Vaccines and Global Health: The Week in Review 16 May 2015

Vaccines and Global Health: The Week in Review is a weekly digest  summarizing news, events, announcements, peer-reviewed articles and research in the global vaccine ethics and policy space. Content is aggregated from key governmental, NGO, international organization and industry sources, key peer-reviewed journals, and other media channels. This summary proceeds from the broad base of themes and issues monitored by the Center for Vaccine Ethics & Policy in its work: it is not intended to be exhaustive in its coverage. You are viewing the blog version of our weekly digest, typically comprised of between 30 and 40 posts below all dated with the current issue date

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blog edition: comprised of the approx. 35+ entries posted below on this date.

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David R. Curry, MS
Executive Director
Center for Vaccine Ethics and Policy
a program of the
– Division of Medical Ethics, NYU Medical School
– Children’s Hospital of Philadelphia Vaccine Education Center
Associate Faculty, Division of Medical Ethics, NYU Medical School

Nepal earthquake 2015 – Grade 3 emergency [to 16 May 2015]

Nepal earthquake 2015 – Grade 3 emergency
:: Health situation report No. 16pdf, 281kb 15 May 2015

:: Nepal ramps up disease surveillance after earthquakes 15 May 2015

:: Global Health Cluster
..Health Cluster 4Ws – 13 May 2015xlsx, 360kb
..Health Cluster Bulletin No. 2pdf, 2.26Mb 12 May 2015

:: WHO South-East Asia Region SEARO
.. Emergency preparedness pays off as Kathmandu hospitals respond to earthquakes  13 May 2015
.. Continuing care for tuberculosis, diabetes and heart patients in earthquake hit Nepal  10 May 2015

EBOLA/EVD [to 16 May 2015]

EBOLA/EVD [to 16 May 2015]
Public Health Emergency of International Concern (PHEIC); “Threat to international peace and security” (UN Security Council)

WHO: Ebola Situation Report – 13 May 2015
:: A total of 9 confirmed cases of Ebola virus disease (EVD) was reported in the week to 10 May: the lowest weekly total this year. Guinea reported a total of 7 cases, Sierra Leone reported 2. For the first time since the beginning of the outbreak in Sierra Leone, the country reported zero confirmed cases for more than 2 consecutive days in the week to 10 May. As at 12 May, Sierra Leone has reported 8 consecutive days without a confirmed case. The EVD outbreak in Liberia was declared over on 9 May, after 42 complete days elapsed since the burial of the last confirmed case. The country has now entered a 3-month period of heightened vigilance. WHO will maintain an enhanced presence in the country until the end of 2015, with a particular focus on areas that border Guinea and Sierra Leone….

:: There have been a total of 26,724 reported confirmed, probable, and suspected cases of EVD in Guinea, Liberia and Sierra Leone (figure 1, table 1), with 11,065 reported deaths (this total includes reported deaths among probable and suspected cases, although outcomes for many cases are unknown). A total of 7 new confirmed cases were reported in Guinea and 2 in Sierra Leone in the 7 days to 10 May. The outbreak in Liberia was declared over on 9 May…

Ebola Interim Assessment Panel 8 May 2015 [First Report]

Editor’s Note
Prepared in time for engagement during the upcoming World Health Assembly, the first report of the Ebola assessment panel is excerpted below. The panel will present its final report after visiting and consulting with the affected countries, currently set for June 2015.
The panel is chaired by Barbara Stocking, President of Murray Edwards College, University of Cambridge the United Kingdom and former chief executive of Oxfam GB; Professor Jean-Jacques Muyembe-Tamfun, Director-General of the National Institute for Biomedical Research, Democratic Republic of the Congo; Dr Faisal Shuaib, Head of the National Ebola Emergency Operations Center, Nigeria; Dr Carmencita Alberto-Banatin, independent consultant and advisor on health emergencies and disasters, Philippines; Professor Julio Frenk, Dean of the Faculty, Harvard T. H. Chan School of Public Health, Boston, Massachusetts; and Professor Ilona Kickbusch, Director of the Global Health Programme at the Graduate Institute of International and Development Studies, Geneva, Switzerland.

Ebola Interim Assessment Panel
Report by the Secretariat A68/25
Provisional agenda item 16.1
8 May 2015 :: 12 pages

[Selected Excerpts]
19. Now is the historic political moment for world leaders to give WHO new relevance and empower it to lead in global health. A strengthened, well-funded WHO can support all countries as they prepare to meet the challenges of increasing global interdependence and shared vulnerability. In response, the Secretariat needs to take serious steps to earn this leadership role in relation to outbreaks and emergency response and to regain the trust of the international community.

20. At present, WHO does not have the operational capacity or culture to deliver a full emergency public health response. A number of options have been suggested by different organizations and individuals: (i) a new agency should be established for health emergencies; (ii) the emergency part of the health response should be led by another United Nations agency; or (iii) investments should be made so that the operational capacity of WHO for emergency response is fully in place.

21. The panel recommends that the third option should be pursued with vigour. Establishing a new agency would take time to put in place and substantial new resources would be required to establish its basic administrative systems, and operational response capacity. A new agency would, in any case, have to rely on and coordinate with WHO for public health and technical resources, creating an unnecessary interface. Similarly, if another United Nations agency were expected to develop health operational capacity, it too would need to coordinate in depth with WHO, especially with respect to the International Health Regulations (2005). All this suggests that, as WHO already has the mandate to deliver on operational response, it would be a far more effective and efficient use of resources to make WHO fit for purpose. This will require the resources and political will of the Member States.

22. The Panel puts this recommendation to the Health Assembly now so that the overarching strategic direction is clear and that change can be driven forward quickly. If Member States agree to this strategic direction, then matters such as the Global Health Emergency Workforce and the proposed Contingency Fund can immediately move to implementation, so that the world is better placed to respond to significant public health emergencies.

23. A WHO that is capable of adequately responding to public health emergencies requires deep and substantial organizational change. The reaffirmation of WHO’s mandate in these emergencies should not be given lightly. This will require accountability and monitoring. Below we set out the key implications…

WHO Director-General addresses high-level meeting on Ebola R&D 11 May 2015

WHO Director-General addresses high-level meeting on Ebola R&D
Dr Margaret Chan, Director-General of the World Health Organization
Opening remarks at a WHO Ebola research and development forum
11 May 2015
Distinguished scientists, representatives of industry, colleagues in public health, ladies and gentlemen,

Good morning and a warm welcome to this high-level meeting. I thank you for your time and expertise.

The Ebola R&D effort has mobilised people, institutions and resources in ways never seen before. This is one positive outcome in an otherwise horrific human calamity.

New tools have been developed with unprecedented speed, though the window of opportunity for testing some is closing. On Saturday, WHO declared an end to the outbreak in Liberia. This is a monumental achievement in by far the worst outbreak since Ebola emerged in 1976.

Prior to the current outbreak, Ebola was considered a rare disease. Much about the disease and its causative agent was poorly understood. Your work has increased that understanding considerably. We are likely very close to having a vaccine that can protect against Ebola.

We have 4 rapid diagnostics to detect infection, and 2 of these are point-of-care. We have much more information about which therapeutic interventions may or may not work.
This is a contribution to scientific knowledge, but it is also a contribution to better preparedness. Thanks to your work, the world will be far better equipped to respond when the next Ebola outbreak inevitably occurs.

You have achieved something even bigger. What we see emerging, over a very short time, is a new model for the accelerated development, testing, and approval of new medical products during emergencies caused by any emerging or re-emerging infectious disease.

Your collaborative efforts prove that the traditional R&D model can be adapted, timeframes can be compressed, and partnerships that are otherwise unlikely can be formed.
The implications are huge. Many other serious diseases have no vaccines or therapeutic options, and some of these diseases have epidemic potential.

The job now is to harness the lessons from Ebola to create a new R&D framework that can be used for any epidemic-prone disease, in any infectious disease emergency.
This is what you will be discussing over the next 2 days: an R&D preparedness plan with clear rules, well-defined platforms for information sharing, and agreed procedures to expedite development and clinical trials.

In emergencies, coordination is the first essential element. Timely and transparent information sharing is the second.

The more we know about what other partners have discovered or achieved, the better equipped we will be to make informed decisions and take the right next steps with the greatest possible speed.

In this sense, the R&D response to Ebola marks an historical, ground-breaking event. Public research institutes, private funders, civil society, countries, and industry have united, in unprecedented ways, to defend the world against a deadly and deeply dreaded disease.

Many of you present today were part of this army. I hope the world will recognize what your engagement means, also as a contribution to future preparedness.
I wish you every success over the coming 2 days and eagerly await the outcome of your discussions.

POLIO [to 16 May 2015]

POLIO [to 16 May 2015]
Public Health Emergency of International Concern (PHEIC)

GPEI Update: Polio this week – As of 13 May 2015
Global Polio Eradication Initiative
[Editor’s Excerpt and text bolding]
Full report:
:: Ministers of Health from around the world will meet in Geneva, Switzerland, next week for the annual World Health Assembly. The Ministers will discuss a number of topics related to public health, including polio eradication. The Global Polio Eradication Initiative has prepared a status report for delegates. The report and an accompanying resolution are expected to inform the discussions.
:: The latest semi-annual status report has been published and covers the period July to December 2014. The report provides an in-depth epidemiological and programmatic update for endemic, re-infected and high-risk countries.
:: Liberia and Sierra Leone have conducted polio and measles vaccination campaigns during the first week of May. These are the first campaigns conducted in these countries since 2013 (due to the Ebola outbreak). Polio staff in these countries continue to assist in the Ebola outbreak response efforts
Selected excerpts from Country-specific Reports [No new polio cases reported]

WHO & Regionals [to 16 May 2015]

WHO & Regionals [to 16 May 2015]
:: Racing to combat an unprecedented meningitis outbreak in Niger
15 May 2015 — WHO and partners have sent an international expert team and negotiated provision of over half a million doses of vaccine to help Niger combat an unprecedented outbreak of meningococcal meningitis. This outbreak is the first large-scale meningitis outbreak caused by strain C to hit any country in Africa’s meningitis belt and has caused 5,855 suspected cases including 406 deaths.
Read the situation assessment
:: Sixty-eighth World Health Assembly
15 May 2015 — The Sixty-eighth session of the World Health Assembly takes place in Geneva 18–26 May 2015, as officials from 194 Member States begin their annual review of the activities of WHO and set new priorities for the future. The main functions of the World Health Assembly are to determine the policies of the Organization and review and approve the proposed programme budget. The Health Assembly is held every May in Geneva, Switzerland.
:: Global Alert and Response (GAR) – Disease Outbreak News (DONs)
.. Rapidly growing outbreak of meningococcal disease in Niger 15 May 2015
.. Human infection with avian influenza A(H7N9) virus – China 14 May 2015
.. Ebola virus disease – Italy 13 May 2015

:: The Weekly Epidemiological Record (WER) 15 May 2015, vol. 90, 20 (pp. 217–252) includes
.. Set of interviews
.. Epidemics timeline
.. Emerging and re-emerging infectious threats in the 21st century
.. Middle East respiratory syndrome coronavirus (MERS-CoV): current situation 3 years after the virus was first identified
.. Plague in Madagascar: overview of the 2014– 2015 epidemic season

:: Millennium Development Goals (MDGs) – Fact sheet N°290
Updated May 2015
Key facts
..Globally, the number of deaths of children under 5 years of age fell from 12.7 million in 1990 to 6.3 million in 2013.
..In developing countries, the percentage of underweight children under 5 years old dropped from 28% in 1990 to 17% in 2013.
..Globally, new HIV infections declined by 38% between 2001 and 2013.
..Existing cases of tuberculosis are declining, along with deaths among HIV-negative tuberculosis cases.
..In 2010, the world met the United Nations Millennium Development Goals target on access to safe drinking-water, as measured by the proxy indicator of access to improved drinking-water sources, but more needs to be done to achieve the sanitation target.

:: World Health Statistics 2015
World Health Statistics 2015 contains WHO’s annual compilation of health-related data for its 194 Member States, and includes a summary of the progress made towards achieving the health-related Millennium Development Goals (MDGs) and associated targets.
WHO presents World Health Statistics 2015 as an integral part of its ongoing efforts to provide enhanced access to comparable high-quality statistics on core measures of population health and national health systems.

:: WHO Regional Offices
WHO African Region AFRO
:: Renowned public health experts and leaders endorse a vision for an Africa Health Transformation Programme to enhance health in the African Region – 14 May 2015

WHO Region of the Americas PAHO
:: LGBT health sees progress and challenges 15 years after homosexuality ceased being considered a disease (05/15/2015)
:: PAHO/WHO urges more attention to blood pressure control (05/14/2015)
:: PAHO/WHO highlights need to train more nursing personnel (05/12/2015)
:: New studies show immunization remains a ‘best buy’ in the fight against vaccine-preventable diseases (05/11/2015)

WHO South-East Asia Region SEARO
:: Emergency preparedness pays off as Kathmandu hospitals respond to earthquakes
13 May 2015
:: Continuing care for tuberculosis, diabetes and heart patients in earthquake hit Nepal
10 May 2015

WHO European Region EURO
:: First confirmed Ebola case in Italy 14-05-2015
:: Better hospital care for children 11-05-2015
:: WHO/Europe supports translation of European Vaccine Action Plan into national immunization plans in Gavi-supported countries
A workshop to build capacity for comprehensive multi-year planning (cMYP) on immunization in countries eligible for support from the Global Alliance for Vaccines and Immunization (Gavi) took place on 27–29 April 2015 in Copenhagen, Denmark.
Continuation of GAVI support to countries is conditional on submission of updated cMYPs, which provide strategic guidance to national immunization programmes and stakeholders. WHO/Europe organized the workshop to help Armenia, Azerbaijan, Georgia, Kyrgyzstan, Republic of Moldova, Tajikistan, Ukraine and Uzbekistan identify critical aspects to be considered while developing their next cMYP, in line with revised WHO–United Nations Children’s Fund cMYP development guidelines and new costing and financing tool.
The process of updating cMYPs for the upcoming cycle (2016-2020) is also a vital time to translate the goals, objectives and proposed actions of the European Vaccine Action Plan 2015–2020 (EVAP) into national immunization plans.
Cross-border collaboration combined with tailored support to countries
Approximately 35 immunization programme managers and programme staff in charge of vaccine management and logistics, surveillance of vaccine-preventable diseases and immunization financing attended the workshop, along with WHO experts and representatives of partner agencies. Working together to improve planning of national immunization programmes allowed the participants to share experiences and best practices across national borders.
The workshop also provided WHO/Europe the opportunity to assess what technical assistance each country needs to finalize its cMYP. Based on this assessment, tailored support will be provided to countries at different stages of the planning process to ensure that development of cMYPs is aligned with national commitments and plans as laid out in the EVAP.

WHO Eastern Mediterranean Region EMRO
:: WHO to deliver additional medicines and medical supplies to Yemen
15 May 2015, Amman, Jordan — WHO is scaling up its provision of medicines and medical supplies to Yemen during the current humanitarian pause. Today, WHO is sending more than 20 tonnes of medicines and medical supplies to Hodeida, comprising international emergency health kits, trauma kits, surgical supply kits, emergency diarrhoeal disease kits, and water, sanitation and hygiene items for more than 120 000 beneficiaries. More than 300 000 people have been newly displaced in Yemen since March, and almost 8.6 million people are in need of health services around the country.
:: Morocco joins the International Agency for Research on Cancer 16 May 2015
:: Egypt: upsurge in H5N1 human and poultry cases but no change in transmission pattern of infection 15 May 2015
:: WHO–Kuwait partnership to help the people of Syria
15 May 2015

WHO Western Pacific Region
:: Four innovative Pacific projects receive WHO Healthy Islands Recognition
YANUCA ISLAND, 11 May 2015 – As part of the Eleventh Pacific Health Ministers Meeting, the World Health Organization (WHO) awarded four innovative projects in Commonwealth of the Northern Mariana Islands, Samoa, Tokelau and Vanuatu with the WHO Healthy Islands Recognition for the outstanding work by health and community leaders in the Pacific.