Vaccines and Global Health: The Week in Review :: 26 January 2019

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

Joint statement by of the main, independent, advisory and oversight committees of the GPEI

Milestones :: Perspectives

Joint statement by of the main, independent, advisory and oversight committees of the GPEI [Global Polio Eradication Initiative]

January 2019
Dear Polio Eradicator,
The global polio eradication effort is 31 years old.

The world is tantalizingly close to being free of polio. From 350,000 wild poliovirus cases every year in 1988, in 2018 the world reported just 29 cases of this devastating disabling disease because of extraordinary global efforts. Wild poliovirus transmission is endemic in only a handful of districts worldwide. The aim of the 2013-2018 Endgame Plan had been to be finished with this job by end 2018. This is not the case, and the Plan has to now be revised and extended through 2023.

This is an effort that cannot be sustained indefinitely: 31 years is long enough. It is resource intensive. It is intensive on the countries affected. It is intensive on donors. It is intensive on health services. It is intensive on communities. Most of all, it is intensive on those children and their families who bear the burden of this terrible disease, needlessly.

There is no reason why polio should persist anywhere in the world.

To succeed by 2023, all involved in this effort must find ways to excel in their roles. If this happens, success will follow.

This means stepping up the level of performance even further. It means using the proven tools of eradication and building blocks that have been established in parts of the world that have been free of polio for years. The vaccines, the cold chains, the networks of vaccinators, the surveillance capacity, the governance, policy, financing and oversight structures must be at peak levels of performance. There must be an unrelenting focus to tighten the management of the effort at all levels.

It also means looking for opportunities to innovate, using local knowledge and insights to overcome obstacles that in the past have seemed insurmountable. It means looking at new and different ways to reach children. It means really understanding the views of parents, and communities, who are unwilling to accept the vaccine and finding ways to address their concerns and come together with them. It means more effectively engaging with communities and better serving their needs than we have been doing thus far. Each person must dedicate themselves to one clear objective – to reach that very last child with polio vaccine.

Please commit to finding that very last child first, before the poliovirus does. Give the poliovirus nowhere to hide.

Whatever barrier to reaching that very last child, the programme has the expertise and experience to overcome it. Let everyone perfect what we know works. Let everyone free their mind to come up with new ideas and transformative solutions. We must all treat this as the public health emergency that it is.

As a global community, we have stood before where we stand today, with smallpox. The scourge of smallpox is gone, for which the world is a much better place. Let us make history again. It is time to finish the job of polio eradication now. The philosopher, poet and essayist Ralph Waldo Emerson said: “To leave the world a bit better, whether by a healthy child, a garden patch or a redeemed social condition, to know even one life has breathed easier because you have lived – this is to have succeeded.”

Eradicate polio, and make the world a better place for future generations.

Thank you.

Professor Alejandro Cravioto
Chair of the Strategic Advisory Group of Experts on immunization (SAGE)

Sir Liam Donaldson
Chair of the Independent Monitoring Board (IMB) of the Global Polio Eradication Initiative

Professor Helen Rees
Chair of the Emergency Committee of the International Health Regulations (IHR) Regarding the International Spread of Poliovirus

Professor David Salisbury
Chair of the Global Commission for the Certification of the Eradication of Poliomyelitis (GCC)

Experts caution against stagnation of immunization coverage in Africa

Milestones :: Perspectives

Experts caution against stagnation of immunization coverage in Africa

23 January 2019, Brazzaville, Congo – Global immunization experts attending the biannual Regional Immunization Technical Advisory Group (RITAG) meeting urged African countries to strengthen their routine immunization. Over the past five years, immunization coverage in sub-Saharan Africa has stagnated at 72%, exposing populations to vaccine-preventable diseases and outbreaks.

The immunization experts also emphasized the importance of increased domestic investment in disease surveillance and the need for community engagement to drive vaccine deployment during outbreaks.

“The regional experts’ meeting presented a unique opportunity to assess current and future immunization needs in Africa,” said RITAG Chair, Professor Helen Rees. “We have mapped out what can and must be done to secure the future of millions of children on this continent.”

In sub-Saharan Africa, nearly 31 million children younger than 5 years suffer from vaccine-preventable diseases every year. More than a half million of them die due to lack of access to the vaccines they needed.

In 2017, Heads of State from across Africa endorsed the Addis Declaration on Immunization, a historic pledge that envisions an Africa in which every child, no matter their economic circumstances, has access to vaccines.

 

This year, the World Health Organization’s (WHO) Regional Office for Africa, in partnership with the African Union Commission, will launch a progress report on the implementation status of the 10 commitments outlined in the Addis Declaration. The report will take stock of progress made over the past two years, highlight gaps and issue recommendations to guide progress towards stronger immunization systems.

“By vaccinating children, we are doing more than preventing diseases and saving lives. We are also ensuring that children get the education they deserve and returning valuable time to their families because they no longer need to make long hospital visits. Vaccinations also release scarce government funds,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.

According to WHO data, illness and deaths due to vaccine-preventable diseases cost sub-Saharan Africa US$13 billion each year – funding that could be channelled towards strengthening health systems and building economies.

The immunization experts gathered in Brazzaville also discussed a range of pressing issues, including the ongoing Ebola outbreak, polio eradication and progress against the Regional Strategic Plan for Immunization.

The Democratic Republic of the Congo is grappling with the second-largest Ebola outbreak in history, with more than 650 confirmed cases so far. Despite challenges in reaching areas marred by long-term conflict, nearly 60,000 people have been vaccinated, including approximately 20 000 health workers and front-line workers. The country’s Ministry of Health has launched its first randomized control trial for experimental Ebola treatments. However, continued efforts are necessary to ensure the outbreak is contained.

In contrast, other diseases, such as polio, are on the brink of eradication. The last case of wild poliovirus in Africa was reported in August 2016 in the north-eastern state of Borno, Nigeria. If no new cases of wild poliovirus are detected in Nigeria by August 2019, Africa will attain the wild poliovirus eradication goal.

As the world nears polio eradication, funds for fighting the disease are declining. Between 2016 and 2019, the Global Polio Eradication Initiative budget more than halved, from US$ 322 million to US$ 153 million. That initiative provides more than 90% of all funding for disease surveillance in sub-Saharan Africa, including 16 polio-funded laboratories that process clinical and environmental samples for acute flaccid paralysis surveillance (used for detecting poliomyelitis) and other vaccine-preventable diseases, such as yellow fever and measles.

The Regional Immunization Technical Advisory Group emphasized the need for greater government ownership of disease surveillance programmes to ensure that the progress made in curbing vaccine-preventable diseases is not reversed.

“The fact that most sub-Saharan African countries continue to rely on external funding for immunization financing is a strong indicator of the work that remains to be done,” said Dr Richard Mihigo, Programme Manager for Immunization and Vaccine Development at the WHO Regional Office for Africa. “Governments have a central role to play to fill upcoming funding gaps and ensure immunization programmes remain strong and vigilant.”

How to Inoculate Against Anti-Vaxxers – Opinion

Milestones :: Perspectives

How to Inoculate Against Anti-Vaxxers – Opinion

The no-vaccine crowd has persuaded a lot of people. But public health can prevail.

By The Editorial Board of  The New York Times
   The editorial board represents the opinions of the board, its editor and the publisher. It is separate from the newsroom and the Op-Ed section.
Jan. 19, 2019
The World Health Organization has ranked vaccine hesitancy — the growing resistance to widely available lifesaving vaccines — as one of the top 10 health threats in the world for 2019. That news will not come as a surprise in New York City, where the worst measles outbreak in decades is now underway. Nor in California or Minnesota, where similar outbreaks unfolded in 2014 and 2017, respectively. Nor in Texas, where some 60,000 children remain wholly unvaccinated thanks in part to an aggressive anti-vaccine lobby.

Leading global health threats typically are caused by the plagues and perils of low-income countries — but vaccine hesitancy is as American as can be. According to the Centers for Disease Control and Prevention, the percentage of children who are unvaccinated has quadrupled since 2001, even though the overall utilization of most vaccines remains high. More than 100,000 American infants and toddlers have received no vaccines whatsoever, and millions more have received only some crucial shots.

It’s no mystery how we got here. On the internet, anti-vaccine propaganda has outpaced pro-vaccine public health information. The anti-vaxxers, as they are colloquially known, have hundreds of websites promoting their message, a roster of tech- and media-savvy influencers and an aggressive political arm that includes at least a dozen political action committees. Defense against this onslaught has been meager. The C.D.C., the nation’s leading public health agency, has a website with accurate information, but no loud public voice. The United States Surgeon General’s office has been mum. So has the White House — and not just under the current administration. That leaves just a handful of academics who get bombarded with vitriol, including outright threats, every time they try to counter pseudoscience with fact.

The consequences of this disparity are substantial: a surge in outbreaks of measles, mumps, pertussis and other diseases; an increase in influenza deaths; and dismal rates of HPV vaccination, which doctors say could effectively wipe out cervical cancer if it were better utilized. But infectious disease experts warn that things could get much worse. Trust in vaccines is being so thoroughly eroded, they say, that these prevention tools are in danger of becoming useless. The next major disease outbreak “will not be due to a lack of preventive technologies,” Heidi Larson, a professor at the London School of Hygiene and Tropical Medicine, writes in the journal Nature, but to an “emotional contagion, digitally enabled.”

Thwarting this danger will require a campaign as bold and aggressive as the one being waged by the anti-vaccination contingent. And to launch such a campaign would require overcoming strong inertia: a waning public health apparatus, countervailing politics and a collective amnesia over the havoc the diseases in question once wrought. But to succeed would be to rescue from oblivion one of the greatest triumphs of human ingenuity over disease — and to save countless lives.

Here’s how to get started.

Get tough. After the 2014 California measles outbreak, the state eliminated nonmedical exemptions for mandatory vaccinations. After a similar outbreak in Michigan, health officials there began requiring individuals to formally consult with their local health departments before opting out of otherwise-mandatory shots. In both cases, these tougher policies drove up vaccination rates. Other states ought to follow this lead, and the federal government should consider tightening restrictions around how much leeway states can grant families that want to skip essential vaccines.

Be savvy. The Vaccine Confidence Project is a London-based academic endeavor that monitors anti-vaccine websites for rumors and conspiracies and addresses them before the messages go viral. It also conducts regular surveys of attitudes and puts out a vaccine confidence index. Federal health officials would do well to implement a similar program, make it as public as possible and pair it with an aggressive and targeted social media campaign that makes as much use of celebrities as the anti-vaccine movement has.

Be clear. Vaccines, to some extent, are victims of their own success. In the United States especially, they’ve beaten so many infectious foes into oblivion that hardly any practicing doctors, let alone new parents, remember how terrible those diseases once were. An effective pro-vaccine campaign needs to remind us: Vaccines prevent two million to three million deaths globally each year. In developing countries, people line up for hours to get these shots. It’s also O.K. to get out of the gray zone. Scientists, especially, are uncomfortable with black-and-white statements, because science is all about nuance. But, in the case of vaccines, there are some hard truths that deserve to be trumpeted. Vaccines are not toxic, and they do not cause autism. Full stop.

Know the enemy. The arguments used by people driving the anti-vaccination movement have not changed in about a century. These arguments are effective because they are intuitively appealing — but they are also easily refutable. Instead of ignoring these arguments, an effective pro-vaccine campaign would confront them directly, over and over, for as long as it takes. Yes, there are chemicals in vaccines, but they are not toxic. No, vaccines can’t overwhelm your immune system, which already confronts countless pathogens every day.

Know the audience. Not every parent with concerns about vaccination is a rabid conspiracy theorist bent on resisting inoculation forever. In fact, studies suggest that less than 2 percent of all parents fall into this category. The rest of vaccine-hesitant families sit along a spectrum. Some reject all vaccines but are still open to receiving information. Others are only worried about one specific vaccine. And others still are merely anxious and looking for reliable information. Any successful campaign will need to mind this diversity and prioritize listening to concerns as much as dispelling myths.

Enlist the right support. Some doctors and scientists have referred to “uneventful vaccination” as “The Greatest Story Never Told.” Though they may not spread on the internet like the stories of terrible mishaps that anti-vaxxers traffic in, these far more common tales of inoculation without incident can be a powerful elixir for a nervous new parent. The best ambassadors of these stories are likely to be parents themselves. Surveys suggest that pro-vaccine families are often eager to help counter misinformation, but they don’t know where to start. If health officials corralled these families and trained them in the basics of vaccine science, they might succeed where official voices sometimes fail.

Investigational monoclonal antibody to treat Ebola is safe in adults :: Safety, tolerability, pharmacokinetics, and immunogenicity of the therapeutic monoclonal antibody mAb114 targeting Ebola virus glycoprotein (VRC 608): an open-label phase 1 study :: Ebola therapies: an unconventionally calculated risk

Milestones :: Perspectives

NIH  [to 26 Jan 2019]
http://www.nih.gov/news-events/news-releases
Friday, January 25, 2019
Investigational monoclonal antibody to treat Ebola is safe in adults
Early-stage trial results show promise.
After multiplying inside a host cell, the string-like Ebola virus is emerging to infect more cells. Ebola is a rare, often fatal disease that occurs primarily in tropical regions of sub-Saharan Africa.Heinz Feldmann, Peter Jahrling, Elizabeth Fischer and Anita Mora, National Institute of Allergy and Infectious Diseases, National Institutes of Health

WHAT:
The investigational Ebola treatment mAb114 is safe, well-tolerated, and easy to administer, according to findings from an early-stage clinical trial published in The Lancet. Eighteen healthy adults received the monoclonal antibody as part of a Phase 1 clinical trial that began in May 2018 at the National Institutes of Health (NIH) Clinical Center in Bethesda, Maryland. The National Institute of Allergy and Infectious Diseases (NIAID) Vaccine Research Center (VRC), part of NIH, developed the investigational treatment and conducted and sponsored the clinical trial.

The investigational treatment is currently being offered to Ebola patients in the Democratic Republic of the Congo (DRC) under compassionate use and as part of a Phase 2/3 clinical trial of multiple investigational treatments. mAb114, a single monoclonal antibody, binds to the core receptor binding domain of the Zaire ebolavirus surface protein, preventing the virus from infecting human cells. Scientists isolated the antibody from a human survivor of the 1995 Ebola outbreak in Kikwit, DRC. Prior studies showed that mAb114 can protect monkeys from lethal Ebola virus disease when given as late as five days after infection.

Participants in the Phase 1 clinical trial received a single intravenous infusion of mAb114, administered over approximately 30 minutes. Three participants received a 5 milligram(mg)/kilogram (kg) dose; five participants received a 25 mg/kg dose; and 10 participants received a 50 mg/kg dose. All infusions were well-tolerated. Four participants reported mild side effects, such as discomfort, muscle or joint pain, headache, nausea, and chills in the three days following the infusion.

As expected, levels of mAb114 in the blood increased as the dosage was increased. Investigators also observed relatively uniform levels of absorption, distribution, and elimination of mAb114 among participants.

The authors note several advantages for deploying mAb114 in an outbreak setting, including the ease and speed of its administration, and its formulation as a freeze-dried powder that does not require freezer storage. The powder is reconstituted with sterile water and added to saline for administration.

In addition to the ongoing Phase 2/3 clinical trial of mAb114 in the DRC, the VRC is planning to initiate another Phase 1 trial of the investigational treatment in Africa.

VRC scientists developed mAb114 in collaboration with scientists at the National Institute of Biomedical Research (INRB) in the DRC; the Institute for Research in Biomedicine and Vir Biotechnology, Inc.’s subsidiary Humabs BioMed, both based in Bellinzona, Switzerland; and the U.S. Army Medical Research Institute of Infectious Diseases at Fort Detrick, Maryland. The Defense Advanced Research Projects Agency funded the production of mAb114 for clinical testing. The investigational treatment is licensed to Ridgeback Biotherapeutics LP based in Coconut Grove, Florida. For more information about clinical trials of mAb114, visit ClinicalTrials.gov and search identifiers NCT03478891 and NCT03719586.

 

ARTICLE:
Safety, tolerability, pharmacokinetics, and immunogenicity of the therapeutic monoclonal antibody mAb114 targeting Ebola virus glycoprotein (VRC 608): an open-label phase 1 study
Martin R Gaudinski, Emily E Coates, Laura Novik, Alicia Widge, Katherine V Houser, Eugeania Burch, LaSonji A Holman, Ingelise J Gordon, Grace L Chen, Cristina Carter, Martha Nason, Sandra Sitar, Galina Yamshchikov, Nina Berkowitz, Charla Andrews, Sandra Vazquez, Carolyn Laurencot, John Misasi, Frank Arnold, Kevin Carlton, Heather Lawlor, Jason Gall, Robert T Bailer, Adrian McDermott, Edmund Capparelli, Richard A Koup, John R Mascola, Barney S Graham, Nancy J Sullivan, Julie E Ledgerwood on behalf of the VRC 608 Study team
The Lancet DOI: 10.1016/S0140-6736(19)30036-4 (2019

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The Lancet
Online First

Comment
Ebola therapies: an unconventionally calculated risk
Mosoka P Fallah, Laura A Skrip
Published: January 24, 2019DOI:https://doi.org/10.1016/S0140-6736(19)30160-6

 

 

144th Session of the WHO Executive Board

Milestones :: Perspectives

144th Session of the WHO Executive Board

24 January – 1 February 2019 Coordinated Universal Time

Geneva, Switzerland

Selected Agenda Content

EB144/1 – Provisional agenda
EB144/1 (annotated) – Provisional agenda (annotated)

EB144/8 – Public health preparedness and response
Report of the Independent Oversight and Advisory Committee for the WHO Health Emergencies Programme

EB144/9 – Polio Eradication
EB144/10 – Polio Transition

EB144/11 Rev.1 – Implementation of the 2030 Agenda for Sustainable Development

EB144/12 – Universal health coverage
Primary health care towards universal health coverage
EB144/13 – Universal health coverage
Community health workers delivering primary health care: opportunities and challenges
EB144/14 – Universal health coverage
Preparation for the high-level meeting of the United Nations General Assembly on universal health coverage

EB144/17 – Medicines, vaccines and health products
Access to medicines and vaccines
EB144/18 – Medicines, vaccines and health products
Cancer medicines
EB144/19 – Follow-up to the high-level meetings of the United Nations General Assembly on health-related issues
Antimicrobial resistance

EB144/21 – Follow-up to the high-level meetings of the United Nations General Assembly on health-related issues
Ending tuberculosis

EB144/23 – Pandemic Influenza Preparedness Framework for the sharing of influenza viruses and access to vaccines and other benefits
Implementation of decision WHA71(11) (2018)

EB144/24 – Member State mechanism on substandard and falsified medical products

EB144/27 – Promoting the health of refugees and migrants
Draft global action plan, 2019–2023

 

Emergencies

Emergencies

 
 
POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 22 January 2019
:: In an extraordinary joint statement by the Chairs of the main independent, advisory and oversight committees of the GPEI, the Chairs urge everyone involved in polio eradication to ensure polio will finally be assigned to the history books by 2023.
The authors are the chairs of the Strategic Advisory Group of Experts on immunization (SAGE), the Independent Monitoring Board, the Emergency Committee of the International Health Regulations (IHR) Regarding International Spread of Poliovirus and the Global Commission for the Certification of the Eradication of Poliomyelitis (GCC).
The Endgame Plan through 2018 has brought the world to the brink of being polio-free.  A new Strategic Plan 2019-2023 aims to build on the lessons learned since 2013.  The joint statement urges everyone involved in the effort to find ways to excel in their roles.  If this happens, the statement continues, success will follow.  But otherwise, come 2023, the world will find itself exactly where it is today:  tantalizingly close.  But in an eradication effort, tantalizingly close is not good enough.  The statement therefore issues an impassioned plea to everyone to dedicate themselves to one clear objective:  to reach that very last child with polio vaccine.  The full statement is attached herewith and also available here.

[See Milestones above for full text]
 
 
Summary of new viruses this week:
:: Pakistan – two cases of wild poliovirus type 1 (WPV1) and five WPV1 positive environmental samples;
:: Afghanistan – seven WPV1 positive environmental samples;
:: Nigeria – one case of circulating vaccine derived poliovirus type 2 (cVDPV2) and eight VDPV2 positive environmental samples.
 

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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 26 Jan 2019]
– No new digest announcements identified
 
 
Bangladesh – Rohingya crisis
:: Bi‐weekly Situation Report 1 – 17 January 2019

KEY HIGHLIGHTS

:: The number of varicella cases reported this week in 1 358. WHO and the health sector are working incollaboration with Education sector and Risk communication to contain the disease.
:: A total of 2.2 million doses were administered in 2018 through two Penta/Td, bOPV campaigns and two OCV campaigns
 
 
Varicella UPDATE
:: The number of varicella cases reported this week in 1 358. The number of varicella cases is higher than previous week but this might be due to improvement of varicella reporting in the camps.
:: Varicella has been added to Indicator‐Based Surveillance (IBS) and Event‐Based surveillance (EBS) in EWARS.
:: Ministry of Health (MoH) & IEDCR has requested to health partners to report all varicella cases on a daily basis.
 
 
DIPHTHERIA UPDATE
:: Ten new diphtheria case‐patients (one probable and nine suspected) were reported this week. Total case patients reported in EWARS is now 8 372.
:: Of these, 293 case patients have tested positive on PCR, with the last confirmed case reported on 31 December 2018. Of the remaining cases 2 710 were classified as probable and 5 369 as suspected. The total number of deaths remains 44. Last death was reported on 28 June 2018.
:: No death has been reported from the host community.
 
 
HEALTH OPERATIONS

Routine Immunization
:: From the beginning of February 2018 to date, the following antigen doses were delivered to
children: 40,965 BCG doses; 56,512 pentavalent doses; 58,234 Oral Polio Vaccine (OPV) doses; 55,086 PCV doses; 29,039 Measles/Rubella (MR) doses and 19,906 Td doses to pregnant women.
:: Before February, several campaigns were held in Rohingya camps among specific age groups, which covered the target cohort of routine immunization to an extent.
 
 
Campaigns in Rohingya Camps
:: A total of 2.2 million doses were administered in 2018 through two Penta/Td, bOPV campaigns and two OCV campaigns…
 

Somalia
:: Somalia developing comprehensive plan to improve health of mothers, children and adolescents
Mogadishu, 24 January 2019 – With support from the World Health Organization (WHO) and other United Nations partners, Somalia is currently developing a strategy that will change the rhetoric in the country and ensure Somali mothers and children can access quality health services equitably all across urban, rural areas in the country…
 
 
Yemen
:: Providing urgent health care to millions: WHO and the Italian Agency for Development Cooperation work together to reach the most vulnerable

24 January 2019, Sana’a, Yemen — With a generous donation of 2 million euros from the Italian Agency for Development Cooperation, the World Health Organization (WHO) is scaling up efforts to meet health needs in Yemen through the health service delivery mechanism known as the Minimum Service Package. This is the first time since the start of the crisis in Yemen that WHO has partnered with the Agency…
 
 
Democratic Republic of the Congo – No new digest announcements identified
Myanmar – No new digest announcements identified  [see above]
NigeriaNo new digest announcements identified
South SudanNo new digest announcements identified
Syrian Arab Republic – No new digest announcements identified
 

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WHO Grade 2 Emergencies  [to 26 Jan 2019]
occupied Palestinian territory
:: WHO concerned over health impact of evolving fuel crisis in Gaza
21 January 2019, Gaza –  The World Health Organization is concerned over the potential impact the evolving fuel crisis in Gaza might have on the lives and health of patients whose treatment requires uninterrupted power supply if no immediate solution to address the aggravating shortages is found.
The functionality of Gaza’s 14 public hospitals is increasingly jeopardized by electricity shortages and the rapidly declining UN coordinated fuel reserves required to run emergency generators during prolonged electricity cuts from the main grid…
 
 
Brazil (in Portugese) – No new digest announcements identified
Cameroon  – No new digest announcements identified
Central African Republic  – No new digest announcements identified
Ethiopia – No new digest announcements identified
Hurricane Irma and Maria in the Caribbean – No new digest announcements identified
Iraq – No new digest announcements identified
Libya – No new digest announcements identified
MERS-CoV – No new digest announcements identified
Niger – No new digest announcements identified
Sao Tome and Principe Necrotizing Cellulitis (2017) – No new digest announcements identified
Sudan – No new digest announcements identified
Ukraine – No new digest announcements identified
Zimbabwe – No new digest announcements identified
 
 
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WHO Grade 1 Emergencies  [to 26 Jan 2019]
Afghanistan
Chad
Indonesia – Sulawesi earthquake 2018
Kenya
Lao People’s Democratic Republic
Mali
Namibia – viral hepatitis
Peru
Philippines – Tyhpoon Mangkhut
Tanzania

 
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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 – No new digest announcements identified
Syrian Arab Republic   – No new digest 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 
:: Ethiopia Humanitarian Bulletin Issue 72 | 7 – 20 January 2019

HIGHLIGHTS
::Scaled-up response urgently required to more than 250,000 IDPs in Western Ethiopia
:: Durable Solutions as nexus opportunity in Somali region: Lessons from SDC
:: New law grants nearly a million refugees to exercise more rights in Ethiopia
:: Nearly 36 million children in Ethiopia are poor and lack access to basic social services: report

Somalia  – No new digest announcements identified
 
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“Other Emergencies”
Indonesia: Central Sulawesi Earthquake – No new digest 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 26 Jan 2019]
http://www.who.int/ebola/en/
– No new digest announcements identified.
 
 
MERS-CoV [to 26 Jan 2019]
http://who.int/emergencies/mers-cov/en/
– No new digest announcements identified.
 
 
Yellow Fever  [to 26 Jan 2019]
http://www.who.int/csr/disease/yellowfev/en/
– No new digest announcements identified.
 
 
Zika virus  [to 26 Jan 2019]
http://www.who.int/csr/disease/zika/en/
– No new digest announcements identified.

 

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