Vaccines and Global Health: The Week in Review 23 January 2016

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_23 January 2016

blog edition: comprised of the approx. 35+ entries posted below on 24January 2016.

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

EBOLA/EVD [to 23 January 2016]

EBOLA/EVD [to 23 January 2016]
Public Health Emergency of International Concern (PHEIC); “Threat to international peace and security” (UN Security Council)

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Ebola Situation Report – 20 January 2016
SUMMARY [Excerpts]
:: Human-to-human transmission directly linked to the 2014 Ebola virus disease (EVD) outbreak in West Africa was declared to have ended in Sierra Leone on 7 November 2015. The country then entered a 90-day period of enhanced surveillance to ensure the rapid detection of any further cases that might arise as a result a missed transmission chain, reintroduction from an animal reservoir, importation from an area of active transmission, or re-emergence of virus that had persisted in a survivor. On 14 January, 68 days into the 90-day surveillance period, a new confirmed cases of EVD was reported in Sierra Leone after a post-mortem swab collected from a deceased 22-year-old woman tested positive for Ebola virus. The woman died on 12 January at her family home in the town of Magburaka, Tonkolili district, and received an unsafe burial. In the preceding 2 weeks the woman travelled from Port Loko, where she was a student, via the districts of Kambia and Bombali before arriving in Magburaka on 7 January. Reports indicate that her symptoms during travel included vomiting and diarrhoea. The Sierra Leone Ministry of Health and Sanitation (MoHS), with the support of WHO and other partners, responded rapidly to the new case, identifying approximately 150 contacts of whom approximately 50 are deemed to be at high risk. Vaccination of contacts and contacts of contacts is underway under the authority and coordination of the Sierra Leone MoHS. However, the woman’s extensive travel history in the 2 weeks prior to her death, her presentation to and subsequent discharge from a health care facility at which health workers did not use personal protective equipment (PPE), her period of close contact with family whilst ill, and her unsafe burial indicate a significant risk of further transmission. One contact in Tonkolili remains to be traced. The origin of infection is under investigation.

:: Human-to-human transmission linked to the most recent cluster of cases in Liberia was declared to have ended on 14 January 2016. Guinea was declared free of Ebola transmission on 29 December 2015, and has now entered a 90-day period of enhanced surveillance that is due to end on 27 March 2016.

:: With guidance from WHO and other partners, ministries of health in Guinea, Liberia and Sierra Leone have plans to deliver a package of essential services to safeguard the health of the estimated more than 10,000 survivors of EVD, and enable those individuals to take any necessary precautions to prevent infection of their close contacts. Over 300 male survivors in Liberia had accessed semen screening and counselling services by 17 January 2016…

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Ebola vaccine purchasing commitment from Gavi to prepare for future outbreaks
20 January 2016
Agreement will help push vaccine towards regulatory approval.
Davos, 20 January 2016 – Gavi, the Vaccine Alliance and Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. (known as MSD outside the U.S. and Canada) have signed an agreement to support the provision of a vaccine to protect against future deadly Ebola outbreaks. The agreement, announced today at the World Economic Forum in Davos, will help Merck take the vaccine through licensure and WHO prequalification.

Under the Advance Purchase Commitment, Gavi has provided US$ 5 million towards the development of Merck’s rVSV∆G-ZEBOV-GP live attenuated Ebola Zaire vaccine, on the understanding that it will be submitted for licensure by the end of 2017. If approved, it would become one of the world’s first licensed Ebola vaccines and Gavi would be able to begin purchasing the vaccine to create a stockpile for future outbreaks.

Additionally, Merck will ensure that 300,000 doses of the vaccine are available from May 2016 for use in expanded use clinical trials and/or for emergency use as needed while vaccine development continues. Merck has already submitted an application through WHO’s Emergency Use Assessment and Listing (EUAL) procedure. If the EUAL is approved, this will provide an opportunity for the investigational vaccine to be used if another public health emergency with Ebola occurs before the vaccine is licensed.

“The suffering caused by the Ebola crisis was a wake-up call to many in the global health community,” said Gavi CEO Dr Seth Berkley. “New threats require smart solutions and our innovative financing agreement with Merck will ensure that we are ahead of the curve for future Ebola outbreaks.”

“We are very pleased to join with Gavi in announcing this Advance Purchase Commitment agreement to support the provision of MSD’s investigational monovalent Ebola Zaire vaccine – in case of a resurgence of the Ebola outbreak or a new outbreak,” said Dr Julie Gerberding, executive vice president, Strategic Communications, Global Public Policy and Population Health for Merck. “We applaud Gavi for this bold step to be a part of the solution to address a disease that has impacted so many lives.”…

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Guinea Revives Border Health Screening to Mitigate Risk of Spread of Ebola
01/22/16 – IOM / International Organization for Migration
Guinea – Following the confirmation of a new Ebola case in Sierra Leone on January 12 – and confirmation of another case on January 20th – IOM and its partners are reactivating cross-border health screening at Guinea’s borders with Sierra Leone and reinforcing their surveillance capacity in Forecariah Prefecture, the border area closest to the outbreak.

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WHO: Clinical care for survivors of Ebola virus disease
22 January 2016 — Today, there are over 10 000 survivors of Ebola virus disease. A number of medical problems have been reported in survivors, including mental health issues. Ebola virus may persist in some body fluids, including semen. Ebola survivors need comprehensive support for the medical and psychosocial challenges they face and also to minimize the risk of continued Ebola virus transmission. WHO has developed this document to guide health services on how to provide quality care to survivors of Ebola virus disease.
Read the guidance for survivors

POLIO [to 23 January 2016]

POLIO [to 23 January 2016]
Public Health Emergency of International Concern (PHEIC)

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Polio this week as of 20 January 2016
:: There are three months to go until the globally synchronized switch from the trivalent to bivalent oral polio vaccine, an important milestone in achieving a polio-free world. Read more here.
:: A sample from environmental surveillance in Kabul, Afghanistan has tested positive for wild poliovirus type 1. A vaccination response is being planned for the immediate vicinity.

Selected content from country-level reports
Afghanistan
:: Two new WPV1 environmental positive samples were reported in the past week – one in Jalalabad in Nangarhar province, and the second Kabul city. Both samples were collected on 27 December 2015.
:: Subnational Immunization Days (SNIDs) were carried out in the south on 12 to 15 January using bOPV. Further SNIDs are planned from 16 to 19 February, also using bOPV and National Immunization Days (NIDs) are planned from 15 to 18 March using tOPV, prior to the switch. Read more about the switch here.
Pakistan
:: One new wild poliovirus type 1 (WPV1) case was reported in the past week, with onset of paralysis on 22 December 2015 in Peshawar. The total number of WPV1 cases for 2015 is now 53, compared to 303 reported for 2014 by this time last year. A total of 306 cases occurred in Pakistan in 2014.
:: Two new WPV1 environmental positive samples were detected in Karachi’s Gadap Town in Sindh province and Quetta, Balochistan with collection dates of 11 December 2015 and 14 December 2015 respectively
Lao People’s Democratic Republic
:: One new case of circulating vaccine-derived poliovirus type 1 (cVDPV1) was reported in the past week, in Longxan district of Xaysomboune province with onset of paralysis on 18 November 2015. The total number of cVDPV1 cases in 2015 is now seven.
:: Outbreaks of cVDPVs can arise in areas with low population immunity, emphasizing the importance of maintaining strong vaccination coverage. Learn more about VDPVs.
:: An emergency outbreak response is continuing in the country, with particular focus on three high-risk provinces.

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ECHO [to 23 January 2016]
http://ec.europa.eu/echo/en/news
22/01/2016
EU supports vaccination campaign to combat polio in Ukraine
The European Commission is providing €1.2 million to support a third round of polio vaccinations in Ukraine following the start of an outbreak in August last year.

The vaccination campaign is carried out with the cooperation of relevant Ukrainian government ministries, UNICEF and the World Health Organisation (WHO).

Speaking at a press conference in Kiev today launching the latest vaccination drive, Director of Operations of the European Commission’s Humanitarian Aid and Civil Protection department (ECHO), Jean-Louis de Brouwer, stated: “I laud the combined efforts of the Ministries of Health and Education who, together with our partners UNICEF and WHO, have made tremendous strides in vaccinating thousands of children against this dreaded disease”.

The first two rounds of polio vaccinations took place in November 2015, after an outbreak was confirmed by WHO. The third round of vaccinations will target 4.75 million children aged 0-10.
The funding is being made available through the European Commission’s Humanitarian Aid and Civil Protection department (ECHO). The vaccines were flown in the first week of January in preparation for the latest vaccination drive…

WHO & Regionals [to 23 January 2016]

WHO & Regionals [to 23 January 2016]

El Niño threatens at least 60 million people
22 January 2016 — WHO and partners predict a major global increase in health-related emergencies this year due to El Niño. According to a new WHO report, severe drought, flooding, rains and temperature rises are all known effects of El Niño that can lead to food insecurity, malnutrition, disease outbreaks, acute water shortages and disruption of health services.
Read the story on El Niño and health

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Weekly Epidemiological Record (WER) 22 January 2016, vol. 91, 3 (pp. 21–32)
Contents
21 Global Advisory Committee on Vaccine Safety, 2–3 December 2015
31 Monthly report on dracunculiasis cases, January– November 2015

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Disease Outbreak News (DONs)
:: 21 January 2016 – Zika virus infection – France – Saint Martin and Guadeloupe
:: 21 January 2016 – Guillain-Barré syndrome – El Salvador
:: 21 January 2016 – Zika virus infection – Haiti
:: 20 January 2016 – Zika virus infection – Bolivia
:: 20 January 2016 – Zika virus infection – Guyana, Barbados and Ecuador
:: 19 January 2016 – Human infection with avian influenza A(H7N9) virus – China
Call for nomination of experts to serve on the Strategic Advisory Group of Experts on immunization (SAGE) Working Group on Typhoid Vaccines
20 January 2016
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:: WHO Regional Offices
WHO African Region AFRO
No new digest content identified.

WHO Region of the Americas PAHO
:: As the Zika virus spreads, PAHO advises countries to monitor and report birth anomalies and other suspected complications of the virus (01/18/2016)
:: PAHO helps countries in the Americas prepare for spread of Zika (01/16/2016)

WHO South-East Asia Region SEARO
No new digest content identified.

WHO European Region EURO
:: Collaboration on refugee and migrant health 21-01-2016
Countries in the WHO European Region have agreed to prepare a common framework for coordinated collaboration and action on refugee and migrant health, based on solidarity and mutual assistance and in the spirit of the 2030 Sustainable Development agenda, whereby “no one should be left behind”
…The document states, among other issues:
:: Migrants and refugees do not pose an additional threat to health security in host communities.
:: Screening can be an effective public health instrument but should be non-discriminatory and non-stigmatizing and should benefit both the individual and the public.
:: Special attention should be paid to the most vulnerable groups, such as children, pregnant women, the elderly, people with disabilities and victims of torture.
:: Health records and health cards must be made portable as a priority…

WHO Eastern Mediterranean Region EMRO
:: New delivery rooms in camps for the internally displaced in Iraq save the lives of mothers and babies
20 January 2016

WHO Western Pacific Region
No new digest content identified.

CDC/ACIP [to 23 January 2016]

CDC/ACIP [to 23 January 2016]
http://www.cdc.gov/media/index.html

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CDC adds countries to interim travel guidance related to Zika virus
FRIDAY, JANUARY 22, 2016
CDC is working with other public health officials to monitor for ongoing Zika virus‎ transmission. Today, CDC added the following destinations to the Zika virus travel alerts: Barbados, Bolivia, Ecuador, Guadeloupe, Saint Martin, Guyana, Cape Verde, and Samoa. On January 15, CDC issued a travel alert (Level 2-Practice Enhanced Precautions) for people traveling to regions and certain countries where Zika virus transmission is ongoing: the Commonwealth of Puerto Rico, a U.S. territory; Brazil; Colombia; El Salvador; French Guiana; Guatemala; Haiti; Honduras; Martinique; Mexico; Panama; Paraguay; Suriname; and Venezuela. Specific areas where Zika virus transmission is ongoing are often difficult to determine and are likely to continue to change over time…

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MMWR Weekly – January 22, 2016 / Vol. 65 / No. 2
http://www.cdc.gov/mmwr/index2015.html
:: Inadequate Diagnosis and Treatment of Malaria Among Travelers Returning from Africa During the Ebola Epidemic — United States, 2014–2015
:: Interim Guidelines for Pregnant Women During a Zika Virus Outbreak — United States, 2016
:: Notes from the Field: Outbreak of Locally Acquired Cases of Dengue Fever — Hawaii, 2015

Gavi launches ‘INFUSE’ initiative to overcome barriers to immunisation

Gavi [to 23 January 2016]
http://www.gavialliance.org/library/news/press-releases/

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22 January 2016
Gavi launches ‘INFUSE’ initiative to overcome barriers to immunisation
Call to entrepreneurs, corporations and implementers to innovate and improve vaccine delivery.
Davos, 22 January 2016 – Gavi, the Vaccine Alliance today called for proven-concept innovations from entrepreneurs and companies that could drive improvements in immunisation in developing countries. The Geneva-based public-private partnership will identify the most promising concepts and technologies and connect them with influential public and private sector leaders.

At the World Economic Forum’s annual meeting, Gavi hosted global business leaders, government officials and high-tech innovators to introduce Innovation for Uptake, Scale and Equity in immunisation (INFUSE) – an initiative focused on overcoming the obstacles that lead to almost 19 million children per year not receiving a full course of the most basic vaccines. Gavi CEO Dr Seth Berkley highlighted the importance of harnessing new thinking, potentially from innovators outside the immunisation and global health fields, to reach more children with vaccines.

The INFUSE topic for 2016 is immunisation data availability, quality, and use – a fundamental step to building an efficient and sustainable immunisation systems in developing countries. Gavi will welcome data-related proposals of projects that are either already operating or have completed their pilot phase. Gavi will encourage new partnerships to enable a small number of successful projects to help bridge the gap between pilot phase, small-scale implementation and regional or global scale- up.

“I am excited that Gavi is ready to embrace new and diverse thinking to solve the challenges that are preventing us from reaching children with vaccines,” said Dr Berkley. “Data is absolutely critical to health as it enables us to track both people and diseases. We are looking forward to exploring new possibilities for capturing and using data in the countries we work with.”

INFUSE is open to local and global entrepreneurs, corporations, and implementers with a proven-to-work technology or implementation innovation enhancing data availability, quality, or use, that could be adapted to the broad developing country context. These could include solutions ranging from better tools and training resources for local health workers to track vaccinated children at the point of care, to the application of emerging “deep data” concepts to identify resource gaps and areas for improving health and immunisation systems.

By connecting innovators with influential public and private sector figures, Gavi hopes to accelerate the use of proven-concept innovations to modernise immunisation delivery. Those interested in joining INFUSE can apply online at infuse.gavi.org

Nigerian Governors Partner with Dangote Foundation, Gates Foundation, and USAID to Bring Life-saving Vaccines to Children

BMGF – Gates Foundation [to 23 January 2016]
http://www.gatesfoundation.org/Media-Center/Press-Releases

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JANUARY 19, 2016
Nigerian Governors Partner with Dangote Foundation, Gates Foundation, and USAID to Bring Life-saving Vaccines to Children
Four northern Nigerian governors, Alhaji Aliko Dangote, Bill Gates, and U.S. Ambassador James Entwistle agree to Memorandum of Understanding to improve routine immunization and strengthen primary health care.

KADUNA (January 20, 2016) – In a ceremony at the Kaduna State Government House, Alhaji Aliko Dangote, chair of the Dangote Foundation; Bill Gates, co-chair of the Bill & Melinda Gates Foundation; and U.S. Ambassador to Nigeria, James Entwistle, joined governors from Kaduna, Sokoto, Yobe, and Borno to launch an ambitious new partnership committing political and financial resources to strengthen and sustain routine immunization programs that will save more lives and keep Nigeria polio-free.

The witnessing of new Memorandums of Understanding (MOUs) served as an opportunity to review successes and lessons learned from existing programs in Kano and Bauchi states. To extend these efforts, the executive governor of Kano State signed a fourth-year extension to the state’s existing MOU.

Professor I.F Adewole, Nigeria’s health minister, congratulated the states and partners for making a significant investment in immunization. “These are tough financial times in Nigeria, but the health of children cannot wait. The country has an ambitious plan to introduce new life-saving vaccines over the next several years, and today’s commitments will ensure we can get those vaccines to the children who need them most.”

Through the MOUs, the governors commit to effective governance, leadership, and financial accountability to reduce child illness and death from diseases such as measles, pertussis, and hepatitis through increased routine immunization in their respective states. The other partners will bring the financial and technical support needed to operationalize the program. All signatories pledged to improve routine immunization coverage in northern Nigeria systematically and sustainably, where vaccine coverage rates are low.

“These agreements strengthen our partnerships with Nigerian states working to provide health services to all their citizens,” said Dangote. “Building on their recent success in eliminating polio from the region, Nigerian governors have and will continue to play a vital role in establishing a legacy of sustained commitment to routine immunization.”

The objective of the MOUs is to reach 80 percent of the target population in the signing states with the necessary life-saving vaccines by December 2018 to prevent common childhood diseases and ensure a polio-free environment. To achieve this, key components of the program include the operationalization of the ‘Primary Health Care Under One Roof’ policy that will see a single management body oversee the program. The implementation of regular audits and reports will ensure transparent funding and financial discipline is paramount during implementation. Contributions towards the costs of the program by the Bill & Melinda Gates Foundation, Dangote Foundation, and state governments will be staggered across three years: 30 percent in year one, 50 percent in year two, and 70 percent in year three with the states taking progressive responsibility for financing immunization services.

“These commitments will improve immunization coverage and help provide reliable health services in Nigeria. The States will be able to reap the full return on their investment through the number of lives improved and saved, and communities will remain protected from vaccine-preventable diseases for years to come,” said Gates. “Nigeria’s governors have the opportunity to build health systems strong enough to stop future outbreaks.” “These MOUs offer the model platform to capitalize on the prospects of evidence-based approaches. Results will include stronger systems for immunizations, equal access to routine immunization services, and building capacity for Nigerian states to lead in developing solutions for its people,” said Ambassador Entwistle.