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

WHO: World Immunization Week 2014: Know, Check, Protect

WHO: World Immunization Week 2014: Know, Check, Protect
17 April 2014 — Immunize for a healthy future: Know, Check, Protect. This is the message of this year’s World Immunization Week, on 24-30 April. This short video encourages you to ask your local health clinic which vaccines you need, check whether your vaccinations are up-to-date, and to get the vaccines you need, when you need them.
Find out more about World Immunization Week

East Africa – Germany Contributes 20 Million Euros to EAC to Support Immunisation Programme in Collaboration With GAVI

GAVI Watch [to 19 April 2014]

:: Press Release: East Africa – Germany Contributes 20 Million Euros to EAC to Support Immunisation Programme in Collaboration With GAVI
AllAfrica | 16 April 2014
East African Community Secretariat; Arusha; 16 April 2014: The Federal Republic of Germany today signed an intergovernmental agreement with the East African Community (EAC) in order to support vaccinations in the region. Germany makes available a financial contribution of 20 million Euros in support of an immunisation programme that will be implemented in collaboration with the GAVI Alliance.

The GAVI Alliance is a public-private global health partnership committed to saving children’s lives and protecting people’s health by increasing access to immunization in poor countries.
Amb. Dr. Richard Sezibera, Secretary General of the EAC and Member of the GAVI Board, during the signing ceremony expressed his appreciation to the Federal Republic of Germany for its support in saving lives. “This is a very important and critical programme, and I am sure with such commitment, it will grow. There is need for immediate support in the coordination of cold chain logistics,” Amb. Sezibera said. The Secretary General stated the EAC Partner States are all introducing antigens simultaneously, making cold chain logistics support vital…

Polio this week – As of 16 April 2014

GPEI Update: Polio this week – As of 16 April 2014
Global Polio Eradication Initiative
Full report:
[Editor’s extract and bolded text]
:: In central Africa, a new wild poliovirus type 1 (WPV1) case was reported in Equatorial Guinea. In total, three cases have now been reported from the country; genetic sequencing indicates the cases are linked to an ongoing WPV1 outbreak in Cameroon. Outbreak response in the country is currently being planned.
:: On 17 March, the World Health Organization (WHO) had elevated the risk assessment of international spread of polio from Cameroon to ‘very high’. The risk assessment was elevated due to: confirmation of additional WPV1 cases from three new regions of Cameroon confirming continued WPV transmission and geographic expansion of infected areas following detection of four cases in October 2013; gaps in surveillance; and, influx of vulnerable refugee populations from Central African Republic.
:: Immunity levels and surveillance sensitivity are also being assessed in neighbouring countries, in particular in Gabon and the Republic of Congo, and additional immunization activities are being planned in these countries for May.
:: Four new WPV1 cases were reported this week including two from South Waziristan, Federally Administered Tribal Areas – FATA, one from Bannu district, Khyber Pakhtunkhwa (KP), and one from Karachi (Khiorangi), Sindh, bringing the total number of cases for 2014 to 47. The most recent reported case had onset of paralysis on 30 March from Khiorangi, previously a polio-free district…
:: North Waziristan is the district with the largest number of children being paralyzed by poliovirus in the world (both wild and cVDPV2). Immunization activities have been suspended by local leaders since June 2012. It is critical that children in all areas are vaccinated and protected from poliovirus. Immunizations in neighboring high-risk areas are being intensified, to further boost population immunity levels in those areas and prevent further spread of this outbreak.
:: The densely populated Peshawar valley is considered to be the main ‘engine’ of poliovirus transmission, alongside North Waziristan, due to large-scale population movements through Peshawar from across this region, and into other areas of Pakistan. The quality of operations must be urgently improved in Peshawar, and immunization activities urgently resumed in North Waziristan.
Central Africa
:: In Equatorial Guinea, a new WPV1 case was reported this week from Bata district, Litoral province, with onset of paralysis on 16 March. The total number of WPV1 cases reported from Equatorial Guinea for 2014 is three.
:: Due to continued poliovirus circulation in Cameroon, gaps in surveillance quality and influx of vulnerable populations from Central African Republic (CAR), WHO had elevated the risk assessment of international spread of polio from Cameroon to ‘very high’ in March of 2014.
:: Since confirmation of the outbreak in Cameroon in October, six nationwide campaigns have been conducted. However, the quality of implementation has varied greatly by region, and serious coverage gaps remain. As many as 40% of children remain under-immunized (with 30% having received zero doses) during SIAs.
:: The recent confirmation of new cases in Cameroon has resulted in planning additional emergency outbreak response activities, including converting a subnational immunization campaign to a full nationwide activity on 11-13 April, and implementing nationwide campaigns in May and June. Critical to success will be to ensure substantial improvement in the quality campaigns so that all children are reached multiple times with OPV. Equally important will be efforts to rapidly improve the quality of surveillance so that the full extent of the outbreak can be determined and tracked.
:: Immunity levels and surveillance sensitivity are also being assessed in neighboring countries, in particular in Gabon and the Republic of Congo, and additional immunization activities are being planned in these countries for May.


Militant-infested areas: polio drops to be administered at security checkpoints [Pakistan]
April 15, 2014
Government officials said Monday they would begin administering polio vaccines to children at security checkpoints in the country’s lawless tribal belt to protect against Taliban attacks. The announcement was made at a ceremony to mark the launch of a three-day anti-polio campaign in Peshawar, and is aimed at children from North Waziristan and other Taliban strongholds.
Farakh Sair Khan, a senior administrative official for the restive tribal areas, told the gathering the new strategy would “vaccinate children belonging to areas that are not accessible for the polio workers.” “North Waziristan is affected most by the polio virus and unfortunately we had not been able to vaccinate the children there for security reasons but we are trying to overcome it,” Khan said.
As many as 2643 polio teams will be participating in the campaign to vaccinate children under five, he added. “We will establish over 50 vaccination sites next to the checkpoints of security forces,” said Shahdab Younis, an official of the UNICEF told AFP. “Establishing these sites next to security checkpoints will minimise the risk of attacks,” she added. She said the move would also pressure parents – many of whom believe polio drops are a Western ploy to sterilise Muslims – into allowing their children to be vaccinated, due to the intimidating presence of armed troops. “We have received 37 new cases of polio in the first three months of this year, 33 of them are from North Waziristan,” Younis said.
“Polio vaccination was banned in North Waziristan since 2012 and the children there have not been vaccinated against polio since,” she added. Meanwhile, a separate official said talks had begun with the army, whose co-operation would be required. “We are discussing it with the army because most of the security checkpoints belong to (them),” the official told AFP on condition of anonymity.


Focusing on Hard-to-Reach Children for Polio Vaccination Campaign in Syria
Posted: 13/04/2014 23:12
Huffington Post
Razan Rashidi, UNICEF Syria communications officer
More than six months after confirmation of the first polio case in Syria, Unicef continues to support efforts to tackle the outbreak in all parts of the country. The April nationwide polio round which started this week aims to reach 2.8million children across Syria with a special focus on hard-to-reach children in conflict zones and besieged areas. It is essential that all children are vaccinated; of the 26 confirmed polio cases in five different Syrian governorates, nearly all had not been vaccinated at all or had not participated in enough rounds of the vaccine, according to Unicef and the Syrian Ministry of Health…
…To improve access, Unicef is supporting local NGOs and the Syrian Arab Red Crescent. In Qudsaya city, for example, which has been sealed off for more than a month, local youth volunteers from Child Rights Society (CRS) are helping out. “We ride a bus and I use a loud speaker, calling parents to bring their under five children for the polio drops,” says a CRS volunteer.
Last month, more than 75,000 children were vaccinated in areas which were previously classified as inaccessible. “Some parents were totally unaware of the outbreak and the vital need for vaccination,” says another volunteer vaccinator. “The use of mosques to announce the campaign proved to be useful.” Unicef is supporting a national communication plan to raise awareness of the campaign among parents.
“It is very positive to see an increase in the number of vaccinated children across Syria,” says Youssouf Abdel-Jelili, Unicef Representative in Syria. “There is still work to be done to reach every child.”
It is estimated that 104,000 children have not been vaccinated in any of the five rounds to date, mainly in East and West Ghouta areas of Rural Damascus Governorate, including parts of Douma district and some villages in Zabadani district.
The support of many donors, including the Governments of Germany and Kuwait, and the UK Department for International Development (DfID), has been vital. Unicef has provided the Ministry of Health with 15million doses of polio vaccine in support of the campaign, and placed an order for an additional three million to cover the May round.
Full text:

WHO: Global Alert and Response (GAR) – Disease Outbreak News [to 19 April 2014]

WHO: Global Alert and Response (GAR) – Disease Outbreak News [to 19 April 2014]
:: Ebola virus disease, West Africa – update 17 April 2014
As of 18:00 on 16 April, the Ministry of Health (MOH) of Guinea has reported a cumulative total of 197 clinical cases of Ebola Virus Disease (EVD), including 122 deaths…
The Ministry of Health (MOH) of Mali has on the 16th April reported that the clinical samples on the 6 suspected cases have tested negative for ebolavirus…
As of 16 April the Ministry of Health and Social Welfare (MOHSW) of Liberia has reported a cumulative total of 27 clinical cases of EVD, including 13 deaths attributed to EVD….
Sierra Leone
On 15 April, the Ministry of Health and Sanitation (MOHS) provided a consolidated report of surveillance activities conducted in that country from 19 March onwards…
…WHO does not recommend that any travel or trade restrictions be applied to Guinea, Liberia, Mali or Sierra Leone based on the current information available for this event.
:: Middle East respiratory syndrome coronavirus (MERS-CoV) – update 17 April 2014
On 17 April 2014, the Ministries of Health of Malaysia and the United Arab Emirates (UAE) reported an additional 5 laboratory-confirmed cases of infection with Middle East respiratory syndrome coronavirus (MERS-CoV)…
…This is the first case with MERS-CoV infection in the country [Malaysia]. The Ministry of Health reported that so far no human-to-human transmission has been observed amongst close contacts and in health-care facilities in Malaysia…
…Globally, from September 2012 to date, WHO has been informed of a total of 243 laboratory-confirmed cases of infection with MERS-CoV, including 93 deaths.
WHO advice
Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns….
:: Human infection with avian influenza A(H7N9) virus – update 16 April 2014
:: Middle East respiratory syndrome coronavirus (MERS-CoV) – update 16 April 2014
:: Human infection with avian influenza A(H7N9) virus – update 15 April 2014
:: Ebola virus disease, West Africa – update 14 April 2014
:: Human infection with avian influenza A(H7N9) virus – update 14 April 2014
:: Middle East respiratory syndrome coronavirus (MERS-CoV) – update 14 April 2014

Vulnerable Groups Key to Defeating AIDS

Global Fund Watch [to 19 April 2014]

Vulnerable Groups Key to Defeating AIDS
16 April 2014
KINGSTON, Jamaica – Government representatives, civil society and technical partners from nine Caribbean countries held intense discussions on how new funding made available from the generous contributions of major donors to the Global Fund will support their efforts to bring the AIDS epidemic under control and build sustainable health systems.
Many countries in the region fund the majority of their own national programs, but additional resources can play a significant role.
There was agreement among many participants in the meeting that by using the new funding model to help target the most vulnerable they could achieve high impact and a sharper fall in infection rates, thereby helping to put health interventions on a firmer long-term footing.
“We want to use the new funding model as an opportunity to strengthen the health system and we have to emphasize a community-based approach,” said Haiti’s Health Minister Florence Guillaume. “By creating a foundation in countries like Haiti we can have a better health impact and maintain the results obtained.”
“If we can prove that health investment is not a charity but an investment in access to services, people will be in good health. A good labor force is good for growth and that will reduce dependence on external donors,” said Guillaume.
Among partners represented at the meeting were the Pan American Health Organization (PAHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS), the United Nations Development Program (UNDP) and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR)….