Nina Schwalbe Profile picture
Apr 19 9 tweets 5 min read Twitter logo Read on Twitter
Tuberculosis and COVID-12 both hit hardest people who are marginalized or in poor health.

There are strong synergies in actions required to prevent, prepare for and respond to both.

That's why we need high-level political UN commitments in September.

Sceptical? Read this 🧵
Both TB and pandemic prevention, preparedness and response (PPR) require:

🕳 Closing the gap in prevention, treatment and access to care.

📚 Implementing evidence-based solutions

🚆 Accelerating research, development, rollout and access to medical countermeasures Screen shot of report cover
⬆️ Ramping up services for the vulnerable

🙋🏽‍♀️ Implementing an equitable, gender-sensitive, rights- and people-centred approach

🦠 Investing in infection prevention and control Image of infection preventi...
As experienced during COVID-19, pandemics pose a significant threat to the gains achieved in TB prevention and control.

TB programs backslid for the first time in decades. TB deaths increased during ...
A concise, action-oriented PPR declaration can lay the groundwork for a healthy future.

We call on governments to:

🌍 Articulate a cohesive, shared, and multisectoral approach at national, regional and global levels. call for multisectoral appr...
🔗 Reinforce other initiatives, including the #PandemicAccord and IHR amendments.

🗺 Create a standing head-of-government and head-of-state level council to drive cohesive, ongoing vigilance and concerted action on current and future pandemic threats. TOR for Threats Council
💉🧫 Secure commitment to a new pandemic countermeasures framework.

💶 Secure commitment to domestic financing for health systems, as well as financing for PPR as a global public good. photo and quote from Elen S...
🪨 Secure commitment to ensure a well-functioning, sustainably financed WHO to support countries to reduce the risk of health emergencies.

📊 Secure agreement on a robust independent monitoring and accountability framework and hold a follow-up summit how an accountability struc...
Read more in our briefing note with @StopTB @PandemicAction @GFadvocates @UNU_IIGH on the outcomes required at the Pandemic Preparedness and Response High-Level Meeting in September.

bit.ly/PPRTBHLM Links between TB and PPR

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More from @nschwalbe

Apr 21
The Working Group on Amendments to the International Health Regulations (made up of member states) just wrapped up its third meeting in Geneva.

Progress is being made, but political tensions persist.

More in this 🧵 from the closing (as negotiations are behind closed doors) photo of meeting of WGIHR
Member states discussed proposed amendments related to compliance, implementation, and public health response.

Inter-sessional work ahead of WGIHR4 includes a discussion of amendments, informal consultations and informational briefings. screen shot of provisional ...
African Member States, negotiating through the African Group provided a revised proposal on the “Implementation Committee” and emphasized universal membership and support to countries. definition of the Africa Group
Read 7 tweets
Apr 20
Confidence in vaccines has dropped in 52 of 55 countries (for which data are available), according to Unicef's just published State of the World's Children.

Overall, the statistics on childhood immunization are grim.

A few highlights (or lowlights) in this 🧵 graph of vaccine confidence
Over the past decade, despite growing efforts to expand immunization, there has been a backsliding in the number of zero-dose children (children who have not received any vaccines).

1 in 5 children remain un or under-immunized. Zero dose children globaly
Backsliding in vaccination coverage during the pandemic resulted in the loss of hard-won growth.

(In much of public health, reaching the last 20 % can be much harder than reaching the first 20%) graph of backslding in immu...
Read 7 tweets
Feb 10
🚨 The Intergovernmental Negotiating Body (INB) published the "zero draft" of the #pandemictreaty last week and briefed Member States about it this week.

The draft will be discussed in Geneva from 27 Feb to 3 March.

Summary of the process & highlights on the new text in this 🧵 Photo of INB
During the briefing, Member States expressed concern:

⏰ too little time between now and the next meeting
⌛️ too little time dedicated to complex issues.

Suggestions included postponing discussions on denser issues or inter-sessional work (which may disadvantage smaller states)
The “zero draft” follows the same structure as the "conceptual zero draft.”

✅ Introduction followed by objectives, guiding principles and scope
✅ Four chapters outlining substantive content
✅ Two chapters dedicated to proposed treaty governance.

Read 11 tweets
Feb 10
💥Deadly #cholera outbreak continues in Malawi.

According to WHO, there have been nearly 37,000 cases and over 1200 associated deaths.

Every distinct is affected.

In the face of the deadliest cholera outbreak in the country’s history, vaccines are in (too) short supply.

🧵 map of cholera outbreak
Prompted by a severe vaccine shortage, in Oct 2022, the International Coordinating Group on Vaccine Provision (ICG), which allocates cholera vaccines to affected countries, announced that it would provide a single-dose regimen instead of two. headline from WHO decision on one vs. two doses.
A long list of countries report cholera outbreaks.

🗺 Afghanistan, Bangladesh, Burundi, Cameroon, DRC, the Dominican Republic, Haiti, Iraq, Kenya, Lebanon, Malawi, Mozambique, Nigeria, Philippines, Somalia, Syria, and Tanzania.

❌There are not enough vaccines to go around. countries with cholera outbreaks
Read 4 tweets
Feb 9
This week, in preparation for its meeting on 20 February, the Working Group on Amendments to the IHR (WGIHR) published the Technical Review Committee's (TRC) report on proposed amendments.

The TRC report is intended to help inform negotiations.

Update in this 🧵 Screenshot of report
The Director-General appointed the TRC to assess amendments proposed by member states for appropriateness, clarity, consistency, and feasibility.

The TRC also identified "shared values" including advancing equity, solidarity, cooperation, trust, transparency, and sovereignty. Excert from report
The Technical Review Committee's report:

✅ provides article-by-article analysis
✅ summarizes implications of each proposed amendment
✅ provides wording improvements.

There are currently no proposals on requirements or modalities to verify information with state parties.
Read 4 tweets
Feb 1
🔥 The "draft zero" of the #pandemictreaty is out.

There is no plan for an independent accountability mechanism (or any accountability mechanism).

As we explain in @TheLancet and 🧵, this is a serious oversight.

bit.ly/lancettreaty
We reviewed the evidence and interviewed experts from around the world.

Independent accountability is key for compliance with any international agreement.

bit.ly/monitoraccord
So far, the "zero draft" treaty

❌only proposes oversight mechanisms assessing achievements and gaps in preparedness capacity
❌doesn't mention independence
❌ mechanism for monitoring overall compliance won't be designed until (at least) the 1st treaty governing body meeting screen shot from draft zero
Read 5 tweets

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