SharecloseShare pageCopy linkAbout sharingImage source, Getty ImagesMore than 1.2 million people died worldwide in 2019 from infections caused by bacteria resistant to antibiotics, according to the largest study of the issue to date.This is more than the annual death toll from malaria or Aids.Poorer countries are worst affected but antimicrobial resistance threatens everyone’s health, the report says.Urgent investment in new drugs and using current ones more wisely are recommended to protect against it.The overuse of antibiotics in recent years for trivial infections means they are becoming less effective against serious infections. People are dying from common, previously treatable infections because the bacteria that cause them have become resistant to treatment. UK health officials recently warned antimicrobial resistance (AMR) was a “hidden pandemic” that could emerge in the wake of Covid-19 unless antibiotics were prescribed responsibly.Particularly deadly The estimate of global deaths from AMR, published in the Lancet, is based on an analysis of 204 countries by a team of international researchers, led by the University of Washington, US.They calculate up to five million people died in 2019 from illnesses in which AMR played a role – on top of the 1.2 million deaths it caused directly. In the same year, Aids (acquired immune deficiency syndrome) is thought to have caused 860,000 deaths and malaria 640,000.Image source, Getty ImagesMost of the deaths from AMR were caused by lower respiratory infections, such as pneumonia, and bloodstream infections, which can lead to sepsis.MRSA (methicillin-resistant Staphylococcus aureus) was particularly deadly, while E. coli, and several other bacteria, were also linked to high levels of drug resistance.Using patient records from hospitals, studies and other data sources, the researchers say young children are at most risk, with about one in five deaths linked to AMR being among the under-fives.Deaths from AMR were estimated to be:highest in sub-Saharan Africa and South Asia, at 24 deaths in every 100,000lowest in high-income countries, at 13 in every 100,000Prof Chris Murray, from the Institute for Health Metrics and Evaluation at the University of Washington, said the new data revealed the true scale of antimicrobial resistance worldwide and was a clear signal immediate action was needed “if we want to stay ahead in the race against antimicrobial resistance.Other experts say better tracking of resistance levels in different countries and regions is essential.Dr Ramanan Laxminarayan, from the Centre for Disease Dynamics, Economics and Policy, in Washington DC, said global spending on addressing AMR needed to rise to levels seen for other diseases.”Spending needs to be directed to preventing infections in the first place, making sure existing antibiotics are used appropriately and judiciously, and to bringing new antibiotics to market,” he said.Much of the world faced the challenge of poor access to affordable, effective antibiotics – and that needed to be taken seriously by political and health leaders everywhere, Dr Laxminarayan added.This video can not be playedTo play this video you need to enable JavaScript in your browser.Antibiotic resistance – NHSThe BBC is not responsible for the content of external sites.

SharecloseShare pageCopy linkAbout sharingImage source, Tom BanksHundreds of patients with rare diseases have been given a diagnosis for the first time, thanks to a study which involved analysing their entire genome.More than 2,000 families took part and were recruited through the 100,000 Genomes Project, which started in 2013.Scientists behind it say the approach can lead to better care, more focused treatments and can save NHS resources.One in four received a new diagnosis, including Terri Hedley, who inherited a kidney condition from her father. Leslie had endured years of treatment for serious kidney disease which led to two kidney transplants – and was worried that his granddaughter Katie, in addition to his daughter, was going to be affected.But through sequencing of Leslie and Terri’s whole genome, it was discovered she did not have the kidney problem.”It was fantastic to know that it stops with me,” 41-year-old Terri said.”She [Katie] doesn’t need to get regular tests now. We were so worried about her.”Terri’s daily life is not affected by the kidney condition, but her kidney function has deteriorated in the last 20 years.Image source, Terri HedleyA 10-year-old girl with a rare, unknown condition also received a diagnosis through the study which meant she was able to have a bone marrow transplant. She had been admitted to intensive care multiple times and visited hospital on more than 300 occasions.Testing of her siblings revealed no other family members were at risk.The study, led by Genomics England and Queen Mary University of London, marks the first time that whole genome sequencing has been used in a healthcare system and applied to large numbers of patients with rare diseases.Queen Mary’s Prof Sir Mark Caulfield, former chief scientist at Genomics England, said it was a “major advance” which could be rolled out worldwide at the first sign of symptoms.He said the study paved the way for the technique being used in the NHS.What is whole genome sequencing?It’s the process of analysing entire genomes – or all the genes plus the DNA that make up a human being.Your genome is unique, is more than three billion letters long, and is found in almost every cell in your body.Sequencing someone’s genome involves donating a sample of DNA, normally from a small blood sample.One human genome can be sequenced in about a day – but the analysis of it takes much longer.Picking out the differences between one person’s genome and a “reference” genome is the goal and there are often millions.Most are harmless, but they are the reason we are different from each other.Using clever software, scientists work out exactly which differences could be the cause of disease, and these are then fed back to the NHS and the patient.What did the study find?Whole genome sequencing led to a new diagnosis for a quarter of those who took part. They were then able to receive better care, such as change of diet, provision of vitamins and other appropriate therapies. Screening of other family members for the same diagnosis could also take place. A total of 14% of those diagnosed were found in regions of the genome which would have been missed by other methods of testing.Most of the rare diseases identified were: eye conditionsneurodevelopmental conditions metabolic conditions, which are related to diabetes, high blood pressure and obesityThe genes of 4,660 people from more than 2,100 families were analysed between 2014 and 2016 for the study, published in New England Journal of Medicine.Many had gone through years of testing and appointments without getting any answers about the disease affecting their family. All were part of the 100,000 Genomes Project, led by Genomics England.Are rare diseases always genetic?About 6% of the population in Western societies is affected by approximately 10,000 rare disorders.More than 80% of these have a genetic component, and they are often disabling and expensive to manage. One third of children with a rare disease die before their fifth birthday.Prof Damian Smedley, from the Queen Mary research team, said the new approach “was key to us being able to solve the ‘needle in a haystack’ challenge of finding the cause of a rare disease patient’s condition amongst the millions of variants in every genome”.Prof Chris Inglehearn, professor of molecular ophthalmology, at the University of Leeds, said the results showed “beyond doubt” that human genome sequencing “can revolutionise medical care for a wide range of human diseases”.But he added that the 100,000 Genomes Project, which provided the data used in the study, “can prove difficult for clinicians and researchers to access” and that needed to be addressed.Another challenge, scientists say, would be deciding how whole genome sequencing could and should be used to identify rare conditions within the NHS.The 100,000 Genomes Project – Genomics EnglandGenomics EnglandRare Disease UKThe BBC is not responsible for the content of external sites.

SharecloseShare pageCopy linkAbout sharingImage source, Getty ImagesThe puzzle of why humans are growing taller and reaching puberty earlier than ever before can be explained by a sensor in the brain, scientists say.Average height in the UK rose by 3.9in (10cm) during the 20th Century, and up to 7.8in in other countries, as nutritional health improved.But exactly how this happens has never been understood.The discovery could lead to drugs to improve muscle mass and treat delayed growth, UK researchers say.Scientists have known for a long time that humans with good diets and reliable access to food tend to grow taller, and mature more quickly. In South Korea, for example, adult height has rocketed as the nation transformed from a poor country to a developed society. Yet in parts of South Asia and Africa, people are only slightly taller than 100 years ago.’Make lots of babies’It’s known that signals from food reach a part of the brain called the hypothalamus, telling it about the body’s nutritional health, and triggering growth.This new study, published in Nature, and led by researchers from the University of Cambridge alongside teams from Queen Mary University of London, University of Bristol, University of Michigan and Vanderbilt University, has discovered the brain receptor behind that process.It’s called MC3R and is the crucial link between food and sex development and growth. “It tells the body we’re great here, we’ve got lots of food, so grow quickly, have puberty soon and make lots of babies,” said Prof Sir Stephen O’Rahilly, study author, from Cambridge.”It’s not just magic – we have the complete wiring diagram for how it happens.” Image source, Getty ImagesWhen the brain receptor doesn’t work normally in humans, the researchers found people tended to be shorter in height, and started puberty later than other people.The team searched through the genetic make-up of half a million volunteers signed up to the UK Biobank – a huge database of genetic and health information – to confirm this was true.Children found to have gene mutations which disrupt the brain receptor, were all shorter and weighed less than other children, which shows the effect starts early in life.The research team found one person who had mutations in both copies of the gene for MC3R, which is extremely rare and damaging. This person was very short, and started puberty after the age of 20.Drugs for the futureBut humans are not alone in this – researchers studied mice to confirm that the same pathway is at work in animals.The discovery could help children with serious delays in growth and puberty, as well as those who become frail with chronic diseases and need to build up muscle.”Future research should investigate if drugs that selectively activate the MC3R might help redirect calories into muscle and other lean tissues, with the prospect of improving the physical functionality of such patients,” Prof O’Rahilly said.Scientists had already identified a brain receptor which controls appetite, called MC4R, and those who lack it are usually obese.Can people keep growing taller?There is a ceiling for height and it’s reached when people achieve their genetic potential.Factors such as health and diet have a huge impact on whether that happens.When children from poorer families get enough food and calories, they can grow to the height they inherit from their parents and grandparents.Taller people generally live longer and are less likely to suffer from heart problems, and may also end up earning more.But humans can’t keep on growing forever.Like many other countries in Europe, average height in the UK shot up during the last century – but there are signs in the last 10 years that it’s flattening.Elsewhere, the largest height rises over the past century have been in South Korean women and Iranian men.The tallest people in the world are men born in the Netherlands (71.8in), while the shortest are women born in Guatemala (55.1in).UKRI – UK Research and InnovationMRC Institute of Metabolic Science at Cambridge UniversityThe BBC is not responsible for the content of external sites.

SharecloseShare pageCopy linkAbout sharingImage source, Getty ImagesMany people who have taken anti-depressants for at least two years may be able to stop them without relapsing, but most will still need long-term treatment, a UK study suggests.Prescriptions for the drugs have more than doubled in the past 15 years because people are staying on them for much longer. But it’s not clear how well they work over many years.The researchers say they want to find out who is benefitting and who isn’t.Their findings, published in The New England Journal of Medicine, show 44% of people who gradually stopped taking their anti-depressants did not have another bout of depression in the following year.Of people who continued to take their medication as normal, 61% did not relapse.’Not ideal for everyone’Study author Dr Gemma Lewis, from University College London, said: “Our findings add to evidence that for many patients, long-term treatment is appropriate, but we also found that many people were able to effectively stop taking their medication when it was tapered over two months.”The researchers said it was important to consult a doctor before doing this. They also said psychological therapies could help prevent a relapse, although there was often a waiting list.Prof Glyn Lewis, also from UCL, said: “Anti-depressants are effective but, like many medications, are not ideal for everyone.”Anti-depressants work, major study says’My anti-depressant withdrawal was worse than depression’The 478 adults involved in the study were recruited from 150 GP surgeries across England, and all had been taking anti-depressants for at least two years and felt ready to come off them.They were separated into two groups – in one, people continued to take their medication while in another, their drugs were tapered off over three months – and followed up for a year.Of those who stopped taking anti-depressants, 56% said they relapsed or felt depressed again for more than two weeks at some point. They were also more likely to experience symptoms of withdrawal, which could be confused with a relapse and may mean some people need to come off the drugs more slowly, the researchers said.Despite this, only half chose to start taking anti-depressants again, and by the end of the study, 59% of the group who had stopped the drugs were no longer taking any depression medication.Even in the group which continued taking their medication, more than a third said they felt depressed at some stage.Long-term useThe research team does not know why some people seem able to come off their anti-depressants and some cannot, but predicting who can stop them safely is the next challenge.With prescriptions for anti-depressants increasing, there are concerns that more and more people could end up taking them for life – and the risks of long-term use are still unclear.Study author Prof Tony Kendrick, from the University of Southampton, says long-term use in people over 65 may be leading to more falls, strokes and seizures – but the overall risks are low, and it is not known whether it is the drugs causing these issues, or underlying health problems.Younger middle-aged patients reported far fewer side-effects from taking anti-depressants for many years.Prof Kendrick said he was “cheered” by the findings which showed people were not taking the drugs “unnecessarily”.The medications in the study are some of the most commonly prescribed – citalopram, sertraline, fluoxetine or mirtazapine. Other drugs, which are more difficult to withdraw from, were not studied.’No right answer’Professor Sir Simon Wessely, regius chair of psychiatry at King’s College London, said the study was “very important”, and would help patients make an informed choice.”Yes, you can come off medication, provided it’s done slowly, but there is a small, but not insignificant, risk of another illness,” he said.”As ever there is no right answer, but this study provides more information to assist people in making up their minds.”Mental health charity Mind said it wanted to make sure that people have access “to a range of treatments and are able to have open discussions with their GP”.These discussions should include any possible side effects so people feel they can change or withdraw from medication safely, it said. Researchers from the universities of York, Southampton and Bristol, and McMaster University in Canada, were also involved in the study.Related Internet LinksOverview – Antidepressants – NHSAntidepressants A-Z – Mind, the mental health charity – help for mental health problemsThe BBC is not responsible for the content of external sites.

SharecloseShare pageCopy linkAbout sharingimage copyrightGetty ImagesA surge in flu and other respiratory viruses could put pressure on people’s health and the NHS this winter, warns a report by leading medics.They say testing for flu, Covid and a respiratory virus common in children and the elderly – called RSV – may help doctors treat cases more quickly.The Academy of Medical Sciences report calls for people with any symptoms to isolate and stay at home.This will help protect against all respiratory viruses this winter.The report, by 29 leading experts and requested by the government, says there is great uncertainty about what the next few months will hold across the UK, but it urges policymakers to prepare for a challenging winter.Comeback of winter virusesDuring lockdown last winter, the UK population was hardly exposed to the viruses which normally circulate. But they are now set to make a comeback as restrictions lift and society opens up.Already this summer, there has been a rise in winter viruses in children coming to A&E.Report author Prof Azra Ghani, from Imperial College London, says their modelling suggests a summer peak of Covid-19 infections “with subsequent local outbreaks over winter”.But “we can’t completely rule out another winter wave”, she said.”Whilst we expect the peak in deaths to be considerably lower than last winter, under some scenarios we could see hospital admissions rise to similar levels.”Will 19 July unlocking gamble pay off or backfire?How many people have been vaccinated so far?Where will I have to carry on wearing a mask?In a worst-case scenario this could mean around twice the levels of flu and respiratory syncytial virus (RSV) as a normal autumn and winter, the report says.There are between 10,000 and 30,000 deaths from flu in a normal winter, and about 20,000 children under five are admitted to hospital each year with RSV, which can cause a lung infection called bronchiolitis.Triple testsThe authors say these viruses often produce similar symptoms, so testing for all three at once would help distinguish between them.This could be done through Test and Trace or in GP practices, but the turnaround would need to be very fast so that anti-virals could be used to treat flu in the most vulnerable.Dr Alexander Edwards, from the University of Reading, said the “triple tests” had “great appeal”, but the logistics could be a challenge.”Whether there will be enough instruments and testing capacity available for this to be available widely in primary care remains to be seen,” he said.The report also recommends booster Covid vaccines alongside flu vaccines this autumn to reduce the spread of the virus, which is already being planned by the NHS for the over-50s, and improving infection control in hospitals.Stay at home adviceIt says all adults need to be vaccinated against Covid by September. Currently, two-thirds of UK adults have received two doses and 87% have had one dose.But the number one way to reduce transmission is for people to have a test when they have symptoms and stay at home if they are ill, says Prof Dame Anne Johnson, president of the Academy of Medical Sciences.”We are calling on the government to urgently strengthen the financial and practical support that will allow all people to self-isolate if they need to, whatever their circumstances,” she said.The medics also emphasise the importance of face coverings, social distancing and meeting friends outdoors – to protect against Covid as well as other respiratory viruses, as society opens up.Related Internet LinksImproving Health Through Research – The Academy of Medical SciencesThe BBC is not responsible for the content of external sites.

SharecloseShare pageCopy linkAbout sharingimage copyrightGetty ImagesEngland’s Euro 2020 progress could be behind infections rising faster among men than women in the past two weeks, Imperial College London data suggests.The React study, which tested more than 47,000 volunteers across England between 24 June and 5 July, confirms a “substantial third wave of infections”.And the men were 30% more likely than the women to test positive for Covid.The infections had not translated into a large number of people in hospital or dying, however, the study found.And vaccinated men and women were much less likely than others to catch the virus. “It could be that watching football is resulting in men having more social activity than usual,” report author Prof Steven Riley said.The report also found:prevalence of the virus had risen from 0.15% in early June to 0.59% in early Julybig rises in infections across all age groups under 75 and especially among younger people1.33% of the 13-17 and 1.4% of the 18-24-year-olds were infectedLondon had seen the largest increase in infections – to 1.08%vaccinated under-65s were three times less likely to be infected than unvaccinated people of the same agetwo vaccine doses gave 72% protection against a positive test resultThe study results show a similar pattern to the Office for National Statistics (ONS) survey data published weekly, which also uses tests of people in the community.”We are entering a critical period with a number of important competing processes,” the report says.They include:the continued vaccination rollout to the whole adult populationincreased natural immunity through infectionreduced social mixing of children during school holidays more mixing outdoors during summerIn addition, on 19 July, the government is lifting all remaining Covid restrictions in England – including all legal limits on social interactions and rules on numbers of people attending large events and performances. Face coverings will also no longer be mandatory indoors, although people are advised to wear one where necessary.Future infection rates were difficult to predict, the researchers said. But the prime minister has made clear cases are expected to rise as society opens up. How could life change on 19 July?Millions could end up self-isolating this summerI’m fully vaccinated, but how can I prove it?React programme director Prof Paul Elliott, from Imperial’s School of Public Health, said: “In spite of the successful rollout of the vaccination programme, we are still seeing rapid growth in infections, especially among younger people.”However, it is encouraging to see lower infection prevalence in people who have had both doses of a vaccine.” It was essential as many people as possible took up both vaccine doses when offered, he added.’Curb transmission’Almost two-thirds of adults – 64% – have now had both doses.Covid-19 Vaccine Deployment Minister Nadhim Zahawi said: “It is hugely encouraging to see the vaccination rollout is having a significant impact on stopping the spread of the virus. “I urge everyone to get their first and second dose when invited, as every jab helps to curb transmission and serious illness. “The small number of people who are double jabbed and experience symptoms should continue to get tested so we all play our part to stop the spread of this awful virus.”LOOK-UP TOOL: How many cases in your area?THE R NUMBER: What it means and why it mattersCOVID IN SCHOOL: What are the risks?VACCINE: When will I get the jab?COVID IMMUNITY: Can you catch it twice?

SharecloseShare pageCopy linkAbout sharingimage copyrightReutersA single-dose Covid vaccine made by Janssen has been approved for use in the UK by the medicines regulator.The vaccine was 85% effective in stopping severe illness from Covid-19 in trials and has met expected safety standards.Twenty million doses have been ordered for the UK and will arrive later this year.It will be the fourth vaccine to be used in the UK to protect against Covid-19.More than 38 million people have now received a first dose of a vaccine in the UK – nearly three-quarters of the adult population.The vaccine can be given to people aged 18 and over and is likely to be used as a booster jab for care home residents ahead of winter because it can be easily stored and transported at fridge temperatures.The UK’s Joint Committee on Vaccination and Immunisation (JCVI) will produce advice on exactly who should receive the Belgian-made jab in due course.The single-dose option has already been authorised by the European Medicines Agency (EMA), the Food and Drug Administration (FDA) in the US and the World Health Organization (WHO).The vaccines that work – and the others on the wayHow many people have been vaccinated so far?Who can book their Covid vaccine now?Covid vaccines and rare clots – what do we know?Nadhim Zahawi, vaccine deployment minister, said the Janssen jab would be “another weapon in our arsenal to beat this pandemic”.”We are doing everything we can to vaccinate all adults as quickly as possible and I encourage everybody to come forward for a jab as soon as they are eligible.”First Minister Nicola Sturgeon said the approval was “really good news” but “we’re focused right now on the supplies we actually have and getting them into people’s arms as quickly as possible”, she said.Originally, the UK ordered 30 million doses but reduced its order after the vaccination programme in the UK picked up pace.The vaccine, developed by Johnson & Johnson’s pharmaceutical arm, Janssen, uses the same technology as the Oxford-AstraZeneca one and is likely to be more suitable for older adults than younger people. Under-40s are being offered an alternative to AstraZeneca in the UK because of a potential link to a type of rare blood clot in the brain.Both vaccines use a modified version of a different virus to deliver instructions to the body’s cells to fire up the immune system and produce antibodies.Since the Janssen jab is given as one single dose, it could speed up rollout to vulnerable people in care homes and those living in remote locations.It has not yet been tested against the variant first detected in India which is spreading fast in the UK, although at low levels.The US, South Africa and the European Union briefly paused the rollout of the Janssen vaccine in April after reports of rare blood clots in very small numbers of people after their jab.The US is now offering the vaccine to people over 18, after concluding that the benefits of using it outweighed any risks of side-effects. The European Medicines Agency (EMA) came to the same conclusion after looking at a potential link between the vaccine and clots.The Janssen jab is currently being tested as part of a UK study to find out whether a third dose could protect against new variants.Dr June Raine, head of the body which approves vaccines in the UK – the Medicines and Healthcare products Regulatory Agency (MHRA) – said information on quality, safety and effectiveness of the Janssen jab had been thoroughly reviewed.”We now have four safe and effective vaccines approved to help protect us from Covid-19,” she said, adding that their work did not end there.”We are continually monitoring all Covid-19 vaccines in use once they have been approved to ensure that the benefits in protecting people against the disease continue to outweigh any risks. “The safety of the public will always come first – you can be absolutely sure of our commitment to this.”The MHRA said pregnant or breast-feeding women should decide whether to have the Janssen option in consultation with a healthcare professional after considering the benefits and risks.There have been a further 10 deaths within 28 days of a positive test for coronavirus and another 4,182 confirmed cases on Friday.

SharecloseShare pageCopy linkAbout sharingimage copyrightOlivia Acland / UNICEFNurse Jeanne Dusungu is vaccinating anyone who turns up to the white Unicef tent in the grounds of North Kivu provincial hospital in Goma against Covid-19 – but very few are locals.”There are some false rumours circulating, that the vaccine is fake, that it will make us sterile. There are people who think that,” she says, disbelievingly.”I tell the people to come and get vaccinated – it is protecting yourself and protecting others, your family, the entire nation.”But in the Democratic Republic of Congo, the second largest country in Africa and nearly the size of Western Europe, this is proving an uphill struggle.Only 5,000 people have been vaccinated out of a population of nearly 90 million.And in the city of Goma, where the rollout has just started after numerous delays, there is a worrying lack of interest. image copyrightOlivia Acland / UNICEFIt means 1.3 million AstraZeneca doses, out of 1.7 million received in early March through Covax – the international fair access scheme – are being redistributed to other African countries for use before they expire at the end of June.The reasons are complex:concerns over the potential link to rare blood clots in Europe delayed vaccine rollout in many African countries too, just as vaccination was startingsome European countries restricted use of the vaccine to certain age groups or gave away their doses altogetheras a result, harmful misinformation spread on social media about its safetyimage copyrightOlivia Acland / UNICEFimage copyrightOlivia Acland / UNICEFThere’s also a lack of trust in the systems and governments and a feeling Covid is less of a threat than many other deadly diseases like Ebola and measles.A recent outbreak of measles in DR Congo killed more than 7,000 people – many of them children, while Ebola outbreaks regularly occur. For some Goma residents, Covid is not visible. Claudine, 40, a cleaner, says she has never seen anyone who died from it and is not scared of it, unlike Ebola.image copyrightUnicefFor others in the conflict-hit DR Congo, there are more pressing priorities than Covid-19.”The war kills a lot more people than corona does,” says Gabriel, 46, a taxi driver.Josue, 23, a student, is put off by what he hears online and prefers to focus his energy on studying and then finding a job.”We heard that Covid-19 would kill lots of people but much bigger problems are insecurity and unemployment, because we don’t know even if tomorrow we’ll be alive,” says John Remi Bahati, who is 35 and unemployed. How many vaccines is Covax delivering?In Africa, 42 out of 54 countries have joined Covax and received 18.3 million doses between them, with nearly eight million used so far.The international scheme aims to ensure equal access to safe and effective Covid vaccines worldwide,The Oxford-AstraZeneca vaccine makes up more than 90% of doses supplied to Africa, which are manufactured in India.Covax wants to vaccinate at least 20% of the African population by the end of 2021, with the first 3% – 90 million doses – going to health workers and other vulnerable groups.What about other African countries?African countries which are not part of Covax can access vaccines through the African Union or through their own deals with manufacturers.Countries doing this include South Africa, Zimbabwe and Gabon.Why are vaccines going to waste in Africa?New virus variants causing concern in AfricaIn Malawi, where uptake of the vaccine had been very good, there’s a different challenge.False rumours started spreading that its vaccine stock was out of date after it received supplies of AZ from South Africa, which no longer wanted them.Dr Charles Mwansambo, Malawi’s health minister, told the BBC: “Unfortunately people thought all our vaccines had expired.”Some stopped coming to our facilities completely, saying that they would be getting expired vaccines, whilst those that came ended up hesitating. So that reduced our numbers by about 50%,” he said.To restore public confidence, health officials in Malawi now plan to set fire to 16,000 unused doses.Meanwhile, neighbouring Rwanda delivered all the AZ doses they received into arms within weeks, as did Ghana and Ethiopia, although there are concerns that delays to new supplies arriving from India could delay progress there. High demand for vaccines in India means no deliveries to African countries until at least June.image copyrightOlivia Acland / UNICEFThe World Health Organization says 22 countries in Africa have used less than a quarter of their supplied vaccines. It says not using them quickly risks another wave of Covid.It’s now a race against time in these countries to increase people’s trust in all the vaccines.Dr Ayoade Alakija, head of the African Union’s vaccine taskforce, says real damage has been done by headlines and delays over safety.”In the US, there were announcements saying ‘don’t take the Johnson & Johnson vaccine but we will give you a Pfizer or a Moderna’. But in most parts of the world there isn’t an alternative,” she said. Only just over 1% of the population of Africa have been vaccinated with a first dose, compared with 20% in Europe and 25% in the US.One worry is that there could be uncontrolled spread of the virus among unvaccinated people which could lead to mutations, or a more virulent form of the disease emerging.image copyrightOLIVIA ACLANDimage copyrightOlivia Acland / UNICEF”Variants are my biggest worry if people stay unvaccinated,” says Catherine Kyobutungi, executive director of the African Population and Health Research Centre.To date, there have been about 122,000 deaths from Covid-19 across Africa – lower than the UK’s death toll alone, but under-reporting means the true figure could be higher.Vaccines are the only way to save lives from Covid-19 in the long term and building trust in them is now vital.Nicolas Sinumyayo Barole, 60, who works in the health sector in Goma, had the vaccine and says: “Lots of people have not understood the importance of the vaccine.”I want to tell them about the advantages, tell them to come and vaccinate themselves. “If the rest of the world is getting vaccinated to stop the spread of Covid-19, then why not here?”Related Internet LinksCOVID-19 vaccines – WHO – Regional Office for AfricaCOVID-19 Vaccination – Africa CDCThe BBC is not responsible for the content of external sites.