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Push to bring coronavirus vaccines to the poor faces trouble – NEWS 1130 – News 1130

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LONDON — An ambitious humanitarian project to deliver coronavirus vaccines to the world’s poorest people is facing potential shortages of money, cargo planes, refrigeration and vaccines themselves — and running into skepticism even from some of those it’s intended to help most.

In one of the biggest obstacles, rich countries have locked up most of the world’s potential vaccine supply through 2021, and the U.S. and others have refused to join the project, called Covaxe.

“The supply of vaccines is not going to be there in the near term, and the money also isn’t there,” warned Rohit Malpani, a public health consultant who previously worked for Doctors Without Borders.

Covax was conceived as a way of giving countries access to coronavirus vaccines regardless of their wealth.

It is being led by the World Health Organization, a U.N. agency; Gavi, a public-private alliance, funded in part by the Bill & Melinda Gates Foundation, which buys immunizations for 60% of the world’s children; and the Coalition for Epidemic Preparedness Innovations, or CEPI, another Gates-supported public-private collaboration.

Covax’s aim is to buy 2 billion doses by the end of 2021, though it isn’t yet clear whether the successful vaccine will require one dose or two for the world’s 7.8 billion people. Countries taking part in the project can either buy vaccines from Covax or get them for free, if needed.

One early problem that emerged: Some of the world’s wealthiest nations negotiated their own deals directly with drug companies, meaning they don’t need to participate in the endeavour at all. China, France, Germany, Russia and the U.S. don’t intend to join.

And so many rich countries bought vaccines from manufacturers — before the shots have even been approved — that they have already snapped up the majority of the vaccine supply for 2021.

The European Union has contributed 400 million euros ($469 million) to support Covax, but the 27-country bloc won’t use Covax to buy vaccines, in what some see as a vote of no-confidence in the project’s ability to deliver. Instead, the EU has signed its own deals to buy more than 1 billion doses, depriving Covax of the bulk negotiating power of buying shots for the continent.

Gavi, WHO and CEPI announced in September that countries representing two-thirds of the world’s population had joined Covax, but they acknowledged they still need about $400 million more from governments or elsewhere. Without it, according to internal documents seen by The Associated Press before the organization’s board meeting this week, Gavi can’t sign agreements to buy vaccines.

Covax did reach a major agreement this week for 200 million doses from the Indian vaccine maker Serum Institute, though the company made clear that a large portion of those will go to people in India.

By the end of next year, Gavi estimates, the project will need $5 billion more.

Covax said negotiations to secure vaccines are moving forward despite the lack of funds.

“We are working with the governments who have expressed interest earlier to ensure we receive commitment agreements in the coming days,” Gavi’s Aurelia Nguyen, managing director of Covax, said in an email. She added that nothing similar has ever been attempted in public health.

Covax “is a hugely ambitious project,” she said, “but it is the only plan on the table to end the pandemic across the world.”

Still, the project is facing doubts and questions from poor countries and activists over how it will operate and how effective it will be.

Dr. Clemens Auer, who sits on WHO’s executive board and was the EU’s lead negotiator for its vaccine deals, said there is a troubling lack of transparency about how Covax will work.

“We would have no say over the vaccines, the price, the quality, the technical platform or the risks,” Auer said. “This is totally unacceptable.”

He said WHO never consulted countries about its proposed vaccine strategy and called the health agency’s goal of vaccinating the world’s most vulnerable people before anyone else a “noble notion” but politically naive.

As part of Covax, WHO and Gavi have asked for countries to first prioritize front-line health workers, then the elderly, with the goal of vaccinating 20% of the world’s population.

One expensive hurdle is that many of the vaccine candidates need to be kept cold from factory to patient, according to internal documents from Gavi. Industry has signalled that “air freight for COVID vaccines will be a major constraint,” and a “significant and urgent ramp-up of cold chain capacity” may be needed.

Another obstacle: Many of the leading vaccine candidates require two doses. That will mean twice as many syringes, twice as much waste disposal, and the complications involved in ensuring patients in remote corners of the world receive the second dose on time and stay free of side effects.

“Because of the fact that we’re looking at trying to get vaccines out as quickly as possible, we’re looking at limited follow-up and efficacy data,” said Gian Gandhi, who runs logistics from UNICEF’s supply division in Copenhagen.

There is also concern that the fear of lawsuits could scuttle deals. According to the internal documents, Gavi told countries that drug companies will probably require assurances that they won’t face product liability claims over deaths or other side effects from the vaccine.

Dr. Nakorn Premsi, director of Thailand’s National Vaccine Institute, said officials there are reviewing whether that condition is acceptable. Thailand so far has only signed a nonbinding agreement with Covaxe.

If anything, some critics say, Gavi isn’t ambitious enough. The pandemic won’t end — and the world can’t reopen its borders — until there is herd immunity well beyond the rich nations that have secured their own doses, said Eric Friedman, a scholar of global health law at Georgetown University who is generally supportive of Covax.

“If we want to achieve herd immunity and get rid of this, 20% is not going to do it,” he said. “What’s the end game?”

Alicia Yamin, an adjunct lecturer on global health at Harvard University, said she fears the “window is closing” for Covax to prove workable. She said it is disappointing that Gavi, WHO and their partners haven’t pushed pharmaceutical companies harder on issues like intellectual property or open licenses, which might make more vaccines available.

With little evidence of such fundamental change in the global health world, Yamin said it’s likely that developing countries will have to rely on donated vaccines rather than any equitable allocation program.

“I would say that poor countries probably will not get vaccinated until 2022 or 2023,” Yamin said.

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Lori Hinnant reported from Paris.

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Follow AP’s pandemic coverage at http://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak

Maria Cheng And Lori Hinnant, The Associated Press

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Health Canada approves updated Moderna COVID-19 vaccine

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TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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These people say they got listeria after drinking recalled plant-based milks

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TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

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VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

The Canadian Press. All rights reserved.

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