Devex CheckUp: Tonga can’t afford another crisis — especially COVID-19

Nearly two weeks have passed since the eruption of a submarine volcano to the north of Tonga’s main island caused a tsunami, leading to massive destruction across the country. But those responding to provide humanitarian assistance are mindful that Tonga has only recorded one case of COVID-19, and any aid flowing into the country also risks inadvertently importing the pandemic.

So the government has requested contactless delivery of supplies. While this will slow the response, aid workers tell Lisa Cornish they are quite aware of the potential threat of a fast-spreading virus in an already fragile country.

• “Ultimately, we're in the hands of the Tongan government,” Australia’s defense minister, Peter Dutton, has told media. One Australian plane had to turn around when a COVID-19 case was confirmed aboard, and aid delivery was held up when a ship ready to deliver supplies announced 23 confirmed cases.

• “Tonga does not need a COVID disaster on top of the impacts of the eruption and tsunami,” Sophie Ford, response manager for international programs with the Australian Red Cross, tells Lisa. “It would potentially devastate the community of 107,000 people and overwhelm the health system.” Almost 61% of the population is fully vaccinated.

• The Tongan government has instituted a three-week quarantine period — and any ship or plane carrying aid supplies can “either stand off or it can port [and] offload the equipment,” making sure the risk of transmitting COVID-19 is “negligible,” Dutton says.

• Tonga, like other Pacific Island countries, is no stranger to the traumatic history of colonial forces bringing life-threatening diseases. Various epidemics — from measles, dysentery, and influenza to the Spanish flu — have severely affected its communities.

• Added to the risk of COVID-19, exposure to air pollution after a volcanic eruption may also put people at risk of acute and chronic respiratory diseases and access to safe drinking water remains a concern, a WHO spokesperson tells Amruta. “There are reports of water reservoirs being contaminated and in the main island of Ha'apai, groundwater has been contaminated with saltwater. There may be a risk of water-borne diseases such as diarrhea if people drink from contaminated water sources,” according to the spokesperson.

Read: The race to avoid a new crisis in Tonga 

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In the supply chain

This year, USAID plans to make one of the largest and most important award decisions in its history: a 10-year, $17 billion suite of nine contracts that will collectively fund the procurement and distribution of life-saving health commodities around the world and form the backbone of global health initiatives including PEPFAR and the President's Malaria Initiative, our colleague David Ainsworth reports.

Devex Pro on USAID: Contracts that could permanently alter the U.S. contracting landscape

+ Stay tuned for more on these contracts. Have any tips, concerns, or questions about this project? Email michael.igoe@devex.com.

+ The next edition of Money Matters, our free weekly newsletter on global development's latest funding opportunities, will feature the top grantees of USAID in 2021. Sign up to receive it on Monday.  

Have faith in clinical trials

Clinical trials have a diversity problem. A 2020 global analysis of participation in clinical trials found that 76% of participants were white, 11% were Asian, and 7% were Black.

The HIV Vaccine Trials Network is trying to change that. Through its Faith Initiative, it’s working to ensure that different types of communities feel comfortable enough to participate in and support HIV vaccine trials.

In 2020, HVTN set up the COVID-19 Prevention Network, through which a group of faith leaders across the United States have worked to educate communities on COVID-19 and its vaccine trials, build trust in the research process, and counter vaccine hesitancy, Sara Jerving reports.

Read: HIV vaccine network using faith to expand clinical trial enrollment

Dispatch from the EB

Jenny has been keeping a close eye on this week’s 150th meeting of WHO’s executive board, which is packed with some contentious agenda items. Here’s what member states have been debating so far:

Tedros gets nominated for a second term. With no other candidates in the running for the WHO director-general position, Tedros Adhanom Ghebreyesus’ reelection bid is all but guaranteed — member states will vote at the 75th World Health Assembly in May. But the job isn’t about to get easier, given the COVID-19 pandemic and member states’ calls for more reforms within the agency. And the push to have member states provide more flexible and predictable financing to WHO, in Tedros’ own words, “has not moved an inch.”

No assessed contribution increase. Björn Kümmel, chair of WHO’s working group on sustainable financing, says no consensus has been reached on the group’s proposal to gradually increase member state contributions to cover 50% of WHO’s core budget by 2029 — although countries understand that the agency’s current funding model is unsustainable.

But they’re not giving up just yet. Countries have agreed to extend the mandate of the working group until the 75th WHA in hopes of reaching some consensus by then, even if that involves an alternative financing solution.

+ ICYMI: Pro subscribers can catch up on the “new momentum” to reform how WHO is funded.

Clarity on the emergency committee. Austria proposed creating a standing committee within WHO’s executive board that would meet within 24 hours after the declaration of a public health emergency of international concern and provide guidance and recommendations to the board. Additionally, “upon request,” the committee would advise the director-general following a declaration.

Some member states welcomed the proposal, but several raised questions about its added value. Norway expressed concern that it may only delay action from WHO as its leadership awaits advice from the proposed committee.

Targeted amendments to the IHR. The United States and several other countries put forward a draft decision to start discussions on strengthening the International Health Regulations. Several member states welcomed the decision, while emphasizing the importance of making discussions inclusive and transparent.

Read: Tedros lays out WHO’s priorities for the next 5 years

Pandemic pains

That’s how much the COVID-19 pandemic will cost the global economy by 2024, according to latest estimates from the International Monetary Fund. The figure represents an increase from a previous estimate of $12.5 trillion.

What we’re reading

Israel recommends a fourth COVID-19 vaccine dose for people age 18 and over. [Financial Times]

Scientists are racing to develop new COVD-19 antiviral drugs amid the looming threat of resistance. [Nature]

Zimbabwean billionaire and African Union special envoy on COVID-19 Strive Masiyiwa joins the Gates Foundation’s board of trustees, the foundation announced Wednesday. [Devex]