Vaccines and Global Health: The Week in Review :: 29 September 2018

.– 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_29 Sep 2018

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

– Twitter:  Readers can also follow developments on twitter: @vaxethicspolicy.
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David R. Curry, MS
Executive Director
Center for Vaccine Ethics and Policy

The Global Immunization Meeting: Successfully Navigating Transitions

Milestones :: Perspectives
 
The Global Immunization Meeting: Successfully Navigating Transitions
[posted 24 Sep 2018]
In June, possibly the largest ever gathering of the immunization community took place in Kigali, Rwanda, co-hosted by WHO and UNICEF. From 26 to 28 June, the Global Immunization Meeting (GIM) was attended by over 250 participants representing key immunization stakeholders and partners at global, regional, and country levels.

Unlike past GIMs that covered key issues related to routine immunization strengthening, the implementation of new and under-utilized vaccines, and accelerated disease control efforts, the 2018 theme of the GIM was Navigating Transitions. This provided an opportunity to work toward a common understanding of current changes such as Gavi transition and polio transition, and to explore new directions for action as the Global Vaccine Action Plan comes to a close in 2020.

The meeting objectives were to:
:: Update global, regional, and country-level partners on key successes and challenges in immunization related to polio and Gavi transition
:: Provide a forum for formal and informal exchange of new ideas and innovations
:: Identify partner and country visions to achieve immunization programme goals after 2020.

The meeting consisted of a mix of multiple interactive session formats, providing many opportunities to engage and explore diverse aspects of immunization. The morning plenary sessions were dynamic and designed to challenge assumptions and bring new knowledge, and afternoon workshop sessions to provide an opportunity to explore technical topics in detail.

Short sessions also took place to introduce new content areas and to share the latest updates on key themes. Lastly, a range of special sessions, including debates and ‘breakfast with an expert’ offered the occasion to dive into specific ‘hot’ topics. For staying up-to-date on all of the action, a meeting app equipped all participants with the agenda, notifications, and an activity tracker for sharing alerts and photos.

With the excellent quality of content across the board, attendees participated actively throughout the meeting. It would be impossible to pin-point any specific sessions in particular, however it should be noted that the plenary presentations were particularly thought-provoking. Prof. Helen Rees kicked off the meeting with a compelling presentation on the global shifts affecting the future of immunization, and day 2 featured Ola and Anna Rosling challenging our preconceptions about demographics, demonstrating that we’re not always right (apparently!), and why trends in global health are actually better than we think.

Thank you to the planning committee for the learning, inspiration, and connections made throughout the meeting!

For further information and the meeting agenda, please see:
https://www.gim2018.org/
To view the plenary presentations from each day:
https://www.gim2018.org/video-and-photography/
 

Ebola – Democratic Republic of the Congo

Milestones :: Perspectives

Ebola – Democratic Republic of the Congo

Ebola virus disease – Democratic Republic of the Congo
Disease Outbreak News (DONs)  27 September 2018

The response to the Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo is at a critical juncture. While substantial progress has been made, the situation is precarious given recent increases in insecurity, incidents of community reluctance and geographical spread.

There have been a number of incidents in recent days, notably in Beni, which have led to loss of life among the local communities. WHO response activities have been severely limited as Beni and other towns mark a period of mourning for those who were killed. Security in Beni and other areas remains challenging.

The Ministry of Health (MoH), WHO and partners continue to work closely with people in the affected areas to overcome reluctance and mistrust which has developed among some communities. Rumours, misinformation and traditional practices have led some families to opt to care for sick relatives at home; some patients have also left health facilities to seek alternative care. Together this results in health workers being unable to provide optimal treatment, and also increases the risk of infection for relatives and local community members. These factors have contributed to the geographical spread of the outbreak.

The movement of several cases across health zones in recent weeks is concerning; one infected individual who recently moved to Kalunguta Health Zone is the first to move into a ‘red’ zone – highly insecure and challenging environments where implementing response activities is extremely difficult, if not impossible. Responders are employing a range of new techniques in these red zones, including using armed escorts and training local health workers to trace contacts.

Where they have access, response teams continue to enhance activities to prevent new clusters and the potential spread to new areas. WHO continues to work in the affected areas, side-by-side with national and international partners, to support the response led by the MoH. There continues to be challenges with identifying all contacts, registered contacts being lost to follow up, delayed recognition of EVD in health centres, poor infection prevention and control (IPC) in health centres, and reluctance among some cases to be treated in Ebola treatment centres (ETCs). The priority remains strengthening all components of the public health response in all affected areas, as well as continuing to enhance operational readiness and preparedness in the non-affected provinces of the Democratic Republic of the Congo and in neighbouring countries.

Since the last Disease Outbreak News (data as of 18 September), nine new confirmed EVD cases were reported: five from Beni, one from Butembo and one from Mabalako health zones in North Kivu Province, as well as two from Tchomia Health Zone in Ituri Province. These are the first confirmed EVD cases to be reported from Tchomia Health Zone which is near the Ugandan border; both cases, a couple, were linked to the ongoing Beni transmission chain. Two of the remaining seven cases have been linked to ongoing transmission chains within the respective communities, while the last five cases are under investigation.

As of 25 September 2018, a total of 151 EVD cases (120 confirmed and 31 probable), including 101 deaths (70 confirmed and 31 probable)1, have been reported in seven health zones in North Kivu Province (Beni, Butembo, Kalunguta, Mabalako, Masereka, Musienene and Oicha), and two health zones in Ituri Province (Mandima and Tchomia) (Figure 1). An overall decreasing trend in weekly case incidence continues (Figure 2); however, these trends must be interpreted with caution given the expected delays in case reporting, the ongoing detection of sporadic cases and the security situation which is limiting contact tracing. Of the 149 confirmed and probable cases for whom age and sex information is known, 23%, 20% and 22% are aged 15-24, 25-34 and 35-44 years, respectively; females (56%) accounted for the greatest proportion of cases (Figure 3). Cumulatively, 19 (18 confirmed and one probable) health workers have been affected to date, three of whom have died.

The MoH, WHO and partners continue to closely monitor and investigate all alerts in affected areas, in other provinces in the Democratic Republic of the Congo and in neighbouring countries. As of 25 September, 17 suspected cases in the Democratic Republic of the Congo are awaiting laboratory testing. Since the last report was published, alerts were investigated in several provinces of the Democratic Republic of the Congo, as well as in neighbouring countries; and to date, EVD has been ruled out in all alerts from neighbouring provinces and countries.

 

:: 08: Situation report on the Ebola outbreak in North Kivu  25 September 2018

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WHO calls for protection of humanitarian workers and civilians in Democratic Republic of the Congo
26 September 2018  News Release
The response to the outbreak of Ebola in North Kivu and Ituri provinces in the Democratic Republic of the Congo is at a critical juncture, threatened by worsening insecurity, mistrust from affected communities, and extension into previously unaffected areas…

But there is a risk now that hard-won gains may be lost.
First, there has been an increase in frequency and severity of attacks by armed opposition groups. Attacks by armed opposition groups on the town Beni, in North Kivu, where the Ministry of Health and partners have based their response, have occurred with alarming frequency. Most recently a deadly attack on 22 September left 21 dead, including 17 civilians.

As a result, WHO and its UN partners were asked to halt operations in Beni, while the city mourns its dead. As of today, some operations have begun to resume, but even a gap of two days has resulted in health workers not being able to reach contacts of Ebola patients to monitor their health; or investigate alerts of potential cases.

Meanwhile, some families have chosen to care for sick relatives at home, often because they have been misinformed, and because a natural fear of the disease is now being exploited by local politicians.

Others sick with Ebola travel widely to seek alternative care, putting themselves, their families and health workers at risk. This has brought infection to new locations, where teams cannot provide them with access to treatment, or provide protective vaccines to their contacts.  These include security red zones which are difficult to access, and to areas bordering Uganda.

WHO calls on all relevant parties, and the governments or groups that have influence over these parties, to help protect responders and civilians.

WHO also calls on governments in surrounding countries to accelerate the preparedness activities which they have begun, with WHO support, to ensure a level of readiness should they face cases of Ebola themselves.

 

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UNICEF teams up with Ebola survivors to help stop spread of deadly outbreak in the Democratic Republic of the Congo

KINSHASA/DAKAR/NEW YORK/GENEVA, 28 September 2018 – Recent survivors of the Ebola virus and UNICEF are partnering to help prevent further transmission of the deadly disease in the eastern Democratic Republic of the Congo (DRC). As part of this effort, the survivors are sharing their stories during public events and through public radio in Ebola-affected communities.

Forty-three people have survived the Ebola virus since the beginning of the latest outbreak in August.

“The survivors are living proof that it is possible to recover from the Ebola virus disease, especially if it is detected and treated early,” said Dr. Gianfranco Rotigliano, UNICEF Representative in the DRC. “The testimonies of these Ebola-survivors help us to reduce the fear in the communities and to encourage people with Ebola-like symptoms to look for early treatment, thereby avoiding the risk of further contamination.”

Lack of awareness of prevention measures and treatment of the disease among the population increases the risk of further transmission, as shown by the newly confirmed case of Ebola in the Tchomia health zone. In response to this case, UNICEF has deployed a team to help with the Ebola-response put in place by the Government and now has response teams operating in Mangina, Beni, Butembo and Tchomia…

 

TB: Commitments/Vaccines/Strategies

Milestones :: Perspectives

TB: Commitments/Vaccines/Strategies

World leaders commit to bold targets and urgent action to end TB

26 September 2018  News Release

World leaders meeting today at the United Nations (UN) General Assembly have committed to ensure that 40 million people with tuberculosis (TB) receive the care they need by end 2022. They also agreed to provide 30 million people with preventive treatment to protect them from developing TB.

“Today is a landmark in the long war on TB,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “These are bold promises – to keep them partnership is vital. WHO is committed to working with every country, every partner and every community to get the job done.”

Heads of state and government attending this first-ever UN High-level meeting on TB agreed to mobilize US$ 13 billion a year by 2022 to implement TB prevention and care, and US$ 2 billion for research. They committed to take firm action against drug-resistant forms of the disease; build accountability and to prioritize human rights issues such as the stigma that still prevails around TB in many parts of the world.

They acknowledged that the current rate of progress was endangering prospects of meeting global targets to end TB. Today, TB remains the world’s deadliest infectious disease: it killed 1.6 million people in 2017, including 300 000 people with HIV. In the same year, 10 million people fell ill with TB.

“The political declaration proposed for this meeting sets a roadmap for accelerated action to end TB in line with the vision and targets for 2030,” said H.E. Ms Maria Fernanda Espinosa Garcés, President of the 73rd Session of the UN General Assembly. “We have before us the opportunity for a clear win – a chance to save the lives of millions, to preserve billions in resources, to demonstrate the success of the Sustainable Development Goals, and to reaffirm the utility, efficacy and necessity of multilateralism and the UN System. Let us not miss this opportunity.”

The political declaration is the culmination of recent leadership commitments at global and regional level – including the 2017 Moscow Declaration to End TB – to drive universal access, sufficient and sustainable financing, intensified research and innovation, and accountability across all sectors.

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GSK candidate vaccine helps prevent active pulmonary tuberculosis in HIV negative adults in phase II study

Publication of primary results in the New England Journal of Medicine shows positive impact of innovative vaccine technology in clinical trial conducted in tuberculosis endemic regions

LONDON (25 September 2018) – Today, GSK and Aeras reported that GSK’s M72/AS01E[1] candidate vaccine significantly reduced the incidence of pulmonary tuberculosis disease in HIV-negative adults with latent tuberculosis infection[2] in an ongoing phase IIb clinical trial testing. These primary results published in the New England Journal of Medicine after two years of trial demonstrate an overall vaccine efficacy of 54%, with varied response rates observed in different demographic sub-groups. The candidate vaccine had an acceptable safety and reactogenicity profile.

Tuberculosis is the leading cause of death through infectious disease worldwide and represents a significant public health threat with 1.6 million attributed deaths in 2017. It is estimated that one-quarter of the global population has latent tuberculosis infection, of whom approximately 10% will develop active pulmonary tuberculosis disease.  Currently, multi-drug resistant strains of tuberculosis are emerging globally, and the only currently available vaccine against tuberculosis, BCG, does not provide proven and consistent protection in adults in tuberculosis endemic countries. Without a more effective vaccine, it will not be possible to achieve the WHO target of decreasing the number of new cases by 90% and the number of tuberculosis deaths by 95% between 2015 and 2035.

Dr Emmanuel Hanon, Senior Vice-President and Head of R&D, Global Vaccines GSK, said: “These initial findings represent a significant innovation in the development of a new and much-needed vaccine and advance the scientific understanding of tuberculosis. This scientific breakthrough – one of the very few in tuberculosis vaccine development for almost 100 years – has been made possible by our strategic partnership with Aeras, in which GSK is providing the innovation expertise and technology platforms, such as the proprietary AS01 adjuvant.”

The study assesses the safety and efficacy of M72/AS01E protecting adults with latent tuberculosis infection against developing pulmonary tuberculosis disease. The ongoing trial is conducted in tuberculosis endemic regions (Kenya, South Africa and Zambia) and involves 3,573 HIV-negative adults. For this analysis, participants who received two doses of either M72/AS01E or placebo 30 days apart have been followed up for at least 2 years to detect evidence of pulmonary tuberculosis disease.  In the vaccine group, 10 participants developed active pulmonary tuberculosis compared to 22 participants in the placebo group.

Jacqui Shea, Chief Executive Officer of Aeras, which contributed to the partnership their decades long experience in tuberculosis vaccine clinical development, clinical operations capabilities and strong links with African clinical sites and patient communities, said: “This ground-breaking study shows – for the first time – that a subunit vaccine can significantly reduce the incidence of pulmonary tuberculosis in healthy, HIV-negative adults with latent tuberculosis infection, and that more effective vaccines against tuberculosis are achievable. Given the overwhelming public health need, the importance of these promising results, which need to be confirmed through additional clinical research, cannot be overstated. An effective vaccine, able to reduce transmission, would be by far the most impactful new intervention to end the global tuberculosis epidemic”.

The study is still ongoing and a final analysis including all efficacy, safety, reactogenicity and immunogenicity data will be performed in 2019 after all participants have completed three years of follow up.

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NIH releases strategic plan to address tuberculosis research

September 26, 2018 — TB is the leading infectious cause of death worldwide.
Recently, the global health community has strengthened its efforts and resolve to tackle this ancient disease. Writing in the Journal of the American Medical Association, Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, details the institute’s new strategic plan for building on these current efforts by furthering the understanding of TB and developing and applying cutting-edge tools to fight the disease.

The NIAID Strategic Plan for Tuberculosis Research prioritizes expanding fundamental knowledge of TB by using modern tools, such as state-of-the-art imaging and systems biology methods, to better understand how TB infection remains latent in some individuals and then progresses to active disease, as well as the host and microbial factors that affect TB disease, transmission, and epidemiology.  The plan is being released to coincide with the United Nations General Assembly High-Level Meeting on Ending TB on September 26…
 

FFDA issues drsft guidance on the use of adaptive designs and master protocols in clinical trials

Milestones :: Perspectives

FDA in Brief: FDA modernizes clinical trial designs and approaches for drug development, proposing new guidance on the use of adaptive designs and master protocols
September 28, 2018
“By modernizing our approach to the design of clinical trials, we can make drug development more efficient and less costly while also increasing the amount of information we can learn about a new product’s safety and benefits. Using more modern approaches to clinical trials, we can lower the cost of developing new drugs and increase the amount of competition in the market,” said FDA Commissioner Scott Gottlieb, M.D. “This can improve patient access. We’ve found that it’s taking much longer after a new drug is approved to get a second or third drug to the market that’s in the same class as the original medicine. That means that new drugs are enjoying monopolies for longer periods of time, and consumers aren’t benefiting from price competition. Also, patients aren’t getting the benefits from a choice between different drugs in a new class of medicines, where each drug is similar but might have slightly different profiles, and where one drug may work better for an individual patient. One of the most promising ways to make drug development more efficient — while enabling providers and patients to get better information about how a new medicine works — is through the use of more modern approaches to the design of clinical trials.

One such approach are master protocol designs. These are clinical trials that allow the evaluation of more than one investigational drug or biologic, more than one disease type, or more than one patient population in parallel, under a single clinical trial structure. The standard approach to generating evidence — a series of clinical trials, each investigating one or two interventions in a single disease — has become more expensive and challenging to execute. As a result, important clinical questions can go unanswered. Instead, well-designed master protocols that look at multiple therapies in a single disease, a single therapy in multiple diseases, or multiple therapies across multiple diseases or disease subtypes, can provide answers more quickly and efficiently than traditional clinical trials. These approaches allow the evaluation of how different drugs, often developed by different manufacturers, affect a common biomarker or genetic mutation that might be a measure of response to treatment. Because of the complexity of these trials and the potential regulatory impact, it’s important that we’re providing adequate guidance on how to conduct well designed trials that protect patient safety and obtain quality data needed to support drug approval. With the two new draft guidance documents being issued today – one on master protocols and one on adaptive clinical trial design – the FDA is proposing important principles for modernizing clinical trials through these and similar approaches.

Adaptive clinical trials can give sponsors the flexibility to react to clinical evidence as it’s being collected, and modify the design and enrollment in trials by including more patients with characteristics that help predict that they’re more likely to derive a benefit. Or exclude patients with characteristics that suggest that they’re more likely to suffer a side effect. By enriching the enrollment in the trial for patients with characteristics that are likely to predict clinical success, it has the potential to make the development process more efficient. This approach also allows us to potentially learn much more about the characteristics that can inform safer prescribing. All of these efforts are part of our broader program to modernize the FDA’s science-based framework for making clinical trials more efficient and lower cost while strengthening the agency’s gold standard for safety and efficacy.”

Today, the U.S. Food and Drug Administration is announcing two new draft guidances for industry. The first document, “Master Protocols – Efficient Clinical Trial Design Strategies to Expedite Development of Cancer Drugs and Biologics,” addresses master protocol design. This includes a discussion of the information sponsors should submit to the FDA as part of these approaches, and how sponsors should interact with FDA to facilitate efficient review and mitigate risks to patients.

The second draft guidance is titled “Adaptive Designs for Clinical Trials of Drugs and Biologics,” addresses principles for designing, conducting and reporting the results from an adaptive clinical trial. An adaptive design is a type of clinical trial design that allows for planned modifications to one or more aspects of the design based on data collected from the study’s subjects while the trial is ongoing. The advantage of an adaptive design is the ability to use information that was not available at the start of the trial to improve efficiency. An adaptive design can provide a greater chance to detect the true effect of a product, often with a smaller sample size or in a shorter timeframe. Additionally, an adaptive design can reduce the number of patients exposed to an unnecessary risk of an ineffective investigational treatment. Patients may even be more willing to enroll in these types of trials, as they can increase the probability that subjects will be assigned to the more effective treatment.

These guidance documents are part of the FDA’s science-based mission to modernize clinical trials and advance the development of safe and effective drugs and biologics for the American public.

FDA has published a 60-day notice requesting public comment on these guidances. To comment, please see these links:

Master Protocols: Efficient Clinical Trial Design Strategies to Expedite Development of Oncology Drugs and Biologics; Draft Guidance for Industry
 

Adaptive Designs for Clinical Trials of Drugs and Biologics; Draft Guidance for Industry

 

Emergencies

Emergencies

 
POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 25 September 2018 [GPEI]
:: Featured on www.polioeradication.org: Coffee with Polio Experts – Head of WHO Chad Dr Jean-Bosco Ndihokubwayo speaks about the ongoing efforts to reach every child with polio vaccine across Chad.
Summary of new viruses this week:
Afghanistan – – two new wild poliovirus type 1 (WPV1) positive environmental samples; Pakistan – five new WPV1-positive environmental samples;
Nigeria – three cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) and two cVDPV2-positive environmental samples;
Niger – two cVDPV2 cases;
Horn of Africa (Somalia) – three cVDPV3 cases and one cVDPV3 positive environmental sample; and,
Papua New Guinea – two new cVDPV1 cases.
 
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Editor’s Note:
WHO has posted a refreshed emergencies page which presents an updated listing of Grade 3,2,1 emergencies as below.

WHO Grade 3 Emergencies  [to 29 Sep 2018]
Bangladesh – Rohingya crisis
:: Weekly Situation Report 44 -19 September 2018 pdf, 281kb

Democratic Republic of the Congo
:: 08: Situation report on the Ebola outbreak in North Kivu  25 September 2018
:: Disease Outbreak News (DONs)  Ebola virus disease – Democratic Republic of the Congo
27 September 2018
[See Milestones above for detail]

Syrian Arab Republic
:: The only tuberculosis control centre in Aleppo is up and running again  26 September 2018

Yemen
:: High-Level Event on the Humanitarian Response in Yemen
Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization
United Nations General Assembly, 24 September 2018

Nigeria – No new announcements identified
Somalia – No new announcements identified
South Sudan – No new announcements identified

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WHO Grade 2 Emergencies  [to 29 Sep 2018]
Myanmar
:: Weekly Situation Report 44 -19 September 2018
 
Zimbabwe
:: WHO is scaling up response to a fast-moving cholera outbreak in Zimbabwe’s capital
Harare/Brazzaville 13 September 2018 – The World Health Organization (WHO) is scaling up its response to an outbreak of cholera in Zimbabwe, which is expanding quickly in Harare, the country’s capital with a population of more than two million people…

Cameroon  – No new announcements identified
Central African Republic  – No new announcements identified
Ethiopia – No new announcements identified
Hurricane Irma and Maria in the Caribbean – No new announcements identified
Iraq – No new announcements identified
occupied Palestinian territory – No new announcements identified
Libya – No new announcements identified
MERS-CoV – No new announcements identified
Niger – No new announcements identified
Sao Tome and Principe Necrotizing Cellulitis (2017) – No new announcements identified
South Africa Listeriosis (2017) – No new announcements identified
Sudan – No new announcements identified
Ukraine – No new announcements identified

Outbreaks and Emergencies Bulletin, Week 37: 15 -21 September 2018
The WHO Health Emergencies Programme is currently monitoring 54 events in the AFRO region. This week’s edition covers key ongoing events, including:
:: Ebola virus disease outbreak in the Democratic Republic of the Congo
:: Cholera outbreak in Niger
:: Cholera outbreak in Zimbabwe
:: Cholera outbreak in Chad
:: Cholera outbreak in Nigeria

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WHO Grade 1 Emergencies  [to 29 Sep 2018]
Afghanistan
Angola (in Portuguese)
Chad
Ethiopia
Kenya
Lao People’s Democratic Republic
Mali
Papua New Guinea
Peru
Tanzania
Tropical Cyclone Gira
Zambia
 
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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. 
Syrian Arab Republic   No new announcements identified.
Yemen  – No new announcements identified.

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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  No new announcements identified.
Somalia   No new announcements identified.

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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 29 Sep 2018]
http://www.who.int/ebola/en/
[See Milestones above for more detail]

MERS-CoV [to 29 Sep 2018]
http://who.int/emergencies/mers-cov/en/
No new announcements identified.
 

Yellow Fever  [to 29 Sep 2018]
http://www.who.int/csr/disease/yellowfev/en/
:: The Republic of Congo to vaccinate more than one million people against yellow fever
26 September 2018, Brazzaville – The Republic of Congo, in collaboration with the World Health Organization (WHO) and partners started today a vaccination campaign to control the spread of yellow fever in the port city of Pointe Noire and surrounding areas. More than 1 million people from nine months of age are expected to be vaccinated in this six-day campaign.
The vaccination campaign uses doses from the global emergency Yellow Fever vaccine stockpile managed by the International Coordination Group on Vaccine Provision (ICG) and funded by Gavi, the Vaccine Alliance. The ICG coordinates the timely and equitable provision of vaccines during outbreaks and maintains an emergency stockpile of six million doses of yellow fever vaccine, which is continually replenished. Gavi will also cover operational costs for this campaign.
The immunization drive is a response to a laboratory-confirmed yellow fever case, which tested positive on 21 August 2018, after visiting a rural area…

Zika virus  [to 29 Sep 2018]
http://www.who.int/csr/disease/zika/en/
No new announcements identified.

WHO & Regional Offices [to 29 Sep 2018]

WHO & Regional Offices [to 29 Sep 2018]

The Global Immunization Meeting
26 – 28 June 2018 [posted 24 September 2018]
[See Milestones above for detail]

World Rabies Day 2018
28 September 2018 | Geneva –– In 2015, the world called for action by setting a goal of zero human dog-mediated rabies deaths by 2030, worldwide. World Rabies Day provides a platform to improve awareness, engage communities and help endemic countries in building successful and sustainable rabies programmes.
Awareness and education are vital to the success of the rabies zero by 30 campaign. Through education we can improve the health, wellbeing and development of communities and save thousands of lives each year.

27 September 2018   News Release
Heads of State commit to lead response to beat noncommunicable diseases, promote mental health

27 September 2018  News Release
WHO Director-General reappoints Michael R. Bloomberg as WHO Global Ambassador for Noncommunicable Diseases and Injuries

26 September 2018  News Release
WHO calls for protection of humanitarian workers and civilians in Democratic Republic of the Congo
[See Milestones above for detail]

26 September 2018  News Release
World leaders commit to bold targets and urgent action to end TB
[See Milestones above for detail]

26 September 2018  News Release
Ray Chambers appointed WHO Ambassador for Global Strategy
::::::
 
Weekly Epidemiological Record, 28 September 2018, vol. 93, 39 (pp. 500–520)
:: Progress towards poliovirus containment worldwide, 2017–2018
:: Summary of global update on provision of preventive chemotherapy in 2017 and progress towards ensuring timely supplies and management
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WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
Selected Featured News
:: From high burden to high impact: getting back on track to end malaria  29 September 2018
:: Uganda steps up Ebola preparedness response in 22 high-risk districts  27 September 2018
:: Yobe State requests WHO’s expertise over fresh cholera outbreak  27 September 2018
:: WHO deploys nearly 4,000 volunteers to tackle malaria in Borno and Adamawa States
27 September 2018
:: The Republic of Congo to vaccinate more than one million people against yellow fever
26 September 2018
:: WHO scales up new front against Ebola in the Democratic Republic of Congo, near the border with Uganda  26 September 2018
:: WHO Supports Training of 450 Community Health Volunteers to Enhance Community Case Detection  24 September 2018

WHO Region of the Americas PAHO
:: PAHO Directing Council ends with agreements to reduce the shortage of health personnel and prevent diseases in the Region (09/27/2018)
:: Actions agreed to improve the health of women, children and adolescents across their life course (09/27/2018)
:: Bioethics must be strengthened in the Region to better prepare for public health emergencies (09/26/2018)
:: Ministers of health commit to reducing cervical cancer cases and deaths by 30% in the Americas by 2030 (09/26/2018)
:: PAHO: No cases of poliomyelitis have been reported in the Region of the Americas since 1991 (09/26/2018)
:: Road safety is improving, but more laws are required to control speed limits, helmet and seat belt use in the Americas (09/26/2018)
:: Countries in the Americas can end preventable child mortality by reaching the most vulnerable (09/26/2018)
:: New PAHO plan aims to reduce a shortage of nearly 800,000 health workers in the Region of the Americas (09/26/2018)
:: Progress must be accelerated to end tuberculosis in the Americas, says new PAHO report (09/25/2018)
:: Ministers of Health of the Americas agree to strengthen actions to prevent vector-borne diseases (09/24/2018)
:: Uruguayan President and pioneer in tobacco control is named a PAHO Health Hero of the Americas (09/24/2018)
:: New challenges threaten health achievements in the Americas and call for innovative solutions  (09/23/2018)
 

WHO South-East Asia Region SEARO
:: EU grant to improve health services for more than one million vulnerable people
SEAR/PR/1701   Dhaka, 25 September: A European Union grant of €1 million (US$1.2 million) is helping the World Health Organization to strengthen health services for the nearly one million vulnerable Rohingyas and their host communities in Cox’s Bazar, Bangladesh, who remain at risk of disease outbreaks.
 

WHO European Region EURO
::  Groundbreaking pledge of United Nations agencies to end HIV, TB and viral hepatitis epidemics in Europe at high-level meeting on ending TB 28-09-2018
:: Adolescents drink less, although levels of alcohol consumption are still dangerously high 26-09-2018
:: Multisectoral action to promote physical activity has increased in the EU 24-09-2018
:: WHO School on Refugee and Migrant Health to build on existing capacities for providing care 24-09-2018

WHO Eastern Mediterranean Region EMRO
:: Tuberculosis control centre reopens in Aleppo  26 September 2018

WHO Western Pacific Region
-No new announcement identified