SERUM Institute of India and Bharat Biotech are expected to pursue late-stage clinical trials of intranasal COVID-19 vaccines in the coming months once they receive regulatory approval, India’s health minister has announced.

Dr Harsh Vardhan said the late-stage trial generally involves thousands of participants, sometimes 30,000 to 40,000.

Of the vaccines currently in Phase 3 trials, all are administered by injection, according to the World Health Organization (WHO).

On Saturday, India’s Dr Reddy’s Laboratories Ltd and the Russian Direct Investment Fund (RDIF) said they have received renewed approval to conduct late-stage clinical trials in India of the Russian COVID-19 vaccine.

India’s coronavirus infections rose by another 61,871 over the past 24 hours, data released on Sunday showed, although the health ministry said it is seeing a trend of steadily declining active cases.

The Indian Council of Medical Research (ICMR) said it will revisit its protocol for COVID-19 treatment after the WHO found some of the commonly used drugs, including remdesivir, had little or no impact on a patient’s chances of surviving, local media reported earlier on Sunday. – Thomson Reuters Foundation.

 

Source: The African Mirror

Zambia moved closer to becoming the first African nation to default on its dollar bonds since the onset of the coronavirus, making it a test case for nations worldwide battling to meet obligations to a range of lenders from bondholders to Chinese state banks.

Holders of Zambia’s $3 billion of Eurobonds will vote next week on the country’s request for a six-month interest-payment holiday. A core group of creditors have already rejected the proposal, prompting Zambia to say Tuesday it won’t be able to service its $3 billion of Eurobonds unless it gets the relief.

 

At the heart of the matter is how commercial creditors are treated in a planned restructure. Eurobond holders want the government to sign up for an economic program with the International Monetary Fund before tackling its commercial debt.

But Zambia’s debt levels are significantly above the Washington-based lender’s thresholds, and a general election in 10 months makes deep spending cuts less likely. There are also questions about transparency around borrowing from China, which accounts for roughly a third of the nation’s $12 billion of external debt.

Demanding Transparency

“Zambia is between a rock and a hard place with the IMF demanding transparency on Chinese loans and the political economy going into the elections next year that makes them reluctant to pull back from infrastructure projects, mostly Chinese backed,” said Ron Raychaudhuri, an emerging-market fund manager at APG Asset Management in Amsterdam. “Some Chinese lenders also seem to be reluctant to allow a moratorium until arrears are dealt with.”

 

The Group of 20 agreed Wednesday to renew a debt-relief initiative for the poorest countries through at least the first half of 2021, according to the World Bank president David Malpass, who warned that may not be enough as the coronavirus pandemic entrenches poverty.

Read more: G-20 Extends Debt Relief Program Amid Warnings It’s Not Enough

Zambia’s Eurobonds slumped for a second day on Wednesday, and are trading below half their face value. Notes due 2024 plunged 7% to 44.4 cents on the dollar by 4:13 p.m. in London. A coupon of $42.5 million on these securities is due on Wednesday, though there is a 30-day grace period before the country is technically in default.

Eurobond holders are due to meet on Oct. 20 to vote on the standstill proposal. Rafael Molina, an adviser to a group holding about 40% of the Eurobonds, declined to comment on Wednesday.

“We have yet to receive enough details from Zambian officials to vote on the consent,” said Kevin Daly, investment director at Aberdeen Standard Investments, which owns Zambian bonds. “I think having a dialogue would be more constructive than issuing press releases.”

 

In Africa, more than a dozen countries are in talks with China to freeze debt payments under a debt service suspension initiative agreed by the Group of 20 leading economies in April. Much of those negotiations, however, are done behind closed doors, raising complaints from commercial creditors worried that China will win better terms in upcoming debt restructuring.

Involving China

“It seems unlikely that the government will receive its deferral request,” Neville Mandimika and Daniel Kavishe, Johannesburg-based analysts at Rand Merchant Bank, said in a client note. “To ensure smooth debt management, the government must involve China and its agencies in its deliberations.”

The only foreign-currency debt that Zambia will continue to pay on time is to multilateral agencies and debt for a few priority projects that have an immediate economic and social impact, Fredson Yamba, the secretary to the Treasury, said in an emailed statement Tuesday. The country is already $485 million in arrears on foreign debt, including $183 million to bilateral lenders and $256 million on commercial loans, according to the finance ministry.

“Should Zambia fail to reach an agreement with its commercial creditors, including holders of its Eurobonds, on the terms of the appropriate standstills, the Republic with its limited fiscal space will be unable to make payments,” Yamba said.

If bondholders approve the standstill, Zambia “will recognize interest accruing on deferred coupons in the restructuring process, at a rate to be determined in good faith with noteholders,” Yamba said.

–With assistance from Alonso Soto.

Source: Aljazeera

MALAWIAN student Kondwani has fought against the stigma of being HIV-positive for most of his life, but COVID-19 has reignited old prejudices and given rise to a new term of abuse – “corona carrier”.

A widely held misconception that HIV-positive people are at high risk of catching the coronavirus is fueling discrimination and making it harder for them to access the medical care they need, health activists in the southern African country said.

Kondwani, 24, said it was also spreading anxiety among the 1.1 million people who live with HIV in Malawi – which has one of the world’s highest HIV rates, according to UK-based charity Avert.

“This stigma is bringing unnecessary fear on those living with HIV,” Kondwani, who asked to give only his first name, told the Thomson Reuters Foundation.

“(The truth is) everyone can contract it and everyone can die,” the agriculture student added.

The evidence for any link between HIV and COVID-19 is still evolving, said Peter Godfrey-Faussett, senior scientific advisor for UNAIDS, the joint U.N. programme on AIDS/HIV.

“While being HIV-positive does appear to slightly increase the risk for catching COVID-19 or for developing stronger symptoms, the risk is still much, much lower than for other conditions or characteristics such as advanced age, obesity or diabetes,” he said in an email.

However, many HIV-positive Malawians are now so scared of becoming infected with COVID-19 they are staying at home – skipping appointments to pick up medication or missing support group meetings, health workers and campaigners said.

There has also been a 35% drop in the number of HIV tests conducted during the lockdown, said Nuha Ceesay, UNAIDS’ country director, and health activists fear the COVID-19 pandemic could roll back years of steady progress to tackle HIV/AIDS in Malawi.

“If you cough or sneeze, people assume you have COVID, especially if they already know you are HIV-positive. People are now afraid to talk openly about their status,” said Grace Ngulube, 25, a Malawian health activist based in Blantyre.

‘AFRAID TO VISIT HOSPITALS’

According to the U.S. Centers for Disease Control and Prevention (CDC), key risk factors for people with HIV getting very ill if they catch COVID-19 are having a low CD4 cell count or not receiving effective antiretroviral (ART) treatment.

Of the 1.1 million HIV-positive Malawians, some 802,000 are taking antiretroviral medication, said Ceesay from UNAIDS.

Malawi has been relatively mildly affected by the coronavirus so far, with 5,800 confirmed cases and about 180 deaths, according to the African Centre for Disease Control.

But the pandemic has dealt a serious blow to the economy, forcing the government to channel budget resources toward healthcare and seek external financing to plug its fiscal deficit and ensure food security.

It has also forced aid groups and healthcare facilities in the country of nearly 18 million to rethink medical treatment and education campaigns for major public health crises such as HIV/AIDS.

“Voluntary male circumcision and HIV awareness programmes were suspended, mainly to make sure people don’t gather in crowds and expose them to COVID-19 risks,” Ceesay said.

Hope Banda, a 22-year-old community development student, said she and other HIV-positive people had been treated with suspicion by staff during recent hospital visits.

“Most of us are now afraid to visit hospitals because at the gate they check our health passport books,” Banda said, speaking at her grandmother’s home in Blantyre.

Health passports in Malawi document a patient’s medical history – including their HIV status.

The director of the Health Ministry’s HIV Treatment Unit Rose Nyirenda dismissed Banda’s allegations that HIV-positive people were being treated any differently.

“I don’t think it’s true,” Nyirenda said, adding that only if people were actively coughing from asthma or tuberculosis could they possibly be stigmatised as having COVID-19.

“Why should they pick on someone with HIV? Because most of the people with HIV are on antiretrovirals and just live a normal life,” she said in a phone interview.

Her department has sought to reduce congestion inwards and consulting rooms during the pandemic by dispensing enough medication to last patients for six months.

‘CORONA CARRIERS’

Violet Banda, who helps run the youth-led support group HIV(y+), lamented the uptick in long-standing stigma affecting her group’s roughly 8,000 members.

“We’ve now seen a trend where some of our members are being accused of being corona carriers,” she said, adding that some members had been finding it harder to check their viral loads or access sexual health services as hospitals prioritise COVID-19.

“People just need to get information from credible sources,” she added.

Banda’s priority during the pandemic has been ensuring her members can access reliable health information about how to keep themselves healthy.

“We’ve been distributing personal protective equipment to our members while educating them on HIV and coronavirus,” she said.

Lockdown restrictions have complicated such efforts, but door-to-door visits, online chats and phone calls have become part of groups’ support programmes during the pandemic.

Ngulube, the Blantyre-based activist who founded the National Association of Young People Living with HIV, has been using WhatsApp to keep in touch with members too scared to meet in person.

Echoing Banda, she said knowledge was key to fighting fear and prejudice against people living with HIV:

“We need civic education to fight these dangerous misconceptions.” – Thomson Reuters Foundation.

Source? The African Mirror

MANY nurses caring for COVID-19 patients are suffering burn-out or psychological distress, and many have faced abuse or discrimination outside of work, the International Council of Nurses (ICN) said.

Supplies of personal protective equipment for nurses and other health workers in some care homes remain insufficient, it said, marking World Mental Health Day.

“We are extremely concerned about the mental health impact on nurses,” Howard Catton, a British nurse who is the ICN’s chief executive, told Reuters Television at the association’s headquarters in Geneva. “Our most recent survey of national nurses’ associations shows that more than 70% of them (the associations) were saying that nurses have been subject to violence or discrimination and as a result of that they are very concerned about extreme cases of psychological distress and mental health pressure,” he said.

The figure was based on responses from roughly a quarter of its national nurses’ associations in more than 130 countries.

Nurses face a broad spectrum of issues that affect their mental health, including physical and verbal abuse, Catton said.

“There are nurses who have been subject to discrimination, where their landlord has not renewed their lease for their apartment, or they can’t get child care for their children,” he said, without giving specifics of physical or verbal abuse.

ICN has lobbied for better protection and working conditions for nurses on the front lines of the pandemic.

“We still continue to see problems with the supplies of personal protective equipment. There have been improvements, particularly in hospitals,” Catton said.

But some care homes and long-term care facilities in Europe, and in North and South America still lack supplies, he said, citing its members’ survey.

The World Health Organization said last Monday that services for mentally ill and substance abuse patients have been disrupted worldwide during the pandemic, and COVID-19 is expected to cause further distress for many. – Thomson Reuters Foundation.

Source: The African Mirror