Tropical Medicine & International Health
August 2012  Volume 17, Issue 8  Pages 935–1046, e1–e110
http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-3156/currentissue

Unsustainable funding of high-burden tuberculosis control programmes: who is responsible? (pages 1044–1046)
Verena Mauch, Rob Baltussen and Koos van der Velden
Article first published online: 12 JUN 2012 | DOI: 10.1111/j.1365-3156.2012.03023.x

Abstract [Free access]
The literature suggests that crowding-out effects of government funding for health happen in low-income countries with a high HIV burden. In a survey, we investigated the hypothesis that domestic funding for TB control has fallen in 11 low-income, high-TB-burden countries in the context of changes in gross domestic product (GDP), development assistance inflows and national health expenditures. We found that despite rises in GDP per capita between 2003 and 2009, health expenditure as per cent of GDP fell or stayed the same for the majority of these countries. Although TB control budgets increased for all 11 countries in absolute terms, 6 countries reduced government contribution to TB control. For health programmes to become sustainable in the long run, we suggest increases in donor funding for health to be accompanied by requirements to increase domestic funding for health. We thereby attribute responsibility to avoid crowding-out effects to donors and governments alike. Moreover, it is the responsibility of both to ensure essential items to be funded by government sources to avoid a collapse of programmes once aid is withdrawn.

Vaccine
http://www.sciencedirect.com/science/journal/0264410X
Volume 30, Issue 38  p. 5585-5698 (17 August 2012)
The impact of making vaccines thermostable in Niger’s vaccine supply chain

Original Research Article
Pages 5637-5643
Bruce Y. Lee, Brigid E. Cakouros, Tina-Marie Assi, Diana L. Connor, Joel Welling, Souleymane Kone, Ali Djibo, Angela R. Wateska, Lionel Pierre, Shawn T. Brown

Abstract
Objective
Determine the effects on the vaccine cold chain of making different types of World Health Organization (WHO) Expanded Program on Immunizations (EPI) vaccines thermostable.

Methods
Utilizing a detailed computational, discrete-event simulation model of the Niger vaccine supply chain, we simulated the impact of making different combinations of the six current EPI vaccines thermostable.

Findings
Making any EPI vaccine thermostable relieved existing supply chain bottlenecks (especially at the lowest levels), increased vaccine availability of all EPI vaccines, and decreased cold storage and transport capacity utilization. By far, the most substantial impact came from making the pentavalent vaccine thermostable, increasing its own vaccine availability from 87% to 97% and the vaccine availabilities of all other remaining non-thermostable EPI vaccines to over 93%. By contrast, making each of the other vaccines thermostable had considerably less effect on the remaining vaccines, failing to increase the vaccine availabilities of other vaccines to more than 89%. Making tetanus toxoid vaccine along with the pentavalent thermostable further increased the vaccine availability of all EPI vaccines by at least 1–2%.

Conclusion
Our study shows the potential benefits of making any of Niger’s EPI vaccines thermostable and therefore supports further development of thermostable vaccines. Eliminating the need for refrigerators and freezers should not necessarily be the only benefit and goal of vaccine thermostability. Rather, making even a single vaccine (or some subset of the vaccines) thermostable could free up significant cold storage space for other vaccines, and thereby help alleviate supply chain bottlenecks that occur throughout the world.

Financial Times
http://www.ft.com
Accessed 4 August 2012

Infectious diseases: Innovation can still be a matter of life or death
Financial Times | 31 July 2012
By Andrew Jack

If necessity is the mother of invention, self-interest is the father. The influenza pandemic of 2009 – which first caught the public eye in Mexico – triggered a surge in research, investment and health preparations in the west to tackle the latest manifestation of an ancient scourge. Richer governments invested billions of dollars in purchasing vaccines and drugs, in the process stimulating fresh activity by companies into new technologies in a field long neglected by lack of interest and money.

http://www.ft.com/cms/s/0/1a688bac-d276-11e1-abe7-00144feabdc0.html#axzz22doJwClN

Twitter Watch [accessed 4 August 2012 – 18:42]
Items of interest from a variety of twitter feeds associated with immunization, vaccines and global public health. This capture is highly selective and is by no means intended to be exhaustive.

Arthur Caplan @ArthurCaplan
Editorial: Continue ban on risky flu research | http://StarTribune.com http://www.startribune.com/opinion/editorials/164947126.html
11:12 AM – 4 Aug 12

CDCgov@CDCgov
@CDCgov has staff in Uganda investigating the #ebola outbreak including lab & epi experts. http://go.usa.gov/Gj7
8:20 AM – 4 Aug 12

World Bank @WorldBank
Visualize #globaldev data with free data mapping tools. http://bit.ly/PjreZi #opendata
3:44 AM – 4 Aug 12

ACP ‏@ACPinternists
Communicating Risk-Benefit of #Vaccination to Patients: free recorded webinar http://bit.ly/xA9X0B from American College of Physicians
8:55 AM – 3 Aug 12

Amanda Glassman ‏@glassmanamanda
Global health policy summit – high-level but none of the usual names http://j.mp/N1Ee9Q
2:56 PM – 2 Aug 12

PATH @PATHtweets
We welcome Dr. Ponni Subbiah, the new program leader for PATH’s drug development program,  @OneWorldHealth. http://ow.ly/cFAKd
12:27 PM – 2 Aug 12

UNICEF @UNICEF
Via @GdnDevelopment #Yemen to vaccinate all children against diarrhoea rotavirus, plus UNICEF comment http://uni.cf/OLlF9L #Promise4Children
11:52 AM – 2 Aug 12