Devex CheckUp: Emergency — pregnancy, TB care in Ukraine

A month has passed since the war in Ukraine began, and its implications for health access are being felt acutely across the country. We have been tracking the medicine shortages, attacks on health care workers and facilities, and ongoing relief efforts. Today, we’re focusing on a particularly vulnerable group: pregnant people.

• Since Russia’s invasion on Feb. 24, there have been at least 4,300 births with another 80,000 expected in the next three months — mothers and newborns who might not have access to critical maternal care, according to the U.N. The global body has also warned that oxygen and medical supplies, often key for the management of pregnancy complications, are running “dangerously low.”

• At least 64 attacks on health care have been verified since the start of the war, according to WHO. Last week, a mother and baby died after the bombing of a maternity hospital in the besieged town of Mariupol.

• In the past month, at least 15 out of 70 specialized perinatal centers for pregnant people in the country have stopped operating, the head of Women Health and Family Planning Charity Foundation tells Sam Mednick in a report for Devex. Data from some cities, such as Sumy and Kharkiv in the northeast and Mariupol to the southeastern, has been completely cut off amid airstrikes.

• Challenges for the functioning maternity hospitals are also manifold. Doctors are worried they might run out of medicines, and there is also a shortage of personnel. In Mykolaiv, a city on the front lines, two facilities lack electricity because of the conflict, leaving just one fully functioning maternity clinic in town: Maternity Hospital Number 3.

• Dr. Andriy Hrybanov, medical director for Maternity Hospital Number 3, says that the facility hasn’t yet received much international support from aid groups or the U.N. “Of course, it's a risky situation and that's why we need to react,” he says.

Read: Pregnant women struggle to access medical care on Ukraine's front lines

+ Catch up on all our coverage of the humanitarian response to the war in Ukraine.

Fresh air

COVID-19 was a wake-up call for the oxygen crisis in Africa. Prior to the pandemic, only two African countries — Ethiopia and Nigeria — had national oxygen policy road maps. According to Nigeria’s National Policy on Medical Oxygen in Health Facilities, more than 625,000 deaths occur annually due to diseases associated with hypoxaemia, which is the insufficiency of oxygen in the blood or low blood oxygen saturation.

“The number one priority for African countries is boosting oxygen production, so we can give critically ill patients a fighting chance,” Dr. Matshidiso Moeti, WHO regional director for Africa, said last year.

Experts are now warning that the lessons learned in the pandemic should not be forgotten, Paul Adepoju reports for Devex.

Read: How COVID-19 laid bare Africa’s medical oxygen crisis

One big number

That’s how much annual funding the Stop TB Partnership estimates will be needed over the next eight years for tuberculosis prevention and care. The figure marks an increase from a previous commitment to reach $13 billion in annual funding by 2022, a pledge that countries made during a 2018 U.N. meeting — but ultimately failed to meet. In 2020, only $5.3 billion was available for TB prevention and care.

TB continued

• It’s World TB Day today — and before COVID-19 emerged, tuberculosis was the world’s top infectious killer. But while pandemic preparedness efforts have seen increased funding and resources, including public funding, being given to organizations such as CEPI, TB doesn’t feature anywhere in these conversations, TB survivors and health access advocates Rhea Lobo and Ingrid Schoeman write for Devex.

• But a lack of attention and resources is not the only problem. Those ill with TB in Ukraine have found their treatment disrupted by Russia’s invasion, and in refugee-hosting European countries, aid organizations are navigating legal and regulatory barriers to procure multidrug-resistant TB medicines for refugees in need of this treatment, Jenny reports.

• Elsewhere, gender disparities are beginning to show. According to WHO, in 2018, men account for 57% of TB cases worldwide, whereas women account for just 32%, while the other 11% are children. Before COVID-19, Mumbai's TB cases had followed the same pattern seen worldwide. But the city’s doctors have begun to see a surprising reversal, and while they’re still investigating why that might be the case, malnutrition among women owing to food insecurity during the pandemic might be one of the reasons, Catherine Davison reports for Devex.

ICYMI: WHO releases new guidelines in treating TB in children

Late entrant

There’s a new company in town: Aerium Therapeutics, whose focus will be discovering and developing treatments for COVID-19, as well as further pandemic threats. Jenny asks Rajeev Venkayya, Aerium’s CEO and a former senior official at the White House and at the Bill & Melinda Gates Foundation, to how the company plans to ensure access to treatments in low- and middle-income countries.

Devex Pro: New biotech company focuses on COVID-19 treatments

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What we’re reading

Why COVAX was doomed to fall short of its goals. [Washington Post]

Africa’s low COVID-19 death rates could be due to its young population, lack of testing, and poor data, according to experts. [New York Times]

Moderna seeks U.S. FDA approval for its COVID-19 vaccine for children six months to six years of age. [AFP]