SAVING NEWBORNS WITH SOMEBODY ELSE’S BREAST MILK — Newborn deaths have seen a massive decline globally over the past three decades, but sub-Saharan Africa bears the highest rate: At least 27 of every 1,000 children born in the region do not survive their first 28 days. Access to breast milk, which confers vital nutrients and can help prevent infections, could save their lives.
“Breast milk has components that help a baby survive compared to formula,” Victoria Nakibuuka, a Ugandan neonatologist, told Global Pulse.
But not every child has access to a caregiver who can breastfeed them and not every mother can breastfeed her child. That is why Nakibuuka set up a human milk bank in Uganda’s capital, Kampala, late last year — to collect, test, process and, ultimately, distribute donated human milk for babies in need.
“The smallest neonates would not be surviving without our unit,” said Emily Njuguna, the head of the pediatrics department at Pumwani Maternity Hospital in Nairobi, Kenya. The hospital opened a human milk bank in 2018. Njuguna estimates 100 newborns now use the service each month.
Kenya and Uganda are rare exceptions in the region. Despite the high rates of newborn deaths and reports that up to 40 percent of the most vulnerable and sick newborns do not have access to their mother’s milk, fewer than 10 countries in sub-Saharan Africa have a single milk bank. Experts said that building a network of milk banks across each country could save thousands of newborn lives in the region every year.
The milk bank shortage stems from a lack of funding and stigma about sharing human milk. The Covid-19 pandemic fueled fears of disease transmission via breast milk, though research doesn’t indicate any risk. But acceptance of milk banking is growing on the sub-continent, driven by the success of existing milk banks.
Njuguna said there was stigma when Pumwani initially opened the bank, but it has been overcome through the experiences of families whose children have benefited from the service. Nearby facilities now request supplies.
And while there are concerns within health ministries about price — Njuguna said the Pumwani unit cost more than $65,000 to set up — experts said the undertaking doesn’t have to be hugely expensive, particularly in more remote settings where less advanced equipment could be deployed. The Seattle-based non-governmental organization PATH is trying to reduce the price tag even further by introducing low-cost innovations like monitoring human milk pasteurization with a cell phone.
More assistance should also be forthcoming, with the World Health Organization preparing to draft guidelines on human milk banking. Experts cautioned that the guidelines must be adaptable to low-resource settings, though.
Penny Reimers, an official with the Human Milk Banking Association of South Africa, emphasizes that human milk banking is part of a continuum of care that includes lactation and breastfeeding services. Such care would ensure a mother could ultimately take over the breast milk provision for her infant and continue breastfeeding after they are discharged from the hospital.
“Donor milk does help,” Reimers said. “But if there’s a mother around, we need to do everything we can to support her to provide her own milk for her baby and to breastfeed.”
Andrew Green is a freelance writer in Berlin.
WELCOME BACK TO GLOBAL PULSE, where we hope your vacation won’t be ruined by monkeypox (or Covid), like it did for this man in Jamaica.
SIERRA LEONE TO OPEN UP ABORTION ACCESS — In a break with the past, the government of Sierra Leone is pressing to replace an 1861 law that prohibits abortion under any circumstances.
President Julius Maada Bio has said his cabinet backs a bill on safe motherhood and reproductive rights, which would legalize abortion, improve access to contraceptives and provide comprehensive sex education.
Last month, Supreme Court Justice Samuel Alito cited an an uncontested historical review of abortion restriction to overturn a federal right to the procedure. But Sierra Leone is headed in the opposite direction, dropping a British colonial era-law to make abortion more easily accessible to women and girls.
Saving lives: When it comes to maternal mortality, Sierra Leone is the third worst in the world — in 2017, more than 1,100 women died for every 100,000 live births. Up to a tenth of those deaths are due to unsafe abortions, said Nicky Spencer-Coker, who leads advocacy and movement building at Purposeful, an African women’s rights NGO.
Women who can’t afford to pay doctors to perform an abortion confidentially “are at the mercy of whatever local remedy or whatever backstreet quack happens to be available in the community,” she told Global Pulse.
The time is now: A previous attempt to liberalize abortion failed in 2015, but Spencer-Coker is confident that things will be different now because the bill is broader than just abortion and already has presidential backing.
While the exact abortion rules are still being drafted, she is certain that there will be some restrictions due to the “religious and cultural context” in the country.
“What we will continue to do is work with the drafters to ensure that the wording is the most permissive, most liberal, […] providing the most choice for women and girls,” she said.
WHAT TO EXPECT AT NEXT WEEK’S ‘PANDEMIC TREATY’ MEETING — The much-discussed WHO pandemic preparedness agreement between countries is currently big on goals and small on plans to accomplish them, according to an early draft obtained by POLITICO.
The document from the WHO’s bureau of the Intergovernmental Negotiating Body shows few answers about how a treaty would be structured or enforced — or the legal force it could hold. The early draft emphasizes each country’s sovereignty.
The document also shows some priorities the INB is eyeing for an agreement:
- Efforts to share (or protect) vaccine tech and other pandemic tools — already an issue of debate
- A focus on equity, especially to build up health systems around the world
- Improvements to global pandemic surveillance and prevention programs, including data sharing and environmental goals to prevent disease spillover
Time is of the essence for the negotiations. Some leaders in the talks are looking to coordinate a global agreement with the World Bank’s Financial Intermediary Fund also aimed at tackling pandemic preparedness. But the FIF is expected to start its work this fall, making coordination dependent on timely negotiations.
PREPPING FOR THE NEXT WAVE — Countries around the world are looking to prepare for the next wave of Covid-19 infections, largely powered by new BA.4 and BA.5 omicron subvariants.
The U.S. is mulling second boosters for adults — while planning for an additional, Omicron-specific booster later in the year. And Europe has urged older people to get second boosters now instead of waiting for a new version of the vaccine.
Omicron-specific boosters are expected to come in the fall — and be more effective than current formulations. But officials are concerned with faster action as case counts grow.
“The virus is running freely, and countries are not effectively managing the disease burden,” WHO Director-General Tedros Adhanom Ghrebeyesus told reporters Tuesday.
GOUT AND DEPRESSION MEDS NOT FOR COVID — The WHO said Wednesday evening that common drugs to treat gout and depression should not be used for non-severe Covid-19, adding there was no guidance on their use in severe cases.
Some global health leaders were hopeful about the drugs’ possible reach because they are common and inexpensive, but the treatments’ potential harms and weak evidence led to the new recommendation.
The new guidance says fluvoxamine, a common antidepressant, should not be used outside of clinical trials for mild Covid-19 cases, despite some hype around the drug in the pandemic. The FDA issued a similar ruling earlier this year.
And the WHO strongly recommended against using colchicine, a drug used to treat gout, for non-severe Covid-19. The recommendations didn’t mention using the drug in future clinical trials.
MORE TPOXX FOR CANADA — Canada has ordered about $26 million for tecovirimat, an antiviral showing promising results for monkeypox, according to Siga Technologies, the maker of the drug.
The company also announced $2 million in orders for other international regions, and the drug, also called TPOXX, recently received approval to treat monkeypox in the U.K.
The recent orders highlight a continued scramble to prepare for continued spread of the virus.
Global Press Journal: Food and medicine shortages in Sri Lanka endanger pregnant women.
The New York Times: The Baduy, an indigenous group in Indonesia, believe that vaccinations are impure, and unnecessary, and that their beliefs protect them. To skeptics, they note their Covid death toll: zero.
Thomson Reuters Foundation News: After Roe v. Wade, health care data privacy fears grow worldwide.