Milestones :: Perspectives

Milestones :: Perspectives

Summary report for the SAGE meeting of April 2017
28 April 2017 :: 5 pages
The Strategic Advisory Group of Experts (SAGE) on Immunization met on 25-27 April 2017 in Geneva, Switzerland.
Summary Report topics: Polio Eradication; Cholera; Ebola Vaccines; Diphtheria

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Ghana, Kenya and Malawi to take part in WHO malaria vaccine pilot programme
Brazzaville, 24 April 2017 – The World Health Organization Regional Office for Africa (WHO/AFRO) announced today that Ghana, Kenya, and Malawi will take part in a WHO-coordinated pilot implementation programme that will make the world’s first malaria vaccine available in selected areas, beginning in 2018.

The injectable vaccine, RTS,S, was developed to protect young children from the most deadly form of malaria caused by Plasmodium falciparum. RTS,S will be assessed in the pilot programme as a complementary malaria control tool that could potentially be added to the core package of WHO-recommended measures for malaria prevention.

“The prospect of a malaria vaccine is great news. Information gathered in the pilot will help us make decisions on the wider use of this vaccine”, said Dr Matshidiso Moeti, WHO Regional Director for Africa. “Combined with existing malaria interventions, such a vaccine would have the potential to save tens of thousands of lives in Africa,” she added.

Africa bears the greatest burden of malaria worldwide. Global efforts in the last 15 years have led to a 62 percent reduction in malaria deaths between 2000 and 2015, yet approximately 429,000 people died of the disease in 2015, the majority of them young children in Africa.

The WHO pilot programme will assess whether the vaccine’s protective effect in children aged 5 – 17 months old during Phase III testing can be replicated in real-life. Specifically, the pilot programme will assess the feasibility of delivering the required four doses of RTS,S, the vaccine’s potential role in reducing childhood deaths, and its safety in the context of routine use.

WHO recommendations and RTS,S
RTS,S was developed by GSK and is the first malaria vaccine to have successfully completed a Phase III clinical trial. The trial was conducted between 2009 and 2014 through a partnership involving GSK, the PATH Malaria Vaccine Initiative (with support from the Bill & Melinda Gates Foundation), and a network of African research sites in seven African countries—including Ghana, Kenya, and Malawi.

RTS,S is also the first malaria vaccine to have obtained a positive scientific opinion from a stringent medicines regulatory authority, the European Medicines Agency (EMA), which  approved RTS,S  in July 2015.

In October 2015, two independent WHO advisory groups, comprised of the world’s foremost experts on vaccines and malaria, recommended pilot implementation of RTS,S in three to five settings in sub-Saharan Africa. The recommendation came from the Strategic Advisory Group of Experts (SAGE) on Immunization and the Malaria Policy Advisory Committee (MPAC), following a joint review of all available evidence on the vaccine’s safety and efficacy. The World Health Organization formally adopted the recommendation in January 2016.

Pilot implementation
The three countries were selected to participate in the pilot based on the following criteria: high coverage of long-lasting insecticidal-treated nets (LLINs); well-functioning malaria and immunisation programmes, a high malaria burden even after scale-up of LLINs, and participation in the Phase III RTS,S malaria vaccine trial. Each of the three countries will decide on the districts and regions to be included in the pilots. High malaria burden areas will be prioritized, as this is where the benefit of the vaccine is predicted to be highest. Information garnered from the pilot will help to inform later decisions about potential wider use of the vaccine.

The malaria vaccine will be administered via intramuscular injection and delivered through the routine national immunization programmes.  WHO is working with the three countries to facilitate regulatory authorization of the vaccine for use in the pilots through the African Vaccine Regulatory Forum (AVAREF).  Regulatory support will also include measures to enable the appropriate safety monitoring of the vaccine and rigorous evaluation for eventual large scale use.

Gavi, the Vaccine Alliance, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and UNITAID, are partnering to provide US$49.2 million for the first phase of the pilot programme (2017-2020) which will be complemented by in-kind contributions from WHO and GSK.

[See related announcements by Gavi, PATH, and others below]

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World Malaria Day, 25 April 2017
WHO Publication:
Malaria prevention works: let’s close the gap
Number of pages: 28
Publication date: 2017 :: 28 pages
WHO reference number: WHO/HMT/GMP/2017.6
Overview
On World Malaria Day 2017, WHO is placing a special focus on prevention, a critical strategy for reducing the burden of a disease that continues to kill more than 400 000 people annually.
This new report offers a brief summary of WHO-recommended tools in the malaria prevention arsenal. It is divided into 2 parts: the first chapter focuses on core vector control measures, and the second on preventive treatment strategies for the most vulnerable groups in Africa. It addresses a key biological threat – mosquito resistance to insecticides – and highlights the need for new anti-malaria tools.

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Global Health Coalition Urges G20 Pledge on Pandemics and Neglected Diseases
BERLIN, April 28, 2017 /PRNewswire/ — A coalition of global health organisations has called on the G20 to provide leadership in combating pandemics, drug resistance, and major poverty-related and neglected diseases.
The public ‘Call to Action’ launched in Berlin on April 28 urges G20 health ministers to commit new long-term investment in pandemic preparedness, and health technologies to combat antimicrobial resistance(AMR) and Poverty-Related and Neglected Diseases(PRNDs).
“Meeting health targets outlined in the UN Sustainable Development Goals will require sustained investment and political will,” coalition representatives said.
“As representatives of the world’s largest and wealthiest economies, the G20 must provide leadership. As we saw during the recent Ebola crisis in West Africa, the world is woefully unprepared to deal with pandemics. AMR, which includes drug resistant strains of HIV/AIDS, TB, malaria, diarrheal disease and pneumonia also poses an increasingly serious threat to public health.”

We urge the G20 to agree to provide the following:
:: Political leadership to address the inter-related issues of AMR, pandemic preparedness/ response and PRNDs.
:: Increased financial support and its co-ordination across the G20 and partner countries for global health innovation, including research and development for drugs, diagnostics, vaccines and other health technologies.
:: Encourage business, philanthropic organizations and other financing institutions from the G20 to increase investment.
:: Make full use of G20 public health and scientific expertise

“These are diseases of poverty: 95% of cases are among poor and marginalised populations in low and middle-income countries. They also fuel the cycle of poverty, exacting a heavy economic toll on affected families and communities, which imposes a significant ‘growth penalty’ on entire regions.
“Failure to invest now will lead to long-term costs. The World Bank has estimated that, without additional resources, these diseases will push an additional 28.3million people into poverty, increase global healthcare costs by $1.2trillion and cost low income countries more than 5% of GDP by 2050.
“G20 leadership is vital if we are to successfully reduce the global disease burden, lift millions out of poverty and avert billions of dollars of economic and social costs.”
Coalition includes:
TB Alliance
Medicines for Malaria Venture
PATH
Sabin Vaccine Institute
CARB-X
The Coalition for Epidemic Preparedness Innovations
Global Health Technologies Coalition

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Sabin Vaccine Institute  [to 29 April 2017]
http://www.sabin.org/updates/pressreleases
April 25, 2017
Dr. Jan Holmgren Receives 2017 Albert B. Sabin Gold Medal Award
WASHINGTON, D.C. –– Tonight, the Sabin Vaccine Institute (Sabin) will honor Dr. Jan Holmgren with the 2017 Albert B. Sabin Gold Medal Award. Dr. Holmgren will be recognized for his pioneering contributions to oral vaccine research and mucosal immunology, as well as his leadership in the discovery of the world’s first effective oral cholera vaccine.

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UNICEF  [to 29 April 2017]
https://www.unicef.org/media/media_94367.html
26 April 2017
UNICEF reaches almost half of the world’s children with life-saving vaccines
NEW YORK, 26 April 2017 – UNICEF procured 2.5 billion doses of vaccines to children in nearly 100 countries in 2016, reaching almost half of the world’s children under the age of five. The figures, released during World Immunization Week, make UNICEF the largest buyer of vaccines for children in the world.
Nigeria, Pakistan and Afghanistan, the three remaining polio-endemic countries, each received more doses of vaccines than any other country, with almost 450 million doses of vaccines procured to children in Nigeria, 395 million in Pakistan and over 150 million in Afghanistan. UNICEF is the lead procurement agency for the Global Polio Eradication Initiative.
Access to immunization has led to a dramatic decrease in deaths of children under five from vaccine-preventable diseases, and has brought the world closer to eradicating polio. Between 2000 and 2015, under five deaths due to measles declined by 85 per cent and those due to neonatal tetanus by 83 per cent. A proportion of the 47 per cent reduction in pneumonia deaths and 57 per cent reduction in diarrhea deaths in this time is also attributed to vaccines.
Yet an estimated 19.4 million children around the world still miss out on full vaccinations every year. Around two thirds of all unvaccinated children live in conflict-affected countries. Weak health systems, poverty and social inequities also mean that 1 in 5 children under five is still not reached with life-saving vaccines.
“All children, no matter where they live or what their circumstances are, have the right to survive and thrive, safe from deadly diseases,” said Dr. Robin Nandy, Chief of Immunization at UNICEF. “Since 1990, immunization has been a major reason for the substantial drop in child mortality, but despite this progress, 1.5 million children still die from vaccine preventable diseases every year.”…

25 April 2017
In drought-hit Somalia, children also face potentially deadly measles threat
BAIDOA, Somalia,– Almost 30,000 young children, many of them displaced by a searing drought, are being vaccinated against measles this week in an emergency campaign in Baidoa, a town at the heart of one of Somalia’s hardest-hit areas.
Many of the children have never been immunized before – they come from remote areas health workers often cannot reach because of a decades-old conflict that has ravaged the impoverished country in the Horn of Africa.
So far this year, almost 5,700 cases of suspected measles have been reported across the country, more than the total number of cases in 2016. Measles, a viral respiratory infection that spreads through air and contact with infected mucus and saliva, thrives in congested, unsanitary displacement camps, which have mushroomed across the town and surrounding areas. More than 100,000 people have come to Baidoa in search of assistance, including at least 70,000 in March alone.
“Among vaccine-preventable diseases, none is more deadly than measles,” said Steven Lauwerier, UNICEF’s Representative in Somalia. “And we know only too well from the 2011 famine that measles, combined with malnutrition and displacement, is an especially lethal combination for children.”…
The Baidoa campaign is part of an effort to vaccinate about 110,000 displaced children below 5 years old in hotspots across south central Somalia, plus 250,000 children in Somaliland, against the deadly contagious disease, by the end of May. Conducted in partnership with the Ministry of Health, WHO, and several non-governmental organizations, it also includes a vitamin A supplement to boost immunity as well as de-worming tablets.