POLITICO NIGHTLY: Virginia is for lovers of close elections

 

BY TYLER WEYANT Presented by American Institutes for Research With help from Matt Friedman, Joanne Kenen and Carmen Paun COMMONWEALTH OF PLAY — We’ve reached an underexamined quadrennial political ritual, one that arrives the year after a presidential election: the moment when the nation’s assembled D.C. news media lift their heads, peer across the Potomac, gaze upon what’s happening in the Virginia gubernatorial race, and try to interpret what it means for next year’s congressional midterms. What they’ll find this year is a doozy. Republican gubernatorial candidate Glenn Youngkin speaks during an Early Vote rally in Stafford, Va. | Win McNamee/Getty Images From Portsmouth to Pulaski to Prince William County, the race has tightened considerably between former Democratic Gov. Terry McAuliffe and Republican Glenn Youngkin. Democrats are panicked by polls consistently showing a dead heat, with Youngkin hammering home a closing message that exploits parent anger at local school boards . The battle stretches beyond the top of the ticket: The state Legislature, which Democrats won back in 2019, is in danger of flipping again, as the suburban losses Republicans sustained in the Trump era could be stemmed. If you aren’t already sipping out of your “Virginia Is For Lovers” mug as you settle in for a supper of country ham, we’ve got you covered. Nightly talked to campaigns reporter Zach Montellaro, who’s been covering the state with the candidates, about what is driving the final days of the campaign and what he thinks will decide the race down the stretch. If there is one area of Virginia where the campaigns are keying in on, what is it and why? The cop-out answer is that every region is important: McAuliffe is going to win Northern Virginia, but by what margin? Youngkin will do well in the southern and southwestern parts of the state, but what’s the turnout? But if there is just one region you want to focus on, I’d say central Virginia, which is anchored by the state capital, Richmond. It is swingy in the traditional sense — both candidates are competitive there — and it is attracting both candidates over the weekend. Former President Barack Obama is scheduled to rally with McAuliffe Saturday afternoon, and Youngkin is planning to be down the street at a meet-and-greet at a restaurant. (I wrote a story about the region last week, you should read it!) Are there other issues beyond education during the pandemic that are animating voters, or has the discussion about schools blotted out the sun? Education, broadly defined, has certainly attracted a heck of a lot of attention recently. But it isn’t the only thing. In a recent Monmouth poll, jobs and the economy were the top issue, and education was the second. And Democrats have ceaselessly tried to tie Youngkin to former President Donald Trump. Trump has endorsed Youngkin and Youngkin has accepted his endorsement, but the nominee would otherwise like not to discuss the former president. McAuliffe is calling in just about every national party leader he can get into the state, while Youngkin is highlighting the fact that he’s not bringing in national figures. That’s intentional — he doesn’t want to remind swingy voters about Trump. Do Democrats feel having Vice President Kamala Harris come out this week, and President Joe Biden come to Arlington next week, will close the deal for McAuliffe? That is the hope for Democrats. Virginia is a different, bluer state now than it was eight years ago, when McAuliffe last ran for governor. If you've read much of any coverage about the race, you’ve seen that Democrats have an enthusiasm gap. By bringing in Biden or Harris (or, heck, Dave Matthews), Democrats hope they can wake up their base and get them to show up. The dumb joke on Twitter for elections is that “it is all gonna come down to turnout!” It is a boring answer, but this race will come down to McAuliffe’s ability to turn out those solid Democrats or not. And of course, there’s the 2022 tea leaves. Republicans are closely watching Youngkin's education message for bigger takeaways, and Democrats are anxious to see how much Trump in a (pseudo) post-Trump world is a factor. Welcome to POLITICO Nightly. Reach out with news, tips and ideas for us at nightly@politico.com. Or contact tonight’s author at tweyant@politico.com or on Twitter at @tweyant.   A message from American Institutes for Research: For 75 years, AIR has used evidence to improve lives. Today, we’re applying our know-how to address our biggest problem right now—inequity. The AIR Equity Initiative is a $100 million, five-year investment in social science research so institutions can combat injustice and build bridges of opportunity for people and society. Learn More.   AROUND THE NATION Incumbent Gov. Phil Murphy, right, speaks while Republican challenger Jack Ciattarelli listens during a gubernatorial debate at Rowan University's Pfleeger Concert Hall in Glassboro, N.J. | Frank Franklin II, Pool/AP Photo BUT WAIT, THERE’S MORE — Virginia isn’t the only off-year gubernatorial election coming in less than two weeks. New Jersey Playbook author Matt Friedman gives us a primer on the battle in the Garden State. He emails Nightly: Democratic incumbent Phil Murphy is largely running on his record as a progressive while tying his Republican opponent, former state Assemblymember Jack Ciattarelli, to Trump. Murphy has slammed Ciattarelli in ads for attending a “Stop the Steal” rally after the 2020 election, despite Ciattarelli’s record as a moderate member of the Assembly and his recent attempts to distance himself from Trump. Ciattarelli in turn has said Murphy’s coronavirus restrictions drove small businesses to close and has protested his mask mandates for school children. He also repeatedly highlighted the Murphy administration’s decision early in the pandemic to require nursing homes to readmit coronavirus patients who had been in the hospital, which Ciattarelli says led to more than 8,000 nursing home deaths. Murphy is bringing Democratic leaders into the state, with a planned rally with Obama in Newark on Saturday and an official visit from Biden on Monday. There has been limited public polling on the race, with recent surveys showing Murphy leading anywhere from six to 13 points. Although New Jersey Democrats have a million-voter registration advantage over the GOP, the state has repeatedly shown a willingness to elect Republicans as governor. No Democrat has been reelected governor since 1977, while three Republicans have — most recently former Gov. Chris Christie.   INTRODUCING CONGRESS MINUTES: Need to follow the action on Capitol Hill blow-by-blow? Check out Minutes, POLITICO’s new platform that delivers the latest exclusives, twists and much more in real time. Get it on your desktop or download the POLITICO mobile app for iOS or Android. GET A FIRST LOOK AT CONGRESS MINUTES HERE.     FROM THE HEALTH DESK THAT OTHER VACCINE — Nightly contributor (and Commonwealth journalist in residence at Johns Hopkins Bloomberg School of Public Health) Joanne Kenen and health reporter Carmen Paun email: Now that the world has a malaria vaccine with the potential for saving tens of thousands of children’s lives in sub-Saharan Africa, can the global health community and its philanthropic funders now check “malaria” off its to-do list and turn to other woes, like antibiotic resistance, a deadly TB resurgence or HIV? Unfortunately, no. Or at least, not yet. The malaria vaccine, recommended this month by the World Health Organization can save young lives — particularly when it’s combined with other preventive tools like bednets to protect against mosquitos. But by itself, the vaccine is only about 35 percent effective. “The malaria vaccine does not offer perfect protection, and the strong recommendations are that they need to be layered with other forms of protection such as bednets. Just as we recommend layering protection for Covid by still wearing masks, practicing social distancing and getting vaccinated,” Rachel Vreeman, director of the Arnhold Institute of Global Health at Mount Sinai medical school, said in an email. A better malaria vaccine may be within reach: Promising research is already underway, said Elizabeth Egan, a malaria researcher and infectious disease pediatrician at Stanford. Plus, even getting the current vaccine to children requires overcoming many production, distribution and financing hurdles in countries with poorly developed health systems. (Carmen spoke to GAVI officials and outlined the next steps in the most recent Global Pulse newsletter.) Beyond that, more challenges remain. This shot works on the most dangerous malaria parasite in the part of the world with the highest disease burden. It won’t fight other variants, including ones in Latin American countries such as Brazil with persistent malaria-affected regions (although gains in treatment and diagnosis have brought down deaths there), said Carlos Espinal, a malaria scientist at Florida International University. And the malaria parasite keeps changing — and becoming resistant to each generation of new drugs. Right now the current therapies — a family of drugs called artemisinin-based — are still quite effective but that’s not likely to last forever. “Resistance — that’s the history of malaria control,” said Egan. And that resistance, the ability of the malaria-causing parasite to change “and outsmart us” is why the world can’t turn the page, said Abdourahmane Diallo, chief executive officer of the RBM Partnership to End Malaria. Still the worries about the future don’t quell the excitement about this new vaccine. “It’s amazing,” said Vreeman, who has treated children with malaria in Africa. “It is a stunning dream come true.”       WHAT'D I MISS? — Biden huddles with Pelosi: Biden had breakfast with Speaker Nancy Pelosi today as Democrats close in on a deal on Biden’s social spending plan , though a final agreement with the party’s two Senate centrist holdouts is unlikely to come this week. Several sources with knowledge of the intensifying talks said they doubted a deal could come together today given where things stand between Biden and Sens. Joe Manchin (D-W.Va.) and Kyrsten Sinema (D-Ariz.). But Democrats are ending the week with far more clarity from that duo than they began, giving the party increasing confidence it can land a framework for the bill this month. — Supreme Court grants expedited review for Texas abortion ban: The Supreme Court has agreed to hear arguments on Texas’ novel abortion ban but declined for a second time to temporarily halt the law. The justices will take up a pair of challenges to the law on a highly accelerated timetable with arguments scheduled for Nov. 1, the court said in an order issued today. Justice Sonia Sotomayor released a partial dissent, arguing that the court should block the Texas law while it considers the issues involved. — Neera Tanden named White House staff secretary: Tanden, a senior adviser to Biden, was named White House staff secretary today— nearly eight months after the White House pulled her nomination to serve as director of the Office of Management and Budget . “The Staff Secretary role is the central nervous system of the White House and moves the decision-making process and manages a wide variety of issues for the President,” a White House official told POLITICO in a statement. “Neera has over two decades of experience in policy and management which are critical elements of the role. Her experience across domestic, economic and national security policy will be a key asset in this new role.”   BECOME A GLOBAL INSIDER: The world is more connected than ever. It has never been more essential to identify, unpack and analyze important news, trends and decisions shaping our future — and we’ve got you covered! Every Monday, Wednesday and Friday, Global Insider author Ryan Heath navigates the global news maze and connects you to power players and events changing our world. Don’t miss out on this influential global community. Subscribe now.     ASK THE AUDIENCE Nightly asked you: What’s your biggest pandemic fear right now? Your select, lightly edited responses: “A big spike in infections in the schools, even in states with relatively high vaccination rates among adults, since kids under 12 still aren’t even eligible to be vaccinated, and the vaccination rate among eligible kids (12+) is still very low. The U.K. is experiencing another surge now, which some experts attribute to secondary schools. Are we next, now that cold weather is starting to creep in up North, kids are attending school in-person, and masking and social distancing measures are spotty, at best?” — Michael Vatis, attorney, New York City “A variant that renders all currently approved vaccines and others in clinical trials ineffective in preventing serious illness or death.” — Pamela Seubert, retired, Morton Grove, Ill. “We are losing our in-home caregiver, who has been providing care for my 93-year-old mother for four years. Recent discussions with her concerning the Covid-19 vaccine have come up. I was shocked and dismayed that she is refusing to be vaccinated. She is 40 years old, married and mother of two children. She also is choosing not to have her children vaccinated either. My mom has a recent cancer diagnosis and was advised by her physicians not to be around people who are not vaccinated. I have called agencies in our area and was also shocked to find out they do not require vaccinations for their employees. So now I am trying to find someone to come into our home and lift the burden off me, her primary caregiver, to help us with her personal care. This is a prime example of the ‘fear’ and misinformation being spread across our community!” — Susan Bannigan, retired nurse, Littlestown, Pa. “We lose a generation of public servants (teachers and school administrators, public health officials and nurses, frontline workers) who put themselves at enormous risk and stretched themselves beyond their limits only to endure threats, hateful rhetoric and an utter lack of concern from a critical mass of the public that fell hook, line and sinker for conspiracy theories and vaccine disinformation.” — Heidi Overbeck, philanthropy, Denver “Indoors anything with unvaccinated people: people in the grocery stores who don’t wear a mask, my family, where the younger generation has not yet and refuses to get vaccinated. Bye-bye holiday parties.” — Nancy-Gay Rowland, writer, Dayton, Ohio AROUND THE WORLD EUROPE BREXITS COVID WORRIES FOR NOW — EU citizens in Western Europe are watching rising coronavirus cases and hospitalizations in the U.K. with increasing trepidation that the Continent may soon face a similar scenario. But experts say they have no reason to panic — yet. Factors such as waning immunity from vaccination have been cited as potential reasons for the U.K.’s exponential rise in cases, Ashleigh Furlong writes. If that turns out to be the key driver of the latest wave of infections in the U.K., it would bode ill for countries in Western Europe that have similar levels of vaccination but are also seeing cases start to inch upwards. Yet for many health experts, there is a more compelling overarching cause: the U.K. abandoning most public health measures. “The differences are pretty clear. Britain is really slack on public health,” said Chris Dye, professor of epidemiology at the University of Oxford. By contrast, other countries in Western Europe have taken a more cautious approach that Dye called “vaccine plus plus” — widespread vaccination backed up by measures such as mask-wearing and coronavirus passports. NIGHTLY NUMBER 61.9-38.1 The official final results of the California recall election announced today by the state’s Secretary of State office , with No winning by a large margin. The results closely mirrored the 2018 gubernatorial election, with every county that rejected the recall voting for Newsom then, save one. (h/t Jeremy B. White) PARTING WORDS LADIES AND GENTLEMEN, THE WEEKEND (WRAP) — Matt Wuerker brings us another collection of the week’s political satire and cartoons in his Weekend Wrap, including jokes on Joe Manchin’s role in the Democratic agenda, the ongoing vaccine efforts and upcoming elections.   A message from American Institutes for Research: AIR is applying its know-how to address the biggest problem we face right now—systemic inequity. By investing over $100 million in social science research over the next five years, AIR’s Equity Initiative will build and use evidence that can guide policy and improve the lives of people and communities. But we won’t do it alone. The AIR Equity Initiative will work side-by-side with partners and stakeholders, bringing together expertise and diverse viewpoints so we can create sustainable change. Systemic inequity is a formidable challenge, but we believe in the power of evidence to bridge the gaps that are holding us back. With research and collaboration, we can improve lives across our country—now and into the future. Learn More.   Did someone forward this email to you? Sign up here.   Follow us on Twitter Chris Suellentrop @suellentrop Tyler Weyant @tweyant Renuka Rayasam @renurayasam Myah Ward @myahward   FOLLOW US

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WHO recommends groundbreaking malaria vaccine for children at risk

Historic RTS,S/AS01 recommendation can reinvigorate the fight against malaria

6 October 2021 

News release

 

Geneva

 

Reading time: 3 min (859 words)

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The World Health Organization (WHO) is recommending widespread use of the RTS,S/AS01 (RTS,S) malaria vaccine among children in sub-Saharan Africa and in other regions with moderate to high P. falciparum malaria transmission. The recommendation is based on results from an ongoing pilot programme in Ghana, Kenya and Malawi that has reached more than 800 000 children since 2019.

“This is a historic moment. The long-awaited malaria vaccine for children is a breakthrough for science, child health and malaria control,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Using this vaccine on top of existing  tools to prevent malaria could save tens of thousands of young lives each year.”

Malaria remains a primary cause of childhood illness and death in sub-Saharan Africa. More than 260 000 African children under the age of five die from malaria annually.

In recent years, WHO and its partners have been reporting a stagnation in progress against the deadly disease.

"For centuries, malaria has stalked sub-Saharan Africa, causing immense personal suffering,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “We have long hoped for an effective malaria vaccine and now for the first time ever, we have such a vaccine recommended for widespread use. Today’s recommendation offers a glimmer of hope for the continent which shoulders the heaviest burden of the disease and we expect many more African children to be protected from malaria and grow into healthy adults.”

WHO recommendation for the RTS,S malaria vaccine

Based on the advice of two WHO global advisory bodies, one for immunization and the other for malaria, the Organization recommends that:

WHO recommends that in the context of comprehensive malaria control the RTS,S/AS01 malaria vaccine be used for the prevention of P. falciparum malaria in children living in regions with moderate to high transmission as defined by WHO.  RTS,S/AS01 malaria vaccine should be provided in a schedule of 4 doses in children from 5 months of age for the reduction of malaria disease and burden.

Summary of key findings of the malaria vaccine pilots

Key findings of the pilots informed the recommendation based on data and insights generated from two years of vaccination in child health clinics in the three pilot countries, implemented under the leadership of the Ministries of Health of Ghana, Kenya and Malawi. Findings include:

• Feasible to deliver: Vaccine introduction is feasible, improves health and saves lives, with good and equitable coverage of RTS,S seen through routine immunization systems. This occurred even in the context of the COVID-19 pandemic.
  
• Reaching the unreached: RTS,S increases equity in access to malaria prevention.
  • Data from the pilot programme showed that more than two-thirds of children in the 3 countries who are not sleeping under a bednet are benefitting from the RTS,S vaccine.
  • Layering the tools results in over 90% of children benefitting from at least one preventive intervention (insecticide treated bednets or the malaria vaccine).
    
    
• Strong safety profile: To date, more than 2.3 million doses of the vaccine have been administered in 3 African countries – the vaccine has a favorable safety profile. 
  
• No negative impact on uptake of bednets, other childhood vaccinations, or health seeking behavior for febrile illness. In areas where the vaccine has been introduced, there has been no decrease in the use of insecticide-treated nets, uptake of other childhood vaccinations or health seeking behavior for febrile illness.
  
• High impact in real-life childhood vaccination settings: Significant reduction (30%) in deadly severe malaria, even when introduced in areas where insecticide-treated nets are widely used and there is good access to diagnosis and treatment.
  
• Highly cost-effective: Modelling estimates that the vaccine is cost effective in areas of moderate to high malaria transmission.

Next steps for the WHO-recommended malaria vaccine will include funding decisions from the global health community for broader rollout, and country decision-making on whether to adopt the vaccine as part of national malaria control strategies.

Financial support

Financing for the pilot programme has been mobilized through an unprecedented collaboration among three key global health funding bodies: Gavi, the Vaccine Alliance; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and Unitaid.

Note to editors:

• The malaria vaccine, RTS,S, acts against P. falciparum, the most deadly malaria parasite globally, and the most prevalent in Africa.
• The Malaria Vaccine Implementation Programme is generating evidence and experience on the feasibility, impact and safety of the RTS,S malaria vaccine in real-life, routine settings in selected areas of Ghana, Kenya and Malawi.
• Pilot malaria vaccine introductions are led by the Ministries of Health of Ghana, Kenya and Malawi.
• The pilot programme will continue in the 3 pilot countries to understand the added value of the 4^th vaccine dose, and to measure longer-term impact on child deaths.
• The Malaria Vaccine Implementation Programme is coordinated by WHO and supported by in-country and international partners, including PATH, UNICEF and GSK, which is donating up to 10 million doses of the vaccine for the pilot.
• The RTS,S malaria vaccine is the result of 30 years of research and development by GSK and through a partnership with PATH, with support from a network of African research centres.
• The Bill & Melinda Gates Foundation provided catalytic funding for late-stage development of RTS,S between 2001 and 2015.

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WHO greenlights the world's first malaria vaccine — but it's not a perfect shot

October 6, 20215:29 PM ET

JASON BEAUBIEN

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The world's arsenal against malaria just got a fancy new bazooka. But it's not the easiest weapon to deploy, it only hits its target 30 to 40% of the time, and it's not yet clear who's going to pay for it.

The weapon in question is the RTS,S vaccine from GlaxoSmithKline, which on Wednesday got the green light from the World Health Organization for widespread use.

This is not only the first authorized malaria vaccine, it's also the first vaccine ever approved for use against a parasitic disease in humans.

The recommendation comes after RTS,S showed positive results in a pilot program in Ghana, Kenya and Malawi. The vaccine cut malaria cases by 40% and reduced hospitalizations of the potentially deadly disease by nearly a third.

Tedros Adhanom Ghebreyesus, WHO's director general, called the approval of RTS,S a historic moment.

"The long-awaited malaria vaccine for children is a breakthrough for science, child health and malaria control," he said.

RTS,S won regulatory approval from the European Medicines Agency back in 2015 but WHO wanted to wait for the results of this latest pilot program before recommending it for use in countries with moderate to high levels of malaria transmission. The expectation is that it will be used primarily in sub-Saharan Africa, where the mosquito-borne disease is one of the top killers of children, claiming nearly a quarter of a million lives each year.

"This opens up a whole new avenue for malaria control," says David Schellenberg of WHO's Global Malaria Program, who says that RTS,S gives health officials a new powerful tool to fight the disease.

Combined with bed nets, spraying for mosquitoes and new drugs, the vaccine could have a major impact in places where malaria remains a chronic problem, Schellenberg says.

Matshidiso Moeti, WHO regional director for Africa, says she's delighted by the new recommendation.

"For centuries, malaria has stalked sub-Saharan Africa, causing immense personal suffering," Moeti said during the announcement. Nearly 95% of all malaria cases globally occur in Africa.

"Now for the first time ever, we have a [malaria] vaccine recommended for widespread use. Today's recommendation, therefore, offers a glimmer of hope for the continent," she said.

But the vaccine won't be rolling out across Africa tomorrow. It's still unclear where the money to purchase doses will come from. Also it's a complicated vaccination to administer, requiring four injections spread out over the first two years of a child's life. And given that it only prevents malaria 30 to 40% of the time, this vaccine is far less effective than health officials had hoped.

Pedro Alonso, head of WHO's Global Malaria Program, says part of the problem is that malaria is a complicated disease. "This is a parasitic disease," he points out. The parasite life cycle plays out in multiple stages in different parts of the human body and in the mosquito hosts. "This is orders of magnitude more complex in terms of the biology of the causative organism [than a virus]," he says.

Decades of research have gone into developing RTS,S. Alonso would love to see a vaccine that's 95% effective in preventing malaria but says the scientific community is still a long way off from developing that: "But what we do have right now is a vaccine that can be deployed, that is accepted, that is safe and that can have a massive impact in terms of lives saved and episodes of malaria averted."

Countries that decide to move forward with administering RTS,S still need to figure out how to pay for it and how to integrate it into their childhood immunization schedules. GlaxoSmithKline had donated 10 million doses of the vaccine for pilot programs and has now pledged to deliver 15 million doses a year at a price of 5% above cost. Eventually GSK says it plans to transfer production to a producer in India.

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