Milestones :: Perspectives

 
EBOLA/EVD  [to 9 Jun 2018]
http://www.who.int/ebola/en/

Disease outbreak news
6 June 2018
Ebola virus disease – Democratic Republic of the Congo
[Excerpt]
Since the last Disease Outbreak News on 30 May 2018, two additional cases have been laboratory confirmed for Ebola virus disease (EVD) in the Democratic Republic of the Congo; both cases were reported from Iboko Health Zone. Recently available information has enabled the classification of some cases to be updated^{1 .}
…Since the launch of the vaccination intervention on 21 May, a total of 1199 people have been vaccinated in Wangata (577), Iboko (323) and Bikoro (299). Populations eligible for ring vaccination are front-line health professionals, people who have been exposed to confirmed EVD cases (contacts) and contacts of contacts…

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WHO: Ebola treatments approved for compassionate use in current outbreak
6 June 2018
On 4 June, an ethics committee in the Democratic Republic of the Congo (DRC) approved the use of five investigational therapeutics to treat Ebola, under the framework of compassionate use/expanded access. This is the first time such treatments are available in the midst of an Ebola outbreak.
Clinicians working in the treatment centres will make decisions on which drug to use as deemed helpful for 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.

Consultation on Monitored Emergency Use of Unregistered and Investigational Interventions for Ebola virus disease – Notes for the Record
Undated
[Excerpt]
A group of independent scientific experts convened by the WHO for the purpose of evaluating
investigational therapeutics for Ebola virus disease (EVD) during the current outbreak, 17 May 2018
Experts:
Dr. Edward Cox (Chair), Dr. Annick Antierens , Dr. Sina Bavari, Dr Gail Carson, Dr. Marco Cavaleri, Dr. Rick Davey, Dr. Robert Fowler, Prof. Stephan Guenther, Prof. Stuart Nichol, Dr. Tim O’Dempsey, Prof. Ross Upshur, Prof. Jean-Jacques Muyembe* , Prof. Steve Ahuka Mundeke*, Dr. Daniel Bausch* (*Unable to attend but reviewed the statement prior to its finalization)

There are many pathogens for which no proven effective intervention exists. For some pathogens there may be interventions that have shown promising safety and efficacy in the laboratory and in relevant animal models but that have not yet been evaluated for safety and efficacy in humans. Under normal circumstances, such interventions undergo testing in clinical trials that are capable of generating reliable evidence about safety and efficacy. However, in the context of an outbreak characterized by high mortality, it can be ethically appropriate to offer individual patients investigational interventions on an emergency basis outside clinical trials.

The WHO developed an ethical framework known as Monitored Emergency Use of Unregistered Interventions (MEURI1.) which established the following criteria to be met for access to investigational therapeutics for individual patients outside of clinical trials:
1) no proven effective treatment exists;
2) it is not possible to initiate clinical studies immediately;
3) data providing preliminary support of the intervention’s efficacy and safety are available, at least from laboratory or animal studies, and use of the intervention outside clinical trials has been suggested by an appropriately qualified scientific advisory committee on the basis of a favourable risk–benefit analysis;
4) the relevant country authorities, as well as an appropriately qualified ethics committee, have
approved such use;
5) adequate resources are available to ensure that risks can be minimized;
6) the patient’s informed consent is obtained; and
7) the emergency use of the intervention is monitored and the results are documented and shared in a timely manner with the wider medical and scientific community.

…A concise summary of key points from the expert panel’s deliberations include the points listed below. The panel noted that the available evidence for these investigational therapies was, in general, well below the usual level evidence for formulating recommendations. Panel members were free to express their viewpoints and contrary views were listened to respectfully.

:: ZMapp (a monoclonal antibody cocktail) – The available data, including the data from a
randomized controlled trial of ZMapp in patients with EVD, provide the highest quality data for
the use of ZMapp under MEURI, where the panel assessed that the benefits outweigh the risks.

:: Remdesivir (GS-5734) (an antiviral drug) – The available data support use under MEURI, however there should be concerted efforts made to study Remdesivir in appropriate clinical trials to assess its benefits and risks for treatment of patients with EVD.

:: REGN3470-3471-3479 (a monoclonal antibody cocktail) – The data were found to be very promising and support use under MEURI in settings where ZMapp or Remdisivir are not
available. However, there should be concerted efforts to study REGN3470-3471-3479 in
appropriate clinical trials.

:: Favipiravir (an antiviral drug) – The experts discussed the available data2 for Favipiravir and noted considerable uncertainty as to whether it provides benefits for patients with EVD. It is important to conduct appropriate clinical trials to establish whether it provides benefits to
patients or not. MEURI of Favipiravir may be considered in select circumstances where use of
ZMapp or Remdesivir or REGN 3470-3471-3479 are not available. Its use is complicated by
dosing selection3 for treatment of EVD.

:: Review of mAb 114 (a monoclonal antibody) – mAb114 is currently in very early stages of
development. The limited early data look potentially promising but more data are needed from
clinical trials before recommending its use for MEURI.
:: The panel affirmed the importance of moving to appropriate clinical trials as soon as possible. WHO is currently developing clinical trial designs to evaluate one, two or more candidate investigational therapeutics and assess which are beneficial to patients with EVD. WHO and partners are in active communication with product manufacturers as well as with the national authorities to expedite preparedness for clinical trials…

2 In total more than 200 EVD patients have been treated with Favipiravir, most at the JIKI doses. Designs included historical controls, and retrospective observational studies.
3 The required dosing regimen is uncertain following publications indicating plasma concentrations being low in the JIKI trial. Therefore, further dose ranging studies should be performed to assess concentrations and tolerance at higher doses.

Milestones :: Perspectives
The Wistar Institute Partners with Nation’s Top Cancer Centers to Endorse Goal of Eliminating HPV-related Cancers in the United States
Joint statement empowers parents, young adults and physicians to act to increase vaccination rates and screenings in effort to eliminate HPV-related cancers, starting with cervical cancer.
PHILADELPHIA — (June 7, 2018) — Nearly 80 million Americans – one out of every four people – are infected with human papillomavirus (HPV). And of those millions, more than 31,000 will be diagnosed with an HPV-related cancer this year. Despite these staggering figures and the availability of a vaccine to prevent the infections that cause these cancers, HPV vaccination remains low in the United States.

The Wistar Institute has partnered with 69 other National Cancer Institute (NCI)-designated cancer centers to issue a statement urging for increased HPV vaccination and screening to eliminate HPV-related cancers, starting with cervical cancer. These centers collectively recognize insufficient vaccination as a public health threat and call upon the nations’ physicians, parents and young adults to take advantage of the opportunity to eliminate several different types of cancer in men and women.

“There is a safe and effective vaccine available to provide protection against HPV infection, which could prevent more than 52,000 cases of cervical, oropharyngeal, anal, penile, vulvar, and vaginal cancers each year,” said Dario Altieri, M.D., president and CEO of The Wistar Institute, director of The Wistar Institute Cancer Center, and the Robert and Penny Fox Distinguished Professor. “Yet U.S. rates for HPV vaccination remain low. We can and must do better for our children and young adults and ensure they receive the HPV vaccine.”

HPV vaccination rates remain significantly lower than other recommended adolescent vaccines in the nation. According to 2016 data from the Centers for Disease Control (CDC), less than 50 percent of girls and 38 percent of boys completed the recommended vaccine series. Research shows there are many barriers to overcome to improve vaccination rates, including a lack of strong recommendations from physicians and parents not understanding the vaccine protects against several types of cancer.

HPV experts from the nation’s top cancer centers, along with partners from the NCI, CDC, and the American Cancer Society, are meeting June 7-8 to discuss a path forward to eliminating cancers caused by HPV, including ways to reduce barriers to vaccination, as well as how to share education, training and intervention strategies to improve vaccination rates.

This is the third year that all 70 NCI-designated cancer centers have come together to issue a national call to action. All of the centers unanimously share the goal of sending a powerful message to parents, adolescents and health care providers about the importance of HPV vaccination for the elimination of HPV-related cancers.
 
 

Milestones :: Perspectives

NIH releases strategic plan for data science
June 4, 2018 — The plan provides a roadmap for modernizing the NIH-funded biomedical data science ecosystem.
Storing, managing, standardizing and publishing the vast amounts of data produced by biomedical research is a critical mission for the National Institutes of Health. In support of this effort, NIH today released its first Strategic Plan for Data Science that provides a roadmap for modernizing the NIH-funded biomedical data science ecosystem.  Over the course of the next year, NIH will begin implementing its strategy, with some elements of the plan already underway. NIH will continue to seek community input during the implementation phase.

Accessible, well-organized, secure, and efficiently operated data resources are critical to modern scientific inquiry. By maximizing the value of data generated through NIH-funded efforts, the pace of biomedical discoveries and medical breakthroughs for better health outcomes can be substantially accelerated. To keep pace with rapid changes in biomedical data science, NIH will work to address the:
:: findability, interconnectivity, and interoperability of NIH-funded biomedical data sets and resources
:: integration of existing data management tools and development of new ones
:: universalizing innovative algorithms and tools created by academic scientists into enterprise-ready resources that meet industry standards of ease of use and efficiency of operation
:: growing costs of data management

To advance NIH data science across the extramural and intramural research communities, the agency will hire a Chief Data Strategist. This management function will guide the development and implementation of NIH’s data science activities and provide leadership within the broader biomedical research data ecosystem.
 

Emergencies
 
POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 5 June 2018 [GPEI]

Summary of newly-reported viruses this week:
Pakistan: One new wild poliovirus type 1 (WPV1) case reported.
Afghanistan : One new WPV1-positive environmental sample.

“The world’s eyes are on us” – expert group makes recommendations for polio eradication in Afghanistan 
Kabul, 4 June 2018 – The Technical Advisory Group for polio eradication (TAG) met 30–31 May to assess progress made towards eradicating polio in Afghanistan so far and to make recommendations for the way forward.
In his opening remarks, Dr Najibullah Mojadidi, Presidential Focal Point for Polio Eradication said, that “polio eradication is a national priority”.
He called on the armed groups to “respect the neutrality of the programme.”
Dr Richard Peeperkorn, WHO Representative in Afghanistan, commended the achievements made. “We are now at a critical juncture. Refusal and access issues continue to be a challenge. We need to tackle these issues in a different way”.
United Nations Humanitarian Coordinator Toby Lanzer said that “We count on the goodwill of all parties to the conflict.“ Despite difficulties, he encouraged the participants. “We must not be discouraged. It is a marathon, not a sprint. Keep moving towards the finishing line – together with Pakistan.”
Adele Khodr, UNICEF Representative in Afghanistan, stated that “It is a difficult time for the programme, and the world’s eyes are on us. However, we must not be discouraged. We must join forces and act as one.”…

Emergencies
 
POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 5 June 2018 [GPEI]

Summary of newly-reported viruses this week:
Pakistan: One new wild poliovirus type 1 (WPV1) case reported.
Afghanistan : One new WPV1-positive environmental sample.

“The world’s eyes are on us” – expert group makes recommendations for polio eradication in Afghanistan 
Kabul, 4 June 2018 – The Technical Advisory Group for polio eradication (TAG) met 30–31 May to assess progress made towards eradicating polio in Afghanistan so far and to make recommendations for the way forward.
In his opening remarks, Dr Najibullah Mojadidi, Presidential Focal Point for Polio Eradication said, that “polio eradication is a national priority”.
He called on the armed groups to “respect the neutrality of the programme.”
Dr Richard Peeperkorn, WHO Representative in Afghanistan, commended the achievements made. “We are now at a critical juncture. Refusal and access issues continue to be a challenge. We need to tackle these issues in a different way”.
United Nations Humanitarian Coordinator Toby Lanzer said that “We count on the goodwill of all parties to the conflict.“ Despite difficulties, he encouraged the participants. “We must not be discouraged. It is a marathon, not a sprint. Keep moving towards the finishing line – together with Pakistan.”
Adele Khodr, UNICEF Representative in Afghanistan, stated that “It is a difficult time for the programme, and the world’s eyes are on us. However, we must not be discouraged. We must join forces and act as one.”…

WHO Grade 3 Emergencies  [to 9 Jun 2018]
Yemen 
:: Amidst the devastation of war in Yemen, efforts are under way to control cholera
… The cholera epidemic began in Yemen in early October 2016, the almost inevitable result of ongoing armed conflict, devastated infrastructure, and a health system on the brink of collapse. Today, it is the largest cholera outbreak ever recorded. By the end of January 2018, the number of suspected cases had risen to over one million.
Controlling the outbreak
Measures are now being taken to mitigate further spread of the disease. As a part of a broader integrated response plan supported by the World Health Organization (WHO), UNICEF and the World Bank partnership, an oral cholera vaccination (OCV) campaign was launched on 6 May 2018 and was fully supported by the national health authorities in cooperation with WHO and UNICEF. It is the first time this has been done in Yemen.
Further OCV campaigns are planned for other priority areas across Yemen. Prevention and control measures are imperative to slow and ultimately contain the outbreak from spreading further.
The outbreak continues to threaten millions in Yemen
“As the third wave of cholera looms upon armed conflict-ridden Yemen, the uptake of this crucial public health tool is a vital and substantial prevention measure in the fight against this epidemic. In addition to conducting vaccination campaigns, an integrated comprehensive cholera outbreak response operational plan has been developed in cooperation with the health authorities and collaboration with health partners to implement activities regarding early detection, referral, case investigation and management, water and sanitation, health education, promotion and food hygiene,” said Dr Nevio Zagaria, WHO Representative in Yemen.
The fight is far from over. The rainy season runs from mid-April to the end of August, which will further increase the risk of transmission. The epidemic continues to threaten millions in Yemen, especially pregnant women, the elderly, and small children like Mossaad and Baraa. Efforts are concerted to save lives of vulnerable population groups and get Yemen rid of this water borne but preventable disease.

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WHO Grade 2 Emergencies  [to 9 Jun 2018]

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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. 
Yemen 
:: Yemen: Cyclone Mekunu Situation Report No. 1, 7 June 2018
An inter-cluster mission led by OCHA visited Socotra from 29 May to 4 June to assess humanitarian needs in the aftermath of cyclone “Mekunu”. The mission was able to visit approximately 70 per cent of the affected areas and assess the status of critical infrastructure such as main roads, water networks and hospitals. While on the ground, the team initiated the distribution of food and non-food items to affected population..
:: Yemen Humanitarian Update Covering 29 May – 4 June 2018 | Issue 18

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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
:: Ethiopia Humanitarian Bulletin Issue 54 | 21 May – 03 June 2018
ECHO announces €2 million to IOM to deliver critical ES/NFIs humanitarian aid to 55,000 flood-affected displaced persons

Somalia
:: Humanitarian Bulletin Somalia, 1 May – 3 June 2018
Cyclone Sagar leaves a trail of destruction

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

EBOLA/EVD  [to 9 Jun 2018]
http://www.who.int/ebola/en/
[See Milestones above for detail]
 
 

WHO & Regional Offices [to 9 Jun 2018]

WHO launches Global Action Plan on Physical Activity
4 June 2018   News Release  Lisbon, Portugal
WHO Director-General Dr Tedros Adhanom Ghebreyesus is today joining Prime Minister António Costa of Portugal to launch the new “WHO Global action plan on physical activity and health 2018-2030: More active people for a healthier world.”
“Being active is critical for health. But in our modern world, this is becoming more and more of a challenge,  largely because  our cities and communities aren’t designed in the right ways,” said Dr Tedros. “We need leaders at all levels to help people to take the healthier step. This works best at city level, where most responsibility lies for creating healthier spaces.”…

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Weekly Epidemiological Record, 8 June 2018, vol. 93, 23 (pp. 329–344)
Meeting of the Strategic Advisory Group of Experts on immunization, April 2018 – conclusions and recommendations
 
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WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
Selected Featured News
:: Adamawa cholera outbreak: Active search for cases in communities avert further spread 
08 June 2018
:: Ministry of Health validates Liberia’s first National Infection Prevention and Control Guidelines to promote quality healthcare and patient safety  07 June 2018
:: WHO in collaboration with partners rolls out a mobile-based surveillance application for Acute Flaccid Paralysis (AFP) to enhance surveillance in South Sudan  06 June 2018
:: Liberia can achieve Universal Health Coverage-Minister of Health  04 June 2018

WHO South-East Asia Region SEARO
:: Preventive, contingency measures reinforced as monsoon sets in Cox’s Bazar
SEAR/PR/1690   Cox’s Bazar, 1 June 2018: With rains starting to intermittently flood the Rohingya refugee camps, the World Health Organization and other health sector partners are further strengthening preventive and contingency measures to minimize the health impact of monsoons for the nearly 1.3 million vulnerable populations in Cox’s Bazar.
“WHO and health sector partners are working with Bangladesh government to maintain life-saving primary and secondary health services for Rohingya refugees and their host communities in the ongoing rainy season. Heavy rains, floods and cyclone are expected to further deteriorate the already suboptimal water and sanitation conditions in the overcrowded refugee camps, increasing the risk of infectious disease such as acute watery diarrhea, cholera, hepatitis, dengue fever and malaria, among others,” Dr Bardan Jung Rana, WHO Representative to Bangladesh, said.
As a preventive measure, a massive cholera vaccination campaign was conducted in May targeting one million people – the refugees, their host communities and people residing in close vicinity to the camps. This was the second massive cholera vaccination campaign for the Rohingyas, with 900 000 doses administered in November-December last year.
As part of the contingency measures, 18 diarrhea treatment centers (DTC) with a total bed capacity of 522, and 41 oral rehydration points (ORPs), have been planned across the various camps…
 
WHO European Region EURO
:: Policy dialogue on implementing 2030 Agenda held during Regional Director’s visit to Romania 08-06-2018
:: New report reveals need for more humane, personalized approach in European Region’s long-term institutions for adults with intellectual and psychosocial disabilities 06-06-2018
:: Protect our environment, protect our health: World Environment Day 2018 05-06-2018

WHO Eastern Mediterranean Region EMRO
:: “The world’s eyes are on us” – expert group makes recommendations for polio eradication in Afghanistan  4 June 2018
:: UN agencies deeply concerned over killing of health volunteer in Gaza  2 June 2018

CDC/ACIP [to 9 Jun 2018]
http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html

MMWR News Synopsis for June 7, 2018
Update: Influenza Activity in the United States During the 2017-18 Season and Composition of the 2018-19 Influenza Vaccine
The severity and duration of the 2017-2018 influenza season underscores the tremendous burden seasonal flu can cause and the importance of influenza countermeasures including influenza vaccination and antiviral treatment. While flu vaccination can vary in how well it works, effectiveness in the range of 20 percent to 50 percent may still prevent tens of thousands of hospitalizations during seasons with high severity. Also, flu vaccination has been shown to be life saving for children.  Prompt treatment with influenza antiviral medications can shorten duration and severity of symptoms and prevent serious flu complications. While CDC and partners are working to improve existing flu countermeasures, increases in flu vaccine uptake and the appropriate use of antiviral drugs for treatment could further reduce the burden of influenza in the United States. Influenza activity in the United States during the 2017-18 season began increasing in November followed by an extended period of high activity nationally during January and February and remained elevated through March. Influenza A(H3N2) viruses were most common through February and predominated overall but influenza B viruses, especially B/Yamagata lineage, were most common from March through May. This was a high-severity season: severity indicators (e.g., hospitalization, mortality rates) were higher than what has been observed during previous influenza A(H3N2) predominant seasons. Studies are underway to better understand the reasons for this high severity. In addition, a high number of influenza-associated pediatric deaths were reported this season.

Update: Recommendations for the Use of Quadrivalent Live Attenuated Influenza Vaccine (LAIV4) — United States, 2018–19 Influenza Season
On February 21, 2018, ACIP recommended that intranasally administered live attenuated influenza vaccine (LAIV4) be an option for influenza vaccination of people for whom it is appropriate for the 2018–19 season. This article provides an overview of the information discussed in the decision-making process leading to this recommendation. Intranasally administered LAIV was initially licensed in the United States in 2003 as a trivalent formulation (LAIV3; FluMist, MedImmune, LLC). Quadrivalent live attenuated influenza vaccine (LAIV4; FluMist Quadrivalent, MedImmune) has been licensed in the United States since 2012 and was first available during the 2013–14 influenza season, replacing LAIV3. During the 2016–17 and 2017–18 influenza seasons, the Advisory Committee on Immunization Practices (ACIP) had recommended that LAIV4 not be used because of concerns about low effectiveness against influenza A(H1N1)pdm09-like viruses circulating in the United States during the 2013–14 and 2015–16 seasons. A description of methodology and data reviewed for the decision will be included in the background materials that will supplement the 2018–19 ACIP Influenza Recommendations, which will replace the 2017–18 ACIP influenza statement, and which will also contain guidance for the use of LAIV4.

Register for upcoming June ACIP meeting
June 20-21, 2018
Deadline for registration:
Non-US Citizens: May 16, 2018
US Citizens: June 11, 2018
Registration is NOT required to watch the live meeting webcast or to listen via telephone.

Announcements

Bill & Melinda Gates Medical Research Institute    [to 9 Jun 2018]
https://www.linkedin.com/company/bill-melinda-gates-medical-research-institute/
   The Bill & Melinda Gates Medical Research Institute is a non-profit research organization dedicated to combating diseases that impact the world’s poorest. We strive to combat inequities in health by accelerating progress in translational science to ensure life-saving products are available and accessible to everyone. We consider ourselves pioneers dedicated to uncovering radical solutions that will close the gap between cutting-edge scientific innovation and its application to challenges in global health.

Forbes  Jun 7, 2018
Bill And Melinda Gates Start A Nonprofit Biotech In Boston
Matthew Herper,
The Bill & Melinda Gates Medical Research Institute, which is holding an event today to show off its plans, will aim to develop new medicines and vaccines for malaria, tuberculosis, and diarrhea, which together account for 2.6 million deaths a year globally, many of them in children.

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EDCTP    [to 9 Jun 2018]
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
8 June 2018
European Commission presents next research & innovation framework ‘Horizon Europe’
The European Commission (EC)published its proposal for Horizon Europe, a €100 billion research and innovation programme, on 7 June 2018. The proposal is part of the next European Union long-term budget. Horizon Europe 2021 – 2027 will succeed Horizon 2020…

6 June 2018
Kick-off for trials of preventive vaccine for dermal leishmaniasis
The PREV-PKDL consortium prepares to start clinical trials of a candidate vaccine to prevent chronic dermal leishmaniasis in patients treated for visceral leishmaniasis. The kick-off meeting will take place in York (UK) on 6-7 June 2018.
The promising vaccine has been developed by Prof. Paul Kaye and his team at the University of York, United Kingdom. EDCTP invested EUR 8 million in the project (2018-2023) to prevent post kala azar dermal leishmaniasis (PKDL). The project is coordinated by Dr Odile Leroy, Executive Director of the European Vaccine Initiative (Germany).
Two phase II clinical trials will be conducted in Sudan to evaluate the safety and efficacy of the vaccine in patients diagnosed with and treated for visceral leishmaniasis. In parallel, the project partners also plan to conduct research studies in Sudan, Ethiopia, Kenya and Uganda to better understand the pathogenesis of the disease and the underlying immune mechanisms.

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European Medicines Agency  [to 9 Jun 2018]
http://www.ema.europa.eu/ema/
07/06/2018
Highlights of 100th Management Board meeting: June 2018
Positive assessment of 2017 operations – Seat Agreement with the Netherlands signed
 
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Gavi [to 9 Jun 2018]
http://www.gavi.org/library/news/press-releases/
07 June 2018
Gavi Board approves funding for inactivated poliovirus vaccine until 2020
Flexible support to Nigeria and post-transition countries also approved.
Geneva, 7 June 2018 – The Gavi Board today approved Gavi core funding for inactivated poliovirus vaccine (IPV) for 2019 and 2020 to contribute to achieving and safeguarding the eradication of polio.
“Polio will remain a threat until every child is protected against this crippling disease,” said Dr Ngozi Okonjo-Iweala, Gavi Board Chair. “That is why the vaccination of every child is the corner stone of the polio eradication effort. Introducing IPV to all countries to interrupt polio transmission and maintain zero cases represents an unprecedented push, and Gavi is proud to be part of it.”…

Gavi Board appoints Bill Roedy as Vice Chair
Former MTVNI CEO and HIV/AIDS advocate to help further protect millions of children from vaccine-preventable diseases
Geneva, 7 June 2018 – Bill Roedy, Global Health Ambassador and Former Chairman and Chief Executive Officer of MTV networks International (MTVNI), was today appointed by the Gavi Board as its new Vice Chair.
Mr Roedy joined Gavi in 2010 as its first envoy. He was appointed to the Board in 2015 and has been acting Vice Chair since April 2018.
“It is an honour to be appointed Vice Chair of the Gavi Board. At this level, I have never seen a leaner and more accountable, sustainable, efficient operation in all of global health, and in fact all of business,” said Mr Roedy. “Universal access to life-saving vaccines is the bedrock of a healthy society and a strong economy, and I look forward to supporting the Board Chair at this critical time for the Vaccine Alliance.”…
Mr Roedy replaces Gunilla Carlsson, former Swedish Minister for International Development Cooperation, who stepped down from the position earlier this year following her appointment as Deputy Executive Director, Management and Governance, UNAIDS, and Assistant Secretary General of the United Nations. As Vice Chair of the Board, Mr Roedy will also become chair of the Gavi Governance Committee.

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GHIT Fund   [to 9 Jun 2018]
https://www.ghitfund.org/newsroom/press
GHIT was set up in 2012 with the aim of developing new tools to tackle infectious diseases that devastate the world’s poorest people. Other funders include six Japanese pharmaceutical
June 7, 2018
GHIT Fund Names Hiroki Nakatani as Board Chair
TOKYO, JAPAN (June 7, 2018)—The Global Health Innovative Technology Fund (GHIT) today announced its appointment of Hiroki Nakatani, MD, PhD, MHPEd, former World Health Organization (WHO) assistant director-general, to the fund’s board of directors and named him its board chair. Nakatani succeeds founding GHIT Board Chair Kiyoshi Kurokawa, who played an instrumental role in the fund’s growth and achievements in its first five years of operation.
“Dr. Nakatani is a pioneer in global health and neglected tropical diseases, with an impeccable science and policy implementation track record. His unparalleled leadership in Japan and internationally in linking health innovation to effective policy and delivery will be critical as GHIT continues to evolve and as its first products hit the market,” said BT Slingsby, CEO and executive director of the GHIT Fund. “Dr. Nakatani joins the board at a very exciting time as we’ve also just launched our second five-year phase. And we are grateful to Dr. Kurokawa for his invaluable contributions.”
Nakatani served as WHO assistant director-general from 2007 to 2015, where he led the largest technical cluster comprising HIV/AIDS, tuberculosis, malaria and neglected tropical diseases. During his tenure, the morbidity and mortality of these diseases showed trends of decline, with some tropical diseases moving toward suppression and even eradication in the case of dracunculiasis (guinea worm disease)…

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IVAC  [to 9 Jun 2018]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
June 2018
Commentary: How can Nigeria achieve sustainable immunization financing in the next decade? Government, business, and health leaders discuss the way forward
a panel discussion on options open to the federal government to sustainably finance the routine immunization program ensued. The panel was moderated by Dr. Kate O’Brien, Executive Director of the International Vaccine Access Center (IVAC) at the Johns Hopkins Bloomberg School of Public Health.

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NIH  [to 9 Jun 2018]
http://www.nih.gov/news-events/news-releases
June 4, 2018
New approach to immunotherapy leads to complete response in breast cancer patient unresponsive to other treatments
— New approach is a modified form of adoptive cell transfer.

HIV vaccine elicits antibodies in animals that neutralize dozens of HIV strains
June 4, 2018 — NIH study results represent major advance for structure-based HIV vaccine design.

NIH releases strategic plan for data science
June 4, 2018 — The plan provides a roadmap for modernizing the NIH-funded biomedical data science ecosystem.
[See Milestones above for more detail]

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UNAIDS [to 9 Jun 2018]
http://www.unaids.org/en
Feature story
Stepping up sexual and reproductive health services in Egypt
04 June 2018
In response to a call by women living with HIV in Egypt for an increase in the availability of quality sexual and reproductive health services delivered free from stigma and discrimination, UNAIDS mobilized partners and engaged with Egypt’s national AIDS programme.
The result was a pilot project that ran from 2016 to 2018 in which almost 300 women across the country were provided with family planning, antenatal care, support during delivery, postpartum care and guidance on the prevention of mother-to-child transmission of HIV.
On 30 May, national stakeholders, including representatives of the Ministries of Foreign Affairs and Health and Population, civil society, academia and people living with and affected by HIV, gathered to highlight the key achievements, experiences and lessons learned from the pilot…
 
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Wellcome Trust  [to 9 Jun 2018]
https://wellcome.ac.uk/news
News / Published: 4 June 2018
Update on Public Health and Tropical Medicine Fellowships
Wellcome’s fellowships for early to intermediate career researchers from low- or middle-income countries (LMICs) are being relaunched.
The schemes are being renamed as the International Master’s, Training and Intermediate Fellowships.
We’ve also updated the scope of the schemes to align with our science remit and strategy.
The International Master’s Fellowship will now have a fixed budget limit of £120,000, including salary, stipend, fees and research costs.
These changes follow a recent review and our aim is to attract a broader group of scientists with more diverse research backgrounds.
 
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The Wistar Institute   [to 9 Jun 2018]
https://www.wistar.org/news/press-releases
Press Release  Jun. 7, 2018
The Wistar Institute Partners with Nation’s Top Cancer Centers to Endorse Goal of Eliminating HPV-related Cancers in the United States
Joint statement empowers parents, young adults and physicians to act to increase vaccination rates and screenings in effort to eliminate HPV-related cancers, starting with cervical cancer.
{see Milestones above for more detail]

Press Release  Jun. 4, 2018
The Wistar Institute and Harbour BioMed Join Forces to Advance Novel Antibody Therapies for Cancer and Infectious Diseases
Collaboration combines Wistar’s cancer biology, immunology expertise with Harbour’s proprietary H2L2 transgenic mouse platform for generating fully human monoclonal antibodies.

Journal Watch

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

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

American Journal of Tropical Medicine and Hygiene
Volume 98, Issue 6, 2018
http://www.ajtmh.org/content/journals/14761645/98/6

Perspective Pieces
Yemen in a Time of Cholera: Current Situation and Challenges
Author: Hesham M. Al-Mekhlafi
https://doi.org/10.4269/ajtmh.17-0811
Received : 16 Oct 2017 : Accepted : 20 Feb 2018
Abstract
Since early 2015, Yemen has been in the throes of a grueling civil war, which has devastated the health system and public services, and created one of the world’s worst humanitarian disasters. The country is currently facing a cholera epidemic the world’s largest on record, surpassing one million (1,061,548) suspected cases, with 2,373 related deaths since October 2016. Cases were first confirmed in Sana’a city and then spread to almost all governorates except Socotra Island. Continued efforts are being made by the World Health Organization and international partners to contain the epidemic through improving water, sanitation and hygiene, setting up diarrhea treatment centers, and improving the population’s awareness about the disease. The provision of clean water and adequate sanitation is imperative as an effective long-term solution to prevent the further spread of this epidemic. Cholera vaccination campaigns should also be conducted as a preventive measure.

BMC Medical Ethics
http://www.biomedcentral.com/bmcmedethics/content
(Accessed 9 Jun 2018)

Debate
The dual use of research ethics committees: why professional self-governance falls short in preserving biosecurity
Dual Use Research of Concern (DURC) constitutes a major challenge for research practice and oversight on the local, national and international level. The situation in Germany is shaped by two partly competing suggestions of how to regulate security-related research: The German Ethics Council, as an independent political advisory body, recommended a series of measures, including national legislation on DURC. Competing with that, the German National Academy of Sciences and the German Research Foundation, as two major professional bodies, presented a strategy which draws on the self-control of science and, inter alia, suggests expanding the scope of research ethics committees (RECs) to an evaluation of DURC.
Authors: Sabine Salloch
Citation: BMC Medical Ethics 2018 19:53
Published on: 5 June 2018

BMC Medicine
http://www.biomedcentral.com/bmcmed/content
(Accessed 9 Jun 2018)

Opinion
Zika vaccines and therapeutics: landscape analysis and challenges ahead
Various Zika virus (ZIKV) vaccine candidates are currently in development. Nevertheless, unique challenges in clinical development and regulatory pathways may hinder the licensure of high-quality, safe, and effective ZIKV vaccines.
Authors: Annelies Wilder-Smith, Kirsten Vannice, Anna Durbin, Joachim Hombach, Stephen J. Thomas, Irani Thevarjan and Cameron P. Simmons
Citation: BMC Medicine 2018 16:84
Published on: 6 June 2018

BMJ Open
June 2018 – Volume 8 – 6
http://bmjopen.bmj.com/content/current

Global health
Protocol
Evaluation of different infant vaccination schedules incorporating pneumococcal vaccination (The Vietnam Pneumococcal Project): protocol of a randomised controlled trial (8 June, 2018)
WHO recommends the use of pneumococcal conjugate vaccine (PCV) as a priority. However, there are many countries yet to introduce PCV, especially in Asia. This trial aims to evaluate different PCV schedules and to provide a head-to-head comparison of PCV10 and PCV13 in order to generate evidence to assist with decisions regarding PCV introduction. Schedules will be compared in relation to their immunogenicity and impact on nasopharyngeal carriage of Streptococcus pneumoniae and Haemophilus influenzae.
Beth Temple, Nguyen Trong Toan, Doan Y Uyen, Anne Balloch, Kathryn Bright, Yin Bun Cheung, Paul Licciardi, Cattram Duong Nguyen, Nguyen Thi Minh Phuong, Catherine Satzke, Heidi Smith-Vaughan, Thi Que Huong Vu, Tran Ngoc Huu, Edward Kim Mulholland

Contemporary Clinical Trials
Volume 70  Pages 1-138 (July 2018)
https://www.sciencedirect.com/journal/contemporary-clinical-trials/vol/70/suppl/C

A review of strategies used to retain participants in clinical research during an infectious disease outbreak: The PREVAIL I Ebola vaccine trial experience
This article describes a retrospective review of participant follow-up and retention strategies in the Partnership for Research on the Ebola Virus in Liberia (PREVAIL) I Vaccine Trial. It illustrates and analyzes strategies used to retain participants in an emergency clinical research response vaccine trial conducted during the 2014 Ebola outbreak in Liberia.
S Browne, T Carter, R Eckes, G Grandits, M Johnson

Developing World Bioethics
Volume 18, Issue 2   Pages: 65-203  June 2018
https://onlinelibrary.wiley.com/toc/14718847/current

ARTICLES
Designing research funding schemes to promote global health equity: An exploration of current practice in health systems research
Bridget Pratt, Adnan A. Hyder
Pages: 76-90
First Published: 23 November 2016

Developing World Bioethics
Volume 18, Issue 2   Pages: 65-203  June 2018
https://onlinelibrary.wiley.com/toc/14718847/current

Application of Ethical Principles to Research using Public Health Data in The Global South: Perspectives from Africa
Evelyn Anane‐Sarpong, Tenzin Wangmo, Osman Sankoh, Marcel Tanner, Bernice Simone Elger
Pages: 98-108
First Published: 22 December 2016

Developing World Bioethics
Volume 18, Issue 2   Pages: 65-203  June 2018
https://onlinelibrary.wiley.com/toc/14718847/current

A critique of the principle of ‘respect for autonomy’, grounded in African thought
Kevin G. Behrens
Pages: 126-134  First Published: 03 May 2017

Developing World Bioethics
Volume 18, Issue 2   Pages: 65-203  June 2018
https://onlinelibrary.wiley.com/toc/14718847/current

H3Africa: An Africa exemplar? Exploring its framework on protecting human research participants
Obiajulu Nnamuchi
Pages: 156-164  First Published: 03 May 2017

Developing World Bioethics
Volume 18, Issue 2   Pages: 65-203  June 2018
https://onlinelibrary.wiley.com/toc/14718847/current

Quarantine, isolation and the duty of easy rescue in public health
Alberto Giubilini, Thomas Douglas, Hannah Maslen, Julian Savulescu
Pages: 182-189
First Published: 18 September 2017

Global Public Health
Volume 13, 2017   Issue 8
http://www.tandfonline.com/toc/rgph20/current
Special Symposium: Critical Perspectives on the ‘End of AIDS’.
Guest Editors: Nora Kenworthy, Matthew Thomann, and Richard Parker

Introduction
Critical perspectives on the ‘end of AIDS’
Nora Kenworthy, Matthew Thomann & Richard Parker
ABSTRACT
This special symposium critically examines optimistic promises about an imminent ‘end of AIDS,’ currently circulating in global health discourse and policy. We aim not simply to interrogate the discourse surrounding calls to end AIDS, but to also explore the broader practices, contexts, and policy landscapes that have transformed the global HIV response during the fourth decade of the epidemic and allowed this discourse to gain such political traction. In this introduction we preview the collection’s five substantive papers, which delve beneath the ‘end of AIDS’ rhetoric, bringing greater realism as well as resolve together with empirical evidence about the state of efforts to end AIDS in diverse locations and populations. Taken together, these papers critique not the hope that one day AIDS may come to an end, but the means by which current policy expects to arrive at such ends, particularly in the absence of realistic, sustained commitments to extending treatment, prevention, and broader support in highly under-resourced places and populations.

Global Public Health
Volume 13, 2017   Issue 8
http://www.tandfonline.com/toc/rgph20/current
Special Symposium: Critical Perspectives on the ‘End of AIDS’.
Guest Editors: Nora Kenworthy, Matthew Thomann, and Richard Parker

Article
The ‘end of AIDS’ project: Mobilising evidence, bureaucracy, and big data for a final biomedical triumph over AIDS
Suzanne Leclerc-Madlala, Lorie Broomhall & John Fieno
Pages: 972-981
Published online: 04 Dec 2017

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 5, 2018, Vol 319, No. 21, Pages 2149-2244
http://jama.jamanetwork.com/issue.aspx

Viewpoint
Value-Based Pricing for DrugsTheme and Variations
Anna Kaltenboeck, MA; Peter B. Bach, MD
JAMA. 2018;319(21):2165-2166. doi:10.1001/jama.2018.4871
In this Viewpoint, Peter Bach and colleagues distinguish 5 pricing reform proposals implied by the concept of value-based drug pricing and discuss the potential of each to ensure value in response to unsustainable drug price increases.

JAMA
June 5, 2018, Vol 319, No. 21, Pages 2149-2244
http://jama.jamanetwork.com/issue.aspx

Value-Based Pricing and Patient Access for Specialty Drugs
James C. Robinson, PhD, MPH; Scott Howell, MD, MBA; Steven D. Pearson, MD, MSc
JAMA. 2018;319(21):2169-2170. doi:10.1001/jama.2018.5367
This Viewpoint discusses the challenges of high prices for payers and high access barriers for patients for specialty drugs and how these can be addressed by value-based pricing and value-based patient access.

JAMA Pediatrics
June 2018, Vol 172, No. 6, Pages 505-604
http://archpedi.jamanetwork.com/issue.aspx

Viewpoint
Considering Whether the Dismissal of Vaccine-Refusing Families Is Fair to Other Clinicians
Michael J. Deem, PhD; Mark C. Navin, PhD; John D. Lantos, MD
JAMA Pediatr. 2018;172(6):514-516. doi:10.1001/jamapediatrics.2018.0259
This Viewpoint assesses the ethical and practical implications of a 2016 resolution by the American Academy of Pediatrics on the acceptability of dismissing vaccine-refusing parents from pediatric clinical practices.

Journal of Empirical Research on Human Research Ethics
Volume 13, Issue 3, July 2018
http://journals.sagepub.com/toc/jre/current

Ethical Issues in Online Research
Opt-Out Parental Consent in Online Surveys: Ethical Considerations
Jane Harris, Lorna Porcellato
First Published April 9, 2018; pp. 223–229

Journal of Empirical Research on Human Research Ethics
Volume 13, Issue 3, July 2018
http://journals.sagepub.com/toc/jre/current

Ethical Issues in Clinical Trials
Development and Preliminary Testing of the Perceived Benefit and Burden Scales for Cancer Clinical Trial Participation
Connie M. Ulrich, Qiuping (Pearl) Zhou, Sarah J. Ratcliffe, Kathleen Knafl, Gwenyth R. Wallen, Therese S. Richmond, Christine Grady
First Published April 9, 2018; pp. 230–238

Journal of Empirical Research on Human Research Ethics
Volume 13, Issue 3, July 2018
http://journals.sagepub.com/toc/jre/current

South African Research Ethics Committee Review of Standards of Prevention in HIV Vaccine Trial Protocols
Zaynab Essack, Douglas R. Wassenaar
First Published April 9, 2018; pp. 239–246

Journal of Empirical Research on Human Research Ethics
Volume 13, Issue 3, July 2018
http://journals.sagepub.com/toc/jre/current

The Ethics of End-of-Trial Obligations in a Pediatric Malaria Vaccine Trial: The Perspectives of Stakeholders From Ghana and Tanzania
Claire Leonie Ward, David Shaw, Evelyn Anane-Sarpong, Osman Sankoh, Marcel Tanner, Bernice Elger
First Published May 13, 2018; pp. 258–269

The Lancet
Jun 09, 2018 Volume 391 Number 10137 p2295-2388  e21
http://www.thelancet.com/journals/lancet/issue/current

Editorial
False hope with the Right to Try Act
The Lancet

The Milbank Quarterly
A Multidisciplinary Journal of Population Health and Health Policy
Volume 96, Issue 2  Pages: 215-408  June 2018
https://onlinelibrary.wiley.com/toc/14680009/current

Original Scholarship
From in vivo to in vitro: How the Guatemala STD Experiments Transformed Bodies Into Biospecimens
KAYTE SPECTOR‐BAGDADY, PAUL A. LOMBARDO
Pages: 244-271
First Published: 13 April 2018

The Milbank Quarterly
A Multidisciplinary Journal of Population Health and Health Policy
Volume 96, Issue 2  Pages: 215-408  June 2018
https://onlinelibrary.wiley.com/toc/14680009/current

Does Decentralization Improve Health System Performance and Outcomes in Low‐ and Middle‐Income Countries? A Systematic Review of Evidence From Quantitative Studies
ADENANTERA DWICAKSONO, ASHLEY M. FOX
Pages: 323-368
First Published: 04 June 2018

The Milbank Quarterly
A Multidisciplinary Journal of Population Health and Health Policy
Volume 96, Issue 2  Pages: 215-408  June 2018
https://onlinelibrary.wiley.com/toc/14680009/current

Emerging Trends in Clinical Research With Implications for Population Health and Health Policy
BENJAMIN CHIN‐YEE, S.V. SUBRAMANIAN, AMOL A. VERMA, ANDREAS LAUPACIS, FAHAD RAZAK
Pages: 369-401
First Published: 04 June 2018
Policy Points:
Significant advances in clinical medicine that have broader societal relevance may be less accessible to population health researchers and policymakers because of increased specialization within fields.
We describe important recent clinical advances and discuss their broader societal impact. These advances include more expansive strategies for disease prevention, the rise of precision medicine, applications of human microbiome research, and new and highly successful treatments for hepatitis C infection.
These recent developments in clinical research raise important issues surrounding health care costs and equitable resource allocation that necessitate an ongoing dialogue among the fields of clinical medicine, population health, and health policy.

New England Journal of Medicine
June 7, 2018  Vol. 378 No. 23
http://www.nejm.org/toc/nejm/medical-journal

Perspective
Assessing Drug Safety in Children — The Role of Real-World Data
Ann W. McMahon, M.D.,
and Gerald Dal Pan, M.D., M.H.S.
There are substantial gaps in evidence regarding the safety of many drugs in children. Increasingly, studies assessing drug safety can incorporate data obtained in the course of clinical care to generate real-world evidence and help fill these gaps.

New England Journal of Medicine
June 7, 2018  Vol. 378 No. 23
http://www.nejm.org/toc/nejm/medical-journal

Special Article
Clinical Trial Participants’ Views of the Risks and Benefits of Data Sharing
Michelle M. Mello, J.D., Ph.D., Van Lieou, B.S., and Steven N. Goodman, M.D., Ph.D.
Abstract
Background
Sharing of participant-level clinical trial data has potential benefits, but concerns about potential harms to research participants have led some pharmaceutical sponsors and investigators to urge caution. Little is known about clinical trial participants’ perceptions of the risks of data sharing.
Methods
We conducted a structured survey of 771 current and recent participants from a diverse sample of clinical trials at three academic medical centers in the United States. Surveys were distributed by mail (350 completed surveys) and in clinic waiting rooms (421 completed surveys) (overall response rate, 79%).
Results
Less than 8% of respondents felt that the potential negative consequences of data sharing outweighed the benefits. A total of 93% were very or somewhat likely to allow their own data to be shared with university scientists, and 82% were very or somewhat likely to share with scientists in for-profit companies. Willingness to share data did not vary appreciably with the purpose for which the data would be used, with the exception that fewer participants were willing to share their data for use in litigation. The respondents’ greatest concerns were that data sharing might make others less willing to enroll in clinical trials (37% very or somewhat concerned), that data would be used for marketing purposes (34%), or that data could be stolen (30%). Less concern was expressed about discrimination (22%) and exploitation of data for profit (20%).
Conclusions
In our study, few clinical trial participants had strong concerns about the risks of data sharing. Provided that adequate security safeguards were in place, most participants were willing to share their data for a wide range of uses. (Funded by the Greenwall Foundation.)

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 9 Jun 2018)

Research Article
Academic response to improving value and reducing waste: A comprehensive framework for INcreasing QUality In patient-oriented academic clinical REsearch (INQUIRE)
Belinda von Niederhäusern, Gordon H. Guyatt, Matthias Briel, Christiane Pauli-Magnus
| published 07 Jun 2018 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1002580

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 9 Jun 2018)

Research Article
‘When Ebola enters a home, a family, a community’: A qualitative study of population perspectives on Ebola control measures in rural and urban areas of Sierra Leone
Nell Gray, Beverley Stringer, Gina Bark, Andre Heller Perache, Freya Jephcott, Rob Broeder, Ronald Kremer, Augustine S. Jimissa, Thomas T. Samba
Research Article | published 08 Jun 2018 PLOS Neglected Tropical Diseases
https://doi.org/10.1371/journal.pntd.0006461

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 9 Jun 2018)

Ensuring no one is left behind: Urgent action required to address implementation challenges for NTD control and elimination
Alison Krentel, Margaret Gyapong, Olumide Ogundahunsi, Mary Amuyunzu-Nyamongo, Deborah A. McFarland
Viewpoints | published 07 Jun 2018 PLOS Neglected Tropical Diseases
https://doi.org/10.1371/journal.pntd.0006426

PNAS – Proceedings of the National Academy of Sciences of the United States
of America
http://www.pnas.org/content/early/
[Accessed 9 Jun 2018]

Trends in health inequalities in 27 European countries
Johan P. Mackenbach, José Rubio Valverde, Barbara Artnik, Matthias Bopp, Henrik Brønnum-Hansen, Patrick Deboosere, Ramune Kalediene, Katalin Kovács, Mall Leinsalu, Pekka Martikainen, Gwenn Menvielle, Enrique Regidor, Jitka Rychtaříková, Maica Rodriguez-Sanz, Paolo Vineis, Chris White, Bogdan Wojtyniak, Yannan Hu, and Wilma J. Nusselder
PNAS June 4, 2018. 201800028; published ahead of print June 4, 2018. https://doi.org/10.1073/pnas.1800028115
Significance
Inequalities in mortality and morbidity among socioeconomic groups are a highly persistent phenomenon despite having been the focus of public health policy in many countries. The United States has recently witnessed a widening of health inequalities due to rising mortality and morbidity among the lowly educated. Our study shows that, despite the financial crisis, most European countries have experienced an improvement in the health of the lowly educated in recent years. In Eastern Europe, this even represents a reversal as compared with previous decades. The 2008 financial crisis has had mixed effects without widening health inequalities. Our results suggest that European countries have been successful in avoiding an aggravation of health inequalities.
Abstract
Unfavorable health trends among the lowly educated have recently been reported from the United States. We analyzed health trends by education in European countries, paying particular attention to the possibility of recent trend interruptions, including interruptions related to the impact of the 2008 financial crisis. We collected and harmonized data on mortality from ca. 1980 to ca. 2014 for 17 countries covering 9.8 million deaths and data on self-reported morbidity from ca. 2002 to ca. 2014 for 27 countries covering 350,000 survey respondents. We used interrupted time-series analyses to study changes over time and country-fixed effects analyses to study the impact of crisis-related economic conditions on health outcomes. Recent trends were more favorable than in previous decades, particularly in Eastern Europe, where mortality started to decline among lowly educated men and where the decline in less-than-good self-assessed health accelerated, resulting in some narrowing of health inequalities. In Western Europe, mortality has continued to decline among the lowly and highly educated, and although the decline of less-than-good self-assessed health slowed in countries severely hit by the financial crisis, this affected lowly and highly educated equally. Crisis-related economic conditions were not associated with widening health inequalities. Our results show that the unfavorable trends observed in the United States are not found in Europe. There has also been no discernible short-term impact of the crisis on health inequalities at the population level. Both findings suggest that European countries have been successful in avoiding an aggravation of health inequalities.
 
 

Preventive Medicine
Volume 111  Pages 1-476 (June 2018)
https://www.sciencedirect.com/journal/preventive-medicine/vol/111/suppl/C

Regular Articles
Variation in health beliefs across different types of cervical screening non-participants
Open access – Original research article
Pages 204-209
Laura A.V. Marlow, Rebecca A. Ferrer, Amanda J. Chorley, Jessica B. Haddrell, Jo Waller
Abstract
Understanding factors associated with different types of cancer screening non-participation will help with the development of more targeted approaches for improving informed uptake. This study explored patterns of general health beliefs and behaviour, and cancer-specific beliefs across different types of cervical screening non-participants using the Precaution Adoption Process Model (PAPM). A population-representative sample of women in Britain completed a home-based survey in 2016. Women classified as non-participants (n=839) completed additional questions about health beliefs.
Some general health beliefs and behaviours, as well as cancer-specific beliefs, were associated with particular types of non-participation. For example, those who scored higher on fatalism were more likely to be unaware of screening (OR=1.74, 95%CI: 1.45–2.08) or unengaged with screening (OR=1.57, CI: 1.11–2.21). Women with greater deliberative risk perceptions were less likely to be unengaged with screening (OR=0.74 CI: 02.55–0.99) and less likely to have decided against screening (OR=0.71, CI: 0.59–0.86). Women who had seen a general practitioner in the last 12 months were less likely to be unaware (O=0.49, CI: 0.35–0.69), and those reporting cancer information avoidance were more likely to be unengaged with screening (OR=2.25, CI: 1.15–4.39). Not wanting to know whether one has cancer was the only factor associated with all types of non-participation.
Interventions to raise awareness of screening should include messages that address fatalistic and negative beliefs about cancer. Interventions for women who have decided not to be screened could usefully include messages to ensure the risk of cervical cancer and the relevance and benefits of screening are well communicated.

Science         
08 June 2018  Vol 360, Issue 6393
http://www.sciencemag.org/current.dtl

Editorial
Still not ready for Ebola
By Thomas R. Frieden
Science08 Jun 2018 : 1049
Summary
Ebola is back. The disease that killed more than 11,000 people in West Africa just a few years ago has returned, striking the Democratic Republic of the Congo (DRC). Last week, intervention with a new vaccine was initiated to help contain the outbreak, adding another tool to a response that is exponentially better than it was 4 years ago. But we are not out of the woods. No matter how long this Ebola outbreak continues, the world faces critical tests in its battle against deadly pathogens. Unlike 2014, when delayed recognition of Ebola led to undetected disease spread, the DRC promptly admitted it had an outbreak and called for assistance. The World Health Organization (WHO) did not try to minimize the problem. Rapid response units from within the DRC and around the world deployed immediately. And, fortunately, the DRC has well-trained epidemiologists as well as laboratory capacity to test for the virus.

Tropical Medicine & International Health
Volume 23, Issue 6  Pages: i-iv, 581-690  June 2018
https://onlinelibrary.wiley.com/toc/13653156/current

Original Research Papers
Dengue Fever and Aedes aegypti in indigenous Brazilians: seroprevalence, risk factors, knowledge and practices
Rafael Henrique Machado Sacramento, Fernanda Montenegro de Carvalho Araújo, Danielle Malta Lima, Carlos Carlos Henrique Alencar, Victor Emanuel Pessoa Martins, Lucas Venâncio Araújo, Tais Castelo de Oliveira, Luciano Pamplona de Góes Cavalcanti
Pages: 596-604
First Published: 19 April 2018

Vaccine
Volume 36, Issue 26   Pages 3717-3882 (18 June 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/26

Short communication
Reintroducing OPV in Israel on the journey to global polio eradication – Estimation at a low rate of contraindicated population
Pages 3717-3720
Chen Rosenberg Danziger, Emilia Anis, Ethel-Sherry Gordon, Itamar Grotto, Yehuda L. Danon

Vaccine
Volume 36, Issue 26   Pages 3717-3882 (18 June 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/26

Review
Knowledge gaps persist and hinder progress in eliminating mumps
Review article
Pages 3721-3726
Ramanathan, E.A. Voigt, R.B. Kennedy, G.A. Poland

Vaccine
Volume 36, Issue 26   Pages 3717-3882 (18 June 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/26

Regular papers
Challenges of cold chain quality for routine EPI in south-west Burkina-Faso: An assessment using automated temperature recording devices
Original research article
Pages 3747-3755
Sow, C. Sanou, C. Medah, M. Schlumberger, … E. Betsem

Vaccine
Volume 36, Issue 26   Pages 3717-3882 (18 June 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/26

Willingness and influential factors of parents to vaccinate their children with novel inactivated enterovirus 71 vaccines in Guangzhou, China
Original research article
Pages 3772-3778
Tiegang Li, Hui Wang, Yin Lu, Qin Li, … Zhicong Yang

Vaccine
Volume 36, Issue 26   Pages 3717-3882 (18 June 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/26

Conditional admission, religious exemption type, and nonmedical vaccine exemptions in California before and after a state policy change
Original research article
Pages 3789-3793
Alison M. Buttenheim, Malia Jones, Caitlin Mckown, Daniel Salmon, Saad B. Omer

Vaccine
Volume 36, Issue 26   Pages 3717-3882 (18 June 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/26

Decline of HPV infections in Scandinavian cervical screening populations after introduction of HPV vaccination programs
Original research article
Pages 3820-3829
Joakim Dillner, Mari Nygård, Christian Munk, Maria Hortlund, … Susanne K. Kjaer

Vaccine
Volume 36, Issue 26   Pages 3717-3882 (18 June 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/26

An innovative medical school curriculum to address human papillomavirus vaccine hesitancy
Original research article
Pages 3830-3835
Abigail M. Schnaith, Erica M. Evans, Caleb Vogt, Andrea M. Tinsay, … Britt K. Erickson

Vaccine
Volume 36, Issue 26   Pages 3717-3882 (18 June 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/26

Determinants of cost of routine immunization programme in India
Open access – Original research article
Pages 3836-3841
Susmita Chatterjee, Arpita Ghosh, Palash Das, Nicolas A. Menzies, Ramanan Laxminarayan