Perspectives on Various Issues of Interest

United Nations World Food Programme wins Nobel Peace Prize for efforts to combat hunger

 

Condensing the time-line of developing vaccine - Some scenarios

Here are some key points from an interesting opinion piece published in the New York Times.

Assuming we already know Corona virus, vaccine is expected to be ready by May 2036 if no strategies for shortening the time-line is taken:

If we don’t wait for academic research, vaccine can be made available by August 2034:

 

If we rely on work from studying SARS and MERS to shorten preparations before clinical trials and start trials early, vaccine can be made available by January 2034:

If we don’t wait for academic research and start trials early, vaccine can be made available by April 2032:

Neither of these scenarios seem to help the prevailing situation. Hence, there is a need to move at “pandemic-speed” and put all the existing drug discovery work that is underway that relate to Covid-19. There are at least 254 therapies and 95 vaccines related to Covid-19 being explored.

It is important to recognize that less than 10 percent of drugs that enter clinical trials are ever approved by the Food and Drug Administration. The rest are either not effective, don’t perform better than existing drugs or have too many side effects.

Typically, vaccine development process takes a decade or longer.

Since the virus that causes Covid-19, are roughly 80 percent identical to the ones causing SARS, and given that both use so-called spike proteins to grab onto a specific receptor found on cells in human lungs, there has been some head start with regards to research. 

Here are some additional options to shorten the timeline (even earlier than April 2032):

By going with ‘pandemic speed’ time-line and starting subsequent steps before previous phases are completed, vaccine can be made available by July 2030:

By moving more swiftly to Phase 3 trials by combining phases, vaccine can be made available by January 2030:

If the decision is made to go with emergency provisioning, i.e. vaccinating front-line and essential workers early, vaccine can be made available by December 2030:

If the three above-mentioned strategies are adopted (i.e. moving at 'pandemic-speed’ timeline, pushing to large-scale testing sooner, and using emergency provisions), vaccine can be made available to front-line and essential workers by February 2028 and to everyone else by June 2029.

Along with the above mentioned steps, if we take a bet on a successful mRNA vaccine, this experimental technology may be faster to produce than traditional vaccines and the vaccine can be made available by February 2028.

 

Unfortunately, none of these scenarios can make the vaccine available in 12 to 18 months time horizon.

The risks and difficulties of fast-tracking vaccine research are huge ranging from the fact that poorly researched vaccines can actually makes it easier to catch the virus, or makes the disease worse after someone’s infected. Researchers also can’t easily infect vaccinated participants with the coronavirus to see how the body behaves. They normally wait until some volunteers contract the virus naturally. That means dosing people in regions hit hardest by the virus, like New York, or vaccinating family members of an infected person to see if they get the virus next. If the pandemic subsides, this step could be slowed.

As can be seen the longest time in the fastest scenario illustrated above is taken by supply chain activities such as building factories and manufacturing. If factories can be built now and manufacture can begin early, anticipating that factories will be useful for a future vaccine and that the product will clear regulatory hurdles, the timeline can be brought down from June 2029 (without taking a bet on the mRNA vaccine) to October 2023:

Finally if we can start building factories now and can bet on mRNA vaccine, vaccine can be made available by June 2022:

Finally fast tracking federal approval from one year to six months can further bring down the time and make the vaccine available by December 2021:

Source: Thompson, S.A. 2020. How Long Will a Vaccine Really Take? New York Times, April 30, 2020

Impact of Coronavirus on Healthcare Supply Chain

China manufactures the bulk of personal protective equipment used by healthcare providers in the United States. Other countries supplies these equipments are also hit hard by the coronavirus. Healthcare organizations in the United States typically buy more than 2 million N95 masks each month. The shortage of available capacity for production due to factory closures can result in a month long delay in the delivery of N95 marks that are used to protect against the spread of airborne illness. These masks differ from the standard surgical masks as they effectiveness depends on they proper fit and use. Healthcare workers are expected to be trained in the Occupational Safety and Health Administration’s protocols for their use. 

In the U.S. only two companies, 3M and Prestige Ameritech, manufacture the full line of N95 respirators. Historically the production of these masks within the U.S. has been insufficient to cover domestic demand. While the two companies are ramping up the production, it is expected to take up to a month to catch up with the demand surge.

On February 26 the U.S. Health and Human Services (HHS) secretary Alex Azar reported to the House Appropriation Committee  that U.S. has a stockpile of 12 million N95 masks. However, HHS estimated that we will need 300 million masks to cover an emergency and the combined production capacity in the U.S. and Mexico is only 65 million.

To address this gap between demand and supply, measures such a limiting the use of these masks by only healthcare staff who are directly involved in patient care is needed.

In addition to the surgical masks, the capacity shortage is also going to hit pharmaceutical products and medical devices. China produces 100% of the active pharmaceutical ingredients (APIs) for two vital products - penicillin and blood-thinner heparin. Capacity constraints and disruptions in the shipment of these drugs from China will necessitate exploration of alternative options. Food and Drug Administration (FDA) identified 20 drug products that are linked to China through API sourcing or product manufacturing, although these products are currently not in short supply.

From a supply chain management perspective, the disruption caused by coronavirus has resulted in a call for setting an industry-wide higher expectations with suppliers to improve supply disruption notification process, as noted by Chaun Powell, group vice president for strategic supplier engagement with Premier Inc. One could see potential price increases due to the an expanded base for manufacturing critical healthcare products in an effort to limit shortages of medical supplies. Inventory management practices should consider having safety stock in excess of 20% over the peak usage for these critical supplies, asserts Scott Cormier, vice president of emergency management, environment of care and safety for Medxcel. However, Powell notes that the increase in inventory should be gradual so as to avoid putting additional burden on suppliers.

Source: https://www.hfma.org/topics/operations-management/article/the-coronavirus-and-the-supply-chain-what-hospitals-need-to-know.html 

 

 

An enlightening and inspiring experience visiting the underprivileged communities in Panama

It was an enlightening and inspiring experience visiting and witnessing success stories of student-led consulting projects in underprivileged communities (villages) in Panama. These projects are facilitated by Global Brigades, an international non-profit that uniquely implements a holistic model to meet a community’s health and economic goals. The projects include establishment of internationally recognized community-owned banks in some of the country’s most under resourced, rural communities, micro-financing ventures created and run by indigenous tribes, helping these ventures succeed by offering hands-on business solutions, and providing healthcare to underprivileged communities.

 

First-Aid, Rapid Response Drone in India

https://t.co/I2QUtW0g8i

— Anand Nair (@Dr_Nair) December 4, 2019

Africa's first drone 'Air Corridor’ - A partnership initiative by UNICEF and Zipline

https://t.co/A2mFRvqmsP

— Anand Nair (@Dr_Nair) December 4, 2019

Keeping children safe at school

“We owe it to children to keep them safe at school. We cannot ask our children to both look to the future while simultaneously ducking for cover.” @unicefchief #ENDviolence #Blagoveshchensk #SantaClarita https://t.co/qDVTz9hjeK

— UNICEF (@UNICEF) November 16, 2019

Strengthening land rights and supply chain for farmers

@FeedtheFuture's Land Market Development Activity is strengthening #LandRights for farmers & establishing a market where farmers can buy, sell, & lease their #agricultural land in a transparent and fair process: https://t.co/USCOsKJEaj@USAIDCtrAsia @USAIDAsiaHQ pic.twitter.com/xHHxo6NVHD

— USAID (@USAID) November 16, 2019

Aerial blood sample deliveries in Norway

https://t.co/CZBmkZCPyf

— Anand Nair (@Dr_Nair) December 4, 2019

2019 WFP Aviation in Numbers

Every day, airlifts, airdrops and airfreight carried out by WFP Aviation bring food🍚, medicine 💉 and other relief items 📦 to populations in need of assistance across the world.

Check the numbers below! 👏👏 @WFPLogistics @WFP_UNHAS pic.twitter.com/1qB5z9mHzZ

— World Food Programme (@WFP) October 19, 2019