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

Milestones :: Perspectives
 
Editor’s Note
We generally reserve this section of our digest for major strategic announcements and significant milestones in the vaccines/immunization space. We share below the text from a WHO recognition that represents, in our view, such a milestone.

“WHO would like to express its thanks and appreciation for the contribution and leadership for the advancement of global health by Dr. Philippe Duclos, Secretary to the Strategic Advisory Group of Experts (SAGE) on Immunization 2005 – 2017”

We understand that WHO held a celebratory event this past Friday to recognize the retirement and final service day of Dr. Philippe Duclos, Executive Secretary to SAGE for many years as indicated. For those who may have served in roles leading and facilitating the development and implementation of global normative standards (in health or any human endeavor) it is clear that it requires an extraordinary mix of technical competence, political skill, and other sensibilities rarely found together.

Phil Duclos evidenced these attributes splendidly and navigated the changing ecology of SAGE with aplomb. His leadership was critical to the many achievements of SAGE during his tenure.

For our part, CVEP found Phil to be ever patient, ever engaged, and ever open to us and the CSO community, which has been a growing part of that SAGE ecology.

We wish him a splendid next adventure, wherever that may take him.

Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 23 August 2017 [GPEI]
:: Read the latest polio updates from WHO Pakistan and from WHO Afghanistan to see information on cases, surveillance and vaccination campaigns.
:: The remarkable impact of frontline workers:  read about Khalida, a frontline health worker in Karachi, Pakistan, and her incredible efforts to forge a path to trust in vaccines.
:: Summary of newly-reported viruses this week:  No new viruses reported this week.

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Situation reports on the polio outbreak in Syria
Situation update 22 August 2017
:: No new cases of cVDPV2 were reported this week. The total number of cVDPV2 cases remains 33. All confirmed cases to date have had onset of paralysis before 11 July 2017.
:: Final lab results are pending for an additional 11 poliovirus type-2 (PV2) isolates (7 from Mayadeen and 3 from Boukamal districts, Deir Ez-Zor governorate, and 1 from Thawra district, Raqqa governorate).
:: Raqqa governorate concluded its first immunization round on 17 August. According to administrative data, 103,720 children were vaccinated, representing 86% campaign coverage. Additional coverage data from independent third party monitoring is being evaluated.
:: The second immunization round in Deir Ez-Zor governorate is expected to start this week. The second immunization round for Raqqa is being planned for after Eid.
:: Under International Health Regulations (2005) (IHR), WHO’s Emergency Committee has issued temporary recommendations for Syria as a ‘state infected with cVDPV2 with potential risk of international spread’.
:: The total number of AFP cases detected in Deir Ez-Zor governorate since the beginning of 2017 is 118 (87 from Mayadeen, 11 from Deir Ez-Zor, and 20 from Boukamal districts).
Raqqa governorate has reported 16 AFP cases (5 from Raqqa, 10 from Tell Abyad, and 1 from Thawra districts).
:: Homs governorate has reported 27 AFP cases (12 from Homs city, 12 from Rastan, 1 from Tadmour and 2 from Talkalakh districts).
 
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WHO Grade 3 Emergencies  [to 26 August 2017]
Iraq  
:: Health services for people fleeing the crisis in Iraq
21 August 2017 – As hundreds of people flee the crisis in Telafar, a city west of Mosul, Iraq, WHO and health partners in collaboration with the health authority have established static and mobile medical clinics to offer 24/7 lifesaving emergency and primary health care services to meet the urgent needs of people fleeing the crisis.
 
The Syrian Arab Republic –
:: Situation reports on the polio outbreak in Syria  22 August 2017
 [See Polio above for more detail]

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UNOG – REGULAR PRESS BRIEFING BY THE INFORMATION SERVICE
25 August 2017
[Excerpt]
Syria immunization programmes
Christian Lindmeier, for the World Health Organization, said that routine immunization programmes restarted in North-West Syria, starting in the spring of 2017 with technical support and guidance from WHO.
As of August 2017, more than 35 centres in the areas of Idlib and Hama offered vaccinations against tuberculosis, measles, rubella, mumps, polio, hepatitis B, diphtheria, tetanus, whooping cough and a special influenza type.
During the years of the crisis, basic vaccines were not always available and clinics and hospitals in some areas could not offer immunization or were even destroyed. During the crisis, WHO’s field office in Gaziantep, Turkey, had worked with UNICEF to do short term vaccination campaigns that lasted several weeks, with vaccination teams fanning out to reach children in remote areas of Northern Syria.
However on-going outbreaks in Syria indicated low vaccine coverage and WHO had worked with local NGOs and local clinics to re-establish centres. In July 2017 alone, thanks to the immunization work at these centres, more than 20,000 children the North-East area were vaccinated with the pentavalent vaccine which protects against hepatitis B, diphtheria, tetanus, whooping cough and the Haemophilus influenza type B.
WHO partners planned to re-establish routine vaccination programmes in dozens more centres in North West by the end of 2017.
Answering questions, Mr. Lindmeier explained that records of immunization had been lost in many cases, with people being displaced; it was very difficult to obtain figures on the number of children who might have died or been sick as a result of low immunization. He also said that, before the war, the level of immunization had been above 95%, but that it was difficult to ascertain the level today.  Ongoing outbreaks of polio and measles were indicators that the vaccination level was too low in Syria.
Answering another question, Mr. Lindmeier said that WHO provided supplies to partners on the ground such as NGOs as well as hospitals or health centres, which in turn negotiated with authorities which, in the areas concerned, would be opposition groups.
On immunization, Christophe Boulierac, for the United Nations Children’s Fund (UNICEF), added that the second round of polio vaccination in Deir ez-Zor had started on 22 August.  On that first day, 14% of the total target had already been reached.

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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
:: OCHA Iraq | Telafar Flash Update #1: Telafar Humanitarian Response, 20 August 2017 [EN/AR/KU]
:: Thousands of civilians fleeing Telafar are at extreme risk [EN/AR/KU] Report
Published on 20 Aug 2017

Syrian Arab Republic
:: 25 Aug 2017  Displaced, disoriented and shocked, children from Raqqa and Deir-ez-Zor need urgent assistance and protection [EN/AR]
:: Joint Statement on Civilian Casualties Due to Coalition Airstrikes in Ar-Raqqa City [EN/AR]
Report Published on 22 Aug 2017 —
Ali Al-Za’tari, the Humanitarian Coordinator for Syria, and Ramesh Rajasingham, the Regional Humanitarian Coordinator for Syria a.i, express their deep concern over the significant number of civilians reportedly killed in the last few days due to the use of explosive ordnances, including through Coalition airstrikes, against targets of the Islamic State of Iraq and the Levant (ISIL) in densely populated neighborhoods of Ar-Raqqa city…

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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.
Ethiopia
:: 22 Aug 2017  Ethiopia Weekly Humanitarian Bulletin, 21 August 2017

DRC
:: Bulletin humanitaire R.D. Congo – Numéro 3 | 21 août 2017
 

WHO & Regional Offices [to 26 August 2017]

New vision and strengthened partnership for WHO and China
21 August 2017 | GENEVA – WHO Director-General Tedros Adhanom Ghebreyesus concluded a 3-day official visit to the People’s Republic of China paving the way for stronger and more strategic WHO-China collaborations. Outcomes of his visit included a new financial contribution to WHO from China, and strengthened commitments to improve the health of billions of people in the 60 countries in the Belt and Road Initiative.

World Humanitarian Day
21 August 2017 – Dr Tedros honoured the heroic people who have died for the humanitarian cause, and thanked those who continue to devote their lives to helping the world’s most vulnerable people – in so many different countries, in such difficult circumstances.

Preventing spread of disease after Sierra Leone mudslide
21 August 2017 – WHO is working closely with the Government of Sierra Leone to prevent the spread of infectious diseases such as malaria and cholera in the wake of last week’s mudslides and flooding in Freetown. The Organization is also working with partners to ensure ongoing health care for the injured and displaced, and to provide psychological aid to those coping with trauma.

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Disease outbreak news
:: Chikungunya – France   25 August 2017

::::::

Weekly Epidemiological Record, 25 August 2017, vol. 92, 34 (pp. 477–500)
:: Cholera vaccines: WHO position paper – August 2017
:: Monthly report on dracunculiasis cases, January-June 2017

::::::
 
WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: Africa on the verge of winning the fight against Neglected Tropical Disease
Brazzaville, Congo. 24 August 2017 – For more than 40 years, the World Health Organization (WHO) has worked to control river blindness (onchocerciasis), the second major infectious cause of blindness in Africa. Today, 30 years after a major donation of medication by Merck & Co, a pharmaceutical company, and after 20 years of the success of the African Program for Onchocerciasis Control (APOC) the reduction of the disease intensity has allowed WHO to shift the goal from control to elimination – a really ambitious achievement.
The unprecedented donation of medication “as much as needed for as long as needed”, combined with innovative distribution mechanism from WHO was protecting more than 110 million people annually in 19 countries by 2015, when the APOC program closed. It prevented over 40,000 cases of blindness every year between 1995 and 2015…

:: Acting on the call (AOTC) 2017 Summit kicks off in Addis Ababa: “Let’s make the world a better place for mothers and children”
Addis Ababa, 24th August, 2017: The 4th Acting On The Call (AOTC) conference started on the 24th August 2017 at the African Union, Addis Ababa Ethiopia with a theme “Overcoming Critical Barriers to Maternal and Child Survival”. The AOTC conference which is hosted by the governments of Ethiopia and India gathered more than 500 participants from 24 countries and held in the presence of the President of the Federal Republic of Ethiopia, Ministers and high level policymakers from the public and private sectors, NGOs and UN agencies including UN Women, UNICEF, UNFPA and WHO. .. 

WHO European Region EURO
:: Chikungunya cases reported in France 25-08-2017
:: Report shows progress towards Health 2020 targets 24-08-2017
:: Towards tobacco-free generations: stopping second-hand smoke and smoking initiation among children 22-08-2017

WHO Eastern Mediterranean Region EMRO
:: WHO and health authorities deliver 24/7 health services for hundreds of people fleeing the crisis in Telafar, Iraq   Baghdad, 22 August 2017
 
WHO Western Pacific Region
:: New vision and strengthened partnership for WHO and China   21 August 2017

CDC/ACIP [to 26 August 2017]
http://www.cdc.gov/media/index.html
Thursday, August 24, 2017
Most U.S. teens are getting cancer-preventing vaccine
CDC encourages parents to protect children from cancers caused by HPV
Six out of 10 U.S. parents are choosing to get the human papillomavirus (HPV) vaccine for their children, according to a report published in this week’s Morbidity and Mortality Weekly Report. The Centers for Disease Control and Prevention (CDC) recommends parents get two doses of HPV vaccine for their children at ages 11 or 12 to protect against cancers caused by HPV infections. Although most children are getting their first dose of HPV vaccine, many children are not completing the vaccination series.

“I’m pleased with the progress, but too many teens are still not receiving the HPV vaccine – which leaves them vulnerable to cancers caused by HPV infection,” said CDC Director Brenda Fitzgerald, M.D. “We need to do more to increase the vaccination rate and protect American youth today from future cancers tomorrow.”

Adolescents who get the first dose of HPV vaccine before their 15th birthday need two doses of HPV vaccine to be protected against cancers caused by HPV. Teens and young adults who start the series at ages 15 through 26 years need three doses of HPV vaccine to be protected against cancers caused by HPV.

Teen HPV vaccination: key findings
The annual National Immunization Survey-Teen (NIS-Teen) report, which examines vaccination coverage among U.S. adolescents, found that 60 percent of teens ages 13 to 17 received one or more doses of HPV vaccine in 2016, an increase of 4 percentage points from 2015.

The report also showed that HPV vaccination is becoming more common among boys. The difference in vaccination rates between boys and girls has been narrowing in recent years. About 65 percent of girls received the first dose of HPV vaccine compared to 56 percent of boys receiving the first dose. These latest estimates represent a 6 percentage point increase from 2015 for boys, while rates for girls were similar to 2015.

Despite these increases, areas for improvement remain. While most adolescents have received the first dose of HPV vaccine, only 43 percent of teens are up to date on all the recommended doses of HPV vaccine. HPV vaccination rates were also lower in rural and less urban areas compared to more urban areas…

MMWR News Synopsis for August 24, 2017
:: National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2016
Human Papilloma Vvirus (HPV) vaccination prevents cancer. Six out of 10 U.S. parents are choosing to get the HPV vaccine for their children. Although most children are getting their first dose of HPV vaccine, many children are not completing the vaccination series. CDC recommends 11- to 12-year-olds get two doses of HPV vaccine at least six months apart. Most U.S. parents are getting the first dose of HPV vaccine for their child, according to the latest estimates from the National Immunization Survey-Teen. In 2016, 60 percent of teens aged 13-17 years received one or more doses of HPV vaccine, an increase of 4 percentage points from 2015. The gap in HPV vaccination rates between boys and girls continues to narrow. Roughly 65 percent of girls received the first dose of HPV vaccine compared to 56 percent of boys who received the first dose of HPV vaccine. Although most children are getting their first dose of HPV vaccine, there continue to be many children who do not complete the vaccination series. HPV vaccination coverage is lower in rural and less urban areas. Those communities could benefit from additional efforts to increase coverage. Recent changes to HPV vaccine recommendations make it easier for parents to protect their children at the recommended ages. CDC recommends 11 to 12 year olds get two doses of HPV vaccine at least six months apart.

Announcements
 
EDCTP    [to 26 August 2017]
http://www.edctp.org/
The European & Developing Countries Clinical Trials Partnership (EDCTP) aims to accelerate the development of new or improved drugs, vaccines, microbicides and diagnostics against HIV/AIDS, tuberculosis and malaria as well as other poverty-related and neglected infectious diseases in sub-Saharan Africa, with a focus on phase II and III clinical trials
22 August 2017
Workshop to launch EDCTP Alumni Network in October
Since its inception, EDCTP has invested in support for individual researchers at different stages of their careers through an evolving…

European Medicines Agency  [to 26 August 2017]
http://www.ema.europa.eu/ema/
23/08/2017
Strengthening EU-US cooperation in medicine inspections
New commitment allows FDA to share full inspection reports with European Commission and EMA …
 
 
Gavi [to 26 August 2017]
http://www.gavi.org/library/news/press-releases/
23 August 2017
Gavi, the Vaccine Alliance welcomes Haiti’s commitment to immunisation
Government commits to fund vaccines and to strengthen its national immunisation programme to protect more Haitian children.
… According to WHO and UNICEF estimates, in 2016 Haiti had 58% coverage for Diphtheria-Tetanus-Pertussis vaccine (DTP3), the lowest rate in the Americas. While the country remains polio, measles and rubella free, recent outbreaks like diphtheria show the potential consequences of weak vaccine coverage. Significant inequity across provinces, districts as well as urban and rural areas also need to be addressed to reduce under five child mortality from 69 to 25/1,000 by 2030 and thereby reach the Sustainable Development Goal for Health (SDG).
“The Prime Minister’s commitment also encourages Gavi and partners to further scale up support to the country”, said Anuradha Gupta. “In the near future, we hope that Haiti will further prioritise investments in health to advance Universal Health Coverage so that all Haitians can have access to quality health services including immunisation.”…

Gavi welcomes contribution from the United Arab Emirates
US$ 5 million pledge will support INFUSE initiative, started in 2016 to help modernise vaccine delivery systems
Geneva, 21 August 2017 – The United Arab Emirates (UAE) has committed US$ 5 million to Gavi, the Vaccine Alliance, to support its Innovation for Uptake, Scale and Equity in Immunisation (INFUSE) initiative. Launched at the 2016 World Economic Forum meeting in Davos, INFUSE helps developing countries accelerate the introduction of tried and tested technology which will modernise their immunisation systems…
 
IVI   [to 26 August 2017]
http://www.ivi.int/
August 22, 2017
ICMR, Department of Health and Family Welfare of MOHFW sign MoU with International Vaccine Institute to support vaccine development in India
The Indian Council of Medical Research (ICMR) under the Department of Health Research and the Department of Health and Family Welfare of the Ministry of Health and Family Welfare(MOHFW) signed a tripartite memorandum of understanding today with the International Vaccine Institute (IVI)to collaborate on vaccine research and development. The agreement will also strengthen the relationship between IVI and India…
 
MSF/Médecins Sans Frontières  [to 26 August 2017]
http://www.doctorswithoutborders.org/news-stories/press/press-releases
Press release
Indian Patent Office Delivers Major Blow to Affordable Pneumonia Vaccine Hopes
August 22, 2017
 
NIH  [to 26 August 2017]
http://www.nih.gov/news-events/news-releases
August 22, 2017
Scientists develop infection model for tick-borne flaviviruses
— Researchers say the work will greatly increase knowledge about how flaviviruses infect ticks.

UNAIDS [to 26 August 2017]
http://www.unaids.org/en
Update
Ending stigma and discrimination in health centres in Mexico
25 August 2017
Mexico has taken steps to strengthen access to health-care services by lesbian, gay, bisexual, transgender and intersex (LGBTI) people. A new Ministry of Health code of conduct aims to put an end to stigma and discrimination based on gender identity and sexual orientation in all health centres in the country.
Establishing guidelines and specific actions for the provision of health-care services, the code of conduct will be implemented throughout the national health system to guarantee effective access to health by respecting the dignity and autonomy of LGBTI people…

Update
UNAIDS fully compliant with UN-SWAP
22 August 2017
UNAIDS has been recognized for meeting or exceeding all of the 15 performance indicators of the United Nations System-wide Action Plan on Gender Equality and the Empowerment of Women (UN-SWAP), a year ahead of the deadline established by the United Nations System Chief Executives Board for Coordination….
 
Wellcome Trust  [to 26 August 2017]
https://wellcome.ac.uk/news
News / Published: 25 August 2017
A global call for action on drug-resistant infections
A global conference in October will accelerate action on tackling drug-resistant infections, one of the greatest health and economic challenges of our time.
The conference, in Berlin on 12 and 13 October 2017, is organised by Wellcome in partnership with the UK and Thai governments and the UN Foundation. It will support the work of the Antimicrobial Resistance Inter-Agency Coordination Group (IACG).
The event is an opportunity for national governments and multilateral institutions to come together with the civil society, private and philanthropic sectors to focus on the most critical gaps in tackling the development and spread of drug-resistant infections, and to commit to concerted and tangible actions…

News / Published: 24 August 2017
Leprosy turns immune system against itself
Researchers have shown for the first time how leprosy bacteria damage nerves by infiltrating the immune cells that are meant to protect us. 
The research found that leprosy hijacks the immune system, turning an important repair mechanism into one that causes potentially irreparable damage to nerve cells….

Journal Watch

   Vaccines and Global Health: The Week in Review continues its weekly scanning of key peer-reviewed journals to identify and cite articles, commentary and editorials, books reviews and other content supporting our focus on vaccine ethics and policy. Journal Watch is not intended to be exhaustive, but indicative of themes and issues the Center is actively tracking. We selectively provide full text of some editorial and comment articles that are specifically relevant to our work. Successful access to some of the links provided may require subscription or other access arrangement unique to the publisher.

If you would like to suggest other journal titles to include in this service, please contact David Curry at: david.r.curry@centerforvaccineethicsandpolicy.org

BMC Cost Effectiveness and Resource Allocation
http://resource-allocation.biomedcentral.com/
(Accessed 26 August 2017)

Research
Cost-effectiveness analysis of a universal mass vaccination program with a PHiD-CV 2+1 schedule in Malaysia
Xiao Jun Wang, Ashwini Saha and Xu-Hao Zhang
Published on: 22 August 2017
Conclusions
A PHiD-CV 2+1 universal mass vaccination program could substantially reduce pneumococcal disease burden versus no vaccination, and was expected to be cost-effective in Malaysia. A PHiD-CV 2+1 program was also expected to be a dominant choice over a PCV13 2+1 program in Malaysia.

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 26 August 2017)

Research article
Distribution of Streptococcus pneumoniae serotypes in the northeast macro-region of São Paulo state/Brazil after the introduction of conjugate vaccine
Infections caused by Streptococcus pneumoniae (Spn) still challenge health systems around the world, even with advances in vaccination programs. The present study evaluated the frequency of various Spn serotypes …
Marta Inês Cazentini Medeiros, Samanta Cristine Grassi Almeida, Maria Luiza Leopoldo Silva Guerra, Paulo da Silva, Ana Maria Machado Career and Denise de Andrade
BMC Infectious Diseases 2017 17:590
Published on: 25 August 2017

BMC Medicine
http://www.biomedcentral.com/bmcmed/content
(Accessed 26 August 2017)

Research article
The impact of repeated vaccination on influenza vaccine effectiveness: a systematic review and meta-analysis
From the patient perspective, our results support current season vaccination regardless of prior season vaccination. We found no overall evidence that prior season vaccination negatively impacts current season VE. It is important that future VE studies include vaccination history over multiple seasons in order to evaluate repeated vaccination in more detail.
Lauren C. Ramsay, Sarah A. Buchan, Robert G. Stirling, Benjamin J. Cowling, Shuo Feng, Jeffrey C. Kwong and Bryna F. Warshawsky
BMC Medicine 2017 15:159
Published on: 21 August 2017

EMBO Reports
01 August 2017; volume 18, issue 8
http://embor.embopress.org/content/18/8

Science & Society
Archives of and for scienceArchives for molecular biology preserve the heritage of science beyond the published record for future scholars
   Through preservation, cataloguing and guaranteeing the authenticity of historical evidence, scientific archives provide unique insight for future scholars into the history of science.
Anne‐Flore Laloë

Globalization and Health
http://www.globalizationandhealth.com/
[Accessed 26 August 2017]

Research
Association of experienced and evaluative well-being with health in nine countries with different income levels: a cross-sectional study
It is important to know whether the relationships between experienced and evaluative well-being and health are consistent across countries with different income levels. This would allow to confirm whether the …
Marta Miret, Francisco Félix Caballero, Beatriz Olaya, Seppo Koskinen, Nirmala Naidoo, Beata Tobiasz-Adamczyk, Matilde Leonardi, Josep Maria Haro, Somnath Chatterji and José Luis Ayuso-Mateos
Globalization and Health 2017 13:65
Published on: 23 August 2017

Research
Mapping mHealth (mobile health) and mobile penetrations in sub-Saharan Africa for strategic regional collaboration in mHealth scale-up: an application of exploratory spatial data analysis
Mobile health (mHealth), a term used for healthcare delivery via mobile devices, has gained attention as an innovative technology for better access to healthcare and support for performance of health workers i…
Seohyun Lee, Yoon-min Cho and Sun-Young Kim
Globalization and Health 2017 13:63
Published on: 22 August 2017

JAMA
August 22/29, 2017, Vol 318, No. 8, Pages 677-764
http://jama.jamanetwork.com/issue.aspx

Viewpoint
August 22/29, 2017
Multidimensional Evidence Generation and FDA Regulatory Decision Making – Defining and Using “Real-World” Data
Jonathan P. Jarow, MD1; Lisa LaVange, PhD1; Janet Woodcock, MD1
JAMA. 2017;318(8):703-704. doi:10.1001/jama.2017.9991
Initial Text
Evidence linking interventions with health outcomes is the basis for good health care decision making. The widespread use of electronic health records, administrative claims, and social media and the ubiquity of smart devices have created “big data” that heretofore have not been widely utilized. There is substantial enthusiasm for the use of real-world data sources to generate so-called real-world evidence (RWE), but confusion remains about what RWE means. Evidence generation is multidimensional, including data source, study design, and degree of pragmatism. Real-world evidence is defined by the data source and degree of pragmatism independent of study design. Generation of RWE therefore is not limited to observational studies but also includes randomized trials conducted in clinical settings. The US Food and Drug Administration (FDA) currently uses RWE in safety surveillance and development of drugs for rare diseases, but there are other potential applications…

The Lancet
Aug 26, 2017 Volume 390 Number 10097 p821-912
http://www.thelancet.com/journals/lancet/issue/current

Articles
Infection-related microcephaly after the 2015 and 2016 Zika virus outbreaks in Brazil: a surveillance-based analysis
Wanderson Kleber de Oliveira, Giovanny Vinícius Araújo de França, Eduardo Hage Carmo, Bruce Bartholow Duncan, Ricardo de Souza Kuchenbecker, Maria Inês Schmidt
 

Nature 
Volume 548 Number 7668 pp371-494  24 August 201
http://www.nature.com/nature/current_issue.html

Articles
A randomized synbiotic trial to prevent sepsis among infants in rural India
Pinaki Panigrahi, Sailajanandan Parida, Nimai C. Nanda, Radhanath Satpathy, Lingaraj Pradhan
+ et al.
Abstract
Sepsis in early infancy results in one million annual deaths worldwide, most of them in developing countries. No efficient means of prevention is currently available. Here we report on a randomized, double-blind, placebo-controlled trial of an oral synbiotic preparation (Lactobacillus plantarum plus fructooligosaccharide) in rural Indian newborns. We enrolled 4,556 infants that were at least 2,000 g at birth, at least 35 weeks of gestation, and with no signs of sepsis or other morbidity, and monitored them for 60 days. We show a significant reduction in the primary outcome (combination of sepsis and death) in the treatment arm (risk ratio 0.60, 95% confidence interval 0.48–0.74), with few deaths (4 placebo, 6 synbiotic). Significant reductions were also observed for culture-positive and culture-negative sepsis and lower respiratory tract infections. These findings suggest that a large proportion of neonatal sepsis in developing countries could be effectively prevented using a synbiotic containing L. plantarum ATCC-202195.

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 26 August 2017)

Research Article
“We are survivors and not a virus:” Content analysis of media reporting on Ebola survivors in Liberia
Elisabeth Anne-Sophie Mayrhuber, Thomas Niederkrotenthaler, Ruth Kutalek
Research Article | published 24 Aug 2017 PLOS Neglected Tropical Diseases
https://doi.org/10.1371/journal.pntd.0005845
Abstract
Background
The Ebola virus disease epidemic between 2013 and 2016 in West Africa was unprecedented. It resulted in approximately 28.000 cases and 10.000 Ebola survivors. Many survivors face social, economic and health-related predicaments and media reporting is crucially important in infectious disease outbreaks. However, there is little research on reporting of the social situation of Ebola survivors in Liberia.
Methods
The study used a mixed methods approach and analysed media reports from the Liberian Daily Observer (DOL), a daily newspaper available online in English. We were interested to know how the situation of Ebola survivors was portrayed; in what way issues such as stigma and discrimination were addressed; and which stigma reduction interventions were covered and how. We included all articles on the situation of Ebola survivors in the quantitative and in-depth qualitative analysis published between April 2014 and March 2016.
Results
The DOL published 148 articles that portrayed the social situation of Ebola survivors between the 24 months observation period. In these articles, Ebola survivors were often defined beyond biological terms, reflecting on a broader social definition of survivorship. Survivorship was associated with challenges such as suffering from after-effects, social and economic consequences and psychological distress. Almost 50% of the articles explicitly mentioned stigmatisation in their reporting on Ebola survivors. This was contextualised in untrustworthiness towards international responses and the local health care system and inconclusive knowledge on cures and transmission routes. In the majority of DOL articles stigma reduction and engaging survivors in the response was reported as crucially important.
Discussion
Reporting in the DOL was educational-didactical and well-balanced in terms of disseminating available medical knowledge and reflecting the social situation of Ebola survivors. While the articles contextualised factors contributing to stigmatisation throughout the reporting, journalistic scrutiny regarding effectiveness of interventions by government and NGOs was missing.
Author summary
The largest Ebola epidemic occurred in West Africa between 2013 and 2016. Liberia was one of the most affected countries with more than 1500 survivors registered. In the height of the Ebola outbreak survivors were increasingly included in the treatment and care of patients and in health sensitizing and social mobilisation efforts. However, the reintegration of survivors back into their communities proved to be challenging across West Africa. Media reporting plays a crucial role in health emergency situations. It gives visibility to what is considered as relevant, frames risk perception and can induce positive health behaviour practices and attitudes. In this study we analysed how one of Liberia’s largest newspapers portrayed and informed the public on the social situation of survivors, in what way it addressed the issues of stigma and discrimination and which stigma reduction interventions were covered and how. We found that reporting was overall comprehensive and well-balanced in terms of disseminating available medical knowledge, scrutinizing stigma. Reports also reflected on contributing factors such as untrustworthiness towards response as well as inconclusive understanding of cures and transmission routes. In a larger context this specific reporting was acting as corrective to what the larger public believed.

PLoS One
http://www.plosone.org/
[Accessed 26 August 2017]

Research Article
Religion and HPV vaccine-related awareness, knowledge, and receipt among insured women aged 18-26 in Utah
Julia Bodson, Andrew Wilson, Echo L. Warner, Deanna Kepka
Research Article | published 25 Aug 2017 PLOS ONE
https://doi.org/10.1371/journal.pone.0183725

Research Article
Cost-effectiveness of inactivated seasonal influenza vaccination in a cohort of Thai children ≤60 months of age
Wanitchaya Kittikraisak, Piyarat Suntarattiwong, Darunee Ditsungnoen, Sarah E. Pallas, Taiwo O. Abimbola, Chonticha Klungthong, Stefan Fernandez, Suchada Srisarang, Tawee Chotpitayasunondh, Fatimah S. Dawood, Sonja J. Olsen, Kim A. Lindblade
Research Article | published 24 Aug 2017 PLOS ONE
https://doi.org/10.1371/journal.pone.0183391

Science         
25 August 2017  Vol 357, Issue 6353
http://www.sciencemag.org/current.dtl

Policy Forum
Fostering reproducibility in industry-academia research
By B. R. Jasny, N. Wigginton, M. McNutt, T. Bubela, S. Buck, R. Cook-Deegan, T. Gardner, B. Hanson, C. Hustad, V. Kiermer, D. Lazer, A. Lupia, A. Manrai, L. McConnell, K. Noonan, E. Phimister, B. Simon, K. Strandburg, Z. Summers, D. Watts
Science25 Aug 2017 : 759-761 Full Access
Summary
Many companies have proprietary resources and/or data that are indispensable for research, and academics provide the creative fuel for much early-stage research that leads to industrial innovation. It is essential to the health of the research enterprise that collaborations between industrial and university researchers flourish. This system of collaboration is under strain. Financial motivations driving product development have led to concerns that industry-sponsored research comes at the expense of transparency (1). Yet many industry researchers distrust quality control in academia (2) and question whether academics value reproducibility as much as rapid publication. Cultural differences between industry and academia can create or increase difficulties in reproducing research findings. We discuss key aspects of this problem that industry-academia collaborations must address and for which other stakeholders, from funding agencies to journals, can provide leadership and support.

Vaccine
Volume 35, Issue 36, Pages 4659-4824 (24 August 2017)
http://www.sciencedirect.com/science/journal/0264410X/35/36?sdc=1

Conference report
Immune correlates of protection for dengue: State of the art and research agenda
Pages 4659-4669
Leah C. Katzelnick, Eva Harris, Participants in the Summit on Dengue Immune Correlates of Protection
Abstract
Dengue viruses (DENV1-4) are mosquito-borne flaviviruses estimated to cause up to ∼400 million infections and ∼100 million dengue cases each year. Factors that contribute to protection from and risk of dengue and severe dengue disease have been studied extensively but are still not fully understood. Results from Phase 3 vaccine efficacy trials have recently become available for one vaccine candidate, now licensed for use in several countries, and more Phase 2 and 3 studies of additional vaccine candidates are ongoing, making these issues all the more urgent and timely. At the “Summit on Dengue Immune Correlates of Protection”, held in Annecy, France, on March 8–9, 2016, dengue experts from diverse fields came together to discuss the current understanding of the immune response to and protection from DENV infection and disease, identify key unanswered questions, discuss data on immune correlates and plans for comparison of results across assays/consortia, and propose a research agenda for investigation of dengue immune correlates, all in the context of both natural infection studies and vaccine trials.

Vaccine
Volume 35, Issue 36, Pages 4659-4824 (24 August 2017)
http://www.sciencedirect.com/science/journal/0264410X/35/36?sdc=1

Commentary
Vaccine opponents’ use of Twitter during the 2016 US presidential election: Implications for practice and policy
Pages 4670-4672
Mark Dredze, Zachary Wood-Doughty, Sandra Crouse Quinn, David A. Broniatowski

Vaccine
Volume 35, Issue 36, Pages 4659-4824 (24 August 2017)
http://www.sciencedirect.com/science/journal/0264410X/35/36?sdc=1

Socioeconomic factors influencing childhood vaccination in two northern Italian regions
Original Research Article
Pages 4673-4680
Paola Anello, Laura Cestari, Tatjana Baldovin, Lorenzo Simonato, Gabriella Frasca, Nicola Caranci, Maria Grazia Pascucci, Francesca Valent, Cristina Canova
Abstract
Background
Infant vaccination rates have been declining in Italy over the past 5–7 years. The aims of this study were to assess the trend in the proportions of children unvaccinated at 24 months old, to identify sociodemographic factors associated with non-vaccination; and to examine changes in parental attitudes to vaccination over time.
Methods
We conducted a population-based birth cohort study by combining existing electronic data sets. The study population consisted of children born from 1995 to 2010 in the Friuli-Venezia Giulia (FVG) region, and from 2007 to 2011 in part of the Emilia Romagna (ER) region, in north-eastern Italy. The immunization registers were linked with the medical birth registers, which contain sociodemographic data on both parents and the newborn. Unconditional logistic regressions were used to identify associations between vaccine uptake at 24 months and maternal sociodemographic variables.
Results
Of 145,571 babies born in FVG and 75,308 in ER, there were 4222 (1.9%) who had not been vaccinated at all, and 23,948 (11.0%) without the optional measles, mumps and rubella (MMR) vaccination. The number of unvaccinated infants increased over time. Mothers who were over 35 or under 25 years old, unmarried, with a higher formal education, and citizens of highly-developed countries were less compliant with vaccination recommendations in both the regions. A cohort effect was observed in FVG, for both educational level and citizenship: babies born between 1995 and 2000 to mothers without an Italian citizenship and with a lower formal education were more likely to refuse vaccination for their offspring, while this association was reversed between 2006 and 2010.
Conclusions
Mothers who are Italian citizens and have a good formal education have begun to refuse vaccination for their children in recent years. Future public health action in this setting should target highly educated parents.

Vaccine
Volume 35, Issue 36, Pages 4659-4824 (24 August 2017)
http://www.sciencedirect.com/science/journal/0264410X/35/36?sdc=1

Untangling the psychosocial predictors of HPV vaccination decision-making among parents of boys
Original Research Article
Pages 4713-4721
Samara Perez, Ovidiu Tatar, Vladimir Gilca, Gilla K. Shapiro, Gina Ogilvie, Juliet Guichon, Anila Naz, Zeev Rosberger
Abstract
Background
HPV vaccination uptake in boys is suboptimal in many jurisdictions, particularly in the absence of publicly funded HPV vaccination programs. Parents represent key decision-makers of HPV vaccination and their HPV vaccine decision-making stage is influenced by multiple psychosocial determinants. Our objective was to assess the relationship between a broad range of psychosocial factors and parents of boys’ HPV vaccine decision-making stage.
Methods
Data were collected through an online survey from a nationally representative sample of Canadian parents of boys in February (T1) and November 2014 (T2). We assessed a broad number of psychosocial factors including: socio-demographics, health behaviours and validated scales for assessing HPV knowledge, attitudes and beliefs. Parents selected their HPV vaccination adoption stage based on the Precaution Adoption Process Model (PAPM). Multinomial logistic regression was used to test the association between predictors and PAPM stage at T1 and T2.
Results
Discussion with a healthcare provider about the HPV vaccine and increased HPV knowledge was associated with increased odds of being in the more advanced PAPM stages. Increased perception of risks in the absence of HPV vaccination, increased perception that others endorse HPV vaccination and positive attitudes related to vaccines in general were associated with increased odds of being in the decided to vaccinate stage. Believing that HPV vaccination is harmful increased, and perceiving the benefits of HPV vaccination decreased the odds of deciding not to vaccinate.
Conclusions
This study highlights the psychosocial predictors of the decision-making stage reported by parents regarding HPV vaccination of their sons, that were significant at two time-points. Targeted interventions that consider the impact of the health care provider and address knowledge gaps as well as individual beliefs about benefits, risks, and harms of the HPV vaccine and vaccines in general should be implemented to help parents make better informed decisions that is, to move closer to actual vaccination adoption.

Vaccine
Volume 35, Issue 36, Pages 4659-4824 (24 August 2017)
http://www.sciencedirect.com/science/journal/0264410X/35/36?sdc=1

Responding to a cVDPV1 outbreak in Ukraine: Implications, challenges and opportunities
Original Research Article
Pages 4769-4776
Nino Khetsuriani, Ihor Perehinets, Dorit Nitzan, Dragoslav Popovic, Thomas Moran, Vusala Allahverdiyeva, Shahin Huseynov, Eugene Gavrilin, Liudmyla Slobodianyk, Olha Izhyk, Anna Sukhodolska, Sahar Hegazi, Katerina Bulavinova, Sergei Platov, Patrick O’Connor
Abstract
Background
The European Region, certified polio-free in 2002, remains at risk of wild poliovirus reintroduction and emergence of circulating vaccine-derived polioviruses (cVDPV) until global polio eradication is achieved, as demonstrated by the cVDPV1 outbreak in Ukraine in 2015.
Methods
We reviewed epidemiologic, clinical and virology data on cVDPV cases, surveillance and immunization coverage data, and reports of outbreak-related surveys, country missions, and expert group meetings.
Results
In Ukraine, 3-dose polio vaccine coverage declined from 91% in 2008 to 15% by mid-2015. In summer, 2015, two unrelated children from Zakarpattya province were paralyzed by a highly divergent cVDPV1. The isolates were 20 and 26 nucleotide divergent from prototype Sabin strain (with 18 identical mutations) consistent with their common origin and ∼2-year evolution. Outbreak response recommendations developed with international partner support included conducting three nationwide supplementary immunization activities (SIAs) with tOPV, strengthening surveillance and implementing communication interventions. SIAs were conducted during October 2015-February 2016 (officially reported coverage, round 1–64.4%, round 2–71.7%, and round 3–80.7%). Substantial challenges to outbreak response included lack of high-level support, resistance to OPV use, low perceived risk of polio, widespread vaccine hesitancy, anti-vaccine media environment, economic crisis and military conflict. Communication activities improved caregiver awareness of polio and confidence in vaccination. Surveillance was enhanced but did not consistently meet applicable performance standards. Post-outbreak assessments concluded that cVDPV1 transmission in Ukraine has likely stopped following the response, but significant gaps in population immunity and surveillance remained.
Conclusions
Chronic under-vaccination in Ukraine resulted in the accumulation of children susceptible to polioviruses and created favorable conditions for VDPV1 emergence and circulation, leading to the outbreak. Until programmatic gaps in immunization and surveillance are addressed, Ukraine will remain at high-risk for VDPV emergence and circulation, as well as at risk for other vaccine-preventable diseases.

From Google Scholar & other sources: Selected Journal Articles, Newsletters, Dissertations, Theses, Commentary
 
Pan African Medical Journal
2017;27 (Supp 3):19.
doi:10.11604/pamj.supp.2017.27.3.11544
Commentary
Delayed introduction of the birth dose of Hepatitis B vaccine in EPI programs in East Africa: a missed opportunity for combating vertical transmission of Hepatitis B
B Bodo, OO Malande –
Abstract
Vertical Transmission of hepatitis B virus is a major route through which children acquire Hepatitis B infection. Only 10 out of 47 countries in Africa, and none from East Africa; have implemented the WHO recommendation of introducing a birth-dose of hepatitis B vaccine in their EPI program. This article therefore examines the challenges as well as the opportunities that exists for the introduction of a birth-dose of hepatitis vaccine in the National Expanded Program for Immunization (EPI) program by countries in the East African Region. It explores probable health systems factors that have hindered the countries from introducing the birth dose of hepatitis B and proposes actions that countries can take to introduce the vaccine based on their context by drawing on the experience of some Asian countries.

Media/Policy Watch
This watch section is intended to alert readers to substantive news, analysis and opinion from the general media and selected think tanks and similar organizations on vaccines, immunization, global public health and related themes. Media Watch is not intended to be exhaustive, but indicative of themes and issues CVEP is actively tracking. This section will grow from an initial base of newspapers, magazines and blog sources, and is segregated from Journal Watch above which scans the peer-reviewed journal ecology.

We acknowledge the Western/Northern bias in this initial selection of titles and invite suggestions for expanded coverage. We are conservative in our outlook in adding news sources which largely report on primary content we are already covering above. Many electronic media sources have tiered, fee-based subscription models for access. We will provide full-text where content is published without restriction, but most publications require registration and some subscription level.
 

Forbes
http://www.forbes.com/
Accessed 26 August 2017
Zipline Is Launching The World’s Largest Drone Delivery Network In Tanzania
Leif Walcutt , Forbes Staf
Aug 24, 2017
One of the greatest challenges in global health is how countries can keep a proper supply of life-saving medicines in rural areas. In some, like Rwanda and Tanzania, governments keep low stock due to the high cost of storage — a reality known as “stock outs” — meaning it can sometimes take upwards of four hours for life-saving medical supplies to arrive.
Enter Zipline, a California-based logistics company that has been operating a blood delivery service in Rwanda since October 2016. It now transports 20% of the nation’s blood supply outside Kigali and announced Thursday plans to expand into Tanzania, where 68% of the country’s 55 million-person population resides in rural areas.
When fully in place, Zipline will have four distribution centers across Tanzania, offering a range of medical supplies becoming the largest drone delivery system in the world…

Why Opting Out of Vaccinations Puts The Greater Population At Risk
Aug 22, 2017
Given that vaccines cause immunity, then why are unvaccinated people considered a danger to the vaccinated ones? This question was originally answered on Quora by Tirumalai Kamala.

Washington Post
http://www.washingtonpost.com/
Accessed 26 August 2017
Despite measles outbreak, anti-vaccine activists in Minnesota refuse to back down
By Lena H. Sun
August 21, 2017
Minnesota’s worst measles outbreak in decades has un­expectedly energized anti-vaccine forces, who have stepped up their work in recent months to challenge efforts by public health officials and clinicians to prevent the spread of the highly infectious disease.

In Facebook group discussions, local activists have asked about holding “measles parties” to expose unvaccinated children to others infected with the virus so they can contract the disease and acquire immunity. Health officials say they are aware of the message posts but haven’t seen evidence that such parties are taking place.

The activists also are using social media to urge families who do not want to immunize their children or who believe their children have been harmed by vaccines to meet in Minneapolis this week with associates of Andrew Wakefield, the founder of the modern anti-vaccine movement. The associates have been touring the United States and abroad with the former doctor’s movie, “Vaxxed: From Cover-up to Catastrophe,” which repeats the debunked theory that vaccines cause autism and that scientists, pediatricians and the public health system are part of an elaborate conspiracy. A recent fundraiser at the clinic of a suburban Minneapolis pediatrician who supports “alternative vaccine schedules” benefited a second film that also will feature Wakefield, whose research has been retracted for falsehoods.

The activity in Minnesota has taken some immunization supporters and clinicians by surprise…

Think Tanks et al

CSIS
https://www.csis.org/
Accessed 26 August 2017
Blog Post
New Partnerships Needed after Ebola’s Hard Lessons
April 25, 2017 | By J. Stephen Morrison, Chris Millard

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_19 August 2017

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Support this knowledge-sharing service: Your financial support helps us cover our costs and to address a current shortfall in our annual operating budget. Click here to donate and thank you in advance for your contribution.

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

Milestones :: Perspectives
 
Yemen
Cholera count reaches 500,000 in Yemen
WHO News release
14 August 2017 | GENEVA – The total number of suspected cholera cases in Yemen this year hit the half a million mark on Sunday, and nearly 2000 people have died since the outbreak began to spread rapidly at the end of April.

The overall caseload nationwide has declined since early July, particularly in the worst affected areas. But suspected cases of the deadly waterborne disease continue to rage across the country, infecting an estimated 5000 people per day.

The spread of cholera has slowed significantly in some areas compared to peak levels but the disease is still spreading fast in more recently affected districts, which are recording large numbers of cases.

Yemen’s cholera epidemic, currently the largest in the world, has spread rapidly due to deteriorating hygiene and sanitation conditions and disruptions to the water supply across the country. Millions of people are cut off from clean water, and waste collection has ceased in major cities.

A collapsing health system is struggling to cope, with more than half of all health facilities closed due to damage, destruction or lack of funds. Shortages in medicines and supplies are persistent and widespread and 30 000 critical health workers have not been paid salaries in nearly a year.

“Yemen’s health workers are operating in impossible conditions. Thousands of people are sick, but there are not enough hospitals, not enough medicines, not enough clean water. These doctors and nurses are the backbone of the health response – without them we can do nothing in Yemen. They must be paid their wages so that they can continue to save lives,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General.

WHO and partners are working around the clock to set up cholera treatment clinics, rehabilitate health facilities, deliver medical supplies, and support the national health response effort.
More than 99% of people sick with suspected cholera who can access health services are surviving. Furthermore, nearly 15 million people are unable to get basic healthcare.

“To save lives in Yemen today we must support the health system, especially the health workers. And we urge the Yemeni authorities – and all those in the region and elsewhere who can play a role – to find a political solution to this conflict that has already caused so much suffering. The people of Yemen cannot bear it much longer – they need peace to rebuild their lives and their country,” said Dr. Tedros.

The Lancet
Aug 12, 2017 Volume 390 Number 10095 p625-714
http://www.thelancet.com/journals/lancet/issue/current
Editorial
Yemen and cholera: a modern humanity test
The Lancet
Urgent warnings began in May as aid agencies called for an immediate response to the growing cholera outbreak in Yemen. By mid-July, over 330,000 cholera cases were reported, with 1700 deaths. Since 2015, a civil war has left 14·5 million people (half the country’s population) without access to clean water and sanitation. The UN has called it the “world’s worst cholera outbreak in the context of the world’s worst humanitarian crisis”. The war, unpaid worker salaries, a decimated health system, controversies around the undeployed cholera vaccine stockpile, and slow global funding efforts are all somehow to blame. Pre-existing health indicators are grim and the estimated 400 000 severely malnourished Yemeni children are particularly vulnerable. Famine and other preventable communicable diseases are forecast. Indisputedly, a ceasefire is needed to allow access to humanitarian aid and abate further suffering and death.

As a collective humanity, the shame is ours to bear. The position of The Lancet family of journals is that with all current knowledge and commitments to acting early on cholera outbreaks, such escalated death rates quite simply should not happen. Cholera has been ravaging communities for two centuries. Yet in 2017, outbreaks are entirely containable early with coordinated efforts to implement water, sanitation, and medical rehydration treatment.
There is a vaccine and antibiotics exist. For workers who witnessed the 1994 cholera outbreak among the Rwandan refugees, which killed 12 000 people in Goma, eastern Zaire, this current humanitarian crisis echoes both the indignation and the slow response to an early warning. Unlike Goma, however, the Yemen crisis has unfolded under the global scrutiny of the internet.

On the eve of World Humanitarian Day, Aug 19, Yemen must be foremost among priorities of every institution and government acting for global health. Containing the cholera crisis and reinstating health and personal security for 27 million Yemeni people is the high stakes sustainable development test for how humanity can and will organise around vocalised commitments to protect the most vulnerable among us today.

Statement by the Humanitarian Coordinator in Yemen Mr. Jamie McGoldrick on Shrinking Humanitarian Space in Yemen [EN/AR]
Sana’a, 17 August 2017: I am deeply concerned by the shrinking humanitarian space in Yemen where parties to the conflict continue to obstruct the timely provision of humanitarian aid to people in need.

For months, humanitarian partners have experienced delays by authorities in Sana’a to facilitate the entry of aid workers into Yemen, interference in the delivery of humanitarian assistance and the choice of implementing partners and obstructions in the conduct of assessments. There have also been increased incidents of aid diversion away from intended beneficiaries in areas under the control of the Sana’a authorities.

I am specifically concerned about the looting of food aid and other humanitarian goods in Taizz Governorate where there have been three separate incidents over a period of two months. Since January 2017, eleven vehicles belonging to humanitarian organisations have been hijacked in Taizz City in areas under the control of the Government of Yemen.

While I acknowledge the efforts of the authorities and local leaders to recover looted items, more needs to be done to ensure a safe and secure operational environment conducive to the timely delivery of humanitarian assistance to people in need. All of these incidents delay the provision of urgently need help to those most affected by the conflict while at the same time putting humanitarian staff at risk.

As basic social services in Yemen are near collapse, there is mounting pressure on humanitarian organisations to expand the humanitarian response. Ensuring unhindered humanitarian access is essential to save the lives of those who depend on assistance, particularly as Yemen is facing an unprecedented cholera crisis and over seven million people are at risk of famine. I urge all parties to the conflict to uphold their obligations under international humanitarian law to facilitate the safe and unhindered delivery of humanitarian assistance in areas under their control.

Emergencies
 
POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 16 August 2017 [GPEI]
:: Marking Pakistan’s Independence Day this week, Canadian Prime Minister Justin Trudeau paid tribute to both countries’ ongoing collaboration, including on the effort to eradicate polio.  “Our two countries established a diplomatic relationship shortly after Pakistan was declared a sovereign nation in 1947. We continue to work together to advance shared priorities, including governance and democracy, regional security, poverty reduction, polio eradication, trade, defense, and the fight against climate change.”

:: The 14th Emergency Committee for polio eradication under the International Health Regulations met on 3 August and has made its recommendations to the WHO Director-General, who has accepted them.  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.  The key change is the inclusion of DR Congo and Syria in the category ‘States infected with cVDPV2s, with potential risk of international spread’.

:: Long-time polio eradicator Iris Tetford retires:  the partners of the Global Polio Eradication Initiative (GPEI) wish Iris Tetford a well-deserved and happy retirement.  For years, Ms Tetford has been an integral part of the polio eradication team at WHO in Geneva.  She contributed substantially to the creation of the weekly global update, and continuously close coordinated with regional and country counterparts to manage the weekly data analysis and public reporting process.  Many thanks for your tremendous engagement and contribution to the global eradication effort, Iris!  We wish you all the best for your well-deserved retirement.

:: Summary of newly-reported viruses this week:  Afghanistan:  one new wild poliovirus type 1 (WPV1) case; Pakistan:  one new WPV1-positive environmental sample; Syrian Arab Republic:  three new circulating vaccine-derived polio type 2 (cVDPV2) from Syria, two from Deir-Ez-Zour and one from Homs governorates…

::::::
 
Statement of the 14th IHR Emergency Committee regarding the international spread of poliovirus
WHO statement
3 August 2017
[Excerpts; Editor’s text bolding]]
The fourteenth meeting of the Emergency Committee under the International Health Regulations (2005) (IHR) regarding the international spread of poliovirus was convened by the Director General on 3 August 2017 at WHO headquarters with members, advisers and invited member states attending via teleconference.

The Emergency Committee reviewed the data on wild poliovirus (WPV1) and circulating vaccine derived 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 current situation and the implementation of the WHO Temporary Recommendations since the Committee last met on 24 April2017: Afghanistan, Democratic Republic of Congo (DR Congo), Nigeria, Pakistan and Syria….

Conclusion
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…

Additional considerations
The Director-General Dr Tedros attended the Emergency Committee and listened to the recommendations of the committee. He thanked Committee Members and Advisors for their advice, and noted that in the context of polio eradication, even one case of polio should be treated as an emergency. He noted that in all the geographic areas reviewed by the committee at the meeting, a sub-regional or multi-country coordinated response greatly improved the chance of success, and that to achieve the final goal of zero cases, the world may need to respond even more aggressively. He affirmed that he was personally committed as Director-General to providing any support needed to reduce the risk of the international spread of polio recommended by the committee.

The Committee strongly urged global partners in polio eradication to provide optimal support to all infected and vulnerable countries at this critical time in the polio eradication programme for implementation of the Temporary Recommendations under the IHR, as well as providing ongoing support to all countries that were previously subject to Temporary Recommendations (Somalia, Ethiopia, Iraq, Israel and Equatorial Guinea).

The Committee urged all countries to avoid complacency which could easily lead to a resurgence of polio. Surveillance particularly needs careful attention to quickly detect any new transmission, and careful assessment of where insecurity and inaccessibility impact on surveillance was needed. Similarly, there needs to be tracking of populations where there are high proportions of unvaccinated children due to inaccessibility, and requested the secretariat to include a report on this issue at its next meeting.

Based on the current situation regarding WPV1 and cVDPV, and the reports made by Afghanistan, DR Congo, Nigeria, Pakistan, and Syria, the Director-General accepted the Committee’s assessment and on 3 August 2017 determined that the situation relating to poliovirus continues to constitute a PHEIC, with respect to WPV1 and cVDPV…

::::::

Situation reports on the polio outbreak in Syria
Situation update 8 August 2017
Three (3) new cases of cVDPV2 were reported this week from 3 new districts: 1 case from Deir Ez-Zor district, Deir Ez-Zor governorate; 1 from Boukamal district, Deir Ez-Zor governorate; and 1 from Tadmour district, Homs governorate.

Five districts in 3 governorates are now infected.

The total number of cVDPV2 cases is 33 (this includes the previously reported 29 cases from Mayadeen district, Deir Ez-Zor governorate, and 1 case from Tell Abyad district, Raqqa governorate). All confirmed cases to date have had onset of paralysis before 11 July 2017.
Final laboratory results for an additional 9 poliovirus type-2 (PV2) isolates from Deir Ez-Zor are pending.

Discussions around expanding the scope of the immunization response to include accessible areas of a Tadmour sub-district in Homs, bordering Deir Ez-Zor, will be held in light of the confirmation of the cases in this area.

Raqqa governorate commenced its first immunization round on 12 August (Raqqa and Thawra districts) and 13 August (Tell Abyad district). The immunization round aims to reach 120 000 children under 5 years of age. Preliminary information suggests the rounds are reaching children in all three districts.

Preparations continue for the second round in Deir Ez-Zor governorate, scheduled for 19-23 August. IPV for use in the second rounds in Deir Ez-Zor and Raqqa governorates has arrived in Damascus.

The total number of AFP cases detected in Deir Ez-Zor governorate since the beginning of 2017 is 113 (83 from Mayadeen, 11 from Deir Ez-Zor, and 19 from Boukamal districts). Raqqa governorate has reported 16 AFP cases (5 from Raqqa, 10 from Tell Abyad, and 1 from Thawra districts). Homs governorate has reported 26 AFP cases (11 from Homs city, 12 from Rastan, 1 from Tadmour and 2 from Talkalakh districts).

The Eradication and Outbreak Management Group (EOMG) has approved the release of additional doses of IPV to cover high-risk population groups in northwest Syria, Turkey and Lebanon. Lebanon requested 144 000 doses and has begun to implement IPV campaigns across the country.

::::::
::::::

WHO Grade 3 Emergencies  [to 19 August 2017]
Yemen –
::  Cholera count reaches 500,000 in Yemen  14 August 2017

The Syrian Arab Republic –
:: Situation reports on the polio outbreak in Syria  8 August 2017
 [See Polio above for more detail]

Nigeria
:: WHO and partners take on malaria: the top killer in north-eastern Nigeria
August 2017
WHO estimates up to 10 000 lives could be saved by November through malaria prevention and control, if more funds are secured

::::::
 
WHO Grade 2 Emergencies  [to 19 August 2017]
Ethiopia
:: Reaching key populations to prevent the spread of disease in Ethiopia  10 August 2017
:: Community engagement contributes to control of acute watery diarrhea in Ethiopia’s Somali region  2 August 2017

Ukraine 
:: World Humanitarian Day: WHO urges more health aid to address Ukraine’s humanitarian crisis  18 August 2017

::::::
::::::
 
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 No. 41 (27 July to 8 August 2017)

Syrian Arab Republic
:: 19 Aug 2017   One Syrian doctor’s determination in the face of violence and displacement

Yemen
:: 17 Aug 2017  Statement by the Humanitarian Coordinator in Yemen Mr. Jamie McGoldrick on Shrinking Humanitarian Space in Yemen [EN/AR]
:: 13 Aug 2017  Yemen Humanitarian Bulletin Issue 26 | 14 August 2017
:: Revised 2017 Yemen Humanitarian Response Plan (YHRP)

::::::

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.
Ethiopia
:: Ethiopia Weekly Humanitarian Bulletin, 7 August 2017

DRC
:: United in the fight against sexual violence in North Kivu 12 Aug 2017
   The widespread use of sexual violence in North-Kivu

Somalia
:: Horn of Africa: Humanitarian Impacts of Drought – Issue 9 (10 Aug 2017)
 
Nigeria.
:: Statement by the UN Deputy Humanitarian Coordinator for Nigeria, Peter Lundberg – Press Conference, 12 August 2017
…Responding to the humanitarian needs of millions of people in the northeast remains our priority and our focus, each and every day. The fact remains that the humanitarian crisis in Nigeria’s north-east and the Lake Chad region – now in its eighth year – is one of the most severe in the world today, with 8.5m people in need of humanitarian assistance in 2017 in the worst-affected states of Borno, Adamawa and Yobe, and 6.9m targeted for humanitarian assistance in these three states.
Civilians continue to bear the brunt of a conflict that has resulted in widespread forced displacement – today more than 1.8 million are internally displaced – and violations of international humanitarian and human rights law, severe protection concerns and a food and nutrition crisis of massive proportions.
Women and girls are also disproportionately affected by this…

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

MERS-CoV [to 19 August 2017]
http://www.who.int/emergencies/mers-cov/en/
21 July 2017   WHO/MERS/RA
DONs
Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia
17 August 2017
Between 4 July and 12 August 2017, the national IHR Focal Point of Saudi Arabia reported 26 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection including six deaths, and two deaths among previously reported cases…Globally, 2066 laboratory-confirmed cases of infection with MERS-CoV including at least 720 related deaths have been reported to WHO..

WHO & Regional Offices [to 19 August 2017]
Patients, health workers and hospitals are #NotATarget
18 August 2017 – Last year 418 people died because health facilities were attacked. Every hospital destroyed and every health worker killed or injured takes years of health services away from the people who need them most. Stop attacks on health care.

Highlights
Reaching key populations to prevent the spread of disease in Ethiopia
August 2017 – In Ethiopia, thousands of pilgrims flock to holy water sites for spiritual cleansing and physical healing. People often drink the holy water and perform ceremonial cleansing, but there is a risk that these sites can be contaminated with bacteria, causing waterborne diseases.

Breaking the link between disability and exclusion in Tajikistan
August 2017 – Several hundred Tajik people developed impairments and now need long-term rehabilitation care following a large poliomyelitis (polio) outbreak in 2010, which also spread to 3 neighbouring countries. To improve the provision of and access to rehabilitation services for people with disabilities in Tajikistan, WHO set up a disability rehabilitation programme in 2013 that focuses on people affected by polio.

WHO delivers medicines and medical supplies to Al-Qamishli, Syria
August 2017 – For the first time in 3 years, WHO has delivered almost 30 tons of medicines and medical supplies by road to health facilities and mobile clinics in Al-Qamishli. The supplies will support the delivery of health services to displaced people from northern and eastern regions of Syria.

::::::
 
Disease outbreak news
:: Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia  17 August 2017
:: Human infection with avian influenza A(H7N9) virus – China  7 August 2017
:: Dengue fever – Côte d’Ivoire  4 August 2017

::::::

Weekly Epidemiological Record, 18 August 2017, vol. 92, 33 (pp. 453–476)
:: Progress towards poliomyelitis eradication: Afghanistan, January 2016–June 2017
:: Human cases of influenza at the human-animal interface, January 2015–April 2017
:: Health conditions for travellers to Saudi Arabia for the pilgrimage to Mecca (Hajj), 2017

Weekly Epidemiological Record, 11 August 2017, vol. 92, 32 (pp. 437–452)
:: Deployments from the oral cholera vaccine stockpile, 2013–2017
:: Yellow fever in Africa and the Americas, 2016

Weekly Epidemiological Record, 4 August 2017, vol. 92, 31 (pp. 417–436)
:: Diphtheria vaccine: WHO position paper – August 2017
:: WHO African Region Immunization Technical Advisory Group: Call for nominations

::::::
 
WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: South Sudan – Oral Cholera Vaccination campaign to combat cholera in South Sudan concludes despite security and access challenges  16 August 2017
:: Taking stock of lessons learnt from the Cholera outbreak response in Tanzania 14 August 2017
The United Republic of Tanzania is battling an outbreak of Cholera…
:: Seventy seven percent (77%) of children 12 – 23 months in Nigeria did not receive all routine immunization – Survey findings  13 August 2017
Abuja, 10 August, 2017 – A major survey finding from 2016…
:: WHO supports the development of the Seychelles’ Introduction Plan for Rotavirus and Pneumococcal Vaccines 09 August 2017

WHO Region of the Americas PAHO
:: PAHO Launches New Initiative to Eliminate Mother-to-Child Transmission of Four Diseases (08/10/2017)
The series of interventions seek to reduce the number of children born with HIV, syphilis, Chagas disease, or hepatitis B in Latin America and the Caribbean
 
WHO South-East Asia Region SEARO
:: Milkha Singh appointed WHO Goodwill Ambassador for Physical Activity in South-East Asia Region  11 August 2017
 
WHO European Region EURO
:: World Humanitarian Day: WHO urges more health aid to address Ukraine’s humanitarian crisis 18-08-2017
:: Experts and patients come together on people-centred hepatitis response in the Russian Federation 11-08-2017
:: Course on health financing for universal health coverage offered in Russian 11-08-2017
:: Breaking the link between disability and exclusion in Tajikistan 07-08-2017
:: Prenatal classes in Georgia turn pregnancy into a life-course opportunity for health 01-08-2017

WHO Eastern Mediterranean Region EMRO
:: Cholera count reaches 500 000 in Yemen  14 August 2017
 
WHO Western Pacific Region
:: Progress on Early Essential Newborn Care in the Western Pacific Region, but millions of newborn infants remain at risk  DA NANG, Viet Nam, 14 August 2017
 

CDC/ACIP [to 19 August 2017]
http://www.cdc.gov/media/index.html
Friday, August 04, 2017

CDC invests more than $200 million to help states respond to infectious disease threats –
The Centers for Disease Control and Prevention (CDC) has awarded more than $200 million through the Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) cooperative agreement to help states, cities, counties, and territories prevent, detect, respond to, and control the growing threats posed by emerging and re-emerging infectious diseases. State programs are the foundation of the U.S. public health system and are integral to the nation’s efforts to combat infectious disease threats. CDC and states work together to improve local surveillance, laboratory diagnostic capabilities, and outbreak response…

Friday, August 04, 2017
Zika Virus CDC’s Emergency Operations Center is activated at Level 2 to respond to Zika. Zika is currently a risk in many countries and territories.
 
MMWR News Synopsis for August 17, 2017
:: Progress Toward Poliomyelitis Eradication — Afghanistan, January 2016–June 2017
Afghanistan has made progress in its polio eradication efforts during the period of January 2016 to June 2017. To accomplish eradication, it is critical that Afghanistan continue to focus on improving campaign quality in the southern part of the country through enhanced oversight and targeted campaigns. Both Afghanistan and Pakistan should continue prioritizing coordination on surveillance and vaccination activities to track and vaccinate children among their high-risk mobile populations. This report highlights polio eradication progress, challenges, and solutions implemented in Afghanistan during January 2016–June 2017. Thirteen cases were confirmed in 2016, a decrease from 20 cases reported in 2015. From January to June 2017, five cases were reported, compared with six during the same period in 2016. The polio program in Afghanistan has enhanced its management and accountability during vaccination campaigns and strengthened its coordination with Pakistan to track and vaccinate the children in high-risk populations that move between both countries. Vaccination teams have been increased at transit points in and out of areas that are inaccessible due to security challenges, as well as along travel routes and at border crossings. Community-based religious leaders and volunteers are deployed to increase acceptance of vaccination among families that had previously refused and to follow up after campaigns to identify and vaccinate children who were missed.

MMWR News Synopsis for August 3, 2017
:: Meningitis Outbreak Caused by Vaccine-Preventable Bacterial Pathogens — Northern Ghana, 2016
Building and sustaining laboratory and surveillance capacity in countries where meningitis outbreaks are common is critical to ensure rapid and effective response to meningitis outbreaks.   
Bacterial meningitis can lead to death and serious disabilities such as deafness, nervous system problems, and brain damage. Countries in the meningitis belt of sub-Saharan Africa, including Ghana, have the highest incidence of bacterial meningitis and experience seasonal epidemics. During 2015-2016, Ghana experienced an increase in pneumococcal meningitis followed by a large outbreak of N. meningitidis serogroup W meningitis. Based on laboratory and epidemiologic data, more than 130,000 doses of meningococcal serogroup W containing vaccine were administered to the most affected districts. Rapid identification of the bacterium causing meningitis outbreaks is critical for directing targeted public health interventions, including vaccination.

Announcements
 
EDCTP    [to 19 August 2017]
http://www.edctp.org/
The European & Developing Countries Clinical Trials Partnership (EDCTP) aims to accelerate the development of new or improved drugs, vaccines, microbicides and diagnostics against HIV/AIDS, tuberculosis and malaria as well as other poverty-related and neglected infectious diseases in sub-Saharan Africa, with a focus on phase II and III clinical trials
2 August 2017
Independent observer assesses Scientific Review Committee meetings
To ensure the integrity of its evaluation procedures and to find ways to improve quality, efficiency and transparency, EDCTP recently enlisted the assistance of independent experts to observe and critically examine its peer review evaluation process…

European Medicines Agency  [to 19 August 2017]
http://www.ema.europa.eu/ema/
08/08/2017
EMA supports regulatory harmonisation in East Africa
East African Community (EAC) envisages the creation of regional regulatory entity
01/08/2017
EMA encourages tailored development of medicines for older people
EMA invites comments on reflection paper by 31 January 2018
 
European Vaccine Initiative  [to 19 August 2017]
http://www.euvaccine.eu/news-events
14 August 2017
Medicines Evaluation Board (MEB) to join VAC2VAC
VAC2VAC is pleased to announce that one year after its start it has already created enough interest to have the Medicines Evaluation Board (MEB), a regulatory agency and an independent administrative body residing under the Government of the Netherlands, joining its membership.
For VAC2VAC, that aims to establish ‘Vaccine batch to vaccine batch comparison by consistency testing’, i.e. replacing animal test with non-animal assays, having regulatory agencies as partners is an important contribution towards its goal…

04 August 2017
VAC2VAC: Progress summary of first year
During the first year of the VAC2VAC project ample of process has been made.

31 July 2017
TRANSVAC2: Funding for European vaccine research infrastructure
The European Commission (EC), in the context of the Horizon 2020 Framework Programme, commits significant funding to TRANSVAC, , a European vaccine research and development (R&D) infrastructure…
 
FDA [to 19 August 2017]
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
What’s New for Biologics
Influenza Virus Vaccine for the 2017-2018 Season
Updated: 8/17/2017

CBER-Regulated Products: Resolved Shortages
Updated: 8/17/2017
August 3, 2017 Summary Basis for Regulatory Action – ZOSTAVAX (PDF – 102KB)
Posted: 8/9/2017
August 3, 2017 Approval Letter – ZOSTAVAX (PDF – 70KB)
Posted: 8/8/2017
 
Gavi [to 19 August 2017]
http://www.gavi.org/library/news/press-releases/
01 August 2017
Indonesian Government to immunise 70 million children against measles and rubella
The two-year campaign will aim to reach 95% immunisation coverage in Indonesia.
…Gavi is supporting the Government of Indonesia by contributing 50% of the total cost of vaccines. WHO is assisting with the preparation of immunisation activities, particularly in high-risk areas and among vulnerable populations, to ensure all children receive the vaccine…
 
Global Fund [to 19 August 2017]
http://www.theglobalfund.org/en/news/?topic=&type=NEWS;&country=
News
The French Council of Investors in Africa and the Global Fund Create Innovative Partnership
31 July 2017
The French Council of Investors in Africa (CIAN) and the Global Fund to Fight AIDS, Tuberculosis and Malaria have entered into a cooperation agreement aimed at involving French companies in the fight against the three diseases in sub Saharan Africa.
CIAN is an organization of French companies operating in Africa, including multinational corporations, as well as small and medium-size businesses. The organization aims to accelerate private sector involvement in health issues through its network of 160 member companies and 10,000 establishments in Africa. CIAN recently created a Health Commission, an initiative that demonstrates its members’ growing interest in combating the AIDS, tuberculosis and malaria epidemics…

IVI   [to 19 August 2017]
http://www.ivi.int/
July 28, 2017
Former UN Secretary-General Ban Ki-moon visits IVI
SEOUL, KOREA – Prof. Ban Ki-moon, former Secretary-General of the United Nations, visited the International Vaccine Institute (IVI) at Seoul National University (SNU) Research Park on July 28.
The former UN chief is currently Honorary Dean of the Institute for Global Engagement and distinguished professor at Yonsei University in South Korea. He visited the Seoul-based non-profit international organization for the first time at the invitation of the Korea Support Committee for IVI (KSC)…
 
MSF/Médecins Sans Frontières  [to 19 August 2017]
http://www.doctorswithoutborders.org/news-stories/press/press-releases
Press release
FDA Reauthorization Act Passes U.S. House and Senate Without Fixes to Deliver Urgently Needed New Drugs, Vaccines for Neglected Diseases
August 03, 2017
Both chambers of U.S. Congress missed another opportunity to help people living with neglected diseases by passing the FDA Reauthorization Act (FDARA) of 2017 today without fixing the Food and Drug Administration’s Priority Review Voucher (PRV) program for neglected diseases. Language included in the bill makes changes to the neglected disease PRV program, but it doesn’t fix the major flaws that limit the program’s ability to help people most in need, said the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF).
 
NIH  [to 19 August 2017]
http://www.nih.gov/news-events/news-releases
August 8, 2017
NIH accelerates the use of genomics in clinical care
— New funding awards focus on diverse and underserved populations.

August 7, 2017
NCI study identifies essential genes for cancer immunotherapy
— Researchers found more than 100 genes that may play a role in facilitating tumor destruction by T cells
 
PATH  [to 19 August 2017]
http://www.path.org/news/index.php
Announcement | August 18, 2017
PATH nominated for Saving Lives at Birth grants to accelerate diagnostic and device innovations that prevent maternal and infant deaths at birth

Announcement | August 10, 2017
PATH celebrates the extension of its digital health partnership with the Government of Tanzania
Second phase of the Data Use Partnership will strengthen Tanzania’s ability to use data to transform its health sector

Announcement | August 09, 2017
PATH partners with the Mahidol Oxford Tropical Medicine Research Unit on first study of the RTS,S malaria vaccine in Asia
Study is the first step toward understanding the vaccine’s potential role in elimination campaigns and combating drug resistance across Southeast Asia’s Greater Mekong Subregion

Press release | August 07, 2017
Versatile health innovator joins PATH to lead technology development and introduction efforts for low-income countries around the world
Dr. Praveen Raja brings passion, experience, and leadership in medical innovation, digital health, technology, pharmaceuticals, and entrepreneurship to new role
 
Sabin Vaccine Institute  [to 19 August 2017]
http://www.sabin.org/updates/pressreleases
Wednesday, August 2, 2017
Wendy Holman Joins Sabin Vaccine Institute Board of Trustees
WASHINGTON, D.C. – The Sabin Vaccine Institute (Sabin) is pleased to announce the election of Wendy Commins Holman to its Board of Trustees. Ms. Holman is the CEO and founder of Ridgeback Biotherapeutics, a biotechnology company focused on developing treatments and diagnostics for underserved patient populations primarily in pediatric orphan and emerging infectious diseases.
Prior to founding Ridgeback Biotherapeutics, Ms. Holman was a principal at Ziff Brothers Investments and director of research at ZBI Equities, a multi-billion dollar public equity investment fund where she spent 15 years guiding investments in healthcare and novel technology.
“We are very pleased to welcome Wendy to our board,” said Dr. Axel Hoos, chairman of Sabin’s Board of Trustees. “Her knowledge and experience of innovative technologies and deep interest in global health will be an important addition to the board as we advance our vision of a future free from vaccine-preventable diseases.”…

UNAIDS [to 19 August 2017]
http://www.unaids.org/en
Update  16 August 2017
Promoting HIV prevention among young people in El Salvador
…In El Salvador, there is a growing concern about the increase in new HIV infections reported since 2011 among adolescents aged between 15 and 19 years. Young people are not receiving the information they need to protect themselves from HIV: only 36.5% of young people aged 15–24 years know how to prevent HIV transmission.

UNICEF  [to 19 August 2017]
https://www.unicef.org/media/
1 August 2017
Babies and mothers worldwide failed by lack of investment in breastfeeding
GENEVA/NEW YORK, 1 August 2017 – No country in the world fully meets recommended standards for breastfeeding, according to a new report by UNICEF and the World Health Organization (WHO) in collaboration with the Global Breastfeeding Collective, a new initiative to increase global breastfeeding rates.
 
Wellcome Trust  [to 19 August 2017]
https://wellcome.ac.uk/news
News / Published: 10 August 2017
Danny Truell to become Emeritus Partner of Wellcome Investments
Danny Truell has led the Wellcome Trust’s Investment division with great distinction as Chief Investment Officer and more recently as Managing Partner, overseeing transformative growth of our endowment that has allowed us to more than double our charitable spending since his arrival in 2005.
 
::::::
 
BIO    [to 19 August 2017]
https://www.bio.org/insights/press-release
August 18, 2017
BIO Applauds Signing of Food and Drug Administration Reauthorization Act (FDARA)
Washington, DC  Biotechnology Innovation Organization (BIO) President and CEO James C. Greenwood issued the following statement regarding President Trump’s signing of the Food and Drug Administration Reauthorization Act (FDARA) today:
“President Trump’s signature today on this landmark legislation is the culmination of a years-long collaborative process in which patients, industry, FDA, legislators and other stakeholders worked tirelessly to identify ways in which FDA’s human drug review programs can be improved to deliver better health care for every American and enhance the incorporation of the patient voice in drug development and review…
 
DCVMN – Developing Country Vaccine Manufacturers Network  [to 19 August 2017]
http://www.dcvmn.org/
25 September 2017 to 28 September 2017
DCVMN Annual General Meeting
Seoul / Korea
 
PhRMA    [to 19 August 2017]
http://www.phrma.org/press-room
August 14, 2017
Medicare Monday: Strengthening access to vaccines for seniors
Importance of access to vaccines for seniors
 
::::::
 
MilliporeSigma and Baylor College of Medicine Advance Vaccine Development and Manufacturing for Neglected Diseases
MilliporeSigma today announced that it has formed a strategic alliance with Baylor College of Medicine, Houston, Texas, and its vaccine product development partnership, Texas Children’s
08 AUG 2017 | Billerica, Massachusetts, United States of America
:: Collaboration furthers both parties’ commitment to advance research and development for neglected diseases
:: Agreement focuses on optimizing vaccine process development and formulation and exchanging know-how
MilliporeSigma today announced that it has formed a strategic alliance with Baylor College of Medicine, Houston, Texas, and its vaccine product development partnership (PDP), Texas Children’s Hospital Center for Vaccine Development (Texas Children’s CVD), to advance vaccine research and development for neglected and emerging infections.
The collaboration focuses on bringing vaccines through development to efficiently deliver them to societies in need. MilliporeSigma’s experts in process development and formulation are working with Texas Children’s CVD scientists at Baylor to optimize the vaccine manufacturing process to increase vaccine stability and yield. Initially, these activities are targeting schistosomiasis, a deadly parasitic disease that affects millions of people a year in tropical and subtropical regions…

Reports/Research/Analysis/Commentary/Conferences/Meetings/Book Watch/Tenders

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: david.r.curry@centerforvaccineethicsandpolicy.org

The Vaccine Confidence Project  [to 19 August 2017]
http://www.vaccineconfidence.org/
Confidence Commentary:
Separating Vaccination Fact From Fiction
Heidi Larson | 6 Aug, 2017
Remember the H1N1 “swine flu” that was rampant in 2009? The U.S. Centers for Disease Control and Prevention (CDC) has estimated the global death toll from that pandemic to be more than 284,000. There’s also the influenza pandemic of 1918, which killed at least 50 million people—more than World War I.
The flu vaccine is the most effective way to combat the disease—yet, in many Western countries, rates of vaccination (and not just for the flu) have actually fallen in the past decade.
Why are some people afraid of vaccination when it’s been proven to save lives?…

Journal Watch

   Vaccines and Global Health: The Week in Review continues its weekly scanning of key peer-reviewed journals to identify and cite articles, commentary and editorials, books reviews and other content supporting our focus on vaccine ethics and policy. Journal Watch is not intended to be exhaustive, but indicative of themes and issues the Center is actively tracking. We selectively provide full text of some editorial and comment articles that are specifically relevant to our work. Successful access to some of the links provided may require subscription or other access arrangement unique to the publisher.

If you would like to suggest other journal titles to include in this service, please contact David Curry at: david.r.curry@centerforvaccineethicsandpolicy.org

American Journal of Infection Control
August 01, 2017 Volume 45, Issue 8, p819-938, e69-e90
http://www.ajicjournal.org/current

Major Articles
Efficacy of the World Health Organization–recommended handwashing technique and a modified washing technique to remove Clostridium difficile from hands
Philippe Deschênes, Frédéric Chano, Léa-Laurence Dionne, Didier Pittet, Yves Longtin
p844–848
Published online: May 16, 2017

Brief Report
Active offer of vaccinations during hospitalization improves coverage among splenectomized patients: An Italian experience
Maria Serena Gallone, Carmen Martino, Michele Quarto, Silvio Tafuri with surgeons from Bari Policlinico General Hospital
e87–e89
Published online: April 11, 2017

American Journal of Tropical Medicine and Hygiene
Volume 97, Issue 2, 2017
http://www.ajtmh.org/content/current

Perspective Piece
Why Did Zika Not Explode in Cuba? The Role of Active Community Participation to Sustain Control of Vector-Borne Diseases
Authors: Marta Castro, Dennis Pérez, Maria G. Guzman and Clare Barrington
https://doi.org/10.4269/ajtmh.16-0906

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 19 August 2017)

Research article
Population effectiveness of the pentavalent and monovalent rotavirus vaccines: a systematic review and meta-analysis of observational studies
Rotavirus was the leading cause of acute gastroenteritis (AGE) in infants and young children prior to the introduction of routine vaccination. Since 2006 there have been two licensed vaccines available; with s…
Daniel Hungerford, Katie Smith, Angela Tucker, Miren Iturriza-Gómara, Roberto Vivancos, Catherine McLeonard, Nigel A Cunliffe and Neil French
BMC Infectious Diseases 2017 17:569
Published on: 15 August 2017

Research article
Evaluation of vaccination herd immunity effects for anogenital warts in a low coverage setting with human papillomavirus vaccine—an interrupted time series analysis from 2005 to 2010 using health insurance data
Shortly after the human papillomavirus (HPV) vaccine recommendation and hence the reimbursement of vaccination costs for the respective age groups in Germany in 2007, changes in the incidence of anogenital war…
Kathrin Thöne, Johannes Horn and Rafael Mikolajczyk
BMC Infectious Diseases 2017 17:564
Published on: 14 August 2017

Research article
Strategies for the prevention of perinatal hepatitis B transmission in a marginalized population on the Thailand-Myanmar border: a cost-effectiveness analysis
Data on the cost effectiveness of hepatitis B virus (HBV) screening and vaccination strategies for prevention of vertical transmission of HBV in resource limited settings is sparse.
Angela Devine, Rebecca Harvey, Aung Myat Min, Mary Ellen T. Gilder, Moo Koh Paw, Joy Kang, Isabella Watts, Borimas Hanboonkunupakarn, François Nosten and Rose McGready
BMC Infectious Diseases 2017 17:552
Published on: 9 August 2017

Database
An extensible framework and database of infectious disease for biosurveillance
Biosurveillance, a relatively young field, has recently increased in importance because of increasing emphasis on global health. Databases and tools describing particular subsets of disease are becoming increa…
Ashlynn R. Daughton, Reid Priedhorsky, Geoffrey Fairchild, Nicholas Generous, Andrea Hengartner, Esteban Abeyta, Nileena Velappan, Antonietta Lillo, Karen Stark and Alina Deshpande
BMC Infectious Diseases 2017 17:549
Published on: 7 August 2017

BMC Medical Ethics
http://www.biomedcentral.com/bmcmedethics/content
(Accessed 19 August 2017)

Research article
Eliciting meta consent for future secondary research use of health data using a smartphone application – a proof of concept study in the Danish population
The increased use of information technology in every day health care creates vast amounts of stored health data that can be used for research. The secondary research use of routinely collected data raises ques…
Thomas Ploug and Søren Holm
Published on: 15 August 2017

Research article
Ethical issues of informed consent in malaria research proposals submitted to a research ethics committee in Thailand: a retrospective document review
The informed-consent process should be one of meaningful information exchange between researchers and study participants. One of the responsibilities of research ethics committees is to oversee appropriate inf…
Pornpimon Adams, Sukanya Prakobtham, Chanthima Limpattaracharoen, Sumeth Suebtrakul, Pitchapa Vutikes, Srisin Khusmith, Polrat Wilairatana, Paul Adams and Jaranit Kaewkungwal
Published on: 14 August 2017

Research article
Healthcare professionals’ and patients’ perspectives on consent to clinical genetic testing: moving towards a more relational approach
This paper proposes a refocusing of consent for clinical genetic testing, moving away from an emphasis on autonomy and information provision, towards an emphasis on the virtues of healthcare professionals seek…
Gabrielle Natalie Samuel, Sandi Dheensa, Bobbie Farsides, Angela Fenwick and Anneke Lucassen
Published on: 8 August 2017

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 19 August 2017)

Research article
Local measles vaccination gaps in Germany and the role of vaccination providers
Measles elimination in Europe is an urgent public health goal, yet despite the efforts of its member states, vaccination gaps and outbreaks occur. This study explores local vaccination heterogeneity in kinderg…
Linda Eichner, Stephanie Wjst, Stefan O. Brockmann, Kerstin Wolfers and Martin Eichner
BMC Public Health 2017 17:656
Published on: 14 August 2017

Research article
Controversial Ebola vaccine trials in Ghana: a thematic analysis of critiques and rebuttals in digital news
Communication is of paramount importance in responding to health crises. We studied the media messages put forth by different stakeholders in two Ebola vaccine trials that became controversial in Ghana. These …
Per Egil Kummervold, William S. Schulz, Elizabeth Smout, Luis Fernandez-Luque and Heidi J. Larson
BMC Public Health 2017 17:642
Published on: 7 August 2017

BMC Research Notes
http://www.biomedcentral.com/bmcresnotes/content
(Accessed 19 August 2017)

Research note
Facilitators and barriers to the acceptance of human papillomavirus (HPV) vaccination among adolescent girls: a comparison between mothers and their adolescent daughters in Hong Kong
The aim of this study is to examine knowledge and attitude as facilitators and barriers to the acceptance of HPV vaccination for adolescent girls by mothers and adolescent girls.
Alice Yuen Loke, Ava Chiu Oi Chan and Yuen Ting Wong
BMC Research Notes 2017 10:390
Published on: 10 August 2017

Research note
Characterizing expanded access and compassionate use programs for experimental drugs
We sought to determine the characteristics of “expanded access” and “compassionate use” programs registered in ClinicalTrials.gov and to determine the percentage of drugs provided through these programs that u…
Jennifer E. Miller, Joseph S. Ross, Kenneth I. Moch and Arthur L. Caplan
BMC Research Notes 2017 10:350
Published on: 28 July 2017

BMJ Open
August 2017 – Volume 7 – 8
http://bmjopen.bmj.com/content/current

Oncology – Research
Ten-year follow-up of human papillomavirus vaccine efficacy against the most stringent cervical neoplasia end-point—registry-based follow-up of three cohorts from randomized trials
Matti Lehtinen, Camilla Lagheden, Tapio Luostarinen, Tiina Eriksson, Dan Apter, Katja Harjula, Marjo Kuortti, Kari Natunen, Johanna Palmroth, Tiina Petäjä, Eero Pukkala, Mari Siitari-Mattila, Frank Struyf, Pekka Nieminen, Jorma Paavonen, Gary Dubin, Joakim Dillner
Conclusions: Ten years post vaccination the AS04-adjuvanted HPV-16/18 vaccine shows continued efficacy against CIN3+ irrespectively of HPV type. Vaccine efficacy was not observed in baseline HPV16 DNA positive subjects.

Bulletin of the World Health Organization
Volume 95, Number 8, August 2017, 545-608
http://www.who.int/bulletin/volumes/95/7/en/

POLICY & PRACTICE
Threats posed by stockpiles of expired pharmaceuticals in low- and middle-income countries: a Ugandan perspective
Pakoyo Fadhiru Kamba, Munanura Edson Ireeta, Sulah Balikuna & Bruhan Kaggwa
http://dx.doi.org/10.2471/BLT.16.186650
Abstract
In some low- and middle-income countries, the national stores and public-sector health facilities contain large stocks of pharmaceuticals that are past their expiry dates. In low-income countries like Uganda, many such stockpiles are the result of donations. If not adequately monitored or regulated, expired pharmaceuticals may be repackaged and sold as counterfeits or be dumped without any thought of the potential environmental damage. The rates of pharmaceutical expiry in the supply chain need to be reduced and the disposal of expired pharmaceuticals needs to be made both timely and safe. Many low- and middle-income countries need to: (i) strengthen public systems for medicines’ management, to improve inventory control and the reliability of procurement forecasts; (ii) reduce stress on central medical stores, through liberalization and reimbursement schemes; (iii) strengthen the regulation of drug donations; (iv) explore the salvage of officially expired pharmaceuticals, through re-analysis and possible shelf-life extension; (v) strengthen the enforcement of regulations on safe drug disposal; (vi) invest in an infrastructure for such disposal, perhaps based on ultra-high-temperature incinerators; and (vii) include user accountability for expired pharmaceuticals within the routine accountability regimes followed by the public health sector.

Clinical and Experimental Vaccine Research
Volume 6(2); July 2017
http://ecevr.org/

Original Articles
Mass vaccination has led to the elimination of rabies since 2014 in South Korea
Yang DK, Kim HH, Lee KK, Yoo JY, Seomun H, Cho IS.

Surveillance and compensation claims for adverse events following immunization from 2011 to 2016 in the Republic of Korea
Kim MK, Lee YK, Kim TE, Kong I, Yang HJ, Suh ES

The European Journal of Public Health
Volume 27, Issue 4, 1 August 2017
https://academic.oup.com/eurpub/issue/27/4

Editorials
Contextual effects on health inequalities: a research agenda
Odile Sauzet; Alastair H. Leyland
European Journal of Public Health, Volume 27, Issue 4, 1 August 2017, Pages 587–588, https://doi.org/10.1093/eurpub/ckx038

Global Public Health
Volume 12, 2017   Issue 10
http://www.tandfonline.com/toc/rgph20/current

Article
Non-communicable diseases and human rights: Global synergies, gaps and opportunities
Laura Ferguson, Daniel Tarantola, Michael Hoffmann & Sofia Gruskin
Pages: 1200-1227
ABSTRACT
The incorporation of human rights in health policy and programmes is known to strengthen responses to health problems and help address disparities created or exacerbated by illness yet this remains underexplored in relation to non-communicable diseases (NCDs). Aiming to understand existing synergies and how they might be further strengthened, we assessed the extent to which human rights are considered in global NCD policies and strategies and the degree of attention given to NCDs by select United Nations human rights mechanisms. Across global NCD policies and strategies, rhetorical assertions regarding human rights appear more often than actionable statements, thus limiting their implementation and impact. Although no human rights treaty explicitly mentions NCDs, some human rights monitoring mechanisms have been paying increasing attention to NCDs. This provides important avenues for promoting the incorporation of human rights norms and standards into NCD responses as well as for accountability. Linking NCDs and human rights at the global level is critical for encouraging national-level action to promote better outcomes relating to both health and human rights. The post-2015 development agenda constitutes a key entry point for highlighting these synergies and strengthening opportunities for health and rights action at global, national and local levels.

Global Public Health
Volume 12, 2017   Issue 10
http://www.tandfonline.com/toc/rgph20/current

Article
Hidden costs: The ethics of cost-effectiveness analyses for health interventions in resource-limited settings
Sarah E. Rutstein, Joan T. Price, Nora E. Rosenberg, Stuart M. Rennie, Andrea K. Biddle & William C. Miller
Pages: 1269-1281
ABSTRACT
Cost-effectiveness analysis (CEA) is an increasingly appealing tool for evaluating and comparing health-related interventions in resource-limited settings. The goal is to inform decision-makers regarding the health benefits and associated costs of alternative interventions, helping guide allocation of limited resources by prioritising interventions that offer the most health for the least money. Although only one component of a more complex decision-making process, CEAs influence the distribution of health-care resources, directly influencing morbidity and mortality for the world’s most vulnerable populations. However, CEA-associated measures are frequently setting-specific valuations, and CEA outcomes may violate ethical principles of equity and distributive justice. We examine the assumptions and analytical tools used in CEAs that may conflict with societal values. We then evaluate contextual features unique to resource-limited settings, including the source of health-state utilities and disability weights, implications of CEA thresholds in light of economic uncertainty, and the role of external donors. Finally, we explore opportunities to help align interpretation of CEA outcomes with values and budgetary constraints in resource-limited settings. The ethical implications of CEAs in resource-limited settings are vast. It is imperative that CEA outcome summary measures and implementation thresholds adequately reflect societal values and ethical priorities in resource-limited settings.

Globalization and Health
http://www.globalizationandhealth.com/
[Accessed 19 August 2017]

Research
Policy approaches to improve availability and affordability of medicines in Mexico – an example of a middle income country
The World Health Organization recommends establishing and implementing a national pharmaceutical policy (NPP) to guarantee effective and equitable access to medicines. Mexico has implemented several policy approaches to regulate the pharmaceutical sector, but it has no formal NPP. This article describes the approach that the Mexican government has taken to improve availability and affordability of essential medicines.
Daniela Moye-Holz, Jitse P van Dijk, Sijmen A. Reijneveld and Hans V. Hogerzeil
Globalization and Health 2017 13:53
Published on: 1 August 2017

Health Affairs
August 2017; Volume 36, Issue 8
http://content.healthaffairs.org/content/current
Issue Focus: Consumerism, Competition, Drug Approval & More

FDA Drug Approval
Drugs Cleared Through The FDA’s Expedited Review Offer Greater Gains Than Drugs Approved By Conventional Process
James D. Chambers, Teja Thorat, Colby L. Wilkinson, and Peter J. Neumann
Health Aff August 2017 36:1408-1415; doi:10.1377/hlthaff.2016.1541
Abstract
We investigated whether drugs approved by the Food and Drug Administration (FDA) through expedited review have offered larger health gains, compared to drugs approved through conventional review processes. We identified published estimates of additional health gains (measured in quality-adjusted life-years, or QALYs) associated with drugs approved in the period 1999–2012 through expedited (seventy-six drugs) versus conventional (fifty-nine) review processes. We found that drugs in at least one expedited review program offered greater gains than drugs reviewed through conventional processes (0.182 versus 0.003 QALYs). We also found that, compared to drugs not included in the same program, greater gains were provided by drugs in the priority review (0.175 versus 0.007 QALYs), accelerated approval (0.370 versus 0.031 QALYs), and fast track (0.254 versus 0.014 QALYs) programs. Our analysis suggests that the FDA has prioritized drugs that offer the largest health gains.

Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 13, Issue 8, 2017
http://www.tandfonline.com/toc/khvi20/current

Review
Adolescent human papillomavirus vaccination in the United States: Opportunities for integrating pharmacies into the immunization neighborhood
Joseph P. Fava, Jacob Colleran, Francesca Bignasci, Raymond Cha & Paul E. Kilgore
Pages: 1844-1855
Published online: 12 Jun 2017

Article
Health economic evaluation of immunization strategies of hepatitis E vaccine for elderly population
Xiaoqing Cheng, Yueyuan Zhao, Xuefeng Zhang, Hui Jin & Jie Min
Pages: 1873-1878
Published online: 27 Apr 2017

Brief report
“To each his own”: Discussions of vaccine decision-making in top parenting blogs
Zoë Meleo-Erwin, Corey Basch, Sarah A. MacLean, Courtney Scheibner & Valerie Cadorett
Pages: 1895-1901
Published online: 08 May 2017

Brief report
Background rates of disease in Latin American children from a rotavirus vaccine study
Marc Baay, Kaatje Bollaerts, Claudio Struchiner & Thomas Verstraeten
Pages: 1916-1920
Published online: 25 Apr 2017

International Health
Volume 9, Issue 4  July 2017
http://inthealth.oxfordjournals.org/content/current

ORIGINAL ARTICLES
Determinants of full vaccination status in children aged 12–23 months in Gurùé and Milange districts, Mozambique: results of a population-based cross-sectional survey
Shellese A. Shemwell; Meridith B. Peratikos; Lázaro González-Calvo; Montse Renom-Llonch; Alexandre Boon …
International Health, Volume 9, Issue 4, 1 July 2017, Pages 234–242, https://doi.org/10.1093/inthealth/ihx020
Abstract
Background
In 2011, 64% of children in Mozambique, ages 12–23 months, were fully immunized. Large provincial differences in vaccine uptake exist.
Methods
We conducted a survey of 1650 females with children aged 12–23 months in the districts of Gurùé and Milange. Implementation occurred from November to December 2014. Descriptive statistics and logistic regression using R-software 3.0.2 were used to examine factors associated with full vaccination status. ArcGIS version 10.3.1 (ESRI, Redlands, CA, USA) was used to map spatial patterns of vaccine uptake.
Results
Full vaccination was roughly 48%. Identifying ‘hospital’ as a location to get vaccinated was associated with having a fully vaccinated child (OR=1.87, 95% CI=1.02, 3.41, p=0.043). Households where health decisions are made solely by the male or the female had 38% (95% CI=0.32, 1.21) and 55% (95% CI=0.29, 0.69) lower odds, respectively, of their child being fully immunized. For every 10 km increase from the nearest health facility there was a 36% lower odds of the child being fully immunized (OR=0.64, 95% CI=0.44, 0.93, p<0.001).
Conclusion
Zambézia Province, as a whole and the districts of Gurùé and Milange specifically, is falling short of vaccination targets. Intensified efforts focused on the least educated, most distant and which take a more family-centered approach are needed to improve vaccine uptake.