International
UK could get COVID vaccines early in 2021, ahead of other European countries
UK could get COVID vaccines early in 2021, ahead of other European countries

COVID-19 vaccines could be approved and available early next year in the UK ahead of other European countries, after its national regulator began its own rolling reviews of shots from AstraZeneca and Moderna.
AstraZeneca has confirmed that the UK’s Medicines and Healthcare Products Regulatory Agency (MHRA) has begun a fast-track rolling review of its AZD1222, the COVID-19 vaccine it developed in conjunction with Oxford University.
This followed last week’s news that the MHRA has begun a parallel rolling review of a rival from Moderna.
The rolling review allows for a real-time assessment of the clinical data from clinical trials, accelerating a process that normally takes around a year to complete using the centralised European regulatory system.
Using the MHRA could allow the UK to make regulatory decisions on COVID-19 vaccines ahead of the European system, where medicines and vaccines are first reviewed by the CHMP scientific committee before being passed on to the European Commission.
The European Medicines Agency (EMA) has already announced its own fast-track rolling reviews of AZ’s vaccine and a rival from Pfizer/BioNTech, although it has not given a timeline for a regulatory decision.
But a source close to the process told pharmaphorum that it is “eminently possible” that the MHRA could reach its conclusions early next year and ahead of its European counterparts as the country reaches the end of the Brexit transition period.
A spokesperson for the MHRA confirmed this is possible and said that from 1st January, it will have new powers to approve medicines, including vaccines with “greater flexibility to do this faster, while maintaining the highest standards of safety, quality and effectiveness.”
The spokesperson said: “The MHRA will evaluate the data rigorously on the quality, safety and effectiveness of COVID-19 vaccines to reach a scientifically robust independent opinion if an earlier authorisation is necessary before the EMA authorises a product.”
“Patient safety is our top priority. The independent Commission on Human Medicines will advise the UK government on the safety, quality and effectiveness of any potential vaccine. No vaccine will be deployed in the UK unless stringent standards have been met through a comprehensive clinical trial programme”
Representatives of the MHRA used to sit on the CHMP but no longer participate as a result of Brexit, leaving the UK to make its own decisions on medicines regulation should it choose to do so.
According to the source, COVID-19 vaccines could be available in early January depending on the length of time it takes for trial data to be published and shared with regulators.
COVID vaccines are being developed at warp speed, with the development and review process that normally takes up to a decade to complete compressed into less than a year after research began at the end of January.
The MHRA’s approach to the AZ and Moderna vaccines also paves the way for similar fast reviews to rivals from the likes of Pfizer/BioNTech and Novavax, which the UK government also has on order and are reaching the end of the clinical trial process.
The news comes as the country prepares for another national lockdown, which will disrupt business and limit people’s freedoms for at least another month.
A vaccine is seen as a potential way out of the cycle of lockdowns that have already caused severe hardship across the UK, which is one of the countries worst hit by COVID-19.
An AstraZeneca spokesperson told pharmaphorum: “Results from the late-stage trials are anticipated later this year, depending on the rate of infection within the communities where the clinical trials are being conducted. It is then up to the regulatory bodies to review and make approval decisions based on this data, as quickly as possible.
“The EMA announced in October that its CHMP had started a ‘rolling review’ of data for AZD1222, the first COVID-19 vaccine to be evaluated under these arrangements. We confirm the MHRA’s rolling review of our potential COVID-19 vaccine.”
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International
MENA Region Faces Another Threat: Water Wars
MENA Region Faces Another Threat: Water Wars
Agricultural water withdrawal way beyond the limit of renewable freshwater resources is most…

Agricultural water withdrawal way beyond the limit of renewable freshwater resources is most common today in countries in the Middle East and North Africa.
Statista's Katharina Buchholz reports that, according to the FAO Aquastat database where the latest available year for the data is 2020, several other nations, with Spain, South Africa, South Korea, Pakistan and India all sticking out for using up a higher share of their freshwater resources in agriculture than their neighbors.
You will find more infographics at Statista
Desert climates like on the Arabian peninsular make countries there overextend their annual water budgets by agriculture alone.
This has led to studies concluding that the United Arab Emirates, for example, could run out of groundwater by 2030. In Pakistan and Iran, between 63 and 70 percent of renewable freshwater resources were dedicated to agriculture in 2020, rising to 68 and 77 percent including all freshwater uses. Extensive and water-intensive agriculture, including cotton crops, is also driving up freshwater use in the semi-arid climates of Central Asia. Here, Uzbekistan used 111 percent of renewable water resources per year, followed by Turkmenistan at 65 percent (106 percent when counting all freshwater use). The only other country extending its freshwater budget only when combining agriculture and other freshwater uses was Jordan.
Agriculture accounts for 72 percent of all freshwater withdrawals globally, including a lot of overuse. According to the FAO, global freshwater resources per person have declined by 20 percent in the past decades, while water availability and quality have also deteriorated. Additional factors playing a role in this are pollution and climate change, stretching the precious resource even thinner.
October 16 marks World Food Day, which this year has the motto: Water is life, water is food. Leave no one behind.
Government
Biden Admin Orders Banks Not To Reject Illegal Immigrants’ Loan Applications
Biden Admin Orders Banks Not To Reject Illegal Immigrants’ Loan Applications
Authored by Tom Ozimek via The Epoch Times (emphasis ours),
The…

Authored by Tom Ozimek via The Epoch Times (emphasis ours),
The Biden administration has warned U.S. banks and other financial institutions that they can't reject illegal immigrants' credit applications based solely or predominantly on their immigration status.
The Department of Justice (DOJ) and the Consumer Financial Protection Bureau (CFPB) said in a recent statement that rejecting illegal immigrants for credit cards and various types of loans just because they are noncitizens is unlawful.
The two agencies stated that they were issuing the warning "because consumers have reported being rejected for credit cards as well as for auto, student, personal and equipment loans because of their immigration status, even when they have strong credit histories and ties to the United States and are otherwise qualified to receive the loans."
Specifically, the agencies cited the provisions of the Equal Credit Opportunity Act (ECOA), which protects credit applicants from discrimination based on such characteristics as race, religion, sexual orientation, and national origin.
The agencies argue that protections afforded by ECOA and other laws extend to alienage, so banks that have blanket policies to deny loans to illegal immigrants may be breaking the law.
“Lenders should not deny people the opportunity to take out a loan to buy a home, build their businesses or otherwise pursue their financial goals because of unlawful bias and without regard to their actual ability to repay,” Assistant Attorney General Kristen Clarke of the DOJ's Civil Rights Division said in a statement.
“Fair access to credit is crucially important for building wealth and strengthening household financial stability,” CFPB Director Rohit Chopra said in a statement. “The CFPB will not allow companies to use immigration status as an excuse for illegal discrimination.”

Bud Cummins, a former U.S. attorney, objected to the agencies' warning to banks and other financial institutions.
"DOJ and CFPB tell banks it might be illegal to refuse to loan money to people [who] broke federal law to reach the bank. You gotta be kidding me. The invasion of illegal immigrants is intentional and must be stopped," he wrote on X, formerly known as Twitter.
According to the Center for Immigration Studies, there were roughly 11.35 million illegal immigrants residing in the United States as of January 2022.
More Details
The agencies said that ECOA protections extend to alienage, although in a joint statement, they acknowledged some gray area, namely that the act "does not expressly prohibit consideration of immigration status."
Some financial institutions have maintained blanket policies denying people credit based on their immigration status, without regard for their ability to repay, interpreting ECOA in a way that they believe shields them from liability, according to the agencies, which added that this is incorrect.
"A creditor may consider an applicant's immigration status when necessary to ascertain the creditor's rights regarding repayment," the agencies said, explaining that Regulation B, a rule that implements ECOA, expressly states that the only conditions under which immigration status may be considered is only to determine creditors' "rights and remedies regarding repayment" of a loan.
If financial institutions consider immigration status for any other reason, the agencies said they're probably breaking the law.
"Creditors should be aware that unnecessary or overbroad reliance on immigration status in the credit decisioning process, including when that reliance is based on bias, may run afoul of ECOA's antidiscrimination provisions and could also violate other laws," the agencies said.
The "other laws" mentioned could refer to the 1866 Civil Rights Act, also known as Section 1981, which the agencies said in their joint statement "has long been construed to prohibit discrimination based on alienage."
They said that courts have found that "ECOA's prohibition of national origin discrimination and Section 1981's prohibitions complement one another and that discrimination that arises from overbroad restrictions on lending to noncitizens may violate either or both statutes."
It's unclear whether any banks or financial institutions intend to challenge the DOJ and CFPB's interpretation of the law regarding the provision of loans to illegal immigrants.
International
Decades of underfunding, blockade have weakened Gaza’s health system – the siege has pushed it into abject crisis
Hospitals have been destroyed, and doctors and health care staff killed. Gaza’s health services may take years to recover, warns a Palestinian health…

For patients in Gaza’s besieged north, the order to evacuate from hospital beds and head south amounts to a “death sentence.”
That was the stark assessment of the World Health Organization on Oct. 14, 2023. By then, four hospitals had already ceased functioning in Gaza’s north due to damage from Israeli bombs.
Beyond the sheer immediate devastation of the current conflict – in which around 1,400 Israels and more than 2,800 Palestinians were killed in the first 10 days of fighting – there will be significant and undoubtedly long-lasting implications for the Gaza Strip’s health system.
As a Palestinian expert in global health who has worked with medical professionals from Gaza, I know that even before this latest escalation of violence, health services in Gaza were in a poor shape. Insufficiently and poorly resourced for decades, doctors and hospitals also had to contend with the devastating effects of a 16-year blockade imposed by Israel, in part with coordination with Egypt.
A system completely overwhelmed
The immediate concern in Gaza is for those seeking assistance due to the bombing campaign that Israel ordered after an attack on its people by Hamas fighters. An expected ground offensive will only further risk more civilian casualties.
Hospitals in Gaza are completely overwhelmed. They are seeing around 1,000 new patients per day, in a health system with only 2,500 hospital beds for a population of over 2 million people. It has forced hospitals to tend to patients in corridors and nearby streets. People maimed in the bombing are being treated for horrific injuries without basics such as gauze dressings, antiseptic, IV bags and painkillers. Those experiencing traumatic injuries are unable to receive sufficient care, increasing rates of infection and amputation.

And things may soon get worse. According to the United Nations’ Office for the Coordination of Humanitarian Affairs, Gaza’s hospitals have been forced to work without electricity, using fuel to run generators to ensure life-saving equipment remains functioning. The U.N. estimates this fuel will run out any day due to a complete siege placed on Gaza by Israel.
Such conditions have led to concerns that alongside the massive number of bombing victims, Gaza health services will soon have to contend with the outbreak of disease. Patients with immediate health needs, like dialysis or chemotherapy, are among those being ordered to leave and head for greater safety in Gaza’s south, although evacuation routes have also been bombed.
A century of underfunding
The current devastation to Gaza’s health system is obvious. But Gaza’s health care system was already under stress before the latest bombardment. In fact, policies that stretch back decades have left it unable to meet even the basic health needs of Gaza’s residents, let alone respond to the ongoing humanitarian catastrophe.
In just over a century, the health system in Gaza has been administered by six authorities: the Ottomans until the end of World War I, the British during the mandate period from 1917 to 1947, Egypt from 1949 to 1967, Israel under occupation starting in 1967, and then a Ministry of Health led first by the Palestinian Authority from 1995-2006 and since then by Hamas.
What each have had in common is that, from my perspective as a global health expert, they invested little in Palestinian health. For periods of the 20th century, the health priorities of successive governing bodies appeared focused more on reducing the spread of communicable disease to protect foreigners interacting with the native Palestinian population.
There was seemingly far less attention paid to building health infrastructure, adequately training health personnel, promoting preventive care and other long-term initiatives that make up a sustainable health system.
Under Israeli occupation from 1967, several Palestinian hospitals were turned into detention centers or military offices, while others were closed, and new ones were prohibited from opening. Palestinian physicians working in the occupied territories earned one-third the salary of their Israeli counterparts.
As a result of this neglect, health indicators throughout what are now called the occupied territories – the West Bank and Gaza Strip – have been poor.
Maternal and infant mortality – typical indicators of health system functioning – tends to be high. For example, in the mid-1980s, infant mortality was over 30 per 1,000 live births for Palestinians, compared with just under 10 per 1,000 among the Jewish population of Israel. And infant mortality has remained stubbornly high in Gaza.
Meanwhile, a lack of a reliable drinkable water infrastructure and overall unsanitary conditions resulted in the spread of parasitic and other infectious diseases, like rotavirus, cholera and salmonella – which remain leading causes of death in Gaza’s children.
Dying before they can leave
Most residents of Gaza fled there in 1948 after being displaced from their homes in what became the state of Israel. They were classified as refugees, many receiving limited services from the United Nations Relief and Works Agency for Palestine Refugees in the Near East that was established in 1949.
Since then, chronic underfunding of public hospitals has meant that Palestinians in Gaza have remained reliant on outside money and nongovernmental organizations for essential health services. This started a trend of humanitarian dependence that continues to this day, with many of Gaza’s health facilities funded by the United Nations, humanitarian agencies like Doctors Without Borders and religious organizations.
During the passage of the Oslo Accords in the mid-1990s, the Palestinian Authority was established to administer services in the occupied territories. The accords called for health responsibilities to be transferred to the newly formed Palestinian Ministry of Health as preparation for a sovereign Palestinian state, which the accords called for within a five-year period.
The Palestinian Authority received a significant influx of humanitarian aid as it took on civil responsibilities, including health. As a result, health indicators for Palestinians, including life expectancy and immunization rates, started to improve in the late 1990s.
But as it became increasingly clear that the overarching goal of the Oslo Accords for Palestinians – statehood – would not materialize, disillusion with the Palestinian Authority led to victory for Hamas in 2006 elections held in Gaza. Since then, Hamas has been considered the de facto governing body in Gaza, while the Palestinian Authority operates in the West Bank.
The rise of Hamas, which the U.S., Israel and others designate as a terrorist group, saw Gaza become isolated from the international community. It also coincided with Israel imposing a full land, sea and air blockade of Gaza.
There is no doubt that the blockade has rapidly accelerated the deterioration of the health system in Gaza and directly impacted the mortality rate.
Gazans who need advanced care, whether for cancer or other chronic illnesses, traumatic injuries and other life-threatening ailments, often can only access needed services in Israeli hospitals and require a permit to cross the border from Gaza. Some die before the permit process is complete.
Gaza health services after the siege
This vulnerable health system is now facing unprecedented challenges, staffed by health professionals who have committed to stay with their patients even under hospital evacuation orders and at risk of death.
It is uncertain what the health system of Gaza will look like in the future.
In years past, international aid would help repair and rebuild some, but not all, of the infrastructure damaged in airstrikes, especially schools and hospitals.
But Israeli Prime Minister Benjamin Netanyahu has promised a “long and difficult war.” And with the level of destruction seen in just a few days, it remains unclear just what will be left in the aftermath.
Already at least 28 doctors and other health workers have been killed in Gaza, with ambulances and a number of hospitals rendered useless by the bombs.
Replacing this human capital and vital infrastructure could take years, if not generations – and that is without the limits of a punishing blockade and continued bombardment.
Yara M. Asi ne travaille pas, ne conseille pas, ne possède pas de parts, ne reçoit pas de fonds d'une organisation qui pourrait tirer profit de cet article, et n'a déclaré aucune autre affiliation que son organisme de recherche.
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