Vaccines and Global Health: The Week in Review 26 August 2017

Vaccines and Global Health: The Week in Review is a weekly digest  summarizing news, events, announcements, peer-reviewed articles and research in the global vaccine ethics and policy space. Content is aggregated from key governmental, NGO, international organization and industry sources, key peer-reviewed journals, and other media channels. This summary proceeds from the broad base of themes and issues monitored by the Center for Vaccine Ethics & Policy in its work: it is not intended to be exhaustive in its coverage. You are viewing the blog version of our weekly digest, typically comprised of between 30 and 40 posts below all dated with the current issue date

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

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

Milestones :: Perspectives  

Milestones :: Perspectives
 
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

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]

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

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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

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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]

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

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

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