Nepal worries future coronavirus wave will hit children hard

By Gopal Sharma

KATHMANDU (Reuters) – Nepal asked its hospitals on Friday to reserve beds for children for fear another surge in coronavirus infections will hit them hard, something officials in neighboring India are also preparing for.

The move came as the government approved for emergency use the COVID-19 vaccine made by Sinovac Biotech of China.

Prime Minister K.P. Sharma Oli’s government has been criticized by experts for its handling of the ongoing second wave in Nepal, which has led to an acute shortage of oxygen, hospital beds and medicines.

“Hospitals and medical institutions must set aside at least 20% of beds for children, who are likely to suffer the most in the potential third and fourth waves of coronavirus,” the Ministry of Health and Population said in a statement.

“Hospitals must also ensure the availability of enough oxygen.”

Daily infections in the Himalayan nation are hovering around 5,000 after hitting a peak of more than 9,000 in early May. Nepal had reported fewer than 100 daily cases in March. It has reported 581,560 infections in total and 7,731 deaths.

Donors have rushed aid including oxygen, protective gear, drugs and face masks to the country, which is also struggling to secure vaccines after neighboring India stopped exports to meet its local demand.

Santosh K.C., a spokesman for the Department of Drug Administration, said “conditional permission for the emergency use” had been given for the coronavirus vaccine (Corona Vac) made by Sinovac Biotech of China, the fifth shot to be approved by Nepal.

Earlier it had approved two Indian-made vaccines – AstraZeneca’s and COVAXIN – China’s Shinopharm and Russia’s Sputnik V for emergency use in the Himalayan nation.

Nepal has provided at least 3.1 million vaccinations to its people so far.

(Reporting by Gopal Sharma; editing by Jonathan Oatis)

China to gift 1 million COVID-19 vaccine doses to Nepal

By Gopal Sharma

KATHMANDU (Reuters) – China will provide 1 million doses of a COVID-19 vaccine to Nepal, its ambassador said on Wednesday, as authorities in the Himalayan country scramble to secure shots amid a surge in infections that has overwhelmed its rickety health system.

The announcement was made during a telephone conversation between Chinese President Xi Jinping and his Nepali counterpart Bidya Devi Bhandari on Wednesday, China’s ambassador Hou Yanqi said in a Twitter post.

In March, China provided 800,000 doses of the Sinopharm COVID-19 vaccine to Nepal, which also received a million shots of the AstraZeneca vaccine as gift from India.

Nepal began its vaccination drive in January but the campaign has been suspended because of the lack of vaccines after New Delhi said it was unable to provide additional shots due to its domestic needs.

China and India jostle for influence in Nepal, a natural buffer between the Asian giants, and both have been giving away COVID-19 vaccines as part of a diplomatic push to strengthen ties with neighbors and countries further afield.

Neither Chinese ambassador Hou nor Nepal’s foreign minister, Pradeep Kumar Gyawali, gave a timeframe for delivery of the latest donation of vaccines.

Nepal has been hit by a sharp surge in COVID-19 cases since early April. The average daily rise in infections is now about 8,000, compared with fewer than 200 a day two months ago, leaving hospital beds, oxygen and medicines in short supply.

In all, the country has reported 535,525 cases and 6,845 deaths from COVID-19, according to government data.

Nepal has also procured 1 million shots of vaccine in a commercial deal with the Serum Institute of India, in addition to 348,000 jabs it received under the COVAX initiative.

The country has administered at least 2,706,835 doses, enough to have vaccinated about 4.7% of the population.

(Reporting by Gopal Sharma; Editing by Devjyot Ghoshal and Alex Richardson)

Leaders of 23 countries back pandemic treaty idea for future emergencies

GENEVA/BRUSSELS (Reuters) – Leaders of 23 countries and the World Health Organization on Tuesday backed an idea to create an international treaty that would help deal with future health emergencies like the coronavirus pandemic by tightening rules on sharing information.

The idea of such a treaty, also aimed at ensuring universal and equitable access to vaccines, medicines and diagnostics for pandemics, was floated by the chairman of European Union leaders, Charles Michel, at a summit of the Group of 20 major economic powers last November.

WHO Director-General Tedros Adhanom Ghebreyesus has endorsed the proposal, but formal negotiations have not begun, diplomats say.

Tedros told a news conference on Tuesday that a treaty would tackle gaps exposed by the COVID-19 pandemic. A draft resolution on negotiations could be presented to the WHO’s 194 member states at their annual ministerial meeting in May, he said.

The WHO has been criticized for its handling of the COVID-19 pandemic and was accused by the administration of U.S. president Donald Trump of helping China shield the extent of its outbreak, which the agency denies.

A joint WHO-China study on the virus’s origins, seen by Reuters on Monday, said it had probably been transmitted from bats to humans through another animal, and that a lab leak was “extremely unlikely” as a cause. But the study left many questions unanswered and called for further research.

On Tuesday, the treaty proposal got the formal backing of the leaders of Fiji, Portugal, Romania, Britain, Rwanda, Kenya, France, Germany, Greece, Korea, Chile, Costa Rica, Albania, South Africa, Trinidad and Tobago, the Netherlands, Tunisia, Senegal, Spain, Norway, Serbia, Indonesia, Ukraine and the WHO itself.

“There will be other pandemics and other major health emergencies. No single government or multilateral agency can address this threat alone,” the leaders wrote in a joint opinion piece in major newspapers.

“We believe that nations should work together towards a new international treaty for pandemic preparedness and response.”

The leaders of China and the United States did not sign the letter, but Tedros said both powers had reacted positively to the proposal, and all states would be represented in talks.

The treaty would complement the WHO’s International Health Regulations, in force since 2005, through cooperation in controlling supply chains, sharing virus samples and research and development, WHO assistant director Jaouad Mahjour said.

(Reporting by Jan Strupczewski and Philip Blenkinsop in Brussels and Stephanie Nebehay in Geneva; Editing by Kevin Liffey)

In blow to WHO, EU seeks powers to declare health emergencies

By Francesco Guarascio

BRUSSELS (Reuters) – The European Commission on Wednesday proposed rules which would give the EU the power to declare a health emergency and stress test national plans to tackle pandemics, in a potential blow to the World Health Organization.

The move follows an often uncoordinated reaction by the 27 EU governments to the COVID-19 pandemic, which at the beginning of the crisis led to competition on vital medical gear and export bans on medicines.

It also comes after the WHO was criticized for having declared the pandemic, which first emerged in China at the end of last year, too late. The U.N. agency has repeatedly denied the accusation.

Under the proposals, the EU would be able to declare an EU-level public health emergency, which would in turn trigger more coordination among EU states.

Currently, the EU relies on the WHO to declare such an emergency.

“The new rules will enable the activation of EU emergency response mechanisms (..) without making it contingent upon the WHO’s own declaration of a Public Health Emergency of International Concern,” an EU document says, adding that such a move would be coordinated with the WHO.

If adopted, the overhaul would partly take away a major power from the WHO, as EU states call for reform of the organization to address shortfalls in emergencies.

“We relied too much on the WHO for the COVID-19 pandemic,” Peter Liese, a top EU lawmaker from German Chancellor Angela Merkel’s party, said.

“Under pressure from China, the WHO declared the health emergency too late. It is therefore very important to have the possibility to act at European level in future similar situations.”

The WHO, which the Trump administration has labelled a puppet of China, was not immediately available to comment.

COORDINATION ON VACCINES

Under the commission’s proposals, the EU would help governments prepare pandemic plans and would audit and stress test them, an EU document says.

EU states have traditionally been reluctant to give more powers to Brussels on the matter.

During the pandemic, they have applied different national measures on a series of issues, including testing policies for COVID-19 cases, quarantine rules and travel restrictions.

But they have shown good coordination on procuring vaccines.

If approved by EU governments and EU lawmakers, the commission said the proposals would be immediately applicable and could strengthen EU powers to tackle the current pandemic, in which most European countries are seeing a surge in cases.

Brussels wants to strengthen the EU public health agency, the European Centre for Disease Prevention and Control, whose non-binding advice, such as on the length of quarantine after contact with an infected person, has often been ignored.

It also wants more power for the EU Medicines Agency to prevent risks of shortages of medicines and medical devices.

Brussels also said it would unveil by the end of next year plans for a new health authority modelled after the U.S. Biomedical Advanced Research and Development Authority, which has played a vital role in procuring experimental dugs and vaccines.

(Reporting by Francesco Guarascio @fraguarascio; Editing by Alison Williams and Nick Macfie)

With medicine running out, Venezuelans with transplants live in fear

Lismar Castellanos, 21, who lost her transplanted kidney, cries while she speaks on the phone with a relative during her birthday celebration at a state hospital in Caracas, Venezuela February 7, 2018. Castellanos lost her transplanted kidney last year and is struggling to get the dialysis needed to keep her body functioning. REUTERS/Carlos Garcia Rawlins

By Alexandra Ulmer

CARACAS (Reuters) – Yasmira Castano felt she had a fresh chance at life when she received a kidney transplant almost two decades ago. The young Venezuelan was able to finish high school and went on to work as a manicurist.

But late last year, Castano, now 40, was unable to find the drugs needed to keep her body from rejecting the organ, as Venezuela’s healthcare system slid deeper into crisis following years of economic turmoil.

On Christmas Eve, weak and frail, Castano was rushed to a crumbling state hospital in Venezuela’s teeming capital, Caracas. Her immune system had attacked the foreign organ and she lost her kidney shortly afterwards.

Now, Castano needs dialysis three times a week to filter her blood. But the hospital attached to Venezuela’s Central University, once one of South America’s top institutions, frequently suffers water outages and lacks materials for dialysis.

“I spend nights not sleeping, just worrying,” said Castano, who weighs around 77 pounds (35 kg), as she lay on an old bed in a bleak hospital room, its bare walls unadorned by a television or pictures.

Her roommate Lismar Castellanos, who just turned 21, put it more bluntly.

“Unfortunately, I could die,” said Castellanos, who lost her transplanted kidney last year and is struggling to get the dialysis she needs to keep her body functioning.

The women are among Venezuela’s roughly 3,500 transplant recipients. After years leading normal lives, they now live in fear as Venezuela’s economic collapse under President Nicolas Maduro has left the once-prosperous OPEC nation unable to purchase sufficient foreign medicine or produce enough of its own.

Some 31 Venezuelans have seen their bodies start to reject their transplanted organs in the last month due to lack of medicine, according to umbrella health group Codevida, a non-governmental organization.

At least seven have died due to complications stemming from organ failure in the last three months.

A further 16,000 Venezuelans, many hoping for an elusive transplant, are dependent on dialysis to clean their blood – but here too, resources and materials are sorely lacking.

Nearly half of the country’s dialysis units are out of service, according to opposition lawmaker and oncologist Jose Manuel Olivares, a leading voice on the health crisis who has toured dialysis centers to assess the scale of the problem.

In the last three weeks alone, seven people have died due to lack of dialysis, according to Codevida, which staged a protest to decry the critical drug shortages.

Once-controlled diseases like diphtheria and measles have returned, due partly to insufficient vaccines and antibiotics, while Venezuelans suffering chronic illnesses like cancer or diabetes often have to forgo treatment.

Hundreds of thousands of desperate Venezuelans, meanwhile, have fled the country over the past year, including many medical professionals.

Amid a lack of basics like catheters and crumbling hospital infrastructure, doctors who remain struggle to cope with ever scarcer resources.

“It’s incredibly stressful. We request supplies; they don’t arrive. We call again and they still don’t arrive. Then we realize it’s because there aren’t any,” said a kidney specialist at a public hospital, asking to remain anonymous because health workers are not allowed to speak publicly about the situation.

Venezuela’s Social Security Institute, tasked with providing patients with drugs for chronic conditions, did not respond to a request for comment.

“STRAIGHT TO THE CEMETERY”

Terrified transplant patients are indebting themselves to buy pricey medicine on the black market, begging relatives abroad to funnel drugs into the country or dangerously reducing their daily intake of pills to stretch out stock.

Larry Zambrano, a 45-year old father of two with a kidney transplant, resorted to taking immunosuppressants designed for animals last year.

Guillermo Habanero and his brother Emerson both underwent kidney transplants after suffering polycystic kidney disease. Emerson, a healthy 53-year-old former police officer, died in November after a month without immunosuppressants.

“If you lose your kidney, you go to dialysis but there are no materials. So you go straight to the cemetery,” said Habanero, 56, who runs a small computer repair shop in the poor hillside neighborhood of Catia.

A Reuters reporter went to the Health Ministry to request an interview, but was asked at the entrance to give her contact details instead. No one called or emailed.

Reuters was also unable to contact the Health Ministry unit in charge of transplants, Fundavene, for comment. Its website was unavailable. Multiple calls to different phone numbers went unanswered. An email bounced back and no one answered a message on the unit’s Facebook page.

Maduro’s government has said the real culprit is an alleged U.S.-led business elite seeking to sabotage its socialist agenda by hoarding medicine and imposing sanctions.

“I see the cynicism of the right-wing, worried about people who cannot get dialysis treatment, but it’s their fault: they’ve asked for sanctions and a blockade against Venezuela,” Socialist Party heavyweight Diosdado Cabello said in recent comments on his weekly television program.

Health activists blame what they see as Maduro’s inefficient and corrupt government for the medical crisis and contend that government announcements of more imports for dialysis are totally insufficient.

Despite his unpopularity, Maduro is expected to win a new six-year term in an April 22 presidential election. The opposition is likely to boycott the vote, which it has already denounced as rigged in favor of the government.

Maduro has refused to accept food and medicine donations, despite the deepening healthcare crisis. Health activists and doctors smuggle in medicines, often donated by the growing Venezuelan diaspora, in their suitcases, but it is far from enough.

In the decaying hospital and dialysis center visited by Reuters, patients clamored for humanitarian aid.

Dolled up for her birthday and surrounded by cakes, the 21-year-old Castellanos took selfies with her friends and spoke excitedly about one day returning to dance, one of her passions.

But fears for her future permeated the room. A hospital worker stopped by to wish Castellanos many more birthday celebrations but her worried face betrayed doubts.

“Other countries need to help us,” Castellanos said.

(Additional reporting by Liamar Ramos and Leon Wietfeld; Writing by Alexandra Ulmer; Editing by Brian Ellsworth, Daniel Flynn and Tom Brown)

United Nations hopes imports will help stave off famine in Yemen as diphtheria spreads

A nurse holds a premature baby in an incubator at the child care unit of a hospital in Sanaa, Yemen January 16, 2018.

By Stephanie Nebehay

GENEVA (Reuters) – United Nations aid agencies called on Tuesday for the Yemeni port of Hodeidah to remain open beyond Friday, the date set by a Saudi-led military coalition, to permit continued delivery of life-saving goods.

Yemen is the world’s worst humanitarian crisis, where 8.3 million people are entirely dependent on external food aid and 400,000 children suffer from severe acute malnutrition, a potentially lethal condition, they said.

The Arab coalition, under international pressure, eased a three-week blockade which was imposed on Yemeni ports and airports in November in response to a ballistic missile fired by the Houthi movement toward the Saudi capital Riyadh.

Four mobile cranes arrived in the important Houthi-controlled Hodeidah port, the U.N. said on Monday, after the coalition agreed to let them into Yemen, where nearly three years of war have pushed it to the verge of famine.

“The port in theory is going be open to the 19th of this month. Then we don’t know if the coalition will close or (leave) it open,” Meritxell Relano, U.N. Children’s Fund (UNICEF) Representative in Yemen, told a news briefing in Geneva.

“Obviously the feeling is that they extend this period so that the commercial goods can come in, but especially the fuel,” she said, speaking from the capital Sanaa.

Before the conflict, Hodeidah port handled around 70 percent of Yemen’s imports, including food and humanitarian supplies.

Fuel is vital to power water and sanitation stations to provide clean water and help avoid diseases, she said.

More than 11 million Yemeni children – virtually all – need humanitarian assistance, Relano said. UNICEF figures show 25,000 Yemeni babies die at birth or before the age of one month.

A child lies in a bed at a hospital in Sanaa, Yemen January 16, 2018

A child lies in a bed at a hospital in Sanaa, Yemen January 16, 2018. REUTERS/Khaled Abdullah

“Yemen is in the grips of the world’s biggest hunger crisis,” World Food Programme (WFP) spokeswoman Bettina Luescher said. “This is a nightmare that is happening right now.”

“We appeal to parties on (the) ground in order to stave off famine that we can continue regularly to get food in, to get medicines in, to get fuel in, be it from the humanitarian or the commercial side,” she said.

Luescher, asked about prospects for the Hodeidah port lifeline to remain open, replied: “Obviously since the cranes were imported and are operational, we are hopeful and optimistic that our work can continue.”

A diphtheria outbreak in Yemen is “spreading quickly”, with 678 cases and 48 associated deaths in four months, Fadela Chaib of the World Health Organisation said.

The number of cases has doubled since Dec 22, when the WHO reported 333 people affected by the highly-contagious disease, with 35 deaths. Ibb and Hodeidah are the worst-hit of the 19 affected governorates, Chaib said.

“We can stop the outbreak by providing antibiotics and also vaccinating,” she said. Some 2.5 million doses have been imported for a planned immunization campaign, she said.

(Reporting by Stephanie Nebehay; Editing by Larry King, William Maclean)