Vaccines and Global Health: The Week in Review 27 May 2017

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

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David R. Curry, MS
Executive Director
Center for Vaccine Ethics and Policy

Milestones :: Perspectives

Milestones :: Perspectives

World Health Assembly
22–31 May 2017, Geneva

Watch WHA70 live
All documents
Selected Documents:
A70/9 – Health emergencies: WHO response in severe, large-scale emergencies
A70/10 – Health emergencies: Research and development for potentially epidemic diseases
A70/14 – Poliomyelitis
A70/14 Add.1 – Polio transition planning
A70/17 – Review of the Pandemic Influenza Preparedness Framework
A70/20 – Addressing the global shortage of, and access to, medicines and vaccines
A70/25 – Global vaccine action plan
WHA70.4 – Expression of appreciation to Dr Margaret Chan

Opening address by Dr Chan, WHO Director-General
22 May 2017

Address by Dr Tedros Adhanom Ghebreyesus as new WHO Director-General
23 May 2017

World Health Assembly elects Dr Tedros Adhanom Ghebreyesus as new WHO Director-General
News release
23 May 2017 | GENEVA – Today the Member States of WHO elected Dr Tedros Adhanom Ghebreyesus as the new Director-General of WHO.

Dr Tedros Adhanom Ghebreyesus was nominated by the Government of Ethiopia, and will begin his five-year term on 1 July 2017.

Prior to his election as WHO’s next Director-General, Dr Tedros Adhanom Ghebreyesus served as Minister of Foreign Affairs, Ethiopia from 2012–2016 and as Minister of Health, Ethiopia from 2005–2012. He has also served as chair of the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria; as chair of the Roll Back Malaria (RBM) Partnership Board; and as co-chair of the Board of the Partnership for Maternal, Newborn and Child Health.

As Minister of Health, Ethiopia, Dr Tedros Adhanom Ghebreyesus led a comprehensive reform effort of the country’s health system, including the expansion of the country’s health infrastructure, creating 3500 health centres and 16 000 health posts; expanded the health workforce by 38 000 health extension workers; and initiated financing mechanisms to expand health insurance coverage. As Minister of Foreign Affairs, he led the effort to negotiate the Addis Ababa Action Agenda, in which 193 countries committed to the financing necessary to achieve the Sustainable Development Goals.

As Chair of the Global Fund and of RBM, Dr Tedros Adhanom Ghebreyesus secured record funding for the two organizations and created the Global Malaria Action Plan, which expanded RBM’s reach beyond Africa to Asia and Latin America.

Dr Tedros Adhanom Ghebreyesus will succeed Dr Margaret Chan, who has been WHO’s Director-General since 1 January 2007.

2017 Public health prizes awarded
26 May 2017 – Every year, national health administrations and former prize recipients submit nominations for prizes awarded for accomplishments in the field of public health. This year’s winners were presented with their awards during the plenary meeting of the Seventieth World Health Assembly.
:: Sasakawa Health Prize
The 2017 Sasakawa Health Prize of US$30 000 for outstanding innovative work in health development, has been awarded to Dr Rinchin Arslan for his remarkable lifelong contribution to the advancement of primary health care in Mongolia and specifically his work in fighting viral hepatitis.
:: United Arab Emirates Health Foundation Prize
The United Arab Emirates Health Foundation Prize of US$ 20 000 went to Professor Lô Boubou Baïdy, 61, of Mauritania, for his significant contribution to the establishment of the national blood transfusion centres and laboratory services , as well as his fight against viral hepatitis, HIV/AIDS and other sexually transmitted infections.
:: Dr LEE Jong-wook Memorial Prize for Public Health
The Dr LEE Jong-wook Memorial Prize for Public Health of US$ 100 000 was awarded to the Henry Reeve International Medical Brigade (Cuba). Established in 2005 by more than 1500 Cuban health professionals, the Henry Reeve Brigade is integrated into the medical cooperation unit of the Ministry of Public Health of Cuba.

Seventieth World Health Assembly update, 26 May 2017
News release
26 May 2017 | GENEVA – Today’s decisions at the World Health Assembly focused on implementation of the International Health Regulations, and improving the prevention, diagnosis and treatment of sepsis.

International Health Regulations
Delegates emphasized the urgent need to achieve full implementation of the International Health Regulations (2005) – the international legal instrument designed to help the global community prevent and respond to acute public health risks that have the potential to cross borders and threaten people worldwide.

The Regulations, which entered into force on 15 June 2007, require countries to report certain disease outbreaks and public health events to WHO. They define the rights and obligations of countries to report public health events, and establish a number of procedures that WHO must follow in its work to uphold global public health security.

Delegates requested the Director-General to work with Member States to develop a five-year global strategic plan for public health preparedness and response and submit it to the World Health Assembly in 2018. The strategic plan is to be based on guiding principles including consultation, country ownership, WHO leadership, broad partnerships, community involvement, regional integration, and results and accountability. The strategic plan is to focus on using an intersectoral approach; integration with the health system; focus on fragile contexts; domestic financing for sustainability; balance between legally binding and voluntary elements; with a guiding focus on monitoring.

Delegates also requested the Director-General to pursue and strengthen efforts to support Member States in full implementation of the Regulations, including through building their core public health capacities.

Delegates also agreed on a resolution to improve the prevention, diagnosis and treatment of sepsis.

Sepsis occurs when a person has an infection and the body’s reaction injures tissues and organs. Sepsis can be triggered by infections caused by bacteria, viruses, fungi, and parasites. Bacterial infections are the most common triggers. Early recognition of sepsis is crucial to treating patients before their condition worsens and becomes fatal. Antimicrobial resistance makes it much more difficult to treat infections and stop them evolving into sepsis.

Antimicrobial resistance occurs when bacteria and other microbes change to resist the effects of antibiotics and other antimicrobial medicine. Most infections can be avoided by improving hygiene, access to vaccinations and other infection prevention measures.

The resolution urges governments to strengthen policies and processes related to sepsis, especially to prevent infections and the further spread of antimicrobial resistance. It emphasizes the importance of reinforcing health worker training to recognize and deal effectively with the condition, improve tracking and reporting of cases, and promote research to develop more tools for sepsis diagnosis and treatment.

Further, the resolution requests that WHO develop a report on sepsis and guidance for its prevention and management. In addition, the resolution directs the Organization to help countries develop the necessary infrastructure, laboratory capacity, strategies and tools to reduce the burden of sepsis. It also asks WHO to work with partners to help developing countries gain access to quality, safe, efficacious and affordable sepsis treatments and tools for infection prevention and control, including immunization.
Seventieth World Health Assembly update, 25 May
News release
25 May 2017 | GENEVA – The World Health Assembly today made decisions relating to polio, the Pandemic Influenza Preparedness Framework, and the health workforce.

Delegates paid tribute to ongoing efforts to end polio transmission in the last three endemic countries – Afghanistan, Nigeria and Pakistan. They expressed concern about the continued shortage of inactivated poliovirus vaccine, and noted the urgent need to contain polioviruses in safe facilities, destroy unneeded materials, and appropriately contain resources that can be used for research or other purposes. This has become particularly important since the eradication of type 2 of the wild poliovirus in 2015.

The Global Polio Eradication Initiative (GPEI) was launched in 1988, following the adoption for a resolution for the worldwide eradication of polio at the Forty-first World Health Assembly. Since then, the number of polio cases has fallen by over 99.9%. The initiative has also strengthened countries’ capacities to tackle other health issues, for example through better disease surveillance; immunization and health systems strengthening; early warning, emergency and outbreak response.

Delegates also addressed the challenge of scaling down the global polio response as eradication becomes closer, acknowledging the importance of developing a strategy to define the critical functions needed to sustain a polio-free world, as well as the global structures and financial requirements to support them. The development of this Post-eradication Certification Strategy is ongoing, and will be presented to the Executive Board and World Health Assembly next year.
Delegates welcomed efforts to plan for a post-polio world, including WHO’s organization-wide work to identify the key programmatic, financial, human resources and organizational risks associated with the eventual closure of the global polio eradication effort. They requested the Director-General to consider polio transition planning an urgent organizational priority and highlighted the need to ensure that polio transition needs are fully incorporated into the development of the next WHO budget and planning cycle.

Pandemic Influenza Preparedness Framework
Delegates reaffirmed the critical role played by the Pandemic Influenza Preparedness Framework’s (PIP) as a specialized international instrument that facilitates expeditious access to influenza viruses of human pandemic potential, risk analysis and the expeditious, fair and equitable sharing of vaccines and other benefits.

They emphasized the importance of prioritizing and supporting global pandemic influenza preparedness and response, including through the strengthening of domestic seasonal influenza virus surveillance, manufacturing and regulatory capacities and international coordination and collaboration through the Global Influenza Surveillance and Response System (GISRS) to identify and share influenza viruses with pandemic potential rapidly.

The Health Assembly agreed that the WHO secretariat should comprehensively analyse, in consultation with Member States and relevant stakeholders, including the GISRS, the implications of amending the definition of PIP biological materials to include genetic sequence data and expanding the PIP Framework to include seasonal influenza. The delegates further agreed that the PIP Framework model has potential to be used for other pathogens.

The PIP Framework was set up in 2011 to introduce greater equity and solidarity among nations when the next pandemic strikes. The PIP Framework provides WHO with real-time access to approximately 10% of global vaccine production, enabling the Organization to send life-saving doses to developing countries in need.

Health Workforce
The Health Assembly agreed to a five-year action plan under which WHO will collaborate with the International Labour Organization, and the Organization for Economic Cooperation and Development in working with governments and key stakeholders to address the global health and social workforce shortfall and contribute to international efforts to achieve the Sustainable Development Goals.

The plan calls on countries to view the health and social workforce as an investment, rather than a cost, and take advantage of the economic benefits of growth in the health and social sector. It outlines how ILO, OECD and WHO will take intersectoral action on five fronts: galvanizing political support; strengthening data and evidence; transforming and scaling up the education, skills and decent jobs of health and social workers; increasing resources to build the health and social workforces; and maximizing the multiple benefits that can be obtained from international health worker mobility.

It also focuses on maximizing women’s economic empowerment and participation. It addresses occupational health and safety, protection and security of the health and social workforce in all settings. It also covers the reform of service models towards the efficient provision of care, particularly in underserved areas.

The action plan supports the WHO Global Strategy on Human Resources for Health: Workforce 2030. It will facilitate implementation of the recommendations of the United Nations Secretary General’s High-Level Commission on Health Employment and Economic Growth, which found that, as populations grow and change, the global demand for health workers will double by 2030.


Public Health Emergency of International Concern (PHEIC)
Polio this week as of 24 May 2017
:: The World Health Assembly (WHA) is meeting this week in Geneva, Switzerland.  Ministers of Health and public health professionals from around the world are discussing global public health issues, including the global drive to eradicate polio.  The Global Polio Eradication Initiative (GPEI) secretariat has prepared a status report, which will inform the discussions by Member States.
:: The Global Polio Eradication Initiative (GPEI) welcomes Dr Tedros Adhanom Ghebreyesus, the new Director-General-elect of the World Health Organization, and looks forward to working with him to achieve a polio-free world. More.
:: Two separate outbreaks of circulating vaccine derived poliovirus type 2 (cVDPV2) have been reported in the Democratic Republic of the Congo, one in Haut Lomami province and one in Maniema.
:: Health Ministers of the Group of Twenty have emphasized the importance of polio eradication and transition planning efforts at their inaugural meeting in Berlin, Germany. More.
:: Polio staff in Nigeria have contributed emergency response expertise to a meningitis outbreak in Sokoto State. More.
:: Summary of newly-reported viruses this week: Afghanistan, one new wild poliovirus type 1 (WPV1) environmental sample. Pakistan, seven new WPV1 environmental samples. Democratic Republic of the Congo, four new cases of circulating vaccine derived poliovirus type 2 (cVDPV2) and one isolate from a healthy individual in the community. For more, see relevant country sections.


WHO Grade 3 Emergencies  [to 27 May 2017]
:: Hundreds of volunteers vaccinate displaced children from Mosul and other underserved areas in Ninewa governorate
Baghdad, 23 May 2017 – More than 1900 health workers and volunteers on Sunday 21 May 2017 began a mass polio vaccination campaign targeting approximately 332 000 children from conflict affected Mosul and other underserved areas in Ninewa governorate.

South Sudan  – No new announcements identified
YemenNo new announcements identified
NigeriaNo new announcements identified
The Syrian Arab Republic  – No new announcements identified

WHO Grade 2 Emergencies  [to 27 May 2017]
Democratic Republic of the Congo
:: Contingency fund aids rapid response to outbreak of suspected Ebola virus
25 May 2017 — Responding quickly to an outbreak means moving people and supplies quickly, and that means moving funds quickly too. When WHO received an alert on 9 May of a cluster of unexplained deaths in a remote part of the Democratic Republic of the Congo, it was able to deploy a team to the affected area just a day later, thanks in part to the WHO Contingency Fund for Emergencies (CFE). The CFE was able to rapidly release the money needed for transport and other vital logistics to get the investigation team to where they were needed.

Cameroon  – No new announcements identified.
Central African Republic  – No new announcements identified.
EthiopiaNo new announcements identified.
LibyaNo new announcements identified.
MyanmarNo new announcements identified.
Niger  – No new announcements identified.
Ukraine  – No new announcements identified
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: Mosul Humanitarian Response Situation Report No. 34 (15 May to 21 May 2017) [EN/KU]
:: Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, Stephen O‘Brien, Statement on protection of civilians in Mosul’s Old City, Iraq [EN/AR/KU]
Published on 26 May 2017
I am deeply concerned for the safety of civilians behind ISIL lines in western Mosul.
Although the UN is not present in the areas where fighting is occurring, we have received very disturbing reports of families being shut inside booby-trapped homes and of children being deliberately targeted by snipers. Families in the city still lack access to clean water and medicine and many have only limited access to food.

When humanitarian agencies developed their contingency plan for Mosul last summer, we estimated that as many as one million civilians might flee the city and that 750,000 people would need assistance in a worst case scenario. Seven months into the fighting and almost 760,000 people have already fled their homes.

Yesterday, the Government asked civilians in districts surrounding and inside the Old City to leave and seek safety across government lines. We don’t know for sure how many civilians are still in ISIL-held districts, but as many as 200,000 additional people may try to leave in coming days.

I remind all parties to the conflict of their obligation under international law to protect civilians against all forms of violence and to ensure people in need have access to the assistance they require. Those who choose to flee their homes to access assistance must be free to do so without hindrance. In the context of Mosul, where ISIL fighters are known to be using human shields in densely-populated neighbourhoods, parties to the conflict must take all feasible precautions to protect civilian lives.

International law is unambiguous. The protection of civilian lives is a legal and moral duty that stands above all other objectives.
New York, 26 May 2017

Syrian Arab Republic
:: 25 May 2017  Syria: WoS Nutrition Reach by sub-district / Jan – Apr 2017
:: Syria Crisis: Ar-Raqqa Situation Report No. 5 (as of 15 May 2017) [EN/AR]

:: 24 May 2017  Statement by the Humanitarian Coordinator in Yemen, Mr. Jamie McGoldrick, on the Urgent need for Funding to Halt the Spread of Cholera [EN/AR]
Sana’a, 24 May 2017
Cholera continues to spread at an unprecedented rate throughout Yemen affecting men, women, and children who have for more than two years withstood the consequences of a conflict that is collapsing institutions and social safety nets. With urgency I appeal to United Nations Members States for financial and political support to help avert what is sure to be an additional and devastating blow to Yemen.

In the last three weeks, health authorities have reported over 35,500 suspected cholera cases, a third of whom are children, and 361 associated deaths in 19 of 22 governorates.

Malnutrition and cholera are interconnected; weakened and hungry people are more likely to contract cholera and cholera is more likely to flourish in places where malnutrition exists. Seventeen million people in Yemen are food insecure, including 462,000 children in the grip of acute malnutrition. Seven million people in Yemen face the possibility of famine and now over one hundred thousand people are estimated to be at risk of contracting cholera.

The speed at which cholera is spreading among the population exceeds the capacity of the health system to respond given its weakened state after more than two years of conflict, import restrictions and the lack of regular salary payments to health workers. Hundreds of thousands of people are at a greater risk of dying as they face the ‘triple threat’ of conflict, starvation and cholera.

Building on their presence in all 22 governorates across the country, national and international humanitarians are valiantly doing everything they can to prevent and treat cholera. However, they are doing so while facing a worst-case scenario – the majority of health care centers are closed, those that are open have limited staff and supplies, water and sanitation services are unable to provide clean water to the population, and humanitarian funds available to cover the existing institutional gaps and thwart the spread of the disease are meager.

Humanitarians are seeking US$55.4 million to prevent and treat cholera at the national, governorate and community level in the next six months. However, every day that funding is delayed the outbreak affects more people and more resources are needed to control it.

Cholera is preventable and treatable and no life should be lost to this disease. Humanitarians are acting and responding and we now need UN Member States to please help us by providing new funds and by ensuring that all funds pledged during the High Level Pledging Event in Geneva are made effective without delay.

:: Integrated Response Plan: Yemen Cholera Outbreak (23 May 2017)
[22 pages. OCV mention: Case Management Conduct cholera risk assessment to identify hotspot areas for possible oral cholera vaccine. May 2017, WHO]

UN OCHA – Corporate Emergencies
When the USG/ERC declares a Corporate Emergency Response, all OCHA offices, branches and sections provide their full support to response activities both at HQ and in the field.
:: Somalia: Drought Response – Situation Report No. 9 (as of 23 May 2017)

:: Ethiopia Weekly Humanitarian Bulletin, 22 May 2017

:: New UN fund to tackle looming famine in Nigeria reaches $24 million  23 May 2017

UNICEF  [to 27 May 2017]
24 May 2017
From cholera in Yemen to attacks on hospitals in Syria, conflict threatens lives of over 24 million children in the Middle East and North Africa
[Editor’s text bolding]
AMMAN, 24 May 2017 – Violence and conflict in the Middle East and North Africa have put in jeopardy the health of 24 million children in Yemen, Syria, the Gaza Strip, Iraq, Libya and Sudan. Damage to health infrastructure is depriving children of essential health care. Water and sanitation services have been compromised, causing waterborne diseases to spread while preventative health care and nutritious food are insufficient to meet children’s needs.

“Violence is crippling health systems in conflict-affected countries and threatens children’s very survival,” said Geert Cappelaere, UNICEF Regional Director for the Middle East and North Africa. “Beyond the bombs, bullets and explosions, countless children are dying in silence from diseases that could easily be prevented and treated.”

In Yemen (9.6 million children in need):
::The two-year conflict has pushed Yemen to the brink of famine and plunged the country into one of the world’s worst humanitarian crises, with widespread severe acute malnutrition among children,
::Salaries for health care and sanitation workers haven’t been paid for more than seven months,
::Contaminated water sources, untreated sewage and uncollected garbage, sparked a cholera outbreak with 323 associated deaths in the last month alone.
::Two thirds of the population use unsafe water,
::Health care facilities are struggling to cope with the volume of patients – many of them children – amid shortages of medical supplies and clean water.

In Syria (5.8 million children in need):
::More than 2 million children live under siege and in hard-to-reach areas with little to no humanitarian aid. Surgical and other lifesaving supplies are regularly removed from the few convoys that are allowed into these areas,
::Many children do not have access to life-saving vaccinations and those who fall ill or are injured struggle to get treatment,
::Attacks on hospitals and other health facilities have become commonplace – almost 20 per month between January and March this year. The few hospitals that are still operational function with limited staff and services.
::The threat of polio – such as the outbreak that hit Syria in 2013 – still looms.

In the Gaza Strip (1 million children in need):
::Since the main power plant shut down on 16 April, power cuts have reduced water supply to 40 litres per person per day, less than half of the minimum international standard,
::Wastewater treatment plants now deposit 100,000 cubic metres of raw sewage into the sea daily, increasing the risk of waterborne diseases,
::14 public hospitals are operating for critical services only.

In Iraq (5.1 million children in need):
::Water supplies in camps for the displaced around Mosul are stretched to the limit with new families arriving daily, many with malnourished children,
::The widespread use of unsafe well water, with the accumulation of solid waste in and around Mosul, are exposing children to the risk of waterborne diseases,
::UNICEF estimates that 85,000 children are trapped in western Mosul, cut off from humanitarian aid for the past seven months and with limited access to medical care.

In Libya (450,000 children in need):
::Last year, Libya recorded 20 attacks against health facilities, second only to Syria,
::Immunization programmes have been facing challenges since the conflict erupted in 2011, with suspected measles cases reported among young children,
::Without new funding, over 1.3 million children won’t be vaccinated against measles or rubella, putting these children – and others in the country – at risk of highly contagious and potentially fatal diseases.

In Sudan (2.3 million children in need):
::Over 8,000 cases of acute watery diarrhoea have been recorded across 10 of the 18 states in just eight months, including those hosting large numbers of refugees from South Sudan.
::Cases of acute watery diarrhoea are set to rise rapidly once the rainy season begins in June.
::Over 200,000 children under the age of five in parts of the conflict affected Jabel Marra, Nuba Mountains and Blue Nile areas have not had access to basic health services such as vaccination, for more than four years.

Across these countries, UNICEF and its partners are working around the clock to provide vulnerable children with safe water, water treatment, medical and nutrition supplies to prevent the total collapse of essential health and water systems. But as conflicts continue, and amid a shrinking humanitarian space, challenges to reach all vulnerable children with lifesaving assistance are growing.

“When children can’t access healthcare or improved nutrition, when they drink contaminated water, when they live surrounded by waste with no sanitation, they become ill and some die as a result,” said Cappelaere. “There is very little standing between them and life-threatening illness, especially when humanitarian access is denied.”

UNICEF is appealing for children’s needs to be prioritized in all conflict-affected countries through:
   :: Unconditional and sustained access to all children in need for UNICEF and other partners to deliver humanitarian assistance and supplies, including lifesaving medical items and vaccination, water purification material and waste treatment.
:: Parties to conflicts should put an immediate end to attacks on health facilities. Health facilities and civilian infrastructure should be protected at all times.
:: Urgent funding for the health, nutrition and WASH sectors. UNICEF received only one third of its 2017 funding requirements for health, nutrition and water and sanitation in these countries.

EBOLA/EVD  [to 27 May 2017]

Ebola Situation report: 25 May 2017
25 May 2017

Situation update

WHO, UN Agencies, International organizations, non-governmental organizations (NGOs) and partners con­tinue to support the Ministry of Health in the Democratic Republic of Congo to rapidly investigate and respond to the outbreak of Ebola virus disease (EVD) in Likati Health Zone, Bas Uele Province located in the north-east of the country.

On 24 May 2017, no new confirmed or probable EVD cases were reported. Two suspected EVD cases were reported, one each from Muma and Nambwa Health Areas in Likati Health Zone. The last confirmed case was reported on 11 May 2017.

Currently there are a total of two confirmed cases, three probable and 37 suspected cases. The confirmed and probable cases were reported from Nambwa (one confirmed and two probable) and Muma (one con­firmed and one probable). The suspected cases have been reported from six health areas (Nambwa, Muma, Ngayi, Azande, Mobenge and Mabongo). No healthcare workers have been affected to date. The outbreak currently remains confined to Likati Health Zone.

As of 24 May 294 contacts remain under follow up for signs and symptoms of Ebola. A total number of 520 contacts have been listed and 226 have completed 21 days of contact monitoring….

Current risk assessment
:: The risk is high at the national level due to the known impact of Ebola outbreaks, remoteness of the af­fected area, and limited access to health care including suboptimal surveillance.
:: The risk at the regional level is moderate due to the proximity of international borders and the recent influx of refugees from Central African Republic.
:: The risk is low at global level due to the remoteness and inaccessibility of the area to major international ports….

Editor’s Note:
We will cluster these recent emergencies as below and continue to monitor the WHO webpages for updates and key developments.

Zika virus  [to 27 May 2017]
Disease outbreak news
Zika virus infection – India  26 May 2017

On 15 May 2017, the Ministry of Health and Family Welfare-Government of India (MoHFW) reported three laboratory-confirmed cases of Zika virus disease in Bapunagar area, Ahmedabad District, Gujarat, State, India….

MERS-CoV [to 27 May 2017]
[No new digest content identified]
Yellow Fever  [to 27 May 2017]
[No new digest content identified]

WHO & Regional Offices [to 27 May 2017]

WHO & Regional Offices [to 27 May 2017]

Report: Ten years of transformation
26 May 2017 — WHO has made extraordinary progress
 in its bold reform agenda over the past decade. Innovative leadership, managerial structures and systems have resulted in increased effectiveness, efficiency, responsiveness, transparency and accountability. This report tells the story of WHO’s transformation from 2007 through to the current day.

Stand up for human rights to – and through – health, experts urge Governments
May 2017 – The world is at a watershed moment that could lead to greater dignity for everyone throughout their lives, but only if Governments invest in the relationship between human rights and health specifically for women, children and adolescents, a UN-backed group of politicians and health and human rights experts said.

Double-duty actions for ending malnutrition within a decade
May 2017 – Malnutrition has many forms. Undernutrition can see children dangerously thin for their height (wasting), or their growth permanently impeded (stunting). Inadequate intake of key nutrients may weaken immune systems, impair brain development, and worsen the risk of conditions such as anaemia and blindness.

WHO list of priority medical devices for cancer management
May 2017 – From kick buckets to MRI units, medical devices are an indispensable part of preventing, diagnosing and treating cancer, as well as for palliative care for cancer patients. WHO’s new List of priority medical devices for cancer management describes hundreds of devices that are needed for six types of cancer: breast, cervical, colorectal, leukemia, lung and prostate.


Weekly Epidemiological Record, 26 May 2017, vol. 92, 21 (pp. 293–300)
:: Virologic monitoring of poliovirus type 2 after OPV2 withdrawal in April 2016: an important advance in eradicating poliomyelitis and eliminating live oral poliovirus vaccines worldwide, 2016–2017


Request for proposals: evaluation of malaria vaccine RTS,S/AS01 pilot implementation 22 May 2017

WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: Unprecedented New Organizational Reforms for WHO in the African Region announced
Three years after Ebola crisis, Dr Matsidisho Moeti’s Transformation Agenda yields numerous achievements by WHO in the Africa region; sets stage for new focus on adolescent health and establishment of emergency response hubs
Geneva, 22 May 2017 – The World Health Organization’s (WHO) Regional Director for Africa announced today four new flagship programs for the region over the next two years, including a major push on adolescent health and the creation of regional emergency hubs. She also announced that WHO country offices in the African region will be held accountable to a mandatory set of performance deliverables over the next two years as part of the next phase of an ambitious reform program begun in 2015 in the wake of the Ebola crisis in West Africa…

WHO Region of the Americas PAHO
:: Sudamérica adapta estrategia mundial para mejorar la salud de las mujeres, niños, niñas y adolescentes (05/25/2017)
WHO European Region EURO
:: Strengthening women’s leadership in public health in Ukraine 23-05-2017

WHO Eastern Mediterranean Region EMRO
:: Jumbo jet lands in war-torn Yemen carrying 67 tons of cholera response supplies
25 May 2017 – A World Health Organization-chartered aircraft carrying intravenous fluids and cholera kits has successfully landed at Sana’a airport in Yemen. At 67 tons, it constitutes the largest planeload of medical goods WHO has brought into the country since the escalation of the conflict in March 2015. The supplies, sufficient for the treatment of 10 000 patients, are a welcome boost to the country’s response to a cholera outbreak which has caused more than almost 70 000 suspected cases since it began in October 2016. The epidemic had shown signs of slowing but recently reignited, causing 42 207 suspected cases and 420 deaths between 27 April 2017 and 24 May 2017.
:: WHO mobilizes health response for Ar-Raqqa, Syria  23 May 2017


CEPI – Coalition for Epidemic Preparedness Innovations  [to 27 May 2017]
CEPI Newsletter 26 May 2017
Address from the CEO
As I mentioned at the end of my last note, the CEPI Scientific Advisory Committee held a special meeting on May 10 to review the white papers submitted in response to CEPI’s first call for proposals. The very next day, while the Scientific Advisory Committee was meeting in regular session, an Ebola outbreak was confirmed in the Bas-Uele province in northern Democratic Republic of Congo, not far from Yambuku, the town where the virus first emerged in 1976. On May 12, a young man, Onwuegbuzie Stanley-Samuel, died of Lassa Fever at the University of Calabar Teaching Hospital in southeastern Nigeria, the latest victim of a Lassa fever outbreak that has been percolating in Nigeria for several months. If we need to be reminded that the threat of epidemic disease is real, these developments do just that (they have prompted me to ask the CEPI team to accelerate the development of our emergency response plans, which are in a very early state).

It is thus not surprising that CEPI continues to attract a great deal of attention and support from global public health partners. Last Friday, Australia announced a donation of $2 million, becoming CEPI’s seventh investor, joining Germany, Japan, Norway, Wellcome, the Bill & Melinda Gates Foundation and Belgium.

The same day, Chancellor Angela Merkel of Germany told the assembled Health Ministers of the G20 nations, who had gathered in Berlin for their first ever meeting, that help for the African nations affected by Ebola in 2014/2015 had been “too late, too slow, and too uncoordinated”. She urged her G20 peers to support CEPI, the WHO Contingency Fund for Emergencies, and the World Bank Pandemic Emergency Financing Facility, noting emphatically that where preparedness is concerned there is “no free lunch”.

On Monday, in her Address to the Seventieth World Health Assembly, Dr. Margaret Chan, the Director General of WHO, reflected on her ten years of service in that role and the role of WHO in responding to the 2009 pandemic, outbreaks of MERS and H7N9 influenza, and the Ebola and Zika epidemics. She pointed to the establishment of CEPI as a key initiative to enhance global preparedness for such threats.

Monday night, with Dr. Chan’s address still fresh in everyone’s mind, Ministers of Health Bent Høie of Norway and Hermann Gröhe of Germany hosted a side event on CEPI at the World Health Assembly. An audience of some 200 delegates filled the room. The interest in CEPI’s progress, and desire for CEPI to succeed, was palpable.

Richard Hatchett, CEPI CEO
Sabin Vaccine Institute  [to 27 May 2017]
From Evidence to Action: Typhoid Experts Exchange Data, Strategies During Biannual Conference
More than 300 researchers from 45 countries gathered in Kampala, Uganda in early April for the 10th International Conference on Typhoid and Other Invasive Salmonelloses.

World Health Assembly Discusses Global Vaccine Action Plan During Historic Meeting
When the 70th World Health Assembly (WHA) begins today in Geneva, Switzerland, it will be one of historic measure. Not only because the WHA be electing a new Director-General of the World Health Organization (WHO), but also because of its sheer scope.

Announcements: WHO Director General

Editor’s Note:
We cluster below announcements from selected organizations saluting and otherwise messaging the new WHO Director General.
Gavi [to 27 May 2017]
23 May 2017
Gavi welcomes election of new WHO Chief
Former Gavi Board member Dr Tedros Adhanom Ghebreyesus is elected Director General of the World Health Organisation (WHO).
Global Fund [to 27 May 2017];&country=
Global Fund welcomes Dr. Tedros Adhanom Ghebreyesus as Director-General of WHO
23 May 2017

The Global Fund congratulates Dr. Tedros Adhanom Ghebreyesus on his election as the new Director-General of World Health Organization.
PATH  [to 27 May 2017]
Announcement | May 23, 2017
PATH statement on election of Dr. Tedros Adhanom Ghebreyesus as Director-General of the World Health Organization
PATH congratulates Dr. Tedros and urges his action to address pressing global health challenges and needs for WHO reform

Announcement | May 23, 2017
PATH statement on the US Administration’s proposed full Fiscal Year 2018 budget
Significant cuts to global health and research programs put the health and security of millions—including Americans—at risk
UNAIDS  [to 27 May 2017]
Selected Press Releases & Updates
Global health partners reflect on priorities for the new WHO Director-General
The panellists shared recommendations for a stronger WHO, from pandemic preparedness to United Nations reform.
#STOPHIVAIDS in the Russian Federation
The campaign is part of the Russian Government’s State Strategy and Implementation Plan on HIV until 2020 and beyond.

Wellcome Trust  [to 27 May 2017]
Opinion / Published: 26 May 2017
Our letter to the new WHO Director-General
In an open letter, our Director Jeremy Farrar congratulates the new head of the World Health Organization Tedros Adhanom Ghebreyesus, and sets out what Wellcome thinks the WHO’s priorities should be.

News / Published: 26 May 2017
Genomes chart Zika’s spread in the Americas
New research from the 2015-16 Zika outbreak shows how far we have come in being able to study disease outbreaks in close to real time.
Three papers, two by Wellcome-funded researchers and all published in the journal Nature, show what can be achieved when researchers collect and analyse genome sequences rapidly on the ground.
The genomes, obtained from infected patients and Aedes aegypti mosquitoes, show that:
the virus circulated undetected for many months before transmission was detected
Northeast Brazil had a crucial role in establishing the spread of the virus throughout the Americas.
The research also demonstrates the enormous potential of combining traditional epidemiology – looking at how a virus affects people at a population level – with rapid genome sequencing to look at the spread and evolution of a virus…



Fondation Merieux  [to 27 May 2017]
Mission: Contribute to global health by strengthening local capacities of developing countries to reduce the impact of infectious diseases on vulnerable populations.
22 May 2017, Bamako (Mali)
Mali: Phase 2 Launch of the LABOMEDCAMP Country Medical Laboratory Project
The official ceremony to launch phase 2 of the LABOMEDCAMP project took place at the Charles Mérieux Center for Infectious Disease on April 5, 2017.
IAVI – International AIDS Vaccine Initiative   [to 27 May 2017]
May 25, 2017
IAVI Statement on the US Administration’s Proposed Full Fiscal Year 2018 Budget
The International AIDS Vaccine Initiative (IAVI) expresses deep concern over drastic cuts to HIV/AIDS biomedical research and development proposed in the U.S. President’s FY 18 budget.
This budget is built on the unfortunate fallacy that the AIDS epidemic can be sustainably controlled using current tools. The proposed 18 percent cut to PEPFAR limits capacity to maintain treatment programs at present levels only, and fails to accommodate treatment for millions of people who will require it. Steadily increased investment in PEPFAR is what has saved millions of lives and given 11.5 million people access to treatment.

To truly end AIDS, we must look to the horizon of new prevention technologies, including an AIDS vaccine. This budget eliminates USAID funding for IAVI, preventing our researchers from moving 10 promising vaccine candidates into the clinic and from understanding the biological basis of HIV infection that has already helped devise approaches to fighting other infectious diseases.

We call on Congress to fully fund the PEPFAR program, including critical support provided by USAID for HIV prevention R&D. This support promotes economic growth at home and abroad, illuminates the value of American innovation, and helps maintain political stability and global security.

The end of AIDS is within our grasp. This budget will keep us from ever realizing a world without AIDS.
NIH  [to 27 May 2017]
May 24, 2017
Zika virus spread undetected for many months, NIH-supported study finds
May 24, 2017 — Virus quickly spread in the Americas, then diverged into distinct genetic groups.

Modified experimental vaccine protects monkeys from deadly malaria
Scientists modified an existing vaccine to more closely mimics the protein complex used by the parasite.
May 22, 2017 — Researchers from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, modified an experimental malaria vaccine and showed that it completely protected four of eight monkeys who received it against challenge with the virulent Plasmodium falciparum malaria parasite. In three of the remaining four monkeys, the vaccine delayed when parasites first appeared in the blood by more than 25 days…

FDA [to 27 May 2017]
FDA News Release
FDA approves first cancer treatment for any solid tumor with a specific genetic feature
May 23, 2017
The U.S. Food and Drug Administration today granted accelerated approval to a treatment for patients whose cancers have a specific genetic feature (biomarker). This is the first time the agency has approved a cancer treatment based on a common biomarker rather than the location in the body where the tumor originated.

Keytruda (pembrolizumab) is indicated for the treatment of adult and pediatric patients with unresectable or metastatic solid tumors that have been identified as having a biomarker referred to as microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR). This indication covers patients with solid tumors that have progressed following prior treatment and who have no satisfactory alternative treatment options and patients with colorectal cancer that has progressed following treatment with certain chemotherapy drugs.

“This is an important first for the cancer community,” said Richard Pazdur, M.D., acting director of the Office of Hematology and Oncology Products in the FDA’s Center for Drug Evaluation and Research and director of the FDA’s Oncology Center of Excellence. “Until now, the FDA has approved cancer treatments based on where in the body the cancer started—for example, lung or breast cancers. We have now approved a drug based on a tumor’s biomarker without regard to the tumor’s original location.”…
European Medicines Agency  [to 27 May 2017]
East African Community looks to EMA as model for future regional agency
EMA and East African regulators met on 18-19 May 2017
As part of the European Medicines Agency’s (EMA) ongoing collaboration with African regulators, a delegation from the East African Community (EAC) visited the Agency on 18-19 May 2017. The goal of the two-day meeting was to gather information and experience to support the potential creation of a networking medicines agency for the EAC.
The delegation included the heads of national agencies from the EAC Partner States, together with representatives from the World Health Organization (WHO) and the World Bank Group. The EAC has six Partner States: Burundi, Kenya, Rwanda, South Sudan, Tanzania and Uganda…