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232. Sarah Newey, Major Covid report suggests virus could have leaked from a US lab, 2022.09.14, https://www.telegraph.co.uk/global-health/science-and-disease/backlash-major-covid-origins-report-suggests-virus-could-have/. The Lancet’s paper said it is “feasible” that Sars-Cov-2 emerged from a natural spillover or a lab incident, but elements provoke backlash. However, discussion around the origins of Sars-Cov-2 was only a small element of the report, and experts said the rest of the paper was based on robust research.

231. Jeffrey D Sachs, Salim S Abdool Karim, etc., The Lancet Commission on lessons for the future from the COVID-19 pandemic, 2022.09.14, https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01585-9/fulltext. The authors argue that when facing COVID-19, the world’s major powers have failed to collaborate to control the pandemic and point out the multiple failures of international cooperation. The final part of the report presents policy recommendations, particularly around multilateral cooperation centred at WHO to address global health crises, and around investments in preparedness for future health crises through strong national health systems and international financing and technology cooperation with the world's lower-income regions.

230. Elliot Hannon, Layth Hanbali, etc., Why we still need a pandemic treaty, 2022.07.13, https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(22)00278-9/fulltext. What we learned from COVID-19 is that data and evidence play too small a role in decision making, which means that we need to focus less on what states should do and focus more on what they did not do, including why they did not comply with the IHR during the pandemic. An important step to prepare for future disease outbreaks is committing to a treaty that keeps the issue elevated at the head of state-level; so that states are ready to live up to their commitments and work together in a coordinated response when the next pandemic hits.

229. Donato Greco, What Does the Monkeypox Outbreak Tell Us about Global Health Governance? Critical Remarks on the New WHO Declaration of Public Health Emergency of International Concern, 2022.08.10, https://www.ejiltalk.org/what-does-the-monkeypox-outbreak-tell-us-about-global-health-governance-critical-remarks-on-the-new-who-declaration-of-public-health-emergency-of-international-concern/. On 23 July 2022, the Director-General of WHO declared that the outbreak of monkeypox constitutes a public health emergency of international concern. Against this backdrop, the present post is aimed at highlighting some critical issues related not only to the PHEIC declaration but, more generally, to global health governance, as designed by the IHRs and the WHO Constitution. If States will not effectively take into consideration these issues, both by amending the IHRs and strengthening the existing normative framework, one may wonder whether the WHO architecture can effectively address current public health challenges. Some authors took a rather sceptical view in this respect.

228. Emily A Siegrist, Joseph Sassine, Antivirals With Activity Against Monkeypox: A Clinically Oriented Review,2022.07.29, https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciac622/6651596?searchresult=1. Monkeypox virus is an emergent human pathogen. While it is less lethal than smallpox, it can still cause significant morbidity and mortality. In this review, we explore 3 antiviral agents with activity against monkeypox and other orthopoxviruses: cidofovir, brincidofovir, and tecovirimat. Cidofovir, and its prodrug brincidofovir, are inhibitors of DNA replication with a broad spectrum of activity against multiple families of double-stranded DNA viruses. Tecovirimat has more specific activity against orthopoxviruses and inhibits the formation of the extracellular enveloped virus necessary for cell-to-cell transmission. For each agent, we review basic pharmacology, data from animal models, and reported experience in human patients.

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