Gavi’s Covid jab guessing game

The ideas and innovators shaping health care

Dec 14, 2022 View in browser   By Carmen Paun, Ben Leonard, Ruth Reader and Grace Scullion PANDEMIC Gavi's Seth Berkley is trying to align Covid vaccine supply with demand. | AP Plummeting interest in Covid-19 vaccination has prompted Gavi — the organization that's sought to bring vaccines to developing countries through its COVAX program – to try to square its supply with demand. It's in the difficult spot of trying to figure out how much vaccine to procur, so that shots aren't wasted, without any certainty about Covid's evolution. It's a big shift from earlier in the pandemic, when COVAX struggled to deliver due to tight vaccine supplies and fierce competition for them among wealthy countries. COVAX has now shipped nearly 1.9 billion vaccine doses, most of them to the poorest countries. Carmen talked with Seth Berkley about Gavi's plans. The interview has been edited for length and clarity. What did the Gavi board decide about COVAX at its meeting last week in Geneva? We've been looking at how long we keep COVAX running and should we keep COVAX running. So the first thing is: COVAX will continue through 2023 the way it has operated. The second discussion we had on the board is what should go on longer term. And the true answer for that is: We don't know what the epidemiology is going to be. Are we going to this winter in the Northern Hemisphere have another series of waves or not? Is the virus gonna change again? Are we going to need new vaccines, different vaccines? Will we get outside of the immunity of existing vaccines? And we don't know that. But the current hypothesis is that what's likely to be needed is at least boosters for high-risk populations. We're at 81 percent coverage for health care workers and we're at 66 percent of the elderly populations in the 92 poorest countries. We'd like to get that higher. The hypothesis then is, for 2024, the program would cover high-risk populations, probably one booster dose once a year for those populations. But at the end of the day, what will define that is what the epidemiology is. And we'll come back to the board in June of 2023 with a firm decision one way or another. What countries will be supported after 2023? Another decision that was taken in principle — not a firm decision — was that for Gavi countries we will provide the continued full support of vaccines in 2024 and 2025 and we will also provide delivery finance: around 70 percent of what we think the cost will be to deliver those vaccines as part of assistance to those lowest-income countries. For the other countries, which are not traditionally part of Gavi [because they have more income], that we brought in for COVAX, we would continue to have vaccines available for them. And in 2024 and 2025, we would give them catalytic support, but we would consider transitioning out of support over time if they are able to support themselves since they are wealthier countries. How many countries still have a Covid-19 vaccination rate of under 10 percent? We started in January 2022 with 34 countries under 10 percent and today we're at eight countries under 10 percent, of which seven are quite fragile countries: the Yemens, the DRCs, the Haitis of the world. And we haven't stopped, we're continuing to work with those countries and trying to provide support for them. In fact, we just had a new country join COVAX last week, Burundi. So we're continuing to work to get that coverage up. In places that are very fragile, the health systems are quite weak and it's difficult to get coverage up and they have other issues going on at the current time that also is competing for their attention.   JOIN THURSDAY FOR A CONVERSATION ON FAMILY CARE IN AMERICA : Family caregivers are among our most overlooked and under-supported groups in the United States. The Biden Administration's new national strategy for supporting family caregivers outlines nearly 350 actions the federal government is committed to taking. Who will deliver this strategy? How should different stakeholders divide the work? Join POLITICO on Dec. 15 to explore how federal action can improve the lives of those giving and receiving family care across America. REGISTER HERE.     WELCOME TO FUTURE PULSE Blue Ridge Mountains, North Carolina | Ruth Reader This is where we explore the ideas and innovators shaping health care.  Did the pandemic warp your sense of time? You're not the only one. Researchers say our sense of time has to do not only with the minutes on the clock, but our emotions and environment. As one psychiatrist told NPR, our perception of time comes from "something beyond the brain." Share news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com, Carmen Paun at cpaun@politico.com or Grace Scullion at gscullion@politico.com.  Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, Ben talks with Krista Mahr about new data from the CDC that says at least 3,500 Americans have died due, at least in part, to long Covid. Listen to today's Pulse Check podcast FOLLOW THE MONEY Renee Wegrzyn's job is to get ARPA-H off the ground. | AP The Advanced Research Projects Agency for Health doesn't plan to release a request for proposals for its highly sought-after headquarters location, an agency spokesperson told Ben. An RFP process typically would entail the agency setting formal criteria indicating how it would choose a winner and require bidders to make formal offers. "We know many states and cities are interested in hosting ARPA-H – and it's great to be wanted," said Jared Adams, ARPA-H's chief of engagement and communications, in an email. He added that the states and cities not chosen can still expect to see grant funding headed their way. Why it matters: Congress gave $1 billion to create the biomedical research agency in a spending bill this spring. ARPA-H will aim to take "high-risk, high-reward" bets on research and be more nimble than current research agencies like the National Institutes of Health. What's next: At least 10 states have shown interest in hosting, including California, Texas and Massachusetts. Lobbyists have said it's unclear to them how the agency will choose a winner. Lawmakers still need to pass authorizing legislation to put a congressional imprimatur on the agency's mission, organization and level of independence from NIH. In September, President Joe Biden tapped Renee Wegrzyn, an executive at Boston-based biotech firm Ginkgo Bioworks, to lead the agency.   A NEW POLITICO PODCAST: POLITICO Tech is an authoritative insider briefing on the politics and policy of technology. From crypto and the metaverse to cybersecurity and AI, we explore the who, what and how of policy shaping future industries. We're kicking off with a series exploring darknet marketplaces, the virtual platforms that enable actors from all corners of the online world to traffic illicit goods. As malware and cybercrime attacks become increasingly frequent, regulators and law enforcement agencies work different angles to shut these platforms down, but new, often more unassailable marketplaces pop up. SUBSCRIBE AND START LISTENING TODAY.     DANGER ZONE Work in high heat puts strain on expectant mothers' fetuses, new research found. | AP During pregnancy, mothers who work in extreme heat may not realize the effects the high temperatures can have on their unborn babies, says a study conducted in Gambia by researchers at the London School of Hygiene & Tropical Medicine. Every degree Celsius increase in the heat the mothers were exposed to resulted in a 17 percent increase in the strain on fetuses as measured by raised heart rates and slowed blood flow through the umbilical cord, according to the study published last week in The Lancet Planetary Health. Climate change will exacerbate the problem in sub-Saharan Africa, a region particularly vulnerable to the planet's warming, said Ana Bonell, the study's lead author. Why it matters: "Despite the growing scientific evidence linking maternal heat exposure to adverse birth outcomes, including premature birth, low birth weight, and stillbirth, up until now there has been little research into the physiological mechanisms responsible for these outcomes," said study author Jainaba Badjie. Diversion of blood from the placenta to the skin is an important physiological factor to research in the future, the London School of Hygiene & Tropical Medicine said in a statement. How it worked: Ninety-two pregnant subsistence farmers in Gambia's Kiang West were fitted with a wearable device to record maternal heart rate, skin temperature and estimated energy expenditure. Portable ultrasound devices recorded fetal heart rate and umbilical artery blood flow at the beginning, middle and end of each worker's shift. Half of the women reported experiencing at least one symptom of heat illness, such as nausea, vomiting, headache, dizziness, weakness, muscle ache, fatigue and dry mouth.   Follow us on Twitter Ben Leonard @_BenLeonard_ Ruth Reader @RuthReader Carmen Paun @carmenpaun   Follow us

To change your alert settings, please log in at https://www.politico.com/_login?base=https%3A%2F%2Fwww.politico.com/settings This email was sent to rouf@idiot.cloudns.cc by: POLITICO, LLC 1000 Wilson Blvd. Arlington, VA, 22209, USA Please click here and follow the steps to unsubscribe.