In an interview with RFI, the assistant director general of the World Health Organization, Mariângela Simão, stated that the WHO is preparing a “treaty on pandemics” and that a new pandemic phenomenon is only “a matter of time”. According to Mariângela Simão, a new pandemic is “inevitable” and the question is “when will it happen”.
Simão says that the WHO will have a World Health Assembly in November in which the possibility of developing a “treaty for pandemics” will be discussed. The decision, according to her, has not yet been approved, but the topic circulates among countries, “not only because it reinforces the role of WHO in an emergency situation of public interest like this one”, but also because it “creates a series of formalities that countries and the private sector have to take it in the event of an emergency like a global pandemic”, he explains.
Is WHO preparing for a new pandemic? “There’s going to be a next pandemic,” says Simão. “This is something we already know and which is inevitable. It’s a matter of when it will happen”, he says.
“This pandemic, after the Spanish flu, was the most impactful and is also an observation: I think the world needs to wake up because we see that it was not just developing countries that were affected. It affected the whole world, nobody was prepared”, he considers. “The World Health Assembly now in November will be discussing the possibility of developing a treaty for pandemics”, says the assistant director general of WHO.
The meeting should still be a time to discuss current issues about coronavirus variants and vaccine distribution. “I think there are two things, one side is related to this specific coronavirus which is Sars-Cov-2 and the variants, some variants of concern, such as the case of Delta, which is present in 188 countries”, he analyzes. “So the concern and commitment [da OMS] to increase vaccine coverage is global, but in all countries and not just a few, to prevent new worrying variants from emerging”, says Simão.
Vaccine for teenagers after priority
On the vaccination of adolescents as a public health policy, Mariângela Simão says that “the WHO issues a recommendation based on a group of experts that helps the organization in this regard.” “Since July of this year, we have recommendations related to the use of the Pfizer vaccine, it is the only one that has a recommendation for use in the population between 12 and 15 years old, and there was already a recommendation for people over 16 years old”, he recalls.
“But the WHO makes the reservation that the vaccine must be prioritized for adolescents with comorbidities. However, for the general adolescent population, the vaccine for this group should be administered after coverage of all other priority groups. This is the recommendation for countries that have not yet achieved higher coverage in the adult population”, he says.
Regarding the intranasal vaccine, encouraged by specialists because of its ease of application (which might reduce some resistance) but also because it protects the entry point for the virus, the director is cautious when evaluating this type of immunization.
“We still don’t have any nasal vaccine approved globally for covid. I believe that some may be in phase 3, the last phase before it is authorized as an emergency in any country. It makes sense if we think of an ideal type of product, it would be great to have a vaccine that could be administered via the nose, but we are not there yet”, he says.
“There is no approved vaccine yet for children, so there cannot be a national policy using vaccines that have not been approved for children under 12 years old”, recalls the director. “We only have one vaccine approved for use in adolescents from 12 years old. There are several studies in progress, but none of them has yet been approved by the WHO for use in children”, points out Simão.
Annual Anticovid Vaccine?
For Mariângela Simão, there are still no clear indications from the WHO that the anti-covid vaccine can become an annual vaccine. “However, it is possible that this will happen. This is the behavior of this type of virus, of the coronavirus family, of becoming endemic. The important thing is to always keep in mind that the most important thing is to prevent the most susceptible people from dying from this virus and for the economy to stop as it did,” he says.
On the inequality in access to vaccines for different populations across the planet, she recalls that “it is a vaccine inequity, we have a huge distance between the average vaccine coverage in some continents, and, for example, the African continent . The global average today is 32%, but the averages, as you know, are ‘dumb’, because there are extremes. The territory of the African Union currently has less than 4% of vaccine coebrutra”, emphasizes Mariângela Simão.
Treatment for Covid
“The WHO has already recommended earlier this year the use of betamethazone, a medication that has been on the market for 50, 70 years is a corticosteroid, for critically ill patients in hospital environments because it impacts mortality,” recalls Mariângela Simão.
“In July the WHO made a recommendation for what we call monoclonal antibodies, biotherapeutics, L6 blockers. So these two drugs were recommended in July and this past week the WHO recommended another combination of monoclonal antibodies, the cocktail of regenerate and that’s just as you said, these medications are expensive and of low availability and they are intended to prevent death. They are used in a hospital environment and we still don’t have any approved medication for prevention, prophylaxis and no approved medication for mild cases”, recalls the executive.
“This is the basic objective, to work with the pharmaceutical industry so that countries have access to sustainable prices in order to provide access to their patients”, says Simão. it concentrates 3 of the 4 products Roche, Regeneron, and Sanofi with another product, so it is very concentrated with a production capacity that is not large. The expectation is that we will have in these first 6 months of production a still difficult availability of these products and a high price, this is a conversation that is happening right now with Roche”, he says.
Covax: vaccine for poor countries
“The United States not only committed to donating 500 million doses of Pfizer next year, but the US government has already made it possible for 200 million doses of Pfizer to enter this year,” recalls Simão. “So France and several other countries are donating, which is very welcome. It does not solve the entire problem, but it is very welcome that countries that are able and that have already achieved greater vaccine coverage are contributing to greater equity in global coverage”, says the assistant director-general of WHO, whose director-general, Tedros Adhanom Ghebreyesus never tires of criticizing the lack of “vaccination equity” between rich and poor countries.