Vaccines and Global Health : The Week in Review 29 October 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_29-october-2016-docx

blog edition: comprised of the approx. 35+ entries posted below.

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

Milestones: Summary of the October 2016 meeting of the Strategic Advisory Group of Experts on immunization (SAGE)

Milestones

Editor’s Note:
We provide the full text of the preliminary report of the WHO SAGE meeting just concluded. The full meeting report will be published in the WHO Weekly Epidemiological Record on 2 December 2016. The meeting documents — including presentations and background readings — can be found at http://www.who.int/immunization/sage/meetings/2016/October/en/

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Summary of the October 2016 meeting of the Strategic Advisory Group of Experts on immunization (SAGE)
The Strategic Advisory Group of Experts (SAGE) on immunization1 met on 18-20 October 2016 in Geneva, Switzerland.
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Global Vaccine Action Plan: 2016 mid-term review of progress and recommendations
At the mid-term of the Decade of Vaccines (DoV), SAGE reviewed the progress made towards the achievement of the Global Vaccine Action Plan (GVAP) goals. SAGE assessment was based on the report prepared by the DoV secretariat on progress against each of the GVAP indicators2; including a section on “Sustainable financing and supply for immunization” to detail the activities initiated in response to the WHA resolution on access to affordable vaccines3 adopted in 2014, progress reports from the regions4 and from priority countries5.

At the midpoint of the GVAP, SAGE remains very concerned that progress toward the goals to eradicate polio, eliminate measles and rubella, eliminate maternal and neonatal tetanus, and increase equitable access to lifesaving vaccines is too slow.

Global immunization coverage has increased by only 1% since 2010. In 2015, 68 countries fell short of the target to achieve at least 90% national coverage with the third dose of diphtheria-tetanus-pertussis vaccine. Twenty-six of these countries reported no change and 25 reported a net decrease in coverage since 2010.

However, SAGE sees many reasons for hope. Sixteen countries, including some of the countries with the highest numbers of un- or under-vaccinated children, have made measurable progress since 2010. Research and development efforts are accelerating the discovery and testing of an expanded portfolio of vaccine candidates and platform delivery technologies.

SAGE reaffirmed that immunization is one of the world’s most effective and cost-effective tools against both the threat of emerging diseases and anti-microbial resistance and has a powerful impact on social and economic development. Finally, SAGE made several important recommendations to countries, immunization partners and the DoV secretariat.

Among those recommendations, SAGE recommends that countries demonstrate stronger leadership and governance of national immunization systems by: 2

a) Ensuring ministers at all levels are strong immunization advocates within their countries and regions, conveying the high return on investment, the urgency and the value of investing more in immunization programmes as an integral part of government-supported Universal Health Coverage packages.
b) Governments are encouraged to enact laws that guarantee access to immunization, establish National Immunization Technical Advisory Groups or equivalent groups, ensure that sufficient budgets are allocated to immunization each year and create mechanisms to monitor and efficiently manage funds at all levels (including those from the private sector).
c) National leaders must take courageous decisions to initiate necessary upgrades to systems, protocols, and policies that will ensure high immunization coverage that is sustained. Such upgrades might require redesigning supply chains, information systems and procurement policies, and reassessing roles and responsibilities in case the government decides to implement the decentralization of the health system.
d) National immunization programme managers should report each year to their National Immunization Technical Advisory Group or equivalent groups on progress made, lessons learnt and remaining challenges toward implementing National Immunization Plans and show how these plans are aligned to Regional and Global Vaccine Action Plan goals.

SAGE recommends that countries secure necessary investments to sustain immunization during polio and Gavi transitions.
a) All countries should mitigate any risk to sustaining effective immunization programmes when polio funding decreases. All Member States with substantial numbers of staff and resources issued from the Global Polio Eradication Initiative are requested to describe, in their polio transition plan, how they propose to maintain and fund critical immunization, laboratory and surveillance activities that are currently supported with polio funding and staff.
b) In all countries transitioning from Gavi support, all national and global immunization partners must advocate strongly and persistently for increased domestic financing to sustain immunization gains over time.

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Yellow fever
Recent outbreaks of yellow fever in Central Africa highlighted the need to revisit and expand the control strategy as well as the vaccine supply, and the need for vaccine supply surge capacity. Therefore, WHO has initiated the development of a new global strategy to Eliminate Yellow Fever Epidemics (EYE strategy) globally by 2026. There are 3 strategic objectives: protect at risk populations, prevent international spread, and rapidly contain outbreaks. The Strategy outlines four key activities: continued access to affordable vaccines through a sustainable vaccine market; political commitment at global, regional and country levels; robust governance and strong partnerships; and research to support better tools and practices. New aspects of the strategy from previous efforts include the revised country risk category, the aim to protect specific risk populations, the need to address the urban risk, and the establishment of a revolving emergency vaccine stockpile. Following establishment of the EYE strategy, WHO and partners will develop an implementation plan.

SAGE confirmed the need for new strategic thinking and supported the general approach of the EYE strategy. SAGE emphasized the importance to link the EYE strategy to existing programmes/initiatives, e.g. measles-rubella strategy, integrated disease surveillance, and also vector control. It was noted that EYE can serve as a driver to raise awareness and preparedness in urban settings for other outbreak prone diseases.
Considering the global spread of Aedes mosquitos, rapid urbanization, and increased international travel, it is critical to have surge capacity in the event of an outbreak. SAGE previously reviewed the evidence for the minimum effective dose (also called fractional dose) in June 2016 in the context of the outbreak in Central Africa and supported its use in this type of situation. The minimum effective dose, administered as a fraction of the volume of the normal dose, should induce a protective immune response equivalent to a full dose. SAGE was updated on the evidence for minimum effective dose, for which most evidence is limited to one of the yellow fever vaccine products. Available studies suggest that a reduced volume dose was equivalent to the standard dose with respect to all measured immunological and virological parameters as long as the dose contained at least 3000 International Units.

SAGE was also updated on the experience of the minimum effective dose campaign in Kinshasa in August 2016. Logistically and operationally, the use of a minimum effective dose was shown to be feasible and a promising approach to protect at-risk populations that would otherwise be left unprotected.

Based on the available evidence, SAGE reaffirmed that a minimum effective dose can be used as part of an exceptional response in a time when there is a large outbreak and a shortage of vaccine.

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Measles and rubella elimination
SAGE reviewed the findings and the recommendations outlined in the mid-term review of the Measles and Rubella Strategic Plan 2012-2022. SAGE commended the MTR team on their work and endorsed the report and its recommendations.

SAGE stressed the critical role of high quality measles and rubella case-based surveillance for achieving the goals of the measles and rubella strategic plans and that countries should move towards weekly reporting to regions. SAGE stressed the importance of achieving and maintaining high population immunity in order to achieve the regional and global measles and rubella goals.

SAGE recommended that a routine second dose of measles containing vaccine (MCV) should be added to national immunization schedules in all countries regardless of MCV1 coverage. In countries meeting the criteria for rubella containing vaccine introduction into national immunization programmes6 , measles and rubella containing vaccines (MRCV) should be used in place of single-antigen MCV.

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Maternal and neonatal tetanus elimination (MNTE) and broader tetanus prevention
SAGE noted that while there was progress with MNTE, the goal to achieve global elimination by 2015 was missed once again. The failure to achieve this goal is a reminder of the persisting health inequities and the inability of some countries to provide basic health services to the most marginalized and vulnerable populations.

Countries yet to achieve MNTE should establish/update and implement their operational plans to achieve the required action within the timelines stated in the report from the Working Group on MNTE and broader tetanus prevention. Achievement of MNTE by 2020 is feasible with timely availability of financial resources and compact single-dose pre-filled auto-disable injection devices (CPAD) to reach the most marginalized populations.

UNICEF, UNFPA (United Nations Populations Fund) and WHO should work with countries to generate and sustain political interest in the continuing elimination of MNT to guard against complacency once a country has been declared to have eliminated the disease.

All immunization programmes should review and adjust their routine immunization schedules to ensure tetanus protection over the life course (3 priming doses in infancy and 3 booster doses in childhood/adolescence). All countries should also scale up and sustain the coverage of clean delivery and improve clean cord care practices. The 3 booster doses schedule intended to achieve protection throughout adulthood (reproductive age for women), and probably providing lifelong protection should preferably be given during the second year of life, between 4-7 years of age, and between 9-15 years of age.

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Hepatitis B vaccination
SAGE reemphasized the importance of introduction of the birth dose and urged all countries to introduce universal birth dose without further delays.

All infants should receive their first dose of hepatitis B vaccine as soon as possible after birth, preferably within 24 hours. However, if this is not feasible the birth dose will still be beneficial in preventing perinatal transmission if given within 7 days, although somewhat less than if given within 24 hours. After 7 days, a late birth dose is effective in preventing horizontal transmission and therefore remains beneficial. Therefore, SAGE recommends that all infants receive the birth dose during the first contact with health facilities any time up to the time of the first primary dose.

Schedules and strategies for human papillomavirus immunization
Noting the high effectiveness and safety of the human papillomavirus (HPV) vaccine, SAGE recommends that it is promptly introduced for adolescent girls as part of a coordinated and comprehensive strategy to prevent cervical cancer and other diseases caused by HPV. The 5

immunization of multiple cohorts of girls aged 9–14 years is recommended when the vaccine is first introduced. If resources are available, the age range could be expanded up to 18 years.
SAGE also discussed polio eradication. It was updated on the tOPV to bOPV switch and the progress with polio eradication and started an initial discussion on post eradication.

The full meeting report will be published in the WHO Weekly Epidemiological Record on 2 December 2016. The meeting documents — including presentations and background readings — can be found at http://www.who.int/immunization/sage/meetings/2016/October/en/

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References
1 http://www.who.int/imunization/sage/en/index.html
2 http://www.who.int/entity/immunization/global_vaccine_action_plan/gvap_secretariat_report_2016.pdf?ua=1
3 http://apps.who.int/gb/ebwha/pdf_files/WHA68-REC1/A68_R1_REC1-en.pdf
4 http://www.who.int/entity/immunization/global_vaccine_action_plan/2_Regional_reports_annex_GVAP_secretariat_report_2016.pdf?ua=1
5
http://www.who.int/entity/immunization/global_vaccine_action_plan/3_Country_reports_annex_GVAP_secretariat_report_2016.pdf?ua=1
6 Rubella Vaccines: WHO Position Paper. WER No. 29, 2011, 86, Pp. 301–316.

ZikaPLAN: 25 Research Organizations Unite to Fight Zika Virus and Build Long-term Outbreak Response Capacity in Latin America

ZikaPLAN: 25 Research Organizations Unite to Fight Zika Virus and Build Long-term Outbreak Response Capacity in Latin America
RECIFE, Brazil, October 25, 2016 /PRNewswire/ — 25 leading research and public health organizations from Latin America, North America, Africa, Asia, and Europe gathered in Recife for the launch of ZikaPLAN (Zika Preparedness Latin American Network). This global initiative, created in response to a Horizon 2020 funding call by the European Commission’s Directorate-General Research and Innovation, has been formed to address the Zika virus outbreak and the many research and public health challenges it poses. The initiative takes a comprehensive approach to tackle the Zika threat by:
:: addressing the knowledge gaps and needs in the current Zika outbreak to better understand the disease, prevent its spread and educate the affected populations,
:: building a sustainable response capacity in Latin America for Zika and other emerging infectious diseases (EID).

The impact of the Zika outbreak took scientists and public health authorities by surprise and hit the most vulnerable populations the hardest. The severity of the outbreak and mutation of the virus have generated numerous research questions. To take effective measures, health authorities need to know the severity of the disease and its impact on public health, what interventions will work to prevent and stop its spread, and how best to manage and treat those who have been infected. This unprecedented Zika outbreak has also highlighted the need to build local capacities: in some of the regions where the virus struck there was not the necessary research infrastructure to understand the threat and take action quickly.

To bridge these gaps, research organizations in the ZikaPLAN consortium will look at Zika’s connection with congenital syndromes and neurological complications, and the pathogenesis of severe cases, through a series of clinical studies. They will explore non-vector and vector transmission and risk factors for geographic spread, measure the burden of disease and investigate how the virus has evolved, comparing current and historic strains. ZikaPLAN will look at novel personal preventive measures, innovation in diagnostics and modelling of vector control and vaccine strategies to inform policy decisions. The social sciences will also play a role in ZikaPLAN, which aims to determine the best communication strategies to keep the affected communities informed.

ZikaPLAN will work closely with two other European Union-funded consortia, ZIKAction and ZikAlliance, to establish a Latin American and Caribbean network. This network will address the broader issue of building local capacity in Latin America to prepare for and rapidly launch a large-scale research response to emerging infectious disease threats. ZikaPLAN will contribute to developing an inter-epidemic research plan, policy recommendations, training, research networks and dissemination strategies that are designed to permanently strengthen local capacities, beyond the four years of the project. The three consortia will set up common bodies for the global management of scientific programs, communication, and ethical, regulatory and legal issues.

ZikaPLAN is receiving a €11.5 million grant from the European Union’s Horizon 2020 research and innovation program, under grant agreement number 734584.

Emergencies [to 29 October 2016]

Emergencies

WHO Grade 3 Emergencies [to 29 October 2016]
Iraq
:: WHO and partners gear up to safeguard lives of displaced persons fleeing Mosul
26 October 2016 — The World Health Organization, together with national health authorities and health cluster partners, have accelerated preparedness and response measures for internally displaced persons from Mosul by prepositioning 46 mobile medical clinics, 45 mobile health teams and 26 ambulances in a number of prioritized areas around the country. Life-saving medicines and supplies for more than 350 000 beneficiaries have also been prepositioned, including chronic disease medicines, diarrhoeal disease medicines, and trauma and surgical supplies. Additional essential medicines are being delivered from WHO’s logistics hub in Dubai, and are also being procured locally.

Nigeria -No new announcements identified.
South Sudan – No new announcements identified.
The Syrian Arab Republic – No new announcements identified.
Yemen – No new announcements identified.

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WHO Grade 2 Emergencies [to 29 October 2016]
Cameroon – No new announcements identified.
Central African Republic – No new announcements identified.
Democratic Republic of the Congo – No new announcements identified.
Ethiopia – No new announcements identified.
Libya – No new announcements identified.
Myanmar – No new announcements identified.
Niger – No new announcements identified.
Ukraine – No new announcements identified.

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Editor’s Note:
While the WHO Emergency webpages above do not capture the announcements below, we add them here for continuity in understanding emergency contexts.
WHO Eastern Mediterranean Region EMRO
:: WHO releases emergency funds to support cholera response in Yemen
27 October 2016 – WHO has released approximately US$ 1 million from its internal emergency funds to support the ongoing response to the cholera outbreak in Yemen. Since the outbreak was announced by the Ministry of Public Health and Population on 6 October, a total of 1184 suspected cases of cholera, including 6 deaths, have been reported. More than 7.6 million people are currently living in areas affected by the outbreak, and more than 3 million internally displaced persons are especially vulnerable.

: WHO expands the system for detection, alert, and containment of potential epidemics in light of Mosul humanitarian response – 26 October 2016
Baghdad, 26 October 2016 – In coordination with the Iraqi Federal Ministry of Health and Ministry of Health of Kurdistan Regional Government, WHO conducted 3 consecutive training sessions from 28 September to 6 October 2016 in Erbil and Suleimaniyah in the Kurdistan region.
The training focused on the early warning alert and response network system (EWARNS) and was targeted at staff from the new health facilities established to respond to the health needs of newly displaced populations in formal and emergency settlements, and hosting communities.
“We have to monitor communicable diseases trends, patterns and vigilance,” said Altaf Musani, WHO Representative to Iraq. “EWARNS will be the tool to measure these trends and help to detect early epidemics in displaced population areas to support the federal and regional ministries of health and health cluster partners with effective epidemic-prone disease prevention and control measures,” he added.
This series of trainings marked the entry of new 43 health facilities to the network in Iraq to scale up the number of reporting sites to over 180. 24 health staff from Ninewa Directorate of Health received comprehensive training on EWARNS reporting and are ready for deployment to the new health facilities to resume related EWARNS functions…

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UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises.
Iraq –
:: Iraq: Mosul Humanitarian Response Situation Report #3 (23-25 October 2016)
Highlights
…Over 10,500 people are currently displaced and in need of humanitarian assistance. Partners are providing emergency assistance in camps and host communities. The majority of displaced people are sheltering in host communities.
…Population movements are fluctuating as the front lines move, including people returning to their homes following improved security conditions in the immediate area.
…Assessments have recorded a significant number of female-headed households, raising concerns around the detention or capture of men and boys.
…Almost 14,500 people have received emergency assistance within 24 hours of areas newly-retaken from ISIL becoming accessible to humanitarian partners since the start of military operations.

Syria
:: 28 Oct 2016 Turkey | Syria: Flash Update – Developments in Eastern Aleppo (as of 27 October 2016) [EN/AR]
:: 26 October 2016 Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator Stephen O’Brien Statement to the Security Council on Syria, 26 October 2016

Yemen
– No new announcements identified.

Haiti’s Ministry of Health organizing a vaccination campaign against cholera in areas affected by Hurricane Matthew, supported by PAHO-WHO, UNICEF and other partners

Haiti’s Ministry of Health organizing a vaccination campaign against cholera in areas affected by Hurricane Matthew, supported by PAHO-WHO, UNICEF and other partners
Port-au-Prince, Haiti, 27 Oct. 2016– The Haitian Ministry of Health (MSPP) is setting up a vaccination campaign against cholera in areas ravaged by Hurricane Matthew, with support from the Pan American Health Organization / World Health Organization (PAHO / WHO).

The decision of WHO and other member of the Global Task Force for Cholera Control to approve the request of the MSPP to bring 1 million doses of oral vaccine against cholera is based on the goal of reducing the burden of cholera cases on health care facilities, and of reducing deaths in the departments of the Sud and Grand’Anse, the areas most affected by Hurricane Matthew.

The target population is estimated at over 820,000 people over one year of age. The vaccination campaign will begin November 8, 2016. Activities will focus on the municipalities most vulnerable to cholera outbreaks in the two southern departments of Grand’Anse and Sud, where there has been significant destruction of water and sanitation supply systems.

Haiti’s Minister of Public Health, Dr. Daphne Benoit, said that the emergency vaccination campaign was taking place in tragic circumstances that have affected the populations of the south. “The vaccine is an additional intervention which will help us to save lives, but does not replace the efforts that the government supports in the field of water and sanitation,” she emphasized.

PAHO-WHO Representative Dr. Jean-Luc Poncelet stressed the importance of the leadership of MSPP in this vaccination campaign, which “will contribute to limit the suffering of individuals and families affected by Hurricane Matthew.” Some municipalities in the south west peninsula have reported outbreaks of cholera since the hurricane hit on October 4, “so it is important to work together and with partners to build local capacity for clinical management of cases in the cholera treatment centers,” he said.

Poncelet noted that PAHO-WHO will support the Ministry of Health in activities including development of tools and technical support as well as reception, storage and transport of the vaccines and supplies in departments, municipalities and institutions. PAHO/WHO will also support training of vaccination staff supervisors and operators, and the coordination, collection and analysis of information, monitoring and evaluation.

Since Hurricane Matthew struck Haiti on October 4, significant increases in suspected cases of cholera and deaths have been reported from several places in the departments of Sud and Grand’Anse.

Numerous partners that work in Haiti are supporting the cholera vaccination campaign, including UNICEF, GHESKIO, Partners in Health, US Centers for Disease Control and Prevention (CDC), International Medical Corps and others.

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UNOG – REGULAR PRESS BRIEFING BY THE INFORMATION SERVICE
25 October 2016
Haiti
Tarik Jasarevic, for the World Health Organization (WHO), said that 500,0000 cholera vaccines had arrived on 22 October and another 500,000 had arrived on 24 October in Port-au-Prince. The one million vaccines had been sent to Haiti following a decision of the Global Taskforce on Cholera Control, taken on 10 October. Vaccination was expected to start early in the week of 31 October, or even on 30 October, in affected departments of Haiti, Sud and Grand Anse. The objective of the campaign was to reduce the burden of cholera cases on health care facilities and reduce deaths in departments affected by the hurricane, preventing cholera’s further spread to neighboring departments, including to the capital Port-au-Prince. WHO was in the process of preparing the campaign and would keep the press informed.

In response to a question, Mr. Jasarevic said that as of 17 October there were 465 suspected cholera cases in Grand Anse and 684 in Sud. There was a decrease and stabilization of admissions in cholera treatment centres operating in the two departments, but the peak of cases followed by a rapid decline was to be expected. A second peak could not be excluded given the current situation with water and sanitation. That is why it was important to proceed with the emergency vaccination campaign, and why the Global Taskforce had decided to send the vaccines.

In response to other questions, he said that there would be a single-dose strategy, allowing to cover twice as many people as if the classical two-dose strategy was to be applied. The protection would be lesser, 60 to 70 per cent for severe cases, and shorter in duration, but the objective was to vaccinate as many people as possible in affected areas and to try to reduce the burden. The target population was all persons over one year of age. The protection with a single dose would be less than a year. Out of the one million doses, 700,000 would be moved to the two departments in question as the target population was 655,000 people so far. Some prioritization would be done to vaccinate in communes where people could be rapidly accessed and where the impact would be the biggest, in urban centres where there was more density and an increased risk of transmission. Some 300,000 vaccines would remain in the capital for the time being…

Zika virus [to 29 October 2016]

Zika virus [to 29 October 2016]
Public Health Emergency of International Concern (PHEIC)
http://www.who.int/emergencies/zika-virus/en/

[See ZikaPLan announcement in Milestones section above]

Zika situation report – 20 October 2016
Full report: http://apps.who.int/iris/bitstream/10665/250590/1/zikasitrep20Oct16-eng.pdf?ua=1
Key Updates
:: Countries and territories reporting mosquito-borne Zika virus infections for the first time in the past week:
… None
:: Countries and territories reporting microcephaly and other central nervous system (CNS) malformations potentially associated with Zika virus infection for the first time in the past week:
… None
:: Countries and territories reporting Guillain-Barré syndrome (GBS) cases associated with Zika virus infection for the first time in the past week:
… None
:: The Ministry of Health of Viet Nam has reported a case of microcephaly, for which testing is underway to determine the cause.
:: The WHO Zika Virus Research Agenda has been published. The goal of the Agenda is to support the gathering of evidence to strengthen essential public health guidance to prevent and limit the impact of Zika virus and its complications. The Research Agenda identifies critical areas of research for which WHO is uniquely placed to implement and coordinate global action. [see below]
:: The quarterly update of the Zika Strategic Response Plan has been published. This update provides key information on the epidemiological situation, response, and updated funding information for WHO and partners.

Analysis
:: Overall, the global risk assessment has not changed.

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WHO Zika virus research agenda
October 2016 :: 19 pages
Languages: English
WHO reference number: WHO/ZIKV/PHR/16.1
PDF: http://apps.who.int/iris/bitstream/10665/250615/1/WHO-ZIKV-PHR-16.1-eng.pdf?ua=1
Overview
The goal of the WHO Zika Virus Research Agenda is to support the generation of evidence needed to strengthen essential public health guidance and actions to prevent and limit the impact of Zika virus and its complications.

The Research Agenda identifies critical areas of research where WHO is uniquely placed to implement or coordinate global activities. Research and evidence are the foundation for sound health policies.

A document summarizes the ongoing efforts of the World Health Organization and Pan American Health Organization, Institut Pasteur and the networks of Fiocruz, CONSISE and ISARIC to generate standardized clinical and epidemiological research protocols and questionnaires to address key public health questions. Specifically, data collected using the standardized protocols will be used to refine and update recommendations for prevention of Zika virus spread, surveillance and case definitions for microcephaly, to help understand the spread, severity, spectrum and impact on the community of ZIKV and to guide public health measures, particularly for pregnant women and couples planning a pregnancy.
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Zika Open [to 29 October 2016]
[Bulletin of the World Health Organization]
:: All papers available here
No new papers identified.

EBOLA/EVD [to 29 October 2016]

EBOLA/EVD [to 29 October 2016]
http://www.who.int/ebola/en/
“Threat to international peace and security” (UN Security Council)

Editor’s Note:
We note that the Ebola tab – which had been listed along with Zika, Yellow Fever, MERS CoV and other emergencies – has been removed from the WHO “home page”. We deduce that WHO has suspended issuance of new Situation Reports after resuming them for several weekly cycles. The most recent report posted is EBOLA VIRUS DISEASE – Situation Report – 10 JUNE 2016. We have not encountered any UN Security Council action changing its 2014 designation of Ebola as a “threat to international peace and security.” We will continue to highlight key articles and other developments around Ebola in this space.

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NIH [to 29 October 2016]
http://www.nih.gov/news-events/news-releases
October 26, 2016
Ebola-affected countries receive NIH support to strengthen research capacity
The recent Ebola epidemic in West Africa highlighted the need for better global preparedness and response to disease outbreaks. To help address that need in Guinea, Liberia and Sierra Leone — the countries most affected by the epidemic — the National Institutes of Health has established a new program to strengthen the research capacity to study Ebola, Lassa fever, yellow fever and other emerging viral diseases. In the initiative’s first funding round, NIH’s Fogarty International Center is awarding grants to four U.S. institutions that will partner with West African academic centers to design training programs for their scientists and health researchers.

The collaborations aim to develop research training proposals that would strengthen the skills required to evaluate vaccines, develop new diagnostic tests and treatments, and identify the most effective intervention strategies for disease outbreaks. These planning grants, totaling $200,000, are intended to help institutions prepare to compete for larger, longer-term Fogarty grants to implement research training programs.

“We hope these awards will catalyze efforts to identify existing resources and plan to address development of sustainable research capacity in the countries that suffered so horribly from Ebola,” said Fogarty Director Roger I. Glass, M.D., Ph.D. “By training local researchers in epidemiology and lab skills, and helping them form networks with U.S. scientists, we believe future disease outbreaks can be better contained.”…