Public Health Emergencies of International Concern (PHEIC) [to 6 May 2017]

Public Health Emergency of International Concern (PHEIC)
Polio this week as of 25 April 2017
:: The Strategic Advisory Group of Experts on immunization (SAGE) convened last week in Geneva.  On polio eradication, the group noted the progress achieved in the remaining endemic countries.  Recognizing an ongoing global supply constraint of inactivated polio vaccine (IPV), the group urged countries to adopt a fractional-dose approach (1/5th of a full dose), noting that several countries which had implemented this approach are able to meet their national vaccine requirements for its populations, and to prioritize supply to routine immunization rather than to outbreak response.  SAGE also reviewed long-term immunization policy options for the post-certification world and put forward key recommendations for this period.  A summary report from the meeting is available here.

:: The report from the 13th Meeting of the International Health Regulations Emergency Committee on the international spread of poliovirus and available on www.polioeradication.org.  The Committee concluded that the current epidemiological situation continued to remain a Public Health Emergency of International Concern, and recommended the extension of the Temporary Recommendations for a further three months.[see below]

Country Updates [Selected Excerpts]
New cases or environmental samples reported across the monitored country/region settings: Afghanistan, Pakistan, Nigeria, Lake Chad Basin. Guinea and West Africa, and Lao People’s Democratic Republic have been removed from the monitored geographies list.
:: Seven new WPV1 positive environmental samples were reported in the past week, all collected in April, from Islamabad, Pishin (Balochistan), Peshawar (Khyber Pakhtunkhwa), and Sindh (three from greater Karachi and one from Sukkur in northern Sindh).


Statement of the 13th IHR Emergency Committee regarding the international spread of poliovirus
WHO statement 2 May 2017
[Excerpts; text bolding by Editor]
The thirteenth meeting of the Emergency Committee under the International Health Regulations (2005) (IHR) regarding the international spread of poliovirus was convened via teleconference by the Director General on 24 April 2017.

The Emergency Committee reviewed the data on wild poliovirus (WPV1) and circulating vaccine­derived polioviruses (cVDPV). The Secretariat presented a report of progress for affected IHR States Parties subject to Temporary Recommendations. The following IHR States Parties presented an update on the implementation of the WHO Temporary Recommendations since the Committee last met on 7 February 2017: Afghanistan, Pakistan, Nigeria, and Equatorial Guinea. The committee also invited the Russian Federation and the Netherlands to provide information about polio events in their respective territories.

Wild polio
Overall the Committee was encouraged by continued steady progress in all three WPV1 infected countries, Pakistan, Afghanistan, and Nigeria, and the fall in the number of cases globally. While falling transmission in these three countries decreased the risk of international spread, the consequences should spread occur would represent a significant set-back to eradication and a risk to public health….

Vaccine derived poliovirus
The committee noted that there were no new outbreaks of cVDPV, and no new cases in the three current cVDPV2 outbreaks (Borno and Sokoto in northern Nigeria, and in Quetta Pakistan). However, these outbreaks highlighted the presence of vulnerable under immunized populations in countries with endemic transmission. The committee noted the comprehensive response to these outbreaks.

The Russian Federation provided an update on the actions taken following the detection of VDPV2s in two children from the Chechen Republic and Moscow, but the committee noted there were still some important gaps in the information and the final classification of the case is therefore pending. However, the surveillance and immunization activities taken in response to this event were welcomed, and there appears to be very little risk of international spread.

In Lao PDR, the most recent case of cVDPV had onset in January 2016, and based on the most recent outbreak response assessment and the criteria of the committee, the country is no longer considered as infected, but remains vulnerable.

The Committee unanimously agreed that the risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC), and recommended the extension of revised Temporary Recommendations for a further three months…

…Based on the advice concerning WPV1 and cVDPV, and the reports made by Afghanistan, Pakistan, Nigeria, and Equatorial Guinea, the Director General accepted the Committee’s assessment and on 2 May 2017 determined that the events relating to poliovirus continue to constitute a PHEIC, with respect to WPV1 and cVDPV. The Director General endorsed the Committee’s recommendations for countries falling into the definition for ‘States infected with WPV1, cVDPV1 or cVDPV3 with potential risk for international spread’, ‘States infected with cVDPV2’ and for ‘States no longer infected by WPV1 or cVDPV, but which remain vulnerable to re-infection by WPV or cVDPV’ and extended the Temporary Recommendations as revised by the Committee under the IHR to reduce the risk of international spread of poliovirus, effective 2 May 2017.


WHO Grade 3 Emergencies  [to 6 May 2017]
Iraq  – No new announcements identified
YemenNo new announcements identified
NigeriaNo new announcements identified
South Sudan  – No new announcements identified
The Syrian Arab Republic  – No new announcements identified


WHO Grade 2 Emergencies  [to 6 May 2017]
Cameroon  – No new announcements identified.
Central African Republic  – No new announcements identified.
Democratic Republic of the CongoNo 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. 31 (24 April to 30 April 2017) [EN/AR/KU]
:: Support provided to Yazidi survivors of kidnapping and sexual violence [EN/AR/KU]
Report Published on 30 Apr 2017

Syrian Arab Republic
:: 5 May 2017 Leo Messi Foundation helps UNICEF get Syrian children back into the classroom

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. 6 (as of 30 April 2017)
:: Humanitarian Bulletin Somalia April 2017 | Issued on 4 May 2017

:: 2 May 2017 Ethiopia Weekly Humanitarian Bulletin, 01 May 2017

NigeriaNo new announcements identified.


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

EBOLA/EVD [to 6 May 2017]
4 May 2017
Leaders gather in Guinea to celebrate Ebola vaccine successes
“The world is far better prepared for another Ebola outbreak,” said Dr Margaret Chan, Director-General of the World Health Organization, today at a celebratory event to recognize the Governments and people of the three most-affected countries for their contribution to the control of the Ebola outbreak in 2014-15.

Dr Chan joined the President of the Republic of Guinea, HE Professor Alpha Conde, His Excellency Minister of Health, Dr Abdourahmane Diallo, and representatives from the Governments of Liberia and Sierra Leone, in celebrating the successful development of the world’s first vaccine against Ebola. Dr Matshidiso Moeti, Regional Director of WHO’s Office of the African Region, was also present at this celebration.

“This truly remarkable achievement is thanks to collaborative efforts of the Government of Guinea, health workers, local and international scientists, public and private entities, international donors and, above all, the thousands of people who consented to be vaccinated in this vaccine trial,” she said.

In December 2016, The Lancet published results of the WHO-led Guinea ring vaccination trial, showing that the world’s first Ebola vaccine provides substantial protection. Among more than 11 000 people who were vaccinated in the trial, no cases of Ebola virus disease occurred.

Building on the work done to fast-track the development and testing of this vaccine, WHO established the R&D Blueprint to help cut the time in future for the development of new vaccines and treatments against new and emerging infectious diseases including Lassa Fever and MERS Coronavirus.

Dr Chan presented certificates to selected individuals for their remarkable contribution to the vaccine trial as well as the control of the Ebola outbreak in Guinea, Liberia and Sierra Leone.
:: Opening remarks by WHO Director-General at the Ebola vaccines for Guinea and the world event