Latest news with #pandemicPreparedness
The Guardian
10 hours ago
- Health
- The Guardian
Pandemic preparedness ‘dramatically eroding' under Trump, experts say
Amid controversial dismissals for independent advisers and staff at health agencies, alongside lackluster responses to the bird flu and measles outbreaks, experts fear the US is now in worse shape to respond to a pandemic than before 2020. H5N1, which has received less attention under the Trump administration than from Biden's team, is not the only influenza virus or even the only variant of bird flu with the potential to spark a pandemic. But a subpar response to the ongoing US outbreak signals a larger issue: America is not ready for whatever pathogen will sweep through next. 'We have not even remotely maintained the level of pandemic preparedness – which needed a lot of work, as we saw from the Covid pandemic,' said Angela Rasmussen, an American virologist at the Vaccine and Infectious Disease Organization at the University of Saskatchewan in Canada. 'But now, we essentially have no pandemic preparedness.' 'I'm concerned on a number of fronts,' said Jennifer Nuzzo, professor of epidemiology and director of the Pandemic Center at Brown University School of Public Health. Those concerns include a lack of quality information from officials, weakened virus monitoring systems, and public health reductions at the federal, state and local levels. 'The thing that I am most concerned about is the veracity of information coming out of the health agencies,' Nuzzo said. In the ongoing outbreaks of measles, for example, Robert F Kennedy Jr, the secretary of health and human services, has downplayed the severity of the disease, spread misinformation about the highly effective vaccine to prevent measles, and pushed unproven treatments. 'The communications on measles gives me deep worries about what would happen in a pandemic,' Nuzzo said. 'If a pandemic were to occur today, the only thing we would have to protect ourselves on day one would be information.' The H5N1 outbreak has been plagued by incomplete information, an issue that began in the Biden administration but has amplified under Trump. In Arizona, 6 million chickens were killed or culled at a Hickman's Family Farms location because of H5N1 in May. That's about 95% of the company's hen population in the state. Hundreds of workers, including inmate laborers, are now being dismissed as Arizona braces for egg shortages. Yet even as H5N1 outbreaks continue to spread on farms and wreak havoc on the food supply, no new bird flu cases have been reported in people for months. 'I am concerned that we may not be finding new infections in humans,' Nuzzo said – and a lack of testing may be the culprit. 'We're not testing – it's not that there are no new cases,' Rassmussen said. The last bird flu case in a person was listed by the US Centers for Disease Control and Prevention (CDC) on 23 February. At that point, at least 830 people in the US had been tested after contact with sick animals. This kind of testing – monitoring the health of people who regularly work with H5N1-infected animals – is how the vast majority of cases (64 out of 70) have been found in this outbreak. But then, several CDC officials overseeing the bird flu response were fired on 1 April. Since then, only about 50 people in the US have been tested after exposure to sick animals – and no positive cases have been announced. It's also been difficult to understand the extent of the outbreak and how the virus spreads among animals. 'We still just don't have a good picture of the scope and scale of this outbreak – we never really have. And until we have that, we're not going to be able to contain it,' Rasmussen said. 'It's extremely bad,' she continued. 'We don't have any information about what's happening right now. The next pandemic could be starting, and we just don't know where that's happening, and we don't have any ability to find out.' Huge reductions in the public health workforce and resources has led to less monitoring of outbreaks, known as disease surveillance. 'Cutting back on that surveillance is leaving us more in the dark,' Nuzzo said. The CDC clawed back $11.4bn in Covid funding in March. This funding was used to monitor, test, vaccinate and otherwise respond to public health issues at the state, local, territorial and tribal level. 'We're seeing health departments scrambling,' Nuzzo said. 'That infrastructure is just dramatically eroding.' International monitoring programs to address outbreaks before they expand across borders have also been cancelled. 'We have taken for granted all of those protections, and I fear that we are poised to see the consequences,' Nuzzo said. Trump's crackdown on immigration also poses a major challenge in detecting cases and treating patients during outbreaks. 'A lot of the people who are most at risk are strongly disincentivized to report any cases, given that many of them are undocumented or are not US citizens,' Rasmussen said. 'Nobody wants to go get tested if they're going to end up in an Ice detention facility.' When cases are not detected, that means patients are not able to access care. Although it's rare for people to become sick with H5N1, for instance – the virus is still primarily an avian, not a human, influenza – this variant of bird flu has a 52% mortality rate globally among people with known infections. Allowing a deadly virus to spread and mutate under the radar has troubling implications for its ability to change into a human influenza without anyone knowing. And if such changes were detected, widening gaps in communication could be the next hurdle for preventing a pandemic, Nuzzo said. 'Communication is our most important public health intervention. People, in order to be able to know how to protect themselves, need to have access to facts, and they need to believe in the messengers. And the communication around the measles outbreaks are deeply eroding our standing with the American people.' Even stockpiled vaccines and other protective measures, like personal protective equipment, take time to distribute, Nuzzo added. 'And flu is a fast-moving disease that could cause a lot of damage in the months it would take to mount a vaccination campaign.' The US government's cancellation of its $766m contract with Moderna to research and develop an H5N1 vaccine also signals a concerning strategy from health officials, Nuzzo and Rasmussen said. Other restrictions on vaccine development, like a new plan to test all vaccines against saline placebos, is 'going to make it extremely difficult to approve any new vaccine' and would 'have a devastating impact on our ability to respond to a potential pandemic', Rasmussen said – especially in a rapidly moving pandemic where speed matters. 'You don't have time for that if this virus causes a human-to–human outbreak,' Rasmussen said. All of these policies mean the US is less prepared for a pandemic than it was in 2020, she said. And it also means there will be preventable suffering now, even before the next big one strikes. 'We are actively making people less safe, less healthy and more dead,' Rasmussen said.
Medscape
2 days ago
- Health
- Medscape
US Needs National Diagnostic Testing Plan for Public Health Threats
Allowing nontraditional laboratories to perform diagnostic testing in a potential pandemic situation was one of the nearly 100 actions proposed by a panel of experts, according to results of a new report published by the Government Accountability Office (GAO). The new report ultimately yielded four recommendations from the GAO to the Department of Health and Human Services (HHS), with two action items. One of these called for the creation of a national diagnostic testing strategy for infectious diseases with pandemic potential. Another called for the creation of a national diagnostic testing forum that would include a range of expert testing stakeholders from HHS and component agencies, but also the public and private sectors, nonprofit organizations, and academia. The other two main recommendations were that the national diagnostic testing strategy, once created, be updated regularly with lessons learned from infectious disease threats, other public health threats, or relevant preparedness exercises; and that the national diagnostic testing forum, once created, meet regularly, including both before and during infectious disease threats with pandemic potential, before and during other public health threats deemed relevant, or any related preparedness exercises. 'Pandemics pose an ever-present threat to American lives, national security, and economic interests, and diagnostic testing is critical to tracking infectious disease and helping reduce potential death rates,' said Mary Denigan-Macauley, director of Public Health for the GAO, in an interview. 'Testing helps us know where the disease is, how it is spreading and if it is gone,' Denigan-Macauley said. During the COVID-19 pandemic and the recent mpox outbreaks, the US Department of HHS struggled to lead the nation's testing efforts, and taking action to improve testing protocols now can boost preparedness for the next infectious disease emergency, Denigan-Macauley said. Diseases know no borders, she added. 'A strain of highly pathogenic avian influenza is widespread in wild birds around the globe and is already on our doorstep, causing outbreaks in poultry and US dairy cows, with several recent human cases in US dairy and poultry workers,' Denigan-Macauley said. 'Tracking these and other diseases is critical so we can be prepared and implement measures to control their spread,' she emphasized. Cooperative Planning Will Promote Current Information Infectious disease testing is not for the federal government to do alone; everyone from the doctor who tests the patient to local, state, and federal health officials should understand the national diagnostic testing strategy so they can work together, said Denigan-Macauley. 'We don't want key stakeholders working in silos that are fragmented and disjointed; this prevents us from understanding what is happening nationally to control a disease,' she said. 'A national diagnostic testing strategy and coordinating group could help the nation avoid some of the challenges faced during previous public health emergencies,' Denigan-Macauley told Medscape Medical News . 'For example, we found that the federal government did not always coordinate its updates to COVID-19 testing guidance with external stakeholders, such as healthcare professional organizations, which led to confusion and disagreement in the practice community,' she said. However, a national testing strategy could establish specific processes for coordination and collaboration related to testing guidance updates, she noted. 'A national coordinating group could then facilitate real-time communication of the updates, which would help ensure that frontline providers are prepared to implement new guidance upon its release,' she added. The current fragmented state of diagnostic testing efforts across numerous government agencies is a barrier to a national strategy, Denigan-Macauley told Medscape Medical News . 'Fragmentation refers to circumstances in which more than one agency is involved in the same broad area,' she said. 'Our states — simply by the way we are set up as a nation — also have differing capabilities, goals and their own health systems causing further fragmentation,' she explained. Establishing a testing coordinating group and implementing practices for interagency collaboration can help manage fragmentation and overcome this barrier, she said. Research Gaps The experts consulted on the report suggested several areas in need of additional research, including determining the types of diagnostic testing required for different types of pathogens, developing diagnostic tests with longer shelf lives, evaluating the new generations of diagnostic testing equipment, and understanding the human behaviors that drive compliance with diagnostic testing guidance, said Denigan-Macauley. A Specialist's Take Having a national diagnostic testing strategy would allow the US to cope more efficiently with the next pandemic, said Romney M. Humphries, PhD, D(ABMM), M(ASCP), professor of pathology, microbiology, and immunology at Vanderbilt University Medical Center, Nashville, Tennessee, in an interview. The COVID-19 pandemic was challenging in many ways, including the inability of many public health labs to handle the surge in testing needs, said Humphries. 'A national diagnostic testing strategy would promote building an infrastructure and developing partnerships among labs,' said Humphries. In addition, developing a universal approach to testing and standardized testing protocols, as are common in European countries, would streamline the process and facilitate such partnerships, she said. However, funding is a significant barrier to implementing any national diagnostic testing strategy, Humphries noted. Funding for various public health initiatives is being reduced or eliminated, but a national diagnostic testing strategy should be prioritized given the benefit to public health in general and the value in the event of a pandemic or other public health crisis, she said. Looking ahead, improvements in management and operations at the federal, state, and local level are needed to make a national diagnostic testing strategy successful, Humphries told Medscape Medical News . Although no action has yet been taken to create a national diagnostic testing strategy, 'HHS officials said they are taking some steps to improve diagnostic testing related to the actions suggested by experts,' according to the GAO website outlining the report.
The Independent
03-06-2025
- General
- The Independent
Chief medical officer ‘anxious' about US leaving World Health Organisation
Scotland's chief medical officer has said he is 'anxious' about the US withdrawal from the World Health Organisation (WHO) and what it could mean for disease surveillance. Sir Gregor Smith said the Donald Trump administration's decision to pull out of the global health body leaves a 'gap' in how experts understand emerging diseases. Mr Trump withdrew the US from the WHO on the first day of his second term in office, claiming it had mishandled the pandemic. Sir Gregor and other officials discussed Scotland's pandemic preparedness in front of MSPs on Tuesday, including what lessons were learned from Covid-19. Conservative MSP Dr Sandesh Gulhane asked about the relationship with Washington after US health secretary Robert F Kennedy Jnr said he believes debunked medical theories of vaccines being linked to autism. Sir Gregor said the US relationship with other countries is 'perhaps not as strong as it used to be', adding: 'I think the withdrawal of the US from the WHO does create a significant gap in our surveillance systems globally. 'Not just in the United States, but actually with the funding that comes with US membership of the WHO there is a risk that global systems are undermined rather than strengthened. 'So it's certainly an area I am anxious about.' Sir Gregor also faced questions on Scotland's preparedness for any future pandemics or similar civil contingencies. He said the health system now has stockpiles of 12 weeks' worth of PPE, while ICU capacity and contact increased capabilities can be surged if necessary. Sir Gregor also said public health officials are keeping an eye on a new strain of coronavirus, called NB1.8.1, which is now the dominant strain in China and has also been detected in the UK. Dr Jim McMenamin of Public Health Scotland noted new developments in the field of metagenomics is improving the rapid identification and understanding of viruses.
Zawya
29-05-2025
- Business
- Zawya
New Project to Boost Tunisia's Health System and Pandemic Response
The World Bank's Board of Executive Directors today approved US$125.16 million in financing — including a US$17.16 million grant from the Pandemic Fund — to support Tunisia's efforts in enhancing access to resilient, quality, and responsive health services through the Tunisia Health System Strengthening Project. This nationwide initiative aims to improve pandemic preparedness and emergency care, modernize primary healthcare services, and strengthen governance and digitalization across the public health system. The project supports Tunisia's National Health Policy (PNS), a government-led reform strategy centered on improving equitable access to care and prioritizing preventive and protective health services. 'By strengthening the resilience and responsiveness of Tunisia's health system, this project will help ensure that all Tunisians, particularly the most vulnerable, can access timely, quality care,' said Alexandre Arrobbio, World Bank Country Manager for Tunisia. 'It builds on a solid partnership that delivered impactful results during the COVID-19 crisis — from protective equipment and vaccine rollout to medical oxygen, digital platforms, and upgraded hospitals and labs. Today, we are scaling up these efforts to support nationwide health service delivery and readiness for future pandemics, in close collaboration with the Food and Agriculture Organization and the World Health Organization.' The Tunisia Health System Strengthening Project aims to reach the entire population by improving access to critical care, emergency services, and hospital-based interventions. It will also directly benefit frontline health workers through enhanced training in disease surveillance, field epidemiology, emergency care, and digital systems such as electronic medical records. Aligned with Tunisia's broader development goals, the project aims to help the country strengthen public health preparedness and ensure continuity and quality of essential services. Through three interlinked components, the project will fortify the health system by developing One Health surveillance systems and bolstering laboratory and public health infrastructure, ensuring robust monitoring and response capabilities. Secondly, it will reorganize community-level health services by promoting family medicine, strengthening facility capacity aligned with needs, and expanding telemedicine and patient electronic health records, thereby improving accessibility and continuity of care. Lastly, the project will advance urgent care and hospital infrastructure by upgrading ambulance fleets, implementing geographically-mapped dispatch systems, and enhancing hospital-based triage and bed management technologies, ensuring efficient and integrated service delivery. 'Tunisia is stepping up efforts to improve health service delivery, aiming to ensure better access and greater equity in care,' said Yassine Kalboussi, Health Specialist at the World Bank and Task Team Leader for the project. 'This project will support the technological and structural transformation of the health system, enhance workforce capacity, and improve service quality, especially in underserved areas.' Distributed by APO Group on behalf of The World Bank Group.
CBC
20-05-2025
- Health
- CBC
Global pandemic accord adopted by WHO amid U.S. absence
Members of the World Health Organization adopted an agreement on Tuesday intended to improve preparedness for future pandemics following the disjointed global response to COVID-19, but the absence of the U.S. cast doubt on the treaty's effectiveness. After three years of negotiations, the legally binding pact was adopted by the World Health Assembly in Geneva. WHO member countries welcomed its passing with applause. The pact was touted as a victory for members of the global health agency at a time when multilateral organizations like the WHO have been battered by sharp cuts in U.S. foreign funding. "The agreement is a victory for public health, science and multilateral action. It will ensure we, collectively, can better protect the world from future pandemic threats," said WHO Director General Tedros Adhanom Ghebreyesus. The pact aims to ensure that drugs, therapeutics and vaccines are globally accessible when the next pandemic hits. It requires participating manufacturers to allocate a target of 20 per cent of their vaccines, medicines and tests to the WHO during a pandemic to ensure poorer countries have access. However, U.S. negotiators left discussions about the accord after President Donald Trump began a 12-month process of withdrawing the U.S. — by far the WHO's largest financial backer — from the agency when he took office in January. Given this, the U.S., which poured billions of dollars into vaccine development during the COVID pandemic, would not be bound by the pact. And WHO member states would not face penalties if they failed to implement it. U.S. Health and Human Services Secretary Robert F. Kennedy Jr. slammed the World Health Organization in a video address to the assembly, saying it had failed to learn from the lessons of the pandemic with the new agreement. "It has doubled down with the pandemic agreement, which will lock in all of the dysfunction of the WHO pandemic response.... We're not going to participate in that," he said. Accord draws mixed reviews The deal was reached after Slovakia called for a vote on Monday, as its COVID-19 vaccine-skeptic prime minister demanded that his country challenge the adoption of the agreement. One hundred and twenty-four countries voted in favour, no countries voted against, while 11 countries, including Poland, Israel, Italy, Russia, Slovakia and Iran, abstained. Some health experts welcomed the treaty as a step toward greater fairness in global health after poorer nations were left short of vaccines and diagnostics during the COVID-19 pandemic. "It contains critical provisions, especially in research and development, that — if implemented — could shift the global pandemic response toward greater equity," Michelle Childs, policy advocacy director at Drugs for Neglected Diseases initiative, told Reuters. Others said the agreement did not meet initial ambitions and that, without strong implementation frameworks, it risked falling short in a future pandemic. "It is an empty shell.… It's difficult to say that it's a treaty with firm obligation where there is a strong commitment.... It's a good starting point. But it will have to be developed," said Gian Luca Burci, an academic adviser at the Global Health Centre at the Geneva Graduate Institute, an independent research and education organization. Helen Clark, co-chair of The Independent Panel for Pandemic Preparedness and Response, described the accord as a foundation to build from. "Many gaps remain in finance, equitable access to medical countermeasures and in understanding evolving risks," she added. The pact will not go into effect until an annex on sharing of pathogenic information is finalized. Negotiations on this would start in July with the aim of delivering the annex to the World Health Assembly for adoption, WHO said. A Western diplomatic source suggested it may take up to two years to be finalized.
