In the current pandemic scenario, public health experts need to look at the establishment of animal health care and the strengthening of an ecosystem where human and animal will live congruently to protect human health. This integrated, holistic and harmonious approach to protecting human health is referred to as one world one health, a name coined by the wildlife conservation society. A better understanding of the ecosystem is needed to protect public health

By Dr. Meenakumari Natarajan, MPH.Ph.D

Health Economist, Epidemiologist

Scientist-C-National Institute of Epidemiology (NIE-ICMR), Chennai – India

 Back to Basics 

Lessons Learnt from COVID-19 Pandemic

 

In this postmodern world, matching pace with the world’s growth and securing a place for oneself, our complicated life is burdened with the fear of new, sometimes anonymous diseases which are growing drastically, and it is a major concern for research. One such disease is COVID-19. The world is becoming small, national borders are diminishing by recent developments in all sectors. More people travel or trade across the global. Our ecosystem also includes forest, sea and space. With all these changes it is becoming easier for diseases have jumped from animals to human.

The viruses find ways to jump from species to species. Jumping from one species to species is a good survival strategy for viruses like swine flu virus, HIV, now coronavirus.  COVID-19 is a relatively new virus. It has only recently jumped to human which is part of the reason. Viruses need hosts and that jumping among hosts is good for viruses but often not so good for hosts. In recent days scientists have made amazing and wonderful progress in tracing the origin of COVID-19: found bats were indeed involved. (Kock, Karesh et al. 2020)

At present mankind is facing many challenges, which will require globally integrated solutions. The spread of infectious diseases that jumped from animals to human was mainly by the interface in the ecosystem which they live. In the preindustrial phase, birth and death rate were similar, the world was balanced fluctuated conferring to natural events like droughts and disease. Unfortunately, the invention of new techniques and procedures caused the death rate to decline further resulting in a population explosion. Millions of animals were hunted to feed billions of people. It is important to note, that the present evidence that exponential growth of population, urbanization, modernization of the farming system all made encroachment of forest and closer interaction of wildlife thereby exposing humans and domestic animals to new pathogens.

In this scenario, public health experts need to look at the establishment of animal health care and the strengthening of an ecosystem where human and animal will live congruently to protect human health. This integrated, holistic and harmonious approach to protecting human health is referred to as one world one health, a name coined by the wildlife conservation society. A better understanding of the ecosystem is needed to protect public health.

World history is plagued with wars, boycotts, violence, and pandemics; however, death and health are shaken by uncontrolled pandemics such as COVID-19. Many countries have done enormous effort to contain COVID-19 such as early diagnosis, contact tracing, contact isolation, quarantine, social distancing, temporary hospital construction, financial support to citizens, closing the national borders, cutting off transportation intra and international etc.. This increases many additional issues such as global economic loss, Economic recession, economic slowdown and supply chain cut off. At present we do not have any clear-cut structure or strategy to confront a future global pandemic and economic crisis. (Pan, Ojcius et al. 2020).

Now the world is moving towards health promotion, disease prevention and it cannot be achieved by alone. It requires support from other sectors such as education, agriculture, industries etc. It requires cooperation and partnership across the disciplines. It is time for the world to review their pandemic plans to address pandemic preparedness in their business plans Many countries have started, tested and updated their plans to reduce the negative impact of a pandemic on the industry, economy, education, ecosystem and health. (Chakraborty and Maity 2020)

However, in line with the ideas of harmonious life with the ecosystem, it can be concluded that this is time for us to Revisit, Revise, Restructure, Reform, and Rebuild ourselves to counteract future crisis.

 

References

1. Chakraborty, I. and P. Maity (2020). “COVID-19 outbreak: Migration, effects on society, global environment and prevention.” Sci Total Environ 728: 138882.
2. Kock, R. A., W. B. Karesh, F. Veas, T. P. Velavan, D. Simons, L. E. G. Mboera, O. Dar, L. B. Arruda and A. Zumla (2020). “2019-nCoV in context: lessons learned?” Lancet Planet Health 4(3): e87-e88.
3. Pan, X., D. M. Ojcius, T. Gao, Z. Li, C. Pan and C. Pan (2020). “Lessons learned from the 2019-nCoV epidemic on prevention of future infectious diseases.” Microbes Infect 22(2): 86-91.

 

News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

News Flash 381

 

Webinar registration: The COVID Pandemic and the WHO: Need for Reflection and Global Solidarity, May 8, 2020 

Weekly COVID-19 Pandemic Briefing – The Geopolitics of the Coronavirus 

 WHO: Coronavirus disease (COVID-2019) situation reports 

‘Finding The Balance’ In Saving Lives & Livelihoods From COVID-19 – Charting Ways Forward In Africa 

WHO: EU draft for WHA on “COVID-19 Response” lacks clarity 

What does the EU’s pledging event on May 4th, to fight COVID-19 actually mean for global health? 

Is ODA up to the challenges posed by the coronavirus pandemic? 

The Economic Impact of COVID-19 around the World: Projections of Economic Growth Falling Further, Food Insecurity, and A Round-Up of Other Recent Analysis 

Interactive: An analysis of COVID-19 funding in West and Central Africa 

Urgent steps are needed to define how COVID-19 medical tools can really be “global public goods” 

Needed: a pandemic patent pool 

March-In Rights And Compulsory Licensing—Safety Nets For Access To A COVID-19 Vaccine 

Public health must be strengthened for a healthy post-COVID world 

Il silenzio degli innocenti 

The One Health Initiative: The Collaboration Between Human and Animal Medicine 

Staying Sane during COVID-1: Mental health resources for ourselves, others, and the world 

The COVID-19 Pandemic And Rural Hospitals—Adding Insult To Injury 

Global Humanitarian Response Plan COVID-19: Information update (1 May 2020) 

Yes, COVID-19. But what about other infectious diseases? 

Microbe that blocks malaria identified in mosquitoes 

Economic evaluation of short treatment for multidrug-resistant tuberculosis, Ethiopia and South Africa: the STREAM trial 

TB and Covid-19 Interactive maps 

UN response to Haiti cholera epidemic lambasted by its own rights monitors 

Reducing antibiotic use in livestock, China 

Sudan criminalises female genital mutilation (FGM) 

Record child displacement figures due to conflict and violence in 2019: UNICEF 

A Global “Hunger Pandemic” is Coming. Who’s Giving to Keep People Alive?

‘Big push’ on food security as COVID-19 response enters second phase 

Food insecurity in West Africa could leave 43 million at risk as coronavirus hits 

EU weighs options for gas grid in zero carbon world 

Energy firms rally behind green stimulus call 

Billions Could Live in Extreme Heat Zones Within Decades, Study Finds 

 

 

 

Postscript piece here by George Lueddeke is just an addition - an update to an article by him first posted on PEAH in March this year. Publishing it further to the article may be of help to reinforce proactivity and awareness governments and policymakers desperately need in preparation for post-Covid-19. Given the devastating worldwide effects of the pandemics, no wonder, indeed, global and national leaders are urged to collaborate and adopt sustainability values and measures without delay to save the world from itself.

Comments on the article and postscript are welcomed – glueddeke@aol.com

By George Lueddeke PhD, MEd, Dipl. AVES (Hon.)

Chair, One Health Education Task Force and the international One Health for One Planet Education initiative (1 HOPE) 

(One Health Commission and the One Health Initiative)

POSTSCRIPT

The World at Risk

Covid-19, Global Sustainability and 1 HOPE

The article published on 25 March 2020 reported data that totally underestimated the devastating global effects of Covid-19. Since that time the pandemic has forced more than 30 million Americans alone to lose their jobs, far exceeding the 25 million job losses worldwide predicted by the United Nations. Indeed, projections are now that close to 200 million people could end up without work globally – ten times the March prediction with over 80% of the global workforce of 3.3 billion people having had their workplace fully or partly closed. Business is in freefall with several countries (e.g., France, Italy) already in recession and GDP possibly collapsing by as much as 12 percent across the Euro area as shoppers stay indoors. The possibility of a global depression similar to the 1930s is very real. While the coronavirus antiviral drug remdesivir looks promising, many scientists agree that it may not be a “game-changer” for most patients, and the hunt is on for a long-term solution to the global crisis. Over 100 clinical labs are conducting intensive research – most collaboratively- to develop a vaccine that would provide protection for billions of people with Oxford University and Imperial College leading the way in the UK.

The impact of Covid-19 has been devastating with the total number of cases across the world now moving toward 4 million (May 3) and most of the more than 254,000 deaths in the US (c. 66, 000), followed by Spain (c. 25,000), Italy (29,000) and the UK (c. 30,000). On a cautiously  more positive note, in some  countries the cases  may have peaked in April and governments have begun to ease restrictions on social distancing as concerns remain over  the psychological effects of those (especially the elderly and young) forced to remain indoors and away from family and friends.

Covid-19 was not unexpected as key reports in the US (e.g., independent Commission on a Global Health Risk Framework for the Future [GHRF], 2016; Harvard’s Global Health Institute report, Global Monitoring of Disease Outbreak Preparedness: Preventing the next Pandemic, 2019) all  reached similar conclusions as the GHRF:  “a flu pandemic could kill millions, cost trillions, and derail the global economy.”  In the UK the possibility of a pandemic was considered a “level five” threat-war-gamed in October 2016. Notably, the Global Preparedness Monitoring Board in 2019 also alerted governments to scale up “research and development for new vaccines and medicines.” Its chair, Dr Gro Harlem Brundtland, formerly Prime Minister of Norway and Director-General of the World Health Organization, lamented that world leaders’ response to an impending crisis was “a cycle of panic and neglect.”

The questions on everyone’s mind are ‘when will the pandemic be over?’ and ‘what changes will need to be put in place to create a new “normal,”?’ –  one that mitigates the probability of a pandemic reoccurrence, and other possibly future crises.  As someone recently said, the “old normal” was never “normal,”  not when we have regions and countries, for example, Africa and India – with over 1 billion people each – excluded as permanent members of the United Nations Security Council (UNSC), the UN’s most powerful body that  has ‘primary responsibility for the maintenance of international peace and security’ but seems to be in a state of  Covid-19 ‘paralysis,’  when we are driving species to extinction at about 1000 times baseline rates, while decreasing vertebrate animals by more than  50% in the past two generations. And, definitely not when social injustices and inequities are allowed to continue  (e.g., the Syrian conflict – creating ‘one of the worst humanitarian crises of our time’ with millions killed or forced to flee their homes now facing Covid-19,  and, globally, 4.5 billion out of c 7.8 billion without safe sanitation). Can we really continue on a planet where annual funding for conflicts and wars (c. US $13 trillion) is prioritised over peace (c. US $ 6 billion) with on-going attempts to reduce even this amount?  And, can we simply ignore the latest metaphorical re-setting of the Atomic Clock (threats to humanity – e.g., nuclear weapons, climate change, pandemics) by the members of the Bulletin of the Atomic Scientists, from 2 minutes to midnight in 2018 to 100 seconds in January 2020?

In terms of responding to the question on the length of the pandemic raised in the previous paragraph no one really knows the answers and will largely depend on how well people follow government guidelines on keeping safe. Unfortunately, many of the most vulnerable living in the poorest conditions will not have any guidelines to follow and will be at greatest risk to themselves and their families and indeed the world. Their plight will need to become a top global priority as we strive to build  a new “normal” and the adoption of  a global new mindset – re-orienting society  from its main concern for itself and separate from and superior to nature (anthropocentrism or humancentrism) – the root causes of most global problems today!- to one that respects and protects the sanctity of all life and the sustainability of the planet (ecocentrism). Transdisciplinary education (holistic learning!) – across all formal and non-formal levels – that demonstrates a much greater concern for the future – remains our best hope for transforming society in the longer run.

In the immediate, the sage advice offered by Angel Gurria, OECD Secretary General, is well worth noting as governments plan for a new “normal”.  In a piece entitled “Tackling the coronavirus (Covid-19) crisis together: Contributing to a global effort,”  he  contends  that in the post-COVID world

“…governments have a unique chance for a green and inclusive recovery that they must seize – a recovery that not only provides income and jobs, but also has broader well-being goals at its core, integrates strong climate and biodiversity action, and builds resilience. Stimulus packages need to be aligned with ambitious policies to tackle climate change and environmental damage. Only such an approach can deliver win-win-win policies for people, planet and prosperity.”

Applying lessons from previous crises, the Secretary General’s recommended strategies include the need to

• align ‘the short-term emergency responses to the achievement of long-term economic, social and environmental objectives and international obligations (the Paris Climate Agreement, the SDGs)’;
• prevent ‘lock-in of high-emissions activities’ while focusing  ‘support on the most vulnerable countries’; and
• ensure the systematic integration of ‘environmental and equity considerations into the economic recovery.’

His concluding comment that ‘Protecting the planet is the most important inter-generational responsibility we have today’ is one that must be taken very seriously by all decision-makers.   Significant steps in this direction would be reversing decades of undervaluing and underfunding (5%: 95% ratios) public health measures at the expense of treatment and increasingly unaffordable cures. Extending the meaning and responsibilities of public health to embrace not only human health and well-being but also all species is another critical advance.  In this regard, bringing human and veterinary medicine more closely together (education, research, practice) would not only reduce costs but most importantly also lead to building our capacity for ensuring the sustainability of life on earth. Over 70% of all emerging diseases today are of animal [zoonotic] origin. Covid-19  is the most recent and likely one of the most devastating pandemics  in the past century, and  to save the world from itself,  global and national leaders – regardless of  political persuasion or ideological leanings – are urged to collaborate and adopt sustainability values and measures without delay.

In the final analysis, will any of our differences or divisions that we have created matter on a planet potentially devoid of life?

 

———————————————

Comments on the article and postscript are welcomed – glueddeke@aol.com

 

 

 

News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

News Flash 380

 

COVID-19 Call to Action: Short – Term Assignments with the WHO Global Outbreak Alert and Response Network (GOARN) 

WHO May Host Virtual World Health Assembly May 18 – COVID-19 To Be Main Agenda Item 

Coronavirus disease (COVID-2019) situation reports 

Coronavirus Response: Commission adopts banking package to facilitate lending to households and businesses in the EU 

Modelling the COVID-19 epidemic and implementation of population-wide interventions in Italy 

‘The World Should Have Listened To WHO’ Says Director General Tedros; Arthritis Drug Shows Promising Results Against COVID-19 In Early Trials 

Coronavirus: ‘One billion’ could become infected worldwide – report 

Study from Chinese City of Shenzhen, Outside Hong Kong in Southern China, Provides Key Insights on How Coronavirus Spreads. ANALYSIS SHOWS HOW EXTENSIVE TESTING AND CONTACT TRACING STOPPED OUTBREAK IN SOUTH CHINESE MEGACITY 

Stop Using The Term ‘Social Distancing’ — Start Talking About ‘Physical Distancing, Social Connection’ 

Contact Tracing Apps: Extra Risks for Women and Marginalized Groups 

Eyeball fever scan ‘could prevent spread of COVID-19’ 

Coronavirus | Why pathogens travel in search of a host 

G20 debt service suspension: A response not fit for purpose (II) 

Opinion: Without funding, there will be no COVID-19 vaccine 

EECA’s response to Covid-19 

Updates – African Countries With Confirmed COVID-19 Cases 

Pandemic Lays Bare Africa’s Deficits, but Youth Will Grow the Future 

More than 13 million children globally missed out routine vaccinations – even before Covid-19 struck 

‘COVID-19 And Global Inequality’: What Needs To Be Done? 

Covid-19 affects everything—more than a disease control plan, we need a manifesto 

Build diverse food systems for post-COVID-19 world 

Understanding the Hunger Surge Caused by the COVID-19 Recession to Mitigate It Before It Is Too Late 

Women Face Amplified Risks in the Pandemic. Funders Are Responding

Giving birth amid a pandemic in Belgium: the challenges faced by mothers and midwives 

OPT-SMC: IMPLEMENTATION RESEARCH TO OPTIMIZE DELIVERY AND EFFECTIVENESS OF SEASONAL MALARIA CHEMOPREVENTION 

TDR publishes new guidance on multisectoral approach to help prevent and control vector-borne diseases 

2020-2021 Joint EMRO/TDR Small Grants Scheme Implementation Research on Infectious Diseases of Poverty: Call for Applications- Deadline for applications: 1 June 2020 

European education corridors: opportunity for academic solidarity 

EU lawmaker puts 65% emissions cut on the table 

From yachts to biofuel, how Spanish farmers are embracing circular economy 

How Do Development Agencies Support Climate Action? 

What’s needed from the Petersberg Climate Dialogue? Climate Finance! When is it needed? Now! 

Can We Use COVID-19 To Transition Towards A Greener, Healthier Future? – Climate Experts Weigh In 

 

 

 

 

 

 

News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

News Flash 379

 

WHO: Coronavirus disease (COVID-2019) situation reports 

Coronavirus: Australia urges G20 action on wildlife wet markets 

Coronavirus: Commission launches data sharing platform for researchers 

Leave Politics Out Of Pandemic: WHO Rebuts United States Criticism Over COVID-19 Early Warnings 

Defunding WHO: Why The President’s Decision Makes America Less Safe 

Covid-19: Trump halts WHO funding in move labelled “petulant” and “short sighted” 

Multilateralism Through Public-Private Partnerships Are Key to Flattening the COVID-19 Curve 

Sanità c’era una volta il multilaterialismo: con l’Oms sotto attacco si scherza col fuoco 

COVID-19: time to plan for prompt universal access to diagnostics and treatments 

British scientist to head UN task force distributing Covid-19 vaccine as US blocks G20 agreement 

The Economic Impact of COVID-19 around the World: A Round-Up of the Most Recent Analysis 

COVID-19 Impact on the Pharmaceutical Industry: Major Challenges and the Way Forward by Aboli Mandurnekar

COVID-19: How Do We Re-open the Economy? 

Despite The Families First Coronavirus Response Act, COVID-19 Evaluation Is Not Necessarily Free 

The moment to see the poor 

How Can We Protect The Health of Justice-Involved Populations During the COVID-19 Pandemic? Decarceration and Timely Access to Medicaid Are Essential 

CGD Conversations on COVID-19 and Development: Antoinette Sayeh WEDNESDAY, APRIL 22, 2020 – 10:00AM ET 

How the coronavirus pandemic exploits the worst aspects of extreme inequality 

European Union Draft Resolution on COVID-19 for WHA73 

G20 debt service suspension: A response not fit for purpose (I) 

How COVID-19 Debt Relief for Africa Will Help World Economies 

International Public Finance and COVID-19: A New Architecture is Urgently Needed 

Coronavirus spread triggers World Bank pandemic bond payout 

Who Cares for the Future: finance gender responsive public services! 

Watch: How Rwanda got ahead of the pandemic curve 

No Exit? The United Kingdom’s Probable Russian Future by Ted Schrecker 

FAO’s Big Data tool on food chains under the COVID-19 pandemic 

Only ecology-based economies can avoid future catastrophe 

Haunting Forest Spirits – is Mother Nature Striking Back? 

WHO guidance helps detect iron deficiency and protect brain development 

 

 

Some insights here by Professor Theodore Schrecker as a renowned political scientist specializing in the political economy of health and health inequalities

https://www.ncl.ac.uk/medical-sciences/people/profile/theodoreschrecker.html

By Ted Schrecker

Professor of Global Health Policy, Population Health Science Institute, Newcastle University

Theodore.schrecker@newcastle.ac.uk

No Exit? The United Kingdom’s Probable Russian Future

 

As many governments are announcing strategies for ending lockdowns, we have the curious situation in which the leader of the Labour Party and the Adam Smith Institute agree that the UK government needs to set out such a strategy, but the government refuses to do so.  It says only that five tests must first be met, but gives no evidence of being able to meet any one of them.

This is dangerously irresponsible, and is likely to have long-term negative consequences for public health and health inequalities – consequences that most public health researchers and practitioners seem determined to ignore.  Look ahead, for example, to next January when new border controls (the UK imports 30 percent of its food from the European Union) create food shortages whilst economic collapse worsens fuel poverty that was already a substantial public health issue before the pandemic.

In the absence of a clear, credible and rigorously implemented exit strategy, the future may well resemble the situation in Russia after the collapse of the former Soviet Union.  The economy contracted by close to 50 percent, existing social provision mechanisms and large portions of the health care system crumbled, and life expectancy – especially for men, who now are hit harder by the coronavirus – plunged by several years.  Conventional wisdom attributes a substantial part of this transition to alcohol consumption, but from a social determinants of health perspective this is explanandum rather than explanans: that is, it demands explanation rather than providing one.  Twenty-five years on, Russian life expectancy still did not reflect the country’s economic recovery.  That recovery was accompanied by rising economic inequality, massive capital flight, and the emergence of a new stratum of politically connected billionaire oligarchs.

All this could be avoided, but there is no sign that either the UK government or the public health community are even taking these risks seriously.

 

Additional sources on the Russian experience: 

Field MG and Twigg JL, eds. Russia’s Torn Safety Nets: Health and Social Welfare during the Transition. New York: St. Martin’s Press; 2000.

Field MG, Kotz DM, Bukhman G. Neoliberal Economic Policy, “State Desertion,” and the Russian Health Crisis. In: Kim JY, Millen JV, Irwin A, Gershman J, eds. Dying for Growth: Global Inequality and the Health of the Poor. Monroe, Maine: Common Courage Press; 2000: pp. 155-73.

 

This posting also appears on Prof. Schrecker’s blog ‘Health as if Everybody Counted’

 

Pharmaceutical industry though being a valuable industry at current times of coronavirus health crisis, is facing tough challenges to conduct its business activity. Ongoing and planned clinical trials for other diseases are getting postponed which will delay the development of new medicines. Major events and conferences organized for health care professionals are getting postponed or are already cancelled. Import of raw materials is restricted, which will affect the manufacturing activity and in turn will lead to lower sales....

 By Aboli Mandurnekar

(M.Pharm, MBA), India

COVID-19 Impact on the Pharmaceutical Industry

Major Challenges and the Way Forward

 

The human race is witnessing an unprecedented health crisis brought by corona virus across the globe. The market is falling, the production units are standing still, and millions of people are suffering the wreck of unemployment. Analysts believe that the economic impact of the corona virus crisis will be worse than the financial crisis of 2007-08.  Every business activity is seeing a downturn in their fortune be it billion Dollars Company or a small retail shop. Even the pharmaceutical industry is not an exception.

Pharmaceutical industry though being a valuable industry at current times of health crisis, is facing tough challenges to conduct its business activity. Ongoing and planned clinical trials for other diseases are getting postponed which will delay the development of new medicines. Major events and conferences organized for health care professionals are getting postponed or are already cancelled. Import of raw materials is restricted, which will affect the manufacturing activity and in turn will lead to lower sales. Insufficient ancillary supplies such as bottles, caps and packaging material for medicine will affect the output, the impact of which is expected to be felt over a period of next 3 to 4 quarters. This supply shortage may also lead to pricing volatility in future. Companies will try to maintain inventories for longer duration, buffer capacity will be increased which may affect the inventory cycles.

Planned mergers and acquisitions, new projects and ventures have been put on hold for a while (for example: Pfizer and Mylan have delayed their generic megamerger). But every crisis brings with it an opportunity and this time the opportunity may knock the doors of small pharmaceutical companies. It is very possible that for cost cutting measures, major drug makers may outsource the projects of secondary importance to smaller pharmaceutical companies. Especially, the domestic players can benefit from grabbing new projects and, if accompanied by favorable government policies, can boost the pharmaceutical business of resource limited as well as developed countries.

China is one of the largest Active Pharmaceutical Ingredients-API producer in the world. Disruption in supply chains may occur as India is the largest supplier of generic drugs worldwide and nearly 70% of its API requirements are fulfilled by imports from China. It will be important to observe what can be a substitute for cost effective imports from China and how the market moves further. Rosemary Gibson has explained the challenges coming up with this dependency very well in her book named China Rx: Exposing the risks of America’s dependence on China for Medicine and we can see the effects in this crisis.

International Pharma Trade Association (IFPMA), WTO and trade authorities of each country are trying to minimize the scarcity of essential medicines in COVID-19 affected areas, raised due to multiple export bans and simultaneous demand of some medical devices and essential medicines. Many countries have started injecting reserves in foreign exchange markets, to face the challenges posed by COVID-19.  Russia has introduced more favorable treatment for FX loans issued to pharmaceutical and medical supplies companies. The Reserve Bank of India has extended the realization period for export proceeds so that companies can retain their buyer contracts in future. This will help in case of Europe and US exports as they are major importers from India and worst affected regions due to COVID-19 outbreak. Nigeria has introduced import duty waivers for pharmaceutical firms. Central Bank of Iran has allocated 0.06 percentage of GDP for import of medicines.

This crisis may also force few companies to think about new business models. Online pharmacy business may show higher growth, especially in the emerging economies, similar to emergence of Alibaba in China post SARS pandemic. We may expect increase in the use of digital channels to interact with healthcare professionals. Companies may focus on backward integration for APIs and intermediates. The thing worth looking for in the future is whether the pre-pandemic scenario in trade will be restored or new countries will emerge as export leaders in next few years as governments will try to become self-sufficient in medical supplies.

As per the World Trade Organization, the trade scenario will largely depend on the duration of the outbreak and the effectiveness of the policy responses. Spending on healthcare by governments will increase. Dependency in terms of imports of APIs of essential drugs like Azithromycin and Cephalosporin should be reduced. Even if we treat this pandemic a one-time shock, we need to build our capability to tackle any such emergencies in future. For now, let’s hope for a quicker recovery from this pandemic and follow social distancing norms as a responsible citizen.

 

References

• Policy Responses to COVID-19; International Monetary Fund; https://www.imf.org/en/Topics/imf-and-covid19/Policy-Responses-to-COVID-19
• WTO 2020 Press Release – Trade set to plunge as COVID-19 pandemic upends global economy; 08/04/2020; https://www.wto.org/english/news_e/pres20_e/pr855_e.htm
• Editorial, The Hindu Business Line – India’s dependence on China for Pharma bulk drugs must be addressed, 04/02/2020, https://www.thehindubusinessline.com/opinion/editorial/indias-dependency-on-china-for-pharma-bulk-drugs-must-be-addressed/article30736188.ece
• Kyle Blankenship, Fierce Pharma; Pfizer, Mylan say COVID-19 delays will postpone their Viatris merger; 26/03/2020; https://www.fiercepharma.com/pharma/pfizer-mylan-postpone-generics-merger-review-due-to-covid-19-delays
• Silvia Garcia, www.efpia.eu; Managing ongoing clinical trials in the current Covid-19 pandemic situation; 08/04/2020; https://www.efpia.eu/news-events/the-efpia-view/blog-articles/managing-ongoing-clinical-trials-in-the-current-covid-19-pandemic-situation/

 

 

News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

News Flash 378

 

Coronavirus: EU Commission issues guidelines on testing 

Coronavirus: European roadmap shows path towards common lifting of containment measures 

Never Let a Crisis Go To Waste 

G20 countries agree debt freeze for world’s poorest countries 

Eurodad reaction to the G20 suspension of debt payments 

IMF Executive Board Approves Immediate Debt Relief for 25 Countries 

IMF Debt Relief: Implications for developing countries 

Six things you should know about Covid-19 and debt for developing countries 

Pressure grows for developing world debt relief over coronavirus 

Confronting COVID-19 In A World Without WHO – Seriously? 

WHO Director General “Regrets” Trump Decision To Suspend Organization’s Funding; UN, European Union, China and Others Decry US Move 

In His Fight Against WHO, Trump Plays Politics with Human Lives 

TRUMP’S BLAME GAME AGAINST THE WHO: THE WRONG MOVE IN THE GLOBAL ENDEAVOUR TO MANAGE THE COVID19 PANDEMIC 

Public health professionals plead with Trump not to defund WHO 

Time to rally behind the World Health Organization 

Interactive: Who’s funding the COVID-19 response and what are the priorities? 

CALL FOR A COORDINATED, EQUITABLE, AND HUMAN RIGHTS-BASED GLOBAL RESPONSE TO COVID-19 

Access To Affordable Biologics In The Context Of COVID-19: Will WHO Step Up To Its Responsibility? 

International organisations call on UK government to prevent Big Pharma profiteering from COVID-19 

MSF response on COVID-19 drugs pricing study by Andrew Hill et al. 

Protecting Decarcerated Populations In The Era of COVID-19: Priorities For Emergency Discharge Planning 

Not a Moment to Lose: Funders Seek to Speed COVID-19 Research

U.N. agencies: 117 million children may miss measles shots due to COVID-19 

COVID-19: Major relief airlift will reach ‘most vulnerable’ African nations 

Apocalisse a sud del Sahara? 

Don’t panic, experts say after COVID-19 animal killings 

WHO Director-General’s Statement on IHR Emergency Committee on Ebola Virus Disease in the Democratic Republic of the Congo 

New Ebola case confirmed in the Democratic Republic of the Congo 

Can ‘mom n’ pop’ schools help educate the world’s children? 

What is the energy charter treaty? 

France, Germany join group of 10 EU countries calling for green recovery 

Foundation for Louisiana is Taking on Climate Change’s Ripple Effects on Communities

 

 

 

 

Dear heads of state and government of G20 countries,

CALL FOR A COORDINATED, EQUITABLE, AND HUMAN RIGHTS-BASED GLOBAL RESPONSE TO COVID-19

We, the undersigned 99 organizations and 40 individuals, call upon you to ensure a robust, coordinated global response to the coronavirus disease 2019 (COVID-19) pandemic that is humane, equitable, based in the universality of human rights, and meets the needs of countries and people who are most vulnerable and have the fewest resources

http://section27.org.za/2020/04/call-for-a-coordinated-equitable-and-human-rights-based-global-response-to-covid-19/

PEAH as co-signatory

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 Menstruation matters in resource-limited countries where poverty substantially impacts menstruation health management. In this connection, PEAH had the pleasure to interview Ugandan stakeholder Ms. Gloria Nirere currently involved as menstrual health management trainer at Kampala based WoMena NGO. Previously, Ms. Nirere long served in poorly equipped Ugandan contexts where she performed tasks concerning clinical research, community health, humanitarian assistance, and project management at local and national level

 By Daniele Dionisio

PEAH – Policies for Equitable Access to Health 

INTERVIEW

 

Ms. Gloria Nirere

Menstrual Health Management Trainer

WoMena Uganda  

 

‘Sanitary pads are very hard to buy because the economy is high. Mum cannot give you the money to buy. Not everybody can even get enough money to buy a cotton wool or tissue paper and using a cloth we always fear because it may fall off while with friends’  

— Anonymous (15 years old, Kasese, Uganda) 

Worldwide, a large number of girls and women struggle to manage their menstruation in a dignified way. They not only lack access to menstrual health products, correct knowledge about menstruation and support from their communities but also have limited access to suitable and safe facilities for changing and disposing of sanitary materials.

Source: WoMena

 

–PEAH: Ms. Nirere, let’s start with a glimpse on menstruation matters in your country and to what extent does poverty impact menstruation health management.

–Nirere: Menstrual Health mattters have for long not been considered as an important aspect in the most part of the Country. Most people think menstruation is easy to manage but the details of what entails in menstrual health management are not their concern. You find that out of 10 girls, 1 has knowldge about menstruation for her first time menstrual period and the rest struggle silently with pain and fear not knowing what to do next. It is just a few families where they have got chance to access education where a small light is shed about menstruation. Even up to date, most women and girls shy so much away from discussions related to menstruation.

I would say that poverty highly impacts on menstrual health management because most of the beneficiaries give an excuse of lack of money to buy decent sanitary pads leading them to use papers, a piece of cloth, sponges and leaves. On the other hand traditional beliefs and myths about menstruation has caused a lot of menstrual health challenges where women and girls are not free and comfortable during their periods.

–PEAH: WoMena is an NGO working with implementation of reproductive health solutions in low-income contexts, focusing on menstrual health & management. Tell us more, please, around WoMena story and profile.

–Nirere: The NGO mainly aims at providing menstrual health training to adolescent school girls, women, refuguee settlements, men and boys  and providing menstrual health management products like the menstrual cup with reusable sanitary pads (Afripads).

Credit: WoMena

The key focus is to tackle issues that have come up with stigmatising women and girls due to community related beliefs and myths by involving local and national leaders; and male in menstrual health related issues.

–PEAH: In depth, as regards WoMena field activities and approach to menstrual issues?

–Nirere: As a WoMena trainer, field work activities involve:

Credit: WoMena

1. Training of Trainers (T.O.T’s), these are participants who are mainly leaders ( Local Council, teachers, church leaders, district heads etc.) in a community. They are trained to volunteer by training the beneficiaries in the community where they belong. After the training, participants are issued with training materials to support them during trainings. However, if they happen to train, normally they are guided by the trainer from WoMena to monitor and support during the training. They are trained so that they can guide a participant to clarify on certain issues in the absence of the WoMena trainer.

In addition, for the case of school going children, the school organises the parent meeting which is mainly held to train parents and get consent of whether they want their children to have the menstrual health products or not.

2. T.O.B’s (Training of Beneficiaries)

The beneficiaries are trained in detail about menstrual health management and product use and care. This training is composed of both female and male sex, the male however excused in the last phase for training of product usage (this is done mainly by schools). At the end of training, their given evaluation forms serve to check whether they acquired knowldege from the training.

3. Refresher training

Before distribution of the product, a refresher training is held to get the depth of knowledge which was acquired in the first training. It also enables the trainer to know areas that need to be retrained to beneficiaries.

4. Distribution of menstrual health products

Distribution focuses on consent of a parent to her child (18 years and below) or consent of a beneficiary. It also depends on whether the beneficiary participated in all the trainings. Normally, soap, small bucket, a pair of knickers, menstrual cup and reusable pad are distributed. (this depends on funding organisation on whether to give both the menstrual cup and reusable pad).

5. Follow ups

After a period of 3 to 6 months, 2  follow ups are done to check on product usage and care, challenges and formulation of reports basing on the information obtained from the field.

NB. The top-bottom approach is used to tackle menstrual health issues since acceptance and cultural issues are majorly the main threat to sensitizing communities about menstrual health issues.

–PEAH: What do you think about the importance of education and male involvement in menstruation matters in Uganda?

–Nirere: It is a very good staregy to involve men in menstrual health issues because when you look at the African setting, the men have most say in financial, social and economic matters of a family and a community. If they ignorate about menstrual health issues, it is very difficult to support their wives, daughters and menstrual health initiatives in communities.

Credit: WoMena

That’s is why WoMena is focussing on male involvement in menstrual health issues by not only having male trainers, but also having male coordinators and trainers in local communities to push the message ahead.

– PEAH: What are your duties and tasks in WoMena?

–Nirere: I faciliate menstrual health training through planning for training sessions and materials, conducting training evaluations, carrying out  follow ups and writing reports associated with the outcomes of the training.

– PEAH: Kindly, detail around the effectiveness, safety and acceptance of WoMena backed menstrual cups as menstruation management method in Uganda’s reality.

–Nirere: Menstrual cups have not for long been used in Uganda, even the elite women are resisting to use the menstrual cups. Just like any form of new technology being introduced to a place, to which there’s always resistance, this as well applies to menstrual cups.

Credit: WoMena

There are majorly two ares which cause fear among women, most wonder wether the virginal area will become wide, some wonder it is too big to enter the vagina  and others fear that it takes away virginity of a girl child which is highly valued. But through trainings, the Organisation has collaborated with other international organisations like Care international, Save the Children, UNHCR to train women and girls on use and care of menstrual product; and tackles frequently asked questions. Currently, the menstrual cups are on market and the number of women and girls using the cup is gradually increasing.

Credit: WoMena

Adoption of the menstrual cup will tackle very many challenges which come with use of disposable pads, among which the cup is durable because it takes 10 years in use, environmentally friendly and it is less expensive since you do not have to buy pads every month.

– PEAH: In this regard, are follow-up study reports on menstrual cups currently available?

–Nirere: Yes, they are available but these reports are shared to partner Organisations which fund projects we do.

–PEAH: Does WoMena work together with national and/or international partners?

–Nirere:  Yes please, information on partners is on the Website.

–PEAH: Before engagement in WoMena you long served in poorly equipped Ugandan contexts where you performed tasks concerning clinical research, community health, humanitarian assistance, and project management at local and national level. What challenges did you face there?

–Nirere: Very many challenges indeed,  but I embrace the fact that I was able to learn a lot of various skills:

• First challenge was the strong traditional attachements and ignorance of people. For example, someone tests HIV+ and they go for traditional healers for help. In the process they end up dying or coming to seek medical assistance in critical condition.
• There’s a lot of dependency where people believe that their lives entirely depend on government support. Even when there’s partial support, someone is not willing to top up to get the assistance they need.
• Illegal selling of government drugs and extortion of money from patients on free services which is unprofessional.
• Selling of donated material or property by beneficiaries to the community, this has created big challenges in refugee settlements.

–PEAH: Thank you Ms. Nirere for your insightful answers and highly commendable engagement