Vaccines and Global Health: The Week in Review has expanded its coverage of new reports, books, research and analysis published independent of the journal channel covered in Journal Watch below. Our interests span immunization and vaccines, as well as global public health, health governance, and associated themes. If you would like to suggest content to be included in this service, please contact David Curry at: firstname.lastname@example.org
WHO issues ethics guidance to protect rights of TB patients
World TB Day 2017 – Unite efforts to leave no one behind
22 March 2017 | GENEVA – New tuberculosis (TB) ethics guidance, launched today by the World Health Organization (WHO), aims to help ensure that countries implementing the End TB Strategy adhere to sound ethical standards to protect the rights of all those affected.
TB, the world’s top infectious disease killer, claims 5 000 lives each day. The heaviest burden is carried by communities which already face socio-economic challenges: migrants, refugees, prisoners, ethnic minorities, miners and others working and living in risk-prone settings, and marginalized women, children and older people.
“TB strikes some of the world’s poorest people hardest,” said Dr Margaret Chan, WHO Director-General. “WHO is determined to overcome the stigma, discrimination, and other barriers that prevent so many of these people from obtaining the services they so badly need.”
Poverty, malnutrition, poor housing and sanitation, compounded by other risk factors such as HIV, tobacco, alcohol use and diabetes, can put people at heightened risk of TB and make it harder for them to access care. More than a third (4.3 million) of people with TB go undiagnosed or unreported, some receive no care at all and others access care of questionable quality.
The new WHO ethics guidance addresses contentious issues such as, the isolation of contagious patients, the rights of TB patients in prison, discriminatory policies against migrants affected by TB, among others. It emphasizes five key ethical obligations for governments, health workers, care providers, nongovernmental organizations, researchers and other stakeholders to:
:: provide patients with the social support they need to fulfil their responsibilities
:: refrain from isolating TB patients before exhausting all options to enable treatment adherence and only under very specific conditions
:: enable “key populations” to access same standard of care offered to other citizens
ensure all health workers operate in a safe environment
:: rapidly share evidence from research to inform national and global TB policy updates…
Journal of Global Oncology
Primary Prevention of Cervical Cancer: American Society of Clinical Oncology Resource-Stratified Guideline
Silvina Arrossi, Instituto Nacional del Cancer, Buenos Aires, Argentina; Sarah Temin, American Society of Clinical Oncology, Alexandria, VA; Suzanne Garland, University of Melbourne, Melbourne, Victoria, Australia; Linda O’Neal Eckert, University of Washington; Vivien Tsu, PATH, Seattle, WA; Neerja Bhatla, All India Institute of Medical Sciences, New Delhi, India; Xavier Castellsagué and Silvia de Sanjosé, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain; Sharifa Ezat Alkaff, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia; Tamika Felder, Cervivor, Upper Marlboro, MD; Doudja Hammouda, Institut National de Santé Publique, Algiers, Algeria; Ryo Konno, Jichi Medical University, Saitama Medical Center, Saitama, Japan; Gilberto Lopes, Sylvester Comprehensive Cancer Center, Miami, FL; Emmanuel Mugisha, PATH, Kampala, Uganda; Rául Murillo, International Agency for Research on Cancer, Lyon, France; Isabel C. Scarinci, University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL; Margaret Stanley, University of Cambridge, Cambridge, United Kingdom; Cosette M. Wheeler, University of New Mexico, Albuquerque, NM; and Isaac Folorunso Adewole, Ministry of Health, Abuja, Nigeria
To provide resource-stratified (four tiers), evidence-based recommendations on the primary prevention of cervical cancer globally.
The American Society of Clinical Oncology convened a multidisciplinary, multinational panel of oncology, obstetrics/gynecology, public health, cancer control, epidemiology/ biostatistics, health economics, behavioral/ implementation science, and patient advocacy experts. The Expert Panel reviewed existing guidelines and conducted a modified ADAPTE process and a formal consensus-based process with additional experts (consensus ratings group) for one round of formal ratings.
xisting sets of guidelines from five guideline developers were identified and reviewed; adapted recommendations formed the evidence base. Five systematic reviews, along with cost-effectiveness analyses, provided evidence to inform the formal consensus process, which resulted in agreement of >= 75%.
In all resource settings, two doses of human papillomavirus vaccine are recommended for girls age 9 to 14 years, with an interval of at least 6 months and possibly up to 12 to 15 months. Individuals with HIV positivity should receive three doses. Maximal and enhanced settings: if girls are age >= 15 years and received their first dose before age 15 years, they may complete the series; if no doses were received before age 15 years, three doses should be administered; in both scenarios, vaccination may be through age 26 years. Limited and basic settings: if sufficient resources remain after vaccinating girls age 9 to 14 years, girls who received one dose may receive additional doses between age 15 and 26 years. Maximal, enhanced, and limited settings: if >= 50% coverage in the priority female target population, sufficient resources, and cost effectiveness, boys may be vaccinated to prevent other noncervical human papillomavirus–related cancers and diseases. Basic settings: vaccinating boys is not recommended.
It is the view of the American Society of Clinical Oncology that health care providers and health care system decision makers should be guided by the recommendations for the highest stratum of resources available. The guideline is intended to complement but not replace local guidelines.