Saturday, August 8, 2020

Yemen's Multilayered War: The Failing Healthcare Infrastructure

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Anant Jani

Article Title

Yemen's Multilayered War: The Failing Healthcare Infrastructure

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Global Views 360

Publication Date

August 8, 2020

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Air strike Al-Thawra hospital, Hodeida on August 2, 2018

Air strike Al-Thawra hospital, Hodeida on August 2, 2018 | Photo credit: ABDO HYDER/AFP/Getty Images | Source: Felton Davis via Flickr

This is the 6th and last part of a short explainer article series on the current crisis in Yemen. To read the earlier parts of the series click on the link.

To read the 1st part of the series click on the link.

To read the 2nd part of the series click on the link.

To read the 3rd part of the series click on the link.

To read the 4th part of the series click on the link.

To read the 5th part of the series click on the link.

The civil war in Yemen, more so after 2015 has taken a toll on the civic infrastructure of the already fragile and poor country. Among these, the healthcare infrastructure of the country was one of the worst affected.

Apart from the physical damage to the hospitals and clinics due to the aerial bombings by the Saudi Arabia led coalition, the naval blockades exacerbated the dire situation. In June 2015 itself, aid agencies warned of the humanitarian risks brought by the US and UK-backed Saudi blockades.

The humanitarian situation aggravated further as there was a consistent famine since 2016 and Yemen was dependent on foreign aid for feeding almost 80% of its population.  According to UNICEF reports, over 3.3 million children and pregnant or lactating women suffer from acute malnutrition.

In 2017, the World Food Programme estimated that an additional 3.2 million people would be pushed into hunger. If left untreated, 150,000 malnourished children could die within the coming months.

Save the Children, the international charity and aid agency, estimated that 85,000 children under the age of five have starved to death in between 2015 to 2018.

Major healthcare operatives are dying due to the active bombing and conflict in Yemen, including personnel from MSF and United Nations Office for Coordination of Humanitarian Affairs (OCHO).

The MSF (or Doctors Without Borders), who have been in Yemen since 2007, have reported that fears of stigmatization are causing people to stay away from hospitals, with misinformation and lack of medical services only compounding the healthcare issue during the pandemic.

As of 24th July, the country reports 1640 confirmed infections and 458 related deaths.  Al Jazeera reported that “Cemeteries in Aden are overflowing with graves, suggesting that the number of people killed by the new coronavirus is higher than the official count.” Yemen and its related aid agencies also suffer from lack of PPEs and adequate information about the pandemic.

As of April 2020, there are 800,000 internally displaced persons in just one province of Yemen Marib. The number of verified civilian deaths stands at 7,700.

The United Nations has been continually asking for donations, but has failed to collect as much as it requires. While it collected $4 billion last year, it has only received $700 million, halfway into 2020.

The UN urged for $2.4 billion this year to fight the humanitarian crises and the Coronavirus. As of 2nd June, 29 countries and the European Commission pledged a total of $1.35 billion to support humanitarian efforts in Yemen, just over half of the amount needed to sustain programs through the end of this year.

In April 2020, the Saudi deputy defence minister, Prince Khalid bin Salman, said Saudi Arabia “will contribute $500m to the UN humanitarian relief program for Yemen in 2020, and an additional $25m to help combat the pandemic. It is up to Houthis to put the health and safety of the Yemeni people above all else.”

There are 41 major UN programmes in Yemen, and it is estimated that more than 30 of them will close due to lack of funds. The UN stated, “Due to the COVID-19 suppression measures, all integrated outreach activities, which include the Expanded Programme on Immunization, Integrated Management of Childhood Illness, Maternal and Newborn Health,and nutrition activities, were suspended.”

Most of Yemen's 3,500 medical facilities have been damaged or destroyed in air strikes, and only half are thought to be fully functioning. Officials warn that monetary relief may not be enough to assist in the war against the pandemic alongside the Civil War. A solution to the war must be found soon, before the pandemic eviscerates more of the healthcare infrastructure.

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February 4, 2021 5:14 PM

Asian countries & the race for COVID-19 Vaccine

Our relationship with the new strain of coronavirus is almost 8 months strong now. Countries like the US, Russia, UK, China, India, and many more have already set their brainy scientists in the task of developing a vaccine, turning it into a race which desperately needs a winner, since no one wants this deadly relationship to endure. Several attempts have proved to be successful, especially in countries like Russia, USA, India, and China.

China was the first to start scouring for a vaccine the day WHO declared that the new strain of SARS-CoV, originating in Wuhan-China, has resulted in a pandemic. It is a fierce competitor, especially to the US, as almost 8 of the 24 promising vaccines approved for clinical trials are from China. It used the technology of ‘inactivated vaccine’ which basically means killing the actual virus and using that to create a vaccine. This method is quite useful in treating measles and influenza, thus, increasing the chances of success in the case of COVID-19 as well.

“It’s a tried and true strategy”, Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, said  about the inactivated vaccine. One potential vaccine from China-based Sinopharm is already in the phase 3 of trials whereas Sinovac will enter the third phase this month. Moreover, China has permitted Sinovac and Sinopharm to dilute phase 1 and 2 of vaccine trials on humans to hasten the process.

The head of the Chinese Center for Disease Control and Prevention, Gao Fu, had also been injected with a potential vaccine on July 28, 2020. “I’m going to reveal something undercover: I am injected with one of the vaccines'' Gao Fu said in a webinar hosted by Alibaba Health, an arm of the Chinese e-commerce giant, and Cell Press, an American publisher of scientific journals. However, he did not reveal any more details about how and when exactly he administered himself with the vaccine and ‘hopes’ that the vaccine works.

Vladimir Putin, President of Russia | Source: Wikimedia

Elsewhere in Russia, on August 11, 2020, President Vladimir Putin proudly announced that Russia was the first country to grant regulatory approval to their vaccine after carrying out human trials for less than 2 months by the Gamalei Institute in Moscow. Regulatory approval permits vaccination of the masses. Although it has not undergone phase 3 of trials, Russia expects to initiate mass production of the vaccine by the end of this year. Kirill Dmitriev, head of Russia's sovereign wealth fund states that the vaccine will be called ‘Sputnik V’, named after Sputnik 1, the first satellite launched by Soveit Union which was a euphoric moment for Russia. More recently, China and Russia have joined hands in proceeding with the clinical trials of their vaccines.

These two instances seem to bring a new hope for the future, yet raise alarms and invite scepticism from the experts in the field of public health. One major concern is that without prolonged trials, vaccines should not be authorized for public use. Anthony Fauci, an infectious disease expert based in the US said “I do hope the Chinese and the Russians are actually testing the vaccines before they are administering the vaccine to anyone. Because claims of having a vaccine ready to distribute before you do testing is problematic at the very least”. Hence, some people are still in doubt regarding the safety of the product. Putin, however, rubbished such concerns and said "I know that it works quite effectively, forms strong immunity, and I repeat, it has passed all the needed checks".

An Indian biotechnological company, Bharat Biotech developed ‘Covaxin’ in collaboration with Indian Council for Medical Research (ICMR), using the mechanism of inactivated vaccine. It was successful in getting approval for human trials which were scheduled to begin in July, 2020. Initial reports stated that it would be ready for mass use by August 15, 2020, which also marked the 73rd Independence Day of India. However, Bharat biotech was clear in letting the public know that phase 1 of the trials are still on-going. ICMR cleared the confusion by stating that it would prepare the results of the phase 1 trials by August 15, 2020, not the actual vaccine for use. Phase 2 of the trials are awaited in September, 2020.

So far, the results of phase 1 trials have been positive as no serious side-effects are observed in the vaccine candidates. “The vaccine has been safe. No adverse effect has been reported. Even the point of injection pain, which is normal in vaccines, has been very mild” said Dr Kushwaha of Prakhar Hospital.

Meanwhile, the South Korean government stated on August 21, 2020, that it will secure adequate vaccine supply to its citizens by cooperating with international bodies and promoting local drug development. Three South Korean companies have started the process of making a vaccine and all are in the clinical trial phase. Bill Gates asserts that the South Korean pharmaceutical company, SK Bioscience, will have around 200 million vaccine doses ready by June 2021.

Japan is jointly collaborating with the UK, France and other European countries to establish a $20 billion fund to buy coronavirus vaccines, with Japan pledging a contribution of $800 million. It’s vaccine program aims to focus on giving primary attention to its medical workers and the elderly people of the country when the first doses of the vaccine are made. The state-funded vaccination program is believed to be officially adopted by Japan in September this year with negotiations with the UK and US based drug makers already in place.

With the race to bring COVID-19 vaccine seemingly coming to a close and it will hopefully be ready by the end of 2020 or early 2021. Till then, the entire world is watching this race with bated breath.

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