Article by Lalita Panicker, Consulting Editor, Views and Editor, Insight, Hindustan Times, New Delhi
The World Health Organization (WHO) on Thursday launched its mRNA vaccine technology hub in South Africa’s Cape Town, to help poorer countries struggling to gain access to life-saving medication. www.reuters.com/business/healthcare-pharmaceuticals/who-officially-launches-mrna-vaccine-hub-cape-town-2023-04-20/
In 2021, the WHO picked South African biotech firm Afrigen Biologics and local vaccine-maker Biovac for a proof-of-concept pilot project to give poor and middle-income countries the know-how and licences to make COVID vaccines, in what South African President Cyril Ramaphosa then called a historic step.
Afrigen Biologics has used the publicly available sequence of Moderna Inc’s mRNA COVID vaccine to make its own version of the shot – AfriVac 2121 – at lab scale and is now scaling up production.
“The pre-clinical data is very promising to demonstrate that what we’ve created here is credible and would be a platform for mRNA vaccine manufacturing,” Petro Terblanche, Afrigen CEO, told Reuters.
The vaccine candidate, which will be tested on humans in early 2024, is the first to be made based on a widely used vaccine without the assistance and approval of the developer. It is also the first mRNA vaccine designed, developed and produced at lab scale on the African continent.
The hub decided to pursue the vaccine on its own after global pharmaceutical firms, including Moderna and Pfizer (PFE.N),
declined to provide the technical know-how to replicate their vaccines mainly over intellectual property concerns.
The visit by WHO chief Tedros Adhanom Ghebreyesus and senior health officials over five days will include discussions about the programme’s sustainability, the science of mRNA technologies and its potential use to combat other diseases such as HIV and tuberculosis that disproportionately affect poorer countries.
WHO said 69.7% of the global population had received at least one dose of a COVID vaccine as of March 2023, but that figure was still below 30% in low-income countries.
A new COVID-19 variant that recently landed on the World Health Organization’s radar may cause previously unseen symptoms in children, according to a new report. www.medscape.com/viewarticle/990671?ecd=mkm_ret_230419_mscpmrk-US_ICYMI&uac=398271FG&impID=5347809&faf=1
While the variant, called “Arcturus,” hasn’t yet made the CDC’s watchlist, a prominent paediatrician in India is seeing children with “itchy” or “sticky” eyes, as if they have conjunctivitis or pinkeye, according to The Times of India.
The new itchy eye symptom is in addition to kids having a high fever and cough, Vipin Vashishtha, MD, said on Twitter, noting that paediatric COVID cases have picked up there for the first time in 6 months.
The country has also seen a rise in another virus among children with similar symptoms, called adenovirus. COVID and adenovirus cannot
be distinguished without testing, and many parents don’t want to have their children tested because the swabs are uncomfortable, The Times of India reported. One doctor told the newspaper that among every 10 kids with COVID-like symptoms, two or three of them had tested positive on a COVID test taken at home.
Arcturus (formally, Omicron subvariant XBB.1.16) made news 2 weeks ago as it landed on the WHO’s radar after surfacing in India. A WHO official called it “one to watch.” The Times of India reported that 234 new cases of XBB.1.16 were included in the country’s latest 5,676 new infections, meaning the subvariant accounts for 4% of new COVID cases.
//// A new report released by UNICEF finds that 67 million children across the world missed out on either some or all routine vaccinations between 2019 and 2021, and 48 million children didn’t receive a single dose during this time period. www.npr.org/sections/goatsandsoda/2023/04/19/1170635284/why-millions-of-kids-arent-getting-their-routine-vaccinations?
“We’ve seen the largest sustained decline in the number of children reached with their basic childhood immunizations,” says Lily Caprani, chief of global advocacy at UNICEF.
“And the consequences of that will be measured in children’s lives. It’s the largest continuous decline in childhood vaccinations in 30 years.”
But preliminary data from 2022 (not included in the report) suggests some encouraging signs of an uptick in vaccinations in the past year.
The unvaccinated children born just before the COVID-19 pandemic, or during it, are now 3 years old — approaching the age when they would have received these vaccines, typically hepatitis B, polio, measles, rotavirus, diphtheria, tetanus and pertussis. So these kids are “completely unprotected,” says Caprani.
It’s a reflection of how the pandemic disrupted basic health services, says Brian Keeley, editor-in-chief of UNICEF’s annual report, State of the World’s Children.
Countries had to make tough choices about how best to prioritise funds and health resources, he adds. In some cases, that resulted in “resources being diverted to treat people who were sick with COVID or provide emergency services.
Countries in Africa and South Asia have the highest number of under-vaccinated kids and those with zero doses. The totals in West and Central Africa come to 6.8 million children. India leads the world with the largest number of children with zero doses – 2.7 million – followed by Nigeria with 2.2 million unvaccinated children.
“We’re seeing a pretty unprecedented number of measles outbreaks,” says Kate O’Brien, director of WHO’s Immunisation, Vaccines and Biologicals Measles usually results in a high fever followed by a rash. The disease can cause serious complications, like blindness, encephalitis, severe diarrhoea, dehydration and pneumonia. According to the WHO, there were almost 10 million cases of measles around the world in 2018, and more than 140,000 individuals died. Most were children under the age of 5.
Polio cases also saw a troubling trend, says Keeley.
“When you look at the numbers for 2022, the number of children paralyzed by polio was up 60% [compared to] the previous year,” he says. Some 800 cases were reported.
“For my generation, we thought [polio] was over. We thought it was dealt with. It isn’t. If we don’t keep up efforts to vaccinate every child, this will come back.”
UNICEF estimates at least 200,000 lives have been lost due to these disruptions in childhood vaccinations, says Caprani.
“All of the diseases we’re talking about that are vaccine preventable, the more you miss children in that community, the more the entire community and wider society is then vulnerable to a public health emergency,” she adds.
The WHO’s O’Brien is hopeful that many countries managed to get back on track with childhood vaccinations in 2022. At least that’s what preliminary data from 72 countries suggests, she says.
“So based on those countries, it looks like we’ve gotten back to roughly a 2019 level, possibly with some improvement.”
One good example is India.
The country had “a strong commitment” to the immunization program, she says. A program called Mission Indradhanush targeted parts of the country where zero-dose children live.
But the new UNICEF report finds another troubling trend that will need to be addressed by public health programs – a decline in people’s perception of the importance of vaccines.
Of the 55 countries surveyed, 52 showed a decline in vaccine confidence. The remaining three — China, India and Mexico — saw a rise in vaccine confidence.
“Given the context of backsliding and escalating outbreaks, we’re really concerned,” says Caprani.
The non-profit World Mosquito Program (WMP) has announced that it will release modified mosquitoes in many of Brazil’s urban areas over the next 10 years, with the aim of protecting up to 70 million people from diseases such as dengue. www.nature.com/articles/d41586-023-01266-9
Researchers have tested the release of this type of mosquito — which carries a Wolbachia bacterium that stops the insect from transmitting viruses — in select cities in countries such as Australia, Brazil, Colombia, Indonesia and Vietnam. But this will be the first time that the technology is dispersed nationwide.
A mosquito factory will be built in a location yet to be determined in Brazil to supply the WMP’s ambitious initiative, in partnership with the Oswaldo Cruz Foundation (Fiocruz), a Brazilian public science institution in Rio de Janeiro. The facility should begin operating in 2024 and will produce up to five billion mosquitoes per year. “This will be the biggest facility in the world” to produce Wolbachia-infected mosquitoes, says Scott O’Neill, a microbiologist at Monash
University in Melbourne, Australia, and head of the WMP. “And it will allow us in a short period of time to cover more people than in any other country.” Brazil has one of the highest rates of dengue infection in the world, reporting more than two million cases in 2022.
The bacterium Wolbachia pipientis naturally infects about half of all insect species. Aedes aegypti mosquitoes, which transmit dengue, zika, chikungunya and other viruses, don’t normally carry the bacterium, however. O’Neill and his colleagues developed the WMP mosquitoes after discovering that A. aegypti infected with Wolbachia are much less likely to spread disease. The bacterium outcompetes the viruses that the insect is carrying.
When the modified mosquitoes are released into areas infested with wild A. aegypti, they slowly spread the bacteria to the wild mosquito population.
Several studies have demonstrated the plan’s likely success. The most comprehensive one, a randomized, controlled trial in Yogyakarta, Indonesia, showed that the technology could reduce the incidence of dengue by 77%, and was met with enthusiasm by epidemiologists.
In Brazil, where the modified mosquitoes have so far been tested in five cities, results have been more modest. In Niterói, the intervention was associated with a 69% decrease of dengue cases. In Rio de Janeiro, the reduction was 38%.
The variation might have to do with environmental differences among the cities — for example, in areas with a larger wild mosquito population, Wolbachia might take longer to spread.
Wolbachia-infected mosquitoes have already been approved by Brazilian regulatory agencies. But the technology has not yet been officially endorsed by the World Health Organization, which could be an obstacle to its use in other countries. The WHO’s Vector Control Advisory Group has been evaluating the modified mosquitoes, and a discussion about the technology is on the agenda for the group’s next meeting later this month.
A large study has shown that a test can indicate a person has Parkinson’s disease before they start having symptoms. The chronic degenerative disease currently lacks a definitive biochemical test. www.sciencemagazinedigital.org/sciencemagazine/library/item/21_april_2023/4095973/?Cust_No=60329732
A research team recruited 1123 participants, some of whom had symptoms of Parkinson’s, and used spinal taps to measure their levels of a protein called alpha-synuclein, which clumps and damages brain cells in people with the disease. Study participants whose alpha-synuclein clumped to an extent above a threshold level were deemed to have Parkinson’s. In 88% of the subjects, the test accurately indicated whether they had the disease, researchers reported last week in The Lancet Neurology. The new approach is likely too costly and invasive to be used widely for screening but may inform research into treatments, scientists say.