WHO COVID origins panel focuses on 2 hypotheses amid big data gaps

News brief

An independent group that studied the origins of SARS-CoV-2 for the World Health Organization (WHO) published its full findings today, which said though most available and accessible scientific evidence supports a jump from animals to people, it can't rule out the second of the two main hypotheses, an accidental lab-related event.

The WHO appointed the group of 27 international experts, called the Scientific Advisory Group for the Origins of Novel Pathogens (SAGO), in November 2021. The group released its initial findings in June 2022 and has been meeting in closed sessions from November 2021 to this month.

At a media briefing today on global health issues, WHO Director-General Tedros Adhanom Ghebreyesus, PhD, said that, over the past 5 years, the world has learned a lot about COVID-19, but one crucial question remains: how it started. "Understanding how any outbreak, epidemic or pandemic starts is essential for preventing future outbreaks. It's also a moral imperative for the sake of those who lose their lives to them," he said.

Tedros acknowledged that not every SAGO member agreed on every point, which he expected. One member from Brazil resigned, and three left their names off the final report. The participants were from Russia, China, and Cambodia.

Tedros presses China, intelligence agencies for more data

China has shared some information, but not everything the WHO has requested, Tedros said. "Despite our repeated requests, China hasn't provided hundreds of viral sequences from individuals with COVID-19 early in the pandemic, more detailed information on animals sold at markets in Wuhan, and information on work done and biosafety conditions at laboratories in Wuhan."

He added that the agency is aware of intelligence reports by other governments, and the WHO has requested access to them. "Neither WHO nor SAGO has yet had access to these reports, or their underlying data. As things stand, all hypotheses must remain on the table, including zoonotic spillover and lab leak," he said, noting that the WHO continues to appeal to China and other countries that have information about the origins of SARS-CoV-2.

WHO adds XFG to SARS-CoV-2 variants under monitoring

News brief

Lisa Schnirring

The World Health Organization (WHO) Technical Advisory Group on Virus Evolution (TAG-VE) on June 25 added the XFG to its SARS-CoV-2 variants under monitoring (VUM) list, as global proportions increase rapidly. In its initial risk assessment, the experts said the public health risk is currently low.

XFG is one of many offshoots of the JN.1 subvariant, and the earliest sample was collected at the end of January. It is a recombinant of LF.7 and LP.8.1.2. Compared to NB.1.8.1, designated as a VUM at the end of May, XFG has some distinct mutations in the spike protein, but also some overlap. Two of the spike mutations are linked to evasion of class 1/2 antibodies.

Experiments with pseudoviruses show a 1.9-fold reduction in neutralization compared to LP.8.1.1. Studies involving vaccinated mice showed similar or modestly lower neutralizing antibodies against XFG compared to KP.2 or LP.8.1 antigens.

Proportions highest in Southeast Asia

In May, the proportion of XFG viruses rose in all three WHO regions that consistently share SARS-CoV-2 sequences, especially in Southeast Asia. Cases and hospitalizations are rising in countries where XFG proportions are high, but so far there is no sign that infections are more severe.

In the United States, XFG made up 14% of sequenced samples, according to the latest variant proportion update from the Centers for Disease Control and Prevention (CDC) on data through June 21.

Overall, the WHO team said XFG seems to have a moderate growth advantage and a low risk of immune escape, though confidence in the assessments are low, owing to recent expansion and low levels of sequencing. Also, only one study has been done to assess antigenicity.

World leaders pledge $9 billion to support Gavi's vaccine initiatives

News brief

Jim Wappes

**Bill Gates at Gavi event in 2011.** Photo: UK DFID / Flickr cc

In the wake of US defunding of Gavi, the Vaccine Alliance, world leaders this week at the "Health and Prosperity through Immunisation" global summit in Brussels pledged €7.7 billion ($9 billion US) to support the group, according to a joint press release posted by the European Commission (EC).

Gavi's target budget for 2026 through 2030 is €10.2 billion ($12 billion). Leaders also committed an unprecedented €3.8 billion ($4.5 billion) in complementary financing from development finance institutions in support of (1) country systems and accelerated access to vaccines, (2) cost savings of up to €170.6 million ($200 million) from manufacturers, and (3) more than €127 million ($149 million) in private sector partnerships focused on vaccine delivery.

Other innovation and supply commitments will further boost equitable access to critical vaccines around the globe and a range of private-sector partnerships aimed at transforming immunization systems in lower-income countries, including a €34.1 million ($40 million) anchor commitment toward a new Innovation Scale-Up Fund.

Investing in global health

The summit, co-hosted by the European Union, Gates Foundation, and Gavi, in partnership with Global Citizen, was attended by representatives of 55 donor and implementing countries—including 10 heads of state and government and 24 ministers—as well as leaders from multilateral institutions, civil society, the private sector, and the vaccine industry.

In a constrained budget environment, it's even more important to focus aid funding on the investments that really work. And Gavi is exactly that.

EC President Ursula von der Leyen said, "Investing in health is investing in our shared future. Our work with Gavi saves lives. For over 20 years, we have stood side by side, with the European Union contributing over EUR 3.2 billion [$3.75 billion] to vaccinate more than 1 billion children against deadly diseases. But millions still need this vital protection."

Antonio Costa, president of the European Council added, "We have to ensure that every person, everywhere, has access to vaccines."

Bill Gates, chair of the Gates Foundation, said, "In a constrained budget environment, it's even more important to focus aid funding on the investments that really work. And Gavi is exactly that."