Vaccines and Global Health: The Week in Review 21 October 2017

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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 pdf version A pdf of the current issue is available here: Vaccines and Global Health_The Week in Review_21 October 2017

– blog edition: comprised of the approx. 35+ entries posted below.

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David R. Curry, MS
Executive Director
Center for Vaccine Ethics and Policy

Milestones :: Perspectives – Dr Mahmoud Fikri

Milestones :: Perspectives
Dr Mahmoud Fikri
WHO statement
17 October 2017
Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization announces with great sadness the death of Dr Mahmoud M Fikri, WHO Regional Director for the Eastern Mediterranean.

The Organization extends its sincere condolences to Dr Fikri’s family and his colleagues and friends throughout WHO and the Eastern Mediterranean Region.

Dr Fikri assumed his duties as Regional Director on 1 February 2017. He was on his way to attend the WHO Global Conference on NCDs in Montevideo, Uruguay when he died.

Dr Fikri had previously served as Adviser to the Minister of Health of United Arab Emirates, and had been a prominent regional public health figure for many years.


WHO supports the immunization of 874,000 people against yellow fever in Nigeria

WHO supports the immunization of 874,000 people against yellow fever in Nigeria
News release
16 October 2017 | Geneva – The Government of Nigeria has launched a campaign to immunize 873 837 people against yellow fever in the states of Kwara and Kogi.

The ten-day campaign began on Friday, 13 October 2017, and mobilizes more than 200 health workers and volunteers. It targets residents aged 9 months to 45 years old.

“This campaign aims to ensure that people living in high-risk areas are protected from yellow fever, and to prevent the disease from spreading to other parts of the country,” said Dr. Wondimagegnehu Alemu, WHO Nigeria Representative.

WHO has been working with health authorities on its implementation in nine local government areas in Kwara State and two in Kogi State.

Nigeria has requested support from the International Coordination Group (ICG) on vaccine provision for yellow fever. A global stockpile of 6 million doses of the yellow fever vaccine is available for countries to access, with the support of Gavi, the Vaccine Alliance.

WHO and health partners have been supporting the Government’s response to the outbreak since the first case of yellow fever was confirmed in Oke Owa Community, Ifelodun Local Government Area of Kwara state on 12 September.

WHO has deployed experts to Nigeria to support surveillance and investigation, lab testing, public health measures, and engagement with at-risk communities. An Emergency Operations Centre has been activated in the area to coordinate the response.


WHO – Subnational immunization coverage data

WHO – Subnational immunization coverage data
140 member states from all WHO regions have shared 2016 subnational data
17 October 2017
In 2017 and for the first time worldwide, WHO has collected and is publishing subnational immunization coverage data reported by its member states. Member states were asked to report their numerator (number of doses administered), denominator (number of eligible individuals) and coverage data (% of eligible individuals receiving the relevant dose of vaccine) for the first and third dose of DTP-containing vaccines (DTP1, DTP3) and measles containing vaccine (MCV1) from their second administrative level (“admin2” often called districts). The data collection is done through the WHO/UNICEF Joint Reporting Form process.

In 2017, 140 member states have shared their subnational data, either from their first subnational administrative level (“admin1”) or admin2 level for DTP1, DTP3 and/or MCV1. Data has been shared for over 20,000 admin1 and/or admin2, and represents about two-third of the total number of surviving infants worldwide. Among them, 94 member states report coverage for DTP3 at admin2 level (bubble charts from 83 of these countries are accessible at the bottom of this page). Of note is that the size of the target population (in the case of DTP3, the number of infants surviving at 12 months of age) of reporting districts varies significantly from a district to another. Indeed the median number of surviving infants in all reported districts is 400, ranging from a population of surviving infants of 1 in the smallest districts to more than 485,000 in the largest (Karachi, Pakistan).

National coverage data often conceals large inequalities in coverage and access within the country, that can be discovered through subnational monitoring. Targeting specific subnational areas with focused interventions will help countries achieve high and equitable coverage and meet their GVAP targets.

WHO and UNICEF are increasing efforts to gather subnational coverage data and support countries in improving the quality and use of the subnational coverage data to take actions to achieve high and equitable immunization coverage.

Descriptive analysis of subnational data pptx, 7.66Mb
Limitations related to globally reported subnational immunization data pdf, 341kb
Access 83 country visuals for DTP3 at administrative level (data as of 15 July 2017)


Over 700 000 people vaccinated against cholera in Cox’s Bazar
Cox’s Bazar, Bangladesh, 20 October 2017 – More than 700 000 people over the age of one year have been administered oral cholera vaccine in the first phase of a campaign here to protect the newly arrived Rohingya population and their host communities against the deadly diarrheal disease.

“The coverage is commendable as the oral cholera vaccination campaign was planned and rolled out against very tight timelines. It demonstrates the commitment of the Ministry of Health, Bangladesh, partners on the ground, as well as partners such as GAVI and the International Coordinating Group on vaccine provision, to help secure the health and wellbeing of these immensely vulnerable people,” said Dr N Paranietharan, WHO Representative to Bangladesh.

The first phase of the oral cholera vaccination (OCV) campaign covered 700 487 people aged one year and above, 179 848 of them children aged between one and five years. The campaign was launched on 10 October to cover 650 000 people. The second phase is scheduled for early November to give an additional OCV dose to children aged between one and five years, for added protection.

“The campaign has successfully vaccinated nearly 180,000 children aged one to five years. We will organize another round for these children to provide them with a second dose that will better protect them against this dangerous disease,” said Edouard Beigbeder, UNICEF Representative in Bangladesh…


Public Health Emergency of International Concern (PHEIC)
Polio this week as of 18 October 2017 [GPEI]
:: On Tuesday [above], Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, announced with great sadness the death of Dr Mahmoud M Fikri, WHO Regional Director for the Eastern Mediterranean (EMRO) Region. His leadership and dedication to public health, and unwavering support for polio eradication in Syria, Afghanistan and Pakistan will be greatly missed. The GPEI extends its sincere condolences to Dr Fikri’s family and his many colleagues and friends throughout WHO and the EMRO Region.

:: Summary of newly-reported viruses this week:
…Afghanistan: one new wild poliovirus type 1 (WPV1) case reported from Nangarhar province. Two new wild poliovirus 1 (WPV1) positive environmental samples reported, one from Hilmand and one from Kandahar provinces.
Pakistan: three new wild poliovirus 1 (WPV1) positive environmental samples reported, two in Balochistan province and one in Sindh province. See country-specific sections for further details. Syria: four new circulating vaccine derived poliovirus 2 (cVDPV2) cases reported in Deir Ez-Zor governorate, three from Mayadeen district, and one from Boukamal district. One new cVDPV2 positive from a healthy child in Mayadeen district.


Situation reports on the polio outbreak in Syria
Situation update 17 October 2017
:: Four (4) new cases of cVDPV2 were reported this week— three (3) from Mayadeen district and one (1) from Boukamal district, Deir Ez-Zor governorate.
:: The total number of confirmed cVDPV2 cases is 52.
:: The second immunization round for Raqqa concluded on 13 October. According to administrative data, a total of 144,414 children aged 0-59m were vaccinated with mOPV2. The numbers of children reported vaccinated represented 96% of a revised estimated target calculated according to updated micro-plans.
:: IPV is being administered to children aged between 2-23 months in 2 districts, Raqqa and Thawra. The campaign in Raqqa and Thawra is ongoing.
:: 540,000 Aqua tabs were distributed to families together with vaccination in areas of Rural Raqqa (Salhabiyah, Khilah, Al-Rasheed camp, Hesha, Karama town and camp) during the second Raqqa campaign.
:: New areas were reached this round in the Thawra desert, where 4,550 children (representing 65% of the target) under 5 were vaccinated after a gap of 18 months.


WHO Grade 3 Emergencies  [to 21 October 2017]
The Syrian Arab Republic
:: WHO health supplies revive weakened health facilities in besieged Deir-Ez-Zor Governorate in Syria
17 October, 2017, Damascus, Syria – A WHO shipment of health supplies delivered through the Syrian Arab Red Crescent to besieged Deir-Ez-Zor governorate in Syria has helped struggling health facilities deliver life-saving health services to thousands of people.
The 14–ton shipment includes medicines for trauma care, treatment of burns, antibiotics; anti-allergens; cardiovascular medicines; and oral rehydration salts. In total, the supplies are sufficient for almost 1800 trauma cases and 260,000 medical treatments…
:: Situation reports on the polio outbreak in Syria
Situation update 17 October 2017
[See Polio above]

WHO supports the immunization of 874,000 people against yellow fever in Nigeria
News release 16 October 2017
[See Milestones above for more detail]
South Sudan
Read the latest health situation report pdf, 2.07Mb  13 October 2017
Republic of South Sudan
13 OCTOBER 2017
Epidemic trends
:: Cholera transmission has continued to decline countrywide with only three counties [Juba,
Budi, and Fangak] reporting cholera cases in the last four weeks [38-41, 2017].
:: In week 41, four out of 13 samples from Juba tested positive for Vibrio cholerae.

UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises. 
:: Thousands of Families from Kirkuk Are Returning [EN/AR/KU]
(Baghdad, 17 October 2017): In the past 48 hours, an estimated 61,200 people have been displaced in areas around Kirkuk. Humanitarian partners have dispatched mobile health clinics and are providing hot meals and food parcels to families who have fled. In coming days, partners will be providing 3,000 emergency food rations and hygiene items to families sheltering in public spaces.
“Authorities have confirmed that the majority of displaced families from Kirkuk are already returning to their homes in Kirkuk city,” said Ms. Lise Grande, Humanitarian Coordinator for Iraq. “Most of the families who are still displaced are staying with families and host communities.”…

Syrian Arab Republic
:: 19 Oct 2017  North East Syria Dashboard – September 2017
…Up to 7,000 civilians remain trapped in Ar-Raqqa city and face increasingly deteriorating humanitarian conditions and protection concerns. Despite the risks of exposure to mines, snipers and military operations, some civilians have fled.
…Displacements from and within Deir-ez-Zor Governorate continued due to heavy fighting and airstrikes. An estimated 63,902 people have been displaced from 1 September to 8 October.
…The overall protection situation for civilians remains of high concern across north-eastern Syria, with ISIL reportedly actively preventing civilians attempting to flee the area.
…Large influxes of IDPs from Deir-ez-Zor Governorate are straining existing capacities and services in IDP sites resulting in increased protection needs.


UN OCHA – Corporate Emergencies
When the USG/ERC declares a Corporate Emergency Response, all OCHA offices, branches and sections provide their full support to response activities both at HQ and in the field.
:: 20 Oct 2017  Ethiopia HRD 2017: Status Update, 19 October 2017
Since the revision of the Humanitarian Requirements Document (HRD) in August 2017, the humanitarian context in Ethiopia has continued to evolve which has led the Government and humanitarian partners to further adjust the HRD requirements. In the food sector the needs have been revised slightly upwards to accommodate an increase in the number of beneficiaries through the inclusion of 4 million former Productive Safety Net Programme (PSNP) clients in the HRD. In other sectors such as health and nutrition, needs have also continued to increase mainly due to the deteriorating nutrition situation in Somali region, increase in the number of displaced people, as well as the Fall Army Worm (FAW) outbreak that continues to ravage crops throughout the country….

WHO & Regional Offices [to 21 October 2017]

WHO & Regional Offices [to 21 October 2017]
Latest news
WHO supports containment of rare virus on Uganda-Kenya border
20 October 2017 – WHO is working to contain an outbreak of Marburg virus disease that has appeared in eastern Uganda on the border with Kenya.

Governments commit to reduce suffering and deaths from noncommunicable diseases
18 October 2017 – Heads of State and Government and ministers from around the world today committed to new and bold action to reduce suffering and death from noncommunicable diseases (NCDs), primarily heart and lung diseases, cancers and diabetes, the world’s leading killers.
Responding to children and adolescents who have been sexually abused
October 2017 – Sexual abuse of children and adolescents is a gross violation of their rights and a global public health problem. It adversely affects the health of children and adolescents. Health care providers are in a unique position to provide an empathetic response to children and adolescents who have been sexually abused.

Evaluation of the election of the Director-General of WHO
October 2017 – The Sixty-fifth World Health Assembly decided, in resolution WHA65.15 (2012), that an evaluation, open to all Member States, will be conducted by the Executive Board within one year from the appointment of the next Director-General of WHO, to assess the efficacy of the revised process and methods for the election of the Director-General, in order to discuss any need for further enhancing fairness, transparency and equity among the Member States of the six regions of WHO.

WHO delivers lifesaving trauma medicines and supplies for victims of Mogadishu blasts
October 2017 – WHO has delivered lifesaving blood supplies and trauma care medicines as part of its emergency response to the bombings in Mogadishu, Somalia on 14 October, in which more than 275 people were killed and more than 300 people severely injured.

Handwashing an affordable way to prevent diseases and save lives
October 2017 – Global Handwashing Day is an opportunity to design, test, and replicate creative ways to encourage people to wash their hands with soap at critical times.


Weekly Epidemiological Record, 20 October 2017, vol. 92, 42 (pp. 625–648)
:: Recommended composition of influenza virus vaccines for use in the 2018 southern hemisphere influenza season
:: Zoonotic influenza viruses: antigenic and genetic characteristics and development of candidate vaccine viruses for pandemic preparedness
WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: South Sudan conducts Joint External Evaluation of Core capacities for International Health Regulation (2005) 20 October 2017
:: WHO supports containment of rare virus on Uganda-Kenya border20 October 2017
:: WHO supports Bayelsa state to rapidly contain outbreak of Monkeypox virus. 20 October 2017
:: WHO facilitates training on contact tracing for health professionals and volunteers on Plague
:: Namibia Continues to invest in Polio Eradication  19 October 2017
:: Monkey pox virus-Sultan dispels rumours linking outbreak to vaccine safety. 18 October 2017
:: Suspected cases from Seychelles test negative for plague  18 October 2017
:: Supporting the mental health needs of frontline responders 18 October 2017
:: WHO supports the immunization of 874 000 people against yellow fever in Nigeria 16 October 2017

WHO Region of the Americas PAHO
:: Governments commit to reduce suffering and deaths from noncommunicable diseases (10/19/2017)

WHO South-East Asia Region SEARO
:: Over 700 000 people vaccinated against cholera in Cox’s Bazar  20 October 2017
[See Cholera above for more detail]

WHO European Region EURO
:: European Region makes huge gains in NCD response, but needs faster progress 19-10-2017
:: Obituary: Dr Mahmoud M. Fikri, WHO Regional Director for the Eastern Mediterranean Region 18-10-2017
:: Using taxes to beat NCDs: success story in Hungary 17-10-2017
:: Giving influenza vaccination a boost among older people 16-10-2017
:: Nurse Gladis leads the way on influenza vaccination in Jönköping, Sweden 16-10-2017

WHO Eastern Mediterranean Region EMRO
:: WHO delivers additional trauma care supplies to patients injured in Mogadishu attacks, Somalia  19 October 2017
:: Tenfold increase in childhood and adolescent obesity in four decades  11 October 2017