Vaccines: The Week in Review 27 April 2013

Editor’s Notes:

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pdf version: A pdf of the current issues is available here: Vaccines_The Week in Review_27 April 2013

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WHO: Human infection with avian influenza A(H7N9) virus – update 25 April 2013

WHO: Global Alert and Response (GAR) – Disease Outbreak News
http://www.who.int/csr/don/2013_03_12/en/index.html

Human infection with avian influenza A(H7N9) virus – update 25 April 2013
As of 25 April 2013 (16:30 CET), one laboratory-confirmed case of human infection with the virus has been reported by the Taipei Centres for Disease Control (CDC).

The patient is a 53-year-old man who had been working in Jiangsu province from 28 March to 9 April 2013. He returned from Jiangsu via Shanghai on 9 April 2013, and became ill on 12 April 2013. The patient was laboratory confirmed with the virus on 24 April 2013.

   To date, a total of 109 laboratory-confirmed cases of human infection with avian influenza A(H7N9) virus including 22 deaths have been reported to WHO. Contacts of the confirmed cases are being closely monitored….

Investigations into the possible sources of infection and reservoirs of the virus are ongoing. Until the source of infection has been identified, it is expected that there will be further cases of human infection with the virus. So far, there is no evidence of sustained human-to-human transmission.

WHO does not advise special screening at points of entry with regard to this event, nor does it recommend that any travel or trade restrictions be applied.

A team of international and Chinese experts has completed its mission to visit Shanghai and Beijing and assess the avian influenza A (H7N9) situation, and to make recommendations to the National Health and Family Planning Commission.

International H7N9 assessment team completes mission to China
Media Release: http://www.wpro.who.int/china/mediacentre/releases/2013/20130424/en/index.html

Joint press conference on the China-WHO Joint Mission on H7N9 Assessment
Opening statement by Dr Keiji Fukuda, WHO’s Assistant Director-General for Health Security
Beijing, China
24 April 2013

Excerpt
“…Almost all cases have been sporadic cases, but a few family clusters have been identified. However, we are not sure if the clusters were caused by common exposure to a source of virus or due to limited person to person transmission. Evidence so far is not sufficient to conclude there is person to person transmission. Moreover, no sustained person to person transmission has been found.

We want to note that if limited person to person transmission is demonstrated in the future, it will not be surprising. Enhancing surveillance is the way to early detect such occurrence.

The situation remains complex and difficult and is evolving. WHO will continue to work closely with China in combating this new threat.

For next steps to prevent and control H7N9, the joint mission team would like to make following recommendations.

– First, it is important to undertake intense and focused investigations to determine the source(s) of human H7N9 infections with a view to taking urgent action to prevent continuing virus spread and its potentially severe consequences for human and animal health.

– Second, it is critical to maintain a high level of alert, preparedness and response for the H7N9 virus even though human cases might drop in the summer, as occurs with many other avian influenza viruses, because of the seriousness of the risk posed by this virus and because much basic information remains unknown.

– Third, it is critical to continue to conduct and strengthen both epidemiological and laboratory-based surveillance in human and animals in all Provinces of China to identify changes that might indicate the virus is spreading geographically and gaining the ability to infect people more easily.

– Fourth, it is important to ensure that there is frequent two-way sharing of information, close and timely communications and, when appropriate, coordinated or joint investigations and research between ministries of health, agriculture and forestry because this threat requires the combined efforts of these sectors.

– Fifth, it is important to continue high level scientific collaborations, communications and sharing of sequence data and viruses with WHO and international partners because the threat of H7N9 is also an international shared risk and concern.

– Sixth, it is important to encourage and foster the scientific and epidemiological studies and research needed to close major gaps in critical knowledge and understanding…

Global Vaccine Summit: Abu Dhabi 2013 — Polio Eradication and Endgame Strategic Plan 2013-2018

The Global Vaccine Summit: Abu Dhabi 2013
Event website: http://globalvaccinesummit.org/

Media Release: Global Leaders Support New Six-Year Plan to Deliver a Polio-Free World by 2018
Global eradication programme will move simultaneously on multiple fronts expanding focus to improve childhood immunization and protect gains made to date.
25 April 2013
[posted on GPEI site at: http://www.polioeradication.org/tabid/488/iid/291/Default.aspx ]
Excerpt
Today, at the Global Vaccine Summit, the Global Polio Eradication Initiative (GPEI) presented a comprehensive six-year plan, the first plan to eradicate all types of polio disease – both wild poliovirus and vaccine-derived cases – simultaneously. Global leaders and individual philanthropists signaled their confidence in the plan by pledging three-quarters of the plan’s projected US$ 5.5 billion cost over six years. They also called upon additional donors to commit up front the additional US$1.5 billion needed to ensure eradication….
…“After millennia battling polio, this plan puts us within sight of the endgame. We have new knowledge about the polioviruses, new technologies and new tactics to reach the most vulnerable communities. The extensive experience, infrastructure and knowledge gained from ending polio can help us reach all children and all communities with essential health services,” said World Health Organization Director-General Margaret Chan.
The Polio Eradication & Endgame Strategic Plan 2013-2018 was developed by the GPEI in extensive consultation with a broad range of stakeholders. The plan incorporates the lessons learnt from India’s success becoming polio free (no cases since January 2011) and cutting-edge knowledge about the risk of circulating vaccine-derived polioviruses. It also complements the tailored Emergency Action Plans being implemented since last year in the remaining polio-endemic countries – Afghanistan, Pakistan and Nigeria – including approaches in place to vaccinate children in insecure areas….

…The plan addresses the operational challenges of vaccinating children, including in densely populated urban areas, hard-to-reach areas and in areas of insecurity. The plan includes the use of polio eradication experience and resources to strengthen immunization systems in high-priority countries. It also lays out a process for planning how to transition the GPEI’s resources and lessons, particularly in reaching the most marginalized and vulnerable children and communities, so that they continue to be of service to other public health efforts. It is estimated that GPEI’s efforts to eradicate polio could deliver total net benefits of US$ 40-50 billion by 2035 from reduced treatment costs and gains in productivity…
…Bill Gates, co-chair of the Bill & Melinda Gates Foundation, announced that his foundation would commit one-third of the total cost of the GPEI’s budget over the plan’s six-year implementation, for a total of US$1.8 billion. The funds will be allocated with the goal of enabling the GPEI to operate effectively against all of the plan’s objectives. To encourage other donors to commit the remaining funding up front, the Gates funding for 2016-2018 will be released when GPEI secures funding that ensures the foundation’s contribution does not exceed one-third of the total budget for those years.
Joining Gates was a new group of individual philanthropists that announced its support for full implementation of the new plan. The total new pledges from philanthropists to the polio initiative amounted to an additional US$335 million toward the plan’s six-year budget. The donors commended the tremendous progress toward eradication made in the last year and their desire to help change history and end polio while the opportunity still exists. Commitments include:
– Albert L. Ueltschi Foundation
– Alwaleed Bin Talal Foundation-Global
– Bloomberg Philanthropies
– Carlos Slim Foundation
– Dalio Foundation
– The Foundation for a Greater Opportunity established by Carl C. Icahn
– The Tahir Foundation
…The plan’s US$ 5.5 billion budget over six years requires sustaining current yearly spending to eradicate polio. The new plan’s budget includes the costs of reaching and vaccinating more than 250 million children multiple times every year, monitoring and surveillance in more than 70 countries, and securing the infrastructure that can benefit other health and development programs.
http://www.polioeradication.org/tabid/488/iid/291/Default.aspx

[web video] Opening Event: Global Immunization Celebration
24 April 2013
“An interactive program highlighting recent immunization and global health successes, and honoring the individuals, communities and partners who have made them possible. We will celebrate how far we have come, and prepare to spend the following day focused on the challenges left to resolve.”
https://www.facebook.com/billmelindagatesfoundation/app_229262693878420

[web video] The Roadmap to Global Polio Eradication
25 April 2013
Video: http://new.livestream.com/gatesfoundation/globalpolioeradication

Polio Eradication and Endgame Strategic Plan 2013-2018
[version at 14 April 2013]
GPEI
96 pages
http://www.polioeradication.org/Portals/0/Document/Resources/StrategyWork/EndGameStratPlan_20130414_ENG.pdf

GPEI Update: Polio this week – As of 24 April 2013

Update: Polio this week – As of 24 April 2013
Global Polio Eradication Initiative
http://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx
[Editor’s extract and bolded text]

– No WPV3 has been reported from Pakistan in more than 12 months. The most recent WPV3 dates to 18 April 2012, from Khyber Agency in Federally Administered Tribal Areas (FATA). However, subnational surveillance gaps remain in FATA, and undetected circulation cannot be ruled out. As part of the national emergency action plan, efforts are ongoing to strengthen surveillance sensitivity, particularly in FATA which has seen a decline in reporting of acute flaccid paralysis (AFP) cases over the past 12 months.

Afghanistan
– One new WPV case was reported in the past week, bringing the total number of WPV cases for 2013 to two. It is the most recent WPV case, and had onset of paralysis on 28 March (WPV1 from Kunar).

Nigeria
– Two new WPV cases were reported in the past week (WPV1s from Borno and Niger), bringing the total number of WPV cases for 2013 to 14. The new case from Borno is the most recent WPV case in the country, with onset of paralysis on 28 March.

Pakistan
The security situation continues to be monitored closely, in consultation with law enforcement agencies. Immunization activities continue to be implemented, in some areas staggered or postponed, depending on the security situation at the local level.

Horn of Africa
– Outbreak response is continuing in various parts of the Horn of Africa, in response to the ongoing cVDPV2 outbreak in south-central Somalia. Somalia conducted subnational activities on 26-29 March, and South Sudan conducted campaigns on 19-22 March. Further activities are planned in the second half of April.

WHO: Global Vaccine Safety Initiative (GVSI) activities portfolio

WHO: Global Vaccine Safety Initiative (GVSI) activities portfolio
The Global Vaccine Safety Initiative (GVSI) is the implementation mechanism for the global vaccine safety Blueprint (the Blueprint). The GVSI is a forum administered by WHO which provides its secretariat. In this regard, GVSI is not a separate legal entity. The Blueprint is the strategic framework reference document endorsed by WHO’s Strategic Advisory Group of Experts (SAGE) on immunization and is regarded as the vaccine safety strategy of the Global Vaccine Action Plan. The purpose of the Blueprint is to optimize the safety of vaccines through effective use of vaccine pharmacovigilance principles and methods.

The GVSI Planning Group (PG) provides overall direction for the Initiative. It is composed of the designated representatives of the GVSI and WHO is an ex-officio member. At present, GVSI Participants come from Brighton Collaboration Foundation, Switzerland; University of Ghana; Ministry of Health Sri Lanka; International Vaccine Institute, Korea; Ministry of Health, Brazil; Uppsala Monitoring Centre, Sweden

One of the tasks of the GVSI PG is to maintain a portfolio of activities to enhance vaccine pharmacovigilance capabilities in low- and middle-income countries. The GVSI portfolio is a dynamic listing of activities identified as priorities for implementing the Blueprint. Source the portfolio here: Global Vaccine Safety initiative activities portfolio 2012-2020.
pdf, 126kb

Each activity in the portfolio the PG has prioritized based on the following:
– Expected impact.
– Level of impact (global or national).
– Change of current practice.
– Anticipated exploitation.
– Valuable stand alone or enabling.

Based on the above, the PG recommends funding for portfolio activities as follows:
– Priority 1- Key activity for which funding is immediately needed.
– Priority 2: Important activity for which funding is recommended.
– Priority 3: Desirable activity that should be part of a full GSVI work plan.

“Activities proposed in the portfolio reflect the work of their initiators, managers and donors regardless of the source of funding. They do not reflect WHO activities but have been identified by WHO as valuable contributions towards the shared goal of implementing the Blueprint. In this regard, WHO is not responsible nor accountable for activities implemented by individual GVSI Participants.”

http://www.who.int/vaccine_safety/news/highlight_3/en/index.html

Annual Albert B. Sabin Gold Medal Awarded to Dr. Anne Gershon

    The Sabin Vaccine Institute presented its annual Albert B. Sabin Gold Medal Award to Dr. Anne Gershon, of Columbia University, “for her outstanding research and public health efforts to combat the varicella zoster virus (VZV).   Dr. Gershon’s research was critical to the widespread adoption of the varicella vaccine, which prevents chickenpox.” Dr. Gershon is the director of the Division of Pediatric Infectious Disease and Professor of Pediatrics at Columbia University College of Physicians and Surgeons, a position she has held for the past 26 years. Her research, which included examining the epidemiology, diagnosis, immunology, latency, prevention and treatment of VZV, played a crucial role in the final steps of the vaccine’s licensure and broad public use.  Dr. Gershon continues to study the safety and efficacy of varicella vaccine, including the growth and pathogenesis of VZV in cell culture and latency of VZV in humans and animal models.

Full announcement: http://www.sabin.org/updates/pressreleases/dr-anne-gershon-receives-2013-albert-b-sabin-gold-medal-award

Global Fund: President of Nigeria Joins Global Fund Support Efforts as Co-Chair

Global Fund: President of Nigeria Joins Global Fund Efforts to Broaden Fight Against HIV, TB and Malaria
23 April 2013

Excerpt
Nigeria’s President, Goodluck Jonathan, accepted an invitation be a Co-Chair in this year’s replenishment efforts by the Global Fund. Other Co-Chairs include UN Secretary-General Ban Ki-moon and heads of state from developed countries, emerging economies and the private sector. President Jonathan met with Mark Dybul, Executive Director of the Global Fund, on Monday to discuss joint efforts to control these deadly infectious diseases in Africa’s most populous nation and globally. Dr. Dybul praised President Jonathan’s effective leadership and personal commitment to expanding health services, embodied by Nigeria’s “Save One Million Lives” initiative that is aiming to dramatically increase access to basic quality health services, particularly for women and children.

Full media release: http://www.theglobalfund.org/en/mediacenter/newsreleases/2013-04-23_President_of_Nigeria_Joins_Global_Fund_Efforts_to_Broaden_Fight_Against_HIV,_TB_and_Malaria/