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Health experts pin their hopes on long-awaited trials into a new potential vaccine for tuberculosis.

In the few minutes it takes to read this article, some 15 people are likely to have died from humanity’s worst infectious killer disease. Over the course of the day, the toll will be around 3,600.

The victims are likely to have died slowly, spending months or years coughing and wasting away as their lungs were relentlessly weakened.

Those victims are also all likely to have been poor and from the developing world, or middle income countries.

The killer is not an exotic new superbug, or recently-emerged virus, but one of the world’s oldest pandemics, caused by a bacterium which has plagued humanity for an estimated 40 millennia.

Locked in a constant arms race against human immune systems, the bug has in that time evolved into a stubborn, stealthy and difficult-to-stop killer.

Some 10.6m people fell ill with tuberculosis, or TB, in 2022 and 1.5m people died, which is an average of 2.5 deaths per minute.

The World Health Organization (WHO) has updated its list of antibiotic-resistant bacteria that pose the greatest threat to human health, ranking the 15 families of bacteria that feature as “critical”, “high” and “medium” threats. 

The Bacterial Priority Pathogens List (BPPL) 2024’s “critical” list features bacteria that are high burden, can resist treatment and spread resistance to other bacteria.

A new entrant on the “critical” list is a third-generation cephalosporin-resistant Enterobacterales. It joins tuberculosis resistant to rifampicin, and gram-negative bacteria resistant to last-resort antibiotics.

Gram-negative bacteria have built-in abilities to find new ways to resist treatment and can pass along genetic material that allows other bacteria to become drug resistant as well.

There is considerable misinformation on social media and from some politicians and other influencers regarding the negotiations for a WHO pandemic treaty. In order to provide better understanding of what is actually being negotiated, this note provides commentary on several key articles, based upon the INB’s May 10 draft text, as published by Health Policy Watch. 1 of 17 https://healthpolicy-watch.news/wp-content/uploads/2024/05/Pandemic-Agreement-Draft-Reflec ting-progress-up-to-10-May.pdf In general, as the negotiations have progressed, in many areas, the obligations have become softer, as the WHO INB pushes for consensus. That said, the text does create norms in several areas, and mandates and mechanisms for cooperation that are potentially important going forward. The discussion covers Articles 4 through 13bis, and Articles 19, 20, 27, 29, 30 and 31.

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A deadlier version of the infectious disease is ravaging the Democratic Republic of Congo, while the type that caused a 2022 outbreak among gay and bisexual men is regaining strength.

With Pride events scheduled worldwide over the coming weeks, U.S. officials are bracing for a return of mpox, the infectious disease formerly called monkeypox that struck tens of thousands of gay and bisexual men worldwide in 2022. A combination of behavioral changes and vaccination quelled that outbreak, but a majority of those at risk have not yet been immunized.

On Thursday, the Centers for Disease Control and Prevention warned of a deadlier version of mpox that is ravaging the Democratic Republic of Congo and urged people at risk to be vaccinated as soon as possible. No cases of that subtype have been identified outside Africa so far. But the escalating epidemic in Congo nevertheless poses a global threat, just as infections in Nigeria set off the 2022 outbreak, experts said.

The latest draft of the World Health Organization’s (WHO) pandemic agreement, which was sent out to member states on Wednesday (15 May), shows just how far the talks still have to go.

Health Policy Watch obtained a copy of the draft agreement, which we are sharing on our paywall-free site:

READ: Latest Pandemic Agreement Draft, reflecting progress up to 10 May

Around a third of the text is still white, indicating either that it has not been agreed on or not even discussed. According to a stakeholder briefing, there were some 300 paragraphs to negotiate on at the last meeting of the Intergovernmental Negotiating Body (INB).

However, some of the most significant articles are awash with yellow and green highlights, indicating progress.

Yellow means the text has been agreed to in a working group. Green means it has been agreed to in the plenary of the Intergovernmental Negotiating Body (INB).

MSF delivered the following statement, with accompanying position paper, on recommendations for the UN High-Level Meeting (UNHLM) on antimicrobial resistance (AMR).

Statement for the Interactive Multi-Stakeholder Hearing as part of the preparatory process for the 2024 High-Level Meeting on antimicrobial resistance (AMR) 

Thank you, Mr. (President). 

I represent Médecins Sans Frontières, a medical humanitarian organisation and a leading actor in the treatment of AMR globally, with 47 AMR projects in 18 countries worldwide. 

Over the last decade we have treated many thousands of patients with drug-resistant bacterial infections, and have noted with alarm the increasing rates of resistance.  

We witness first-hand inequities in health care, resulting in gaps in prevention, diagnosis and treatment that are putting patient lives, and quite frankly, modern medicine, at risk.  

We can attest that basic, targeted interventions to strengthen healthcare facilities against AMR in low-resource settings work, and yet, the necessary international financing and mobilization to implement these measures are still lacking. 

The latest draft of the World Health Organization’s (WHO) pandemic agreement, which was sent out to member states on Wednesday (15 May), shows just how far the talks still have to go.

Health Policy Watch obtained a copy of the draft agreement, which we are sharing on our paywall-free site:

READ: Latest Pandemic Agreement Draft, reflecting progress up to 10 May

Around a third of the text is still white, indicating either that it has not been agreed on or not even discussed. According to a stakeholder briefing, there were some 300 paragraphs to negotiate on at the last meeting of the Intergovernmental Negotiating Body (INB).

However, some of the most significant articles are awash with yellow and green highlights, indicating progress.

Yellow means the text has been agreed to in a working group. Green means it has been agreed to in the plenary of the Intergovernmental Negotiating Body (INB).

Hours before the scheduled deadline on May 10^th to conclude the negotiations towards a Pandemic Agreement, unable to find consensus WHO member states struggled to find a way to extend the negotiations.

Diplomatic sources told us that countries were divided on devising a way ahead to continue the discussions. While some preferred to take “sufficient” time conclude these crucial talks carefully, groups of countries are keen on having an agreement “at any cost” ahead of the World Health Assembly that begins on May 27th.

Countries have now decided to continue to work till the last mile in an attempt to reach consensus. How they will do so, is less clear at this point.

In this story we describe the dynamics and events that unfolded at the close of the meeting of the Intergovernmental Negotiating Body on May 10.

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• Vaccines have saved 150 million children over the last 50 years

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Governments of the world today agreed to continue working on a proposed pandemic agreement, and to further refine the draft, ahead of the Seventy-seventh World Health Assembly that starts 27 May 2024.

Governments meeting at the World Health Organization headquarters in Geneva agreed to resume hybrid and in-person discussions over coming weeks to advance work on critical issues, including around a proposed new global system for pathogen access and benefits sharing (i.e. life-saving vaccines, treatments and diagnostics); pandemic prevention and One Health; and the financial coordination needed to scale up countries’ capacities to prepare for and respond to pandemics.

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