7 Thoughts on This — and Next — Week in Global Health
Latest developments in global health policy, politics and practice
1. The headline you didn’t see (because the news media missed it)
Pandemic risk persists because countries fail to reduce risks of either lab leak or spillover
In the media coverage of the declassified information about whether Covid was the result of a lab leak or animal spillover, the most important issue — reducing the risk of both in every country — continues to be ignored and neglected, resulting in little or no progress making the world safer from either.
2. Good news
Work has started on studies of a promising vaccine against tuberculosis. TB kills more people than any other infectious disease, impoverishes families and communities, and remains a risk to healthcare workers and others. An effective vaccine against tuberculosis would merit a Nobel Prize. The planned studies, funded by the Bill and Melinda Gates Foundation and the Wellcome Trust, will cost more than half a billion dollars. The wonderful George Comstock thought deeply and for decades about how to conduct pragmatic trials of new vaccines against tuberculosis; every ethical and valid methodology should be considered.
3. Bad news
Polio viruses continue to spread in many countries. Two countries of particular concern: DRC and Madagascar. The outbreak in Madagascar has been going on for years and without a much better response will remain and increase as a risk for people there and regionally. (I’ll be participating as a member of the polio Independent Monitoring Board next week — more to come on polio.)
4. New Science
More benefits of physical activity have been documented (hat tip to Eric Topol for his tweet on this). Physical activity really is the closest thing we have to a wonder drug: It increases just about everything you’d want to increase and decreases just about everything you’d want to decrease. The new study found that adding physical activity to reducing calorie intake doubled the benefit on insulin sensitivity. Public policy to promote active transport — walking and cycling as part of daily activity — can improve health, reduce pollution, and strengthen not only muscles but also communities!
5. Global policy
Negotiations on both a new pandemic treaty and revisions to the International Health Regulations continue. Hot-button topics are global governance, transparency on data, sharing intellectual property emanating from pathogen discovery, and sharing of vaccines and other life-saving materials in the event of another pandemic. Progress won’t be easy. WHO published a research agenda on another major global risk — antimicrobial resistance.
6. United States
Dr. Rochelle Walensky stepped down after two years at the helm of the CDC. Her essay in the New York Times includes the following, which is well worth reading:
“Most people are likely to never know the name of the person who rappelled from a helicopter to drop Covid-19 test kits onto a cruise ship, nor the fear of a public health officer deployed to an Ebola-laden Ugandan community…. You may not have considered the grueling hours necessary to conduct door-to-door exposure assessments after the Ohio train derailment, and you most likely do not know the tenacity of the team of C.D.C. experts who, after months of investigation, isolated deadly bacteria normally found half a world away from a commonly sold air freshener (the contaminated batch now off the market). And that’s how it’s supposed to be. The people who do this work for you — who often put themselves in harm’s way — serve you and the nation tirelessly, skillfully and selflessly.”
7. Next week
More developments in AI? Climate change? Forest fires? Maybe measles outbreaks — which result from the immunity gap from missed infections and may result in more travel-associated cases in the United States. Measles, which can be completely controlled, kills more than 100,000 children every year — but effective action could make measles outbreaks a thing of the past.
