I have been quite busy with book writing, but here are a few updates, starting with Japan’s public health measures after lifting the emergency state. From 1-7 June 2020, the Japanese Ministry of Health, Labour and Welfare began blood testing approximately 10,000 members of the public in Tokyo, Miyagi and Osaka prefectures to measure national antibody levels (我が国の抗体保有状況) and trace the infection’s history.[1] This will be done in combination with PCR testing, which remains in hospitals and healthcare institutions, and is sourced from FujiRebio’s エスプライン®︎, the first nationally approved COVID-19 antibody testing kit.[2] Early results announced 16 June after testing 8,000 people showed that the Japanese population in these three locations showed low antibody rates: 0.17% (Osaka), 0.1% (Tokyo) and 0.03% (Miyagi).[3] The preliminary study concluded that the public health implications are too soon to tell with such a small sample, but will help inform emergency measures as the situation normalises. Many other countries are conducting similar national antibody measuring tests, though in the UK this will first draw from healthcare workers.[4]
On 15 June 2020, the US FDA has revoked the emergency COVID-19 treatment use of antimalarials hydroxychloroquine and chloroquine, noting recent results in a clinical trial found these drugs not effective enough balanced against risks for heart health.[5] I still haven’t unpacked the implications, whether they are scientific, bureaucratic or geopolitical. A 200 billion GBP merger between Gilead (Remdesivir-ebola and COVID-19) and AstraZeneca was rumored as the biggest ever M&A in the pharmaceutical sector, but recent news has reported that this has fallen through.[6] AstraZeneca was in the midst of vaccine development in collaboration with Oxford University, receiving $1 billion from US BARDA, but beyond this American injection of funds to accelerate delivery, commentators are unsure what the M&A was intending to achieve.[7]
In vaccine news, on 4 June 2020, GAVI’s Global Vaccine Summit, hosted by the UK government, amassed pledges of $8.8 billion for the next 5 years.[8] A full breakdown of the pledged funds here: <https://www.gavi.org/sites/default/files/2020-06/4-June-2020-Global-Vaccine-Summit-Gavi-3rd-Replenishment-Chairs-Summary.pdf>.
I will do another analysis in a following post, but for here, I will point out the past histories that have led to this current practice of ‘global’ vaccine development and funding. Vaccination fascination in international health began in earnest in the 1980s, a topic I am just now covering in my book’s first chapter. Following the successful eradication of smallpox declared in 1980, WHO and UNICEF began thinking that vaccines were a more realistic disease control strategy, particularly for international agencies as UN funding declined while health sector needs expanded in developing countries during the debt crises of the 1980s. WHO’s Global Programme on AIDS (GPA) began the practice in 1989 of bringing together a wide range of research actors in this new vaccine field and establishing standards for clinical trials in developing countries. But for the first time, it had to contend with, not just established pharma houses and university laboratories, but new genres of global health actor: the grassroots biotech company and ambitious individual clinicians. These new actors gained access to established international health agencies in interesting ways.
For instance, I have just now found a letter from one of these new vaccine biotech company’s chairman to WHO, offering a donation of vaccine reagents to gain access to clinical trials in developing countries (I can no longer find evidence of this company through a simple internet search), which WHO declined. Keeping in mind this is all new territory, and there were few rules of appropriate dialogue, beyond WHO setting guidelines on vaccine trials in developing countries including promises for full access if successful, there are implications here about the supply of vaccine reagent materials, as I covered in a previous post with chemical compounds for treatments. Between these potential vaccine developers, GPA cleverly positioned itself as both a central information clearinghouse, through its AIDS Reagent Project, and an intermediary and gatekeeper, as developing countries also saw the benefits of being a trial site, which included improving local clinically trained manpower and laboratory capacity.
This idea subsequently morphed through several iterations: the International AIDS Vaccine Initiative out of Rockefeller Foundation launched 1994 and the Global AIDS Vaccine Initiative (GAVI) by the Bill and Melinda Gates Foundation in 2004. And here we come to the international GAVI pledging conference on 4 June 2020, please find here with English subtitles: <https://www.youtube.com/watch?v=4Zcoz_c8dYc>. It is over 4 hours long, and I will consider in my next post breaking the conference down into the most important takeaway points.
In a completely different yet equally exciting area of global interaction, and a personal passion of mine, I wish GAVI had been as efficient about its presentation as Sony was in the recent PlayStation 5 Future of Gaming announcement on 11 June. Hopefully Microsoft, another Gates venture, with the Xbox announcement planned for July will take some notes. In my opinion, gaming commentators have not talked as much about PlayStation’s focus on indies having a greater capacity and scale on the PS5. I suspect the presentation was designed to appeal to a wide range of audiences, beyond the typical E3 blockbuster announcements. To be fair, Future of Gaming did sandwich major titles, like Horizon 2, Demon Souls, Resident Evil 8 and Marvel’s Spiderman: Miles Morales. In that sense, it was two-birds/one-stone: Sony iterates on the E3 model since it did not attend last year, and PS5’s Future of Gaming Show also acts like a trade-show to attract smaller developers. Indies don’t just need to sell anymore, they have the chance to scale up their ideas and achieve a greater vision. I think PlayStation’s intention was to show these developers that PS5 can optimise their ideas. Most importantly, this reinforces the purpose of a console: to help smaller developers deliver their insights in the best way, which is very good for the industry: creators, developers, console developers and consumers. Games at any scale matter, now more than ever, and I’m extremely excited for the Future of Gaming.
Most anticipated games: Elden Ring, new Silent Hill, Zelda BOTW 2.
[1] テレ東N E W S、「抗体検査はじまる」1 June 2020, <https://youtu.be/x2L6FCcIBR0>. [2] 厚生労働省、「抗原検査について」<https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000121431_00132.html>; Fujirebio, 「製品概要エスプライン®︎SARS-CoV-2」, <https://www.fujirebio.co.jp/products/espline/sars-cov-2/index.html>. [3] MHLW, 「抗体保有調査結果」16 June 2020. <https://www.mhlw.go.jp/content/000640287.pdf>. [4] UK Department of Health & Social Care, ‘Guidance Coronavirus (COVID-19): antibody tests’, 22 May 2020. <https://www.gov.uk/government/publications/coronavirus-covid-19-antibody-tests/coronavirus-covid-19-antibody-tests>. [5] テレ東N E W S、「米 抗マラリア薬のコロナ治療への許可撤回 トランプ氏も服用」16 June 2020, <https://youtu.be/fejCzryFx6o>; US FDA, ‘Memorandum Explaining Basis for Revocation of Emergency Use Authorization for Emergency Use of Chloroquine Phosphate and Hydroxychloroquine Sulfate’, 15 June 2020. <https://www.fda.gov/media/138945/download> and <https://www.fda.gov/drugs/drug-safety-and-availability/fda-cautions-against-use-hydroxychloroquine-or-chloroquine-covid-19-outside-hospital-setting-or>. [6] ‘COvid-19 vaccine: AstraZeneca has “approached Gilead over possible merger”’, Guardian, 7 June 2020, <https://www.theguardian.com/business/2020/jun/07/covid-19-vaccine-astrazeneca-approached-gilead-over-possible-merger>. [7] ‘AstraZeneca advances responses to global COVID-19 challenge as it receives first commitments for Oxford’s potential new vaccine’, 21 May 2020. <https://www.astrazeneca.com/media-centre/press-releases/2020/astrazeneca-advances-response-to-global-covid-19-challenge-as-it-receives-first-commitments-for-oxfords-potential-new-vaccine.html>. [8] UK Government International aid and development, ‘PM Global Vaccine Summit closing remarks: 4 June 2020’, 4 June 2020 <https://www.gov.uk/government/speeches/pm-global-vaccine-summit-closing-remarks-4-june-2020>.