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September 11, 2020

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The weekly global report provides brief updates on COVID-19 related activity and policy development in AdvaMed’s priority markets. For additional information, please contact Ralph Ives at Rives@AdvaMed.org.

COVID-19 Outbreak: Weekly Global Report for Friday, September 11, 2020

 

AdvaMed recognizes that its members, particularly those with global government affairs responsibilities, are tracking COVID-19 related developments around the world to assess the public health and economic impacts on their businesses. Knowing that companies are consuming information from a variety of sources, AdvaMed's global team would like to provide members with a weekly snapshot of the key statistics, policy developments and advocacy initiatives underway in our priority markets.  If you have any suggestions, we welcome your feedback.

 

Global

  • Weekly COVID-19 statistics- global cases reached 28 million, nearly a 3.5 million increase over the previous week. Deaths around the world exceeded 906,000 The countries with the most reported cases continue to be the U.S. (million), India (4.46 million), and Brazil (4.2 million).
  • U.S. cases exceeded 6.1 million with deaths increasing to 191,612.
  • Staff Contact: Ralph Ives (rives@advamed.org).

    China

    • Weekly COVID-19 statistics –China’s total COVID cases now stand at 90,112 (an increase of 160 over the previous week) and deaths at 4,733 (an increase of 6 over the previous week).With localized outbreaks now under control, most new cases have been linked to foreign arrivals.
    • The State Council has called for urgent preparations to combat the virus during the autumn and winter months. Priority measures include: enhanced customs inspections (notably of “carrier” foods like fresh seafood imports), more efficient and accurate nucleic acid testing platforms, and more rigorous management of quarantined areas.
    • This week, China held a ceremony in the Great Hall of the People to commemorate China’s “victory” over COVID-19. President Xi conferred medals to individuals (both alive and deceased) who are credited with leading China’s battle against the virus.
    • The Chinese economy performed better than expected in August, according to government statistics. Exports experienced a noticeable rebound in July and August, as other large manufacturing nations struggle with COVID fallout. Consumption levels have continued to rise.
    • Anecdotal evidence suggests that hospitals have been gradually resuming elective/regular surgeries and operations appear to be at 80-90% of pre-COVID levels, with this range varying by particular medical condition of the patient and geographical area.
    • Last week, direct flights to Beijing resumed from eight countries: Thailand, Cambodia, Pakistan, Greece, Denmark, Austria, Sweden, Canada. Previously, all international flights destined for Beijing had to transit through another Chinese city beforehand.
    • While U.S.-China relations remain in a downward trajectory with President Trump signing executive orders targeting Chinese apps WeChat and TikTok. The Phase One trade deal, however, remains intact and has emerged as a key area of cooperation. USTR Lighthizer and Secretary Mnuchin spoke with Vice Premier Liu He on Aug. 25 to discuss Phase One implementation from a high level
    • Staff Contact: Kyle Churchman (kchurchman@advamed.org)

          India

          • Weekly COVID-19 statistics – 4,462,965 total cases, 919,018 active cases/75,062 deaths as compared to 3,848,968 total cases with 815,538 active cases/67,376 deaths last week.  India registered a record 95,735 coronavirus cases in 24 hours. The country also recorded the highest deaths in a day with 1,172 fatalities. The last recorded highest spike was on Tuesday when India registered 90,802 cases. The highest deaths were recorded a day later with 1,133 fatalities.
          • India resumed some metro rail services in urban locations including New Delhi on Sep 7,2020. The government has mandated that all passengers wear masks and maintain a social distance.  
          • The Indian Government is in discussions with Russia to pave the way for phase-3 trials and scale up the manufacture of the Sputnik V vaccine for coronavirus developed by Moscow-based Gamaleya Institute in India, V K Paul, member-health, NITI Aayog said on Sep 8,2020. He also said that Indian scientists have studied the Russian vaccine data and assessed a need for a phase three trial which can be facilitated by the government as per the regulatory system of India.
          • Dr Reddys Laboratories Ltd. announced the launch of Remdesivir, meant for treatment of COVID-19 patients, under a brand name ‘Redyx’ in India on Sep 9,2020. According to a press release from the drug maker, the launch is part of the licensing agreement with Gilead Sciences that grants Dr Reddys the right to register, manufacture and sell Remdesivir, a potential treatment for COVID-19, in 127 countries including India.
          • India's first indigenous coronavirus vaccine, Covaxin developed by Hyderabad-based Bharat Biotech, is likely to be launched in early 2021. Covaxin has successfully completed Phase 1 trials and the Centre has given its approval for Phase 2 of clinical trials from September 7. Speaking to IANS, Sanjay Rai, Professor, Community Medicine, and Principal Investigator for COVID-19 vaccine trial at AIIMS, said: "Phase 1 trial has been successfully completed. Phase 2 trial is most likely to get completed sometime in October. After this, the Phase 3 trial will begin. Covaxin may be launched in early 2021 (after completion of all trial stages)."
          • The Government is reconsidering the inclusion of tocilizumab in its treatment protocol for COVID-19 after new evidence emerged that it does not improve the condition of people with the disease. Tocilizumab is a rheumatoid arthritis drug manufactured by Swiss pharmaceutical company Roche under the brand name Actemra. The medication is part of the health ministry’s clinical management protocol for COVID-19 under investigational therapies for patients with moderate symptoms of the illness.
          • Eleven teams of Indian and US scientists will soon jointly start scouting for out of the box solutions, ranging from novel early diagnostic tests, antiviral therapy, drug repurposing, ventilator research, and sensor-based symptom tracking for COVID-19, the department of science and technology said on Saturday, Sep 5, 2020.
          • Scientists at the Institute of Genomics and Integrative Biology have developed a rapid and sensitive method to detect coronavirus infection in 30 minutes using a mass spectrometer. In the study by the scientists of IGIB, an institute under the Council for Scientific and Industrial Research (CSIR), the rapid test method can detect two peptides, QIAPGQTGK and AIVSTIQRKYK, from structural spike glycoprotein and replicase polyprotein with a sensitivity of 90 per cent and specificity of 100 per cent.
          • India’s economy is projected to contract 11.8% on the year in the current fiscal year beginning from April, before bouncing back in the next fiscal year, India Ratings and Research , a domestic arm of ratings agency Fitch, said on Sep 8, 2020.
          • Staff Contact: Abby Pratt (apratt@advamed.org).

                        Japan

                        • Weekly COVID-19 statistics – 74,738 reported cases and 1, 429 reported deaths compared to 71,118 reported cases and 1,347 reported deaths the previous week.
                        • Despite the growing number of cases, the Japanese government has no plans to reinstate emergency measures.
                        • The growing caseload has had a severe impact on Japan’s hospitals.       Some hospitals are cutting back or halting elective surgeries in order to deal with the influx of new cases. Nearly 70% of Japan’s hospitals are now operating in the red.
                        • According to a survey conducted by the Japan Public Hospital Federation of 1,481 member hospitals, patient visits in May 2020 were down by 24.9 percent, compared with one year ago.
                        • The majority of new cases are in Tokyo and are affecting people in their 20s and 30s.
                        • Japan and Vietnam have agreed to ease bilateral travel restrictions in stages. Vietnam will first accept 440 Japanese business travelers on three charter flights. The travelers will be required to undergo tests upon arrival and be quarantined for two weeks at hotels.   Thailand will likely be next in line for eased restrictions, followed by Australia and New Zealand.
                        • Japan currently has an entry ban in place for 111 countries and regions, with foreign travelers who have been to any of those areas within the last two weeks being turned away.
                        • Japan's Ministry of Health has adopted priority regulatory review procedures for new COVID-related medical devices.
                        • Japan will ban purchases from foreign companies of advanced medical device companies that are deemed essential to the national security in the fight against Covid-19. This measure is based on concerns about China but applies to companies from all countries.  The government aims to ensure stable supply of essential devices that are vulnerable to contamination by infection, such as implants and dialyzers.
                        • Staff Contact:  Phil Agress (PAgress@AdvaMed.org).

                                Korea

                                • South Korea’s spike is easing, but still at a level higher than they would like to see. (155 new cases per day). This remains low compared to many other countries.
                                • There are 21,743 cases, 4,037 active cases, and 346 deaths. Korea is still reporting 2 deaths per day.  
                                • A COVID-19 infection cluster that so far numbers 17 cases emerged at one of the country’s biggest general hospitals in Seoul on Thursday, as health authorities struggle to bring the number of infections nationwide below 100 per day.
                                • South Korea is finalizing a supplementary budget that will draw up a 7.8 trillion won ($6.57 billion) to shore up the economy. Cash subsidies for small businesses in the amount of 3.2 trillion won are among the items to be covered. Also included are a one-off 20,000 won subsidy for telecommunications bills for all South Koreans over the age of 13.       The supplementary budget is ‘tailored emergency aid focusing on the industries and groups most heavily affected.’
                                • Korean businesses dedicated to auto parts manufacturing, oil refining, hotels, duty-free shops, theaters and aviation are seeing a negative credit outlook and facing heightened financial pressure, making them subject to credit downgrading in the second half of 2020. The domestic industrial sectors that are reeling from the coronavirus fallout in South Korea are unlikely to see a drastic rebound and probably face longer-lasting financial strain, officials of credit rating agency the Korea Investors Service said Thursday.
                                • South Korea has not surprisingly experienced a major decline in foreign visitors. During the pandemic, Japanese visitors declined 66%, Chinese 14% and Americans 6%.
                                • South Korea's major hospitals are maintaining scaled down operations, as trainee doctors have yet to return to work despite an agreement reached to end their weekslong strike, medical sources said Saturday. Large university hospitals have reduced treatments and surgeries and have restricted the number of patients they admit, as thousands of interns and resident doctors have taken part in the walkout since Aug. 21.
                                • The Ministry of Science and ICT and the Ministry of Trade, Industry and Energy launched a government-industry team on Thursday dedicated to developing next-generation semiconductors. The government will inject a total of 1 trillion won ($842.4 million) by 2029, starting this year. The ICT Ministry will provide 488 billion won and the Trade Industry will give 521 billion won.
                                • South Korea maintains its 2-week quarantine for all other incoming international travelers and a requirement for all inbound flights to check passengers' temperatures. Anyone with a temperature over 37.5 degrees Celsius (99.5 Fahrenheit) is denied entry. Korea has not issued any guidance on an exemption that is supposedly available.  Korea has indicated all US inbound travelers will be tested for symptoms prior to being moved to quarantine.
                                • Korea appears to be moving toward implementation of a proposal that would potentially reduce the price of certain cardiac stents. AdvaMed is in touch with members and the medtech association in Korea and has had preliminary discussions with the US Government on this topic. Please contact Joseph Gatewood (jgatewood@advamed.org) if you have an interest in this matter and are not already engaged.
                                • Resources: http://ncov.mohw.go.kr/en/. 
                                • Staff Contact: Joseph Gatewood (jgatewood@advamed.org).

                                             ASEAN

                                            • Weekly COVID-19 statistics – ASEAN now has 529,970 reported cases and 12,787 reported deaths compared to 484,862 reported cases and 11,675 reported deaths the previous week.
                                            • The Philippines and Indonesia account for 97.9% of the deaths from COVID-19 in the region. Indonesia’s total COVID-19 deaths exceed 8,400, the highest level in East Asia.  The Philippines reported 4,066 deaths.
                                            • Cambodia, and Laos have each reported zero deaths, while Brunei has reported 3 deaths, Singapore has reported 27 deaths (despite having over 56,000 cases), and Thailand has reported 58 deaths. All of these totals are unchanged from the previous week. Myanmar reported 14 deaths, up from 6 the previous week.
                                            • Vietnam’s outbreak in Danang several weeks ago followed 100 days without any locally transmitted cases and led to its first COVID-19 fatalities (35 reported to date). Following strong measures to contain the outbreak, the number of cases in Vietnam grew by only 13 over the past week. Vietnam has begun its 3rd phase of reopening now that the outbreak has been contained. It is planning to resume international air routes with China, South Korea, Japan, Taiwan, Cambodia, and Laos from September 15.
                                            • Malaysia has imposed an entry ban on citizens of countries recording more than 150,000 cases of COVID-19. International chambers of commerce, including AmCham and EuroCham, have urged the Malaysian government to reconsider the entry ban.
                                            • Thailand broke its 100-day streak without any locally transmitted COVID-19 cases, as the country reported its first case from community transmission after largely eradicating the virus over the summer. 
                                            • Elective surgeries have resumed in Thailand and Vietnam.
                                            • In Indonesia, provincial hospitals are resuming elective surgery with COVID-19 protocols in place.
                                            • Malaysia maintains limits on elective surgery except in emergency cases.
                                            • Singapore restricts most elective surgeries but allows certain procedures including cancer screening, surgical operations for advanced cataracts, flu vaccinations, and dental procedures.  The government has lifted measures requiring doctors and healthcare workers in the public and private sectors to limit their movements across healthcare institutions. 
                                            • Indonesia has lifted the ban on export of medical devices for COVID-19 purposes. At the same time, President Jokowi has called for an end to PPE imports as the country is capable of manufacturing them locally. Indonesia has produced its own rapid test called RI-GHA COVID-19. 
                                            • Malaysia and Singapore partially reopened their border on August 10. Both governments have agreed to implement a Reciprocal Green Lane (RGL) and Periodic Commuting Arrangement (PCA). The RGL will enable cross-border travel for essential business and official purposes between both countries and the PCA will allow residents of Singapore and Malaysia who hold long-term immigration passes for business and work purposes in the other country to enter the country for work.  
                                            • Singapore has agreed with Australia, Brunei, China, Malaysia, and Korea on fast-lane arrangements for essential travel.
                                            • The Thai Government adopted a fifth phase of lockdown easing, allowing most daily activities and businesses to resume.  It has lifted the ban on international flights and allows certain categories of individuals from Japan, China, South Korea, Hong Kong, and Singapore to enter the country. The Civil Aviation Authority will still apply stringent international travel restrictions preventing the entry of tourists.
                                            • Thailand’s Centre for Covid-19 Situation Administration (CCSA) approved another extension of the state of emergency nationwide until September 30.
                                            • Staff Contact:  Phil Agress (PAgress@AdvaMed.org).

                                                  Europe 

                                                  There is some spiking in the case rates across the EU including Central and Western Europe. New cases are spiking in the UK, France and Spain as authorities contemplate return to stricter measures. Italy and Germany appear to still be flattened. Spain leads the EU in cases and the UK leads the EU in deaths, followed by Italy and France. Although not in the EU, Russia's reported numbers on COVID are problematic. Russia remains the COVID hot spot in Europe, now reporting 1,046,370 cases, with just 18,263 reported deaths.  By comparison, Italy, with much fewer (283,180) cases, reports 35,587 deaths.

                                                   

                                                   

                                                  Europe Chart for Sept 11th
                                                  • New daily cases, which tends to show which countries are increasing in COVID incidence is as follows:  Spain 10,764 (up dramatically from 4,503 last week); Italy 1,597 (down from 1,733 last week) Germany 739 (down from 1,467 last week); France 9,843 (up from 8,974 last week); UK 1,940 (up from 1,048 last week); Belgium 633 (up from 355 last week), Russia 5,343 (up from 4,676 last week).  Spain, France and Russia are experiencing the worst spikes in Europe. Italy and Germany are flattened. After hours information indicates the UK may be recording 3,000 new cases per day and France may be spiking to 10,000 new cases per day. But this is not reflected in the figures I have at the moment, (contained in the chart above).
                                                  • New deaths per day (which tend to lag any increased infection rates) remain low and are as follows:  Spain 71; Italy 10; Germany 2; France 19; UK 14; Belgium 5.
                                                  • Tougher coronavirus restrictions are to be imposed in Portugal ahead of the start of the school year, including halving the size of permitted gatherings and new curbs on drinking. Ministers decided on new rules to come into force from Tuesday, including limiting gatherings to 10 people rather than 20 previously - a cap already in force in the capital Lisbon since late June.
                                                  • Western Europe is once again overtaking the US in daily coronavirus infections, with numbers of new cases rising once again since lockdowns that brought the pandemic under control this spring have ended.

                                                  A report by Bloomberg news points out that the 27 countries of the European Union, plus the UK, Norway and Liechtenstein, reported 27,233 new cases on Wednesday, compared with 26,015 for the US. The resurgence comes after Europe largely abandoned the strict coronavirus measures that had been put in place across the continent earlier this year, with most economies almost completely reopened and children back at school.

                                                  • Central Europe has come out of the first wave of the coronavirus pandemic in much better shape than most of their western European counterparts. However, they are now facing higher numbers than during the spring peak of Covid-19, as restrictions return to the region. On Tuesday, the Czech Republic had more than 1,000 Covid-19 cases in a day for the first time, while Hungary has closed its borders for September to counter rapidly rising daily infection rates. Romania is reaching the milestone of 100,000 confirmed cases. Poland has seen a recent spike in August but the numbers have since dropped.
                                                  • The EU prohibition against inbound travelers from the US, Russia and Brazil based on COVID concerns remains in place. Inbound travel is permitted from any of 15 approved countries and the list is updated every two weeks. The EU recommended member states gradually lift the travel restrictions for the following countries: Japan, Canada, Georgia, Australia, New Zealand, Rwanda, South Korea, Thailand, Tunisia and Uruguay. There has also been a recommendation to ease restrictions on China, subject to confirmation of reciprocity measures by China’s government.
                                                  • The Commission continues to have exploratory talks with vaccine companies to purchase a potential vaccine when it becomes ready. To date the Commission has reported positive talks with Sanofi-GSK, Johnson and Johnson, CureVac and AstraZeneca.
                                                  • The European Court of Justice has struck down the EU-US Privacy Shield law based on arguments from an EU plaintiff that the US security laws did not sufficiently protect EU citizens. Commerce Secretary Wilbur Ross expressed ‘deep disappointment’ in the ruling and said he would work with the EU to limit any negative consequences. AdvaMed will be holding an informational webinar with the International Pharmaceutical Privacy Consortium (IPPC) on September 16 at 11:30 Eastern. Registration details have been sent to all relevant working groups.
                                                  • EU countries lost an estimated €140 billion in Value-Added Tax (VAT) revenues in 2018, according to a new report released by the European Commission.
                                                  • The eighth round of negotiations on the future EU-UK partnership took place in London this week, with apparently little progress. The EU made a public statement that indicated it has shown flexibility to work around the UK's red lines and find solutions that fully respect the UK's sovereignty, specifically with regard to the role of the European Court of Justice, the future legislative autonomy of the UK, and fisheries. However, the EU indicated the UK has not engaged in a reciprocal way on fundamental EU principles and interests. The EU noted significant differences remain, stating that the UK is refusing to include indispensable guarantees of fair competition in our future agreement, while requesting free access to our market. According to the EU, the UK still has not provided important guarantees on non-regression from social, environmental, labor and climate standards and other issues as well. The EU indicated it is intensifying its preparedness work to be ready for all scenarios on 1 January 2021.
                                                  • In the UK there is again controversy swirling over Brexit. In addition to both the EU and the UK reporting that Brexit talks are not going well, there was public vetting of a proposal to bring forward legislation that would override the EU withdrawal agreement. The proposed legislation would override portions of the Northern Ireland protocol in the event of a no deal Brexit and is controversial due the fact that it appeared to violate international law (namely the Brexit deal the UK signed with the EU). Some ministers disagreed with the proposal, adding to the controversy. For its part, the EU has threatened the UK with legal action if it does not abandon the bill to override key parts of the Brexit divorce deal "by the end of the month".
                                                  • The disruption to hospitals in England during the pandemic has meant the number of patients facing long waits for routine operations has soared. More than two million people on the waiting list - half the total - have been waiting more than 18 weeks. 83,000 have waited over a year, up from 2,000 before the pandemic.
                                                  • On Thursday, gatherings of more than six persons are banned in England due to fears of COVID resurgence.
                                                  • The British Medical Journal has reported on the Government’s plans to carry out 10m covid-19 tests per day by early next year as part of a £100bn expansion of its national testing program.
                                                  • The House of Commons Public Administration and Constitutional Affairs Committee have published two reports on i) the Parliamentary Scrutiny of the Government’s handling of Covid-19 and ii) on A Public Inquiry into the Government’s response to the Covid-19 pandemic.
                                                  • ABHI is conducting a comprehensive analysis of the re-start of elective procedures in each Trust and Health Board in the UK. The results can be found here: https://www.abhi.org.uk/membership/members-area/updates/2020/july/the-restart-of-planned-care/.
                                                  • Germany is experiencing divergent policies in its states on many key issues, such as wearing of masks by children in schools, due to the fact that the states have considerable autonomy to pursue their own policies in health and education among other areas.
                                                  • The German Foreign Ministry announced new travel warnings late Wednesday for high-risk regions throughout Europe. In France, existing warnings will be extended to the island Corsica, Ile-de-France, Provence-Alpes-Cote-d'Azur and Nouvelle-Aquitaine.  Travelers to Switzerland are warned against visiting the cantons of Geneva and Vaud, while the censure also applies to the Czech capital of Prague and parts of Croatia.  Germany’s blanket travel warning for around 160 non-European countries will only be extended until the end of September, after which authorities will evaluate each country individually. 
                                                  • Germany has pledged to spend 4 Billion Euros by 2026 to allow for an additional 5,000 public health workers and digitalization of public health departments.
                                                  • France has announced details of a 100 billion euro recovery plan. While all of the funds are earmarked for economic activity and to create jobs, a third of the funds are earmarked for green investment. This would come on top of existing measures that currently amount to around 460 billion euro.
                                                  • France’s government will announce new Covid-19 measures tomorrow (Friday), after Emmanuel Macron hosts a defense council meeting. Ministers are saying nothing is excluded but it is known that many officials are opposed to a national lockdown. The expected Friday announcement occurs the day after the country’s scientific council warned that the government may have to make unpopular decisions within days to counter persistently high infection rates and the risk of very rapid, exponential rise of the infection.      
                                                  • France is rigorously testing a potential revolutionary test called EasyCov which gives a color based reaction to determine the presence of antibodies, eliminating the need to send samples to labs. Another similar saliva test is also being studied.
                                                  • If you are experiencing difficulties with exporting PPE from the EU, please let us know immediately. We have not seen any instances of this occurring since an initial incident was resolved.
                                                  • The proposed one-year suspension of implementation of the EU's MDR is now final.  The measure extends until May 26, 2021 the date of application of the current regulation but does not extend every target deadline referenced in the law.  It also creates the possibility of EU-wide derogations for specific medical devices.
                                                  • https://ec.europa.eu/commission/presscorner/detail/en/IP_20_718;
                                                  • https://www.medtecheurope.org/news-and-events/press/medtech-europe-welcomes-the-amendment-of-the-medical-devices-regulation-and-urges-similar-action-for-the-ivd-regulation/.
                                                  • AdvaMed's joint programs in Germany and the UK continue to provide COVID-19 updates and support on MDR implementation. We recently hosted joint webinars and working group calls with ABHI to give members the latest information.  
                                                  • Resources: https://www.ecdc.europa.eu/enlll;
                                                  • https://www.europarl.europa.eu/news/en/headlines/priorities/eu-response-to-coronavirus;
                                                  • https://www.gov.uk/guidance/coronavirus-covid-19-information-for-the-public;
                                                  • https://www.ecdc.europa.eu/en;
                                                  • https://ec.europa.eu/info/live-work-travel-eu/health/coronavirus-response/economy_en;
                                                  • https://www.abhi.org.uk/what-we-do/abhi-covid-19-hub/;
                                                  • https://ec.europa.eu/commission/presscorner/detail/en/IP_20_582;
                                                  • https://www.bundesgesundheitsministerium.de/en/press/2020/coronavirus.html;
                                                  • https://www.medtecheurope.org/covid-19-information-hub;
                                                  • https://www.medtecheurope.org/resource-library/european-industry-trade-and-supply-chain-needs-to-respond-to-covid-19/;
                                                  • https://www.medtecheurope.org/wp-content/uploads/2020/03 European_Union_Emergency_Support_Instrument_for_the_healthcare_sector_-_questions_and_answers.pdf;
                                                  • https://www.medtecheurope.org/resource-library/eu-materials-covid-19/.
                                                  • Med Tech Europe White Paper on Companion Diagnostics under the IVDR:       https://www.medtecheurope.org/resource-library/joint-medtech-europe-efpia-white-paper-on-companion-diagnostics-under-the-ivdr/
                                                  • Staff Contact:  Joe Gatewood (jgatewood@advamed.org)

                                                     Latin America

                                                    Latin America Chart for Sept 11th

                                                    Regional

                                                    • Total COVID-19 cases up 6% and deaths up 6% over the previous week.

                                                    WEEKLY HIGHLIGHTS –COVID 19

                                                    • Argentina: President Fernández focuses agenda on productive recovery.
                                                    • Bolivia: Tensions between Congress and government rises while cases exceed 120,000 mark.
                                                    • Brazil: Government extends aids.
                                                    • Chile: Trucker strike ends after agreement signed with the government.
                                                    • Colombia: INVIMA drafts list of possible drug shortages.
                                                    • Ecuador: National Austerity Plan approved by the National Assembly.
                                                    • Mexico: 2021 Economic Package will be delivered to Congress on September 8.
                                                    • Paraguay: Government signs agreement with private health companies.
                                                    • Peru: The 2021 budget was presented; it includes a 13% increase for the health sector.
                                                    • Uruguay: Bilateral agreement signed to control the virus expansion in border zone.
                                                    • Staff Contact: Steven Bipes (sbipes@advamed.org)

                                                     

                                                         

                                                         

                                                         

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