How has the NHS been able to vaccinate Britons so quickly?

The UK’s vaccination programme has been a rare success during the pandemic. Lucy Thompson, Rebecca Forman and Elias Mossialos (LSE) explain why the NHS has been able to deliver jabs faster than any other European country

Me-first vaccine nationalism makes the spread of dangerous new COVID variants more likely

Richer countries are vaccinating their own citizens first. But leaving the rest without access to jabs makes it more likely that new, possibly more dangerous, COVID-19 variants will spread, warn Rebecca Forman, Michael Anderson and Elias Mossialos (LSE). We urgently need a strategy to scale up vaccine supply

Extractive resources, global volatility and Africa’s growth prospects

Africa is endowed with an incredible amount of natural resources of which the extractive sector is a key component. Unfortunately, however, the continent is characterized by a paradox of plenty or resource curse, depicting a situation of abundant resources that have not translated into economic growth and prosperity for the population. The potential role of the extractive sector is further affected by global volatilities. This article reviews the importance of the extractive sector to selected African countries. It identifies sources of global volatility that affect the sector and further attempts to establish the factors that drive the volatility-growth nexus. We use panel data covering 18 selected African countries from 1970-2013 to explain the gross domestic product (GDP) growth. Volatility persistence estimates are also calculated. The article further examines the policy space that African governments might consider to make the extractive sector play a major role in the development of the continent. We find that the extractive sector makes a huge contribution to GDP of the selected countries. The empirical evidence also indicates that 12 out of 18 countries find it difficult to adjust their economies back to equilibrium when hit with volatility shocks or changes in the volatility of GDP growth.Keywords: economic diversification, extractive sector, growth, natural resources, resource curse, volatilit

Social and physical environment disparities contribute to mortality outcomes during the COVID-19 pandemic in the United States

Demographic patterns suggest that fatalities from Covid-19 are disproportionately high in Black and Hispanic communities in the United States. This short commentary postulates that disparities in social & economic status and physical environment, with their resultant inequities, may also be contributing to high fatality rates. The top ten counties in the United States with the highest COVID-19 fatalities (as of May 16, 2020) from the Johns Hopkins University Coronavirus resource center were compared to county-level population density, racial demographics, socioeconomic status and physical environment factors. We conclude by recommending a multi-pronged response approach with coordination between health systems and local governments using county-level data to identify social disparity ‘hotspots’ where extra resources can be allocated and targeted interventions can be implemented

COVID-19 vaccine challenges: what have we learned so far and what remains to be done?

Developing and distributing a safe and effective SARS-CoV-2 (COVID-19) vaccine has garnered immense global interest. Less than a year after COVID-19 was declared a pandemic, several vaccine candidates had received emergency use authorization across a range of countries. Despite this scientific breakthrough, the journey from vaccine discovery to global herd immunity against COVID-19 continues to present significant policy challenges that require a collaborative, global response. We offer a framework for understanding remaining and new policy challenges for successful global vaccine campaigns against COVID-19 as well as potential solutions to address them. Decision-makers must be aware of these challenges and strategize solutions that can be implemented at scale. These include challenges around maintaining R&D incentives, running clinical trials, authorizations, post-market surveillance, manufacturing and supply, global dissemination, allocation, uptake, and clinical system adaption. Alongside these challenges, financial and ethical concerns must also be addressed

Social determinants of disparities in mortality outcomes in congenital heart disease: a systematic review and meta-analysis

Background: Social determinants of health (SDoH) affect congenital heart disease (CHD) mortality across all forms and age groups. We sought to evaluate risk of mortality from specific SDoH stratified across CHD to guide interventions to alleviate this risk. Methods: We searched electronic databases between January 1980 and June 2019 and included studies that evaluated occurrence of CHD deaths and SDoH in English articles. Meta-analysis was performed if SDoH data were available in >3 studies. We included race/ethnicity, deprivation, insurance status, maternal age, maternal education, single/multiple pregnancy, hospital volume, and geographic location of patients as SDoH. Data were pooled using random-effects model and outcome was reported as odds ratio (OR) with 95% confidence interval (CI). Results: Of 17,716 citations reviewed, 65 met inclusion criteria. Sixty-three were observational retrospective studies and two prospective. Of 546,981 patients, 34,080 died. Black patients with non-critical CHD in the first year of life (Odds Ratio 1.62 [95% confidence interval 1.47–1.79], I2 = 7.1%), with critical CHD as neonates (OR 1.27 [CI 1.05-1.55], I2 = 0%) and in the first year (OR 1.68, [1.45-1.95], I2 = 0.3%) had increased mortality. Deprived patients, multiple pregnancies, patients born to mothers <18 years and with education <12 years, and patients on public insurance with critical CHD have greater likelihood of death after the neonatal period. Conclusion: This systematic review and meta-analysis found that Black patients with CHD are particularly vulnerable for mortality. Numerous SDoH that affect mortality were identified for specific time points in CHD course that may guide interventions, future research and policy

Speciation in Duckweeds (Lemnaceae): Phylogenetic and Ecological Inferences

Species of duckweeds (Letnnaceae) that were resolved as sister taxa in a phylogeny based on combined molecular and non-molecular data were compared for morphological, physiological, and ecological attributes to infer factors important in the initial divergence leading to speciation. The ability to survive extreme conditions such as desiccation and cold temperatures is the most common difference identified between species. Two morphological characters facilitating survival in extreme environments are production of special resting buds called turions and increased seed production. The prevalent geographic pattern for species pairs consists of one restricted species occurring on the periphery of a more widespread taxon; this pattern indicates that divergence of peripheral isolates is a common geographical mode of speciation in duckweeds. Other species differ in optimal environmental conditions for growth, and these species are largely sympatric. In only one instance does it appear that divergence and speciation occurred following long-distance dispersal. Sympatric species pairs have the lowest molecular divergence; widespread primarily allopatric, and distantly allopatric species have the highest molecular divergence. Despite infrequent sexual reproduction, some degree of detectable variation (molecular, physiological, etc.) occurs within populations and among populations of the same species. Molecular evidence indicates that variation within duckweeds extends from the population and intraspecific levels to very different levels of divergence among recognized species. Contrary to the appearance of morphological and ecological uniformity implied by their reduced morphology and restricted occurrence in fresh water habitats, duckweeds are not a group in evolutionary stasis. Rather, these smallest of all flowering plants are dynamic evolutionarily, and comprise a model system for studying plant evolution and speciation