Tag Archives: rural areas

Analysis-India’s vaccine inequity worsens as countryside languishes

By Krishna N. Das, Abhirup Roy and Rajendra Jadhav

NEW DELHI/SATARA, India (Reuters) – Urban Indians are getting COVID-19 shots much faster than the hundreds of millions of people living in the countryside, government data shows, reflecting rising inequity in the nation’s immunization drive.

In 114 of India’s least developed districts – collectively home to about 176 million people – authorities have administered just 23 million doses in total.

That’s the same number of doses as have been administered across nine major cities — New Delhi, Mumbai, Kolkata, Chennai, Bengaluru, Hyderabad, Pune, Thane and Nagpur — which combined have half the population.

The disparity was even stronger last month, after the government allowed private sales of vaccines for adults aged under 45 years, an offer which favored residents of cities with larger private hospital networks. For the first four weeks of May, those nine cities gave 16% more doses than the combined rural districts, data from the government’s Co-WIN vaccination portal shows.

“My friends from the city were vaccinated at private hospitals,” said Atul Pawar, a 38-year-old farmer from Satara, a rural western district of Maharashtra, India’s wealthiest state. “I am ready to pay, but doses are not available and district borders are sealed because of the lockdown.”

The Ministry of Health and Family Welfare did not respond to a request for comment.

India has administered more than 222 million doses since starting its campaign in mid-January – only China and the United States have administered more – but it has given the required two doses to less than 5% of its 950 million adults.

Rural India is home to more than two-thirds of the country’s 1.35 billion people. While urban areas account for a disproportionately large share of the confirmed COVID-19 cases, those concerned about the spread of the virus in the countryside say statistics undercount cases in villages, where testing is less comprehensive.

The health system in several regions in India collapsed in April and May as the country reported the world’s biggest jump in coronavirus infections, increasing pressure on the immunization program.

Prime Minister Narendra Modi’s government offers vaccines to vulnerable people, healthcare workers and those aged over 45 for free. Since last month, individual states have also been expected to procure vaccines for younger adults, or to provide them commercially through the private sector.

Poorer states say this leaves their residents more vulnerable. The eastern state of Jharkhand, where nearly all districts are categorized as poor, this week urged Modi to give it free vaccines for all age groups.

In many states the doses for those under 45 are available mostly or entirely in urban areas. Some officials say this is intentional, as the infection spreads more easily in crowded cities.

“It’s because of high-positivity” in urban areas, said Bijay Kumar Mohapatra, health director of the eastern state of Odisha, explaining the state’s decision to prioritize cities.

Major international and domestic firms such as Microsoft, Pepsi, Amazon, Reliance Industries, Adani Group and Tata Motors have organized inoculations for their employees, in many cases in partnership with private hospitals. Most of these companies and the huge private hospitals that serve them are located in urban centers.

Vaccination rates in rural areas have also been depressed because of patchier internet access to use the complex online system for signing up for shots, and possibly because of greater hesitancy among villagers than among city dwellers.

“LUCRATIVE DEALS”

India’s Supreme Court criticized the government’s handling of the vaccination program this week and ordered it to provide a breakdown of shots given in rural and urban areas.

“Private hospitals are not equally spread out” across the country and “are often limited to bigger cities with large populations”, the top court said in its order dated May 31.

“As such, a larger quantity will be available in such cities, as opposed to the rural areas,” it said. Private hospitals may prefer to sell doses “for lucrative deals directly to private corporations who wish to vaccinate their employees”.

Dr. Rajib Dasgupta, head of the Centre of Social Medicine and Community Health at New Delhi’s Jawaharlal Nehru University, said the risk of inequity was that parts of India would build up immunity disproportionately.

“It can leave the rural population relatively more vulnerable.”

(Reporting by Krishna N. Das, Abhirup Roy and Rajendra Jadhav; Additional reporting by Prasanta Kumar Dutta, Jatindra Dash, Sumit Khanna, Rupam Nair; Graphics by Tanvi Mehta; Editing by Peter Graff)

Moderna’s coronavirus vaccine faces U.S. FDA expert panel review

(Reuters) – A panel of outside advisers to the U.S. Food and Drug Administration is expected to endorse emergency use of Moderna Inc’s coronavirus vaccine during a meeting on Thursday, as the nation prepares to roll out a second vaccine.

The panel vote on whether the vaccine’s benefits outweigh its risks is likely to come some time after 3 pm ET (2000 GMT), with an FDA authorization expected as soon as Friday.

This is the same committee of expert advisers that last week backed the COVID-19 vaccine from Pfizer Inc and German partner BioNTech SE, clearing the way for the FDA emergency use authorization (EUA) a day later.

That vaccine is being distributed throughout the country. A massive inoculation program began at U.S. hospitals on Monday.

The Moderna vaccine uses similar messenger RNA technology but with less onerous cold storage requirements than the Pfizer/BioNTech shot, making it a better option for remote and rural areas. Both vaccines were about 95% effective in preventing illness in pivotal clinical trials.

The FDA advisory committee is likely to discuss Moderna’s reports of side effects from its 30,000-person trial, which were more frequent than those reported by Pfizer. These were primarily relatively short-lived reactions to the vaccination rather than serious adverse events.

SVB Leerink analysts said the Moderna vaccine appears less tolerable than the Pfizer/BioNTech shot, but noted that is not a proper comparison across trials and unlikely to stand in the way of an EUA.

The FDA staff did not raise any serious concerns about safety in documents published on Tuesday in preparation for the meeting. It said a link between Bell’s palsy, which causes temporary paralysis of facial muscles, and the vaccine could not be ruled out after some cases were reported in trials of both vaccines.

Pfizer and BioNTech said those cases occurred at the same rate as in the general population.

Moderna is seeking authorization for people aged 18 and older. That could sidestep the lively discussion last week among panel members about whether there was enough data to authorize use of the Pfizer/BioNTech vaccine in adolescents aged 16 and 17. They ultimately voted to back that vaccine for those 16 and older.

Initial Moderna vaccine supply would likely go to the United States, which has signed deals to secure as many as 200 million doses and is expecting the first 20 million this month. The vaccine is administered in two doses about four weeks apart.

The company has also signed supply deals with Canada, the European Union and the UK. The vaccine is undergoing a “rolling review” by regulators for all three.

(Reporting by Manas Mishra in Bengaluru; Editing by Caroline Humer and Bill Berkrot)

New Mexico counties revolt against migrant releases

FILE PHOTO: New bollard-style U.S.-Mexico border fencing is seen in Santa Teresa, New Mexico, U.S., March 5, 2019. Picture taken March 5, 2019. REUTERS/Lucy Nicholson - RC1FD8531B60/File Photo

By Andrew Hay

TAOS, N.M. (Reuters) – Two more New Mexico counties have declared their opposition to taking in migrants in a growing revolt against federal authorities dropping off a surge in Central American families in the state’s rural, southern communities.

The record influx of asylum seekers has overwhelmed border detention facilities and shelters, forcing U.S. immigration authorities to bus migrants to nearby cities and even fly them to California.

Las Cruces, New Mexico, has received over 6,000 migrants since April 12. Deming, population 14,183, gets 300 to 500 a day, according to City Administrator Aaron Sera.

Democratic Governor Michelle Lujan Grisham has dismissed President Donald Trump’s claims of a border security crisis and advocated a humanitarian response. She is in Washington seeking federal funds to reimburse cities that give support.

But some New Mexico counties say they want nothing to do with sheltering migrants, with officials saying the governor’s approach may worsen the border crisis.

Sierra County, population 11,116, was one of two Republican-controlled New Mexico counties to pass resolutions on Tuesday evening opposing the relocation of migrants to their communities.

Sierra County also called on Trump to close the border to immigration to end the crisis.

“We have to take care of our veterans, our seniors, our residents, first and foremost,” said County Manager Bruce Swingle. “We’re a very impoverished county.”

Sierra County has a median annual household income of $29,690 and a 21 percent poverty rate, according to Data USA.

‘FEEDING PIGEONS’

To the east, Lincoln County passed a resolution that it was not prepared to spend taxpayer dollars on housing “illegal immigrants,” said Commissioner Tom Stewart.

“We have a tight budget and need to focus on a new hospital that we are building,” Stewart said. “As long as we continue to extend citizen benefits to unregistered aliens the flows will continue.”

The moves followed a similar May 2 resolution by neighboring Otero County.

County Commission Chairman Couy Griffin said sheltering migrants sent the wrong message to other Central Americans thinking of leaving their homes and would deepen the border crisis.

“If you begin to feed pigeons in the parking lot, pretty soon you have every pigeon in town,” Griffin said.

Lujan Grisham spokesman Tripp Stelnicki said there was no evidence humanitarian aid encouraged people to leave their homes.

“They are moving because they have no other choice and its frankly un-American to suggest we close our doors to people in need,” he said.

The border situation is taking a tragic toll on the migrants themselves. On Wednesday, the Department of Health and Human Services, which oversees unaccompanied child migrants, said a 10-year-old girl from El Salvador died in its custody in September, bringing to six the number of children who have died in U.S. custody, or shortly after release, in the last eight months.

(Reporting By Andrew Hay; Editing by Sonya Hepinstall)

Russia orders five-hour daily truce in Syria’s eastern Ghouta

A child and a man are seen in hospital in the besieged town of Douma, Eastern Ghouta, Damascus, Syria February 25, 2018. REUTERS/Bassam Khabieh

By Angus McDowall and Jack Stubbs

BEIRUT/MOSCOW (Reuters) – Russia will establish a humanitarian corridor and implement a five-hour daily truce in Syria’s eastern Ghouta, it said on Monday, after a U.N. Security Council resolution demanding a 30-day ceasefire across the entire country.

Over the past week Syria’s army and its allies have subjected the rebel-held enclave of eastern Ghouta near Damascus to one of the heaviest bombardments of the seven-year war, killing hundreds.

On Sunday health authorities there said several people had suffered symptoms consistent with chlorine gas exposure and on Monday rescue workers and a war monitor said seven small children were killed by air and artillery strikes in one town.

“Eastern Ghouta cannot wait, it is high time to stop this hell on earth,” U.N. Secretary-General Antonio Guterres told the U.N. Human Rights Council in Geneva, calling for implementation of the ceasefire.

Fighting has raged across Syria since Saturday’s resolution, as Turkey presses its offensive against a Kurdish militia in Afrin, rival rebel groups fight each other in Idlib and a U.S.-led coalition targets Islamic State in the east..

Russia’s defense minister was cited by the RIA news agency as saying President Vladimir Putin had ordered a daily ceasefire in eastern Ghouta from 9am to 2pm each day and for the creation of a “humanitarian corridor” to allow civilians to leave.

Russia, along with Iran and Shi’ite militias, is a major backer of Syrian President Bashar al-Assad and it joined the war on his side in 2015, helping him claw back important areas.

The Russian defense minister, Sergei Shoigu, did not say whether the Syrian government or other allied forces had agreed to abide by the five-hour daily truce.

Mohamad Alloush, the political chief of one of eastern Ghouta’s biggest rebel factions, said the Syrian army and its allies had launched “a sweeping ground assault” after the U.N. resolution, adding it was vital that the truce be implemented.

“We hope for real, serious, practical action,” he said.

DEATHS

A picture issued by Civil Defence rescue workers, which Reuters could not independently verify, showed seven small bodies lying next to each other, wrapped in white and blue sheets, after air and artillery strikes on the town of Douma in eastern Ghouta.

The Syrian Observatory for Human Rights, a Britain-based war monitor, said four of them were among a single family of nine killed by an air strike. The other three were among seven killed by shelling in the same town, it said.

Russian Foreign Minister Sergei Lavrov said allegations the Syrian government was responsible for any chemical attack, after reports of people suffering symptoms of chlorine gas poisoning, were aimed at sabotaging the truce.

The Syrian government has consistently denied using chemical weapons in the war, which will soon enter its eighth year having killed hundreds of thousands of people and forced half of Syria’s pre-war population of about 23 million from their homes.

Man with a child are seen in hospital in the besieged town of Douma, Eastern Ghouta, Damascus, Syria February 25, 2018. REUTERS/Bassam Khabieh

Man with a child are seen in hospital in the besieged town of Douma, Eastern Ghouta, Damascus, Syria February 25, 2018. REUTERS/Bassam Khabieh

The bombardment of eastern Ghouta over the past week has been one of the heaviest of the war, killing at least 556 people in eight days, according to a toll compiled by the Syrian Observatory for Human Rights, a UK-based war monitor.

The intensity of the bombardment has diminished since the U.N. resolution, the Observatory said, but it added that 21 people had been killed in eastern Ghouta on Monday, including the seven small children in the photograph.

Rebel shelling has caused 36 deaths and a number of injuries in Damascus and nearby rural areas in the last four days, Zaher Hajjo, a government health official, told Reuters.

Speaking in Riyadh, deputy director general of the World Health Organisation, Peter Salama, said the WHO urgently needed to evacuate 750 medical cases from eastern Ghouta.

“We also need sustained access for medical equipment and for medical drugs and commodities,” he said, adding that some supplies had been “systematically removed from convoys”.

RELATIVE LULL

In eastern Ghouta, people were making use of a relative lull in the bombardment to find provisions, said Moayad Hafi, a rescue worker based there.

“Civilians rushed from their shelters to get food and return quickly since the warplanes are still in the sky and can hit at any moment,” he told Reuters in a voice message.

Lavrov said the ceasefire would not cover either the Ahrar al-Sham or the Jaish al-Islam factions, describing them as partners of the former al Qaeda affiliate, the Nusra Front.

The two major rebel factions in eastern Ghouta are Jaish al-Islam and Failaq al-Rahman. Tahrir al-Sham, an alliance of jihadists including Nusra, also has a small presence there.

A young boy rides a bicycle, near damaged houses, after an air raid in the besieged town of Douma, Eastern Ghouta, Damascus, Syria February 23.

A young boy rides a bicycle, near damaged houses, after an air raid in the besieged town of Douma, Eastern Ghouta, Damascus, Syria February 23.
REUTERS/Bassam Khabieh

“Partners of al-Nusra are not protected by the ceasefire regime. They are also subject to the legitimate actions of Syrian armed forces and all those who support the Syrian army,” said Lavrov.

In Idlib, Ahrar al-Sham and Tahrir al-Sham have been battling each other in recent days, rather than working in partnership.

Syrian state television reported that army units had advanced against militants near Harasta in eastern Ghouta. State news agency SANA also reported that the army had stopped a car bomb being driven into Damascus.

The Nusra Front has consistently been excluded from ceasefires in Syria, and the opposition says the government has used this as an excuse to keep up its bombardments.

(Additional reporting by Ellen Francis and Dahlia Nehme in Beirut, Stephanie Nebehay in Geneva, Sarah Dadouch in Riyadh and Polina Ivanova in Moscow Editing by Gareth Jones)