Vaccines and Global Health: The Week in Review

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

Email Summary: Vaccines and Global health : The Week in Review is published as a single email summary, scheduled for release each Saturday eveningbefore midnight (EDT in the U.S.). If you would like to receive the email version, please send your request to
pdf versionA pdf of the current issues is available here: Vaccines and Global Health_The Week in Review_26 April 2014

Twitter:  Readers can also follow developments on twitter: @vaxethicspolicy.
Links:  We endeavor to test each link as we incorporate it into any post, but recognize that some links may become “stale” as publications and websites reorganize content over time. We apologize in advance for any links that may not be operative. We believe the contextual information in a given post should allow retrieval, but please contact us as above for assistance if necessary.
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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

World Immunization Week 2014

WHO: World Immunization Week campaign
Immunize for a healthy future – Know. Check. Protect
24 April 2014
This year’s World Immunization Week campaign asks “Are you up-to-date?” with your immunizations. It focuses on providing people with the information they need to make informed decisions about vaccination.
:: World Immunization Week on Facebook
:: Twitter #RUuptodate
:: More on World Immunization Week

World Malaria Day 2014

World Malaria Day 2014: WHO helps countries assess feasibility of eliminating malaria
24 April 2014 | GENEVA – On World Malaria Day (25 April), WHO is launching a manual to help countries to assess the technical, operational and financial feasibility of moving towards malaria elimination…The WHO manual will help countries assess what resources they need to reduce malaria transmission to very low levels, i.e. the point at which focused elimination programmes can start in earnest. It will also help them consider appropriate timelines and provide them with essential knowledge for long-term strategic planning for malaria programmes. “This long-term view on malaria is critical: it is vital to plan for the period after elimination,” says Dr John Reeder, Director of WHO’s Global Malaria Programme. “If interventions are eased or abandoned, malaria transmission can re-establish relatively quickly in areas that are prone to the disease, leading to a resurgence in infections and deaths.”

WHO Manual: From malaria control to malaria elimination: a manual for elimination scenario planning
April 2014 68 pages
ISBN: 978 92 4 150702 8
Since 2000, there has been a 42% reduction in malaria mortality rates globally, and a 49% decline in the WHO African Region. This progress has led many malaria-endemic countries, even those with historically high burdens of malaria, to explore the possibility of accelerating towards elimination.
The elimination scenario planning (ESP) manual provides malaria-endemic countries with a comprehensive framework to assess different scenarios for moving towards this goal, depending on programme coverage and funding availability. It also helps countries set realistic timelines and provides essential knowledge for strategic planning in the long term.
The manual was produced in collaboration with colleagues from the Clinton Health Access Initiative, Imperial College United Kingdom, Johns Hopkins University, the University of Southampton and the Global Health Group at the University of California.
Related tools
The ESP manual can be used in conjunction with malaria transmission modelling software to better understand what levels of intervention coverage might be needed to make elimination possible. Malaria Tools, available from Imperial College London, is a malaria intervention model which has been tested as a means to carry out calculations suggested in the manual…
Malaria Tools

Global Fund: Partners Press for Accelerated Progress against Malaria
24 April 2014
GENEVA – Partners in global health are working together to accelerate progress toward a world free of malaria, with ambitious planning and optimized use of all funding, in order to increase impact and reach more people affected by the disease.
In its message for World Malaria Day, which is 25 April, Roll Back Malaria cited the great progress that has been made against the disease, reducing death rates and shrinking the malaria map. But it also called on the world to “strengthen the potential of individuals, communities and countries to achieve our ultimate goal – a world free from malaria.”…

NIH World Malaria Day statement
B.F. (Lee) Hall, M.D., Ph.D., and Anthony S. Fauci, M.D. National Institute of Allergy and Infectious Diseases
On World Malaria Day, it is encouraging to note that enhanced global efforts to control and eliminate malaria have saved an estimated 3.3 million lives since 2000.
However, the mosquito-borne disease continues to sicken and kill far too many people each year, most of them children. In 2012, roughly 207 million cases of malaria occurred worldwide resulting in 627,000 deaths, according to the World Health Organization (WHO). In 2013, 97 countries had ongoing malaria transmission, placing 3.4 billion people at risk for the disease. And in a globally connected world, even people living in the United States can be at risk. In 2011, nearly 2,000 people in this country were diagnosed with malaria — the highest number since 1971. Virtually all of those cases occurred in U.S. residents or citizens who had travelled abroad.
The WHO World Malaria Day theme is “Invest in the Future. Defeat Malaria.” The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), affirms its continued commitment to supporting and applying innovative research approaches to find new treatments and tools for addressing this infectious disease. For example, through the establishment of the International Centers of Excellence for Malaria Research in 2010, we have worked to strengthen research capacity in the countries most affected by malaria. The 10 research centers, which operate 50 sites in 20 countries, have established dynamic programs to understand the epidemiology of malaria as it changes over time due to the implementation of malaria control and elimination programs. The research centers have also created capacity for clinical trials of novel antimalarial interventions…
Full statement:

PATH marks World Malaria Day 2014
Announcement | April 17, 2014
Events in Seattle and Berkeley, California, highlight progress and commitment toward eliminating malaria.

Benefits from Immunization During the Vaccines for Children Program Era — United States, 1994–2013

CDC/MMWR Watch [to 26 April 2014]

:: CDC Telebriefing: Report shows 20-year U.S. immunization program spares millions of children from diseases – Transcript
April 24, 2014, 3:30 PM
…TOM FRIEDEN: Thank you very much for joining us. This year marks the 20th anniversary of the implementation of the U.S. Vaccines for Children Program, VFC. Since 1994 VFC has provided vaccines at no cost to uninsured children throughout the country and today we’re releasing a report that shows that our national immunization program and VFC will save hundreds of thousands of lives and over $1 trillion…The program allows CDC to buy vaccines at a discount and to distribute them at no charge to more than 44,000 enrolled VFC providers across the country. To summarize the impact of the U.S. immunization program on the health of all children, both VFC eligible and VFC non-eligible children, CDC used information from a variety of sources and previously published models to estimate how many illnesses, how many hospitalizations and how many premature deaths were saved in this 20-year period and what we found was that for the 79 million children born in this 20-year period, vaccination over the course of their lifetimes, will prevent 322 million illnesses, 21 million hospitalizations, and 730,000 early deaths. In addition, the net financial costs saved because these illnesses will not occur are substantial. According to the report, use of the vaccination will avert $295 billion dollars in direct costs and $1.38 trillion– with a “t” — dollars in societal costs because of illnesses prevented in these cohorts. This is an enormous impact. It demonstrates why the VFC program is one of our country’s most successful public/private partnerships to improve the health of our children and our country…

:: MMWR for April 25, 2014 / Vol. 63 / No. 16
Benefits from Immunization During the Vaccines for Children Program Era — United States, 1994–2013
…Among 78.6 million children born during 1994–2013, routine childhood immunization was estimated to prevent 322 million illnesses (averaging 4.1 illnesses per child) and 21 million hospitalizations (0.27 per child) over the course of their lifetimes and avert 732,000 premature deaths from vaccine-preventable illnesses (Table). Illnesses prevented ranged from 3,000 for tetanus to >70 million for measles. The highest estimated cumulative numbers of hospitalizations and deaths that will be prevented were 8.9 million hospitalizations for measles and 507,000 deaths for diphtheria. The routine childhood vaccines introduced during the VFC era (excluding influenza and hepatitis A) together will prevent about 1.4 million hospitalizations and 56,300 deaths.

Vaccination will potentially avert $402 billion in direct costs and $1.5 trillion in societal costs because of illnesses prevented in these birth cohorts. After accounting for $107 billion and $121 billion in direct and societal costs of routine childhood immunization, respectively, the net present values (net savings) of routine childhood immunization from the payers’ and societal perspectives were $295 billion and $1.38 trillion, respectively….

Surveillance Systems to Track Progress Toward Global Polio Eradication — Worldwide, 2012–2013
Notes from the Field: Measles — California, January 1–April 18, 2014
Announcements: National Infant Immunization Week
Announcements: World Malaria Day — April 25, 2014

WHO: Global Alert and Response (GAR) – Disease Outbreak News [to 26 April 2014]

WHO: Global Alert and Response (GAR) – Disease Outbreak News [to 26 April 2014]
:: Human infection with avian influenza A(H7N9) virus – update 24 April 2014
:: Middle East respiratory syndrome coronavirus (MERS-CoV) – update 24 April 2014
:: Yellow fever in the Democratic Republic of Congo update 24 April 2014
:: Middle East respiratory syndrome coronavirus (MERS-CoV) – update 23 April 2014
:: Ebola virus disease, West Africa – update 22 April 2014
:: Middle East respiratory syndrome coronavirus (MERS-CoV) – update 20 April 2014

MERS-CoV :: Developments to 26 April 2014

WHO vigilant on new Middle East respiratory syndrome developments
Cairo, 23 April, 2014 – The World Health Organization (WHO) is concerned about the rising number of cases of Middle East respiratory syndrome coronavirus (MERS-CoV) in recent weeks, especially in Saudi Arabia and the United Arab Emirates, and in particular that two significant outbreaks occurred in health facilities.

“Approximately 75% of the recently reported cases are secondary cases, meaning that they are considered to have acquired the infection from another case through human-to-human transmission,” WHO Regional Director for the Eastern Mediterranean Dr Ala Alwan said. “The majority of these secondary cases have been infected within the healthcare setting and are mainly healthcare workers, although several patients are also considered to have been infected with MERS-CoV while in hospital for other reasons.”

Although the majority of the cases had either no or only minor symptoms, and most do not continue to spread the virus, WHO acknowledges that some critical information gaps remain to better understand the transmission of the virus as well as the route of infection. WHO is unaware at this point in time of the specific types of exposure in the health care facilities that have resulted in transmission of these infections, but this remains a concern.

Therefore, WHO has offered its assistance to mobilize international expertise to work jointly with national health authorities in Saudi Arabia and the United Arab Emirates to investigate the current outbreaks in order to determine the transmission chain of this recent cluster and whether there is any evolving risk that may be associated with the current transmissibility pattern of the virus.
Since the emergence of MERS in April 2012, a total of 253 laboratory-confirmed cases of human infections with MERS have been reported to WHO, including 93 deaths. These cases have been reported in the Middle East (including Jordan, Kuwait, Oman, Qatar, Saudi Arabia and United Arab Emirates); in Europe (France, Germany, Greece, Italy and the United Kingdom of Great Britain and Northern Ireland); in North Africa (Tunisia); and in Asia (Malaysia and the Philippines). The source and mode of infection for the virus remain undetermined.

Several recent cases of people becoming infected in either Saudi Arabia or United Arab Emirates and travelling to a third country have also been reported. Greece, Jordan, Malaysia, and Philippines each reported one such case. So far no further spread of the virus in those countries has been detected. Imported cases already occurred in the past that resulted in limited further human-to-human transmission in France and United Kingdom.

WHO urges all Member States to remain vigilant and enhance surveillance to detect any early sign that the virus has changed and has attained the possibilities of causing sustained person-to-person transmission. WHO expects that it is only through an enhanced coordinated effort the mystery and the risk to global health associated with the emergence of this virus can be unraveled.


Announcements: Ministry of Health Portal – Kingdom of Saudi Arabia
:: 20 April 2014
Dr. Al-Rabeeah Says no Coronavirus Cases Recorded among School Students, We Are Ready for the Umrah Season
His Excellency the Minister of Health, Dr. Abdullah bin Abdulaziz Al-Rabeeah, has announced that 13 new cases of the novel Coronavirus have been recently recorded in the Kingdom’s regions, including seven cases in Jeddah, four cases in Riyadh, one case in each of Madinah and Najran. “Thus, the total number of affected cases reaches 244 ones all over the Kingdom’s regions,” Dr. Al-Rabeeah said, stressing that the Ministry exerts strenuous efforts to control the situation in the Kingdom. Within the same vein, Dr. Al-Rabeeah highlighted that the MOH is fully ready for the Umrah and Hajj seasons of this year thanks to its remarkable experiences, making it a scientific reference in the mass gathering medicine…
:: 22 April 2014
Al-Rabeeah Leaves His Office for the Royal Court, Labor Minister to Lead the Ministry of Health
The Custodian of the Two Holy Mosques, King Abdullah bin Abdulaziz Al-Saud, issued today a Royal Decree, relieving His Excellency the Minister of Health Dr. Abdullah bin Abdulaziz Al-Rabeeah of his post and appointing him as an adviser at the Royal Court (Diwan). Instead, His Excellency the Labor Minister Adel bin Mohamed bin Abdel Qader Faqih will occupy the ministerial position, besides his current post. Here is the wording of the Royal Decree:
:: 24 April 2014
The Acting Minister of Health Issues a Decision Appointing Dr. Tarek Madani as an Independent Medical Advisor for the MOH
His Excellency Eng. Adel bin Mohammed Fakeih, the acting Minister of Health issued, today, a decision appointing Dr. Tarek Madani as a medical advisor for the Ministry of Health (MOH).
This decision came according to the acting Minister of Health’s statement made shortly after taking the office, in which he took a pledge to constantly communicate with the community, and to coordinate with the health care experts with the aim of gathering all the information, helping determine the current situation, the seriousness of the situation, and potential risks…
…The acting Minister of Health, Eng. Adel Fakeih said “according to the extensive medical experience he possesses, Dr. Tarek is to work on coordinating the imperative medical plan in relation to fighting the CoronaVirus (CoV). We intend to draw on the expertise and caliber to help us apply our plan in an effective way, in turn enabling us to guarantee safety of the public.
He went on adding “I would like to reiterate my commitment to working ceaselessly on fighting the CoronaVirus, and the decision of appointing Dr. Tarek is a key step towards achieving that goal.”…

PAHO/WHO urges vaccination against measles and rubella to protect the Americas during the 2014 FIFA World Cup

PAHO/WHO urges vaccination against measles and rubella to protect the Americas during the 2014 FIFA World Cup
Transmission has been interrupted in the Americas, but measles and rubella continue to circulate in other parts of the world. More than 600,000 people are expected to attend the FIFA World Cup in Brazil. With the theme “Vaccination: Your best shot!” Vaccination Week in the Americas highlights the importance of immunization.