#513 | A new weapon against cholera; The WHO defines air-borne illnesses; The US says it will prevent the next pandemic
Hello, and welcome back to The Kable for your weekly round-up of all things life sciences. We begin with a story that may seem slightly outside our remit. But that’s only because our remit is expanding – more on that in the future, though. Right now, let us give Nestle its well-earned share of brickbats for believing babies in the Global South (excluding Australia and New Zealand, of course) don’t have the same health requirements from their foods. In case you missed the findings of an investigation by Public Eye and IBFAN, it would seem Nestle wants children in developing nations to become obese and diabetic. Why else would the company add sugar and honey to infant food products in these countries?
Over in Africa, the Africa CDC is mincing no words while trying to make sense of Moderna’s decision to put a pause on its manufacturing facility in Kenya. The agency’s statement reiterates its intent to make Africa self-reliant when it comes to medicines and vaccines. There is also a longer Health Policy Watch piece on what the future portends for African manufacturing.
Elsewhere in Africa, Nigeria became the first country to roll out a new Men5CV vaccine against meningitis. This 5-in-1 shot gives protection against all five major strains of the disease prevalent in Nigeria.
We can’t leave Africa just yet, though. Don’t you want to know about the new mutated strain of mpox found in The Democratic Republic of the Congo (DRC)? According to a report published on the pre-print server medRxiv, this new strain has “pandemic potential.” Yippee.
In news guaranteed to give you déjà vu, India’s Glenmark Pharma is issuing a recall of over 6,000 bottles of a BP drug in the US due to “failed dissolution specifications.”
In more déjà vu-inducing news, the latest draft of a pandemic agreement, recently sent to WHO member states, still doesn’t have consensus. The draft includes preliminary agreements on equitable resource sharing, such as a pathogen access and benefit-sharing system and a global supply chain. Despite these agreements, many operational details remain to be defined, with a legally binding instrument expected by May 2026. Health Policy Watch does a great job of dissecting this draft here.
In India, the government is reportedly considering allowing sale of OTC meds at grocery stores.
Speaking of India, India’s Biocon is partnering with Brazil’s Biomm to bring its diabetes drug – gOzempic – to Brazil.
Pfizer keeps up the ongoing trend in Big Pharma of paring back R&D resources with an announced culling of an entire R&D unit.
If animal testing bothers you, here’s good news. CRO Charles River Laboratories has initiated what it calls the Alternative Methods Advancement Project to reduce animal testing in drug discovery by incorporating animal model alternatives into its services, investing in AI for candidate identification, and collaborating with policymakers to enhance regulatory acceptance of alternative testing methods.
And finally, finally, the WHO, with 500 experts, has revealed, for the first time, what it means for a disease to spread through the air. Finally.
Pharmaconex West opens doors on Monday at the Landmark Centre in Lagos, Nigeria. Prof Moji Adeyeye, Director General of National Agency for Food and Drug Administration and Control (NAFDAC) will deliver the keynote address. One more reason to attend if you didn’t have enough already. Register to beat the queue.
Stories Of The Week
Cough, cough. Remember last week we told you Nigeria’s drugs regulator had issued a recall for J&J’s Kenvue’s cough syrups? NAFDAC has since said that it has not yet identified any deathsdue to this cough syrup. However, the syrup saga is far from over. Kenya, Tanzania, Rwanda, and South Africa have all also issued recall alerts for the same cough syrup. Zimbabwe’s regulator says it doesn’t have a record of this cough syrup being legally available in the country but has nevertheless issued an alert. The manufacturer’s response to all these alerts is a statement to Reuters (and ostensibly other media outlets) that “it was conducting its own assessment and working with health authorities to determine a course of action.”
(Reuters, Kenya PBB, Tanzania TMDA, Rwanda FDA, SAHPRA, MCAZ)
Typhoid begone! The challenge of efficiently targeting and managing typhoid fever, which affects millions annually, is being innovated through novel surveillance techniques in urban areas, particularly in Bangladesh. Traditional methods of tracking the disease, such as blood cultures, are costly and slow, hindering effective vaccination strategies. Researchers have now developed a new approach using bacteriophages specific to the Salmonella Typhi bacterium as indicators, which can be detected in environmental samples like urban sewage. This method offers a cheaper and quicker way to identify typhoid presence and could guide targeted vaccination efforts. The success of this approach was demonstrated in a pilot study, showing a higher prevalence of these bacteriophages in areas with known typhoid cases. This groundbreaking surveillance project aims to map the burden of Salmonella Typhi across Bangladesh, assisting in the strategic deployment of vaccines to curb typhoid fever, with the government planning to make typhoid conjugate vaccines widely available by May 2025.
(Gavi)
Pandemic? How dare it, says the US. Looking at how astutely it led the world in handling the pandemic just past (yes, we know… ongoing), it should come as no surprise that that bastion of virtue, the US, has a plan to prevent any future pandemics. That plan, called the Global Health Security Strategy, involves collaborations between US agencies and 50 countries, primarily in Africa and Asia, to enhance their capacity to identify and respond to infectious diseases. The program, which has already commenced activities such as vaccination campaigns against mpox in Congo, plans to expand to include 100 countries by year’s end.
(US Department of State)
Mix and match. PATH says childhood immunisation schedules around the world have become increasingly complex and expensive, making the need for combination vaccines that incorporate multiple immunisations into a single injection more urgent. These combination vaccines offer the potential to simplify vaccine delivery, reduce costs, and improve compliance, particularly in low- and middle-income countries with a high burden of infectious diseases. However, despite their advantages and strong preference from stakeholders in these regions, very few combination vaccines are currently under development or licensed due to technical, regulatory, and commercial challenges. One can’t help but think this is opportunity knocking on someone’s door. Someone with the will and ability to navigate various regulatory and policy mazes to advocate for prioritising combination vaccine development. And then going ahead and doing the development.
(PATH)
They call me Mr. Bombastic. The World Bank Group has announced a new initiative aimed at providing affordable healthcare to 1.5 billion people by 2030, focusing on expanding services to underinvested areas, reducing financial barriers, and ensuring lifetime care. To achieve this, the World Bank will use financing, expert guidance, and partnerships with private-sector firms, NGOs, and civil society. The plan addresses challenges such as climate change, pandemics, conflicts, societal ageing, and a projected shortfall of healthcare workers. Financial support will come from the International Development Association for the poorest countries and the International Bank for Reconstruction and Development for middle-income countries, promoting government health investments and private-sector engagement.
(World Bank)
Agency Observer
Cholera begone! In exceedingly good news on the cholera front, a new oral vaccine for cholera, Euvichol-S, has been prequalified by the WHO. This vaccine, made by South Korea’s Eubiologics, offers similar efficacy to existing vaccines but features a simplified formulation that could significantly boost production speeds. The world has witnessed a cholera resurgence over the past few years, especially in Africa. This prequalification should hopefully act as a springboard to get production of this vaccine rolling at double speed. Manufacturers, assemble!
(WHO)
Breakthroughs
Bacteria begone! The overuse of antibiotics has led to the increasing development of drug-resistant bacteria, posing a growing threat to global health. Now, a novel machine learning approach developed by researchers has identified potential new bacterial targets for antibiotics by analysing the effects of nonantibiotics on bacteria. This approach offers new strategies to combat antibiotic resistance and opens avenues for discovering antibiotics with novel mechanisms.
(The Conversation)
Dengue and Zika begone! Researchers in China have discovered a new bacterium in the guts of local mosquitoes, which shows promise in disabling the viruses responsible for dengue and Zika before they can establish an infection in the insects. This finding, published in Science, represents a potential new method for controlling these diseases, which currently lack widespread effective treatments and vaccines. The bacterium was found to reduce viral presence significantly in mosquitoes one week after they were fed blood containing the dengue virus. This innovative approach, which could complement existing methods like those involving the Wolbachiabacterium, also demonstrated efficacy in outdoor tests where mosquito larvae were raised in water containing the bacterium. Further research is needed to confirm if this bacterium, called Rosenbergiella_YN46, can effectively block disease transmission to humans, but early results are promising and suggest a natural, potentially plant-based strategy for disease control in mosquito populations.
(Science)
Outbreaks
Dengue makes a comeback. PAHO has declared an “emergency situation” in the Americas due to a significant rise in dengue cases, with over 5.2 million confirmed this year – a 48% increase from the previous count of 3.5 million. Despite this surge, the dengue hotspots of Argentina and Brazil have shown some signs of stabilisation or even a reduction in cases. However, the situation remains critical, with over 1,800 deaths reported, up from 1,000 earlier in the year. The effectiveness of the dengue vaccine in curbing this outbreak is limited by its scarce supply, and while it may reduce severe cases and fatalities, its impact on overall case numbers will take time to manifest.
(PAHO)
Bottom line
Heatwave? More like heat stroke! A recent study highlighted a concerning trend where over half a million people died from strokes linked to both high and low temperatures in 2019, with an increasing trend observed since 1990. The research, which assessed global data on climate and health outcomes, pointed out that strokes related to non-optimal temperatures are rising and are expected to continue increasing as the planet warms. This connection is not confined to any specific region; while typically colder temperatures are associated with higher stroke rates, climate change is also causing unusual cold spells in warmer areas by affecting atmospheric conditions like the polar vortex. The study’s findings underscore the urgent need for global health and policy responses to address the broader impacts of climate change, which disproportionately affect poorer regions and fragile healthcare systems. The research calls for heightened awareness and action to mitigate these risks as the burden of disease linked to climate change grows globally.
(Neurology)
Feeling hot? Why don’t you switch the AC on, stupid? At the end of March and early April 2024, the Sahel and West Africa experienced a severe heatwave with temperatures reaching unprecedented highs, particularly in the Sahel, where they soared above 45°C, and night-time temperatures remained above 32°C in places like Burkina Faso. This extreme weather event – described as the worst in living memory by the World Weather Attribution – was marked by significant hospitalisations and over a hundred deaths in a Mali hospital over just four days, underscoring the vulnerability of these regions to heatwaves, which are among the deadliest natural hazards. Compounded by Ramadan fasting and widespread power outages, the situation was exacerbated, preventing people from finding relief during the night and limiting the use of mechanical cooling. Researchers attribute the intensity and likelihood of such extreme heat events to human-induced climate change, making them significantly more probable and severe than they would have been in a cooler climate. The study highlights the urgent need for adaptive measures in urban planning, infrastructure, and health services to mitigate future risks.
(World Weather Attribution)
$38 trillion and counting. Researchers from the Potsdam Institute for Climate Impact Research have released findings indicating that climate change could cost the global economy $38 trillion annually by 2049 due to extreme weather impacting agriculture, labour, and infrastructure. Their study, which assesses data from over 1,600 regions across four decades, projects a 19% reduction in global income by mid-century compared to a scenario without climate change. This damage could worsen, potentially reducing global income by up to 60% by 2100 if emissions are not drastically cut. The financial toll is especially harsh on developing nations, which have contributed less to global emissions but are facing severe economic impacts.
(Nature)
Plastic fantastic. A recent analysis by the Lawrence Berkeley National Laboratory has revealed alarming projections that global emissions from plastic production could triple by 2050, potentially accounting for one-fifth of the Earth’s remaining carbon budget. This growth is driven by the fossil fuel-intensive process of plastic production, which includes mining, refining, and various chemical processes. Currently, plastic production is a major consumer of global resources, responsible for 5% of worldwide carbon emissions, 12% of oil demand, and 8.5% of gas demand as of 2019. Even with a fully decarbonised power grid, the inherent emissions from raw material processing remain a significant challenge. The findings underscore the urgent need for a global plastics treaty to address and potentially reverse the expansion of plastic production to mitigate its profound impact on climate change and public health.
(The Guardian)
Long reads
Make in Africa. Research also in Africa. Not a long read, strictly speaking, but an important one nevertheless. One where SciDev looks at the road ahead for clinical research in Africa. This piece contends Africa is witnessing significant growth in population and economic transformation, presenting an opportunity to enhance clinical research and trials to address the continent’s unique health challenges. Currently, Africa contributes just 4% to global clinical studies, with actual trials rarely encompassing the entire continent.
(SciDev)
What does your toilet say about you? A proper long read, this one. Beginning with how researchers tracked Covid using wastewater and how wastewater testing can monitor other pathogens and also track health indicators like drug use and potential cancer markers. Happy weekend to you.
(Nature)
Oh, and Gopal Nair doesn’t want you to see this.