With the coronavirus killing an estimated 15 million people worldwide, including nearly 1 million in the United States, the Biden administration, despite a lack of funding for domestic and international pandemic response, is set to mobilize a global effort to end the acute phase of COVID-19.

The move comes as the World Health Organization announced that the COVID-19 pandemic directly or indirectly caused 14.9 million deaths worldwide from January 1, 2020 to December 31, 2021.

The U.S. will co-host the second Global COVID-19 Summit on May 12, following the first in September 2021. The virtual summit will mark a shift from a crisis management strategy to the more sustainable approach of building resilient public health systems.

“The virus — after omicron particularly — has shown us that we have to evolve our strategy,” a senior administration official told VOA. The goal, the official said, is to reduce transmission, deaths and hospitalizations rather than eradicate the virus.

The summit will focus on “supporting locally led solutions” toward global goals, which include getting shots into arms, enhancing access to tests and treatments, and generating sustainable financing for future pandemic preparedness.

“We cannot have just one solution, which might fit all of these different situations,” Dr. Thierno Baldé of the World Health Organization’s Africa regional office told VOA. “The reality is to try to understand that, and therefore to have the most appropriate solution constructed commonly, with different countries, with different partners.”

To galvanize international support, the U.S. will co-host the event together with CARICOM (Caribbean Community) chair Belize; Group of Seven president Germany; Group of 20 President Indonesia, and African Union chair Senegal.

No pandemic funding

The U.S., however, will bring no new pledges to the summit table. The administration’s request for $22.5 billion in additional COVID-19 response money, including $5 billion for global pandemic funding, has been stuck for weeks largely because of Republican lawmakers who insist they won’t pass it unless the administration brings back Title 42. The Trump-era order allows authorities at the Mexican border to turn away migrants during a pandemic emergency.

The lack of funding jeopardizes the administration’s global pandemic response, including Global Vax, an international initiative launched in December to turn vaccines into vaccinations in 11 African countries, and which is set to run out of money in September. It could also undermine the administration’s ability to galvanize other countries’ commitments, particularly at an event that has been designed with a “step up to speak up” approach, meaning that countries can secure a speaking role only if they bring either financial pledges or policy commitments to support summit goals.

White House press secretary Jen Psaki told VOA the summit would highlight to Congress the need for more funding so that the U.S. “can continue to be the arsenal of vaccines for the world.” She noted that even without the additional funding, the U.S. remains the largest contributor to the global fight against the pandemic.

Lack of global coordination

The first two years of the pandemic were marked by rich countries stockpiling more doses than they needed for boosters and protection against new variants, which threatened supplies to lower-income countries, where vaccination rates were low.

Now, with 2 billion doses of vaccine being produced each month, the problem is not a lack of supply but slowing demand and poor delivery capacity — problems that activists argue also stem from lack of coordination.

“If we’d had a coordinated global plan to end the pandemic, we wouldn’t now be in the situation where there’s quite a lot of vaccine doses but not enough money to actually distribute them in countries that need them,” Tom Hart told VOA. Hart is president of the ONE Campaign, an advocacy organization that fights preventable disease.

Beyond vaccines, the summit will also seek to improve access to testing and treatment, including by scaling up production and diversifying local and regional manufacturing capacity. Current efforts to achieve that include technology transfer agreements and the so-called TRIPS (Trade-related Aspects of Intellectual Property Rights) waiver proposal by South Africa and India at the World Trade Organization that called for intellectual property waivers on COVID-19 therapeutics and diagnostics. While the proposal is supported by more than 100 member countries, negotiations have been gridlocked for months.

Test to treat

Meanwhile, the Biden administration has recently rolled out a national “test to treat” program that tests people for COVID-19 and immediately treats them with the Pfizer antiviral drug Paxlovid if results are positive. It now aims to introduce similar pilot projects in other countries.

“The exact model may be different because the health systems are different,” the administration official said, noting that additional hurdles need to be addressed, including securing supplies of the generic drugs nirmatrelvir and ritonavir, which make up Paxlovid — a drug that is prohibitively expensive for lower- to middle-income countries.

Dr. Krishna Udayakumar, founding director of the Duke Global Health Innovation Center, told VOA that it would be up to Pfizer, Merck and other companies that already have antivirals on the market to work with countries and existing multilateral systems to get these “test to treat” pilot projects in place so when the money and the supply ramp up, countries can scale up quickly.

In March, the Medicines Patent Pool, a United Nations-backed organization, signed agreements with 35 manufacturers in 12 countries to produce nirmatrelvir and ritonavir, but these are unlikely to be on the market until 2023. Udayakumar said the U.S. was working to make an affordable generic version of Paxlovid available within several months.

The Global COVID-19 Summit aims to secure pledges to help close the gap of about $15 billion in funding that the WHO says the world needs. While those pledges will be made, advocates are pessimistic.

“It’s not clear whether that’s being coordinated, whether one country or one region will have more than it needs and another region will go without,” Hart said. “That’s the problem with no coordination and no global plan.”
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There is renewed interest nuclear energy in Europe driven in part by climate goals but also the war in Ukraine – especially as the European Union moves to cut all energy ties with Russia. But tapping nuclear power remains expensive, time consuming and deeply controversial. For VOA, Lisa Bryant takes a look at the debate from Paris. Camera: Lisa Bryant
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It took two trips over state lines, navigating icy roads and a patchwork of state laws, for a 32-year-old South Dakota woman to get abortion pills last year.

For abortion-seekers like her, such journeys, along with pills sent through the mail, will grow in importance if the Supreme Court follows through with its leaked draft opinion that would overturn the landmark Roe v. Wade decision and allow individual states to ban the procedure.

The woman, who spoke on the condition of anonymity because she was concerned for her family’s safety, said the abortion pills allowed her to end an unexpected and high-risk pregnancy and remain devoted to her two children.

But anti-abortion activists and politicians say those cross-border trips, remote doctors’ consultations and pill deliveries are what they will try to stop next.

“Medication abortion will be where access to abortion is decided,” said Mary Ziegler, a professor at Florida State University College of Law who specializes in reproductive rights. “That’s going to be the battleground that decides how enforceable abortion bans are.”

Use of abortion pills has been rising in the U.S. since 2000 when the Food and Drug Administration approved mifepristone — the main drug used in medication abortions. More than half of U.S. abortions are now done with pills, rather than surgery, according to the Guttmacher Institute, a research group that supports abortion rights.

Two drugs are required. The first, mifepristone, blocks a hormone needed to maintain a pregnancy. A second drug, misoprostol, taken one to two days later, empties the uterus. Both drugs are available as generics and are also used to treat other conditions.

The FDA last year lifted a long-standing requirement that women pick up abortion pills in person. Federal regulations now also allow mail delivery nationwide. Even so, 19 states have passed laws requiring a medical clinician to be physically present when abortion pills are administered to a patient.

South Dakota is among them, joining several states, including Texas, Kentucky, Arkansas, Ohio, Tennessee and Oklahoma, where Republicans have moved to further restrict access to abortion pills in recent months.

Those moves have spurred online services that offer information on getting abortion pills and consultations to get a prescription. After the woman in South Dakota found that the state’s only abortion clinic could not schedule her in time for a medication abortion, she found an online service, called Just The Pill, that advised her to drive to Minnesota for a phone consultation with a doctor. A week later, she came back to Minnesota for the pills.

She took the first one almost immediately in her car, then cried as she drove home.

“I felt like I lost a pregnancy,” she said. “I love my husband and I love my children and I knew exactly what I had to say goodbye to and that was a really horrible thing to have to do.”

Besides crossing state lines, women can also turn to international online pharmacies, said Greer Donley, a professor specializing in reproductive health care at the University of Pittsburgh Law School. Some women also are having prescribed pills forwarded through states without restrictions.

“It allows for someone to have an abortion without a direct role of a provider. It’s going to be much harder for states to control abortion access,” she said, adding, “The question is how is it going to be enforced?”

Abortion law experts say it’s an unsettled question whether states can restrict access to abortion pills in the wake of the FDA’s decision.

“The general rule is that federal law preempts conflicting state law,” said Laura Hermer, a professor at the Mitchell Hamline School of Law in St. Paul, Minnesota. “There is no question that the FDA has proper authority to regulate the drugs used in medication abortions. The question is whether a state can make a viable, winning argument that, for public health purposes, it needs to further regulate access to the relevant medications.”

Hermer said she doesn’t think there is a valid public health reason because the published evidence is that the drugs are “exceptionally safe.” But if the Supreme Court overrules Roe v. Wade and a state gives embryos and fetuses full rights as people “then all bets would be off.”

The Planned Parenthood regional organization that includes South Dakota doesn’t believe it can legally mail abortion pills to patients there.

Telemedicine providers have to abide by the laws of the state where the patient is, said Dr. Sarah Traxler, chief medical officer for Planned Parenthood North Central States in St. Paul. She acknowledged that some organizations disagree.

“But,” she added, “we don’t feel like we have liberty to mail pills from Minnesota to other places in the country where it’s illegal to provide medication abortion.”

Sue Leibel, the state policy director for Susan B. Anthony List, a prominent organization opposed to abortion, acknowledged that medication abortions have “crept up” on Republican state lawmakers.

“This is a new frontier and states are grappling with enforcement mechanisms,” she said, adding, “The advice that I always give — if you shut the front door, the pills are going to come in the back door.”

Leibel maintained women should not be prosecuted for seeking abortions, keeping with a long-standing principle of many abortion opponents. She suggested the next target for state enforcement should be the pharmacies, organizations and clinics that provide the abortion pills. She also said abortion-rights opponents should focus on electing a presidential candidate who would work to reverse the FDA’s decision.

The FDA said a scientific review supported broadening access to the drugs and found complications were rare. The agency has reported 26 deaths associated with the drug since 2000, though not all of those can be directly attributed to the medication because of existing health conditions and other factors.

However, with new legal battles on the horizon and abortion seekers going to greater lengths to obtain the procedure, Donley, the law school professor, worried that state lawmakers will turn their attention toward the women who get the pills.

Indeed, a Louisiana House committee advanced a bill Wednesday that would make abortion a crime of homicide for which a woman ending her pregnancy could be charged, along with anyone helping her.

“Many anti-abortion legislators might realize the only way to enforce these laws is to prosecute the pregnant person themselves,” Donley said. 
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The Global Network, an alliance of humanitarian and developmental agencies, says around 193 million people globally experienced extreme hunger last year, with more than half a million on the brink of famine in Ethiopia, southern Madagascar, South Sudan, and Yemen.

The network, which includes the European Union, U.N. Food and Agriculture Organization, and World Food Program, is calling for action to tackle the life-threatening crisis.  

Authors of the report warn the crisis is set to worsen this year. They say the key drivers of food insecurity — conflict, climate change, and the COVID-19 pandemic — are pushing increasing numbers of people into poverty.

The executive director of the World Food Program, David Beasley, calls it a perfect storm. He says whatever progress has been made in feeding the destitute is being lost because of Afghanistan, Ethiopia, and now Ukraine. 

“As we look around the world, 276 million people marching towards starvation,” he said. “And now we have got the breadbasket of the world being turned into breadlines. Who would have ever thought that we would see this in our time, our lifetime. Mass migration taking place out of Ukraine. And it is going to devastate the food security situation around the world.” 

He notes Ukraine and Russia together produce 30 percent of the world’s wheat, 20 percent of the world’s maize, and up to 80 percent of sunflower seed oil. He says those supplies are not moving out of Ukraine because Russia has blockaded Black Sea ports. 

“If we do not get ahead of this thing, we will have not just famine in multiple countries around the world because, you know, we got additional droughts and all types of issues. But you will have destabilization of some nations and you will have mass migration by necessity. And no one wants that,” Beasley said. 

UNICEF Executive Director Catherine Russell warns the global food crisis threatens child survival and development. 

“By stark contrast, inadequate nutrition is the leading cause of child mortality,” she said. “In fact, nearly half of all deaths of children under five are attributable to undernutrition. … We now estimate that by the end of 2021, 50 million children were suffering from wasting, the most life-threatening form of malnutrition. We expect this number is now higher.” 

The Global Network is calling for coordinated, collective action to address the food and nutrition crisis. It says emergency funding is needed now to pull starving people back from the brink, and longer-term action is crucial to create more sustainable agri-food systems. 

 
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South African health officials are urging COVID-19 vaccine manufacturer Aspen to keep its plant in the Eastern Cape province open. This follows a Reuters article quoting Aspen’s senior director saying they may have to shut down as there have been no orders for their rebranded COVID vaccine.

A South African-owned subsidiary of pharmaceutical giant Aspen struck a deal with American company Johnson & Johnson in March to package, price, sell and distribute its vaccine in Africa.

This vaccine was rebranded as Aspenovax.

The move was hailed by many as there had been much concern about Africa’s reliance on imported vaccines which were often costly and at times in short supply.

But there have been no orders for Aspenovax.  South Africa’s National Health Department Spokesperson Foster Mohale said the lack of orders is due to low vaccination rates not only at home, but globally.

“Vaccine hesitancy is one of the factors which contribute to these low vaccination rates or demand for more vaccines which also affect the production. Because obviously we understand that they are in a business, they can’t keep on producing vaccines when they know that the demand for vaccines is very low. So, we understand the situation where they are, and we sympathize with them,” he said.

Mohale said for now, South Africa has enough vaccines. He adds that in March, 100,000 vaccines expired. And more are due to expire in June and July.

However, he said that Aspen’s vaccine plant is important because no one knows what the future holds.

“We will try to engage them not to rush their decision precisely because we anticipate especially our scientists, our epidemiologists, we anticipate that the fifth wave might hit the country, South Africa, during the winter season which is a few weeks away from now. As you can see the number of daily COVID-19 patients has been rising for the past seven days,” he said.

Professor Petro Terblanche, who is the managing director of South African company, Afrigen, which in a continent-first made an mRNA COVID vaccine using Moderna’s data — said the situation at Aspen is a tragedy for the industry.

“This is just indicating again how important it is that this continent looks at policy reform. This is about how are we going to make sure that we give preferential procurement to local companies. How are we going to make sure that we create a marketplace and eco-system that will absorb local capacity? Otherwise, we will not have capacity locally in a sustainable manner and we’re going to get the next pandemic and we will be unprepared, and we will not have health security,” said Terblanche.

She believes money should also be put into educating people on the importance of vaccines.

“We need to ensure that we also put effort into advocacy for vaccination. Because we now have 17% of the continent that is vaccinated. We need to get them to at least 40% to ensure that we fully arrest this pandemic,” she said.

Mohale was unable to say when the Health Department would be meeting with Aspen’s executives.
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A body inside a barrel was found over the weekend on the the newly exposed bottom of Nevada’s Lake Mead as drought depletes one of the largest U.S. reservoirs. Officials say the discovery could be the first of more grim finds. 

“There is a very good chance as the water level drops that we are going to find additional human remains,” Las Vegas police Lt. Ray Spencer told KLAS-TV on Monday. 

The lake’s level has dropped so much that the uppermost water intake at drought-stricken Lake Mead became visible last week. The reservoir on the Colorado River behind Hoover Dam has become so depleted that Las Vegas is now pumping water from deeper within Lake Mead, which also stretches into Arizona. 

Personal items found inside the barrel indicated the person died more than 40 years ago in the 1980s, Spencer said. 

He declined to discuss a cause of death and declined to describe the items found, saying the investigation is ongoing. 

Police plan to reach out to experts at the University of Nevada, Las Vegas to analyze when the barrel started eroding. The Clark County coroner’s office will try to determine the person’s identity. 

Boaters spotted the barrel Sunday afternoon. National Park Service rangers searched an area near the lake’s Hemenway Harbor and found the barrel containing skeletal remains. 

Lake Mead and Lake Powell upstream are the largest human-made reservoirs in the U.S., part of a system that provides water to more than 40 million people, tribes, agriculture and industry in Arizona, California, Colorado, Nevada, New Mexico, Utah, Wyoming and across the southern border in Mexico. 
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