Article by Lalita Panicker, Consulting Editor, Views and Editor, Insight, Hindustan Times, New Delhi
In June, France hosted the launch of African Vaccine Manufacturing Accelerator (AVMA), an approximately US$1 billion project geared towards making vaccines more available in Africa – away from African soil. www.independent.co.ug/africa-races-to-increase-vaccine-manufacturing-capacity-concerns-rise-over-europes-control/
Only 2% of vaccines in Africa are made on the continent – most of them in South Africa, among few countries with ability to produce vaccines. The African Union wants to raise that percentage to 60% by 2040.
“France and Europe have supported this ambition since 2021 with 1.3 billion euros, but we can do more,” said French president Emmanuel Macron at the Global Forum for Vaccine Sovereignty and innovation in Paris.
At the forum, European Union member countries committed to contribute more than US$ 750 million- including up to US$ 220 million from the EU budget, making them the largest contributors to the financial instrument.
Other donors filling the remaining gap include Germany, the United Kingdom, the United States, Canada, Norway, Japan and the Gates Foundation.
The African Union, represented by the leaders of Botswana, Rwanda, Senegal and Ghana, represented the continent in the launch of the financial instrument, which is backed by Gavi, the Vaccine Alliance — a public-private partnership that provides vaccines to developing countries.
More than three years ago, Africa faced huge inequalities during the global distributions of COVID-19 vaccines, exposing its inefficiencies and vulnerabilities to pandemic shocks – where African countries struggled to access vaccines, testing equipment and treatment tools bought by richer countries in large quantities.
These new funds are intended to offset high vaccine production costs, while also offering bigger incentives for manufacturers that produce priority vaccines such as those against malaria, cholera, and measles.
On the sidelines of the event, African Export-Import (Afriexim) Bank and the Africa Centres for Diseases Control and Prevention (Africa CDC) committed a US$2 billion facility to the “Africa Health Security Investment Plan” which they say will complement AVMA efforts over the next decade.
In a joint statement, Afrieximbank and Africa CDC said their renewed partnerships would address low investor confidence, lack of appropriate infrastructure, trade related barriers, and regulatory challenges that constrain investment in Africa’s health sector.
A week before the Paris forum, Amref Health Africa Group Chief Executive Officer, Dr Githinji Gitahi, raised reservations over hosting the launch in a foreign country, asserting it was sending the wrong message on Africa’s ownership and leadership of the initiative.
An African venue for the launch, Dr Gitahi said, would have provided an ideal platform to showcase existing hubs and potential local manufacturing capacities, building confidence among international partners and investors in Africa’s ability to scale up vaccine production.
Africa has been making progress in its effort to locally manufacture vaccines, with South Africa, Egypt and Senegal leading in this front.
South Africa’s Biovac Institute continues to lead in fostering strategic partnerships with global pharmaceutical companies -the most recent being with Sanofi to establish the first manufacturing capabilities for inactivated polio vaccines (IPV) in Africa.
Under this arrangement, Sanofi will produce the IPV in bulk, while Biovac, holding the marketing authorization, will be responsible for late-stage formulation, filling, packaging, and distribution.
“We are very proud of this partnership with Sanofi, which will empower Biovac as an African manufacturer to champion polio eradication on and for the continent by bringing manufacturing of IPV doses closer to people’s needs,” said Biovac Chief Executive Officer, Dr Morena Makhoana.
Egypt’s Vacsera has been expanding its facilities to increase vaccine production capacity. The company plans to open the first factory for manufacturing bird flu vaccines with a production capacity of 800 million doses per year later in 2024. This development will position Egypt as an African and logistical centre for providing the region’s needs for bird flu vaccine.
In February, the Institut Pasteur in Dakar, Senegal, renowned for its yellow fever vaccine production, benefited from a partnership between Mastercard Foundation and the European Union. This partnership inaugurated the Centre for Africa’s Resilience to Epidemics (CARE) targeting to train 1,000 students in biology to predict, respond to, and prevent epidemics.
“These local initiatives exemplify Africa’s commitment to build a resilient, self-sufficient vaccine supply chain, ensuring better health outcomes and fostering economic growth across the continent,” said Dr Gitahi.
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The Nipah virus claimed the life of a 14-year-old boy from Kerala’s Malappuram district in India on July 21. The resurgence of the disease, which often spreads from fruit bats to other animals and human beings, has prompted the government to impose containment measures in at least two sub-sections in the district.
Kerala Health Minister Veena George said that the teenager died at the Government Medical College Hospital, Kozhikode, while under intense medical care. She attributed the cause of death to a massive cardiac arrest.
The National Institute of Virology (NIV) confirmed that the teenager had succumbed to a Nipah virus infection. A previous Nipah outbreak in Malappuram and Kozhikode districts of Kerala had claimed 17 lives in 2018.
At least three of the boy’s relatives are under surveillance at the hospital, and four others who interacted with him are under observation at the Manjeri Government Medical College Hospital in Malappuram, George said.
She said that those in the high-risk contacted category did not show any symptoms of a Nipah infection. At least seven samples have tested negative. The State Health Minister counselled the public against panic and said that the situation was under control.
Doctors had injected the boy with a monoclonal antibody procured from Australia by the Indian Council of Medical Research, but George noted that the injection is meant to be administered within five days of the patient showing signs of infection. “In the teenager’s case, the deadline for the infusion of antibodies had passed. Still, the medical board authorised the administration as a desperate life-saving measure,” she added.
The national government will deploy a multi-member joint outbreak response team in Malappuram to support the State. The team will help identify epidemiological linkages and provide technical assistance.
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When a snake sinks its fangs into flesh and injects its deadly venom, some of the toxins start to tear through tissues almost immediately. The destruction these toxins can wreak leaves some 400,000 people maimed by snakebites every year. And antibody-based antivenoms, which are the current gold standard of care, are largely powerless to prevent these disabilities. Now, researchers have discovered that a common blood thinner can thwart these toxins in cells and mice—and could one day do the same for people.
www.science.org/content/article/common-blood-thinners-could-combat-cobra-venom?
In their research, published last Tuesday in Science Translational Medicine, the team showed that a blood thinner called heparin and related compounds are highly effective at stopping cobra venoms from killing tissues and cells.
Snakebite is already considered a neglected tropical disease, one that predominately impacts rural populations in Africa and South and Southeast Asia. But even within snakebite, morbidity is somewhat overlooked.
Unfortunately, current treatments for bites do little to stop venoms from creating lesions, which can cause permanent limb damage or even require amputation. In most cases, people arrive at hospitals hours to days after a bite, when “it’s almost too late for the antibodies to be able to work,” says study co-author Nicholas Casewell, a biologist with the Liverpool School of Tropical Medicine (LSTM). Another problem is that the antivenoms’ proteins are so large they don’t make their way into the external tissues where lesions occur.
Further complicating matters is the fact that snake venoms are complex mixtures of dozens of components, and despite decades of research, it remains unclear exactly which are responsible for causing lesions. So, Casewell and other researchers from LSTM and the University of Sydney used the gene-editing tool CRISPR to analyse how human cells respond when attacked by the venoms of red and black-necked spitting cobras, African species known to cause devastating injuries even when antivenom is administered. Knocking out genes involved in the production of heparan sulphates—sugars commonly found in human cell membranes and the scaffolding that supports cells—made the cells resilient to the venoms. That indicated the toxins need to bind to these sugars to destroy tissues. And if that’s the case, the researchers wondered whether molecules shaped like these sugars—including heparins and heparinoids—could act as decoys, binding up toxins and preventing them from harming cells.
Sure enough, when the researchers tried to do this by “flooding” human cells with heparin and heparinoids, the venom toxins stuck to the drugs, preventing them from destroying cells. Heparinoids also reduced the size of venom-induced lesions in mice, even when injected to the animals a few minutes after the venom. The most effective drug was tinzaparin, a $60 per dose heparinoid commonly used to treat excessive blood clotting, which reduced the size of the animals’ wounds by 94% when injected alongside the venom.
Further analyses revealed the primary toxins responsible for forming lesions are three-finger toxins—which are commonly found in the venoms of cobras and many of their relatives. Indeed, when the researchers tested heparin and heparinoids against the venom of three other cobra species native to parts of Asia, the drugs were similarly effective.
A strength of the CRISPR approach, Perry says, is this ability to discover compounds to create a more universal treatment. “It might mean that we can start to create more generalizable antivenoms that don’t rely on being closely matched to the species that are in a particular area.”
However, the drugs didn’t work at all against viper venoms, which generally don’t contain three-finger toxins—and, therefore, must liquefy tissue some other way.
Still, because heparinoids are already approved and sold in pharmacies, clinical trials to test their utility against many species’ venoms could be straightforward and speedy, Casewell says.
Although heparinoids cannot be considered a replacement for antivenoms for preventing death, they could be very useful in saving people with fewer resources in more remote locations. It’s something that’s easy to use in the field and buys us a few hours until they get to the hospital.
