Media/Policy Watch
This section is intended to alert readers to substantive news, analysis and opinion from the general media on vaccines, immunization, global; public health and related themes. Media Watch is not intended to be exhaustive, but indicative of themes and issues CVEP is actively tracking. This section will grow from an initial base of newspapers, magazines and blog sources, and is segregated from Journal Watch above which scans the peer-reviewed journal ecology.

We acknowledge the Western/Northern bias in this initial selection of titles and invite suggestions for expanded coverage. We are conservative in our outlook in adding news sources which largely report on primary content we are already covering above. Many electronic media sources have tiered, fee-based subscription models for access. We will provide full-text where content is published without restriction, but most publications require registration and some subscription level.

Al Jazeera
http://www.aljazeera.com/Services/Search/?q=vaccine
Accessed 29 November 2014
Syria struggles to vaccinate residents
Inoculation campaigns have faced massive challenges amid the country’s plummeting security situation.
Sophie Cousins Last updated: 23 Nov 2014 10:40
Beirut – Since the beginning of the Syrian crisis in early 2011, war has all but destroyed the country’s healthcare system. Hundreds of doctors and health practitioners have been killed or have fled to neighbouring countries, drug supply routes have been destroyed, and government forces have routinely and indiscriminately targeted hospitals.
As a result – and on top of unsanitary living conditions and a sharp drop in overall vaccination coverage – there have been outbreaks of communicable diseases such as hepatitis, leishmaniasis, polio, and tuberculosis.
Polio, eliminated in Syria in 1995, re-emerged last year and spread across large swaths of the country’s opposition-held north.The highly contagious disease also re-emerged in Iraq this year for the first time since 2000, infecting a baby boy and a young girl. The World Health Organisation (WHO) and UNICEF responded by launching a mass polio vaccination campaign across the region, but health workers say the response was too slow.
“The first cases of flaccid paralysis were diagnosed clinically in July of 2013, and they weren’t confirmed by WHO until October,” Zaher Sahloul, president of the Syrian American Medical Society (SAMS), told Al Jazeera. “The WHO initially underestimated the risk and took the Syrian line.”
Despite the odds, a hugely successful polio campaign has been ongoing in Syria – largely thanks to the Polio Task Force, a coalition of Syrian groups including SAMS, the opposition-linked Assistance and Coordination Unit (ACU) and about half a dozen other groups supported by the Turkish Ministry of Health. Some 8,200 volunteers, including a network of activists and doctors, have completed seven rounds of vaccinations, inoculating about 1.4 million of the estimated 1.5 million children in the area it covers.
But those delivering the vaccinations have faced insurmountable challenges amid the country’s plummeting security situation, including the deaths of more than four volunteers.
“[The volunteers] have faced shelling, explosive barrel bombs and were subjected to sniper fire while working,” Bashir Taj al-Din, a technical coordinator with the ACU, told Al Jazeera.
Doctors running the campaign said they also had to work against rumours that vaccination could cause side effects such as AIDS and impotence, thwarting their efforts to vaccinate as many children as possible against diseases like polio, measles and rubella….

The Atlantic
http://www.theatlantic.com/magazine/
Accessed 29 November 2014
Africa Nears Eradication of Polio
A rigorous vaccination campaign has nearly eliminated the crippling infectious disease from Nigeria and the continent at large, according to a new CDC report.
Nicholas St. Fleur Nov 21 2014, 5:32 PM ET
| 21 November 2014
One month after quelling its deadly Ebola outbreak, Nigeria stands poised to make another public-health triumph—the near-eradication of polio.

Since 2012, when the World Health Organization declared the crippling infectious disease a “global-health emergency,” the West African country (the last center of polio on the continent) has overhauled its strategies for combating the scourge. Now, through rigorous vaccination campaigns, Nigeria is on the verge of eliminating the virus and making Africa polio-free, the CDC reported Thursday.

From January to August of this year, Nigeria only reported six cases of polio—a significant drop from the 49 cases it had during that same period in 2013. And when compared with the 122 polio cases from all of 2012, the recent report reveals the rigor of the nation’s vaccination efforts. For a four-day period every six to eight weeks, health officials from Nigeria’s national polio-eradication program go door-to-door and drop oral immunizations into the mouths of some 10 to 20 million children under the age of five. The campaign especially targets children living in 11 high-risk states located mostly in the northern part of the country.

“The goal is to vaccinate every child in every community that these campaigns hit,” said John Vertefeuille, an epidemiologist and head of the CDC’s polio eradication team for Nigeria. “Every child in that house gets vaccinated, even if they’ve had [the vaccine] 10 times before.”…

Council on Foreign Relations
http://www.cfr.org/
Accessed 29 November 2014
Expert Brief
The Downside of Securitizing the Ebola Virus
Author: Yanzhong Huang, Senior Fellow for Global Health
November 25, 2014
The Ebola outbreak in West Africa, the largest of its kind in history, has been responsible for more than 15,000 cases, including more than 5,400 reported deaths as of late November. Unlike the responses to previous Ebola outbreaks, political and public health leaders have upped the ante by explicitly framing the disease in national and international security terms. Margaret Chan, the director general of the World Health Organization (WHO), spoke of “a threat to national security well beyond the outbreak zones,” and U.S. President Barack Obama described the outbreak as “a growing threat to regional and global security.”…

…To sum up, while securitization might be necessary to address the ongoing Ebola outbreak, it may have negative impacts on socioeconomic stability, civil-military relations, risk management, and long-term health system capacity building. Instead of promoting a securitization approach to handling acute disease outbreaks, a more effective approach would be to frame disease control as a global public good. Under this new approach, countries would be obliged to contribute to an international capacity building fund—administered by the World Health Organization—and to use that fund to strengthen disease surveillance and response capacities in countries that fail to meet the requirements of the revised International Health Regulations. With a more robust health system capacity, these countries will be able to nip a rising pathogen in the bud. And if an outbreak was to evolve into a Public Health Emergency of International Concern as Ebola has, it should trigger an institutionalized (not securitized) arrangement that could lead to a surge of international assistance.

On the domestic front, it would be more responsible and constructive to adopt a risk-based approach that tailors government interventions to the actual risks posed by the disease. The implementation of this approach, when combined with effective international collaboration, would maximize the protection of domestic population health while minimizing the disturbance the virus-spawned fear may cause to the economy and the society.

The Guardian
http://www.guardiannews.com/
Accessed 29 November 2014
Boost Ebola aid to Sierra Leone, Justine Greening told
Open letter calls on international development secretary to increase response to outbreak to avoid ‘catastrophic loss of life’
The Guardian | 27 November 2014
Justine Greening, the international development secretary, has been warned by senior medical professionals that Sierra Leone risks “a public health disaster” worse than Ebola unless UK efforts to contain the virus are significantly stepped up.

In an open letter signed by 53 doctors, charity representatives and a former British diplomat, Greening is told the government needs to quickly review operations in Sierra Leone to avert further crisis.

“Much more needs to be done to avoid further catastrophic loss of life,” says the letter, sent to Greening on Thursday.

The signatories warn that, unless a comprehensive response to the crisis is adopted, “health services will collapse entirely”, resulting in a “public health disaster that will eclipse the Ebola outbreak itself and provide the perfect incubator for further outbreaks”…

The Huffington Post
http://www.huffingtonpost.com/
Accessed 29 November 2014
Ebola Vaccines: Why Clinical Trials Are Just the First Step
Seth Berkley is CEO of Gavi, the Vaccine Alliance
With clinical trials for Ebola vaccines now under way, and with governments and manufacturers stepping up to fund them, there is an almost palpable sense that the panic is over and the problem solved. The reality, however, is that even if a safe and effective vaccine emerges and the epidemic is brought under control, we are still in many ways no better prepared for future outbreaks than we were a year ago.

So how is it that we can spend billions of dollars every year keeping fleets of nuclear-armed submarines permanently patrolling our oceans, to protect us from a threat that will almost certainly never happen, and yet invest virtually nothing into the prevention of something as tangible and evolutionarily certain as virulent infectious disease?

Even now, with more than 5,000 people dead and 14,000 confirmed cases of Ebola in eight countries, it is still not clear who will pay if, or when, a vaccine becomes available. Millions of doses will be needed, and not just to help end the current epidemic but also, crucially, as a stockpile to prevent future outbreaks from getting out of control.

What is now clear though is that West Africa needs a vaccine, and needs one now. Modeling carried out by the London School of Hygiene and Tropical Medicine, on behalf of the World Health Organization, suggests that even if the outbreak was already in decline by the time a viable vaccine becomes available, it could still help prevent tens of thousands of deaths between now and the end of 2015. And in the worst-case scenario, if the virus were to continue to spread and become endemic, this figure could rise well into the millions.

The problem is that there is no market. It’s one thing developing and approving a vaccine, and quite another getting it out to the people who need it the most. Just ask the 15 million predominantly poor children who still don’t receive any of the basic vaccines that you and I take for granted.

It can take a billion dollars to bring a vaccine to market. Yet with diseases like Ebola, which kills ferociously but occurs sporadically, usually with only a few hundred cases every few years, and in poor African countries that can ill-afford to pay top dollar, manufacturers would be unlikely to see a return on that investment. Even now, with the virus having reached the Western world, the financial incentives are just not there.

So with no market, even if one of these candidate Ebola vaccines receives clinical approval, we’ll still be left with a significant funding gap standing between the vaccine and the people in West Africa who desperately need it. Not just in terms of who pays for the doses, but also the significant costs involved in scaling-up to commercial production, the costs involved in delivery and deployment and for stockpiling to ensure we are prepared for the next outbreak. That means making funds available to not only improve on the first wave of vaccines so that they include more than one strain of Ebola and are easier to store and use, but also to develop vaccines for other virulent diseases, such as Marburg, which also have the same devastating potential but for whom there is also no market.
Such market failures are nothing new in global health, and one of the reasons why in 2000 Gavi, the Vaccine Alliance, was created; to find innovative solutions to help poor countries pay for existing vaccines for infectious diseases, and to incentivise manufacturers to develop new ones. This has led to the development of new approaches to funding which have already proved extremely effective when dealing with vaccines for more common – and in terms of headcount far more deadly – infectious diseases, such as measles, hepatitis B, pneumonia and diarrhoea.

So in the case of Ebola, one approach we are currently considering has the potential to plug the funding gap that exists in the scaling-up of vaccine production, which would be necessary both for mass vaccination programmes and stockpiling. This could take the form of an advanced purchase commitment, where donor funds are committed to guarantee manufacturers an agreed price once the vaccine has been developed. This sort of pull mechanism could involve frontloaded incentives to make it attractive for industry to make the necessary investments to scale-up production.

Similarly it may be possible to plug the future procurement gap by using long-term flexible guaranteed funding, like the International Finance Facility for Immunisation (IFFIm), to pay for doses to be stockpiled. IFFIm currently works by using long-term government donor pledges, from a range of governments, to sell “vaccine bonds” in capital markets, making large volumes of long-term funds available immediately for vaccine programs at the point in time when funds are required.

So in theory we could have a flexible standing fund available to scale-up production, pay for vaccines, assist countries with rollout and the restocking of a stockpile when they are needed. But there is a catch. For it to work we need to change our attitude towards infectious disease. We need to stop waiting for evidence of a disease becoming a global threat before we treat it like one. If we want to prevent major outbreaks of diseases like Ebola then we need to invest in vaccine stockpiles and start viewing them as though they were nuclear submarines; willing to pay for them and at the same time praying we never have to use them.

New Yorker
http://www.newyorker.com/
Accessed 29 November 2014
Currency
November 25, 2014
The Race for an Ebola Vaccine
By Vauhini Vara

New York Times
http://www.nytimes.com/
Accessed 29 November 2014
Sierra Leone to Eclipse Liberia in Ebola Cases
RICK GLADSTONE NOV. 26, 2014
Sierra Leone will soon displace Liberia as the worst-hit of the West African countries ravaged by Ebola, the World Health Organization said Wednesday.
More than 600 new cases of Ebola were reported in the three countries most affected — Sierra Leone, Liberia and Guinea — in the week that ended Sunday, and more than half were in Sierra Leone, according to figures in an updated summary of cases and deaths on the W.H.O. website.

The W.H.O. update suggested that taken together, all three countries would miss the Dec. 1 target date for achieving important progress benchmarks — 70 percent isolation of patients and 70 percent of burials performed safely. Corpses of Ebola patients are extremely infectious and are an acute source of contagion.

While Guinea has met or exceeded the benchmarks, the W.H.O. said, progress has been slower in Liberia and Sierra Leone, and that “at a national level, both countries are apparently unable to isolate 70 percent of patients.” The updated data showed a total of 15,935 confirmed, probable and suspected cases of Ebola, nearly all of them in the three worst-hit countries, and 5,689 reported deaths…