A World Without a Mouse? The African Monkeypox Epidemic Implications and Their Impact on Health Care Workers in Sub-Saharan Africa

Ollario says that the monkeypox virus causes death in Africa, and that could lead to future epidemics around the world. “Monkeypox may come back again in a more nasty way,” he adds. Scientists worry that a strain of the virus found in Central Africa could spread. This one kills about 10% of infected people, making it more lethal than the strain circulating in West Africa that is thought to have sparked the global outbreak. There have already been signs that the clade I strain can spread beyond its typical range: it was responsible for an outbreak last year at a refugee camp in Sudan that led to more than 15 confirmed and 180 suspected infections, Lewis says.

Millions of vaccines purchased by and distributed throughout wealthy countries such as Canada and the UK have been out of reach for fighting mpox in Africa. (The viruses that cause smallpox and mpox are related, so health officials hoped that smallpox vaccines would also work for mpox.) According to an announcement by Africa Centres for Disease Control and Prevention, the African Union is receiving a 50,000-dose donation from South Korea, which is the continent’s first vaccines not designated for research purposes. Nature asked when the doses would be delivered, but the agency did not reply.

He thinks that global health inequalities are inevitable, so he doesn’t get upset about them. He says the real problem is that African countries rely on the West too much. For one, Tomori says Western aid always comes too late. He stressed that your help is not helping us. It’s making us more dependent.”

The value chain might allow for some independence, but Happi thinks that the most important thing to do is invest in public health professionals. African countries should thus aggressively train field epidemiologists, Ph.D. scientists and frontline health-care workers — such as doctors, nurses, and midwives — “to build capacity on the ground,” he says.

Part of the problem is that, of the 47 countries in sub-Saharan Africa, six of them don’t even have a single medical school while 20 countries only have one. By 2030, WHO estimates that Africa will be short 6.1 million health-care workers, relative to the Sustainable Development Goal threshold of 4.45 health-care workers per 1,000 people.

A hub-and-spoke model for preventing epidemics: the West African Ebola case study in Likouala, Congo

Perhaps the most infamous example was during the West African Ebola epidemic when it took nearly three months to identify the virus in Guinea. Clinicians had never managed cases, which caused the country to take so long. No laboratory had ever diagnosed a patient specimen. No government had ever witnessed the social and economic upheaval that can accompany an outbreak of this disease.” When it was finally acknowledged that it was the Ebola, it was ready to explode.

Mombouli also gives the example of Likouala Prefecture, a swampy area in northern Congo and one of the poorest, least developed regions in the country. He calls Likouala a “paradise for pathogens,” rife with everything from the disease-causing bacteria treponema to the viral disease Rift Valley Fever. “You know something terrible is going to come out of that area,” he says. Without proper pathogen monitoring, it’s only a matter of time.

Public health agencies have an important role to play in empowering locals with educational programs and coordinating the response, says Tomori. Some of the best early warning systems come from those living on the frontlines of novel diseases. “If you take care of that first case, you can prevent an epidemic,” he says.

Mombouli’s team similarly visited 268 villages in northern Republic of Congo between 2008 and 2018; they were trying to establish community-based surveillance system for Ebola. They educated locals about the virus and how it could spread through infected wildlife carcasses, emphasizing the core message: “Do not touch, move or bury the carcass and contact the surveillance network immediately.”

What’s the solution? There’s something called the hub-and-spoke model, where one “hub” aggressively develops novel vaccine technology and then freely transfers it to the “spokes,” local manufacturers that can scale up production. The philosophy is that Africa’s value chain needs to be independent of high-income countries.

Last year, WHO chose South African biotech company Afrigen to be the hub for mRNA technology transfer, and 15 spokes have since been identified across various low- and middle-income countries, including six in Africa. A version of the vaccine that doesn’t require cold storage was made by Afrigen despite Moderna and Pfizer-BioNTech refusing to share their technology. African countries will be the first to use novel vaccine technology to contain diseases that are spreading on the continent in particular.

“If the company decides to move out,” he says, “then we go back to square one.” Due to hesitancy and difficulties in distributing the vaccine, Aspen pharmacare may soon shut down its South African plant making COVID-19 vaccines because of insufficient demand.

Undoubtedly, this will take time, with Afrigen expected to enter clinical trials later this year and vaccine approval coming in 2024, but much can be done in the interim. African countries can identify other aspects of the value chain that they can start to contribute to immediately. For instance, one might manufacture glass vials, another rubber stoppers, another testing swabs and so on. Each country doesn’t need to produce everything end-to-end, but Tomori says they should all be starting somewhere instead of patiently waiting for international aid.

But things are beginning to change. Namibia, for instance, is one of four African countries that has surpassed the WHO threshold — with 10.28 workers per 1,000.

This fledgling success stems from government prioritization. In a recent paper in World Health and Population, authors from Namibia’s Ministry of Health and Social Services described how they used a WHO tool to diagnose the country’s staffing shortcomings. They made evidence-based decisions about expanding nurses’ scope of practice and redeploying health- care workers to the regions of most need with this data.

There must be a focus on retention as it is critical to continue building more medical institutions, such as the GE Healthcare Skills and Training Institute and the University of Global Health Equity.

While better pay might be the lynchpin, other incentives could include a mix of personal benefits and career improvements: housing, land ownership, modern equipment and pathways for professional growth, according to Kasonde Bowa, dean of Copperbelt University School of Medicine in Zambia. And if the brain drain still persists, Happi thinks that Western countries should start reimbursing the continent for its educational expenses, given that it costs African countries between $21,000 to $59,000 to train one doctor.

This wouldn’t necessarily stop the exportation of health-care workers, but having the West fork over the money could help African countries replenish their workforce. “People should be honest enough to say that you cannot deplete a continent of its own resources,” Happi says.

That is not to say that partnerships between Africa and Western countries should not be pursued. After all, it was Sikhulile Moyo, the laboratory director at the Botswana-Harvard AIDS Institute Partnership and a research associate with the Harvard T.H. Chan School of Public Health, who first identified the omicron variant. They deployed COVID-19 tests in hospitals in Nigeria and other countries before the US had them. Partners in Health also recently announced plans for the $200 million Paul E. Farmer Scholarship Fund, which will support students at the University of Global Health Equity in order to “educate future health care leaders in Africa.”

Source: https://www.npr.org/sections/goatsandsoda/2022/11/04/1133319628/african-scientists-say-western-aid-to-fight-pandemic-is-backfiring-heres-their-p

The Case for a Realistic Intellectual Property Law: The Case against COPs in the Era of the End of the Global Biosecurity Crisis

Simar is an American journalist who used to work at The Atlantic, TIME, Guardian, and Washington Post. He studies the history of science at Harvard University and is also a research fellow at Massachusetts General Hospital. Follow him on the social networking site, t he name is Simar.

The WHO does not say so explicitly. statement can be read as a rebuke to the leaders of high-income nations, highlighting the fact that their response to the ongoing pandemic has not been a model of cooperation or compassion. A promise to support a vaccine distribution scheme went unfulfilled. Rich countries were busy with vaccines and were unable to reach people in other countries who needed them. Intellectual property is at the heart of the pharmaceutical industry and some of the best-known and well-respected companies fought to stop it being shared. Had they not done so, more manufacturers could have produced vaccines and treatments, and more lives could have been saved. The WHO drafted a treaty to make sure that this wouldn’t happen again. But as Nature has argued before, a treaty on its own offers no guarantee that promises will be kept.

All of this has the backing of scientists and campaigning organizations. Researchers are concerned by the lack of clarity on the way the treaty will work, and how it will be used in practice. The WHO says that a democratic forum in which all countries have an equal voice in decision-making is the best way to make decisions.

The creation of a framework would mean that the WHO would struggle to get countries to fund it properly, even though COPs are expensive to run. We know from the decisions made by those in charge of international action on climate change and biodiversity loss thatCOPs take their time to reach them.

What African HIV is telling us about HIV in Africa: A case study of mpox in Uganda, Nigeria, and Ogoina

Ogoina says that the infections in Africa are still not being noticed. Out of more than 7,200 infections on the continent suspected of being mpox in 2022, only about 1,200 could be confirmed by standard diagnostic methods, because of an underfunded testing and surveillance infrastructure. TheDRC has reported more than 70% of the suspected cases on the continent.

Outside of Africa over the past year, the virus has spread mainly among men who have sex with men, through close skin-to-skin contact. Transmission patterns and clinical manifestations of the disease are much harder to pin down in some African countries, where rodent species are thought to naturally harbour the virus and regularly spread it to humans. In the United States, most people with the viruses have been men and in Nigeria, only 60 percent of the people who have been confirmed with the virus are men.

Still, the global focus on the virus has changed a few things in Africa. For one, because of all the published case reports, physicians who had never heard of the disease now know what the telltale lesions look like, Ogoina says.