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

W.H.O Predicts Steep Drop in Covid Deaths in Africa in 2022

The World Health Orga­ni­za­tion expects the num­ber of Covid-19 deaths in its Africa region to fall sharply this year, com­pared with 2021, the agency said on Thurs­day. The pre­dic­tion was a hope­ful one for the world’s least vac­ci­nat­ed con­ti­nent, though it reflect­ed a vast under­count­ing of past coro­n­avirus infec­tions and deaths in offi­cial tal­lies. W.H.O.…

Report: Global Pandemic Increased Poverty in Africa

Nairo­bi —  The glob­al pan­dem­ic has pushed more than 55 mil­lion Africans into extreme pover­ty and reversed two decades of hard work in pover­ty reduc­tion on the con­ti­nent. The Eco­nom­ic Report on Africa for 2021 blamed the grow­ing pover­ty on job loss­es, reduced income and the inabil­i­ty of house­holds to man­age the risks In a 150-page…

Africa’s First Covid-19 Vaccine Factory Has Not Received a Single Order

JOHANNESBURG — The first fac­to­ry in Africa licensed to pro­duce Covid-19 vac­cines for the African mar­ket has not received a sin­gle order and may shut down that pro­duc­tion line with­in weeks if the sit­u­a­tion doesn’t change, accord­ing to exec­u­tives of the com­pa­ny, Aspen Phar­ma­care. The fac­to­ry, in the coastal South African city of Gqe­ber­ha, formerly…

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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