PLoS One
http://www.plosone.org/
[Accessed 30 Jun 2018]

Targeting vaccinations for the licensed dengue vaccine: Considerations for serosurvey design
Natsuko Imai, Neil M. Ferguson
Research Article | published 26 Jun 2018 PLOS ONE
https://doi.org/10.1371/journal.pone.0199450
Abstract
Background
The CYD-TDV vaccine was unusual in that the recommended target population for vaccination was originally defined not only by age, but also by transmission setting as defined by seroprevalence. WHO originally recommended countries consider vaccination against dengue with CYD-TDV vaccine in geographic settings only where prior infection with any dengue serotype, as measured by seroprevalence, was >170% in the target age group. Vaccine was not recommended in settings where seroprevalence was <50%. Test-and-vaccinate strategies suggested following new analysis by Sanofi will still require age-stratified seroprevalence surveys to optimise age-group targeting. Here we address considerations for serosurvey design in the context of vaccination program planning.
Methods
To explore how the design of seroprevalence surveys affects estimates of transmission intensity, 100 age-specific seroprevalence surveys were simulated using a beta-binomial distribution and a simple catalytic model for different combinations of age-range, survey size, transmission setting, and test sensitivity/specificity. We then used a Metropolis-Hastings Markov Chain Monte-Carlo algorithm to estimate the force of infection from each simulated dataset.
Results
Sampling from a wide age-range led to more accurate estimates than merely increasing sample size in a narrow age-range. This finding was consistent across all transmission settings. The optimum test sensitivity and specificity given an imperfect test differed by setting with high sensitivity being important in high transmission settings and high specificity important in low transmission settings.
Conclusions
When assessing vaccination suitability by seroprevalence surveys, countries should ensure an appropriate age-range is sampled, considering epidemiological evidence about the local burden of disease.

PNAS – Proceedings of the National Academy of Sciences of the United States
of America

http://www.pnas.org/content/early/

[Accessed 30 Jun 2018]

Disease outbreak thresholds emerge from interactions between movement behavior, landscape structure, and epidemiology

Lauren A. White, James D. Forester, and Meggan E. Craft

PNAS June 25, 2018. 201801383; published ahead of print June 25, 2018

Significance

Understanding how emerging infectious and zoonotic diseases spread through space and time is critical for predicting outbreaks and designing interventions; disease models are important tools for realizing these goals. Currently, humans are altering the environment in unprecedented ways through urbanization, habitat fragmentation, and climate change. However, the consequences of increasingly heterogeneous landscapes on pathogen transmission and persistence remain unclear. By synthesizing mathematical modeling and movement ecology approaches, we examined how wildlife movement patterns interact with broad-scale landscape structure to affect population-level disease dynamics. We found that habitat fragmentation could counterintuitively promote disease outbreaks but that, for higher wildlife densities and longer infectious periods, small differences in how hosts navigated their environments could dramatically alter observed disease dynamics.

Abstract

Disease models have provided conflicting evidence as to whether spatial heterogeneity promotes or impedes pathogen persistence. Moreover, there has been limited theoretical investigation into how animal movement behavior interacts with the spatial organization of resources (e.g., clustered, random, uniform) across a landscape to affect infectious disease dynamics. Importantly, spatial heterogeneity of resources can sometimes lead to nonlinear or counterintuitive outcomes depending on the host and pathogen system. There is a clear need to develop a general theoretical framework that could be used to create testable predictions for specific host–pathogen systems. Here, we develop an individual-based model integrated with movement ecology approaches to investigate how host movement behaviors interact with landscape heterogeneity (in the form of various levels of resource abundance and clustering) to affect pathogen dynamics. For most of the parameter space, our results support the counterintuitive idea that fragmentation promotes pathogen persistence, but this finding was largely dependent on perceptual range of the host, conspecific density, and recovery rate. For simulations with high conspecific density, slower recovery rates, and larger perceptual ranges, more complex disease dynamics emerged, and the most fragmented landscapes were not necessarily the most conducive to outbreaks or pathogen persistence. These results point to the importance of interactions between landscape structure, individual movement behavior, and pathogen transmission for predicting and understanding disease dynamics.

Qualitative Health Research
Volume 28 Issue 9, July 2018
http://qhr.sagepub.com/content/current

Research Articles
Public Discourses of Ebola Contagion and Courtesy Stigma: The Real Risk to International Health Care Workers Returning Home From the West Africa Ebola Outbreak?
Stephanie Gee, Morten Skovdal
First Published February 27, 2018; pp. 1499–1508
Abstract
This article explores the homecoming experiences of international health care workers who responded to the 2014 to 2016 West African Ebola outbreak. Interviews with 11 frontline international medical staff were undertaken and data thematically analyzed. It was found that international health care workers faced an unforeseen risk of stigmatization upon their return home, related to others’ fears of their infectious status. Media representations of the disease appear to have played a significant role in heightening societal perceptions of the risks associated with the returning health care workers, resulting in public hostility toward them. For participants, these social risks overtook concerns about biological risks during the immediate postmission period. The participants developed different strategies to cope with courtesy stigma, by rationalizing stigmatizing attitudes, educating people, or simply through an avoidance of others.

Social Science & Medicine
Volume 207   Pages 1-116 (June 2018)
https://www.sciencedirect.com/journal/social-science-and-medicine/vol/206/suppl/C

Regular articles
Individual decisions to vaccinate one’s child or oneself: A discrete choice experiment rejecting free-riding motives
Original research article
Pages 106-116
Frederik Verelst, Lander Willem, Roselinde Kessels, Philippe Beutels
Abstract
It is essential for public health to understand what drives people’s hesitance towards vaccination. Theoretical models of vaccination decisions are ubiquitous, often incorporating herd immunity, perceptions of vaccine-related side-effects (VRSE) and of vaccine-preventable burden of disease, but with little to no empirical exploration. Herd immunity is a (usually) positive externality where vaccinated individuals influence others’ risks by their reduced capability to transmit an infectious disease to them. It is often assumed that (rational) individuals incorporate this externality in their strategic vaccination decision, from which free-riding behavior arises. We performed a Bayesian D-efficient discrete choice experiment in February–March 2017 to study vaccination behavior in 1919 Belgian respondents. Choice sets with vaccine profiles were constructed using six attributes: vaccine effectiveness, VRSE, accessibility (in terms of convenience and reimbursement), vaccine-preventable burden of disease, local (respondents’ network of contacts) vaccination coverage, and population (the population at large) vaccination coverage. VRSE and accessibility are the most influential attributes, followed by vaccine effectiveness and burden of disease. Both population and local coverage are less important than the other attributes, but show a significant direct linear relationship with vaccine utility. This supports the existence of peer influence (more incentivized as more and more vaccinate), rather than free-riding on herd immunity. These findings were independent of whether respondents made vaccine choices for themselves or for their child. Around 40% of the respondents indicated accepting vaccination with little or no questioning. These ‘acceptors’ were less sensitive to changes in the vaccine-preventable burden of disease for their child’s vaccination choices (but not for themselves). Public health institutions are critical in stimulating vaccine uptake by making vaccines conveniently available at an affordable price and by communicating pro-actively on perceived VRSEs. The free-riding assumption as a driver of individual vaccine decisions, seems inappropriate, but this observation needs confirming in other populations.

Travel Medicine and Infectious Diseases
May-June, 2018  Volume 23
http://www.travelmedicinejournal.com/

 
Editorials
WHO bites back rabies pre-travel vaccination schedules – Implications for travel medicine
Cornelis Adrianus De Pijper, Cornelis Stijnis, Martin Peter Grobusch
Vol. 23, p4–5
Published online: April 23, 2018

Travel Medicine and Infectious Diseases
May-June, 2018  Volume 23
http://www.travelmedicinejournal.com/

Systematic review
A systematic review of emerging respiratory viruses at the Hajj and possible coinfection with Streptococcus pneumoniae
Jaffar A. Al-Tawfiq, Samir Benkouiten, Ziad A. Memish
Vol. 23, p6–13
Published online: April 16, 2018

Vaccine
Volume 36, Issue 29  Pages 4153-4392 (5 July 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/28

Review
Caregiver recall in childhood vaccination surveys: Systematic review of recall quality and use in low- and middle-income settings
Review article
Pages 4161-4170
Rakesh N. Modi, Carina King, Naor Bar-Zeev, Tim Colbourn

Vaccine
Volume 36, Issue 29  Pages 4153-4392 (5 July 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/28

A systematic review and meta-analysis on the safety of newly adjuvanted vaccines among older adults
Original research article
Pages 4207-4214
Marc Baay, Kaatje Bollaerts, Thomas Verstraeten

Vaccine
Volume 36, Issue 29  Pages 4153-4392 (5 July 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/28

Childhood vaccines in Uganda and Zambia: Determinants and barriers to vaccine coverage
Open access – Original research article
Pages 4236-4244
David E. Phillips, Joseph L. Dieleman, Jessica C. Shearer, Stephen S. Lim

Vaccine
Volume 36, Issue 29  Pages 4153-4392 (5 July 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/28

Neighborhood political composition and personal belief exemptions from immunization requirements in California Kindergartens, 2000–2015
Original research article
Pages 4298-4303
Kevin A. Estep

Vaccine
Volume 36, Issue 29  Pages 4153-4392 (5 July 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/28

Cost-effectiveness of nonavalent HPV vaccination among males aged 22 through 26 years in the United States
Original research article
Pages 4362-4368
Harrell W. Chesson, Elissa Meites, Donatus U. Ekwueme, Mona Saraiya, Lauri E. Markowitz

Vaccine
Volume 36, Issue 29  Pages 4153-4392 (5 July 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/28

Impact of the addition of new vaccines in the early childhood schedule on vaccine coverage by 24 months of age from 2006 to 2016 in Quebec, Canada
Original research article
Pages 4383-4391
Marilou Kiely, Nicole Boulianne, Denis Talbot, Manale Ouakki, … Gaston De Serres

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.
 
 
The Atlantic
http://www.theatlantic.com/magazine/
Accessed 30 Jun 2018
[No new, unique, relevant content]

BBC
http://www.bbc.co.uk/
Accessed 30 Jun 2018
[No new, unique, relevant content]
 
The Economist
http://www.economist.com/
Accessed 30 Jun 2018
[No new, unique, relevant content]

Financial Times
http://www.ft.com/home/uk
Accessed 30 Jun 2018
[No new, unique, relevant content]
 
Forbes
http://www.forbes.com/
Accessed 30 Jun 2018
[No new, unique, relevant content]

Foreign Affairs
http://www.foreignaffairs.com/
Accessed 30 Jun 2018
[No new, unique, relevant content]

Foreign Policy
http://foreignpolicy.com/
Accessed 30 Jun 2018
[No new, unique, relevant content]

The Guardian
http://www.guardiannews.com/
Accessed 30 Jun 2018
[No new, unique, relevant content]

New Yorker
http://www.newyorker.com/
Accessed 30 Jun 2018
[No new, unique, relevant content]
 
New York Times
http://www.nytimes.com/
Accessed 30 Jun 2018
Health  June 29
Vaccination Critic Placed on Probation by Medical Board
A Southern California pediatrician and outspoken critic of mandatory vaccinations has been placed on probation for 35 months by the state’s medical board.

Health  June 28
Ebola Outbreak in Central Africa Is ‘Largely Contained’
The first Ebola outbreak fought with a new vaccine is winding down, according to the World Health Organization. The outbreak lasted just seven weeks.

Africa  June 28
Congo Completes Surveillance of Ebola Contacts, No New Cases
Democratic Republic of Congo moved closer to declaring its Ebola outbreak over when the health ministry said it had completed surveillance of the last people who came into contact with patients and had not found any new cases.

Wall Street Journal
http://online.wsj.com/home-page?_wsjregion=na,us&_homepage=/home/us
Accessed 30 Jun 2018
[No new, unique, relevant content]

Washington Post
http://www.washingtonpost.com/
Accessed 30 Jun 2018
[No new, unique, relevant content]

Think Tanks et al
 
Brookings
http://www.brookings.edu/
Accessed 30 Jun 2018
[No new relevant content]

Center for Global Development  
http://www.cgdev.org/page/press-center
Accessed 30 Jun 2018
[No new relevant content]

CSIS
https://www.csis.org/
Accessed 30 Jun 2018
Commentary
Health Security Downgraded at the White House
June 28, 2018
On May 9, the day after the Democratic Republic of the Congo confirmed an Ebola outbreak, the Trump administration dismissed Rear Admiral Tim Ziemer and dissolved his post as senior director for global health security and biothreats. Ironically, the creation of that directorate in the fall of 2016 stemmed directly from the costly mishandling of the response to the prior Ebola crisis in West Africa. We are now at risk of repeating the mistakes of 2014…

Council on Foreign Relations
http://www.cfr.org/
Accessed 30 Jun 2018
[No new relevant content]

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_23 Jun 2018

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

– Twitter:  Readers can also follow developments on twitter: @vaxethicspolicy.
.
– Links:  We endeavor to test each link as we incorporate it into any post, but recognize that some links may become “stale” as publications and websites reorganize content over time. We apologize in advance for any links that may not be operative. We believe the contextual information in a given post should allow retrieval, but please contact us as above for assistance if necessary.

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.

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

Milestones :: Perspectives

::::::

Ebola/EVD
 
EBOLA VIRUS DISEASE – Democratic Republic of the Congo
External Situation Report 12: 22 June 2018
The Ministry of Health and WHO continue to closely monitor the outbreak of Ebola virus disease (EVD) in the Democratic Republic of the Congo. Over one month into the response, further spread of EVD has largely been contained. However, in spite of the progress made, there should be no room for laxity and complacency until the outbreak is controlled. The focus of the response remains on intensive surveillance, including active case finding, investigation of suspected cases and alerts and contact tracing.

On 20 June 2018, four new suspected EVD cases were reported in Iboko (2) and Bikoro (2) health zones. Four laboratory specimens (from suspected cases reported previously) tested negative. Since 17 May 2018, no new confirmed EVD cases have been reported in Bikoro and Wangata health zones, while the last confirmed casepatient in Iboko Health Zone developed symptoms on 2 June 2018, was confirmed on 6 June 2018 and died on 9 June 2018.
Since the beginning of the outbreak (on 4 April 2018), a total of 61 EVD cases and 28 deaths have been reported, as of 20 June 2018. Of the 61 cases, 38 have been laboratory confirmed, 14 were probable cases (deaths for which it was not possible to collect laboratory specimens for testing) and nine were suspected cases. Of the 52 confirmed and probable cases, 28 died – giving a case fatality rate of 54%. Twenty-seven (52%) confirmed and probable cases were from Iboko, followed by 21 (40%) from Bikoro and four (8%) from Wangata health zones. Five healthcare workers have been affected, with four confirmed cases and two deaths.

The number of contacts requiring follow-up is progressively decreasing, with a total of 1 527 contacts having completed the mandatory 21-day follow-up period. As of 20 June 2018, 179 contacts were under follow up and all (100%) were reached on the reporting date…

[Excerpts]
Implementation of ring vaccination protocol
Since the launch of the vaccination exercise on 21 May 2018, a total of 3 199 people have been vaccinated in Iboko (1 464) Wangata (836), Bikoro (779), Ingende (107), and Kinshasa (13), as of 21 June 2018. The targets for vaccination are front-line health professionals, people who have been exposed to confirmed EVD cases and contacts of these contacts…

Case management
WHO is providing technical advice on the use of investigational therapeutics under the Monitored Emergency Use of Unregistered Interventions (MEURI) framework and provision of essential medical supplies. Four of the five investigational therapeutics are in-country and all protocols have been approved by the Ethics Review Board (ERB). This is the first time such treatments have been available during an Ebola outbreak. Clinicians working in the treatment centres will make decisions on which drug will be most helpful to their patients, and appropriate for the setting. The treatments can be used as long as informed consent is obtained from patients and protocols are followed, with close monitoring and reporting of any adverse events. Four of the five approved drugs are currently in the country. They are Zmapp, GS-5734, REGN monoclonal antibody combination, and mAb114…

Disease Outbreak News [DONs]
20 June 2018
Ebola virus disease – Democratic Republic of the Congo
The Ministry of Health and WHO continue to closely monitor the outbreak of Ebola virus disease (EVD) in the Democratic Republic of the Congo. There is cautious optimism. Slightly over a month into the response, further spread of EVD has largely been contained. However, in spite of progress, there should be no room for laxity and complacency until the outbreak is controlled. The focus of operations remains on intensive surveillance and active case finding.
Since 17 May 2018, no new confirmed EVD cases have been reported in Bikoro and Wangata health zones, while the last confirmed case-patient in Iboko developed symptoms on 2 June 2018 and died on 9 June…

Milestones :: Perspectives

WHO releases new International Classification of Diseases (ICD 11)

18 June 2018 ¦ Geneva: The World Health Organization (WHO) is today releasing its new International Classification of Diseases (ICD-11).

The ICD is the foundation for identifying health trends and statistics worldwide, and contains around 55,000 unique codes for injuries, diseases and causes of death. It provides a common language that allows health professionals to share health information across the globe.

“The ICD is a product that WHO is truly proud of,” says Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “It enables us to understand so much about what makes people get sick and die, and to take action to prevent suffering and save lives.”

ICD-11, which has been over a decade in the making, provides significant improvements on previous versions. For the first time, it is completely electronic and has a much more user-friendly format. And there has been unprecedented involvement of health care workers who have joined collaborative meetings and submitted proposals. The ICD team in WHO headquarters has received over 10 000 proposals for revisions.

ICD-11 will be presented at the World Health Assembly in May 2019 for adoption by Member States, and will come into effect on 1 January 2022. This release is an advance preview that will allow countries to plan how to use the new version, prepare translations, and train health professionals all over the country.

The ICD is also used by health insurers whose reimbursements depend on ICD coding; national health programme managers; data collection specialists; and others who track progress in global health and determine the allocation of health resources.

The new ICD-11 also reflects progress in medicine and advances in scientific understanding. For example, the codes relating to antimicrobial resistance are more closely in line with the Global
Antimicrobial Resistance Surveillance System (GLASS). ICD-11 is also able to better capture data regarding safety in healthcare, which means that unnecessary events that may harm health – such as unsafe workflows in hospitals – can be identified and reduced.

The new ICD also includes new chapters, one on traditional medicine: although millions of people use traditional medicine worldwide, it has never been classified in this system. Another new chapter on sexual health brings together conditions that were previously categorized in other ways (e.g. gender incongruence was listed under mental health conditions) or described differently. Gaming disorder has been added to the section on addictive disorders…

:: ICD website

:: ICD-11 coding too

Emergencies
 
POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 19 June 2018 [GPEI]
:: Advance notification of cVDPV1 in Papua New Guinea:  Following identification last month of an AFP case from which VDPV type 1 had been isolated, genetic sequencing of two VDPV1s from two non-household contacts of the AFP case, has now confirmed that VDPV1 is circulating and will be officially classified as a  ‘circulating’ VDPV type 1 (cVDPV1).  The National Department of Health (NDOH) is closely working with the GPEI partners in launching a comprehensive response. The cVDPV1 will be officially reported in next week’s data.
::  Advance notification of new cVDPV2 in DR Congo:  Advance notification of a new cVDPV2 case was received this week from Ituri province, in the north-east of DR Congo, close to the border with Uganda.  Initial investigations are ongoing, but early reports are that the child had onset of paralysis on 5 May 2018, and has a recent travel history with Haut Katanga.  Genetic sequencing indicates the case is linked to the Haut Lomami/Tanganika/Haut Katanga outbreak. The case will be officially reported in next week’s data.

Summary of newly-reported viruses this week:
Pakistan: Three wild poliovirus type 1 (WPV1) positive environmental samples reported
Afghanistan: Two wild poliovirus type 1 (WPV1) positive environmental samples reported
Somalia: One circulating vaccine-derived poliovirus type 2 (cVDPV2) environmental sample reported

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

WHO Grade 3 Emergencies  [to 23 Jun 2018]
Yemen 
:: WHO continues life-saving support to Yemen’s blood transfusion centres
On the occasion of World Blood Donor Day 2018, WHO reaffirms the need of having an adequate blood supply to meet the needs of patients14 June 2018 – It has been over 3 years since Yemen was hit by one of the world’s worst humanitarian crises. The crisis has worsened an already the appalling health situation. Conditions in the blood transfusion centres across the country are no different, further aggravated by the ongoing conflict and facing the threat of closure due to shortages in essential blood bags and reagents.
WHO is working hard to prevent the closure of these centres, scaling up support for the supply of safe blood products in Yemen. In 2017–2018, WHO provided over 130 000 blood bags and various types of laboratory reagents to the national blood transfusion centre, maintained the provision of services in Sana’a, and helped in re-opening the other branches in Ibb, Hudydah and Aden…

::::::
 
WHO Grade 2 Emergencies  [to 23 Jun 2018]
[Several emergency pages were not available at inquiry]

::::::
::::::
 
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. 
Yemen 
:: Yemen: Al Hudaydah Update Situation Report No. 4, 22 June 2018
HIGHLIGHTS/KEY PRIORITIES
:: Fighting and airstrikes are continuing in Al Hudaydah City and in southern districts. Casualties are reported.
:: More people are fleeing areas of conflict and seeking shelter in safer locations, including in the capital, Sana’a
:: IDPs from Al Hudaydah City have arrived in the capital, Sana’a. Total figures on displacement are not available yet as humanitarian organisations are verifying the IDPS.
:: Humanitarian partners have ramped up rapid response activities amid security and access constraints

::::::

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 Humanitarian Bulletin Issue 55 | 4 – 17 June 2018
:: Ethiopia: Oromia – Somali Conflict-Induced Displacement – Situation Report No. 4 (20 June 2018)

::::::
::::::
 
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 23 Jun 2018]
http://who.int/emergencies/mers-cov/en/
DONs
Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia
18 June 2018
Between 12 January through 31 May 2018, the National IHR Focal Point of The Kingdom of Saudi Arabia reported 75 laboratory confirmed cases of Middle East respiratory syndrome coronavirus (MERS_CoV), including twenty-three (23) deaths…

WHO & Regional Offices [to 23 Jun 2018]

Paediatric chewable medicine promises improved treatment against intestinal worms
20 June 2018 | Geneva −− The World Health Organization (WHO) will begin distributing a paediatric (chewable) formulation of mebendazole to countries with a high prevalence of soil-transmitted helminthiases (intestinal worms). Mebendazole is one of the medicines recommended by WHO to treat intestinal worm infections of humans. This formulation was approved by the United States Food and Drug Administration in 2016 and is now donated to WHO by the pharmaceutical company Johnson & Johnson…

::::::

Weekly Epidemiological Record, 22 June 2018, vol. 93, 25 (pp. 357–368)
:: Joint External Evaluation in crisis countries – a perspective from the Eastern Mediterranean Region
:: Strategic response to an outbreak of circulating vaccine-derived poliovirus type 2, Syrian Arab Republic, 2017–2018
 
::::::
 
WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
Selected Featured News
:: Polio Eradication-Regional Certification Commission concludes meeting with far-reaching recommendations for countries  22 June 2018
:: On the hunt for Ebola in the Democratic Republic of Congo  21 June 2018
:: Maximising digital health technology to improve quality and patient safety in Africa  20 June 2018
:: Zimbabwe reaches One million men with Voluntary Medical Male Circumcision  19 June 2018
:: Nigeria and Africa on track to eradicating poliomyelitis says Minister of Health  18 June 2018

 
WHO European Region EURO
:: Is European Region ready to respond to next influenza pandemic? 21-06-2018
:: WHO opens new Country Office in Greece 20-06-2018
:: World Refugee Day: WHO trains Syrian refugees to serve as home-care staff to older and disabled refugees in Turkey 19-06-2018
:: Commemorating the impact of Semmelweis’ work on global health 19-06-2018
:: Investment and innovation for inclusive health systems key to nations’ prosperity 18-06-2018

WHO Eastern Mediterranean Region EMRO
:: World Refugee Day 2018
19 June 2018 – On World Refugee Day 2018, the WHO Regional Office for the Eastern Mediterranean calls for renewed support for the protection and well-being of refugees and other displaced populations, and their right to seek health services with dignity, without discrimination, and without undergoing financial hardship…

CDC/ACIP [to 23 Jun 2018]
http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html

MMWR News Synopsis for June 21, 2018
Strategic Response to an Outbreak of Circulating Vaccine-Derived Poliovirus Type 2 — Syria, 2017–2018
The 2017 circulating vaccine-derived poliovirus type 2 (cVDPV22) outbreak in Syria underscores the risk of emergence of vaccine-derived polioviruses in settings of low oral poliovirus vaccine (OPV) coverage and also demonstrates the effectiveness of targeted vaccination using monovalent OPV type 2 in controlling cVDPV2 outbreaks. In areas with very low oral poliovirus vaccine (OPV) coverage, prolonged transmission of vaccine-associated viruses can lead to the emergence of vaccine-derived polioviruses (VDPVs). In 2017, an outbreak of circulating VDPV type 2 (cVDPV2) occurred in Syria, resulting in 74 cases. Implementation of three rounds of monovalent OPV type 2 campaigns coupled with intensified surveillance interrupted the outbreak. A longstanding humanitarian crisis, precipitated by war and political unrest, has left much of Syria’s population vulnerable to recurrent disease outbreaks, including the recent cVDPV2 outbreak. Subnational gaps in acute flaccid paralysis (AFP) surveillance performance and delays in receiving laboratory results, due to difficulties transporting stool specimens, as a result of the country’s complex humanitarian emergency, contributed to the inability to detect the outbreak earlier.

ECDC – European Centre for Disease Prevention and Control  [to 23 Jun 2018]
https://ecdc.europa.eu/en/home
Publication
ECDC public health microbiology strategy 2018–2022
corporate publication – 20 Jun 2018
 
Data
HEPSA – health emergency preparedness self-assessment tool
tool – 20 Jun 2018
 
News
ECDC launches preparedness self-assessment tool
– 20 Jun 2018
ECDC launches the HEPSA (Health Emergency Preparedness Self-Assessment) tool, in order to support countries in improving their level of public health emergency preparedness.

Announcements

European Medicines Agency  [to 23 Jun 2018]
http://www.ema.europa.eu/ema/
22/06/2018
Committee for Medicinal Products for Veterinary Use (CVMP) meeting of 19–21 June 2018
First stem cell-based veterinary medicine recommended for marketing authorisation …

22/06/2018
Reinforced EU/US collaboration on medicines
Update on the European Commission/EMA–FDA bilateral of 18-19 June 2018 …

21/06/2018
Interested in joining the Committee for Advanced Therapies (CAT) to represent patients’ associations or clinicians?
Call for expressions of interest open until 18 July 2018 …

19/06/2018
Modernising the orphan designation process
EMA launches new submission portal today

Global Fund [to 23 Jun 2018]
http://www.theglobalfund.org/en/news/?topic=&type=NEWS;&country=
News
Global Fund Appoints New Head of External Relations, Chief Financial Officer and Chief Information Officer
20 June 2018
Peter Sands, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, today announced the appointments of three new leaders joining the senior management team to accelerate the Global Fund’s work toward ending epidemics..
Françoise Vanni will become the Global Fund’s new Head of External Relations, bringing more than 20 years of leadership experience in resource mobilization and advocacy, most recently as Director of External Relations and Communications for the United Nations Relief and Works Agency in the Middle East.
Jacques Le Pape, a finance expert with rich experience in government and in the private sector, will be the Global Fund’s new Chief Financial Officer. Le Pape has served as a senior auditor, an executive at Air France KLM, an advisor to successive ministers in the French government, and as a manager at France’s Treasury. He will begin his new role on 23 July.
Michael Johnson, an innovative and accomplished leader in information technology with experience in both the public and private sectors, will become the new Chief Information Officer at a time when the Global Fund is building greater capacity for managing and synthesizing data with a focus on an enhanced digital agenda…
 
 
Human Vaccines Project   [to 23 Jun 2018]
http://www.humanvaccinesproject.org/media/press-releases/
Media Release: 19-Jun-2018
Michelson Prize Awards $450,000 to Young Scientists Advancing Immunology and Vaccine Research
The Michelson Medical Research Foundation and the Human Vaccines Project award three recipients with inaugural Michelson Prizes for Human Immunology and Vaccine Research
…Today the Michelson Medical Research Foundation and the Human Vaccines Project are announcing the cutting edge researchers under the age of 35 that were selected as the award’s first recipients from a global competition that included over a hundred applications spanning 12 countries. Each of the three recipients will be awarded a $150,000 Prize to fund specific aspects of their research.
“We are thrilled to recognize these three young scientists that hail from the U.S. and Australia – Patricia Illing, PhD, Ansuman Satpathy, MD, PhD, and Laura Mackay, PhD – as the first recipients of the Michelson Prizes for Human Immunology and Vaccine Research,” said Gary Michelson, MD, founder of the Michelson Medical Research Foundation. “The high caliber of their scientific pursuits, their disruptive ideas, and their passion for innovation and problem solving gives me great hope for the future of science.”…

IVAC  [to 23 Jun 2018]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
June 2018
Commentary: The Ideal Community of Practice—Engaging Local Stakeholders in Uganda to Develop Cost of Illness Estimates and Beyond
 
 
IVI   [to 23 Jun 2018]
http://www.ivi.int/
[Undated]
NIBSC, IVI jointly organize meeting on cholera vaccine standardization
 
[Undated]
In Memoriam: Prof. Adel Mahmoud (1941 – 2018)
The International Vaccine Institute (IVI) is greatly saddened by the June 11 passing of Prof. Adel Mahmoud, former Chairman of the IVI Board of Trustees and a global pioneer in the treatment and prevention of infectious diseases.
Prof. Mahmoud joined the IVI BOT as a member-at-large in 2010 and served as its Chairman from 2013 when IVI was going through a difficult period, before resigning due to health reasons in February of this year. He came to the IVI Board after a remarkable career in academia and industry, culminating as the President of Merck Vaccines.  Before passing away, he was a Professor of the Department of Molecular Biology and the Woodrow Wilson School of Public and International Affairs at Princeton University, USA.
IVI is a stronger and more vital institution because of Prof. Mahmoud’s vision and leadership. IVI is eternally grateful to him and would like to extend our deepest and most sincere condolences to his family and to all those who knew him, as we join the community in  the mourning of his loss. He will be remembered and dearly missed by IVI and the broader international community for his contributions to global health.

PATH  [to 23 Jun 2018]
http://www.path.org/news/index.php
Press release | June 20, 2018
PATH and SD BIOSENSOR announce partnership to advance diagnostic test critical for malaria treatment and elimination
Agreement supports development and availability of an affordable, high-quality enzyme deficiency test

Press release | June 19, 2018
New report finds $100 million shortfall in annual global investments in malaria research and development
Report highlights a ‘second valley of death’ threatening to keep developed malaria products from reaching those most in need
[See Research/Reports below for more detail]
 
 
UNAIDS [to 23 Jun 2018]
http://www.unaids.org/en
Update
Women’s rights advocates join UNAIDS to address sexual harassment
22 June 2018
For decades, women’s rights leaders and civil society organizations have been actively working to advance gender equality. Civil society have also been critical partners to UNAIDS since its inception in 1996, UNAIDS being the only United Nations organization to include non-governmental organizations as active participants on its board.
The partnership between UNAIDS and civil society continues to be essential and on 18-19 June, UNAIDS and the ATHENA Network co-convened a meeting on addressing sexual harassment. The meeting provided a unique opportunity for dialogue with civil society on concerns and questions around sexual harassment and gender equality, as well as to provide valuable inputs on how to strengthen the work of UNAIDS in this area.
UNAIDS welcomed more than 30 women’s rights leaders and civil society advocates to share good practices, articulate concerns and discuss ways of moving forward to strengthen rights-based responses to sexual harassment and protect survivors and people who come forward to report incidents of harassment…

UNICEF  [to 23 Jun 2018]
https://www.unicef.org/media/
Selected Press Releases/Reports
No new digest content identified…most recent press release dated 15 May 2018]

World Organisation for Animal Health (OIE)   [to 23 Jun 2018]
http://www.oie.int/en/for-the-media/pressreleases/2018/
20/06/18
Discover the 2017 OIE Annual Report
To meet the goal of protecting animals and thereby preserving our future, the World Organisation for Animal Health (OIE) worked in 2017 with its 181 Member Countries to control animal health risks, ensure transparency in communication and reinforce the resilience of animal health systems: the 3 main objectives of its 6th Strategic Plan. This Annual Report reviews the progress achieved over the past year.

::::::
 
BIO    [to 23 Jun 2018]
https://www.bio.org/insights/press-release
Jun 21 2018
Distinguished Professor and Dean from South Korea to Receive 2018 George Washington Carver Award
The Biotechnology Innovation Organization (BIO) today announced that Distinguished Professor Sang Yup Lee at the Department of Chemical and Biomolecular Engineering at the Korea Advanced Institute of Science and Technology (KAIST) will receive the 11th annual George Washington Carver Award for Innovation in Industrial Biotechnology. The award will be presented on Wednesday, July 18, 2018 during a plenary session at the 2018 BIO World Congress on Industrial Biotechnology. The world’s largest conference on industrial biotechnology and partnering event will be held July 16-19, 2018, at the Pennsylvania Convention Center in Philadelphia.

Jun 21 2018
Corteva Agriscience’s Krysta Harden to Receive 2018 Rosalind Franklin Award
The Biotechnology Innovation Organization (BIO) today announced that Corteva AgriscienceTM Vice President of External Affairs and Chief Sustainability Officer Krysta Harden will receive the 5th annual Rosalind Franklin Award for Leadership in Industrial Biotechnology and Agriculture. Corteva Agriscience™ is the Agriculture Division of DowDuPont. The award will be presented on Wednesday, July 18, 2018 during a plenary session at the 2018 BIO World Congress on Industrial Biotechnology. The world’s largest conference on industrial biotechnology and partnering event will be held July 16-19, 2018, at the Pennsylvania Convention Center in Philadelphia.

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
 
 
 
Bridging the gaps in malaria R&D: An analysis of funding—from basic research and product development to research for implementation
June 2018:: 20 pages   PDF: http://www.path.org/news/press-room/881/
The development of this report was undertaken by PATH, the Special Programme for Research and Training in Tropical Diseases, and Malaria No More UK, in collaboration with the Foundation for Innovative New Diagnostics, Innovative Vector Control Consortium, Medicines for Malaria Venture, and the World Health Organization’s Global Malaria Programme. Data collection was completed by Policy Cures Research.
Support for the development and dissemination of the report was provided by the Bill & Melinda Gates Foundation and the ExxonMobil Foundation. The views expressed in the report or related materials are solely those of the authors and do not necessarily reflect the views of the funders.
 
Press Release
New report finds $100 million shortfall in annual global investments in malaria research and development
Report highlights a ‘second valley of death’ threatening to keep developed malaria products from reaching those most in need
London and Washington, DC, 19 June 2018—A new report on the state of funding of malaria research and development (R&D) globally shows that funding for basic research and product development falls short of the need.

“Right now, annual investments in basic research and product development for malaria are about US $100 million less than what is required to meet funding targets,” said David C. Kaslow, MD, Vice President of Essential Medicines at PATH. “We see evidence of this shortfall across malaria R&D. In addition to that gap, however, we now face a ‘second valley of death’—not enough resources to move products through development, all the way to impact.”

The report, Bridging the gaps in malaria R&D: An analysis of funding—from basic research and product development to research for implementation, combines original research with regularly reported data on funding for basic research and product development. It is the first time a report has quantified the funds not only devoted to initial product development but to the additional research to improve access to those prevention or treatment products. This research for implementation included implementation research, operational research, and health systems research.

The report spotlights the results of a pilot survey of leading funders of malaria R&D covering a three-year period, 2014–2016. It found that research for implementation comprised 16% of total average annual malaria R&D investments of $673 million, averaging $107 million annually…

The report makes three overarching recommendations on basic research and product development in malaria, and five additional recommendations specific to research for implementation.

Overarching recommendations from the report:

• Improve coordination across intervention areas (from basic through implementation research). Product developers must work together to ensure that next-generation interventions will fit together seamlessly.
• Develop more innovative funding approaches. New types and approaches of funding mechanisms and incentives are clearly needed.
• Continue existing tracking of funding flows and strengthen systems to address data gaps. Key stakeholders, including those who have experience tracking resource flows and conducting research, should work together—in particular, on research for implementation.

Key research for implementation topics recommended for discussion:

• Agree to definitions and a core data set to track research for implementation. The use of a range of definitions complicates and, in some cases, prevents tracking and analysis into funding flows. Few funders are doing this, and many who would like to do this do not have the systems or personnel to do it.
• Determine how to collect data on research for implementation funding at the institutional, national, and subnational levels. This survey has been limited to a subset of organizations. However, there is a deep well of research to be mined at the local level that is necessary to complete the full picture.
• Investigate the value of tracking funding for training and capacity building for research for implementation. Several organizations provided funding for building this capacity, yet this report (and others) have identified gaps in research capacity. Can the tracking of funding for training be useful for funders and program planners?
• Review diagonal versus horizontal research for implementation. How can the outcomes of research for implementation be shared across health systems so that the learnings do not remain siloed within a particular disease area or type of intervention?
• Consider a funding target for research for implementation as part of any elimination or control program. The goal would be to increase funding to the areas with the greatest gaps, not to reallocate from within the current funding pool.

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

Annals of Internal Medicine
19 June 2018 Vol: 168, Issue 12
http://annals.org/aim/issue

Position Papers |19 June 2018
Women’s Health Policy in the United States: An American College of Physicians Position Paper
Hilary Daniel, BS; Shari M. Erickson, MPH; Sue S. Bornstein, MD; for the Health and Public Policy Committee of the American College of Physicians *
Abstract
In this position paper, the American College of Physicians (ACP) examines the challenges women face in the U.S. health care system across their lifespans, including access to care; sex- and gender-specific health issues; variation in health outcomes compared with men; underrepresentation in research studies; and public policies that affect women, their families, and society. ACP puts forward several recommendations focused on policies that will improve the health outcomes of women and ensure a health care system that supports the needs of women and their families over the course of their lifespans.

BMC Medicine
http://www.biomedcentral.com/bmcmed/content
(Accessed 23 Jun 2018)

Research article
Simple rules for evidence translation in complex systems: A qualitative study
Ensuring patients benefit from the latest medical and technical advances remains a major challenge, with rational-linear and reductionist approaches to translating evidence into practice proving inefficient and ineffective. Complexity thinking, which emphasises interconnectedness and unpredictability, offers insights to inform evidence translation theories and strategies. Drawing on detailed insights into complex micro-systems, this research aimed to advance empirical and theoretical understanding of the reality of making and sustaining improvements in complex healthcare systems.
Authors: Julie E. Reed, Cathy Howe, Cathal Doyle and Derek Bell
Citation: BMC Medicine 2018 16:92
Published on: 20 June 2018

BMC Research Notes
http://www.biomedcentral.com/bmcresnotes/content
(Accessed 23 Jun 2018)

Research note
Brief report: Parental attitudes and knowledge on routine childhood immunization: an experience from Central Sri Lanka
A lack of correct awareness about immunization among parents put them at risk of falling prey to the anti-vaccine movement. This risk is present even in countries with a high vaccine uptake. This study was don…
Authors: N. C. Herath, T. Kudagammana, T. T. Sanathchandra, H. K. Gamage, I. M. Razik and V. Liynapathirana
Citation: BMC Research Notes 2018 11:402
Published on: 22 June 2018

Child Care, Health and Development
Volume 44, Issue 4   Pages: 507-658  July 2018
https://onlinelibrary.wiley.com/toc/13652214/current

ORIGINAL ARTICLES
Factors associated with delayed infant immunization in a nationally representative cohort study
[Australia – Parental attitudes accounted for a relatively small percentage of delayed infant immunization. In contrast, many children who did not receive vaccines on time were characterized by social disadvantage, especially larger family size. Researchers and policy‐makers should consider how to make timely immunization easier for busy parents.
Homel, B. Edwards
Pages: 583-591
First Published: 20 February 2018

EMBO Reports
01 June 2018; volume 19, issue 6
http://embor.embopress.org/content/19/6?current-issue=y

Opinion
Nobody at the top
Science bears some hallmarks of religion. But, unlike many organized religions, there is no central authority and no tenet remains unchallenged.
EMBO Reports (2018) 19: e46329
Brooke Morriswood, Oliver Hoeller

EMBO Reports
01 June 2018; volume 19, issue 6
http://embor.embopress.org/content/19/6?current-issue=y

Opinion
Reproducibility crisis in science or unrealistic expectations?
The reproducibility crisis in biomedical research has spurred much debate about the causes of the failure to validate experimental results. But the discussion may be overlooking one crucial factor that is inherent to research with low sample sizes: random variation.
EMBO Reports (2018) 19: e46008
Thiago FA França, José Maria Monserrat

Globalization and Health
http://www.globalizationandhealth.com/
[Accessed 23 Jun 2018]

Research
20 June 2018
Does quality influence utilization of primary health care? Evidence from Haiti
Expanding coverage of primary healthcare services such as antenatal care and vaccinations is a global health priority; however, many Haitians do not utilize these services. One reason may be that the population avoids low quality health facilities. We examined how facility infrastructure and the quality of primary health care service delivery were associated with community utilization of primary health care services in Haiti.
Authors: Anna D. Gage, Hannah H. Leslie, Asaf Bitton, J. Gregory Jerome, Jean Paul Joseph, Roody Thermidor and Margaret E. Kruk
 

Health and Human Rights
Volume 20, Issue 1, June 2018
http://www.hhrjournal.org/
Special Section on Neglected Tropical Diseases and Human Rights
in collaboration with Helen Keller International, USA and with financial support from Children’s Investment Fund Foundation, London, UK

FOREWORD Embodying Law and Embedding Public Health with the Voices of Those Affected: Ending NTDs by 2030
Alice Cruz

Health and Human Rights
Volume 20, Issue 1, June 2018
http://www.hhrjournal.org/
Special Section on Neglected Tropical Diseases and Human Rights
in collaboration with Helen Keller International, USA and with financial support from Children’s Investment Fund Foundation, London, UK

EDITORIAL “Equipping Practitioners”: Linking Neglected Tropical Diseases and Human Rights
Joseph J. Amon and David G. Addiss
In 2007, Paul Hunt, the United Nations Special Rapporteur on the right to health, and colleagues published a report entitled Neglected Diseases: A Human Rights Analysis. In introducing the report, the authors wrote:
   The human rights implications of neglected diseases, and the contribution that human rights can make to addressing neglected diseases, have not been given the attention they deserve. This report aims to equip practitioners with an understanding of human rights, how human rights abuses cause and result from neglected diseases, and how a human rights approach can contribute to the fight against neglected diseases.[1]
More than a decade later, the human rights implications of neglected tropical diseases (NTDs) are still only infrequently addressed, and there remains a need to “equip practitioners”—in both the NTD and the human rights fields—and to ensure that rights-based principles and approaches are examined and integrated into NTD programs. Seeking to expand this attention, the call for articles for this special issue of Health and Human Rights Journal asked NTD scholars and practitioners to share examples of how rights interact with NTDs and how current NTD programs respect, protect, and promote human rights…

Special Section on Judicial Enforcement of Health Rights: Focus on Latin America
in collaboration with the O’Neill Institute, Georgetown University, Washington DC, USA
June 20, 2018

EDITORIAL Health in the Courts of Latin America
Octávio Luiz Motta Ferraz
To address any complex issue in a large and diverse geographical region of the world is always a daunting and risky task. Latin America is no exception. Despite the semblance of uniformity that the use of the term “Latin American” often misleadingly imparts, the truth is that there is no such thing as a homogeneous bloc of countries occupying the territory running from the border between the United States and Mexico down to Uruguay, plus a few islands in the Caribbean Sea. Not even a single language is shared, let alone a broader “Latin American culture.”
We are dealing with a large region spanning 20 million square kilometers (13% of the earth’s land surface), including very poor countries such as Haiti, middle-income ones such as Peru, Colombia, and Brazil, and relatively wealthy ones such as Uruguay and Argentina. There are democracies at different levels of maturity and stability alongside authoritarian regimes, as well as a diverse range of political-economic systems, from socialist Cuba to economically liberal Chile.[1] Health systems also vary significantly in their structures (from national health services in Brazil to social security and public insurance schemes in Mexico and Colombia), coverage, and quality. As an influential historian has recently claimed, the idea of Latin America should have probably vanished by now. But he also acknowledges that “[t]he term is here to stay, and it is important.”[2]
The topic addressed in this special section—the judicial enforcement of health rights—inevitably reflects this remarkable diversity. Despite some interesting common trends, no “Latin American model” of health litigation emerges, unsurprisingly, from the growing but still limited studies of the past few decades (including those published in this issue). On the contrary, there is significant variety in terms of the magnitude of the phenomenon, its main characteristics, its potential causes, the impact it has on equity and health systems, and the emerging initiatives in reaction to the phenomenon…

Special Section on Judicial Enforcement of Health Rights: Focus on Latin America
in collaboration with the O’Neill Institute, Georgetown University, Washington DC, USA
June 20, 2018

General Papers
Access to Medicines in Times of Conflict: Overlapping Compliance and Accountability
Frameworks for Syria
Brianne McGonigle Leyh and Marie Elske Gispen
Abstract
Syria is currently experiencing the world’s largest humanitarian crisis since World War II, and access to medicines for emergency care, pain control, and palliative care remains shockingly restricted in the country. Addressing the dire need for improved access to medicines in Syria from an international law compliance and accountability perspective, this article highlights four complementary legal frameworks: international human rights law, international drug control law, international humanitarian law, and international criminal law. It arrives at two central conclusions. First, all four bodies of law hold clear potential in terms of regulatory—hence compliance—and accountability mechanisms for improving access to medicines in times of conflict, but they are too weak on their own account. Second, the potential for on-the-ground change lies in the mutual reinforcement of these four legal frameworks. This reinforcement, however, remains rhetorical and far from practical. Finally, within this complex picture of complementary international legal frameworks, the article proposes concrete recommendations for a more integrated and mutually reinforcing interpretation and implementation of these areas of law to foster better access to medicines in Syria and elsewhere.

Special Section on Judicial Enforcement of Health Rights: Focus on Latin America
in collaboration with the O’Neill Institute, Georgetown University, Washington DC, USA
June 20, 2018

Missing: Where Are the Migrants in Pandemic Influenza Preparedness Plans?
Kolitha Wickramage, Lawrence O. Gostin, Eric Friedman, Phusit Prakongsai, Rapeepong
Suphanchaimat, Charles Hui, Patrick Duigan, Eliana Barragan, and David Harper

Health Research Policy and Systems
http://www.health-policy-systems.com/content
[Accessed 23 Jun 2018]

Research
Priority-setting in public health research funding organisations: an exploratory qualitative study among five high-profile funders
Priority-driven funding streams for population and public health are an important part of the health research landscape and contribute to orienting future scholarship in the field. While research priorities are often made public through targeted calls for research, less is known about how research funding organisations arrive at said priorities. Our objective was to explore how public health research funding organisations develop priorities for strategic extramural research funding programmes.
Authors: Yuri Cartier, Maria I. Creatore, Steven J. Hoffman and Louise Potvin
Citation: Health Research Policy and Systems 2018 16:53
Published on: 22 June 2018

Humanitarian Exchange Magazine
Number 71  March 2018
https://odihpn.org/magazine/humanitarian-response-urban-areas/

Humanitarian response in urban areas
Humanitarian crises are increasingly affecting urban areas either directly, through civil conflict, hazards such as flooding or earthquakes, urban violence or outbreaks of disease, or indirectly, through hosting people fleeing these threats. The humanitarian sector has been slow to understand how the challenges and opportunities of working in urban spaces necessitate changes in how they operate. For agencies used to working in rural contexts, the dynamism of the city, with its reliance on markets, complex systems and intricate logistics, can be a daunting challenge. Huge, diverse and mobile populations complicate needs assessments, and close coordination with other, often unfamiliar, actors is necessary.

[Reviewed earlier]

JAMA
June 19, 2018, Vol 319, No. 23, Pages 2349-2450
http://jama.jamanetwork.com/issue.aspx

Viewpoint
An Incomplete Prescription – President Trump’s Plan to Address High Drug Prices
Ameet Sarpatwari, JD, PhD; Jerry Avorn, MD; Aaron S. Kesselheim, MD, JD, MPH
JAMA. 2018;319(23):2373-2374. doi:10.1001/jama.2018.7424
This Viewpoint discusses missed opportunities in the 2018 White House blueprint to reduce prescription drug prices, including a proposal that would require CMS to negotiate prices with manufacturers and that would ban unfair practices companies use to extend brand exclusivity.

Journal of Pharmaceutical Policy and Practice
https://joppp.biomedcentral.com/
[Accessed 23 Jun 2018]

Research
21 June 2018
Regulatory requirements for the registration of generic medicines and format of drug dossiers: procedures in Sri Lanka in comparison with selected regulatory authorities
The regulatory requirements for approval of generic medicines and the format of compiling drug dossiers vary among regulatory authorities. The variation is particularly wide between High-income countries (HIC) and lower and middle-income countries (LMIC) with different regulatory frameworks. In this study, document requirements for approval of generic products, approval timelines, and consideration of bioequivalence and/or biowaiver data by Regulatory Authorities (RAs) of 10 selected jurisdictions was studied.
Authors: D. Thambavita, P. Galappatthy and R. L. Jayakody

Journal of Pharmaceutical Policy and Practice
https://joppp.biomedcentral.com/
[Accessed 23 Jun 2018]

Research
21 June 2018
Regulatory requirements for the registration of generic medicines and format of drug dossiers: procedures in Sri Lanka in comparison with selected regulatory authorities
The regulatory requirements for approval of generic medicines and the format of compiling drug dossiers vary among regulatory authorities. The variation is particularly wide between High-income countries (HIC) and lower and middle-income countries (LMIC) with different regulatory frameworks. In this study, document requirements for approval of generic products, approval timelines, and consideration of bioequivalence and/or biowaiver data by Regulatory Authorities (RAs) of 10 selected jurisdictions was studied.
Authors: D. Thambavita, P. Galappatthy and R. L. Jayakody

Nature 
Volume 558 Issue 7710, 21 June 2018
http://www.nature.com/nature/current_issue.html

Editorial | 20 June 2018
Evidence synthesis needs greater incentives
Enlarge and better reward efforts that examine past discoveries to set policy and agendas.
As societal challenges grow in research priority, there is ever more need for such synthesis. But it takes effort, as described by, for example, a Cornell University Library guide to a systematic review (go.nature.com/2k6ftil). And, more problematically, the academic ecosystem does not incentivize such work.
To help nudge the system in that direction, Nature this week publishes two Comment articles that highlight the importance of such assessments of evidence, and suggest ways to maximize their effectiveness. In the first, several experts from policy, funding and publishing (including Nature’s editor-in-chief) present four principles to help make evidence syntheses aimed at policymakers easier to commission, and more powerful in delivery and implementation. The second, by two researchers who focus on evidence for conservation biology, discusses a form of evidence synthesis that can provide a more cost-effective way to appraise evidence when data are sparse and patchy. This is a reflection of the reality that, for some interventions, randomized controlled trials aren’t possible, but there is, nevertheless, a need to make sense of the available evidence…

Nature 
Volume 558 Issue 7710, 21 June 2018
http://www.nature.com/nature/current_issue.html

Comment | 20 June 2018
Four principles to make evidence synthesis more useful for policy
Reward the creation of analyses for policymakers that are inclusive, rigorous, transparent and accessible, urge Christl A. Donnelly and colleagues.
Christl A. Donnelly, Ian Boyd[…] & Chris Wormald

Nature 
Volume 558 Issue 7710, 21 June 2018
http://www.nature.com/nature/current_issue.html

Comment | 20 June 2018
A fresh approach to evidence synthesis
Systematic reviews have transformed medicine, but a more cost-effective means of appraisal is needed for fields in which data are sparse and patchy, argue
William J. Sutherland and Claire F. R. Wordley.

New England Journal of Medicine
June 21, 2018  Vol. 378 No. 25
http://www.nejm.org/toc/nejm/medical-journal

Perspective
Keeping Your Cool — Doing Ebola Research during an Emergency
Charlotte J. Haug, M.D., Ph.D.
Two key international actors, Médecins sans Frontières (MSF, or Doctors without Borders) and the World Health Organization (WHO), are testing an Ebola vaccine during the current outbreak in the Democratic Republic of Congo (DRC), in collaboration with the ministry of health (see map). They must act in a state of extreme uncertainty: the situation is evolving by the hour, information is hard to come by, and the ethical dilemmas and practical hurdles are abundant. And they are using slightly different approaches…

PLoS One
http://www.plosone.org/
[Accessed 23 Jun 2018]

Research Article
Early life malaria exposure and academic performance
Ninja Ritter Klejnstrup, Julie Buhl-Wiggers, Sam Jones, John Rand
Research Article | published 22 Jun 2018 PLOS ONE
https://doi.org/10.1371/journal.pone.0199542

PLoS One
http://www.plosone.org/
[Accessed 23 Jun 2018]

Adverse events after vaccination among HIV-positive persons, 1990–2016
John R. Su, Carmen Ng, Paige W. Lewis, Maria V. Cano
Research Article | published 19 Jun 2018 PLOS ONE
https://doi.org/10.1371/journal.pone.0199229

PLoS One
http://www.plosone.org/
[Accessed 23 Jun 2018]

Acceptability of HPV vaccines and associations with perceptions related to HPV and HPV vaccines among male baccalaureate students in Hong Kong
Teris Cheung, Joseph T. F. Lau, Johnson Z. Wang, P. K. H. Mo, Y. S. Ho
Research Article | published 18 Jun 2018 PLOS ONE
https://doi.org/10.1371/journal.pone.0198615

PLoS One
http://www.plosone.org/
[Accessed 23 Jun 2018]

Acellular pertussis vaccines effectiveness over time: A systematic review, meta-analysis and modeling study
Ayman Chit, Hossein Zivaripiran, Thomas Shin, Jason K. H. Lee, Antigona Tomovici, Denis Macina, David R. Johnson, Michael D. Decker, Jianhong Wu
Research Article | published 18 Jun 2018 PLOS ONE
https://doi.org/10.1371/journal.pone.0197970

Reproductive Health
http://www.reproductive-health-journal.com/content
[Accessed 23 Jun 2018]

Commentary
Overcoming challenges to dissemination and implementation of research findings in under-resourced countries
Authors: Richard J. Derman and Frances J. Jaeger
Citation: Reproductive Health 2018 15(Suppl 1):86
Published on: 22 June 2018
Abstract
Louis Pasteur once commented on the happiness that a scientist finds when, besides making a discovery, study results find practical application. Where health status is poor and resources are limited, finding such applications is a necessity, not merely a joy.
Dissemination, or the distribution of new knowledge gained through research, is essential to the ethical conduct of research. Further, when research is designed to improve health, dissemination is critical to the development of evidence-based medicine and the adoption of evidence-supported interventions and improved practice patterns within specific settings. When dissemination is lacking, research may be considered a waste of resources and a useless pursuit unable to influence positive health outcomes.
Effective translation of the findings of health research into policy and the practice of medicine has been slow in many countries considered low or lower middle-income (as defined by the World Bank). This is because such countries often have health care systems that are under-resourced (e.g., lacking personnel or facilities) and thus insufficiently responsive to health needs of their populations. However, implementation research has produced many tools and strategies that can prompt more effective and timelier application of research findings to real world situations.