This week’s Pandora Report covers updates on mpox, COVID-19 misinformation, the US Government’s plan to re-launch its no-cost COVID-19 testing kit program, and more.
Mpox Updates
WHO Launches Global Strategic Preparedness and Response Plan
The WHO announced this week the launch of its global Strategic Preparedness and Response Plan that is designed to stop outbreaks of human-to-human transmission of mpox. According to the organization, “The plan covers the six-month period of September 2024-February 2025, envisioning a US$135 million funding need for the response by WHO, Member States, partners including Africa Centres for Disease Control and Prevention (Africa CDC), communities, and researchers, among others,” and it aims to coordinate this through global, regional, and national efforts.
Furthermore, “The plan, which builds on the temporary recommendations and standing recommendations issued by the WHO Director-General, focuses on implementing comprehensive surveillance, prevention, readiness and response strategies; advancing research and equitable access to medical countermeasures like diagnostic tests and vaccines; minimizing animal-to-human transmission; and empowering communities to actively participate in outbreak prevention and control.”
The same statement also says that WHO Regional Office for Africa (AFRO) will collaboratively spearhead the effort to respond to mpox in the WHO Africa Region with Africa CDC. It explains that “WHO AFRO and Africa CDC have agreed on a one-plan, one-budget approach as part of the Africa Continental Mpox Strategic Preparedness and Response Plan, currently under preparation.”
However, not everyone is convinced the WHO will find success in its approach. In a recent article for The Bulletin of the Atomic Scientists titled “A new mpox variant is taking off in Africa. The WHO plan for stopping it isn’t realistic,” Georgios Pappas writes, “In the mpox-affected areas of the Democratic Republic of the Congo and the Central African Republic, local health care systems may lack in capabilities to deal with threats like mpox. At the same time, political instability can be a barrier to improving health care facilities. Furthermore, malnutrition in the region predisposes children to unfavorable mpox outcomes. The WHO’s declaration of Public Health Emergency of International Concern (PHEIC), the designation the body gives to the most threatening crises, should have served as a chance to support this lacking health infrastructure. But the proposals so far to address the crisis don’t appear to be rising to the occasion.”
DRC Struggles Without Adequate Access to Vaccines, Tests, and Treatments
Officials in the Democratic Republic of Congo (DRC), the epicenter of the current mpox outbreak, say they are without the necessary resources to contain the outbreak and treat those who are infected. NYT‘s Stephanie Nolen explains in a recent piece that the country has limited ability to diagnose mpox cases, a particularly concerning fact as the transmission and presentation of the disease change. She also writes “There is no effective antiviral treatment for mpox in Congo. The country is also short on the medications necessary to treat people with painful mpox lesions. Its fragile public health system is struggling to provide those infected with basic care, which has been shown to improve survival rates even in the absence of antiviral drugs.”
The DRC also continues to want for mpox vaccines, despite the country requesting them two years ago and manufacturers saying they have the supplies. This is in large part because of the WHO’s regulatory process. In the years since the last worldwide mpox outbreak, the WHO has still yet to approve the vaccines nor issue an emergency use license for them. This prevents UNICEF and Gavi from helping to facilitate immunizations in developing countries as they require one of these forms of authorization.
As Nolen explains in another piece, many low- and middle-income countries depend on the WHO to make these judgments about vaccines and other pharmaceuticals, in contrast to high-income countries that rely on their own regulators. This is a problem as “…the organization is painfully risk-averse, concerned with a need to protect its trustworthiness and ill-prepared to act swiftly in emergencies,” according to Blair Hanewall, a global health consultant who “managed the W.H.O. approvals portfolio as a deputy director of the Bill & Melinda Gates Foundation, a key funder, for more than a decade.”
Despite these roadblocks, the WHO announced today that mpox vaccines are set to arrive in the DRC over the next few days. 230,000 doses, which were donated by the European Commission and Bavarian Nordic, are immediately available to be dispatched.
Read More-“Mpox Vaccine Tracker: Millions Pledged, Millions Still Yet to Be Delivered,” Chloe Searchinger and Allison Krugman, Think Global Health
WHO Urges Diagnostic Test Rapid Access and Invites Manufacturers to Emergency Review
This week, the WHO also asked manufacturers of in vitro diagnostics (IVDs) for mpox to submit expressions of interest for Emergency Use Listing (EUL). This comes after discussions with these manufacturers about the need for IVDs, especially in low-income settings. WHO explained in its statement on the action that “With as many as 1000 suspected cases reported in the Democratic Republic of the Congo alone this week, the demand for diagnostic tests is on the rise. In this heavily affected country, WHO has worked with partners to scale up diagnostic capacity to respond to the upsurge of cases. Since May 2024, six additional labs have been equipped to diagnose mpox, enabling a decentralization of testing capacity from major cities to affected provinces. Two of these labs are in South Kivu, selected to respond to the outbreak of the new viral strain, called Ib. Thanks to these efforts, testing rates have dramatically improved in the country, with four times as many samples tested in 2024 so far as compared to 2023.”
US Government to Resume Offering COVID-19 Tests Through Mail at No Cost Again
Early this week, the US government announced it will again offer COVID-19 test kits to American households at no cost. Households will be able to order up to four COVID-19 nasal swab tests upon the program’s reopening. This announcement comes alongside urging people to seek out updated COVID-19 boosters before the fall and winter come. While many Americans do have some immunity to COVID-19 because of previous infections or immunizations, less than 25% of adults in the US got an updated COVID-19 vaccination last fall.
More Americans Believe COVID-19 Vaccine Misinformation
Research from the University of Pennsylvania’s Annenberg Public Policy Center found that 28% of respondents incorrectly believe that COVID-19 vaccines are responsible for thousands of deaths. This is in contrast to 22% in June of 2021. Furthermore, the percentage of respondents who say this is false declined from 66% to 55% during the same time period. 22% believe it is safer to be infected rather than get the vaccine, in contrast to 10% in April of 2021. The belief that COVID-19 vaccines change patients’ DNA rose from 8% in April 2021 to 15% now. Finally, while about two-thirds of respondents said the benefits of COVID-19 vaccines outweigh the potential risks, this number is lower than those who believe the same for mpox, RSV, and MMR vaccines.
As Axios’ Adriel Bettelheim explains, “Previous polling has shown sizable numbers of Americans who believe COVID vaccine misinformation know they’re at odds with scientists and medical experts, suggesting that educating people on the science behind vaccines won’t change many minds.”
These trends are especially concerning given the United States’ renewed struggles with COVID-19 this summer and the push to prepare the public for the upcoming fall and winter respiratory virus season.
“International Talent Programs in the Changing Global Environment”
From the National Academies: “The U.S. science, technology, engineering, and mathematics (STEM) workforce plays a vital role in fostering and sustaining innovation, economic competitiveness, and national security. This workforce currently depends, and for the foreseeable future will depend, on both international and domestic talent. Foreign STEM talent contributes to domestic innovation, economic growth, and U.S. leadership in science and technology and also expands perspectives and networks essential to future scientific collaborations and discoveries.”
“At the request of the U.S. Department of Defense, this report reviews foreign and domestic talent or incentive programs and their corresponding scientific, economic, and national security benefits. International Talent Programs in the Changing Global Environment makes recommendations to improve the effectiveness of U.S. mechanisms for attracting and retaining international students and scholars relative to the programs and incentives other nations use to support national research capabilities, especially in national security and defense-related fields.”
Sonia Ben Ouagrham-Gormley, an associate professor with George Mason’s Biodefense Graduate Program, provided the study committee with insight into China’s Thousand Talent Program.
“We Need a Global Framework for Promoting Safe Handling of High Consequence Pathogens”
Karlsson et al. authored this opinion piece for the BMJ, writing in their introduction “The covid-19 pandemic has highlighted ongoing concerns regarding biosafety and biosecurity procedures in global pathogen research. This includes questions about any possible role of field and laboratory research into the emergence of the SARS-COV-2 virus.1 The $125m Discovery and Exploration of Emerging Pathogens-Viral Zoonoses programme, funded by the US Agency for International Development, researching new zoonotic viruses was recently cancelled partly because of these concerns.2 This has raised broader discussion about the risks and benefits of viral surveillance and research. Limiting funds for pathogen surveillance and research compromises long term preparedness for pandemics and leaves pathogen spillover threats unmonitored. Rather than restrict scientific surveillance and research, a global safety governance framework that spans the entire pathogen value chain must be urgently developed. This must cover the life cycle of pathogen research, including collection, transportation, and laboratory handling.”
“Biotechs Bolster Biosecurity to Safeguard the Future of Nucleic Acid Sequencing”
Danielle Gerhard discusses expert calls for stricter security measures regarding synthetic DNA in this piece for The Scientist: “Since then, industry consortia and government bodies have stepped up to fill this gap and provide guidance on how DNA providers can help prevent biosecurity risks through enhanced screening frameworks. However, to keep pace with the evolving landscape of rapid technology advancements and requests for guidance from industry, the government has updated its framework for providers of these services, but some experts in the field call for end-users, including institutions, to take on more responsibility when it comes to minimizing the biosecurity risks associated with these technologies.”
“Can Operation Warp Speed Serve as a Model for Accelerating Innovations Beyond COVID Vaccines?”
Arielle D’Souza, Kendall Hoyt, Christopher M. Snyder, and Alec Stapp’s work on a framework for applying mission approaches and economic principles from Operation Warp Speed to other innovations was recently made available by the National Bureau of Economic Research: “Operation Warp Speed (OWS) was a U.S. government-led program to accelerate the development, production, and administration of COVID-19 vaccines. The program cut the typical ten-year timeline needed to develop a new vaccine down to ten months and began vaccinating vulnerable populations within a year after launch. OWS’s success has led to calls for a similar mission model to accelerate innovations addressing other pressing social needs, including a cure for Alzheimer’s disease or atmospheric-carbon removal to combat global warming. We provide a framework to understand which innovations call for a mission approach and apply economic principles to identify key design features that contributed to the success of OWS.”
“2022-2024 NBAF Science Accomplishments Report”
The US Department of Agriculture recently released this report on scientific accomplishments at the National Bio and Agro-Defense Facility in Manhattan, KS. The report covers NBAF’s mission and capabilities as well as accomplishments made by the ARS Foreign Animal Disease Research Unit, ARS Foreign Arthropod-Borne Animal Disease Research Unit, ARS Zoonotic and Emerging Disease Research Unit, Biologics Development Module, and APHIS Foreign Animal Disease Diagnostic Laboratory.
“Behind the Smoke: How Disinformation Surrounding Syria’s Chemical Attacks Undermines Public Health”
Salma Daoudi recently authored this article for the Tahrir Institute for Middle East Policy that “…explores the strategic use of disinformation to manipulate public perceptions around the Assad regime’s chemical attacks and its ramifications for the public health sector.”
“Worldwide Trends in COVID-19-Related Attacks Against Healthcare: A Review of the Safeguarding Health in Conflict Coalition Database”
Duffhues et al. recently published this article in Health Security: “During the COVID-19 pandemic, violence targeting healthcare reportedly increased. Attacks against healthcare can severely hamper the public health response during a pandemic. Descriptive data analysis of these attacks may be helpful to develop prevention and mitigation strategies. This study aimed to investigate trends regarding COVID-19-related attacks against healthcare from January 2020 until January 2023. COVID-19-related incidents occurring between January 2020 and January 2023 were extracted from the Safeguarding Health in Conflict Coalition database and screened for eligibility. Included incidents were linked to COVID-19 health measures or were attacks directly interfering with COVID-19 healthcare, including conflict-related attacks. Data collected per incident included temporal factors; country; setting; attack and weapon type; perpetrator; motive; number of healthcare workers (HCWs) killed, injured, or kidnapped; and health facility damage. The study identified 255 COVID-19-related attacks against healthcare, with 18 HCWs killed, 147 HCWs injured, and 86 facilities damaged. The highest attack frequency was reported during the beginning of the pandemic and predominantly concerned stigma-related attacks against healthcare. Reported incidents in 2021 included attacks targeting vaccination campaigns, as well as conflict-related attacks interfering with COVID-19 healthcare. COVID-19-related attacks against healthcare occurred in heterogeneous contexts throughout the pandemic. Due to underreporting, the data presented are a minimum estimate of the actual magnitude of violence. The findings of this study emphasize the importance of public education campaigns, improved coordination between healthcare organizations and law enforcement, and the possible need to bolster the security of medical facilities and health workers.”
Asimov Press Pandemic Prevention Mini-Issue
Asimov Press recently published a handful of essays as part of its Pandemic Prevention Mini-Issue, including “Is That DNA Dangerous?” by Tessa Alexanian and Max Langenkamp, “Day Zero Antivirals for Future Pandemics” by Brian Wang, “Measuring the Black Death” by Saloni Dattani, and “Defense-Forward Biosecurity” by Allison Berke.
“Unmasking the Threat”
Goran Georgiev recently published this blog post focused on WMD information manipulation in Bulgaria and Romania with the Center for the Study of Democracy, writing in part “The analysis underscores a stark contrast between Bulgaria and Romania in the spread and impact of misleading content about biological laboratories, reflecting broader cultural differences in how Russia is perceived publicly. Romania does not share many of the cultural pull factors or cognitive capture that make citizens in majority Slav countries vulnerable to pro-Kremlin information interference, particularly the shared linguistic, ethnic, and historical heritage. Differences in geopolitical public perceptions have been evident in numerous comparative surveys, with Romanians being over eight times less likely (at 3%) to see Russia as a strategic ally after the invasion compared to Bulgarians (at 26%) or Slovaks (25%). These differences appear to be reflected in the level of engagement with pro-Kremlin narratives related to WMD.”
“Transoceanic Pathogen Transfer in the Age of Sail and Steam”
Elizabeth N. Blackmore and James O. Lloyd-Smith authored this article in PNAS: “In the centuries following Christopher Columbus’s 1492 voyage to the Americas, transoceanic travel opened unprecedented pathways in global pathogen circulation. Yet no biological transfer is a single, discrete event. We use mathematical modeling to quantify historical risk of shipborne pathogen introduction, exploring the respective contributions of journey time, ship size, population susceptibility, transmission intensity, density dependence, and pathogen biology. We contextualize our results using port arrivals data from San Francisco, 1850 to 1852, and from a selection of historically significant voyages, 1492 to 1918. We offer numerical estimates of introduction risk across historically realistic ranges of journey time and ship population size, and show that both steam travel and shipping regimes that involved frequent, large-scale movement of people substantially increased risk of transoceanic pathogen circulation.”
What We’re Listening to 🎧
Technologically Speaking Podcast: Season 4, Episode 3
“The Technologically Speaking Podcast sits down with Lindsay Gabbert, a microbiologist at the S&T Plum Island Animal Disease Center (PIADC). Lindsay and her colleagues at PIADC are on the front lines keeping dangerous animal diseases at bay and away from our farms. She talks about what the greatest threats are and what S&T and PIADC are doing to thwart them. She also shares anecdotes about her time working at PIADC, one of the most interesting and unique labs in the United States, nestled on a small and historic island in the Long Island Sound.”
BSL4ZNet International Conference
“The Biosafety Level 4 Zoonotic Laboratory Network (BSL4ZNet) is an international group of federal institutions in Australia, Germany, United Kingdom, United States and Canada responsible for high-containment laboratories that allows countries to work together to respond to dangerous zoonotic diseases that spread between animals and people.”
“The 2024 BSL4ZNet International Conference is taking place in September 2024. This year’s theme is “Emerging disease meets innovative science. The working language of the BSL4ZNet is English. The 2024 BSL4ZNet International Conference will be presented in English only.”
“The 2024 BSL4ZNet International Conference includes 4 sessions:
- Wednesday, September 4: Threats and challenges – Delving into topics such as Highly Pathogenic Avian Influenza (HPAI), Climate-Related Risks, and the nuanced landscape of Science Communication amidst Misinformation/Disinformation Challenges.
- Wednesday, September 11: Innovation and emerging technologies – Innovation and Emerging Technologies: Exploring the latest advancements and breakthroughs in the realm of emerging technologies shaping our response to infectious diseases.
- Wednesday, September 18: Biosecurity and biosafety – Addressing critical issues surrounding biosecurity and biosafety measures, crucial pillars in combating zoonotic diseases
- Wednesday, September 25: Innovation for BSL4 activities and challenges – Featuring an enlightening panel discussion focusing on innovative approaches to address challenges inherent to BSL4 activities.”
Safeguarding the Food Supply: Integrating Diverse Risks, Connecting with Consumers, and Protecting Vulnerable Populations – A Workshop
From the National Academies: “On September 4-5, the Food Forum will host a workshop that explores the state of the science around hazard- and risk-based approaches to safeguarding both domestic and global food systems. Workshop presenters will examine nutrition, economic, and equity implications in food safety decision-making, and considerations and strategies for communicating hazard and risk across sectors. The workshop will also include national and international perspectives on risk assessment and tools to mitigate risk, as well as opportunities for the future of risk management and assessment, food safety, and public health.”
Learn more and register for this virtual event here.
The Pandora Report 