Aid to Ukraine hits a roadblock

The people and politics driving global health.

Mar 03, 2022 View in browser   By Daniel Payne With help from Ben Leonard THE BIG IDEA People gather in the Kyiv subway, using it as a bomb shelter in Kyiv, Ukraine, Wednesday, March 2, 2022. The WHO is calling for protected distributions of medical supplies through the country — including in Kyiv, where medical supply stockpiles are still inaccessible. | AP Photo/Efrem Lukatsky WHO PLEADS FOR PATHS TO DELIVER CARE IN UKRAINE — The World Health Organization warned Wednesday of still significant barriers to getting care and supplies into the country. Health care workers still can't access warehouses storing WHO supplies, officials said at a press briefing. Lack of supply access through the country has led to urgent shortages — including oxygen, insulin and cancer and high blood pressure drugs. Three major oxygen plants in Ukraine shut down after Russia invaded, and the remaining supply is being depleted. Distribution is even a challenge — the WHO has had difficulty finding people willing to drive trucks without safe pathways for aid supply chains. "There is certain access. But as the current situation erodes, the access is decreasing, and the challenge is, where the major needs are … we don't have access," said Jarno Habicht, the WHO representative in Ukraine. The first shipment from outside stockpiles of supplies will land today in Poland, officials said. Hospitals attacked: WHO officials also said one attack on a hospital had been confirmed — killing four people and injuring 10. Other attacks on hospitals are now being investigated. "When you see nurses mechanically ventilating infants in basements of hospitals, you know, even the toughest of us, we struggled to watch that," Michael Ryan, executive director of the WHO Health Emergencies Programme, said in the briefing. The cause that shall not be named: The WHO hasn't called out Russia — a member state of the organization — in its statements about the conflict in Ukraine. "What we try to do is honor the organization's commitment, standing beside those who are suffering and leave the politics of punishing perpetrators to others better capable of doing that," said Ryan, who added that the WHO called on the Russian government to "reconsider its position" in the invasion, considering the suffering caused by the conflict. Covid concerns: Though the conflict is the primary health crisis in the region, officials said, a spike of Covid-19 cases is notable. Ukraine saw a surge in cases before the invasion, and mass migrations — like the nearly 900,000 displaced people in the country — could make it worse. WELCOME TO GLOBAL PULSE WELCOME BACK TO GLOBAL PULSE, where we're wondering which books about global health we should add to our shelves. Send recommendations — and tips — to dpayne@politico.com. Global Pulse is a team effort. Thanks to editors Eli Reyes and Barbara Van Tine. Follow us on Twitter: @ErinBancoand @_daniel_payne. BEYOND THE PANDEMIC AFRICA CDC'S SHORT PAST, HOPEFUL FUTURE — John Nkengasong, the director of the Africa CDC, led the young agency through its first five years — two of them during a pandemic. Now, as he awaits confirmation to head the U.S. President's Emergency Plan for AIDS Relief, Nkengasong talked with Global Pulse about the current state of the pandemic, the changing health care possibilities on the continent and his legacy at the agency. This conversation has been edited for length and clarity. The Africa CDC is a very young agency compared to its peers around the world. How has it been able to keep up through the pandemic? There is a series of factors that have enabled Africa CDC to play the role: It is what I call the political leadership and political ownership of the institution. I remember, on the 26 of March 2020, we raised issues of lack of resources, (African nations) started pledges … that political leadership and political ownership enabled that young organization to be. Thirdly is the confidence they invested in it. They based their decisions many times on the advice given by Africa CDC. It's unprecedented in the history of politics in Africa where heads of state are seeing their own data from their own organization and believing in it, managing it, using it to make a decision there. There have been several developments in recent weeks regarding increasing mRNA vaccine manufacturing across Africa. Do you think this is a turning point not just for Covid but for African vaccine infrastructure overall? I think so. The way we fight the next pandemic will be very different from the way we fight this pandemic because of this development on the continent in terms of vaccine manufacturing. We also say that we need a platform to coordinate — that is why we've established the Partnership for African Vaccine Manufacturing. It has been endorsed by the (African Union's) executive council of foreign ministers as a platform to coordinate efforts on vaccine production on the continent. You have been nominated to PEPFAR in the U.S., which could mean your departure from the Africa CDC in the near future. What do you hope your legacy at the Africa CDC will be? Not everybody in their career will be given the opportunity to start an organization from scratch. Was it easy? Is it easy? No, no. But it is that joy of building something from scratch in public health that is going to save lives, transforming a promissory note into something actually deliverable, I think, has been the most important contribution. But I'm not so much a person of legacy. I do my little job and move on, and that is all that is of interest to me. NEW CLIMATE REPORT SUGGESTS HEALTH SYSTEMS ARE AT RISK — The newest report from the U.N.'s Intergovernmental Panel on Climate Change warns that health care is still at serious risk of being affected by climate change. The threats of increased disease, malnutrition, heat exposure, displacement and even mental health risks were mentioned in the new report, with negative impacts forecast across continents. The impact: The models of climate change impacts are often adding health care challenges to countries around the world — mosquitos will carry diseases like malaria farther in warmer conditions, for example. In turn, organizations that address these challenges are amending their plans; Malaria No More, among others, is working to develop improved capacity to meet the new needs. Aaron Bernstein, interim director of the Center for Climate, Health, and the Global Environment at Harvard's school of public health, said two areas caught his eye in the new report: climate-resilient health systems and a more integrated approach to health care. A rethinking: He told Global Pulse that climate financing should more often include the health sector, especially in low- and middle-income countries, to keep it up and running through climate shocks. That might require rethinking the mandate of climate-oriented organizations, he said. Bernstein also said that the health of humans, animals and ecosystems need to be seen as interconnected to tackle these problems in more effective ways. "Pandemic risk and climate risk are connected," he said in an email. "We will make better policies and reap greater rewards when we act knowing how they relate." GLOBAL PULSE NUMBER 475 million The updated number of vaccine doses the U.S. has delivered around the world. The administration has pledged to donate 1.1 billion doses in all. AROUND THE WORLD WHO EYEING DIGITAL VACCINE YELLOW CARD — The World Health Organization is developing a digital "yellow booklet" proving vaccination status in all countries, Ben reports. The WHO has approved a paper yellow booklet as a proof-of-vaccination passport for yellow fever and polio immunization requirements, but the organization is now creating a digital version. International tool: "In the near term, the paper-based booklet will be revised to include an extra section on laboratory results aimed at providing a universally accepted tool for international travel," the organization told POLITICO. The WHO has recommended against requiring proof of Covid-19 vaccination for international travel. But this spring, it's convening member states and issuers of digital Covid-19 vaccination credentials to recognize different vaccine certificates across nations and regions. Trust but verify: The groups aim to develop a "trust framework" that enables countries to verify whether vaccine credentials are legitimate, said Brian Anderson, chief digital health physician at MITRE and a co-founder of Vaccination Credential Initiative. The effort would try to make international travel and proof of vaccination requirements more seamless than it currently is, with a number of digital credential standards. "It's piecemeal, not coordinated and done nation to nation," Anderson said. "It can be a real challenge." MENTAL HEALTH ISSUES SPIKED GLOBALLY THROUGH PANDEMIC — a new WHO study suggests more concretely what has been vaguely said by leaders for a while: The pandemic led to more mental health issues — particularly, a 25 percent increase in the prevalence of anxiety and depression worldwide. WHO officials said women and young adults — especially those 20–24 — saw the largest impact in the pandemic's first year when the study was conducted. Researchers said the rise in anxiety and depression reveals a chronic underinvestment in mental health care around the world. WHAT WE'RE CLICKING The New York Times: Threats Emerge in Germany as Far Right and Pandemic Protesters Merge. NBC News: Global Health Has Improved for Decades. Climate Change Could Change That. Nature: Hundreds of Covid Trials Could Provide a Deluge of New Drugs.   Follow us

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