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.

AFP
http://www.afp.com/
UN struggles to stem new rise in Haiti cholera cases
8 May 2015
United Nations (United States) (AFP) – A deadly cholera epidemic in Haiti that experts say was introduced by UN peacekeepers from Nepal is on the rise, with hundreds of new cases registered weekly, a UN official said Thursday.
Pedro Medrano, the UN coordinator for Haiti’s cholera outbreak, said years of work to beat back the disease are in jeopardy as donors turn away from the emergency.
“Unfortunately because of lack of resources and of the rainy season, in the last six months we have moved from a thousand new cases a month to almost a thousand a week, ” Medrano told AFP in an interview.
The UN official predicts more than 50,000 new cases this year, up from 28,000 last year, the lowest level since the outbreak began in October 2010.
More than 8,800 people have died from cholera and 736,000 Haitians have been infected since the outbreak that expert studies have shown was brought to the island by Nepalese troops…

.

The Atlantic
http://www.theatlantic.com/magazine/
Accessed 9 May 201
Bill Gates’s Quest to Determine Why Children Are Dying – The Atlantic
Olga Khazan
May 6, 2015
When it comes to child deaths, the world has made great strides in the past 25 years. “In 1990, one in ten children in the world died before age 5,” Bill and Melinda Gates write on their blog. But thanks to things like vaccines and better nutrition, “today, it’s one in 20.”
The death rate for children younger than one month has proven harder to budge. Newborns account for 44 percent of all childhood deaths, and health experts aren’t sure why. They know it might have something to do with prematurity, or infections, or complications during delivery. But they often don’t know exactly what happened right after a given birth that brought death just a few weeks later. Was the baby not dried off properly? Did the umbilical cord get infected?
In order to better understand the drivers of mortality for all children, on Wednesday, the Bill & Melinda Gates Foundation announced that it’s investing $75 million in a series of surveillance sites that will gather data “about how, where and why children are getting sick and dying,” according to the release. This Child Health and Mortality Prevention Surveillance Network, or CHAMPS, will be spread initially throughout six locations in Africa and South Asia. It will rely on field workers to take biopsies of children who have perished and on beefed-up laboratories that will perform medical testing…

.

Brookings
http://www.brookings.edu/
Accessed 9 May 2015
What does the past tell us about the future? Possibilities for child survival in 2030
John McArthur | May 7, 2015
As the Millennium Development Goals approach their 2015 deadline, debates are in full swing about what might form appropriate targets for Sustainable Development Goals (SDG) to 2030 and beyond. At the intergovernmental level, there is active debate around setting a formal SDG target at perhaps 20 or 25 for 2030. Meanwhile Bill and Melinda Gates recently made a high-profile “bet” that global under-5 child mortality will drop from around 46 per 1,000 live births today to 23 by 2030.
In considering potential new goals, a first step is to adopt a clear set of terms. Trajectories usually extrapolate from recent trends. Projections imply assumptions about the future. Possibilities examine potential outcomes under a range of scenarios. Why care about such basic word choices? Simply put, because we need to ensure past trajectories don’t lead to flawed projections that limit our thinking regarding future possibilities…

.

CSIS
http://csis.org/
The United States Should Take a Proactive Stance on Polio Eradication Legacy Planning
By Nellie Bristol
May 6, 2015
The U.S. government is a staunch supporter of the ongoing global effort to eradicate polio. It has contributed more than $2 billion to the cause, providing invaluable resources for vaccine purchases, communications, and social mobilization. The U.S. Centers for Disease Control and Prevention and the U.S. Agency for International Development have provided funding and technical assistance for everything from program to disease surveillance and response to laboratory strengthening. While eradication remains elusive—with Pakistan now producing the bulk of the disease—solid support from the United States has helped the Global Polio Eradication Initiative reduce the number of reported polio cases worldwide by more than 99 percent. Given its significant support for the polio program and the potential for polio resources to contribute to other global health priorities, the U.S. government should actively champion polio “legacy planning” over the next several years.
Download PDF file of “The United States Should Take a Proactive Stance on Polio Eradication Legacy Planning”

.

Forbes
http://www.forbes.com/
Accessed 9 May 2015
Will Sanofi’s Big Bet On Vaccines Pull It Out Of Its Diabetes Slump?
Arlene Weintraub Contributor
1 May 2015
…Sanofi flipped the standard model of production, choosing to invest in manufacturing capacity long before anyone could say for certain the vaccine would succeed. Michael Watson, vice president of global immunization policy at Sanofi, says the company chose that route so it could get the vaccines to the countries that needed it the most right out of the gate. “Historically it has taken five to 10 years to get vaccines out to lower-income countries,” Watson said in a phone interview shortly after the World Vaccine Conference, held in early April in Washington, D.C., where he was a featured speaker. “What we said with dengue is that we would go ahead and invest in [production] right up front. So we took a risk.”
After more than 20 years of stops and starts, and an estimated $1.5 billion in R&D costs, Sanofi is now preparing to apply for approval for the vaccine in several countries. During a conference call with analysts after the first-quarter results were released, Sanofi’s vaccines chief, Olivier Charmeil, said he expects the first licenses to be granted in Asia and Latin America in the second half of 2015.
Sanofi has several other vaccines in the pipeline, including a late-stage combination shot for children that protects against six diseases. But the company is constantly fighting headwinds in the market that Watson refers to as the “Five A’s” of vaccine development: access, awareness, acceptance, availability, and activation.
In developing countries, access to standard vaccines like polio and diphtheria-tetanus-pertussis (DTP) has been one of the biggest challenges, Watson says, but not because vaccines are unaffordable. “Most children don’t get polio or DTP [vaccines], which cost 12 and 19 cents respectively,” Watson says. “So while some of the newer vaccines were quite expensive to begin with, actually bringing those prices down hasn’t solved the access problem to those one in five children who are not getting anything.”
To combat the access problem, Sanofi is pilot testing research programs in Mexico, Romania, and the African country of Gabon aimed at understanding why coverage gaps are occurring and then developing plans to address the issues. Last year, Watson says, the Mexican government took what it learned from the research and developed a plan to expand access to the flu vaccine. Vaccination rates have risen 60% there in the last year, he says.
As for access to the dengue vaccine, that’s where the flipped production model comes into play, Watson says. The company’s goal is to make the vaccine available in large quantities in the countries where the disease is endemic. He expects Sanofi will still see a significant return on its investment—just not in the same way vaccines makers did in the past. “Rather than taking the old-fashioned route, which was to start with a smaller volume of higher-priced vaccines, we’re going for much higher volume initially,” Watson says. “It’s a much bigger risk, but for everybody’s benefit, we need to do it.”

.

New York Times
http://www.nytimes.com/
Accessed 9 May 2015
Africa
Liberia, Ravaged by Ebola, Faces a Future Without It
By NORIMITSU ONISHI
MAY 8, 2015
.
After Nearly Claiming His Life, Ebola Lurked in a Doctor’s Eye
By DENISE GRADY MAY 7, 2015
Before he contracted Ebola, Dr. Ian Crozier had two blue eyes. After he was told he was cured of the disease, his left eye turned green. Credit Emory Eye Center
ATLANTA — When Dr. Ian Crozier was released from Emory University Hospital in October after a long, brutal fight with Ebola that nearly ended his life, his medical team thought he was cured. But less than two months later, he was back at the hospital with fading sight, intense pain and soaring pressure in his left eye.
Test results were chilling: The inside of Dr. Crozier’s eye was teeming with Ebola….
.
Health
Tracing the Ebola Outbreak, Scientists Hunt a Silent Epidemic
By SHERI FINK- MAY 5, 2015
Scientists are using blood samples collected throughout the Ebola outbreak to map the virus’s spread from country to country by tracking tiny mutations in its gene sequences.
The picture is not yet complete, but intriguing discoveries have been made. Virus mutations first detected in Sierra Leone last spring were found later in Liberia and Mali, and scientists are examining whether this resulted from the chance movements of people across borders.
While some scientists think it is unlikely that the mutations made a difference in how the virus functioned, others are looking at whether this version of the virus had properties that made it more capable of causing infection…
.
Science
Review: Paul Offit’s ‘Bad Faith’ Explores Casualties of Doctrine
Books
By ABIGAIL ZUGER, M.D.
MAY 4, 2015

.

US News & World Report
http://www.usnews.com/
Vaccines: Why There Is Really No Debate At All
As states continue to clarify laws about exemptions, here’s what we must remember.
By Elaine Cox, M.D. May 4, 2015

.

Washington Post
http://www.washingtonpost.com/
Accessed 9 May 2015
A horrifying reminder of what life without vaccines was really like [polio]
By Ana Swanson May 4
.
Making polio history
The Post’s View
By Editorial Board May 3
PAKISTAN NOW stands as the main barrier to the global elimination of wild poliovirus. In two other countries where it is endemic, things are going well: There hasn’t been a case in Nigeria in nine months, and there has been only one in Afghanistan so far this year. Outbreaks last year in Syria, Iraq and other parts of Africa have been contained. Consider the progress: In 1988, there were more than 125 countries where polio was endemic. But now, all eyes are on Pakistan as the high season approaches for transmission of the virus. Plans are in place for the fight, methods are known, good intentions declared. Now a nation often weakened by its own internal chaos must deliver.

The poliovirus is highly contagious, largely strikes children under 5 years old and can cause permanent paralysis. The oral vaccine is effective if it can be given to enough children to prevent and interrupt transmission.

Last year, Pakistan recorded 306 cases, which was the highest in 15 years and 85 percent of all those in the entire world. A review of the program in October declared, “Pakistan’s polio programme is a disaster.” The review found inadequate political backing, poor public health programs and little engagement at the local level. “Something big has to change in Pakistan,” the review concluded. Then, Pakistan began this year with a terrible surge of attacks on vaccination teams in what looked like a new campaign by Taliban militants. Violence is a major disruption to the vaccination effort, tearing a hole in the prevention net and allowing the virus to spread.

For two years, children in North and South Waziristan could not be vaccinated because local leaders suspended the campaigns. Then a military operation in the North Waziristan and Khyber tribal areas in the last six months of 2014 displaced nearly a million people. The movement created risks of the virus spreading, but it also opened up a window of opportunity to vaccinate children who had been inaccessible. Outbreaks occur even in more stable areas in Pakistan, where there are clusters of unvaccinated children.

ortunately, research shows that parents have a high degree of acceptance of the need for oral polio vaccines, although suspicion and distrust still linger in some places.
Pakistan is rallying. There have been only 22 cases so far this year, compared with almost 60 at this time last year. Violence has abated, at least in the past month. Emergency operations centers, an important innovation to help monitor the virus, have been set up. Experts also applaud another recent tactic, the recruitment of female volunteers to work on vaccination in their own communities with approval from local religious and tribal leaders. This approach seems to be making headway in previously inaccessible areas. Pakistan’s political leadership also has vowed a renewed campaign.

In the end, the only metric that really counts with polio is getting to zero. The world has never been closer. Pakistan could do much to push this disease into the history books.