Health
WHO moves to roll out first malaria vaccine in Africa – St. Catharines Standard
BLANTYRE, Malawi (AP) — As the World Health Organization announces the next step in its rollout of the world’s first authorized malaria vaccine in three African countries, concerns about its value have come from an unlikely source: the Bill and Melinda Gates Foundation, arguably the vaccine’s biggest backer.
WHO endorsed the vaccine last fall as a “ historic ” breakthrough in the fight against malaria, but the Gates Foundation told The Associated Press this week it will no longer offer direct financial support to the shot although it will fund an alliance backing the vaccine.
Some scientists say they’re mystified by that decision, warning it could leave millions of African children at risk of dying from malaria as well as undermine future efforts to solve intractable problems in public health.
The vaccine, sold by GlaxoSmithKline as Mosquirix, is about 30% effective and requires four doses.
The malaria vaccine has “a much lower efficacy than we would like,” Philip Welkhoff, the Gates Foundation’s director of malaria programs, told the AP. Explaining its decision to end support after spending more than $200 million and several decades getting the vaccine to market, he said the shot is relatively expensive and logistically challenging to deliver.
“If we’re trying to save as many lives with our existing funding, that cost-effectiveness matters,” he said. The Gates Foundation will continue its financial support to Gavi, a vaccines alliance that is also backed by WHO and the World Bank.
“We’re supporting the roll-out via the Gavi funding, but we decided we would not dedicate additional direct funding to extend the supply of the vaccine,” Welkhoff said.
The Gates Foundation’s decision to pivot away from supporting the rollout of the vaccine in Africa was made years ago after detailed deliberations, including whether the foundation’s money would be better spent on other malaria vaccines, treatments or production capacity, Welkhoff said. Some of the resources that might have gone into getting the vaccine to countries have been redirected to buy new insecticidal nets, for example.
“It’s not the greatest vaccine in the world, but there are ways of using it that could have a big impact,” said Alister Craig, dean of biological sciences at Liverpool School of Tropical Medicine. The world is struggling to contain the spike in malaria seen since the coronavirus pandemic disrupted efforts to stop the parasitic disease, which killed more than 620,000 people in 2020 and caused 241 million cases, mainly in children under 5 in Africa, Craig said.
“It’s not like we have a lot of other alternatives,” Craig said. “There could be another vaccine approved in about five years, but that’s a lot of lives lost if we wait until then,” he said, referring to a shot being developed by Oxford University. BioNTech, creator of the Pfizer COVID-19 vaccine, plans to apply the messenger RNA technology it used for the coronavirus to malaria, but that project is in its infancy.
Another big obstacle is availability; GSK says it can only produce about 15 million doses per year until 2028. WHO estimates that to protect the 25 million children born in Africa every year, at least 100 million doses every year might be needed. Although there are plans to transfer the technology to an Indian drugmaker, it will be years before any doses are produced.
“All the money in the world” wouldn’t alleviate the vaccine’s short-term supply constraints, said Welkhoff, of the Gates Foundation. He noted that the Gates Foundation continues to support vaccines alliance Gavi, which is investing nearly $156 million into making the shot initially available in three African countries: Ghana, Kenya and Malawi.
On Thursday, WHO and Gavi invited developing countries to apply for funding to pay for the malaria vaccine in their countries.
“If delivered to scale, the vaccine will help to prevent millions of cases of malaria, save tens of thousands of lives and ensure a brighter future for the continent,” said Dr. Matshidiso Moeti, WHO’s Africa director.
The Gates Foundation’s withdrawal of financial support for the malaria vaccine might unnerve others, Dr. David Schellenberg of the London School of Hygiene and Tropical Medicine, said.
“There is a risk that this could discourage others who are considering financing the malaria vaccine or even be a disincentive for people working on other vaccines,” he said. He said that combining the vaccine’s use with other measures, like distributing drugs during malaria’s peak season could dramatically reduce cases and deaths.
“We still see people coming in with four or five episodes of malaria a year,” he said. “We don’t have a magic bullet, but we could make better use of the tools we do have.”
An imperfect roll-out of the vaccine would still save lives, Dr. Dyann Wirth, an infectious diseases expert at Harvard University, said.
“We would love to have 100 million doses, but that kind of money doesn’t exist for malaria,” she said. “The 15 million doses we have is still 15 million opportunities to protect children that we didn’t previously have.” The Gates Foundation had done its part in bringing the vaccine to market and it is now up to countries, donors and other health organizations to ensure it is used, she said.
The vaccine, even with its imperfections, is eagerly awaited in Malawi.
Nolia Zidana, 32, said she is keen to get her two young sons immunized after seeing malaria sicken them numerous times — and surviving it herself.
“Growing up with my parents and siblings, we have been sick from malaria all the time,” said Zidana, who lives in Malawi’s central Ntcheu district. “My elder son has had malaria countless times within the four years that he has been around. While just at 7 months old, twice my younger son has already been down with malaria,” she said.
She said although they sleep under mosquito nets, sometimes they get bitten before going to bed as they are preparing meals for supper in the dark of the evening.
“We hear other people use mosquito repellents or burn anti-mosquito incense coils, which we cannot afford as we are just peasant farmers that live from hand to mouth,” she said.
Dr. Michael Kayange of Malawi’s Ministry of Health, urged everyone in the country to take whatever measures they can to curb malaria. Immunization itself is insufficient to stop the disease and people should adopt multiple strategies, he said.
“Even just by sleeping under a mosquito net, you have played your role in reducing the malaria burden in the country,” he said.
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Cheng reported from London.
Health
MUHC opens Quebec's first multidisciplinary referral centre for endometriosis – McGill University Health Centre
Montreal, March 28, 2023 – The McGill University Health Centre (MUHC) is proud to launch Quebec’s first multidisciplinary referral centre for multisystem endometriosis. EndoCARES, or the Endometriosis Centre for the Advancement of REsearch and Surgery, aims to provide patients suffering from pain and infertility due to endometriosis with timely access to specialized diagnostic imaging, followed by multidisciplinary care based on individual needs.
Endometriosis is an inflammatory condition where endometrial-like tissue (similar to the inner lining of the uterus) grows outside of the uterus. Affecting about 1 in 10 women of reproductive age, it commonly causes infertility and debilitating pelvic pain, often severe enough to limit a woman’ s ability to carry out normal daily activities.
“While half of women with infertility and up to 70 per cent of those with chronic pelvic pain have endometriosis, studies show an average delay of seven years from the start of symptoms to diagnosis,” explains Dr. Togas Tulandi, chief of the Department of Obstetrics and Gynecology at the MUHC. “EndoCARES aims to significantly reduce this delay by uniting a team of gynecologic surgeons specialized in minimally invasive surgery – more specifically, in the removal of endometriosis lesions – along with other specialists, such as bowel surgeons, urologists, radiologists and fertility specialists, in a single patient-centered clinic.”
Bottom row, left to right: Dr. Togas Tulandi; Karine Rousseau, operating room nurse; Dr. Jessica Papillon-Smith, and Dr. Srinivasan Krishnamurthy.
EndoCARES specialists come together regularly to discuss complex surgical cases and devise the best treatment strategies to offer patients. Meanwhile, a dedicated nursing staff provides continuity of care for the patients by facilitating the coordination of care between specialists and monitoring post-operative recovery following complex surgeries.
A centre of excellence
Drs. Dong Bach Nguyen and Andrew Zakhari, co-directors of the centre, both pursued additional training at renowned endometriosis hubs in Europe after completing minimally invasive surgery fellowships in Ottawa and Toronto respectively. As a result, patients treated at EndoCARES now benefit from innovative surgeries specific to endometriosis not previously offered in Quebec. “In Europe, several countries have established centres of excellence to provide specialized care to patients affected by endometriosis. Training in these centres allowed us to bring back not only new surgical techniques, but also the foundations to build an endometriosis referral centre for women with multi-organ endometriosis in Quebec,” explains Dr. Nguyen.
“The primary objective of this centre is to provide women with severe endometriosis affecting other organs like the bladder,bowel or diaphragm, with dedicated surgical and radiological expertise,” says Dr. Zakhari. Along with Drs. Srinivasan Krishnamurthy, Fady Mansour, Jessica Papillon-Smith and Togas Tulandi, this team of surgical gynecologists is committed to improving the care of Quebec women suffering from endometriosis.
Many questions remain unanswered
“Today, we still do not understand the exact cause of endometriosis, nor do we have a cure,” explains Dr. Tulandi, who is also an associate investigator at the Child Health and Human Development Program at the Research Institute of the MUHC.
Moving forward, EndoCARES aims to enhance basic, epidemiological and clinical research in endometriosis with the establishment of a patient registry that will function as a database for future research. Additionally, the program will facilitate international networking, collaborative research and the standardization of clinical practice through the exchange of ideas and experiences.
EndoCARES’ state-of-the-art clinical care and forthcoming research are made possible in part by generous donations made to the MUHC Foundation, which has pledged to raise $700,000 in support of personnel and equipment for the EndoCARES program.
“Endometriosis is very common and yet, so many women endure years of pain before receiving a diagnosis. This is completely unacceptable. The MUHC Foundation is proud to support the EndoCARES program, because it will change women’s health care for the better and reduce the pain and uncertainty so many women endure,” says Julie Quenneville, president and CEO of the MUHC Foundation.
Someone to reach out to
It took five long years before Anisa Gjoka was referred to Dr. Andrew Zakhari and diagnosed with stage 4 endometriosis at 25 years old. “On February 8, 2021, in the middle of a pandemic, I finally had my surgery,” recounts Anisa. “After a four-hour surgery, and with only four small incisions, they were able to carefully remove the endometriosis lesions, leaving all of my organs intact!”
Today, at 28 years old, Anisa maintains a pain-free lifestyle, something that seemed unimaginable before entering under the expert care of Dr. Zakhari. “It gives me great peace of mind to know that EndoCARES exists – that there is finally someone for me to reach out to whenever I’m in need, and that the young women experiencing their first symptoms will be spared years of suffering and will be cared for by a multidisciplinary team of experts, all in one place.”
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About the McGill University Health Centre
The McGill University Health Centre (MUHC) is one of the world’s foremost academic health facilities. Building on the tradition of medical leadership of its founding hospitals, the MUHC provides exceptional multidisciplinary patient-centric care in French and in English. Affiliated with the Faculty of Medicine and Health Sciences of McGill University, the MUHC continues to shape the course of adult and pediatric medicine by attracting clinical and research expertise from around the world, assessing the latest in medical technology, and training the next generation of medical professionals. In collaboration with our network partners, we are building a better future for our patients and their families; for our employees, professionals, researchers and students; for our community and above all, for life. www.muhc.ca
Media contact:
Rebecca Burns
McGill University Health Centre
[email protected]
514-929-1329
Several public health units in southwestern Ontario say there’s been a rise in cases of whooping cough across the region.
Residents in the Southwestern Public Health region are being urged to get vaccinated against the respiratory illness after 82 cases of whooping cough were recorded from January 2022 to the end of February.
Meantime, Huron Perth Public Health has confirmed at least 21 cases of the illness so far this year, compared to only three cases last year. The Windsor-Essex County Health Unit said last week that it counted 18 cases since November, 2022.
Written by: Ian McCallum
NEWS RELEASE
NIAGARA HEALTH
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Niagara Health’s COVID-19 assessment centre and COVID, cold and flu care clinics (CCFCC) will permanently close on Friday, March 31.
COVID-19 testing will be available at select pharmacies across the region, and the prescription drug Paxlovid will continue to be available through family physicians and at select pharmacies across the region. Remdesivir infusion therapy, which aids in treating COVID-19, will be available in the community.
Niagara Health’s first assessment centre opened on March 17, 2020, at our Niagara Falls Site and has since administered more than 327,000 swabs. The centres served as the primary screening and testing locations for COVID-19 in the region. The Niagara Falls centre is the final of the three to close.
Closing these operations will help our health human resources efforts by allowing teams to return to their regular work or to NH priorities and help address staffing pressures and support for those providing frontline care.
“Working with our partners, we also opened an additional temporary location in Niagara Falls to test hospitality and tourism sector workers,” says Zeau Ismail, director of interprofessional practice, research and education; director lead at COVID-19 assessment centre and COVID, cold and flu care clinic. “Community health-care professionals, including family physicians, stepped up to work at these centres, in addition to a number of redeployed hospital staff and physicians.”
Niagara Health, along with partnering members of the Niagara Ontario Health Team-Équipe Santé Ontario Niagara (NOHT-ÉSON), operated five CCFCCs to test, assess and provide treatment for people with COVID-19 and other cold and flu-like illnesses. Since opening in 2022, the CCFCCs and Niagara Health’s clinical assessment centre have had more than 1,900 visits.
After March 31:
- If a person has symptoms of a respiratory illness, they are encouraged to call their primary care provider if they have one as the first option for guidance and care.
- If someone develops severe symptoms, they are urged to go to their nearest emergency department or call 9-1-1.
“We are incredibly grateful to our staff, physicians and partners, both on the frontlines and behind the scenes, who helped make the ACs and CCFCCs possible throughout our fight against COVID-19,” says Ismail.
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