolo Mancini

Speaking as the report was released on Monday night, Tedros Adhanom Ghebreyesus, the WHO’s director-general, said: “The report reveals an important truth — infertility does not discriminate.”

The WHO report said the lifetime prevalence of infertility was 17.8 per cent in high-income nations and 16.5 per cent in low- and middle-income countries. However, assistive reproduction technology such as IVF remained “underfunded and inaccessible to many due to high costs, social stigma and limited availability”, the report added.

“Millions of people face catastrophic healthcare costs after seeking treatment for infertility, making this a major equity issue and all too often, a medical poverty trap for those affected,” said Pascale Allotey, director of sexual and reproductive health and research at the WHO. “Better policies and public financing can significantly improve access to treatment and protect poorer households from falling into poverty as a result.”

This story originally appeared on: Financial Times - Author:Donato Paolo Mancini

Global genomic repository Gisaid made the data, which was first made available this January by researchers affiliated to the Chinese Centers for Disease Control and Prevention, accessible again on Tuesday. Analysis of the data found molecular evidence that animals including raccoon dogs on sale in late 2019 at a Wuhan market were susceptible to being infected by Sars-Cov-2, the virus that causes Covid-19.

Wuhan, where the virus is thought to have originated, hosts a laboratory called the Wuhan Institute of Virology which is known to have conducted viral experiments. The central Chinese city of 12mn people also hosts the Huanan wet market, to which early cases of the disease in late 2019 were linked.

This story originally appeared on: Financial Times - Author:Donato Paolo Mancini

The German biotech company, Pfizer’s partner for the Covid-19 vaccine, said on Monday that revenues from Covid vaccines would drop to about €5bn in 2023. That compares with total revenues of more than €17bn in 2022 and €19bn the year before that, the vast majority of them generated by coronavirus jabs. 

This story originally appeared on: Financial Times - Author:Donato Paolo Mancini

The global health body’s response to recently analysed genetic sequences casts further doubt on Beijing’s handling of the viral outbreak and will intensify debate about the source of the coronavirus pandemic.

This story originally appeared on: Financial Times - Author:Donato Paolo Mancini

The US pharmaceutical company has agreed to extend its contract from 2023 to 2026, according to two people with knowledge of the talks. But it is insisting on payment for doses ordered in the contract that will never be manufactured, angering some governments.

This story originally appeared on: Financial Times - Author:Donato Paolo Mancini

The more than 190 signatories urge world leaders to pledge that “never again will the lives of people in wealthy countries be prioritised” over those in poorer ones. They say publicly funded medical innovations should be treated as “global common goods” and used to maximise health rather than profits.

The signatories said co-operation would require removing intellectual property barriers during pandemics. The industry and some national governments fiercely resisted such attempts as Covid-19 continued to spread. A voluntary initiative by the WHO, known as C-Tap, failed to attract significant support.

This story originally appeared on: Financial Times - Author:Donato Paolo Mancini

The Pharmaceutical Accountability Foundation, which logged a claim against the company on Tuesday at a district court in Amsterdam, said in a statement that AbbVie had abused its dominant position in the market from 2004 to 2018 “to keep prices and profits high”.

This story originally appeared on: Financial Times - Author:Donato Paolo Mancini

The World Organisation for Animal Health this month said a rising number of cases had been reported in mammals, “causing morbidity and mortality” in species such as otters and seals. Reports of infections in farmed mink in Spain had increased concerns, WOAH said, because cases involving large numbers of animals kept close to one another exacerbated the risk of wider transmission.

If H5N1, the strain mainly responsible for the latest outbreak from late 2021, develops mutations that make it easier to transmit to humans, experts fear the emergence of a pandemic that carries more risks for global health than the Covid-19 outbreak. Though bird flu has infected relatively few humans, its fatality rate is about 50 per cent, according to the European Centre for Disease Prevention and Control.

And what other measures should be taken?

Richard Ebright, professor of chemistry and chemical biology at Rutgers University, said it was “clear” that further measures should be taken to reduce the zoonotic potential of H5N1.

He urged an end to two activities that could enable avian influenza viruses to make the jump to humans — fur farming and gain-of-function research, in which pathogens are manipulated to help scientists understand how they behave.

“The former, in effect, selectively breeds for new H5N1 influenza viruses that can transmit efficiently in mammals,” Ebright said. “The latter, by definition, deliberately creates new H5N1 influenza viruses reasonably anticipated to transmit efficiently in mammals.”

“Both are unnatural. Neither offers benefits that offset the risks,” he added.

What counter-measures are available?

According to the WHO, vaccines for use in humans against H5N1 infection have been developed, but have not been widely used.

“Several manufacturers have developed prototype H5 vaccines that can be authorised when and if a pandemic H5N1 strain emerges,” it said, adding the most important tool was the identification of positive cases and the monitoring of their contacts as part of routine outbreak investigations. Influenza antivirals are also available.

Only a handful of countries such as Russia, China and Egypt have vaccinated animals against avian flu in the past three years, according to WOAH. But with vaccines unable to offer immunity or complete protection against disease, many experts say the safest measure is the separation of sick and healthy animals.

To protect humans in the long term, Farrar advocates building up a global reserve of vaccines “for every single strain of influenza that exists in the animal kingdom through at least phase 1 and phase 2 studies [in humans], so that you know the vaccines are safe and immunogenic and that you could manufacture them well”.

This story originally appeared on: Financial Times - Author:Donato Paolo Mancini

The UK drugmaker, which has solely focused on drugs and vaccines since spinning off its consumer healthcare division last year, posted fourth-quarter sales of £7.4bn, a decline of 3 per cent at constant exchange rates.

For the full year, sales rose 13 per cent to £29.3bn. Adjusted quarterly profit was 25.8p per share. This compares with GSK-compiled fourth-quarter consensus estimates of £7.1bn for sales and 21.2p earnings per share.

This story originally appeared on: Financial Times - Author:Donato Paolo Mancini