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

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– pdf version:  A pdf of the current issue is available here:  Vaccines and Global Health_The Week in Review_27 June 2015

– blog edition: comprised of the approx. 35+ entries posted below on this date.

– Twitter:  Readers can also follow developments on twitter: @vaxethicspolicy.
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– 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
– Children’s Hospital of Philadelphia Vaccine Education Center
Associate Faculty, Division of Medical Ethics, NYU Medical School

MERS-CoV [to 27 June 2015]

Middle East respiratory syndrome coronavirus (MERS-CoV) – Republic of Korea
Disease outbreak news
23 June 2015

Situation in Korea
Between 20 and 23 June 2015, the National IHR Focal Point of the Republic of Korea notified WHO of 9 additional confirmed cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) alongside 3 additional deaths.

Additional information on the outbreak in Korea
To date, a total of 175 MERS-CoV cases, including 27 deaths, have been reported. One of the 175 cases is the case that was confirmed in China and also notified by the National IHR Focal Point of China.

The median age of the cases is 56 years old (ranging from 16 to 87 years old). The majority of cases are men (60%). Twenty-three cases (13%) are health care professionals. To date, all cases (excluding the index case) have been linked to a single chain of transmission and are associated with health care facilities.

Detailed information concerning MERS-CoV cases in the Republic of Korea can be found in a separate document (see related links).

Public health response
The government of the Republic of Korea continues to implement intense case and contact management activities. As of 23 June, 2,805 contacts are being monitored while a total of 10,718 contacts have been released. The downward trend of reported MERS-CoV cases seems to indicate that the containment measures put in place by the national health authorities of Korea are beginning to work.

Global situation
Globally, since September 2012, WHO has been notified of 1,348 laboratory-confirmed cases of infection with MERS-CoV, including at least 479 related deaths.

WHO advice
Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for acute respiratory infections and to carefully review any unusual patterns.

Infection prevention and control measures are critical to prevent the possible spread of MERS-CoV in health care facilities. It is not always possible to identify patients with MERS-CoV early because, like other respiratory infections, the early symptoms of MERS-CoV are non-specific. Therefore, health-care workers should always apply standard precautions consistently with all patients, regardless of their diagnosis. Droplet precautions should be added to the standard precautions when providing care to patients with symptoms of acute respiratory infection; contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection; airborne precautions should be applied when performing aerosol generating procedures.

Until more is understood about MERS-CoV, people with diabetes, renal failure, chronic lung disease, and immunocompromised persons are considered to be at high risk of severe disease from MERS‐CoV infection. General hygiene measures, such as regular hand washing, should be adhered to.

WHO remains vigilant and is monitoring the situation. Given the lack of evidence of sustained human-to-human transmission in the community, WHO does not recommend travel or trade restrictions with regard to this event. Raising awareness about MERS-CoV among travellers to and from affected countries is good public health practice.

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:: Summary of MERS statistics in the Republic of Korea (translated from the www.mers.go.kr website) as of 27 June 2015

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Global Alert and Response (GAR) – Disease Outbreak News (DONs)
:: 26 June 2015 – Middle East respiratory syndrome coronavirus (MERS-CoV) – United Arab Emirates
:: 23 June 2015 – Middle East respiratory syndrome coronavirus (MERS-CoV) – Republic of Korea
:: 23 June 2015 – Middle East Respiratory Syndrome coronavirus (MERS-CoV) – Saudi Arabia

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After MERS, South Korea Authorizes Prison for Quarantine Scofflaws
By CHOE SANG-HUN
New York Times, JUNE 26, 2015
SEOUL, South Korea — Stung by the outbreak of Middle East respiratory syndrome, South Korea has passed a law authorizing prison terms of up to two years for people who defy quarantine orders or lie about their possible exposure to an infectious disease.
South Korea has had 181 confirmed cases of the disease known as MERS, including 31 deaths. The outbreak, which began last month, is the worst seen outside Saudi Arabia, where the disease was first identified.
The spread of MERS here has been attributed mainly to poor infection control at the country’s hospitals, as well as failures of communication and coordination on the government’s part. But the public has also been angered by reports of people flouting orders to stay home while they were being monitored for symptoms. One such person went golfing; another went to China, where he was detained and later tested positive for MERS. Under current law, such defiance can result in a fine but not imprisonment.
The new law, which was passed on Thursday and takes effect in six months, gives more authority to public health investigators, empowering them to close down the site of a possible outbreak of infectious disease and to place people there under quarantine. People who defy the orders can be sentenced to up to two years in prison or fined up to 20 million won, or about $18,000. The same penalties can be imposed for lying about one’s possible exposure to infectious disease…

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ASEAN Ascertains Region’s Information Network in Response to MERS
JAKARTA, 22 June 2015 – “ASEAN is concerned about the widening spread of Middle East Respiratory Syndrome (MERS),” said H.E. Le Luong Minh, Secretary-General of ASEAN. “ASEAN is taking initiatives on preparedness in responding to the MERS coronavirus (MERS CoV) disease,” he added.
Today, a video conference took place among health experts in ASEAN together with their counterparts from the World Health Organisation and from China and Japan in response to this health concern. The conference was held to help ascertain the region’s information network and share information and experience on the current situation and what is being done in ASEAN and other countries towards MERS. In this video conference, it was re-affirmed that sharing of lessons learned or sharing of important and updated information in preparedness and response to MERS is very useful to the internal preparations and response plans of the respective countries in the region…

EBOLA/EVD [to 27 June 2015]
Public Health Emergency of International Concern (PHEIC); “Threat to international peace and security” (UN Security Council)

WHO: Ebola Situation Report – 24 June 2015
[Excerpts]
SUMMARY
:: There were 20 confirmed cases of Ebola virus disease (EVD) reported in the week to 21 June, compared with 24 cases the previous week. Weekly case incidence has stalled at between 20 and 27 cases since the end of May, whilst cases continue to arise from unknown sources of infection, and to be detected only after post-mortem testing of community deaths. In Guinea, 12 cases were reported from the same 4 prefectures as reported cases in the previous week: Boke, Conakry, Dubreka, and Forecariah. In Sierra Leone, 8 cases were reported from 3 districts: Kambia, Port Loko, and the district that includes the capital, Freetown, which reported :: Although cases have been reported from the same 4 prefectures in Guinea for the past 3 weeks, the area of active transmission within those prefectures has changed, and in several instances has expanded…

COUNTRIES WITH WIDESPREAD AND INTENSE TRANSMISSION
:: There have been a total of 27,443 reported confirmed, probable, and suspected cases of EVD in Guinea, Liberia and Sierra Leone (figure 1, table 1), with 11207 reported deaths (this total includes reported deaths among probable and suspected cases, although outcomes for many cases are unknown). A total of 12 new confirmed cases were reported in Guinea and 8 in Sierra Leone in the 7 days to 21 June. The outbreak in Liberia was declared over on 9 May…

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WHO: News
Helping Guinean communities fight Ebola
26 June 2015
In May 2015, cases of Ebola began to appear in Tanene, Dubreka Prefecture, Guinea, an area that had previously been unaffected.

One of Sierra Leone’s toughest slums beats Ebola
22 June 2015
On a stretch of scenic coastline at the edge of the Atlantic Ocean sits one of Freetown, Sierra Leone’s, toughest neighbourhoods – Moa Wharf.

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UNMEER
:: The UN will continue to support prevention and response efforts against Ebola in Guinea-Bissau – UNMEER SRSG 25 Jun 2015

POLIO [to 27 June 2015]
Public Health Emergency of International Concern (PHEIC)

GPEI Update: Polio this week – As of 24 June 2015
Global Polio Eradication Initiative
[Editor’s Excerpt and text bolding]
Full report: http://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx
:: In June an outbreak response assessment took place in the Horn of Africa. The team concluded that transmission in Kenya and Ethiopia has been interrupted, however, undetected low level transmission cannot be ruled out in Somalia. They outlined key measures to continue to strengthen immunity and surveillance, and to put risk mitigation plans in place.
:: Five cases of circulating vaccine derived poliovirus type 1 (cVDPV1) have been reported in Madagascar, with dates of onset of paralysis in April and May 2015. These cases are genetically linked to that from September 2014, indicating prolonged and widespread circulation of cVDPV1. The emergency outbreak response is now being intensified to build immunity against the virus in the country, as 25 % of children across Madagascar remain un- or under- immunized.

Selected excerpts from Country-specific Reports
Afghanistan
:: One new polio case was reported in the past week, in Bakwa district of Farah province on the 21 April. The most recent case had onset of paralysis on 05 May, in Gulestan district, Farah. The total number of WPV1 cases for 2015 is now four.
Horn of Africa
:: An international outbreak response assessment took place last week in the Horn of Africa, to examine the impact of the regional emergency outbreak response activities. The team concluded that transmission in Kenya and Ethiopia has been interrupted, however, undetected low level transmission cannot be ruled out in Somalia. They outlined key measures to continue to strengthen immunity and surveillance, and to put risk mitigation plans in place.
:: Subnational Immunization Days (SNIDs) are planned in Ethiopia from 1 – 3 July and in Somalia for August, with dates to be confirmed. In September, National Immunization Days are planned in Eritrea and Somalia, and SNIDs in Ethiopia, Kenya and Uganda.

WHO & Regionals [to 27 June 2015]
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A commentary on “Health and climate change: policy responses to protect public health”
June 2015 — Dr Margaret Chan, WHO Director-General, comments on 3 recommendations where WHO will make direct contributions: financing for climate-resilient health systems; policy recommendations on energy systems that contribute to cleaner air; and monitoring and assessing progress.

Striving to prevent collapse of Yemen’s health system during conflict
June 2015 — In Yemen, more than 15 million people are in dire need of health services. WHO and Health Cluster partners have been responding by providing supplies, services and support to national and regional authorities.

In public health emergencies, risk communication is essential
26 June 2015 — Risk communication is an integral part of any public health emergency response. In epidemics and pandemics, in humanitarian crises and natural disasters, risk communication allows people at risk to understand and adopt protective behaviours.
More on risk communication during emergencies

New film showcasing the Controlled Temperature Chain (CTC)
24 June 2015
The Controlled Temperature Chain, or CTC is an innovative approach to vaccine management and distribution which allows certain vaccines to be kept at ambient temperatures outside of the traditional vaccine cold chain.
The 3-episode film promotes the CTC approach. Episode 1 explains what is CTC, why it is useful and how it is feasible; episode 2 features a case study on CTC implementation; and episode 3 looks at the options for countries and what manufacturers can do to support countries.

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The Weekly Epidemiological Record (WER) 26 June 2015, vol. 90, 26 (pp. 321–336)
includes:
:: Index of countries/areas
:: Index, Volume 90, 2015, Nos. 1–26
:: Yellow fever in Africa and the Americas, 2014
:: Monthly report on dracunculiasis cases, January–May 2015
:: WHO Regional Offices
WHO African Region AFRO
:: Strong partnerships needed to tackle health challenges faced by Small Island Developing States in the African Region
Mauritius, 24 June 2015 – Health Ministers from Small Island Developing States (SIDS) in the African Region have begun a meeting today in Mauritius to take stock of the health of their people and chart a way forward on possible approaches and actions that will promote sustainable health development. The meeting, organized by the World Health Organization is attended by Health Ministers from Cape Verde, Comoros, Seychelles, Sao Tome & Principe, Mauritius, high ranking officials of the health ministry, representatives of the Indian Ocean Commission and public health experts.In a message read on her behalf by Dr Francis Kasolo, Coordinator…
:: Staying at zero: Keeping Liberia Ebola free – 22 June 2015

WHO Region of the Americas PAHO
:: Women’s health needs still not adequately met, according to new articles in the Pan American Journal of Public Health (06/24/2015)
:: Health Coverage Reaches 46 Million More in Latin America and the Caribbean, says new PAHO/WHO–World Bank report (06/22/2015)

WHO South-East Asia Region SEARO
:: WHO calls for stepping up vigil for MERS, Thailand confirms case  18 June 2015

WHO European Region EURO
:: Health ministers in South-eastern Europe commit to achieving universal health coverage 26-06-2015
:: Special report on Healthy Cities in Europe launched 22-06-2015

WHO Eastern Mediterranean Region EMRO
No new digest content identified.

WHO Western Pacific Region
No new digest content identified.

CDC/MMWR/ACIP Watch [to 27 June 2015]
http://www.cdc.gov/media/index.html

MMWR June 26, 2015 / Vol. 64 / No. 24
:: National HIV Testing Day — June 27, 2015
:: Prevalence of Diagnosed and Undiagnosed HIV Infection — United States, 2008–2012
:: Identifying New Positives and Linkage to HIV Medical Care — 23 Testing Site Types, United States, 2013
:: Notes from the Field: Measles Transmission in an International Airport at a Domestic Terminal Gate — April–May 2014

Advocacy for Immunisation Platform Launches

The new web-based platform – developed by PATH and IVAC/Johns Hopkins University with significant input from WHO, Unicef, and Gavi, the Vaccine Alliance and the support of many immunisation partners at global and country level – is intended “to further collective efforts to improve immunisation and help ensure life-saving vaccines reach children everywhere…”

The online advocacy platform http://advocacy.vaccineswork.org “provides guidance and tools to in-country stakeholders in developing their advocacy strategies and implementation plans in support of strengthened immunisation programmes and increased coverage and equity. The platform has been developed in response to a high demand from in-country stakeholders for advocacy capacity and skills strengthening. It contains self-guided tools, resources and information about advocacy and communications, vaccines and immunisation…” In October the tool will also be available in French.

GAVI [to 27 June 2015]
http://www.gavialliance.org/library/news/press-releases/

:: Enhanced polio protection to reach 650,000 Côte d’Ivoire children every year
26 June 2015
Côte d’Ivoire is introducing the inactivated polio vaccine (IPV) into its routine immunisation programme.
26 June 2015

:: Health in the Sahel region, together to improve immunisation programmes
The AFD, the Bill and Melinda Gates Foundation and Gavi signed an Initiative to increase coverage rates in six Sahel countries.

Paris, 26 June 2015 – Today, the Agence française de développement (AFD, French Development Agency), Gavi, the Vaccine Alliance and the Bill and Melinda Gates Foundation signed an innovative partnership worth €100 million at the Ministry of Foreign Affairs and International Development, in the presence of Minister Laurent Fabius and Minister of State for Development and Francophony, Annick Girardin. The partnership aims to increase vaccine coverage in six French-speaking countries of the Sahel region: Burkina Faso, Mali, Mauritania, Niger, Senegal and Chad.

This three-way financing agreement will facilitate the introduction of new vaccines and renewal of existing programmes, as well as strengthening the healthcare systems of the countries concerned. Thanks to the efforts made by these countries, vaccine coverage has improved significantly in the last decade, but the proportion of children receiving all basic vaccines remains too small…

Global Fund [to 27 June 2015]
http://www.theglobalfund.org/en/mediacenter/newsreleases/

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News Releases
25 June 2015
Uganda and Global Fund Sign New Grants
KAMPALA, Uganda – Uganda and the Global Fund today signaled a new phase of partnership by signing five new grants for US$226 million to fight HIV and tuberculosis as well as to build resilient and sustainable systems for health in the country.

Funding for grants supported by the Global Fund partnership come from various donors, many of whom were present at a signing ceremony today, including the United States, United Kingdom, European Union, Denmark, Sweden, Belgium, Ireland and South Korea.

“Under this funding model, the Global Fund aims at creating a bigger impact on the three diseases in its design to provide predictable funding, to reward ambitious plans, to work on more flexible time lines and with a smoother, shorter processing of funds,” said Dr. Ruhakana Rugunda, Prime Minister of Uganda.

Dr. Elioda Tumwesigye, Minister of Health, added: “We are committed to efficient utilization of funds and guarantee stewardship to ensure maximization of the monies. To attain this commitment, there is need for increased and sustained funding to ensure testing and treatment for all who are in need and request for holistic support and full country coverage.”

“If Uganda is to achieve its vision 2040, we need a healthy population.” said Matia Kasaija, Minister of Finance Planning and Economic Development of Uganda, confirming that the Ministry will receive and implement grants to continue their education and prevention programs as well as expanding provision of antiretroviral treatment (ART) to people living with HIV, including expectant mothers with HIV.

While investing for HIV prevention among general and most-at-risk populations, Uganda aims to increase coverage of ART to 69 percent of people living with HIV in 2017 from a baseline of 44 percent in 2014. The Prevention of Mother-to-Child Transmission of HIV will be further increased from 85 percent to 90 percent by end of 2016. Uganda’s joint TB and HIV control efforts will aim to have all people with TB tested for HIV. It will also seek to give ART to co-infected TB/HIV patients during their TB treatment…

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24 June 2015
Partnership Forum Looks at Strategy to End Epidemics
BANGKOK, Thailand – Consultations began today among partners in global health, including civil society, nongovernmental organizations and public health experts, seeking input into a new strategy to accelerate the end of AIDS, tuberculosis and malaria as epidemics and build resilient and sustainable systems for health.

The Partnership Forum brings together more than 120 people to a two-day gathering to focus on developing the Global Fund’s strategy for 2017-2021. The forum is considering recent advances in science and delivery of health services, and at how barriers such as stigma and discrimination can be removed. It also involves private sector partners who are contributing resources towards a sustainable response.

“The Global Fund is a partnership in the truest sense of the word,” said Aida Kurtovic, the Vice-Chair of the Global Fund Board. “A strategy to defeat these epidemics will be more powerful and effective if it is built by people living with the three diseases and those who support them.”

The Forum will focus closely on building resilient and sustainable systems for health, working in challenging environments and the human rights dimension of the epidemics…

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Announcements
25 June 2015
UNAIDS and Lancet Commission Call for Urgent Action on AIDS Response
Countries most affected by HIV must focus on stopping new HIV infections and expanding access to antiretroviral treatment or risk the epidemic rebounding, urges a major new report from the UNAIDS and Lancet Commission.

“We must face hard truths—if the current rate of new HIV infections continues, merely sustaining the major efforts we already have in place will not be enough to stop deaths from AIDS increasing within five years in many countries,” said Professor Peter Piot, Director of the London School of Hygiene & Tropical Medicine, Co-Chair of the Commission, and lead author of the report. “Expanding sustainable access to treatment is essential, but we will not treat ourselves out of the AIDS epidemic. We must also reinvigorate HIV prevention efforts, particularly among populations at highest risk, while removing legal and societal discrimination.”

While unprecedented progress has been made to increase access to HIV treatment globally, the report shows that the rate of new HIV infections is not falling fast enough. This, combined with high demographic growth in some of the most affected countries, is increasing the number of people living with HIV who will need antiretroviral therapy to stay alive.

“We have to act now. The next five years provide a fragile window of opportunity to fast-track the response and end the AIDS epidemic by 2030,” said Michel Sidibé, Executive Director of UNAIDS and Co-Convenor of the Commission. “If we don’t, the human and financial consequences will be catastrophic.”…

Aeras, IDT Biologika Form a Strategic Partnership with Acquisition of Aeras’s Manufacturing Facility

Rockville, MD., USA and Dessau, Germany, June 23, 2015 – Aeras and IDT Biologika today announced a strategic partnership that includes the acquisition of Aeras’s Biopharmaceutical Development Center (BDC) manufacturing facility by IDT.

Aeras is a non-profit biotech organization with offices in the U.S., China, and South Africa, working to develop new tuberculosis (TB) vaccines that are affordable and accessible to all who need them. IDT Biologika is a privately-held company with more than 90 years of experience researching, developing, manufacturing and marketing biologics for the global protection of human and animal health. This strategic partnership allows each organization to focus on its core strengths, with Aeras concentrating its resources on TB vaccine development and IDT working to grow this new commercial entity for vaccine development manufacturing…

IVI [to 27 June 2015]
http://www.ivi.org/web/www/home

IVI Holds Inauguration Ceremony for New Director General Dr. Jerome H. Kim
June 22, Seoul, South Korea – The International Vaccine Institute (IVI) held an inauguration ceremony for its new Director General Jerome H. Kim, M.D., at the IVI headquarters at Seoul National University today. Dr. Kim began his term in March 2015 and will be leading the Seoul-based international organization for the next four years…

DCVMN / PhRMA / EFPIA / IFPMA / BIO Watch [to 27 June 2015]

:: Pfizer Enters Into Agreement To Acquire Nimenrix And Mencevax From GlaxoSmithKline
June 22, 2015
NEW YORK–(BUSINESS WIRE)–Pfizer Inc. (NYSE: PFE) today announced that it has entered into an agreement with GlaxoSmithKline (GSK) to acquire its quadrivalent meningitis ACWY vaccines, Nimenrix and Mencevax, for a total consideration of approximately $130 million (€115 million). This transaction will add two high-quality and complementary vaccines to Pfizer’s portfolio, allowing the company to reach a broader global population…
… “The addition of Nimenrix and Mencevax is an important milestone for Pfizer Vaccines. Adding these two innovative and complementary vaccines to our current portfolio will allow us to more completely respond to meningococcal disease outbreaks as well as proactively address a critical public health need – the prevention of meningococcal disease across all ages,” said Susan Silbermann, President, Pfizer Vaccines. “Acquiring these quadrivalent vaccines will broaden our ability to address the burden of meningococcal meningitis – an uncommon but serious and sometimes fatal disease. This helps us to further fulfill our vision to protect lives with innovative vaccines to fight serious diseases worldwide and gives us even greater capability to meet the needs of the global community we serve.”…

:: U.S. CDC committee recommends physicians make individual decisions on the use of meningococcal group B vaccines
PHILADELPHIA, June 24, 2015 /PRNewswire/ — GlaxoSmithKline (LSE: GSK) announced today that the U.S. Centers for Disease Control (CDC) Advisory Committee on Immunization Practices (ACIP) voted for a Category B recommendation for meningococcal group B vaccination, including BEXSERO® (Meningococcal Group B Vaccine), in individuals aged 16 to 23 (with a preferred age of 16-18). This recommendation means that the decision to vaccinate against meningococcal group B will be made by qualified healthcare professionals, based on individual patient risk assessment. BEXSERO® was approved by the U.S. Food and Drug Administration (FDA) in January 2015 through an accelerated approval pathway for use in individuals aged 10 through 25 years and acquired by GSK in March 2015 following the closure of the three-part transaction with Novartis.
“GSK welcomes this vote as an important step forward to help protect against meningococcal disease in the U.S.,” said Patrick Desbiens, Senior Vice President, U.S. Vaccines, GSK. “Meningococcal disease is fast-moving, unpredictable and can cause irreversible damage, so vaccination is the best tool to help prevent it. Today’s vote is the latest milestone on a 20-year journey to develop a vaccine in order to help protect individuals from this devastating condition.”…

:: CDC Advisory Committee on Immunization Practices Votes to Recommend Serogroup B Meningococcal Disease Vaccination including TRUMENBA® for Adolescents and Young Adults 16 through 23 Years of Age
Committee’s Recommendation Allows for Individual Clinical Decision
June 24, 2015
NEW YORK–(BUSINESS WIRE)–Pfizer Inc. (NYSE:PFE) announced today that the U.S. Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) voted to recommend that decisions to vaccinate adolescents and young adults 16 through 23 years of age against serogroup B meningococcal disease should be made at the individual level with healthcare providers. Specifically, the ACIP voted that a serogroup B meningococcal (MenB) vaccine series may be administered to adolescents and young adults 16 through 23 years of age to provide short term protection against most strains of serogroup B meningococcal disease. The preferred age for MenB vaccination is 16 through 18 years of age.
“Serogroup B meningococcal disease is an uncommon but serious illness that attacks without warning and may become life-threatening within 24 hours”
Pfizer’s TRUMENBA® (Meningococcal Group B Vaccine) is FDA-approved for active immunization to prevent invasive disease caused by Neisseria meningitidis serogroup B in individuals 10 through 25 years of age.
“Healthcare providers should understand the importance of today’s ACIP recommendation to help protect adolescents and young adults,” said Dr. Laura York, Global Medical Lead for Meningococcal Vaccines, Pfizer Vaccines. “This recommendation is an important step forward that provides guidance that serogroup B meningococcal disease vaccination may be administered between the ages of 16 through 23, with preferred timing for vaccination between ages 16 through 18.”…

:: PhRMA Statement on ASCO Value Framework
Washington, D.C. (June 22, 2015) — Pharmaceutical Research and Manufacturers of America (PhRMA) executive vice president, policy and research, Lori Reilly provided the following statement on the American Society of Clinical Oncology’s (ASCO) conceptual framework for assessing the value of new cancer treatment options based on clinical benefit, side effects, and cost.

Health Coverage Reaches 46 Million More in Latin America and the Caribbean, says new PAHO/WHO–World Bank report
Health system financing and efficiency remain top challenges to sustainability Since the early 2000s, Latin America and the Caribbean has seen meaningful progress toward universal health coverage with an additional 46 million people in nine countries having at least nominal guarantees of affordable health care, according to a new joint publication by the Pan American Health Organization/World Health Organization (PAHO/WHO) and the World Bank, released here today.“ The region has increased its spending on health and narrowed the gap between rich and poor on a number of key outcomes: average life expectancy has risen significantly, more children live to see their first and fifth birthdays, and fewer mothers are dying from complications of childbirth,” said Jorge Familiar, World Bank Vice President for Latin America and the Caribbean.
Date: June 22, 2015 Type: Press Release

Progress for Children – Beyond averages: learning from the MDGs
UNICEF
NUMBER 11, 2015 :: 72 pages
Full Report: http://weshare.unicef.org/archive/Progress%20for%20Children%202015_Web_PDF-2AM408THYY33.html

Press Release
Millions of world’s poorest children left behind despite global progress, new UNICEF report says
‘Progress for Children’ report highlights lessons from the MDGs
Download the report, photos, b-roll, graphs and the audio recording from the press briefing at: http://uni.cf/1IZy0VV

NEW YORK, 23 June 2015 – The global community will fail millions of children if it does not focus on the most disadvantaged in its new 15-year development roadmap, UNICEF warned today.

Progress for Children: Beyond Averages, UNICEF’s final report on the child-related Millennium Development Goals, says that, despite significant achievements, unequal opportunities have left millions of children living in poverty, dying before they turn five, without schooling and suffering chronic malnutrition.

“The MDGs helped the world realize tremendous progress for children – but they also showed us how many children we are leaving behind,” said UNICEF Executive Director Anthony Lake. “The lives and futures of the most disadvantaged children matter – not only for their own sake, but for the sake of their families, their communities and their societies.”

Disparities within countries have left children from the poorest households twice as likely to die before their fifth birthday and far less likely to achieve minimum reading standards than children from the richest households.

Continued failure to reach these children can have dramatic consequences. At current rates of progress, given projected population growth, it is estimated that:
:: 68 million more children under five will die from mostly preventable causes by 2030;
:: An estimated 119 million children will still be chronically malnourished in 2030;
:: Half a billion people will still be defecating in the open, posing serious risks to children’s health in 2030;
:: It will take almost 100 years for all girls from sub-Saharan Africa’s poorest families to complete their lower secondary education.

The report highlights notable successes since 1990:
:: Under-five mortality dropped by more than half, from 90 per 1,000 live births to 43 per 1,000 live births;
:: Underweight and chronic malnutrition among children under five decreased by 42 per cent and 41 per cent, respectively;
:: Maternal mortality decreased by 45 per cent;
:: Some 2.6 billion people gained access to improved drinking water sources.

And the gaps between the poorest and the wealthiest are narrowing in more than half of the indicators UNICEF analysed:
:: In many countries, greater gains in child survival and school attendance are seen in the poorest households.
:: The gap in maternal mortality rates between low- and high-income countries halved between 1990 and 2013, from 38 times higher to 19 times higher.

The report also highlights the bad news: Progress still eludes the nearly 6 million children who die every year before their fifth birthday, the 289,000 women who die every year while giving birth and the 58 million children who don’t go to primary school.

As world leaders prepare to adopt the Sustainable Development Goals, the most disadvantaged children should be at the heart of the new goals and targets, UNICEF said. Better data collection and disaggregation – going beyond averages such as those used to measure the MDGs – can help identify the most vulnerable and excluded children and where they live. Stronger local health, education and social protection systems can help more children to survive and thrive. And smarter investments tailored to the needs of the most vulnerable children can yield short and long-term benefits.

“The SDGs present an opportunity to apply the lessons we have learned and reach the children in greatest need – and shame on us if we don’t,” Lake said “For greater equity in opportunity UNICEF

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Excerpt from Report, p. 28
Measles
Measles was responsible for an estimated 145,700 deaths and nearly 279,000 cases globally in 2013. Compared with estimated mortality assuming the complete absence of measles vaccination, an estimated 15.6 million deaths were averted by measles vaccination during 2000–2013.

Notable improvements in routine immunization among children in the appropriate age group who received the first dose of measles-containing vaccine (MCV1) and in supplementary immunization activities in vaccinating children who are beyond the reach of existing health services have led to major successes to date. During 2000–2009, global coverage with MCV1 increased from 73 per cent to 83 per cent and then remained at 83–84 per cent through 2013.

However, an estimated 21.6 million infants – many of whom are among the poorest, most marginalized children residing in especially hard-to-reach areas – did not receive MCV1 in 2013.

Although 84 per cent of infants received MCV1 during 2013, an additional 15 million children needed to be reached to meet target coverage of 95 per cent with MCV1 worldwide.66

Although few countries report reaching 95 per cent coverage in every district, it is difficult to comment on progress towards such district-level targets – critical for achieving measles elimination. This is because district data are not available or are invalid from one third of countries, reflecting a wider problem with the quality and use of vaccination data within national immunization programmes…

American Journal of Public Health
Volume 105, Issue S3 (July 2015)
http://ajph.aphapublications.org/toc/ajph/current

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Editorials
Embarking on a Science Vision for Health Disparities Research
Irene Dankwa-Mullan, Yvonne T. Maddox
American Journal of Public Health: July 2015, Vol. 105, No. S3: S369–S371.

Calling for a Bold New Vision of Health Disparities Intervention Research
Lisa A. Cooper, Alexander N. Ortega, Alice S. Ammerman, Dedra Buchwald, Electra D. Paskett, Lynda H. Powell, Beti Thompson, Katherine L. Tucker, Richard B. Warnecke, William J. McCarthy, K. Vish Viswanath, Jeffrey A. Henderson, Elizabeth A. Calhoun, David R. Williams
American Journal of Public Health: July 2015, Vol. 105, No. S3: S374–S376.

Beyond Health Equity: Achieving Wellness Within American Indian and Alaska Native Communities
Valarie Blue Bird Jernigan, Michael Peercy, Dannielle Branam, Bobby Saunkeah, David Wharton, Marilyn Winkleby, John Lowe, Alicia L. Salvatore, Daniel Dickerson, Annie Belcourt, Elizabeth D’Amico, Christi A. Patten, Myra Parker, Bonnie Duran, Raymond Harris, Dedra Buchwald
American Journal of Public Health: July 2015, Vol. 105, No. S3: S376–S379.

Review of State Legislative Approaches to Eliminating Racial and Ethnic Health Disparities, 2002–2011
Jessica L. Young, Keshia Pollack, Lainie Rutkow
American Journal of Public Health: July 2015, Vol. 105, No. S3: S388–S394.

BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content
(Accessed 27 June 2015)

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Research article
Association between health literacy and medical care costs in an integrated healthcare system: a regional population based study
Jolie Haun, Nitin Patel, Dustin French, Robert Campbell, Douglas Bradham, William Lapcevic BMC Health Services Research 20

Research article
The readiness of the national health laboratory system in supporting care and treatment of HIV/AIDS in Tanzania
Leonard Mboera, Deus Ishengoma, Andrew Kilale, Isolide Massawe, Acleus Rutta, Gibson Kagaruki, Erasmus Kamugisha, Vito Baraka, Celine Mandara, Godlisten Materu, Stephen Magesa BMC Health Services Research 20

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 27 June 2015)

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Research article
Rubella outbreak in a Rural Kenyan District, 2014: documenting the need for routine rubella immunization in Kenya
Ian Njeru, Dickens Onyango, Yusuf Ajack, Elizabeth Kiptoo BMC Infectious Diseases 2015, 15:245 (27 June 2015)
Abstract
Background
Rubella infection has been identified as a leading cause of birth defects commonly known as Congenital Rubella Syndrome (CRS). Kenya does not currently have a rubella immunization program nor a CRS surveillance system. In 2014, a rubella outbreak was reported in a rural district in Kenya. We investigated the outbreak to determine its magnitude and describe the outbreak in time, place and person. We also analyzed the laboratory-confirmed rubella cases from 2010 to 2014 to understand the burden of the disease in the country.
Methods
The Rubella outbreak was detected using the case-based measles surveillance system. A suspected case was a person with generalized rash and fever while a confirmed case was a person who tested positive for rubella IgM. All laboratory-confirmed and epidemiologically linked cases were line listed. The measles case-based surveillance database was used to identify rubella cases from 2010 to 2014.
Results
A total of 125 rubella cases were line listed. Fifty four percent of cases were female. Case age ranged from 3 months to 32 years with a median of 4 years. Fifty-one percent were aged less than 5 years, while 82 % were aged less than 10 years. Six percent of the cases were women of reproductive age. All cases were treated as outpatients and there were no deaths. The number of confirmed rubella cases was 473 in 2010, 604 in 2011, 300 in 2012, 336 in 2013 and 646 in 2014.
Conclusions
Analysis of Kenya rubella data shows that rubella is endemic throughout the country, and many outbreaks may be underestimated or undocumented. Six percent of all the cases in this outbreak were women of reproductive age indicating that the threat of CRS is real. The country should consider initiating a CRS surveillance system to quantify the burden with the goal of introducing rubella vaccine in the future.

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Research article
Changing risk awareness and personal protection measures for low to high pathogenic avian influenza in live-poultry markets in Taiwan, 2007 to 2012
Ming-Der Liu, Ta-Chien Chan, Cho-Hua Wan, Hsiu-Ping Lin, Tsung-Hua Tung, Fu-Chang Hu, Chwan-Chuen King BMC Infectious Diseases 2015, 15:241 (24 June 2015

BMC Public Health
http://www.biomedcentral.com/bmcpublichealth/content
(Accessed 27 June 2015)

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Research article
Determinants of students’ willingness to accept a measles–mumps–rubella booster vaccination during a mumps outbreak: a cross-sectional study
Hanna Donkers, Jeannine Hautvast, Reinier Akkermans, Corien Swaan, Wilhelmina Ruijs, Marlies Hulscher BMC Public Health 2015, 15:575 (27 June 2015)

British Medical Journal
27 June 2015(vol 350, issue 8014)
http://www.bmj.com/content/350/8014

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Views & Reviews Personal View
Preparedness explains some differences between Haiti and Nepal’s response to earthquake
2015; 350 doi: http://dx.doi.org/10.1136/bmj.h3059 (Published 05 June 2015) Cite this as: 2015;350:h3059
Paul S Auerbach responded to recent disasters in both countries and reflects on why Nepal saw so many fewer deaths and injuries
Excerpt
On 12 January 2010, a magnitude 7 earthquake struck Haiti 25 km from the capital, Port-au-Prince. Between 160 000 and 200 000 people are estimated to have died and more than 300 000 were injured.
Five years later, on 25 April 2015 a 7.8 magnitude earthquake struck Nepal, its epicentre 77 km from Kathmandu. This was followed on 12 May by a 7.3 magnitude earthquake equidistant from Kathmandu but on the opposite side. So far 8604 people are reported to have died and 16 808 have been injured.1
In both countries, buildings collapsed and enormous numbers of people were displaced and relocated to improvised shelters. The risk of communicable diarrhoeal disease loomed because of crowding and rain. Restricted airport capacity delayed relief workers and supplies.
The many differences between the two countries help explain why Haiti was far more vulnerable than Nepal to a similar sized earthquake. Both countries are poor, but Haiti is significantly poorer than Nepal. Haiti is considered politically a fragile, if not failed, …

Clinical Infectious Diseases (CID)
Volume 61 Issue 2 July 15, 2015
http://cid.oxfordjournals.org/content/current

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Editor’s choice: The Cost-effectiveness, Health Benefits, and Financial Costs of New Antiviral Treatments for Hepatitis C Virus
David B. Rein, John S. Wittenborn, Bryce D. Smith, Danielle K. Liffmann, and John W. Ward
Clin Infect Dis. (2015) 61 (2): 157-168 doi:10.1093/cid/civ220

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Compared to previous treatments for hepatitis C, new treatments provide much higher cure rates with far fewer adverse effects and contraindications. This article estimates the cost-effectiveness and financial impact of new hepatitis C medications as compared to treatments of the past.
Diane M. Richardson, Elina L. Medvedeva, Christopher B. Roberts, and Darren R. Linkin for the Centers for Disease Control and Prevention Epicenter Program
Comparative Effectiveness of High-Dose Versus Standard-Dose Influenza Vaccination in Community-Dwelling Veterans
Clin Infect Dis. (2015) 61 (2): 171-176 doi:10.1093/cid/civ261
High-dose influenza vaccine was not more effective than standard-dose vaccine in protecting against hospitalization for influenza or pneumonia in patients ≥65 years of age; subgroup analysis found that it was more effective in those ≥85 years of age.

Eurosurveillance
Volume 20, Issue 25, 25 June 2015
http://www.eurosurveillance.org/Public/Articles/Archives.aspx?PublicationId=11678

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Rapid communications
Epidemiological investigation of MERS-CoV spread in a single hospital in South Korea, May to June 2015
by HY Park, EJ Lee, YW Ryu, Y Kim, H Kim, H Lee, SJ Yi
Preliminary epidemiological assessment of MERS-CoV outbreak in South Korea, May to June 2015
by BJ Cowling, M Park, VJ Fang, P Wu, GM Leung, JT Wu
The role of superspreading in Middle East respiratory syndrome coronavirus (MERS-CoV) transmission
by AJ Kucharski, CL Althaus

Globalization and Health
http://www.globalizationandhealth.com/
[Accessed 27 June 2015]

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Research
Implementation of an electronic fingerprint-linked data collection system: a feasibility and acceptability study among Zambian female sex workers
Wall KM, Kilembe W, Inambao M, Chen YN, Mchoongo M, Kimaru L, Hammond YT, Sharkey T et al. Globalization and Health 2015, 11:27 (27 June 2015)
Abstract (provisional)
Background
Patient identification within and between health services is an operational challenge in many resource-limited settings. When following HIV risk groups for service provision and in the context of vaccine trials, patient misidentification can harm patient care and bias trial outcomes. Electronic fingerprinting has been proposed to identify patients over time and link patient data between health services. The objective of this study was to determine 1) the feasibility of implementing an electronic-fingerprint linked data capture system in Zambia and 2) the acceptability of this system among a key HIV risk group: female sex workers (FSWs).
Methods
Working with Biometrac, a US-based company providing biometric-linked healthcare platforms, an electronic fingerprint-linked data capture system was developed for use by field recruiters among Zambian FSWs. We evaluated the technical feasibility of the system for use in the field in Zambia and conducted a pilot study to determine the acceptability of the system, as well as barriers to uptake, among FSWs.
Results
We found that implementation of an electronic fingerprint-linked patient tracking and data collection system was feasible in this relatively resource-limited setting (false fingerprint matching rate of 1/1000 and false rejection rate of <1/10,000) and was acceptable among FSWs in a clinic setting (2 % refusals). However, our data indicate that less than half of FSWs are comfortable providing an electronic fingerprint when recruited while they are working. The most common reasons cited for not providing a fingerprint (lack of privacy/confidentiality issues while at work, typically at bars or lodges) could be addressed by recruiting women during less busy hours, in their own homes, in the presence of “Queen Mothers” (FSW organizers), or in the presence of a FSW that has already been fingerprinted.
Conclusions
Our findings have major implications for key population research and improved health services provision. However, more work needs to be done to increase the acceptability of the electronic fingerprint-linked data capture system during field recruitment. This study indicated several potential avenues that will be explored to increase acceptability.

Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 11, Issue 6, 2015
http://www.tandfonline.com/toc/khvi20/current

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Short Report
Evaluation of safety and immunogenicity of a quadrivalent human papillomavirus vaccine in healthy females between 9 and 26 years of age in Sub-Saharan Africa
Nelly Mugo, Nana Akosua Ansah, Deborah Marino, Alfred Saah & Elizabeth IO Garner
pages 1323-1330
DOI:10.1080/21645515.2015.1008877
Abstract
Due to sporadic and not easily accessible cervical cancer screening, human papillomavirus (HPV)-related cervical cancer is a leading cause of cancer death in Sub-Saharan African women. This study was designed to assess the safety and immunogenicity of a quadrivalent human papillomavirus (qHPV) vaccine in sub-Saharan African women. This seven month, double-blind study enrolled 250 healthy, human immunodeficiency virus (HIV)-uninfected females ages 9–26 residing in Ghana, Kenya, and Senegal. Thirty females ages 13–15 and 120 females ages 16–26 received qHPV vaccine. In addition, 100 females ages 9–12 y were randomized in a 4:1 ratio to receive either qHPV vaccine (n = 80) or placebo (n = 20 ). The primary immunogenicity hypothesis was that an acceptable percentage of subjects who received the qHPV vaccine seroconvert to HPV6/11/16/18 at 4 weeks post-dose 3, defined as the lower bound of the corresponding 95% confidence interval (CI) exceeding 90%. The primary safety objective was to demonstrate that qHPV vaccine was generally well tolerated when administered in a 3-dose regimen. The pre-specified statistical criterion for the primary immunogenicity hypothesis was met: the lower bound of the 95% exact binomial CI on the seroconversion rate was at least 98% for each vaccine HPV type and all subjects seroconverted by 4 weeks post-dose 3. Across vaccination groups, the most common adverse events (AE) were at the injection site, including pain, swelling, and erythema. No subject discontinued study medication due to an AE and no serious AEs were reported. There were no deaths. This study demonstrated that qHPV vaccination of sub-Saharan African women was highly immunogenic and generally well tolerated.

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Research Paper
A brief educational intervention increases providers’ human papillomavirus vaccine knowledge
Abbey B Berenson, Mahbubur Rahman, Jacqueline M Hirth, Richard E Rupp & Kwabena O Sarpong
pages 1331-1336
Abstract
Recommendation by a healthcare provider is critical to increase human papillomavirus (HPV) vaccine uptake in the US. However, current deficits in providers’ knowledge of HPV and its vaccine are not fully understood and interventions to amend knowledge gaps are untested. To determine whether attending a structured presentation could increase provider knowledge of the HPV vaccine, we assessed knowledge levels of physicians, non-physician healthcare workers, and medical students before and after attending a 30-minute lecture held between October 2012 and June 2014. Paired t-test and McNemar’s test were used to compare knowledge scores and the proportion of correct responses for each question, respectively. Multiple linear regression analyses were performed to examine correlates of baseline knowledge and change in knowledge scores post-intervention. A total of 427 participants, including 75 physicians, 208 medical students, and 144 nurses or other healthcare workers, attended one of 16 presentations and responded to both pre-test and post-test surveys. Baseline knowledge was low among all groups, with scores higher among older participants and physicians/medical students. On average, knowledge scores significantly improved from 8 to 15 after the presentation (maximum possible score 16) (P < .001), irrespective of specialty, race/ethnicity, gender, and age. Although lower at baseline, knowledge scores of younger participants and non-physician healthcare workers (e.g., nurses, physician assistants (PAs), nursing students) improved the most of all groups. We conclude that a brief, structured presentation increased HPV knowledge among a variety of healthcare workers, even when their baseline knowledge was low.

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Review
Comparing the immunogenicity and safety of 3 Japanese encephalitis vaccines in Asia-Pacific area: A systematic review and meta-analysis
Shi-Yuan Wang, Xiao-Hua Cheng, Jing-Xin Li, Xi-Yan Li, Feng-Cai Zhu & Pei Liu
pages 1418-1425
DOI:10.1080/21645515.2015.1011996

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Commentary
Clinical benefits of routine varicella vaccination for adults
Cinzia Germinario, Maria Serena Gallone, Maria Giovanna Cappelli & Silvio Tafuri
pages 1426-1428
DOI:10.1080/21645515.2015.1030559

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Review
Is a single infant priming dose of meningococcal serogroup C conjugate vaccine in the United Kingdom sufficient?
Helen Findlow & Ray Borrow
pages 1501-1506
DOI:10.1080/21645515.2015.1019189

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Coverage of the expanded program on immunization in Vietnam: Results from 2 cluster surveys and routine reports
Trung Dac Nguyen, Anh Duc Dang, Pierre Van Damme, Cuong Van Nguyen, Hong Thi Duong, Herman Goossens, Heidi Theeten & Elke Leuridan
pages 1526-1533
DOI:10.1080/21645515.2015.1032487

JAMA
June 23/30, 2015, Vol 313, No. 24
http://jama.jamanetwork.com/issue.aspx

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Viewpoint | June 23/30, 2015 Scientific Discovery and the Future of Medicine
Broadly Neutralizing Antibodies and the Development of Vaccines
Barton F. Haynes, MD1,2,3; Todd Bradley, PhD1,3
Author Affiliations
JAMA. 2015;313(24):2419-2420. doi:10.1001/jama.2015.2427.
[Excerpt]
This Viewpoint discusses the importance and progress of neutralizing human immunodeficiency virus through efforts to induce broadly reactive neutralizing antibodies.
Human immunodeficiency virus (HIV) infects 2.5 million people worldwide and accounts for more than 1 million deaths every year. Thus, an HIV vaccine is desperately needed. One roadblock to development of an effective HIV vaccine is the extraordinary ability of HIV to mutate and evolve into myriad quasi-species. Therefore, a key goal in developing a successful HIV vaccine is the induction of antibodies that can recognize and neutralize the majority of HIV quasi-species, called broadly reactive neutralizing antibodies (bnAbs). The search for an HIV vaccine has led to a greater understanding of bnAbs…

Journal of Medical Ethics
July 2015, Volume 41, Issue 7
http://jme.bmj.com/content/current

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Review
A comparison of justice frameworks for international research
Bridget Pratt1,2,3, Bebe Loff4
Author Affiliations
1International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
2Johns Hopkins Berman Institute of Bioethics, Baltimore, Maryland, USA
3Nossal Institute of Global Health, University of Melbourne, Melbourne, Victoria, Australia
4Michael Kirby Center for Public Health and Human Rights, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Abstract
Justice frameworks have been developed for international research that provide guidance on the selection of research targets, ancillary care, research capacity strengthening, and post-trial benefits. Yet there has been limited comparison of the different frameworks. This paper examines the underlying aims and theoretical bases of three such frameworks—the fair benefits framework, the human development approach and research for health justice—and considers how their aims impact their guidance on the aforementioned four ethical issues. It shows that the frameworks’ underlying objectives vary across two dimensions. First, whether they seek to prevent harmful or exploitative international research or to promote international research with health benefits for low and middle-income countries. Second, whether they address justice at the micro level or the macro level. The fair benefits framework focuses on reforming contractual elements in individual international research collaborations to ensure fairness, whereas the other two frameworks aim to connect international research with the reduction of global health inequities. The paper then highlights where there is overlap between the frameworks’ requirements and where differences in the strength and content of the obligations they identify arise as a result of their varying objectives and theoretical bases. In doing so, it does not offer a critical comparison of the frameworks but rather seeks to add clarity to current debates on justice and international research by showing how they are positioned relative to one another.

The Lancet
Jun 27, 2015 Volume 385 Number 9987 p2547-2644
http://www.thelancet.com/journals/lancet/issue/current

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Editorial
Sustainable equality—a goal to aspire to
The Lancet
DOI: http://dx.doi.org/10.1016/S0140-6736(15)61144-8
Summary
2015 marks a transition point for development which is, in its own way, exhilarating. The Millennium Development Goals (MDGs) will shortly expire, and these familiar and extensively discussed benchmarks can then be judged to have culminated in successes, failures, or opportunities against the extraordinary backdrop of the era—from the response to a catastrophic epidemic of HIV/AIDS to the profound and challenging global shifts in disease epidemiology, demography, and migration. A new set of aspirations must be fashioned to prepare the world’s people for times of continuing, indeed perhaps intensifying, change and uncertainty.

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Comment
Japan’s vision for health care in 2035
Hiroaki Miyata, Satoshi Ezoe, Manami Hori, Machiko Inoue, Kazumasa Oguro, Toshihisa Okamoto, Kensuke Onishi, Kohei Onozaki, Takeshi Sakakibara, Kazuhisa Takeuchi, Yasuharu Tokuda, Yuji Yamamoto, Mayuka Yamazaki, Kenji Shibuya
for the Health Care 2035 Advisory Panel
DOI: http://dx.doi.org/10.1016/S0140-6736(15)61135-7
Summary
Over the past half century Japan has made remarkable achievements in good population health at low cost, with increased equity.1 However, a demographic shift towards rapid ageing, the growth of non-communicable diseases (NCDs), and advances in medical technology have led to great changes in health-care needs. In the Lancet 2011 Series on Japan: Universal Health Care at 50 Years, three major challenges to Japan’s health system were identified: sustainability, governance, and responsiveness.2 In that Series, several reforms were proposed to assure the sustainability and equity of Japan’s health accomplishments: implementation of human-security, value-based reforms; redefinition of the roles of central and local governments; improvements in the quality of health care; and a commitment to global health.

Medical Decision Making (MDM)
July 2015; 35 (5)
http://mdm.sagepub.com/content/current

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Modeling the Effect of Herd Immunity and Contagiousness in Mitigating a Smallpox Outbreak
Ellie Graeden, PhD, Russel Fielding, BSc, Kyle E. Steinhouse, BSc Ilan N. Rubin, BA
Gryphon Scientific LLC, Takoma Park, Maryland
Abstract
The smallpox antiviral tecovirimat has recently been purchased by the U.S. Strategic National Stockpile. Given significant uncertainty regarding both the contagiousness of smallpox in a contemporary outbreak and the efficiency of a mass vaccination campaign, vaccine prophylaxis alone may be unable to control a smallpox outbreak following a bioterror attack. Here, we present the results of a compartmental epidemiological model that identifies conditions under which tecovirimat is required to curtail the epidemic by exploring how the interaction between contagiousness and prophylaxis coverage of the affected population affects the ability of the public health response to control a large-scale smallpox outbreak. Each parameter value in the model is based on published empirical data. We describe contagiousness parametrically using a novel method of distributing an assumed R-value over the disease course based on the relative rates of daily viral shedding from human and animal studies of cognate orthopoxvirus infections. Our results suggest that vaccination prophylaxis is sufficient to control the outbreak when caused either by a minimally contagious virus or when a very high percentage of the population receives prophylaxis. As vaccination coverage of the affected population decreases below 70%, vaccine prophylaxis alone is progressively less capable of controlling outbreaks, even those caused by a less contagious virus (R0 less than 4). In these scenarios, tecovirimat treatment is required to control the outbreak (total number of cases under an order of magnitude more than the number of initial infections). The first study to determine the relative importance of smallpox prophylaxis and treatment under a range of highly uncertain epidemiological parameters, this work provides public health decision-makers with an evidence-based guide for responding to a large-scale smallpox outbreak.

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 27 June 2015)

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Transmission of Multidrug-Resistant and Drug-Susceptible Tuberculosis within Households: A Prospective Cohort Study
Louis Grandjean, Robert H. Gilman, Laura Martin, Esther Soto, Beatriz Castro, Sonia Lopez, Jorge Coronel, Edith Castillo, Valentina Alarcon, Virginia Lopez, Angela San Miguel, Neyda Quispe, Luis Asencios, Christopher Dye, David A. J. Moore
Research Article | published 23 Jun 2015 | PLOS Medicine 10.1371/journal.pmed.1001843

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 27 June 2015)

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Characterization of the Burkholderia mallei tonB Mutant and Its Potential as a Backbone Strain for Vaccine Development
Tiffany M. Mott, Sudhamathi Vijayakumar, Elena Sbrana, Janice J. Endsley, Alfredo G. Torres Research Article | published 26 Jun 2015 | PLOS Neglected Tropical Diseases 10.1371/journal.pntd.0003863

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Neglected Tropical Diseases in the Ebola-Affected Countries of West Africa
Peter J. Hotez
Editorial | published 25 Jun 2015 | PLOS Neglected Tropical Diseases 10.1371/journal.pntd.0003671

PLoS One
http://www.plosone.org/
[Accessed 27 June 2015]

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Cost-Effectiveness Analysis of Universal Vaccination of Adults Aged 60 Years with 23-Valent Pneumococcal Polysaccharide Vaccine versus Current Practice in Brazil
Patrícia Coelho de Soárez, Ana Marli Christovam Sartori, Angela Carvalho Freitas, Álvaro Mitsunori Nishikawa, Hillegonda Maria Dutilh Novaes

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Research Article | published 26 Jun 2015 | PLOS ONE 10.1371/journal.pone.0130217
Access and Attitudes to HPV Vaccination amongst Hard-To-Reach Populations in Kenya
Deborah Watson-Jones, Nelly Mugo, Shelley Lees, Muthoni Mathai, Sophie Vusha, Gathari Ndirangu, David A. Ross
Research Article | published 26 Jun 2015 | PLOS ONE 10.1371/journal.pone.0123701
Abstract
Background
Sub-Saharan Africa bears the greatest burden of cervical cancer. Human papillomavirus (HPV) vaccination programmes to prevent the disease will need to reach vulnerable girls who may not be able access health and screening services in the future. We conducted formative research on facilitators and barriers to HPV vaccination and potential acceptability of a future HPV vaccination programme amongst girls living in hard-to-reach populations in Kenya.
Methods
Stakeholder interviews with Ministry of Health staff explored barriers to and support for the uptake of HPV vaccination. A situation assessment was conducted to assess community services in Maasai nomadic pastoralist communities in Kajiado County and in Korogocho informal settlement in Nairobi city, followed by focus group discussions (n=14) and semi-structured interviews (n=28) with health workers, parents, youth, and community and religious leaders. These covered marriage, knowledge of cervical cancer and HPV, factors that might inhibit or support HPV vaccine uptake and intention to accept HPV vaccine if a programme was in place.
Results
Reported challenges to an HPV vaccination programme included school absenteeism and drop-out, early age of sex and marriage, lack of parental support, population mobility and distance from services. Despite little prior knowledge of cervical cancer and HPV, communities were interested in receiving HPV vaccination. Adequate social mobilisation and school-based vaccination, supplemented by out-reach activities, were considered important facilitating factors to achieve high coverage. There was some support for a campaign approach to vaccine delivery.
Conclusions
Given the high level of support for a vaccine against cervical cancer and the experience of reaching pastoralist and slum-dwellers for other immunizations, implementing an HPV vaccine programme should be feasible in such hard-to-reach communities. This may require additional delivery strategies in addition to the standard school-based delivery, with vaccine offered at multiple venues, potentially through a campaign approach.

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The Cooperative Landscape of Multinational Clinical Trials
David Hsiehchen, Magdalena Espinoza, Antony Hsieh
Research Article | published 23 Jun 2015 | PLOS ONE 10.1371/journal.pone.0130930
Abstract
The scale and nature of cooperative efforts spanning geopolitical borders in clinical research have not been elucidated to date. In a cross-sectional study of 110,428 interventional trials registered in Clinicaltrials.gov, we characterized the evolution, trial demographics, and network properties of multinational clinical research. We reveal that the relative growth of international collaboratives has remained stagnant in the last two decades, although clinical trials have evolved to become much larger in scale. Multinational clinical trials are also characterized by higher patient enrollments, industry funding, and specific clinical disciplines including oncology and infectious disease. Network analyses demonstrate temporal shifts in collaboration patterns between countries and world regions, with developing nations now collaborating more within themselves, although Europe remains the dominant contributor to multinational clinical trials worldwide. Performances in network centrality measures also highlight the differential contribution of nations in the global research network. A city-level clinical trial network analysis further demonstrates how collaborative ties decline with physical distance. This study clarifies evolving themes and highlights potential growth mechanisms and barriers in multinational clinical trials, which may be useful in evaluating the role of national and local policies in organizing transborder efforts in clinical endeavors.

Revista Panamericana de Salud Pública/Pan American Journal of Public Health (RPSP/PAJPH)
April/May 2015 Vol. 37, Nos. 4/5
http://www.paho.org/journal/

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NÚMERO ESPECIAL SOBRE SALUD DE LA MUJER EN LAS AMÉRICAS / SPECIAL ISSUE ON WOMEN’S HEALTH IN THE AMERICAS
This special issue of the Pan American Journal of Public Health on women’s health aims to identify and reflect on the main challenges that demographic, social, and epidemiological changes will pose to women’s health in the Region of the Americas in the coming years. The manuscripts address a variety of subjects ranging from the health of women at different stages of life, sexual and reproductive health, gender-based violence, non-communicable chronic diseases, infectious diseases, and mental and occupational health, to adapting quality health services to meet promotion, prevention, treatment, and rehabilitation needs during the different stages of life and in several regional contexts.

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REFLEXIONES DE LA DIRECTORA / FROM THE DIRECTOR
A new agenda for women’s health in the Americas

EDITORIAL
Women’s health in the Region of the Americas ; La salud de la mujer en la Región de las Américas
Leticia Artiles, Francisco Becerra-Posada, Aníbal Faundes, Suzanne Jacob Serruya, Alejandra López Gómez y Raffaela Schiavon

ARTÍCULOS DE INVESTIGACIÓN ORIGINAL / ORIGINAL RESEARCH ARTICLES
Obstetric transition in the World Health Organization Multicountry Survey on Maternal and Newborn Health: exploring pathways for maternal mortality reduction
[Transición obstétrica en la Encuesta Global de la Organización Mundial de la Salud sobre Salud Materna y Neonatal: exploración de las vías de reducción de la mortalidad materna]
Solange da Cruz Chaves, José Guilherme Cecatti, Guillermo Carroli, Pisake Lumbiganon, Carol J. Hogue, Rintaro Mori, Jun Zhang, Kapila Jayaratne, Ganchimeg Togoobaatar, Cynthia Pileggi-Castro, Meghan Bohren, Joshua Peter Vogel, Özge Tunçalp, Olufemi Taiwo Oladapo, Ahmet Metin Gülmezoglu, Marleen Temmerman, and João Paulo Souza

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.

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Associated Press
http://hosted.ap.org/dynamic/fronts/HOME?SITE=AP&SECTION=HOME
Accessed 27 June 201
California vaccine bill clears major legislative hurdle
26 June 2015
SACRAMENTO, Calif. (AP) — California’s Assembly on Thursday approved a hotly contested bill requiring that nearly all public schoolchildren be vaccinated, clearing one of its last major legislative obstacles before the measure heads to the desk of Gov. Jerry Brown.
The bill aims to increase immunization rates after a measles outbreak linked to Disneyland in December sickened over 100 people in the U.S. and Mexico.
It would give California one of the nation’s strictest vaccine laws by striking the state’s personal belief exemption. Only children with serious health issues would be allowed to opt out of mandatory vaccine schedules. Unvaccinated children would need to be homeschooled.
If the bill becomes law, California would join Mississippi and West Virginia as the only states with such strict requirements…

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New York Times
http://www.nytimes.com/
Accessed 27 June 2015
Boy Dies of Diphtheria in Spain, Parents Rejected Vaccine
Officials say a six-year-old boy who had been the first child to contract diphtheria in Spain in 29 years has died from the disease in a Barcelona hospital.
June 27, 2015 – By THE ASSOCIATED PRESS

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Wall Street Journal
http://online.wsj.com/home-page?_wsjregion=na,us&_homepage=/home/us
Accessed 27 June 2015
NIH Expands Testing of Ebola Drugs and Vaccines Into New Countries
06/23/15
The National Institutes of Health has widened its research into Sierra Leone and Guinea, a move that increases the chances of getting definitive results from clinical studies.

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Washington Post
http://www.washingtonpost.com/
Accessed 27 June 2015
Nearly instantaneous, finger-prick test for Ebola could be game changer
The blood test can detect the virus in minutes.
Ariana Eunjung Cha | National | Jun 26, 2015

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

.– Request an Email Summary: Vaccines and Global Health : The Week in Review is published as a single email summary, scheduled for release each Saturday evening before midnight (EDT in the U.S.). If you would like to receive the email version, please send your request to david.r.curry@centerforvaccineethicsandpolicy.org.

– pdf version:  A pdf of the current issue is available here:  Vaccines and Global Health_The Week in Review_20 June 2015

– blog edition: comprised of the approx. 35+ entries posted below on this date.

– Twitter:  Readers can also follow developments on twitter: @vaxethicspolicy.
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– 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
– Children’s Hospital of Philadelphia Vaccine Education Center
Associate Faculty, Division of Medical Ethics, NYU Medical School

MERS-CoV [to 20 June 2015]

WHO statement on the ninth meeting of the IHR Emergency Committee regarding MERS-CoV
WHO Statement
17 June 2015
[Editor’s text bolding]
The ninth meeting of the Emergency Committee (EC) convened by the Director-General under the International Health Regulations (IHR 2005) regarding Middle East respiratory syndrome coronavirus (MERS-CoV) was conducted with members and advisors of the Emergency Committee by teleconference on 16 June 2015, from 12:00 to 15:00 Central European Summer Time (UTC +2). WHO convened the meeting in regards to the outbreak in the Republic of Korea.

The WHO Secretariat updated the Committee on epidemiological and scientific developments, including recent cases and transmission patterns in the Republic of Korea and China, related risk assessments, and control and prevention measures. These countries provided updates and assessments on the MERS-CoV situation and developments in their countries.

Members and advisers of the Committee who participated in the recent Republic of Korea-WHO MERS Joint Mission, were invited to share their observations based on their experience.

The Committee noted the assessment of the Joint mission regarding main factors contributing to the spread of MERS-CoV in the Republic of Korea were:
:: lack of awareness among health care workers and the general public about MERS;
:: suboptimal infection prevention and control measures in hospitals;
:: close and prolonged contact of infected MERS patients in crowded emergency rooms and multibed rooms in hospitals;
:: the practice of seeking care at multiple hospitals ( “doctor shopping”);
:: the custom of many visitors or family members staying with infected patients in the hospital rooms facilitating secondary spread of infections among contacts.

The Committee commended the speed with which the Republic of Korea provided information under the IHR about an infected traveller, enabling China to rapidly locate, isolate and provide care to the individual and place his contacts in quarantine.

The Committee noted that available evidence on genetic sequencing did not identify any significant changes in the viruses obtained from cases in the Republic of Korea compared to viruses from the Middle East. Ongoing monitoring of potential genetic changes in these viruses is important. In this outbreak, transmission of MERS-CoV has been strongly associated with health care settings. This aspect stresses the need for health authorities to make every possible effort to ensure that effective infection prevention and control measures are in place at all times.

There is no current evidence of sustained community transmission. The Committee noted that subsequent public health measures to stop the outbreak, including extensive efforts to enhance contact tracing and steps to ensure that cases and contacts (during the incubation period) are appropriately isolated or quarantined and monitored and that they do not travel, appear to have coincided with a decline in the incidence of cases. However, close monitoring of the situation remains critical to ensure that transmission is interrupted and that all cases without an evident epidemiological link to known chains of transmission be evaluated carefully. For the next several weeks, it is possible for additional cases to be identified, including among contacts who were not identified in the early stages of the outbreak. If reports or rumours of contacts travelling outside of the country are identified, it is important that other countries take notice and quickly assess such possibilities.

The Committee noted that there are still many gaps in knowledge regarding the transmission of this virus between people, including the potential role of environmental contamination, poor ventilation and other factors, and indicated that continued research in these areas was critical.

The Committee expressed its assessment that this outbreak is a wakeup call and that in a highly mobile world, all countries should always be prepared for the unanticipated possibility of outbreaks of this, and other serious infectious diseases. The situation highlights the need to strengthen collaboration between health and other key sectors, such as aviation, and to enhance communication processes.

The Committee reiterated that its previous advice1 remains relevant and indicated its strong support for the recommendations of the Joint Mission2.

The Committee concluded that the conditions for a Public Health Emergency of International Concern have not been met.

In reaching this conclusion, the Committee noted that after the outbreak was detected, and after a period of organization, the Republic of Korea has strongly initiated actions to bring this outbreak under control. This includes use of multiple approaches to identify contacts and to ensure their appropriate quarantine and monitoring, as well as effective means to stop inappropriate travel of cases and contacts during the period of time when they are potentially infectious. Such efforts reflect adoption of the recommendations of the Joint Mission.

Based on the Committee’s advice and information currently available, the Director-General accepted the Committee’s assessment. She thanked the Committee for its work.

WHO does not recommend the application of any travel or trade restrictions and considers screening at points of entry to be unnecessary at this time. Raising awareness about MERS and its symptoms among those travelling to and from affected areas is good public health practice.

WHO will continue to provide updates to the Committee Members and Advisors. The Emergency Committee will be reconvened should circumstances require.

1 IHR Emergency Committee concerning Middle East respiratory syndrome coronavirus
2 High level messages – assessment and recommendations
:: Emergency Committee Members

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WHO: Virtual press briefings on MERS-CoV
17 June 2015.

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WHO calls for stepping up vigilance for MERS, Thailand confirms case
18 June 2015 — Thailand confirmed Middle East respiratory syndrome coronavirus (MERS CoV) disease in a traveller from the Middle East region, the first case in the WHO South-East Asia Region, as WHO urged countries in the region to step up vigil and review preparedness to respond to the disease. WHO has been working with countries in the Region to build their capacities and strengthen preparedness to effectively detect and respond to outbreaks and other hazards.

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Global Alert and Response (GAR) – Disease outbreak news
Middle East Respiratory Syndrome coronavirus (MERS-CoV) – Thailand
20 June 2015
Middle East respiratory syndrome coronavirus (MERS-CoV) – Republic of Korea
19 June 2015
Middle East Respiratory Syndrome coronavirus (MERS-CoV) – Saudi Arabia
16 June 2015

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Situation and risk assessments
Summary and risk assessment of current situation in Republic of Korea and China
pdf, 867kb
19 June 2015
MERS-CoV: Situation assessment in the Republic of Korea
15 June 2015

EBOLA/EVD [to 20 June 2015]
Public Health Emergency of International Concern (PHEIC); “Threat to international peace and security” (UN Security Council)

WHO: Ebola Situation Report – 17 June 2015
[Excerpts]
SUMMARY
:: There were 24 confirmed cases of Ebola virus disease (EVD) reported in the week to 14 June, compared with 27 cases the previous week. In Guinea, 10 cases were reported from 4 prefectures (Boke, Conakry, Dubreka, and Forecariah). A total of 14 cases were reported from 2 districts (Kambia and Port Loko) in Sierra Leone.
:: Of 76 confirmed cases reported from Guinea and Sierra Leone in the 21 days to 14 June, 69 (91%) have come from 3 prefectures in Guinea (Boke, Dubreka, and Forecariah) and 2 districts in Sierra Leone (Kambia and Port Loko). Most (55) of these 69 cases came from well-characterised chains of transmission, and arose among registered, monitored contacts of previous cases. Each of these cases presents a risk of further transmission, but in most instances that risk is well understood and can be planned for accordingly. However, 14 of those 69 cases, and 5 of the 7 cases that were reported from other prefectures and districts during the same period, arose from unknown sources of infection, and/or are associated with a large number of high-risk contacts, some of whom it was not possible to trace. Effectively managing the risks associated with cases such as these will be crucial to getting to zero. To that end, a package of enhanced surveillance and response measures has been introduced in both Guinea and Sierra Leone:
…In Guinea, health checkpoints have been established in the western prefectures of Boke and Coyah. A 6-day door-to-door case-finding and sensitization campaign was carried out in Dubreka from 7 June, leading to the detection of 1 confirmed case. In addition, intensive investigations are underway to trace a number of high-risk contacts associated with 3 cases reported from the Guinean capital, Conakry, over the past 2 weeks. All of the 3 cases acquired infection outside the capital.
…In Sierra Leone, a large-scale operation is planned in the districts of Kambia and Port Loko, aimed at ending the secret movement of cases, contacts, and dead bodies that has propagated transmission over the past 2 months. Measures include broadened criteria for identifying and tracing contacts, improved incentives to increase compliance with quarantine measures and encourage the timely reporting and isolation of cases, and expanded use of rapid diagnostic tests.
:: As at 14 June, there were 1927 contacts being monitored across 8 prefectures in Guinea. In Sierra Leone, 443 contacts were under follow-up in 3 districts. A total of 660 laboratory samples were tested in Guinea in the week to 14 June: 4% tested positive. Over the same period, 1787 new samples were tested in Sierra Leone, with less than 1% testing positive.
:: In Guinea there were a total of 15 unsafe burials in the week to 14 June, representing 4% of 357 community deaths. In the week to 7 June, 1 unsafe burial was reported in Sierra Leone.

COUNTRIES WITH WIDESPREAD AND INTENSE TRANSMISSION
:: There have been a total of 27,305 reported confirmed, probable, and suspected cases of EVD in Guinea, Liberia and Sierra Leone (figure 1, table 1), with 11,169 reported deaths (this total includes reported deaths among probable and suspected cases, although outcomes for many cases are unknown). A total of 10 new confirmed cases were reported in Guinea and 14 in Sierra Leone in the 7 days to 14 June. The outbreak in Liberia was declared over on 9 May.

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WHO: Staying at zero: Keeping Ebola out of Liberia
18 June 2015 — Over a month has passed since Ebola transmission ceased in Liberia. This hard-fought achievement is still being celebrated across the country, where nearly 11 000 people became infected with the virus and 4 800 died. Liberia is still urging communities not to let their guard down until Ebola is gone from the region. Liberia is working closely with WHO and partners to keep Ebola from re-emerging.

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NIH Watch [to 20 June 2015]
http://www.nih.gov/news/releases.htm
Study of Ebola survivors opens in Liberia
Trial to examine long-term health effects of Ebola virus disease
June 17, 2015
The Liberia-U.S. clinical research partnership known as PREVAIL has launched a study of people in Liberia who have survived Ebola virus disease (EVD) within the past two years. The study investigators hope to better understand the long-term health consequences of EVD, determine if survivors develop immunity that will protect them from future Ebola infection, and assess whether previously EVD-infected individuals can transmit infection to close contacts and sexual partners. The study, sponsored by the Ministry of Health of Liberia and the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, will take place at various sites in Liberia and is expected to enroll approximately 7,500 people, including 1,500 people of any age who survived EVD and 6,000 of their close contacts.
“The clinical course of Ebola virus disease is reasonably well-understood, but we still have much to learn about the long-term health effects of the illness in those who recover,” said NIAID Director Anthony S. Fauci, M.D. “To unravel the many unknowns, we have expanded the focus of our partnership with Liberia’s Ministry of Health to include research on the long-term health effects of Ebola virus disease, in addition to our ongoing efforts to find an effective preventive vaccine and treatments for Ebola virus disease.”…

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Wellcome Trust [to 20 June 2015]
http://www.wellcome.ac.uk/News/2015/index.htm
Update on Ebola treatment trial in Sierra Leone
A clinical trial of a potential treatment for Ebola, called TKM-Ebola-Guinea, is no longer recruiting patients after reaching a pre-defined endpoint. Early results indicated that continued enrolment to the study, which has been running since March 2015 in Sierra Leone, was unlikely to demonstrate an overall therapeutic benefit to patients.

The research team is currently analysing the data collected during the trial and will make the results available as soon as possible. The single-arm phase II study (RAPIDE-TKM), is led by Professor Peter Horby of the University of Oxford on behalf of the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) in collaboration with the College of Medicine and Allied Health Sciences in Sierra Leone. The study is funded by the Wellcome Trust.

Professor Horby, Associate Professor of Infectious Diseases and Global Health at the University of Oxford and Chief Investigator of the study, said: “It is a great tribute to our colleagues in Sierra Leone that the trial has been run so efficiently and that we now have substantial experience on the use of TKM-Ebola-Guinea in patients with Ebola.

“While the trial has reached a statistical endpoint, and has therefore completed, final conclusions on the efficacy and tolerability of the drug must await full analysis of the data.”

TKM-Ebola-Guinea, is a synthetic small interfering RNA (siRNA) therapeutic developed and manufactured by Tekmira Pharmaceuticals. It is one of a number of candidate Ebola treatments to be evaluated through the Wellcome Trust Ebola therapeutics platform, which was set up in September 2014 to enable multiple partners to quickly establish clinical trials at existing Ebola treatment centres.

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World Bank [to 20 June 2015]
http://www.worldbank.org/en/news/all
As Ebola Crisis Wanes, a Mixed Picture of Economic Recovery for Households in Sierra Leone
Results from third round of mobile-phone surveys show progress since February
WASHINGTON, June 15, 2015—Employment in Sierra Leone has returned to pre-crisis levels, though earnings and hours worked still lag behind. This is according to respondents in the latest round of high-frequency mobile-phone surveys, led by Statistics Sierra Leone with support from the World Bank Group, assessing how Ebola is impacting people’s livelihoods. The survey contacted a sample of 1,715 households during May, 2015, which represents 41 percent of the 4,199 households covered in the baseline, nationally-representative Labor Force Survey conducted in July and August 2014. “Sierra Leone is working tirelessly to get to zero cases of Ebola,” said Francis Ato Brown, World Bank Group Country Manager for Sierra Leone. “Our job has to be not only to support the country in eradicating Ebola, but also to look toward economic recovery and toward mitigating the short-, medium-, and long-term impacts…
Date: June 15, 2015 Type: Press Release

POLIO [to 20 June 2015]
Public Health Emergency of International Concern (PHEIC)

GPEI Update: Polio this week – As of 17 June 2015
Global Polio Eradication Initiative
[Editor’s Excerpt and text bolding]
Full report: http://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx

:: An Independent Outbreak Response Assessment in Equatorial Guinea took place last week with over a year since the most recent case of polio on the 3 May 2014. They concluded that there is no evidence that wild poliovirus continues to circulate in the country and that there has been a significant improvement in surveillance. Strengthening routine immunization was identified as the highest priority for sustaining the gains of the outbreak response.

:: Expert groups in polio-infected areas are actively evaluating progress. Last week, the Technical Advisory Group for Afghanistan and Pakistan met to review the latest epidemiology, while this week an international outbreak assessment team is evaluating the situation in the Horn of Africa. Similar expert bodies will convene in other infected areas/countries over the coming months.

Selected excerpts from Country-specific Reports
Pakistan
:: One new wild poliovirus type 1 (WPV1) case was reported this week in South Waziristan in the Federally Administered Tribal Areas (FATA), with onset of paralysis on the 24 May. The total number of WPV1 cases for 2015 is now 25.

WHO & Regionals [to 20 June 2015]
Nepal Earthquake – Global Health Cluster
Health Cluster Bulletin No. 6 pdf, 1.11Mb
19 June 2015

Global Alert and Response (GAR) – Disease Outbreak News (DONs)
20 June 2015 – Middle East respiratory syndrome coronavirus (MERS-CoV) – Republic of Korea
20 June 2015 – Middle East Respiratory Syndrome coronavirus (MERS-CoV) – Saudi Arabia
5 June 2015 – Middle East respiratory syndrome coronavirus (MERS-CoV) – Republic of Korea
4 June 2015 – Middle East respiratory syndrome coronavirus (MERS-CoV) – Republic of Korea
4 June 2015 – Middle East Respiratory Syndrome coronavirus (MERS-CoV) – Saudi Arabia

The Weekly Epidemiological Record (WER) 19 June 2015, vol. 90, 25 (pp. 309–320) includes:
:: Update on vaccine-derived polioviruses worldwide, January 2014–March 2015

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:: WHO Regional Offices
WHO African Region AFRO
:: WHO mobilizes 164 500 doses of oral cholera vaccine to help control the cholera outbreak in Tanzania
Kigoma, 18 June 2015 – The cholera risk remains high in villages around entry points for asylum seekers in Kigoma region, Western Tanzania. The daily influx of asylum seekers has caused the population in the Nyarugusu camp in Tanzania to swell to over 55,500.
:: Rural mothers in Namibia given access to quality maternal and newborn care – 17 June 2015
:: Experts meet to discuss a range of public health issues in the African Region – 16 June 2015

WHO Region of the Americas PAHO
No new digest content identified

WHO South-East Asia Region SEARO
:: WHO calls for stepping up vigil for MERS, Thailand confirms case
18 June 2015

WHO European Region EURO
:: Stepping up action on migrant and refugee health 18-06-2015
:: Health a priority for European Development Days 17-06-2015

WHO Eastern Mediterranean Region EMRO
:: Kuwait donation supports scaling up of health care services to displaced populations and host communities in Iraq
18 June 2015
:: WHO airlifts from Damascus medical supplies to the besieged Deir ez-Zor city and Qamishly
18 June 2015
:: WHO welcomes new Kuwait donation for Syrians in need
15 June 2015

WHO Western Pacific Region
:: WHO recommends continuation of strong disease control measures to bring MERS-CoV outbreak in Republic of Korea to an end
MANILA, 13 JUNE 2015 – A joint mission by the World Health Organization and the Republic of Korea’s Ministry of Health and Welfare to review the outbreak of Middle East Respiratory Syndrome coronavirus (MERS CoV) in the Republic of Korea has recommended that continuing strengthening of contact tracing, monitoring and quarantine as well as expanded laboratory testing will prevent further spread of the virus.

International AIDS Vaccine Initiative [to 20 June 2015]
http://www.iavi.org/

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AIDS Vaccine Candidate Successfully ‘Primes’ Immune System in Animal Models
June 18, 2015
New research led by scientists at The Scripps Research Institute (TSRI), International AIDS Vaccine Initiative (IAVI) and The Rockefeller University shows that an experimental vaccine candidate can stimulate the immune system to block HIV infection in mice.
The new candidate has the potential to inform immunization strategies against AIDS for humans. The effort to develop a vaccine against HIV has so far struggled to elicit antibodies that can effectively fight off different strains of the fast and extensively mutating virus. The new results were published June 18 in concurrent studies in Cell and Science.
“The results are pretty spectacular,” said Dennis Burton, chair of the TSRI Department of Immunology and Microbial Science and scientific director of the IAVI Neutralizing Antibody Consortium (NAC) and National Institutes of Health Center for HIV/AIDS Vaccine Immunology and Immunogen Discovery at TSRI…

BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content
(Accessed 20 June 2015)

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Research article
The rise of digital direct-to-consumer advertising?: Comparison of direct-to-consumer advertising expenditure trends from publicly available data sources and global policy implications
Tim Mackey, Raphael Cuomo, Bryan Liang BMC Health Services Research 2015, 15:236 (19 June 2015)
Abstract
Background
Pharmaceutical marketing is undergoing a major shift in the United States, in part due to new transparency regulations under the healthcare reform act. Changes in pharmaceutical marketing practices include a possible shift from more traditional forms of direct-to-consumer advertising towards emerging use of Internet-based DTCA (“eDTCA”) given the growing importance of digital health or “eHealth.” Though legally allowed only in the U.S. and New Zealand, eDTCA poses novel regulatory challenges, as it can cross geopolitical boundaries and impact health systems and populations outside of these countries.
Methods
We wished to assess whether changes in DTCA and eDTCA expenditure trends was occurring using publicly available pharmaceutical marketing data. DTCA data was analyzed to compare trends in aggregate marketing expenditures and to assess if there were statistically significant differences in trends and magnitudes for data sources and DTCA sub-categories (including eDTCA). This was accomplished using regression lines of DTCA trend data and conducting pairwise comparisons of regression coefficients using t-tests. Means testing was utilized for comparing magnitude of DTCA expenditure.
Results
Data from multiple data sources indicate that aggregate DTCA expenditures have slightly declined during the period from 2005–2009 and are consistent with results from other studies. For DTCA sub-categories, television remained the most utilized form of DTCA, though experienced trends of declining expenditures (−13.2 %) similar to other traditional media platforms such as radio (−30.7 %) and outdoor ads (−12.1 %). The only DTCA sub-category that experienced substantial increased expenditures was eDTCA (+109.0 %) and it was the only medium that had statistically significant differences in its marketing expenditure trends compared to other DTCA sub-categories.
Conclusions
Our study indicates that traditional DTCA marketing may be on the decline. Conversely, the only DTCA sub-category that experienced significant increases was eDTCA. However, to fully understand this possible shift to “digital” DTCA, improvements in publicly available DTCA data sources are necessary to confirm changing trends and validate existing data. Hence, utilizing the newly implemented U.S. physician-payment expenditure transparency requirements, we advocate for the mandatory disclosure of DTCA/eDTCA in order to inform future domestic and international health policy efforts regarding appropriate regulation of pharmaceutical promotion.

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 20 June 2015)

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Research article
Trends in antibiotic resistance of Streptococcus pneumoniae and Haemophilus influenzae isolated from nasopharyngeal flora in children with acute otitis media in France before and after 13 valent pneumococcal conjugate vaccine introduction
François Angoulvant, Robert Cohen, Catherine Doit, Annie Elbez, Andreas Werner, Stéphane Béchet, Stéphane Bonacorsi, Emmanuelle Varon, Corinne Levy BMC Infectious Diseases 2015, 15:236 (21 June 2015)
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Research article
High multiple carriage and emergence of Streptococcus pneumoniae vaccine serotype variants in Malawian children
Arox Kamng’ona, Jason Hinds, Naor Bar-Zeev, Katherine Gould, Chrispin Chaguza, Chisomo Msefula, Jennifer Cornick, Benard Kulohoma, Katherine Gray, Stephen Bentley, Neil French, Robert Heyderman, Dean Everett BMC Infectious Diseases 2015, 15:234 (20 June 2015)
Abstract |

BMC Public Health
http://www.biomedcentral.com/bmcpublichealth/content
(Accessed 20 June 2015)

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Research article
Determinants of students’ willingness to accept a measles–mumps–rubella booster vaccination during a mumps outbreak: a cross-sectional study
Hanna Donkers, Jeannine Hautvast, Reinier Akkermans, Corien Swaan, Wilhelmina Ruijs, Marlies Hulscher BMC Public Health 2015, 15:575 (20 June 2015)

BMC Research Notes
http://www.biomedcentral.com/bmcresnotes/content
(Accessed 20 June 2015)

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Research article
Level of immunization coverage and associated factors among children aged 12–23 months in Lay Armachiho District, North Gondar Zone, Northwest Ethiopia: a community based cross sectional study
Melkamu Kassahun, Gashaw Biks, Alemayehu Teferra BMC Research Notes 2015, 8:239 (13 June 2015)

British Medical Journal
20 June 2015(vol 350, issue 8013)
http://www.bmj.com/content/350/8013

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Head To Head
Should we welcome multinational companies’ involvement in programmes to improve child health?
2015; 350 doi: http://dx.doi.org/10.1136/bmj.h3046 (Published 17 June 2015) Cite this as: 2015;350:h3046
Simon Berry, cofounder and chief executive, ColaLife 1,
Jane Berry, cofounder and business development, ColaLife1,
Rohit Ramchandani, doctor of public health candidate and public health adviser, ColaLife2,
Nick Spencer, emeritus professor of child health3
Author affiliations
Pragmatic partnerships with industry can work argue Simon Berry and colleagues, but Nick Spencer thinks the conflicts of interest are too great

Eurosurveillance
Volume 20, Issue 24, 18 June 2015
http://www.eurosurveillance.org/Public/Articles/Archives.aspx?PublicationId=11678

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Rapid communications
Imported case of MERS-CoV infection identified in China, May 2015: detection and lesson learned
by J Wu, L Yi, L Zou, H Zhong, L Liang, T Song, Y Song, J Su, C Ke

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Review articles
Systematic review of fever, febrile convulsions and serious adverse events following administration of inactivated trivalent influenza vaccines in children
by J Li-Kim-Moy, JK Yin, H Rashid, G Khandaker, C King, N Wood, KK Macartney, C Jones, R Booy

Global Health: Science and Practice (GHSP)
June 2015 | Volume 3 | Issue 2
http://www.ghspjournal.org/content/current

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COMMENTARIES
Leveraging the Power of Knowledge Management to Transform Global Health and Development
Good knowledge is essential to prevent disease and improve health. Knowledge management (KM) provides a systematic process and tools to promote access to and use of knowledge among health and development practitioners to improve health and development outcomes. KM tools range from publications and resources (briefs, articles, job aids) and products and services (websites, eLearning courses, mobile applications), to training and events (workshops, webinars, meetings) and approaches and techniques (peer assists, coaching, after-action reviews, knowledge cafés).
Tara M Sullivan, Rupali J Limaye, Vanessa Mitchell, Margaret D’Adamo, Zachary Baquet
Glob Health Sci Pract 2015;3(2):150-162. First published online April 27, 2015. http://dx.doi.org/10.9745/GHSP-D-14-00228

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How Can We Better Evaluate Complex Global Health Initiatives? Reflections From the January 2014 Institute of Medicine Workshop
An IOM workshop on evaluation design drew on recent evaluations of 4 complex initiatives (PEPFAR; the Global Fund to Fight AIDS, TB and Malaria; the President’s Malaria Initiative; and the Affordable Medicines Facility-malaria). Key components for good evaluations: (1) a robust theory of change to understand how and why programs should work; (2) use of multiple analytic methods; and (3) triangulation of evidence to validate and deepen understanding of results as well as synthesis of findings to identify lessons for scale-up or broader application.
Sangeeta Mookherji, Kate Meck
Glob Health Sci Pract 2015;3(2):174-179. First published online May 20, 2015. http://dx.doi.org/10.9745/GHSP-D-14-00184

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Establishing and Scaling-Up Clinical Social Franchise Networks: Lessons Learned From Marie Stopes International and Population Services International
Sarah Thurstona, Nirali M Chakrabortyb, Brendan Hayesc, Anna Mackayc, Pierre Moonb
Family planning social franchising has succeeded in countries with an active private sector serving low- and middle-income clients, with services provided mostly by mid-level providers, such as nurses and midwives. Key support for social franchising includes: clinical training and supportive supervision, help building sustainable businesses, marketing and demand creation, and mechanisms to make services affordable for clients. The forward agenda includes selectively introducing other priority health services, improving cost-effectiveness of the model, and promoting sustainability and health systems integration.
Abstract
In many low- and middle-income countries, a majority of people seek health care from the private sector. However, fragmentation, poor economies of scale, inadequate financing, political opposition, a bias toward curative services, and weak regulatory and quality control systems pose serious challenges for the private sector. Social franchising addresses a number of these challenges by organizing small, independent health care businesses into quality-assured networks. Global franchisors Marie Stopes International (MSI) and Population Services International (PSI) have rapidly scaled their family planning social franchising programs in recent years, jointly delivering over 10.8 million couple-years of protection (CYPs) in 2014—up 26% from 8.6 million CYPs just 1 year prior. Drawing on experience across MSI’s 17 and PSI’s 25 social franchise networks across Africa, Asia, and Latin America and the Caribbean, this article documents the organizations’ operational approaches, challenges faced, and solutions implemented. The organizations provide intensive capacity building and support for private-sector providers, including clinical training, branding, monitoring quality of franchised services, and commodity support. In addition, franchising programs engage providers and clients through behavior change communication (BCC) and demand generation activities to raise awareness and to attract clients, and they implement initiatives to ensure services are affordable for the lowest-income clients. Social franchise programs offer the private sector a collective platform to better engage government in health policy advocacy and for integrating into new public health care financing and procurement mechanisms. The future of social franchising will require developing approaches to scale-up and sustain the model cost-effectively, selectively integrating other health services into the franchise package, and being responsive to evolving health care financing approaches with the potential to contribute to universal health coverage

Health Policy and Planning
July 2015 30 (6)
http://heapol.oxfordjournals.org/content/current

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Applying lessons learned from the USAID family planning graduation experience to the GAVI graduation process
Angela K Shen*,1,2, Marguerite M Farrell3, Mary F Vandenbroucke4, Elizabeth Fox5 and Ariel Pablos-Mendez1
Author Affiliations
1Bureau for Global Health, US Agency for International Development, Washington, DC, USA, 2US Department of Health and Human Services, Washington, DC, USA, 3Office of Population and Reproductive Health, US Agency for International Development, Washington, DC, USA, 4Office of Country Support, US Agency for International Development, Washington, DC, USA and 5Office of Health Infectious Disease and Nutrition, US Agency for International Development, Washington, DC, USA
Abstract
As low income countries experience economic transition, characterized by rapid economic growth and increased government spending potential in health, they have increased fiscal space to support and sustain more of their own health programmes, decreasing need for donor development assistance. Phase out of external funds should be systematic and efforts towards this end should concentrate on government commitments towards country ownership and self-sustainability. The 2006 US Agency for International Development (USAID) family planning (FP) graduation strategy is one such example of a systematic phase-out approach. Triggers for graduation were based on pre-determined criteria and programme indicators. In 2011 the GAVI Alliance (formerly the Global Alliance for Vaccines and Immunizations) which primarily supports financing of new vaccines, established a graduation policy process. Countries whose gross national income per capita exceeds $1570 incrementally increase their co-financing of new vaccines over a 5-year period until they are no longer eligible to apply for new GAVI funding, although previously awarded support will continue. This article compares and contrasts the USAID and GAVI processes to apply lessons learned from the USAID FP graduation experience to the GAVI process. The findings of the review are 3-fold: (1) FP graduation plans served an important purpose by focusing on strategic needs across six graduation plan foci, facilitating graduation with pre-determined financial and technical benchmarks, (2) USAID sought to assure contraceptive security prior to graduation, phasing out of contraceptive donations first before phasing out from technical assistance in other programme areas and (3) USAID sought to sustain political support to assure financing of products and programmes continue after graduation. Improving sustainability more broadly beyond vaccine financing provides a more comprehensive approach to graduation. The USAID FP experience provides a window into understanding one approach to graduation from donor assistance. The process itself—involving transparent country-level partners well in advance of graduation—appears a valuable lesson towards success.

Health Policy and Planning
July 2015 30 (6)
http://heapol.oxfordjournals.org/content/current

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Ten best resources on conditional cash transfers
Caroline Marshall* and Peter S Hill
Author Affiliations
School of Population Health, University of Queensland, QLD 4006, Australia
Abstract
The world’s economy is in a fragile state. Although cautiously recovering from a global recession, unemployment rates and poverty levels remain high. At the same time, food and fuel crises have resulted in skyrocketing commodity costs, straining household budgets even further than before. In the wake of these financial pressure points, there has been increased focus on social safety net programmes. More recently, Brazil’s ‘Bolsa Familia’ conditional cash transfer (CCT) programme has celebrated its tenth-year anniversary, renewing focus on this particular aspect of social transfer programmes. This essay examines one particular aspect of these social safety net programmes: CCTs. CCT programmes are useful social programmes that have had demonstrable effects on many different populations. However, they are not a ‘magic bullet’ against poverty, and their image has suffered from unreasonable expectations of their impacts. This 10 best list is an ideal starting point from which a potential user can begin to understand CCTs. There remain significant gaps in the literature behind CCTs, with a particular need for much more research on emerging areas such as impacts on gender, long-term school and health outcomes, methods for increasing efficiency and adapting conditionalities within cultural contexts, among others. However, this list can function as a starting point from which the reader can gain an understanding and appreciation for what we believe to be one of the most innovative social programmes for addressing poverty worldwide.

JAMA
June 16, 2015, Vol 313, No. 23
http://jama.jamanetwork.com/issue.aspx

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Scientific Discovery and the Future of Medicine
Science, Medicine, and Society: A View From the Wellcome Trust
Jeremy Farrar, FRS, FRCP, FMedSci, OBE

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Editorial | June 16, 2015
Development Assistance for Health Potential Contribution to the Post-2015 Agenda
Andy Haines, MD, MB, BS1
Author Affiliations
JAMA. 2015;313(23):2328-2330. doi:10.1001/jama.2015.5790.
Despite economic growth in low-income countries, the internal resources available to some governments will be inadequate to support the delivery of health care to their populations for years to come.1 Approximately 150 million people worldwide experience catastrophic expenditure annually to cover out-of-pocket payments for health.1 Despite substantial progress, 6.6 million children who were younger than 5 years died in 2012 and a quarter of all children younger than 5 years were stunted (having an inadequate height or length for age).2 Almost 300 000 women died in 2013 of causes related to pregnancy and childbirth.2 Against this background, the study by Dieleman and colleagues3 in this issue of JAMA makes a substantial contribution to the current understanding of the flow of development assistance for health (DAH) and how these resources can contribute to the achievement of international health goals…

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Special Communication | June 16, 2015
Sources and Focus of Health Development Assistance, 1990–2014
Joseph L. Dieleman, PhD1; Casey Graves, BA1; Elizabeth Johnson, BA1; Tara Templin, BA1; Maxwell Birger, BS1; Hannah Hamavid, BA1; Michael Freeman, MPH2; Katherine Leach-Kemon, MPH1; Lavanya Singh, BS1; Annie Haakenstad, MA1; Christopher J. L. Murray, MD1
Author Affiliations
JAMA. 2015;313(23):2359-2368. doi:10.1001/jama.2015.5825
Abstract
Importance
The governments of high-income countries and private organizations provide billions of dollars to developing countries for health. This type of development assistance can have a critical role in ensuring that life-saving health interventions reach populations in need.
Objectives
To identify the amount of development assistance that countries and organizations provided for health and to determine the health areas that received these funds.
Evidence Review Budget, revenue, and expenditure data on the primary agencies and organizations (n = 38) that provided resources to developing countries (n = 146-183, depending on the year) for health from 1990 through 2014 were collected. For each channel (the international agency or organization that directed the resources toward the implementing institution or government), the source and recipient of the development assistance were determined and redundant accounting of the same dollar, which occurs when channels transfer funds among each other, was removed. This research derived the flow of resources from source to intermediary channel to recipient. Development assistance for health (DAH) was divided into 11 mutually exclusive health focus areas, such that every dollar of development assistance was assigned only 1 health focus area.
Findings
Since 1990, $458.0 billion of development assistance has been provided to maintain or improve health in developing countries. The largest source of funding was the US government, which provided $143.1 billion between 1990 and 2014, including $12.4 billion in 2014. Of resources that originated with the US government, 70.6% were provided through US government agencies, and 41.0% were allocated for human immunodeficiency virus (HIV)/AIDS. The second largest source of development assistance for health was private philanthropic donors, including the Bill and Melinda Gates Foundation and other private foundations, which provided $69.9 billion between 1990 and 2014, including $6.2 billion in 2014. These resources were provided primarily through private foundations and nongovernmental organizations and were allocated for a diverse set of health focus areas. Since 1990, 28.0% of all DAH was allocated for maternal health and newborn and child health; 23.2% for HIV/AIDS, 4.3% for malaria, 2.8% for tuberculosis, and 1.5% for noncommunicable diseases. Between 2000 and 2010, DAH increased 11.3% annually. However, since 2010, total DAH has not increased as substantially.
Conclusions and Relevance
Funding for health in developing countries has increased substantially since 1990, with a focus on HIV/AIDS, maternal health, and newborn and child health. Funding from the US government has played a substantial role in this expansion. Funding for noncommunicable diseases has been limited. Understanding how funding patterns have changed across time and the priorities of sources of international funding across distinct channels, recipients, and health focus areas may help identify where funding gaps persist and where cost-effective interventions could save lives.

Journal of Immigrant & Refugee Studies
Volume 13, Issue 2, 2015
http://www.tandfonline.com/toc/wimm20/current#.VQS0KOFnBhW

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Special Issue: Implementing Human Rights: Civil Society and Migration Policies
NGOs and Health Services for Irregular Immigrants in Italy: When the Protection of Human Rights Challenges the Laws
Maurizio Ambrosini
pages 116-134
DOI:10.1080/15562948.2015.1017631
Published online: 17 Jun 2015

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The Integration of Forced Migrants Into the Italian Labor Market
Livia Elisa Ortensi
pages 179-199
DOI:10.1080/15562948.2014.907952
Published online: 17 Jun 2015

The Lancet
Jun 20, 2015 Volume 385 Number 9986 p2433-2546
http://www.thelancet.com/journals/lancet/issue/current

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Editorial
The G7 and global health: inaction or incisive leadership?
The Lancet
DOI: http://dx.doi.org/10.1016/S0140-6736(15)61121-7
Preview
“They came, they met, and nothing happened.” So was the conclusion of James Rubin, former US Assistant Secretary of State. A harsh, but many might say fair, statement about the recent G7 meeting held in Germany. A few days before the start of the Summit, UN Secretary General Ban Ki-moon set the scene for leaders: “When they meet at the Schloss Elmau Summit in Germany on June 7–8, G7 leaders can show they are serious about seizing the moment and protecting people and the planet.” He was right to suggest that as the international community prepares to adopt a new sustainable development agenda in New York in September, together with a new climate treaty in Paris in December, G7 countries have “a special responsibility to lead”.

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Comment
Capacity for science in sub-Saharan Africa
Alison Elliott, Barbara Nerima, Bernard Bagaya, Andrew Kambugu, Moses Joloba, Stephen Cose, Guiseppe Pantaleo, Maria Yazdanbakhsh, David Mabey, David Dunne, Ashley Moffett, Eli Katunguka Rwakishaya, Pontiano Kaleebu, Edward Katongole Mbidde
DOI: http://dx.doi.org/10.1016/S0140-6736(15)61111-4
Preview
During the past decade there has been an increase in funding for research capacity building in Africa. Two major European programmes are at a turning point: the Wellcome Trust’s African Institutions Initiative is about to end, while their new initiative, DELTAS Africa,1 will be launched later this year. The European Union’s Seventh Framework Programme (FP7) is ending, superseded by Horizon 2020,2 with the transition of some research areas that are important to Africa into the expanded second phase of the European and Developing Countries Clinical Trials Partnership.