South Africa Hails COVID-19 Vaccine Patent Waiver

Johannesburg, South Africa — 
South Africa on Saturday hailed a WTO agreement to allow developing countries to start producing their own COVID vaccines following a near two-year battle.
“We secured an agreement. It was a strongly fought agreement,” said Minister of Trade Ebrahim Patel, who along with India and NGOs had been calling for an intellectual property rights waiver on COVID-related treatments.
The World Trade Organization (WTO) announced a relaxation of intellectual property restrictions on vaccines Wednesday in a move aimed at a providing more equitable access to shots but which many observers criticized for being limited in time and scope.
After months of wrangling, and talks going down to the wire this week to win over some major players in pharmaceutical manufacturing to a compromise, the United States and China finally clinched the deal by agreeing on which countries would benefit from the waiver.
Both South Africa and India had been vocal in their demands for such a move which they said was needed to stop “vaccine apartheid.”
According to the WTO, 60% of the world’s population has received two doses of the COVID vaccine but there are glaring examples of inequity with only 17% having been inoculated in Libya, with the figure at 8% in Nigeria and less than 5% in Cameroon.
In a statement, the South African government saluted a waiver designed to provide local vaccine manufacturers with the right to produce either vaccines or ingredients or elements that are under patents, without the authority of the patent holder, hailing this as a notable step forward — even if limited to five years.
Pretoria added that “to scale up the production on the continent, further partnerships will be needed including access to know-how and technologies.”
The accord for the time being excludes, however, tests and costly therapeutic treatments against COVID on which the WTO is to pronounce in the coming six months.
Commercialization in Africa will be a challenge, however.
Durban-based South African pharma giant Aspen, which clinched a deal last November with U.S.-based Johnson & Johnson to manufacture a “made in Africa for Africa” Aspen-branded COVID vaccine Aspenovax, said last month it could pull the plug owing to lack of orders.
“Our focus now is to ensure we address demand by persuading global procurers for vaccines to source from African producers,” said Patel.
South Africa has three sites under the aegis of Aspen in Durban, Afrigen in Cape Town and Biovac, also in Cape Town, which makes the Pfizer-BioNTech vaccine.
Afrigen’s biotech consortium makes the messenger RNA shot based on the Moderna formula, the first to be made based on a broadly used vaccine that does not require the developer’s assistance and approval.

Vaccination rates for the vulnerable are soaring in Africa, the W.H.O. says.

Most countries in Africa have made significant gains in vaccinating two vulnerable groups against Covid-19, but new infections are creeping upward as summer travel begins and some countries ease public health measures, the World Health Organization said on Thursday. About half of public health workers and people over 60 have been fully vaccinated in 31…

Pregnant people in Sub-Saharan Africa are at higher risk of complications and death from COVID-19

Pregnant people who are hospitalized with COVID-19 in Sub-Saharan Africa are dying at a rate far greater than pregnant people without COVID-19 and non-pregnant people with COVID-19, according to a new multicenter study encompassing six African countries. The research was published today in Clinical Infectious Diseases and led by a University of Pittsburgh School of Public Health infectious diseases epidemiologist.

The effects of COVID-19 on pregnancy have been studied in detail in high-income countries, such as the U.S., but studies of similar size and scope are lacking in low- and middle-income countries and non-Western settings. The new findings confirm that pregnant people are at higher risk of complications and death from COVID-19 and, therefore, should be prioritized with other high-risk people for COVID-19 vaccination in Sub-Saharan Africa.

Our findings indicate that hospitalized pregnant women with COVID-19 in Sub-Saharan Africa have two to five times greater risk of needing intensive care and dying than uninfected, hospitalized pregnant women. We must urgently prioritize pregnant women among at-risk populations in COVID-19 vaccine programs in Africa.”

Jean B. Nachega, M.D., Ph.D., M.P.H., lead author, associate professor of infectious diseases and microbiology and epidemiology at Pitt Public Health

The large study looked at outcomes of over 1,300 female patients of child-bearing age who were hospitalized between March 2020 and March 2021 in one of six countries: the Democratic Republic of the Congo, Ghana, Kenya, Nigeria, South Africa and Uganda. Specifically, this study looked at three categories: pregnant women with COVID-19, non-pregnant women with COVID-19 and pregnant women without COVID-19.

Researchers found that the rates of intensive care unit (ICU) admission and use of supplemental oxygen were at least two-fold higher and the death toll increased five-fold in the pregnant women with SARS-CoV-2.

Related StoriesSub-Saharan Africa also has higher rates of tuberculosis (TB) and HIV than the U.S., and published studies on COVID-19 among people with these chronic infections have had conflicting results, so the team also investigated the impact of these infections on their study population. Among the participants, both pregnant and non-pregnant women with HIV or a prior history of TB had a two-fold increased risk of ICU admission.

“The burden of TB and HIV infections in Africa adds to the risk of severe COVID-19 during pregnancy,” said coauthor John W. Mellors, M.D., chief of the Division of Infectious Diseases in Pitt’s School of Medicine. “This further underscores the importance of COVID-19 vaccination as part of prenatal care.”

Nachega, who splits his time between Pitt Public Health and a faculty position at Stellenbosch University in South Africa, noted recent progress on increasing the COVID-19 vaccine supply in Africa but emphasized that COVID-19 vaccine hesitancy and misinformation about public health guidance is a global issue, and Africa is no exception. In an editorial published alongside the study, Nachega and fellow researchers emphasized that targeting COVID-19 vaccinations to this population is key in improving mother and infant outcomes.

“COVID-19 vaccine hesitancy and low vaccine uptake in pregnancy include misinformation and disinformation promoted on social media and other platforms, which mislead the public about side effects, such as infertility and potential fetal harm,” Nachega said. “Along with devoting resources to promoting vaccination, we must also work to stop the spread of misinformation.”
University of PittsburghJournal reference:Clinical Infectious Diseases. DOI: doi.org/10.1093/cid/ciac294

Widespread population immunity of Covid-19 observed in South Africa before Omicron wave

1. Widespread underlying SARS-CoV-2 seropositivity was observed in Gauteng province, South Africa, before the omicron wave.
2. Epidemiologic data demonstrated a decoupling of hospitalizations and deaths from infections while omicron was circulating.
Evidence Rating Level: 2 (Good)
Study Rundown: The Omicron variant was first identified in November 2021 in Gauteng province, South Africa, and was designated as a variant of concern due to its predicted high transmissibility and its potential to evade immunity from neutralizing antibodies induced by vaccination or natural infection with wild-type virus. The omicron variant outcompeted the delta variant in Gauteng and was responsible for 98.4% of the cases sequenced in South Africa in December 2021, and a prior population-wide seroepidemiologic study demonstrate that 19.1% of the population was seropositive for Covid-19. However, there is a gap in knowledge as to understanding the seroprevalence of Covid-19 before the omicron wave. This study found that there was widespread underlying SARS-CoV-2 seropositivity in Gauteng before the omicron-dominant wave of Covid-19. This study was limited by changes in the frequency of testing over time which limited head-to-head comparisons of case numbers across waves, and the fourth omicron wave had not fully subsided at the time of this analysis, which will result in a lag in the reporting of data such as hospitalizations and deaths attributable to this wave. Nevertheless, these study’s findings are significant, as they demonstrate that there was widespread seropositivity of Covid-19 in Gauteng prior to the omicron wave and that there was a decoupling of hospitalizations and deaths from infections while omicron was circulating.
Click to read the study in NEJM
Relevant Reading: Omicron — Decoupling Infection from Severe Disease
In-Depth [seroepidemiologic survey]: This seroepidemiologic survey was conducted from October to December 2021 in Gauteng province, South Africa, to determine the seroprevalence of SARS-CoV-2 IgG, obtaining samples from 7010 participants, of whom 18.8% had received a Covid-19 vaccine. Patients who live in the Gauteng province and were able to provide written informed consent were eligible for the study. Patients who resided outside of the studied province or declined to participate were excluded from the study. The primary outcome measured was seroprevalence measured with dried-blood-spot samples and tested for IgG against SARS-CoV-2 spike protein and nucleocapsid protein. Outcomes in the primary analysis were assessed via unadjusted, univariable analyses for each risk factor with generalized linear models with a log link to estimate risk ratios. Based on the analysis, the seroprevalence of SARS-CoV-2 IgG ranged from 56.2% among children younger than 12 years (95% Confidence Interval [CI], 52.6 to 59.7) to 79.7% among adults older than 50 years of age (95% CI, 77.6 to 81.5). 93.1% of vaccinated participants were seropositive for SARS-CoV-2 while 68.4% of unvaccinated participants were seropositive. Epidemiologic data also demonstrated that the incidence of Covid-19 infection increased and subsequently decreased more rapidly during the omicron wave than it had during the three previous waves. The incidence of infection was decoupled from the incidences of hospitalization, recorded death, and excess death during the fourth wave, as compared to the proportions seen in the previous three waves. Overall, this study demonstrated that there was widespread Covid-19 seropositivity in the Gauteng province of South Africa before the omicron wave, showing that there was a decoupling of hospitalizations and deaths from Covid-19 infections while the omicron variant was still circulating.
Image: PD
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New COVID Vaccine Aims to Boost Underserved Nations in Africa, India

  Why CORBEVAX?  Scientists in the state of Texas in America have developed a new accessible COVID-19 vaccine (CORBEVAX) to combat low inoculation rates in low-income and underserved countries. Hailed as “the World’s COVID-19 vaccine,” Texas Children’s Hospital and Baylor College of Medicine’s CORBEVAX uses the conventional method of taking a harmless protein from the…