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Malaria kills 180,000 more people annually than previously thought, says WHO | Global development

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The World Health Organization has called for a “massive, urgent” effort to get the new malaria vaccine into the arms of African children, as it warned that about 180,000 more people were dying annually from the disease than had previously been thought.

Dr Pedro Alonso, director of the WHO’s global malaria programme, said the RTS,S vaccine, recommended for widespread rollout in October, represented a historic opportunity to save tens of thousands of lives, mostly those of under-fives in sub-Saharan Africa.

But he warned that the global community risked “massive failure” if funding commitments aimed at boosting production and helping deployment of the vaccine were not rapidly made.

“What I think is the real barrier [is] international solidarity,” he said. “Is the world going to allow that there is a first malaria vaccine that can save the lives of tens of thousands of African children every year and they’re going to let it sit on a shelf? Or are they going to step up?”

The British pharmaceutical company GlaxoSmithKlein, which developed the RTS,S vaccine, has committed to donate up to 10m doses for use in the pilot programmes already under way, and to supply up to 15m doses annually.

However, with more than 240m cases globally last year, the potential demand could reach 80 to 100m doses annually, Alonso warned. “Therefore, this is a prime example of where international mechanisms will need to come into play,” he said.

“A vaccine that could save somewhere between 40 and 70-80,000 lives every year, of African children, is something that needs to be treated with the utmost ambition and sense of urgency. And therefore, a slow, gradual scale-up, if you ask me, would not be acceptable. This needs to be a massive, urgent operation to ensure that we can reach as many children as possible and as soon as possible.”

He added: “If the global health community does not respond to this challenge, it will represent a massive failure. I cannot imagine how different leaders, leaders of philanthropy or of financing institutions, are going to go to Africa and advocate for efforts to prevent childhood deaths if they don’t, first and foremost, support the deployment of this vaccine.”

Last week, the global vaccine alliance, Gavi, said its board had approved an initial $155.7m (£117m) for the rollout of RTS,S. The funding would help the introduction, procurement and delivery of the vaccine for eligible countries in sub-Saharan Africa from 2022 until 2025, it said.

Dr Abdourahmane Diallo, CEO of the RBM Partnership to End Malaria, said the announcement would give the private sector “a crucial motive to scale up” the rollout.

“We now call on leaders to step up investment to accelerate the development and delivery of more effective, transformative tools to combat the ever-evolving malaria parasite,” he said.

New figures released by the WHO on Monday underlined the scale of the problem, with a new, “more precise” method of counting estimating that 627,000 people died of malaria last year, 180,000 more than the total would have been according to the old methodology.

The vast majority of all malaria deaths – 96% – were in sub-Saharan Africa.

In its annual malaria report, the WHO said the “doomsday scenario” some had predicted at the beginning of the Covid-19 pandemic – that deaths from malaria would double as a result of disruption to treatment and services – had not materialised.

Nonetheless, it said, deaths had risen by nearly 70,000 last year, an increase of 12%, of which nearly 50,000 were attributable to disruptions during the pandemic. One main cause of disruption was that more than a quarter of insecticide-treated bed nets – the backbone of WHO efforts to combat malaria – were not distributed in 2020.

Faced with a slowing of progress in the fight against malaria, the WHO believes the vaccine could be a crucial new weapon, even though questions have been raised over its limited efficacy. Over four years of trials, RTS,S was found to prevent 39% of malaria cases and 29% of severe malaria cases.

But Alonso rejected concerns. “A reduction of 30% [in] severe cases of malaria means a massive public health impact, larger probably than any other vaccine against any other disease being used right now,” he said.

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Protests flare across Poland after death of young mother denied an abortion | Abortion

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Protests are under way across Poland after the death of a 37-year-old woman this week who was refused an abortion, a year since the country introduced one of the most restrictive abortion laws in Europe.

On the streets of Warsaw on Tuesday night, protesters laid wreaths and lanterns in memory of Agnieszka T, who died earlier that day. She was pregnant with twins when one of the foetus’ heartbeat stopped and doctors refused to carry out an abortion. In a statement, her family accused the government of having “blood on its hands”. Further protests are planned in Częstochowa, the city in southern Poland where the mother-of-three was from.

“We continue to protest so that no one else will die,” Marta Lempart, organiser of the protests, told Polish media. “The Polish abortion ban kills. Another person has died because the necessary medical procedure was not carried out on time.” All-Poland Women’s Strike has called on people across the country to picket the offices of the ruling Law and Justice party (PiS) and organise road blockades in the coming days.

Agnieszka was first admitted to the Blessed Virgin Mary hospital in Częstochowa with abdominal pain on 21 December. She is said to have been in the first trimester of a twin pregnancy when she arrived and was in “a good physical and mental shape”, according to her family, who said her condition then deteriorated.

On 21 December the heartbeat of one of the twins stopped and, according to Agnieszka’s family, the doctors refused to remove it, quoting the current abortion legislation. They waited several days until the second foetus also died. A further two days passed before the pregnancy was terminated on 31 December, according to the family.

A priest was then summoned by hospital staff to perform a funeral for the twins, the family said.

The family say that the doctors refused to terminate the pregnancy earlier, citing Poland’s abortion legislation. “Her husband begged the doctors to save his wife, even at the cost of the pregnancy,” Agnieszka’s twin sister, Wioletta Paciepnik, said on Tuesday.

After the termination, Agnieszka was moved from the gynaecological ward and her health continued to deteriorate. Her family suspect that she died of sepsis but the cause of death was not identified in a statement released by the hospital.

Shortly after her death, a statement by her family accusing the hospital of neglect was published on Facebook, alongside a distressing video of Agnieszka’s last days.

Agnieszka’s death marks the first anniversary of the 2021 ruling that declared abortion due to foetal abnormalities illegal. Abortion can now only be carried out in cases of rape, incest or if the mother’s life and health are in danger.

Her death comes after that of a woman known as Izabela last September, who died after being denied medical intervention when her waters broke in the 22nd week of her pregnancy. Her family claim the 30-year-old was refused an abortion or caesarean section and that the hospital cited the country’s abortion laws. An investigation found that “medical malpractice” led to Izabela’s death and the hospital was fined. Soon after, an anonymous man from Świdnica in south-west Poland came forward to share that his wife, Ania, died in similar circumstances in June last year.

While “selective abortion” is possible in the case of a twin pregnancy, it is unclear whether aborting an unviable foetus to save its healthy twin is permitted by the new abortion legislation. The Polish court has not referenced the questions raised by this situation, presented by opposition senators last year, in the new legislation.

“We want to honour the memory of my beloved sister and save other women in Poland from a similar fate,” Paciepnik said in a video appeal. The case is now being investigated by the regional prosecutors in Katowice, who also investigated the case of Izabela.

The family are represented by Kamila Ferenc, from the Federation for Women and Family Planning, who confirmed that an autopsy of Agnieszka’s body has been ordered by the court.

According to a statement from the hospital, Agnieszka tested positive for Covid before her death, although she tested negative twice when first admitted. “We stress that the hospital staff did all the necessary actions to save the patient,” the statement read. The hospital did not respond to the Guardian for a request for comment.

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Italy welcoming back EU tourists from February

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Italy will remove all Covid-linked restrictions on international visitors from the EU from 1 February, except the requirement to carry a “Green Pass” – a certificate of vaccination, negative test result, or immunity through having had the virus. Roberto Speranza, the health minister, also gave Italians the go-ahead to travel once again to Cuba, Singapore, Turkey, Thailand (the island of Phuket), Oman, and French Polynesia, Reuters reports.

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Polish state has ‘blood on its hands’ after death of woman refused an abortion | Abortion

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The family of a Polish woman who died on Tuesday after doctors refused to perform an abortion when the foetus’s heart stopped beating have accused the government of having “blood on their hands”.

The woman, identified only as Agnieszka T, was said to have been in the first trimester of a twin pregnancy when she was admitted to the Blessed Virgin Mary hospital in Częstochowa on 21 December. Her death comes a year after Poland introduced one of the most restrictive abortion laws in Europe.

According to a statement released by relatives, the 37-year-old was experiencing pain when she arrived at the hospital but was “fully conscious and in good physical shape”.

The first foetus died in the womb on 23 December, but doctors refused to remove it, quoting the current abortion legislation, and Agnieszka’s family claim “her state quickly deteriorated”. The hospital waited until the heartbeat of the second twin also stopped a week later, and then waited a further two days before terminating the pregnancy on 31 December.

Agnieszka died on 25 January after weeks of deteriorating health. Her family suspect that she died as a result of septic shock, but the hospital did not identify the cause of her death in statement issued on Wednesday.

“This is proof of the fact that the current government has blood on their hands,” the woman’s family said in a statement on Facebook. The family also uploaded distressing footage of Agnieszka in poor health shortly before she died.

After the termination of the pregnancy a priest was summoned by the hospital staff to perform a funeral for the twins, Agnieszka’s family said.

Her death follows that of a woman known as Izabela last September, who died after being denied medical intervention when her waters broke in the 22nd week of her pregnancy. Her family claim the 30-year-old was denied an abortion or caesarean section and that the hospital cited the country’s abortion laws. An investigation found “medical malpractice” led to Izabela’s death and the hospital was fined.

Agnieszka’s family claim that contact with the hospital was very poor and that the hospital refused to share the results of Agnieszka’s medical tests citing confidentiality guidelines. They say the doctors “insinuated” that Agnieszka’s rapidly deteriorating state could be caused by BSE, commonly known as “mad cow disease”, or Creutzfeldt–Jakob disease (CJD) and suggested she ate raw meat. The hospital did not reference this claim in their statement.

According to the statement from the hospital, Agnieszka tested positive for Covid before her death, although she tested negative twice when first admitted. “We stress that the hospital staff did all the necessary actions to save the patient,” the statement read. It is not clear whether an autopsy has been ordered.

Agnieszka is survived by her husband and three children.

The Guardian has contacted the Blessed Virgin Mary hospital for comment.

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