OFFICES IN Washington D.C. & New Delhi

Center For Disease Dynamics, Economics & Policy

Global health equity & research; Avian flu outbreaks

A flock of wild birds over land with a blue sky in the background

Global health research funders must join the conversation on equity. One Health Trust researchers and collaborators find that much of global health inequity is tied to approaches to research funding. Disparities in power and resources between high-income countries (HICs) and low- and middle-income countries (LMICs) lead to LMIC researchers being excluded from lending a voice to the shaping of global health research priorities and agendas. An imbalance in financial investment by LMIC governments in health research puts LMIC health professionals and researchers who are at the forefront of global health practice at a disadvantage. Although many LMICs do not have resources for direct investment, some LMICs like Brazil, Mexico, and India, could invest more and alleviate some disparities. Funders and donors in HICs must address inequities in their approach to research funding and find methods that promote greater equity, including through direct funding to LMIC researchers and constructing local LMIC-based, led, and run knowledge infrastructures. [PLOS Global Public Health]

Nutrition in research involving animals is important for rigor and reproducibility. Scientists have developed multiple standardized diets for animal facilities and laboratories, producing various standardized pellet foods. However, these diets were developed based on cost and practicality, rather than on animals’ natural nutrient intake. A focus on animal welfare (including nutrition that mirrors animals’ natural diets) can boost scientific rigor, as it is more likely to attain results that are reproducible under a broad range of circumstances. [Nature]

A new strain of Avian flu outbreaks is cause for alarm. A highly infectious and deadly strain of avian influenza virus, H5N1, has infected millions of poultry birds across Europe, Asia, Africa, and North America. Scientists are particularly concerned about the spread in wild birds that may transport the virus globally through migration, making outbreaks harder to contain. Infections in humans are uncommon, with only two cases reported since October 2021. However, increasing acquired mutations could make the H5N1 strain more transmissible to people and other species. Improvements in surveillance of wild birds and poultry facilities, along with mitigating measures such as effective vaccines, less crowded conditions in production facilities, and inter-sectoral collaborations are needed to detect and prevent viral spillovers. [Nature]

Scarce resource allocation protocols during the early pandemic augmented disparate mortality rates. Mortality patterns for historically discriminated against communities have been 1.9 to 2.4 times greater than in the general population during the COVID-19 pandemic in the United States. Researchers surveyed allocation protocols designed to deal with an extreme scarcity of vital resources (like medical oxygen and hospital beds) in the earliest phases of the pandemic and found that standard allocation schemes prioritize those already likely to benefit from systemic disparities, perpetuating and even exasperating inequity. Structural inequities that account for disparate mortality rates must be addressed to prepare for the next pandemic. [International Journal of Equity in Health]

Periodical serological screening along with PCR testing are effective at detecting silent COVID-19 infection. Prior to vaccination with COVID-19 vaccines, PCR and serological tests of 685 healthcare workers (HCWs) at a Tokyo Hospital indicated that SARS-CoV-2 positivity ranged between 3.5% to 27.7% among the different assays used for the testing. Positive rates of HCWs working in COVID-19 wards were significantly higher than those of HCWs working in the non-COVID-19 wards, with silent infection rates being 21.1% in the former compared with 6.0% in the latter. Periodical screening of HCWs is essential to prevent nosocomial infections. [PLOS One]

Delayed climate effects on pulmonary tuberculosis (PTB) incidence in Brunei. An analysis of weekly PTB case counts and climate variables from Brunei-Muara District in Brunei Darussalam from January 2001 to December 2018, reveals a positive but delayed relationship between PTB incidence and minimum temperature, with a significant adjusted relative risk (adj.RR) at 25.1 °C when compared to the median, from week 30 onwards (adj.RR = 1.17), suggesting an effect of minimum temperature on PTB incidence after 30 weeks. [Scientific Reports]

Elevated COVID-19 transmission among older adults and inadequate healthcare access augmented infection fatality rates in developing countries. A systematic literature review assessing COVID-19 infection fatality rates (IFRs) synthesized data from serology studies conducted in developing countries including representative samples collected by February 2021. In most developing countries, seroprevalence among older adults was like that of younger age cohorts, and age-specific IFRs were roughly two times higher than in high-income countries, revealing a limited capacity to protect older age groups and inequitable healthcare access. [BMJ Global Health]

The emergence of SARS-CoV-2 variants challenges current vaccine efficacy and vaccination strategies. Both double- and triple-dose vaccinated individuals show strong antibody and B memory (Bmem) responses to Omicron infection. However, not all vaccine-induced Bmem can recognize Omicron and it is unclear if this quantitative difference will impact vaccine effectiveness and response durability after the third dose. The capacity to respond to variants is based on antibody affinity as well as diversity. While vaccine boosters can improve affinity, enhancing diversity will not be as easy. Responses to new specificities will require the engagement of naive B cells or altered vaccine formulations that go beyond Spike variants. [Science Immunology]

Immune modulator drugs could reduce deaths in COVID-19 patients. A large randomized, placebo-controlled clinical trial was conducted to investigate the treatment of hospitalized adults with COVID-19 with infliximab or abatacept (drugs commonly used to treat certain autoimmune diseases). Patients undergoing treatment displayed clinical improvement and had lower adjusted odds of dying compared to those receiving placebo; patients receiving infliximab or abatacept had 40.5% and 37.4% lower adjusted odds of dying, respectively. [NIH]

The Global Vaccine and Immunization Research Forum (GVIRF) webinar. Evidence on the impact of vaccines in mitigating antimicrobial resistance (AMR) is increasing, however, this knowledge has yet to be translated into policy and decision-making regarding which vaccines to develop and introduce for AMR prevention. The GVIRF webinar, organized by the U.S. National Institute of Allergy and Infectious Diseases, the Bill & Melinda Gates Foundation, and the World Health Organization, will explore the mechanisms, evidence, and value of vaccines in preventing AMR. Discussion topics will include assessments of the value of vaccines in preventing AMR, research priorities, development pipeline for vaccines against AMR priority pathogens, and the role of vaccines in National Action Plans on AMR, among others. The webinar will take place on June 23, 2022, 3-6 pm (CEST). [GVIRF]