Health Brief: One Health, One Earth

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The COVID pandemic has raised more awareness of how closely our health is interconnected with animals and the environment, the chief scientist of EU’s Food Safety Agency (EFSA) told EURACTIV.

Last week, we sat down with Marta Hugas, who leads the development of EFSA’s scientific strategic direction, for an exclusive interview for EURACTIV’s Health Brief.

We spoke about lessons learnt from COVID-19 (of course) and about the One Health concept – which is particularly dear to the European Commission.

“[After COVID,] it’s more clear that health threats are complex and cannot be adequately addressed by individual disciplines or experts acting alone,” she said.

For this reason, the One Health approach could take advantage of this renewed interest in holistic remedies to cope with public health risks.

Asked to better describe this concept, she said that there is no such univocal definition of One Health.

“There are many different formulation but it’s basically the concept behind that matters: it’s a comprehensive approach.”

The European Commission launched the One Health Action Plan in June 2017 calling for effective action against the threat of antimicrobial resistance (AMR).

However, the term One Health was initially coined in the context of zoonosis, namely shared infections among animals and humans and in particular to deal with silent infections in animals that could be transmitted to humans with deadly consequences.

“That’s how it initially started, but then it was also evolving over the recent decades including also the environment,” Hugas said.

She added that, from belonging to medical and veterinary science the concept is now including a rapidly growing range of other disciplines, including food safety, public health, health economics, and social science.

“This is because we realise that we are not isolated in the world but all interconnected,” she said, mentioning that deforestation happening in West Africa, for example, gave rise to the Ebola crisis.

The One Health Action Plan adopted by the Commission in 2017 recognises that human and animal health is interconnected, that diseases are transmitted from humans to animals and the other way around and must, therefore, be tackled in both.

Not much has moved on that front since then, but COVID-19 may now be a game changer.

According to Hugas, the pandemic has also shown that health borders do not materially exist.

“We live in a global world, we trade goods, and we continue spreading threats and spreading hazards and risks,” she said.

Among the lessons from COVID-19, there is also the importance of sharing of data which comes handy for One health too.

“The sharing of the sequence of the COVID led to early development of vaccines in a in a time frame that was deemed impossible before the pandemic,” she pointed out.

The other positive aspects is that politicians seem to be listening more to scientists.

“We’ve seen also that countries whose politicians listen more to scientists are in a better situation compared to other countries whose politicians have taken political decisions without listening to the scientists,” she said.

When we think how we can move towards a One Health approach, we also need to reflect on what kind of education we need for future scientists, according to the EFSA chief scientist.

Next EFSA scientific conference in June in Brussels will also address how the new generation of scientists will approach One Health, as well as lessons from the pandemic.

“I always try to see the full glass instead of an empty glass,” she concluded.

(G.F.)

EU News

The European Parliament plenary voted on Thursday (11 November) for transparency, close cooperation and an in-depth review of HERA operations, aligning the new EU health emergency body with the future regulation on cross-border health threats.

A year after the Polish Constitutional Tribunal’s ruling that de facto banned abortion, the European Parliament called on the government in Warsaw on Thursday (11 November) to lift the ban that puts women’s lives at risk.

EMA

EMA has recommended granting a marketing authorisation in the European Union for Tavneos (avacopan), a first-in-class medicine to treat adult patients suffering from two forms of a rare multisystem autoimmune condition called anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis, in which the immune system attacks small to medium-sized blood vessels in the body. Tavneos is to be used in combination with rituximab or cyclophosphamide – two medications used to treat certain autoimmune diseases and types of cancer.

COVID-19

Two monoclonal antibody medicines for treating COVID-19 have been recommended for authorisation by the European Medicines Agency on Thursday (11 November), sparking new hopes in the fight against the virus.

EMA has started evaluating an application to extend the use of Moderna’s COVID-19 vaccine, Spikevax, to children aged 6 to 11. Spikevax is a vaccine for preventing COVID-19, currently authorised for use in people aged 12 years and older. It contains a molecule called messenger RNA (mRNA) with instructions for producing a protein, known as the spike protein, which is naturally present in SARS-CoV-2, the virus that causes COVID-19. The vaccine works by preparing the body to defend itself against SARS-CoV-2.

Last month EMA started evaluating an application to extend the use of BioNTech/Pfizer’s COVID-19 vaccine, Comirnaty, to children aged 5 to 11.

EU has signed an advance purchase agreement with Valneva, securing 60 million doses of inactivated COVID-19 vaccine VLA2001, topping up its vaccine portfolio up to 4.6 billion doses.

On Wednesday (November 10) the European Commission approved the eighth contract with a pharmaceutical company with a view to purchasing its potential vaccine against COVID-19.

The contract with Valneva provides for the possibility for all EU member states to purchase almost 27 million doses in 2022. It also includes the possibility to adapt the vaccine to new variant strains, and for the member states to make a further order of up to 33 million additional vaccines in 2023.

Interim data from a phase 3 trial of BBV152, a COVID-19 vaccine developed in India, reports that two doses offer 78% protection against symptomatic COVID-19. The study, which was was published in The Lancet on 11 November, found no severe vaccine-related adverse events or deaths were reported among the trial participants. The majority of the adverse events, including headache, fatigue, fever, and pain at the injection site, were mild and occurred within seven days of vaccination.

The vaccine recently received emergency use approval from the World Health Organization (WHO) for people aged 18 and older.

Tobacco

The fourth WHO global tobacco trends report released on Tuesday (16 November) shows that there are 1.30 billion tobacco users globally compared to 1.32 billion in 2015. This number is expected to drop to 1.27 billion by 2025.  

Sixty countries are now on track to achieving the voluntary global target of a 30% reduction in tobacco use between 2010 and 2025. In comparison,  two years ago only 32 countries were on track.

The report urges countries to accelerate implementation of the measures outlined by the WHO in an effort to further reduce the number of people at risk of becoming ill and dying from a tobacco-related disease.

In Europe 18% of women still use tobacco – substantially more than in any other region. Women in Europe are the slowest in the world to cut tobacco use.  All other WHO regions are on track to reduce tobacco use rates among women by at least 30% by 2025.

Approximately 38 million children (aged 13-15) currently use tobacco (13 million girls and 25 million boys).  In most countries it is illegal for minors to purchase tobacco products. The goal is to achieve zero child tobacco users.

Diabetes

A WHO report published on 12 November, ahead of World Diabetes Day, highlighted the alarming state of global access to insulin and diabetes care, and found that high prices, low availability of human insulin, few producers dominating the insulin market and weak health systems are the main barriers to universal access.

Insulin is the bedrock of diabetes treatment – it turns a deadly disease into a manageable one for nine million people with type 1 diabetes. For more than 60 million people living with type 2 diabetes, insulin is essential in reducing the risk of kidney failure, blindness and limb amputation.

However, one out of every two people needing insulin for type 2 diabetes does not get it. Diabetes is on the rise in low- and middle-income countries, and yet their consumption of insulin has not kept up with the growing disease burden. The report highlights that while three in four people affected by type 2 diabetes live in countries outside of North America and Europe, they account for less than 40% of the revenue from insulin sales.

“The scientists who discovered insulin 100 years ago refused to profit from their discovery and sold the patent for just one dollar,” said WHO Director-General, Dr Tedros Adhanom Ghebreyesus. “Unfortunately, that gesture of solidarity has been overtaken by a multi-billion-dollar business that has created vast access gaps”.

COP26

COP26 came to an end but some stakeholders are unhappy with the outcome on health. 

In a press release published on 13 November, the Global Climate and Health Alliance stated that COP26 outcomes are “not nearly enough to protect health”. 

Jeni Miller, Executive Director of the alliance, said that “governments must focus on what is needed for a healthy and equitable future, and to ensure the protection of people’s health from the worst impacts of climate change”.

“They must deliver on their commitments to limit warming to 1.5C; and they must deliver on the climate finance that redresses the outsized benefits wealthy countries have enjoyed from their high carbon economies, and addresses the devastating impacts on people’s health outsourced around the world,” she said.

Measles

Progress toward measles elimination continues to decline and the risk of outbreaks is mounting, according to a report published on 10 November from the World Health Organisation (WHO) and U.S. Centers for Disease Control and Prevention (CDC).  During 2020, more than 22 million infants missed their first dose of measles vaccine – 3 million more than in 2019, marking the largest increase in two decades and creating dangerous conditions for outbreaks to occur.  

Compared with the previous year, reported measles cases decreased by more than 80% in 2020. 

Public Health

The European Commission’s Joint Research Centre (JRC) and the World Health Organisation (WHO) concluded a Collaborative Research Arrangement on 12 November that aims to mainstream behavioural insights into public health programmes and policies worldwide.  Behavioural insights can help improve understanding on how and why people behave in ways that affect their health, and help design policies and services that address behavioural factors for improved physical and mental well-being.

The Commission, through the JRC, will assist WHO in expanding its behavioural insights for health programme.  Both organisations will agree on specific areas of focus, which would include issues like non-communicable diseases, antimicrobial resistance and the use of behavioural insights to increase the capacity of the health workforce.

News from the Capitals

VIENNA

Austria introduces lockdown for the unvaccinated. Austria’s unvaccinated people, around 25% of the population, are being placed into a fully-fledged lockdown from Monday 15 November. But according to experts, additional measures will soon be needed to combat the rise in infection rates. By  Oliver Noyan |  EURACTIV.de

DUBLIN 

Ireland does not rule out restrictions as rising COVID-19 cases ‘extremely’ concerning. Further restrictions cannot be ruled out, Irish Taoiseach Micheál Martin has said, noting that he is “extremely concerned” about the rise in COVID-19 cases in the country. By  Molly Killeen |  EURACTIV.com

 ROME

Italy’s 40-60-year-olds eligible for boosters from December. A third COVID-19 dose will be available for those in the 40-60 age group from 1 December, Health Minister Roberto Speranza announced on Wednesday (10 November). This means another 15 million will be eligible for boosters. By  Eleonora Vasques |  EURACTIV.com

The leadership of the European Commission is currently discussing with scientists how long a third dose is effective in protecting against COVID-19, EURACTIV.com has learnt. Italy mulls shortening COVID pass validity while Greece considers a similar step even without a joint EU decision. Meanwhile, rumours of a fourth dose are circulating if high rates of unvaccinated citizens persist. By  Eleonora Vasques and Sarantis Michalopoulos |  EURACTIV.com and EURACTIV.it

BUCHAREST

Romania extends state of alert. The Romanian government extended the state of alert by 30 more days in the context of the COVID-19 epidemic. No new measures were introduced, but those in place will continue to apply, including mandatory masks and restrictions for unvaccinated persons.

Romania has one of the lowest vaccination rates in Europe, although the number of inoculations rose over the past month in the wake of a vast number of new infections. (Bogdan Neagu | EURACTIV.ro)

LISBON

Portugal’s health authority reports 86% of population fully vaccinated. Portugal has 86% of the population fully vaccinated against COVID-19, and 87% with at least one dose of the vaccine, the national health authority (DGS) announced Wednesday (10 November). By  Pedro Caetano |  Lusa.pt

PARIS

Macron: health pass for over 65s conditioned on a third dose of vaccine. In his ninth address to the nation since the beginning of the COVID-19 crisis on Tuesday (9 November) evening, President Emmanuel Macron called on unvaccinated citizens to show solidarity by getting the vaccine. Macron also announced that from 15 December, a third injection would be necessary for all those over 65 to extend the validity of their COVID passes. By  Magdalena Pistorius |  EURACTIV.fr

SOFIA

Bulgaria to issue COVID green certificate to people with antibodies. Bulgarian authorities have surrendered to the demands of the restaurant industry and announced that a green certificate would be issued for people with large amounts of COVID-19 antibodies. The EU Commission has announced that there is not enough data to allow antibodies to justify a European green certificate, but states are free to develop their own solutions. By  Krassen Nikolov |  EURACTIV.bg

SOFIA

Bulgaria asks other EU countries for ventilators and ICU beds. Bulgaria has activated the EU Civil Protection Mechanism because of the problematic COVID-19 situation in the country. A Commission spokesperson said that authorities had requested a range of medical items via the mechanism, including a significant amount of ventilators, patient monitors, ICU beds, and oxygen masks. By  Krassen Nikolov |  EURACTIV.bg

MADRID

Spain to reserve 2 million COVID-19 vaccines exclusively for ‘humanitarian contexts’. Of the 50 million doses of COVID-19 vaccines Spain is set to donate to the most vulnerable countries in the first quarter of 2022, two million will be exclusively reserved “for humanitarian contexts”, Prime Minister Pedro Sánchez stressed on Monday (9 November). By  Fernando Heller |  EuroEFE.EURACTIV.es

Events

16 November |European Centre for Disease Prevention and Control (ECDC) is opening the 2021 European Scientific Conference on Applied Infectious Disease Epidemiology (ESCAIDE)

18 November | Civil Liberty Committee will focus on European Antibiotic Awareness Day

18 November| ENVI Committee will focus on EMA and on ECDC

18-24 November | World Antimicrobial Awareness Week

18-21 November | World Congress on Adolescent Health

18 November |Sixth meeting of the WHO Council on the Economics of Health for All

23 November | “Health systems in digital transition – Towards a European Health Data Space – the V4 perspective“, event organised by the Hungarian Presidency of the Visegrad Group

23 November | “Screening for type 1 diabetes: why is it needed?”, virtual symposium organised jointly by  JDRF, EUDF and INNODIA

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