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Pandemic preparedness is in limbo

The ideas and innovators shaping health care
Nov 17, 2023 View in browser
 
Future Pulse

By Shawn Zeller, Evan Peng, Carmen Paun, Daniel Payne and Ruth Reader

PANDEMIC

Sen. Bob Casey (D-Pa.) arrives for a press conference outside the U.S. Capitol Nov. 15, 2023. (Francis Chung/POLITICO via AP Images)

Casey, left, has bipartisan support for his Senate pandemic preparedness bill, but the parties are divided in the House. | AP

The Covid pandemic is fading into memory, and so is the impetus to do better next time.

How so? The Biden administration seeks to water down language in a pandemic treaty the World Health Organization hopes to finalize next spring.

A recent draft reviewed by POLITICO’s health team in Europe found the U.S. repeatedly asking that binding commitments be made optional.

The U.S. wants the word “shall” to be replaced with “intends” when the text says that countries “shall” cooperate on strengthening pandemic prevention or “shall” develop public health surveillance plans.

The U.S. also requests that provisions African countries want requiring the rich world to share pandemic products like vaccines be made optional.

And on Capitol Hill: Reauthorization of the Pandemic and All-Hazards Preparedness Act, which instructs public health agencies on how to prepare for future health threats, faces a tough road.

Though a bill to re-up the expired law by Pennsylvania Democrat Bob Casey won bipartisan support in the Senate’s health committee in July, the House is divided.

The Energy and Commerce Committee advanced its version on a party-line vote over the summer, with Democrats objecting to a GOP move to flatline funding for a pandemic-preparedness program at the Centers for Disease Control and Prevention.

Democrats also asked for language expanding the Food and Drug Administration’s authority to combat drug shortages, but Republicans said that would muddy up the bill.

Meanwhile, House conservatives angry over how public health agencies handled Covid want new limits on their authority and threaten to block a floor vote.

Those limits include a reduction in pandemic-preparedness funding to pre-Covid levels and language asserting American sovereignty over the WHO.

Readiness assessed: The WHO and World Bank’s Global Preparedness Monitoring Board recently found that the world is falling short when it comes to preparing for the next pandemic, our team in Europe reports.

Amélie Rioux, technical officer for the board’s secretariat at the WHO, said countries aren’t spending enough to shore up the weaknesses in their public health systems that Covid exposed.

“The board has called this ‘canary-in-the-coal-mine issues’ because we see this as the earliest signs of more systemic problems,” she said.

 

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WELCOME TO FUTURE PULSE

Armstrong Redwoods State Natural Reserve, Calif.

Armstrong Redwoods State Natural Reserve, Calif. | Shawn Zeller

This is where we explore the ideas and innovators shaping health care.

A Florida Republican has a beef with lab-grown meat, our colleague Bruce Ritchie reports. State Rep. Tyler Sirois has proposed legislation that would make it a criminal offense to sell “cultivated” meat in the Sunshine State, arguing that it’s an "affront to nature and creation."

Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Evan Peng at epeng@politico.com, Ruth Reader at rreader@politico.com or Erin Schumaker at eschumaker@politico.com.

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Today on our Pulse Check podcast, host Katherine Ellen Foley talks with POLITICO Europe health care reporter Carlo Martuscelli about the U.K.’s approval of a gene-editing treatment for some rare blood diseases that may receive U.S. approval next month.

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THE NEXT CURES

A pedestrian walks along Sunset Boulevard in Hollywood, California on May 29, 2018 beneath a billoard from the AIDS Healthcare Foundation (AHF) warning of a drug resistant Gonorrhea. - A billboard on Sunset Boulevard in Hollywood screams out a stark warning: "drug-resistant gonorrhea alert!" Sexually transmitted diseases have made an alarming resurgence across the US, where 2016 saw a record two million cases of   chlamydia, gonorrhea and syphilis, including 628 cases of congenital syphilis. But California, the most populous US state, stands out for its willingness to tackle the crisis head-on, with cases of the three ailments up 45 percent in 2017 from five years ago. (Photo by Frederic J. BROWN / AFP) / TO GO WITH AFP STORY by Javier TOVAR, "California on front line as STDs run rampant in US"        (Photo credit should read FREDERIC J. BROWN/AFP via Getty Images)

Cases of gonorrhea have grown, and antimicrobial resistance has made it more difficult to treat. | AFP via Getty Images

A novel antibiotic to treat gonorrhea demonstrated efficacy in clinical trials, preliminary results show.

The Phase III trial included 930 people with gonorrhea in Belgium, the Netherlands, South Africa, Thailand and the U.S.

Researchers found that a single dose of zoliflodacin, developed by Innoviva Specialty Therapeutics, is safe and effective for treating cases of uncomplicated urogenital gonorrhea. The results have not yet been peer-reviewed or published.

In addition to its efficacy, zoliflodacin is taken orally, which could aid in patient access and compliance.

The current standard treatment, ceftriaxone, is injected.

The antibiotic, developed with support from the National Institute of Allergy and Infectious Diseases, uses a unique mechanism to inhibit an enzyme crucial for bacterial function and reproduction.

Why it matters: Gonorrhea, a sexually transmitted disease, is increasingly difficult to treat due to antimicrobial resistance in Neisseria gonorrhoeae, the bacteria that causes gonorrhea.

Left untreated, gonorrhea can create serious and permanent damage, including pelvic inflammatory disease and infertility.

While antimicrobial resistance is on the rise across bacteria and viruses, N. gonorrhoeae is particularly adept at evading treatment, with demonstrated resistance to most existing classes of antibiotics. Researchers have recently detected strains that don’t respond to ceftriaxone.

Meanwhile, STD numbers are rising in the U.S. According to data from the Centers for Disease Control and Prevention, from 2017 to 2021, STD cases increased by 7 percent, including a 28 percent increase in gonorrhea cases, reaching more than 700,000 cases in 2021.

What’s next? “These encouraging results should bolster additional, intersectoral efforts to develop safe and effective therapeutic options for gonorrhea and other bacteria that exhibit antimicrobial resistance,” said Dr. Jeanne Marrazzo, the NIAID director, in a release.

 

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AROUND THE AGENCIES

Dr. W. Kimryn Rathmell

Rathmell will be the second woman to lead the National Cancer Institute. | Courtesy of Vanderbilt University Medical Center

Dr. W. Kimryn Rathmell will be the next leader of the National Cancer Institute and play a principal role in trying to achieve President Joe Biden’s moonshot goal of reducing the cancer death rate by 50 percent over 25 years.

Who is she? Rathmell is a Vanderbilt University professor of medicine and chair of medicine at its medical center.

She treats and studies complex renal cell carcinomas, a type of kidney cancer most common in older men.

Her research has resulted in over 20 years of funding from the National Institutes of Health and more than 200 articles in leading peer-reviewed journals, according to a Vanderbilt release.

What’s next? Rathmell will be the second woman to lead the cancer institute after her immediate predecessor, Dr. Monica Bertagnolli. The Senate confirmed Bertagnolli to lead the National Institutes of Health earlier this month.

 

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