Milestones :: Perspectives

Thousands of children vaccinated in remote Rukban settlement amid severe lack of access to medical care
UNICEF, UN and Syrian Arab Red Crescent reach more than 40,000 people with life-saving supplies in largest-ever humanitarian convoy since the start of the Syria crisis

NEW YORK/DAMASCUS, 15 February 2019 – UNICEF-supported vaccinators were able to immunize thousands of children during a 9-day mission to the remote makeshift settlement in Rukban at the border with Jordan, home to more than 40,000 people – mostly women and children.

The joint UNICEF, UN and Syrian Arab Red Crescent mission to Rukban is the largest humanitarian delivery in Syria’s eight-year crisis. Thirty of the convoy’s 118 trucks were loaded with UNICEF’s life-saving supplies for children, including health and nutrition supplies for an estimated 20,000 children and mothers; hygiene kits for more than 40,000 people; recreational kits; and education supplies, including school books, stationery and school bags, for over 8,000 children…

Milestones :: Perspectives

World Organisation for Animal Health (OIE)   [to 16 Feb 2019]
http://www.oie.int/en/for-the-media/press-releases/2018/
14/02/19
New report shows global shift in use of antibiotics in animals

Figures released in a new report today by the World Organisation for Animal Health (OIE) show positive global progress on the regulation and monitoring of antimicrobial use in animals. The report aims to build the capacity of all countries to collect critical data on the use of antimicrobials in animals.  

Paris, 14 February 2019 – The OIE has developed a voluntary data collection system on the use of antimicrobial agents in animals to which any country can contribute. The report presents the overall findings of the third annual data collection, providing a global and regional analysis from 2015 to 2017. A record of 155 countries participated in it, demonstrating increased international understanding and prioritisation of this issue.

“The OIE database is an important initiative building national and global surveillance capacity on antimicrobial use in animals,” said Dr Monique Eloit, Director-General of the OIE. “Irrespective of the financial resources at their disposal, the OIE aims to support countries to ensure that antibiotics and other important veterinary medicines are used prudently and responsibly. One of the OIE’s key recommendations is for countries to immediately phase out the use of critical antimicrobials for growth promotion.”

Indeed, the report shows that the reported use of antimicrobials for growth promotion has declined from 60 to 45 countries since the last round of data collection. However, key antimicrobials, classified by the WHO as ‘Highest Priority Critically Important Antimicrobials’, including colistin, continue to be used routinely in several regions for this purpose. This practice puts at risk many of the medicines that we take for granted today, for both animals and humans.

The development of a robust regulatory framework is a key component to protect and ensure responsible and prudent use of antimicrobial agents in animal health and production. It is also a powerful instrument to phasing out their use as growth promoters, while recognising that voluntary approaches can be effective in certain countries. The report shows positive progress, while 72 countries do not have a regulatory framework on the use of growth promotors, it is a decrease from the first database report in which 110 countries lacked such a framework. This decline suggests critical progress in the implementation of regulations on the use of antimicrobial agents.

“Many countries have already taken key actions, such as setting up surveillance systems and regulating the use of antimicrobials in human and animal health, but we still have a long way to go,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “Working together is the only way to avoid the huge human, social, economic and environmental costs of antimicrobial resistance.”…

Milestones :: Perspectives

DRC

DRC 2018 Ebola outbreaks
Potential new Ebola drugs being trialled in MSF treatment centres
Statement 12 Feb 2019
Four potential new treatments for Ebola are being used in a randomised controlled trial (RCT) at the Ebola Treatment Centres operated by Médecins Sans Frontières (MSF) in Katwa and Butembo, in North Kivu province, Democratic Republic of Congo (DRC).

The trial, being run in collaboration with the Ministry of Health, originally began in November 2018 in another treatment centre in the region, and MSF facilities are now able to contribute to providing valuable information on these developmental drugs.

The treatments that will be used in the RCT are drugs remdesivir, mAb114, REGN-EB3 and ZMapp. They have been offered to patients since the beginning of the current Ebola outbreak under Monitored Emergency Use of Unregistered and Investigational Interventions (MEURI) protocols.

The switch from MEURI protocols to a clinical trial is a critical step, as a clinical trial can generate the scientific data needed to draw conclusions on how effective these treatments are. The main objective of the trial is to identify the most effective of the four products to treat Ebola patients.

The trial is overseen by a steering committee convened by the World Health Organization and led by the National Institute of Biomedical Research of DRC (INRB) and the US National Institute of Health (NIH) in collaboration with other national and international organisations.
Butembo and Katwa are currently the hotspots of the Ebola epidemic that was declared in DRC on 1 August 2018.

The Butembo treatment centre can admit 96 people, while the one in Katwa, which opened last month, has a 62-bed capacity. Since they opened, MSF has admitted more than 2,100 patients to these two centres, of which 250 were confirmed cases, with 110 people recovering.

Featured Journal Content

The Lancet
Feb 16, 2019  Volume 393  Number 10172p611-716, e29
https://www.thelancet.com/journals/lancet/issue/current

Comment
Ebola in the Democratic Republic of the Congo: time to sound a global alert?
Lawrence Gostin, Alexandra Phelan, Alex Godwin Coutinho, Mark Eccleston-Turner, Ngozi Erondu, Oyebanji Filani, Tom Inglesby, Rebecca Katz, Allan Maleche, Jennifer B Nuzzo, Oyewale Tomori, Matthew Kavanagh
[Excerpt]
…We call upon the WHO Director-General to reconvene the EC to review the grounds for a PHEIC declaration. He should invite states, the UN, and NGOs to attend and submit evidence. 10  The United Nations Organization Stabilization Mission in the Democratic Republic of the Congo (MONUSCO), UNHCR, the UN Refugee Agency, and civil society could provide critical information. The EC should recommend proactive measures on health, diplomacy, security, and community engagement. Concrete recommendations could specify the level and kind of resources needed and composition of security and diplomatic assets.

A PHEIC is a clarion call to galvanise high-level political, financial, and technical support. A PHEIC would provide a clear signal from the world’s global health body that UN leadership is urgent. A PHEIC also empowers the WHO Director-General to make temporary, non-binding recommendations that have normative force.10

The IHR do not specify any surge in authority or financing when declaring a PHEIC. In the past, states did not heed WHO warnings that travel and trade restrictions are harmful. During the west African Ebola epidemic, 58 states restricted travel from affected areas, and during the 2009 influenza A H1N1 pandemic, states imposed trade and travel restrictions.12,13,14]

Trade or travel barriers in the DRC would have devastating impacts. WHO, with UN support, should take active steps to prevent unlawful and harmful restrictions. In 2009, WHO and the World Trade Organization (WTO) criticised governments that took non-evidence-based actions; going forward, WHO and WTO could publicly name non-compliant countries. Governments should also agree to dispute resolution, including binding IHR arbitration.10

If a PHEIC escalated conflict by raising the profile of the international response, it would be deeply concerning. Recent elections in DRC were clouded by concerns about vote-rigging, unsettling lines of power and legitimacy. Armed groups have used violence to generate chaos. A PHEIC could increase incentives to target Ebola responders to gain leverage. As in South Sudan, armed groups could manipulate aid for non-humanitarian purposes.15 Like any complex multilateral negotiation, cultural competence and smart diplomacy are required. Outsiders are unlikely to be privy to all on-the-ground realities and risks.

The IHR were designed to respond to a health emergency like the DRC Ebola epidemic. We urge the WHO Director-General to reconvene the EC and re-assess the declaration of a PHEIC. The UN and governments should increase support for WHO and partners. If the IHR fails, or worse, increases political instability, it will require urgent reform.

State non-compliance should not obscure the value of the IHR in establishing norms of rapid identification, notification, and response. The IHR require states to develop health-system capacities, assessed by WHO’s Joint External Evaluation. IHR reform should focus on technical and financial assistance for national health capacities. A PHEIC should trigger surge capacity in relation to authority and finances, with effective mechanisms to gain state compliance.

WHO has shown leadership and operational endurance, working tirelessly to combat the DRC Ebola epidemic. But WHO and partners cannot succeed alone. We live at a political moment when international solutions to collective threats are increasingly hard to achieve. But WHO and the UN system will be called upon with ever-greater frequency in the future to manage complex humanitarian crises. We must plan for a future in which political violence and instability become the new abnormal.

[References at title link above]

Emergencies
 
 
POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 13 February 2019
:: The 2019 Annual Letter by Bill & Melinda Gates makes a case for investment in global health. Progress by Global Polio Eradication Initiative is a good reminder of how investment in global health funds benefits people around the world. Read the letter here.
:: In Indonesia, a circulating vaccine-derived poliovirus type 1 (cVDPV1) outbreak is confirmed.
 
 
Summary of new viruses this week:
:: Pakistan – once case of wild poliovirus type 1 (WPV1) and four wild polioviruses type 1 (WPV1) positive environmental samples;
:: Nigeria – two circulating vaccine derived poliovirus type 2 (VDPV2) positive environmental samples;
:: Indonesia– one case of circulating vaccine derived poliovirus type 1 (cVDPV1).
 
 

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 16 Feb 2019]
Democratic Republic of the Congo
:: Ebola virus disease – Democratic Republic of the Congo   14 February 2019
… Main challenges this past week primarily pertain to community mistrust, particularly in Katwa, and the difficulty in encouraging community members to be more proactive in reporting suspected cases, presenting early to ETCs for treatment, and participating in community-based prevention and response efforts. However, in the face of these protracted challenges, response strategies have demonstrated to be effective in curtailing the spread of EVD. Fostering greater community trust by strengthening engagement with its members remains a top priority for response teams.
 
On 13 February, the Ministry of Health (MoH) launched the Strategic Response Plan 3 (SRP 3). The plan lays out the response strategy, objectives and budget requirements for the MoH, WHO, and all implementing partners for the next six months (February through July 2019). SRP 3 takes into account recommendations from operational reviews, and builds on a series of new strategic directions that capitalize on lessons learned under the scope of SRP 2. Activities laid out aim to stop the transmission of EVD in North Kivu and Ituri provinces, and prevent its spread to other provinces and neighbouring countries.
 
WHO remains confident that this outbreak can be successfully brought to an end through strategies outlined in SRP 3. To achieve the goals set out by the plan, MoH, WHO, and partners are appealing for US$ 148 million. WHO and partners count on the continued support of the international community to provide the required funding in order to stop this outbreak…
 
Nigeria
:: WHO supports five countries to fight lassa fever outbreaks   8 February 2019
 
Bangladesh – Rohingya crisis – No new digest announcements identified  
Myanmar – No new digest announcements identified  
Somalia – No new digest announcements identified
South Sudan – No new digest announcements identified  
Syrian Arab Republic – No new digest announcements identified  
Yemen – No new digest announcements identified
 
::::::
 
WHO Grade 2 Emergencies  [to 16 Feb 2019]
Libya
:: US$ 43.5 million needed to provide life-saving health aid in Libya in 2019
Cairo, 11 February 2019 – The World Health Organization and health partners are appealing for US$ 43.5 million to provide life-saving interventions for 388 000 people inside Libya affected by ongoing conflict…
 
Iraq
:: WHO intercountry cooperation yields rich health dividends
13 February 2019 – Intercountry collaboration between Iraq and Jordan allowed WHO and health authorities in Iraq to rapidly and successfully respond to an increase in cases of acute respiratory infections…
 
MERS-CoV
:: MERS therapeutics and vaccines workshop 30 November 2018
13 Feb 2019
Meeting report pdf, 606kb
Final Agendapdf, 290kb
List of participantspdf, 348kb
 
 
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
Niger – No new digest announcements identified
occupied Palestinian territory  – 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
 
 
WHO Grade 1 Emergencies  [to 16 Feb 2019]
Afghanistan
Chad
Indonesia – Sulawesi earthquake 2018
Kenya
Lao People’s Democratic Republic
Mali
Namibia – viral hepatitis
Peru
Philippines – Tyhpoon Mangkhut
Tanzania
 
::::::
 
WHO AFRO Outbreaks – Week 06: 04 – 10 February 2019
The WHO Health Emergencies Programme is currently monitoring 60 events in the region. This week’s edition covers key new and ongoing events, including:
:: Ebola virus disease in the Democratic Republic of the Congo
:: Lassa fever in Nigeria
:: Ebola virus disease in the Democratic Republic of the Congo
:: Measles in Madagascar
:: Humanitarian crisis in Central African Republic
 
 
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
 
 
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 digest announcements identified
Somalia  – No new digest announcements identified

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

 
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 16 Feb 2019]
http://www.who.int/ebola/en/
:: Ebola virus disease – Democratic Republic of the Congo   14 February 2019
 
 
MERS-CoV [to 16 Feb 2019]
http://who.int/emergencies/mers-cov/en/
:: MERS therapeutics and vaccines workshop 30 November 2018  13 Feb 2019
Meeting report pdf, 606kb
Final Agendapdf, 290kb
List of participantspdf, 348kb
 
 
Yellow Fever  [to 16 Feb 2019]
http://www.who.int/csr/disease/yellowfev/en/
– No new digest announcements identified.
 
 
Zika virus  [to 16 Feb 2019]
http://www.who.int/csr/disease/zika/en/
– No new digest announcements identified.

WHO & Regional Offices [to 16 Feb 2019]
 
12 February 2019
News Release
New WHO-ITU standard aims to prevent hearing loss among 1.1 billion young people
 
12 February 2019
News Release
International push to improve food safety
 
11 February 2019 | News release
US$ 43.5 million needed to provide life-saving health aid in Libya in 2019
 
::::::
  
Weekly Epidemiological Record, 15 February 2019, vol. 94, 07 (pp. 81–84)
:: 7th Meeting of the WHO Expert Working Group of the Global Influenza Surveillance and Response System for Surveillance of Antiviral Susceptibility
:: Executive summary of the 10th meeting of the WHO Working Group for the Molecular :: Detection and Subtyping of Influenza Viruses and the use of next-generation sequencing in the Global Influenza Surveillance and Response System
 
 
WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: Cabo Verde is ready to host 2nd African Health Forum and share good practices on progress towards Universal Health Coverage  14 February 2019
:: Uganda Health Workers Respond Swiftly to a Suspected Ebola Death  12 February 2019
:: Ethiopia Launches Measles Vaccine Second Dose (MCV2) Introduction: Over 3.3 million children will receive the vaccine annually  11 February 2019
:: Nigeria’s call to action – Time to Eliminate Cervical Cancer in Nigeria  10 February 2019
 
 
WHO Region of the Americas PAHO
:: Latest PAHO “Basic Indicators” shed light on health situation in the Americas (02/13/2019)

Vaccination
Vaccination coverage in 2017 varies for different vaccines: 94% percent of the target population of children in the Americas received the tuberculosis (BCG) vaccine; 90% received the vaccine for the first dose of measles, mumps, and rubella (MMR1); 88% received three doses of diphtheria, tetanus and pertussis (DTP3) vaccine; 85% received three doses of polio vaccine; and 73% received the last dose of rotavirus vaccine.
 
WHO South-East Asia Region SEARO
– No new digest announcements identified.
 
WHO European Region EURO
:: Towards a digital health roadmap for the WHO European Region 14-02-2019
 
 
WHO Eastern Mediterranean Region EMRO
:: Effective collaboration mitigates risk of potential outbreak
13 February 2019 – Intercountry collaboration between Iraq and Jordan allowed WHO and health authorities in Iraq to rapidly and successfully respond to an increase in cases of acute respiratory infections.
The last week of November 2018 witnessed an alarming rise in the incidence of acute respiratory infections in Suleimaniya governorate in the Kurdistan Region of Iraq. By 31 December, more than 35 suspected cases of influenza were admitted to Shaheed Hemin Hospital for Internal Medicine in the governorate…
:: US$ 43.5 million needed to provide life-saving health aid in Libya  11 February 2019
 
 
WHO Western Pacific Region
– No new digest announcements identified.

CDC/ACIP [to 16 Feb 2019]
http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html

MMWR News Synopsis for February 15, 2019
Update: Influenza Activity — United States, September 30, 2018–February 2, 2019
Influenza activity in the United States remained elevated through February 2, 2019, and is expected to continue for several more weeks. Influenza vaccination is the best way to reduce the risk of influenza and its potentially serious consequences, including hospitalizations in adults and deaths in children. Influenza antiviral medications are an important adjunct to vaccination in the treatment and prevention of influenza. Since December 2018, influenza activity increased overall and remained elevated through early February. Nationwide, influenza A(H1N1)pdm09 viruses have predominated, but in the southeastern United States influenza A(H3N2) viruses have predominated. As of February 2, 2019, this has been a low-severity influenza season, with a lower percentage of outpatient visits for influenza-like illness (ILI), lower rates of hospitalization, and fewer deaths attributed to pneumonia and influenza compared with recent seasons. Nevertheless, this season has resulted in many illnesses, hospitalizations and deaths, which are being reported in-season for the first time. The majority of the influenza viruses characterized antigenically and genetically are similar to the cell-grown reference viruses representing the 2018–19 Northern Hemisphere influenza vaccine viruses.

Interim Estimates of 2018–19 Seasonal Influenza Vaccine Effectiveness — United States, February 2019
While flu vaccines vary in how well they work, vaccination can provide important protection against influenza. People age 6 months and older who have not yet been vaccinated this season should be vaccinated. People who are at high risk of serious flu complications and develop flu symptoms, and people who are very sick with flu should be treated early with antiviral medications. CDC recommends yearly influenza vaccination for children at least 6 months old and adults. Early estimates indicate that influenza vaccines have reduced the risk of medically attended influenza-related illness by almost half (47%) in vaccinated people so far this season. Vaccination reduced the rate of illness caused by the predominant influenza H1N1 virus by about 46 percent among patients of all ages, and by about 62 percent among children 6 months through 17 years of age. Vaccination provided similar protection to that seen in previous H1N1 seasons in children and in adults younger than age 50. For these estimates, 3,254 children and adults with acute respiratory illness were enrolled from November 23, 2018 to February 2, 2019 at five study sites with outpatient medical facilities in the United States.

Recommendations of the Advisory Committee on Immunization Practices for Use of Hepatitis A Vaccine for Persons Experiencing Homelessness
The Advisory Committee on Immunization Practices now recommends routine hepatitis A (HepA) vaccination for all people ages 1 year and older who experience homelessness. In October 2018, the Advisory Committee on Immunization Practices (ACIP) unanimously approved updating the recommendations for HepA vaccine to include all people ages 1 year and older experiencing homelessness. The new recommendation is based on evidence showing the substantial public health and cost benefit of routine HepA vaccination for people who are homeless. Additionally, recent outbreaks of hepatitis A virus transmission have demonstrated the vulnerability of this population to this infection. Between 2016 and 2018, more than 7,000 cases of hepatitis A infection were reported in 12 states. The majority of these infections were among people reporting homelessness and/or injection or non-injection drug use. HepA vaccination for people who are homeless will protect these vulnerable individuals and reduce the risk of person-to-person outbreaks among this population.

Africa CDC   [to 16 Feb 2019]

https://au.int/en/africacdc

No new digest content identified.

China CDC 

http://www.chinacdc.cn/en/

New website launched…no “news” or “announcements” page identified. Link to National Health Commission of the People’s Republic of China not responding at inquiry [16 Feb 2019]

Announcements
 
 
Paul G. Allen Frontiers Group    [to 16 Feb 2019]
https://www.alleninstitute.org/news-press/
No new digest content identified.
 
 
BMGF – Gates Foundation  [to 16 Feb 2019]
http://www.gatesfoundation.org/Media-Center/Press-Releases
No new digest content identified.
 
 
Bill & Melinda Gates Medical Research Institute    [to 16 Feb 2019]
https://www.gatesmri.org/
The Bill & Melinda Gates Medical Research Institute is a non-profit biotech organization. Our mission is to develop products to fight malaria, tuberculosis, and diarrheal diseases—three major causes of mortality, poverty, and inequality in developing countries. The world has unprecedented scientific tools at its disposal; now is the time to use them to save the lives of the world’s poorest people
No new digest content identified.
 
 
CARB-X   [to 16 Feb 2019]
https://carb-x.org/
CARB-X is a non-profit public-private partnership dedicated to accelerating antibacterial research to tackle the global rising threat of drug-resistant bacteria.
No new digest content identified.
 
 
CEPI – Coalition for Epidemic Preparedness Innovations  [to 16 Feb 2019]
http://cepi.net/
No new digest content identified.
 
 
EDCTP    [to 16 Feb 2019]
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
Latest news
No new digest content identified.
 
 
Emory Vaccine Center    [to 16 Feb 2019]
http://www.vaccines.emory.edu/
No new digest content identified.
 
 
European Medicines Agency  [to 16 Feb 2019]
http://www.ema.europa.eu/ema/
News and press releases
Role of big data for evaluation and supervision of medicines in the EU
15/02/2019
Recommendations for a path towards understanding the acceptability of evidence derived from ‘Big data’ in support of the evaluation and supervision of medicines by regulators were published today as part of a summary report of the Heads of Medicines Agencies (HMA) – EMA Joint Big Data task force . The recommendations and associated actions set out what needs to be addressed, but the mechanisms by which this may be achieved requires further focused work over the coming year. Stakeholders are invited to submit feedback and observations on the recommendations to inform the upcoming work of the group.

Massive amounts of data are generated on a daily basis through wearable devices, electronic health records, social media, clinical trials or spontaneous adverse reaction reports. There is no doubt that insights derived from this data will increasingly be used by regulators to assess the benefit-risk of medicines across their whole lifecycle. However, in order to benefit from and make prudent use of the data collected, regulators need a deeper understanding of the data landscape.

The HMA – EMA Joint Big Data task force is composed of experienced medicines regulators from 14 national competent authorities and EMA. In preparing the report, it assessed the generation of ‘big data’, their relevant sources and main formats, the methods for processing and analysing big data and the current state of expertise across the European medicines regulatory network.

A crucial step was defining ‘big data’ itself, a widely-used term that is lacking a commonly-accepted definition. The definition adopted by the task force reads as follows: “extremely large datasets which may be complex, multi-dimensional, unstructured and heterogeneous, which are accumulating rapidly and which may be analysed computationally to reveal patterns, trends and associations. In general, big data sets require advanced or specialised methods to provide an answer within reliable constraints.”

Six subgroups of data sources relevant to regulatory decision-making were considered by the taskforce: genomics, bioanalytical ‘omics (proteomics, etc.), clinical trials, observational data, spontaneous adverse drug reactions data and social media and mobile health data.

Stakeholders and members of the public are invited to submit their comments on the core recommendations in the summary report (not to exceed 1,000 words) to bigdatasec@dkma.dk

until 15 April 2019. In particular, views on prioritisation of future actions would be welcomed.

The feedback received will be taken into account in the next phase of the work of the task force. A newly-refined mandate for the group is in place for the next year to define next steps and prioritisation of actions.
 
 
European Vaccine Initiative  [to 16 Feb 2019]
http://www.euvaccine.eu/news-events
Latest news
No new digest content identified.
 
 
FDA [to 16 Feb 2019]
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
No new digest content identified.
 
 
Fondation Merieux  [to 16 Feb 2019]
http://www.fondation-merieux.org/
No new digest content identified.
 
 
Gavi [to 16 Feb 2019]
https://www.gavi.org/
13 February 2019
UK to host Gavi replenishment in 2020
Geneva, 13 February 2019 – The UK government today announced that it will host Gavi’s replenishment pledging conference in mid-2020.
The event will follow the successful Gavi pledging conference in Berlin in January 2015, which raised US $7.5 billion for the 2016-2020 period. Next year’s event will raise funds to support Gavi’s programmes from 2021-2025, and will aim to bring together contributions from donors.    These resources will be complemented by developing countries co-financing and the vaccine industry’s contributions. The investment case, which will set out the amount required, will be published later this year…

12 February 2019
Ethiopia introduces measles vaccine second dose with support from Gavi
Addis Ababa, 12 February 2019 – Ethiopia has introduced measles vaccine second dose (MCV2) vaccination into the routine immunization programme, with technical and financial support from Gavi, the Vaccine Alliance and the World Health Organisation. Around 3.3 million children throughout the country will receive measles vaccine second dose annually…
 
 
GHIT Fund   [to 16 Feb 2019]
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
No new digest content identified.
 
 
Global Fund  [to 16 Feb 2019]
https://www.theglobalfund.org/en/news/
News
No new digest content identified.
 
 
Hilleman Laboratories   [to 16 Feb 2019]
http://www.hillemanlabs.org/
No new digest content identified.
 
 
Human Vaccines Project   [to 16 Feb 2019]
http://www.humanvaccinesproject.org/media/press-releases/
February 13, 2019
Decoding the Human Immune System
For the first time ever, researchers are comprehensively sequencing the human immune system, which is billions of times larger than the human genome. In a new study published in Nature from the Human Vaccines Project, scientists have sequenced a key part of this vast and mysterious system — the genes encoding the circulating B cell receptor repertoire.
Sequencing these receptors in both adults and infants, the scientists found surprising overlaps that could provide potential new antibody targets for vaccines and therapeutics that work across populations. As part of a large multi-year initiative, this work seeks to define the genetic underpinnings of people’s ability to respond and adapt to an immense range of disease.
Led by scientists at Vanderbilt University Medical Center and the San Diego Supercomputer Center, this advancement is possible due to the merging of biological research with high-powered frontier supercomputing. While the Human Genome Project sequenced the human genome and led to the development of novel genomics tools, it did not tackle the size and complexity of the human immune system…
 
 
IAVI  [to 16 Feb 2019]
https://www.iavi.org/newsroom
No new digest content identified.
 
 
IFFIm
http://www.iffim.org/library/news/press-releases/
No new digest content identified.
 
 
IVAC  [to 16 Feb 2019]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
No new digest content identified.
 
 
IVI   [to 16 Feb 2019]
http://www.ivi.int/
IVI News & Announcements
IVI and Yonsei University College of Medicine’s IIID to collaborate in vaccine R&D
On February 12 IVI exchanged a memorandum of understanding with the Institute of Immunology and Immunological Diseases (IIID), part of Yonsei University’s College of Medicine [Korea]. With this agreement, the two organizations are establishing a collaborative relationship in research and development of vaccines in order to help achieve the common goal of accelerating safe, effective, and affordable vaccines for people in developing countries and global health….
 
 
JEE Alliance  [to 16 Feb 2019]
https://www.jeealliance.org/
Selected News and Events
No new digest content identified.
 
 
MSF/Médecins Sans Frontières  [to 16 Feb 2019]
http://www.msf.org/
Selected News; Project Updates, Reports [as presented on website]
Cameroon
Nothing to drink and nowhere to sleep for thousands who’ve fl…
Press Release 14 Feb 2019

Democratic Republic of Congo
Even during a widespread measles epidemic, we can sa…
Interview 14 Feb 2019

Yemen
MSF opens new emergency room in Ad Dahi hospital
Project Update 14 Feb 2019

DRC 2018 Ebola outbreaks
Potential new Ebola drugs being trialled in MSF treatment centres
Statement 12 Feb 2019
[See Emergencies above for detail]

El Salvador
Breaking the invisible barriers that divide neighbourhoods con…
Project Update 11 Feb 2019

Colombia
Buenaventura: “MSF fills a huge vacuum in helping victims of vio…
Interview 11 Feb 2019
 
 
NIH  [to 16 Feb 2019]
http://www.nih.gov/news-events/news-releases
February 14, 2019
NIH names Dr. Noni H. Byrnes director of the Center for Scientific Review
— National Institutes of Health Director Francis S. Collins M.D., Ph.D., announced today the selection of Noni H. Byrnes, Ph.D., as director of the NIH Center for Scientific Review (CSR), effective Feb. 17, 2019.
 
Patients to share personal journeys at NIH Rare Disease Day events
February 11, 2019 — Connect with patients about navigating life with a rare disease.
 
 
PATH  [to 16 Feb 2019]
https://www.path.org/media-center/
No new digest content identified.
 
 
Sabin Vaccine Institute  [to 16 Feb 2019]
http://www.sabin.org/updates/pressreleases
Monday, February 11, 2019
The Bill & Melinda Gates Foundation and the Sabin Vaccine Institute Partner to Improve Vaccine Access by Strengthening Immunization Programs

WASHINGTON, DC – With the mutual goal of improving access to life-saving vaccines, the Bill & Melinda Gates Foundation recommitted its support to the Sabin Vaccine Institute (Sabin) to relaunch a global network for immunization managers. The success of immunization programs to reach populations with vaccines depends on excellent program management. Sabin will use the three-year, U.S. $3.5 million grant to provide national and sub-national immunization managers with training, education and networking opportunities, with an emphasis on strengthening management and leadership skills.

This initiative builds on the IAIM Network (International Association of Immunization Managers), established five years ago with support from the Bill & Melinda Gates Foundation to help immunization managers connect, share best practices and learn from trusted peers. The IAIM Network has become the world’s largest network for immunization managers, with more than 400 managers from over 120 countries engaging in virtual or in-person activities.

“We know that improving management capabilities and skills has a direct effect on program performance,” said Dr. Bruce Gellin, president of Global Immunization at Sabin. “This network will empower immunization managers to get answers, grow in their role and raise their collective voice.”…
 
 
UNAIDS [to 16 Feb 2019]
http://www.unaids.org/en
Selected Press Releases/Reports/Statements
15 February 2019
Healthy populations for healthy economies in Africa

15 February 2019
Ethiopia demonstrates that communities deliver

14 February 2019
OAFLA to broaden its scope of work

14 February 2019
Taking action against HIV medicine stock-outs in the Bolivarian Republic of Venezuela

12 February 2019
AIDS care in the Californian desert

12 February 2019
UNAIDS is awarded the Science and Medicine Award at the 25th Annual Steve Chase Awards
 
 
UNICEF  [to 16 Feb 2019]
https://www.unicef.org/media/press-releases
Selected Press Releases/Reports/Statements
Press release
Thousands of children vaccinated in remote Rukban settlement amid severe lack of access to medical care
UNICEF, UN and Syrian Arab Red Crescent reach more than 40,000 people with life-saving supplies in largest-ever humanitarian convoy since the start of the Syria crisis
15/02/2019

Press release
UNHCR and UNICEF urge action in Europe to end childhood statelessness
14/02/2019

Press release
More than 3,000 children released from armed groups in South Sudan since conflict began, but thousands more continue to be used
12/02/2019

News note
Fast Facts: 10 facts illustrating why we must #EndChildMarriage
11/02/2019

Press release
Dubai Cares and UNICEF announce the Dubai Declaration on Early Childhood Development at the World Government Summit
Declaration is a follow-up to the official MENA launch of the Lancet Series Advancing Early Childhood Development
10/02/2019

Press release
13.5 million children now uprooted in Africa – including those displaced by conflict, poverty and climate change
On eve of African Union Summit, UNICEF urges African States to lead in the protection and empowerment of uprooted children
 
 
Vaccine Confidence Project  [to 16 Feb 2019]
http://www.vaccineconfidence.org/
No new digest content identified.
 
 
Vaccine Education Center – Children’s Hospital of Philadelphia  [to 16 Feb 2019]
http://www.chop.edu/centers-programs/vaccine-education-center
No new digest content identified.
 
 
Wellcome Trust  [to 16 Feb 2019]
https://wellcome.ac.uk/news
Opinion | 15 February 2019
This is a pivotal moment for clinical trial regulations
by Beth Thompson
Globally, clinical research is governed by guidelines established almost three decades ago. And Brexit is a looming issue for trials that take place in the UK. Wellcome’s Policy team is working to address both problems.
 
 
The Wistar Institute   [to 16 Feb 2019]
https://www.wistar.org/news/press-releases
Press Release    Feb. 15, 2019
Wistar’s David B. Weiner, Ph.D., Awarded Prestigious Scientific Achievement Award from Life Sciences Pennsylvania
PHILADELPHIA — (Feb. 15, 2019) — David B. Weiner, Ph.D., executive vice president, director of the Vaccine & Immunotherapy Center, and the W.W. Smith Charitable Trust Professor in Cancer Research at The Wistar Institute, has been named the recipient of this year’s Scientific Achievement Award from Life Sciences Pennsylvania. The organization, with its more than 800-member companies, has a single mission to make Pennsylvania a hub of innovation by creating a business and public policy environment that fosters life sciences growth and success.

“Our Scientific Achievement Award recognizes a scientist in the Pennsylvania life sciences community who has demonstrated outstanding achievement by advancing scientific knowledge, innovation, and/or patient care,” said Christopher P. Molineaux, president & CEO of Life Sciences PA. “We can’t think of a better honoree this year than David – considered a founder of the field of synthetic DNA vaccines with more than 30 years of research contributions and scientific influence.”…
 
 
World Organisation for Animal Health (OIE)   [to 16 Feb 2019]
http://www.oie.int/en/for-the-media/press-releases/2018/
14/02/19
New report shows global shift in use of antibiotics in animals
[See Milestones above for detail]
 
::::::
 
BIO    [to 16 Feb 2019]
https://www.bio.org/insights/press-release
Feb 15 2019
BIO Statement on CMS Proposed Decision Memo for the CAR-T National Coverage Determination
Washington, DC (February 15, 2019) – Today, Biotechnology Innovation Organization (BIO) Executive Vice President for Health Policy, Dan Durham, issued the following statement r  regarding the CMS proposed decision memo for the CAR-T National Coverage Determination:
“We are further analyzing CMS’ released proposed decision memo for the National Coverage Determination for CAR T-cell therapy and look forward to providing the Agency with detailed comments in the coming weeks. It is critical that CMS coverage policies balance timely access to FDA-approved therapies across all potential appropriate settings of care, particularly when making determinations around innovations that represent significant advances in the delivery of treatment, such as CAR T. Further, such policy requirements should not be overly burdensome for providers, should be well aligned with FDA REMS requirements, and should provide enough flexibility as the class of medicines evolves.”
 
 
DCVMN – Developing Country Vaccine Manufacturers Network  [to 16 Feb 2019]
http://www.dcvmn.org/
No new digest content identified.
 
 
IFPMA   [to 16 Feb 2019]
http://www.ifpma.org/resources/news-releases/
No new digest content identified.
 
 
PhRMA    [to 16 Feb 2019]
http://www.phrma.org/press-room
No new digest content identified.
 
 
Industry Watch  [to 16 Feb 2019]
:: Moderna Announces Positive Interim Phase 1 Data for First Combination Vaccine Against the Respiratory Viruses hMPV and PIV3 February 12, 2019
   Interim data show vaccination with mRNA-1653 boosted serum neutralization titers against hMPV and PIV3 at all dose levels tested and was generally well tolerated
   Company plans to advance mRNA-1653 into a Phase 1b study in seropositive pediatric subjects

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

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 16 Feb 2019)

Research article
Comparison of influenza disease burden in older populations of Hong Kong and Brisbane: the impact of influenza and pneumococcal vaccination
Influenza and pneumococcal vaccine uptake in the older population aged 65 years or over of Hong Kong dramatically increased since the 2003 SARS outbreak. This study is aimed to evaluate the impact of increased…
Authors: Lin Yang, King Pan Chan, Chit Ming Wong, Susan Shui Seng Chiu, Ricardo J. Soares Magalhaes, Thuan Quoc Thach, Joseph Syrial Malik Peiris, Archie C. A. Clements and Wenbiao Hu
Citation: BMC Infectious Diseases 2019 19:162
Published on: 14 February 2019

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 16 Feb 2019)

Research article
Epidemiological characteristics and trends of a Nationwide measles outbreak in Mongolia, 2015–2016
Mongolia was one of the four countries that received a measles-elimination certificate from the World Health Organization Regional Office for the Western Pacific in 2014. Following the outbreaks in many countr…
Authors: Oyunchimeg Orsoo, Yu Mon Saw, Enkhbold Sereenen, Buyanjargal Yadamsuren, Ariunsanaa Byambaa, Tetsuyoshi Kariya, Eiko Yamamoto and Nobuyuki Hamajima
Citation: BMC Public Health 2019 19:201
Published on: 15 February 2019

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 16 Feb 2019)

Research article
Pertussis vaccination status and vaccine acceptance among medical students: multicenter study in Germany and Hungary
Medical students are at risk of contracting and transmitting infectious diseases such as pertussis. Complete vaccination status is important to protect own, patient and public health. Knowing own vaccination s…
Authors: Mandy Böhme, Karen Voigt, Erika Balogh, Antje Bergmann, Ferenc Horváth, Joachim Kugler, Jörg Schelling, Jeannine Schübel and Henna Riemenschneider
Citation: BMC Public Health 2019 19:182
Published on: 12 February 2019

BMC Research Notes
http://www.biomedcentral.com/bmcresnotes/content
(Accessed 16 Feb 2019)

Research note
Immunization coverage and factors associated with incomplete vaccination in children aged 12 to 59 months in health structures in Lomé
To estimate the immunization coverage among children admitted for consultation or hospitalization in health structures of Lomé.
Authors: Wendpouiré I. C. Zida-Compaore, Didier K. Ekouevi, Fifonsi A. Gbeasor-Komlanvi, Essèboè K. Sewu, Tetouyaba Blatome, Adama D. Gbadoe, Diparidè A. Agbèrè and Yawo Atakouma
Citation: BMC Research Notes 2019 12:84
Published on: 14 February 2019

Ethics & Human Research
Volume 41, Issue 1  January-February 2019
https://onlinelibrary.wiley.com/journal/25782363

New Challenges and Unresolved Issues
The inaugural issue of Ethics & Human Research (E&HR) marks an exciting milestone in The Hastings Centers’ 40‐year history of publishing a journal that focuses on the ethical, regulatory, and policy issues related to research with humans. Like its predecessor, IRB: Ethics & Human Research, E&HR will publish conceptual and empirical analyses on a wide range of topics related to the human research enterprise.

The journal’s name change conveys to the global community of authors and readers that E&HR is not solely about issues related to institutional review boards (IRBs) in the United States. The title shift provides an opportunity to identify new ethical, policy, and regulatory challenges that rapid developments in science, medicine, and regulatory frameworks bring to the conduct and oversight of human subjects research in the United States and elsewhere. Along with publishing work that investigates new challenges, E&HR aims not only to draw attention to unresolved issues but also to broaden the scope of issues for investigation and analysis in the field of human research ethics. The pieces in this inaugural issue identify several new challenges and hint at some of the unresolved issues and broader topics that merit further attention.

Global Public Health
Volume 14, 2019   Issue 4
http://www.tandfonline.com/toc/rgph20/current

Special Issue: Analysing power and politics in health policies and systems;
Guest Editors: Radhika Gore and Richard Parker 
introduction
Analysing power and politics in health policies and systems
Radhika Gore & Richard Parker
Pages: 481-488
Published online: 16 Feb 2019
ABSTRACT
This special issue of Global Public Health presents a collection of articles that analyse power and its mechanisms in health systems and health policy processes. Researchers have long noted that the influence of power is implicated throughout the global health field, yet theories and methods for examining power—its sources, workings, and effects—are rarely applied in health policy and systems research. By engaging with the social sciences and humanities, contributors to this collection aim to analytically sharpen and thematically broaden the study of power and politics in global health. Contributors analyse the exercise of power by actors typically considered powerful on the global stage as well as actors across the health system who may be powerful in national or local contexts. Additionally, the papers draw attention to actors, interest groups, and practices not usually viewed as politically salient in health policy and systems research in low- and middle-income countries. The papers not only analyse power but also identify ways to counteract it, such as by using human rights-based frameworks to investigate and challenge power asymmetries. Collectively, they show how researchers working on global health issues can theorise power and deepen political analysis of health policy and systems.

Humanitarian Exchange Magazine
Number 74,  February 2019
https://odihpn.org/magazine/communication-community-engagement-humanitarian-response/

Communication and community engagement in humanitarian response
This edition of Humanitarian Exchange, co-edited with Charles-Antoine Hofmann from the UN Children’s Fund (UNICEF), focuses on communication and community engagement. Despite promising progress, coherent and coordinated information is still not provided systematically to affected communities, and humanitarian responses take insufficient account of the views and feedback of affected people. In 2017, UNICEF, the International Federation of Red Cross and Red Crescent Societies (IFRC), the UN Office for the Coordination of Humanitarian Affairs (OCHA) and other partners came together under the auspices of the Communicating with Disaster Affected Communities (CDAC) Network to establish the Communication and Community Engagement (CCE) initiative, which aims to organise a collective service for communications and community engagement. The articles in this edition take stock of efforts to implement this initiative.

Drawing on lessons from 23 Peer 2 Peer Support missions, Alice Chatelet and Meg Sattler look at what’s needed to integrate CCE into the humanitarian architecture. Viviane Lucia Fluck and Dustin Barter discuss the institutional and practical barriers to implementing community feedback mechanisms. Bronwyn Russel analyses the performance of the Nepal inter-agency common feedback project; Justus Olielo and Charles-Antoine Hofmann outline the challenges of establishing common services in Yemen; and Gil Francis Arevalo reports on community engagement in preparedness and response in the Philippines. Ian McClelland and Frances Hill discuss emerging findings from a strategic partnership in the Philippines between the Humanitarian Innovation Fund and the Asian Disaster Reduction and Response Network.

Charlotte Lancaster describes how call centres in Afghanistan and Iraq are enhancing two-way communication with crisis-affected people. Mia Marzotto from Translators without Borders reflects on the importance of language and translation in communication and community engagement, and Ombretta Baggio and colleagues report on efforts to bring community perspectives into decision-making during an Ebola outbreak in the Democratic Republic of Congo. Ayo Degett highlights emerging findings from a Danish Refugee Council project on participation in humanitarian settings, and Jeff Carmel and Nick van Praag report on the Listen Learn Act (LLA) project. Geneviève Cyvoct and Alexandra T. Warner write on an innovative common platform to track the views of affected people in Chad. The edition ends with an article by Stewart Davies on collective accountability in the response to the Central Sulawesi earthquake.

Infectious Diseases of Poverty
http://www.idpjournal.com/content
[Accessed 16 Feb 2019]

Scoping Review
|   13 February 2019
Are malaria elimination efforts on right track? An analysis of gains achieved and challenges ahead
Authors: Sunil Dhiman

JAMA
February 12, 2019, Vol 321, No. 6, Pages 523-620
http://jama.jamanetwork.com/issue.aspx

Viewpoint
Trust in Health Care
A Framework for Increasing Trust Between Patients and the Organizations That Care for Them
Thomas H. Lee, MD, MSc; Elizabeth A. McGlynn, PhD; Dana Gelb Safran, ScD
free access
JAMA. 2019;321(6):539-540. doi:10.1001/jama.2018.19186
This Viewpoint summarizes key findings and conclusions of a working group of health care leaders and patient advocates who participated in a 2018 American Board of Internal Medicine (ABIM) Foundation Forum on [Re]Building Trust, convened to identify and prioritize interventions to restore trust in health care teams, standards, measures, and systems.

JAMA
February 12, 2019, Vol 321, No. 6, Pages 523-620
http://jama.jamanetwork.com/issue.aspx

Editorial
Trust in Health Care
Howard Bauchner, MD

Journal of Evidence-Based Medicine
Volume 12, Issue S1  Pages: 1-34  January 2019
https://onlinelibrary.wiley.com/toc/17565391/current

7th Meeting of the COMET Initiative (VII), Thursday 15th and Friday 16th November 2018, De Rode Hoed, Amsterdam
On the 15^th and 16^th November 2018, the Core Outcome Measures in Effectiveness Trials (COMET) Initiative held its seventh international meeting. After success at COMET VI, the COMET meeting returned to De Rode Hoed (The Red Hat) in Amsterdam for their second consecutive meeting. One‐hundred and fifteen participants gathered from around the world, coming from five continents and 18 countries.

Journal of Public Health Policy
Volume 40, Issue 1, March 2019
https://link.springer.com/journal/41271/40/1

Original Article
The World Breastfeeding Trends Initiative: Implementation of the Global Strategy for Infant and Young Child Feeding in 84 countries
Arun Gupta, Shoba Suri, J. P. Dadhich, Marta Trejos… Pages 35-65

Journal of Public Health Policy
Volume 40, Issue 1, March 2019
https://link.springer.com/journal/41271/40/1

Viewpoint
A public health framework for the regulation of marketing
Anthony Biglan, Mark Van Ryzin, Erika Westling Pages 66-75

Journal of Public Health Policy
Volume 40, Issue 1, March 2019
https://link.springer.com/journal/41271/40/1

Viewpoint
Barriers to the evaluation of evidence-based public health policy
Megan Freund, Alison Zucca, Robert Sanson-Fisher… Pages 114-125

The Lancet
Feb 16, 2019  Volume 393  Number 10172p611-716, e29
https://www.thelancet.com/journals/lancet/issue/current

Editorial
Russia’s burgeoning HIV epidemic
The Lancet
While some countries in western Europe celebrate relative successes in the treatment and control of HIV, a burgeoning epidemic in the eastern part of the region poses a continued threat to progress.

A report, published Feb 4, from the European Centre for Disease Prevention and Control underlines the inequality of treatment and care for people living with HIV in Europe and central Asia. The report states that in these regions overall, one of five people living with HIV (PLHIV) is unaware of their status and only 43% of PLHIV have viral loads low enough to prevent transmission—substantially than the UNAIDS goal of 73%. The failure to reach the target is largely due to low rates of viral suppression reported from countries in the central and eastern subregions of the WHO European Region. Specifically, in Russia, the number of PLHIV is reported as 998 525, with only 26% achieving viral suppression and in Ukraine, the number is 244 000, with 23% achieving viral suppression. However, the situation in Russia is worthy of closer examination because the findings in the report are based on estimates from data provided for the first time by the country’s Ministry of Health to UNAIDS, in 2017, and covering the year ending 2016.

The latest information, obtained directly by us from the Ministry, covers the year ending 2017, and reports the number of newly registered PLHIV has increased by 105 844. Clearly, this is not an exact measure of incidence, but it gives an indication that numbers continue to rise unabated. Reasons for the absence of progress in Russia are numerous and include insufficient access to sterile injecting equipment, unavailability of opioid substitution therapy, and a shortage of treatment in populations where it is most needed, namely people who inject drugs and their partners, sex workers, and men who have sex with men.

The release of HIV data by Russia is to be applauded. But if serious inroads are to be made into the epidemic, then attention must now turn to treatment of key, marginalised populations of PLHIV.

The Lancet
Feb 16, 2019  Volume 393  Number 10172p611-716, e29
https://www.thelancet.com/journals/lancet/issue/current

Comment
Ebola in the Democratic Republic of the Congo: time to sound a global alert?

Lawrence Gostin, Alexandra Phelan, Alex Godwin Coutinho, Mark Eccleston-Turner, Ngozi Erondu, Oyebanji Filani, Tom Inglesby, Rebecca Katz, Allan Maleche, Jennifer B Nuzzo, Oyewale Tomori, Matthew Kavanagh

[See Milestones above for full text]

We call upon the WHO Director-General to reconvene the EC to review the grounds for a PHEIC declaration. He should invite states, the UN, and NGOs to attend and submit evidence. 10  The United Nations Organization Stabilization Mission in the Democratic Republic of the Congo (MONUSCO), UNHCR, the UN Refugee Agency, and civil society could provide critical information. The EC should recommend proactive measures on health, diplomacy, security, and community engagement. Concrete recommendations could specify the level and kind of resources needed and composition of security and diplomatic assets.

A PHEIC is a clarion call to galvanise high-level political, financial, and technical support. A PHEIC would provide a clear signal from the world’s global health body that UN leadership is urgent. A PHEIC also empowers the WHO Director-General to make temporary, non-binding recommendations that have normative force.10

The IHR do not specify any surge in authority or financing when declaring a PHEIC. In the past, states did not heed WHO warnings that travel and trade restrictions are harmful. During the west African Ebola epidemic, 58 states restricted travel from affected areas, and during the 2009 influenza A H1N1 pandemic, states imposed trade and travel restrictions.12,13,14]

Trade or travel barriers in the DRC would have devastating impacts. WHO, with UN support, should take active steps to prevent unlawful and harmful restrictions. In 2009, WHO and the World Trade Organization (WTO) criticised governments that took non-evidence-based actions; going forward, WHO and WTO could publicly name non-compliant countries. Governments should also agree to dispute resolution, including binding IHR arbitration.10

If a PHEIC escalated conflict by raising the profile of the international response, it would be deeply concerning. Recent elections in DRC were clouded by concerns about vote-rigging, unsettling lines of power and legitimacy. Armed groups have used violence to generate chaos. A PHEIC could increase incentives to target Ebola responders to gain leverage. As in South Sudan, armed groups could manipulate aid for non-humanitarian purposes.15 Like any complex multilateral negotiation, cultural competence and smart diplomacy are required. Outsiders are unlikely to be privy to all on-the-ground realities and risks.

The IHR were designed to respond to a health emergency like the DRC Ebola epidemic. We urge the WHO Director-General to reconvene the EC and re-assess the declaration of a PHEIC. The UN and governments should increase support for WHO and partners. If the IHR fails, or worse, increases political instability, it will require urgent reform.

State non-compliance should not obscure the value of the IHR in establishing norms of rapid identification, notification, and response. The IHR require states to develop health-system capacities, assessed by WHO’s Joint External Evaluation. IHR reform should focus on technical and financial assistance for national health capacities. A PHEIC should trigger surge capacity in relation to authority and finances, with effective mechanisms to gain state compliance.

WHO has shown leadership and operational endurance, working tirelessly to combat the DRC Ebola epidemic. But WHO and partners cannot succeed alone. We live at a political moment when international solutions to collective threats are increasingly hard to achieve. But WHO and the UN system will be called upon with ever-greater frequency in the future to manage complex humanitarian crises. We must plan for a future in which political violence and instability become the new abnormal.

[References at title link above]

Nature 
Volume 566 Issue 7743, 14 February 2019
http://www.nature.com/nature/current_issue.html

Editorial | 11 February 2019
Trump’s goal to eradicate the HIV epidemic in the United States is achievable — yet remote
The president’s pledge rings hollow without a major shift in policy and rhetoric.

Nature 
Volume 566 Issue 7743, 14 February 2019
http://www.nature.com/nature/current_issue.html

Editorial | 13 February 2019
Artificial intelligence alone won’t solve the complexity of Earth sciences
Studies of complex climate and ocean systems could gain from a hybrid between artificial intelligence and physical modelling.

Nature 
Volume 566 Issue 7743, 14 February 2019
http://www.nature.com/nature/current_issue.html

Comment | 11 February 2019
Overdue: a US advisory board for research integrity
Research needs an authoritative forum to hash out collective problems, argue C. K. Gunsalus, Marcia K. McNutt and colleagues.

1. K. Gunsalus, Marcia K. McNutt[…]& Robert M. Nerem

New England Journal of Medicine
February 14, 2019   Vol. 380 No. 7
http://www.nejm.org/toc/nejm/medical-journal

Perspective
Brazil’s Fight against Hepatitis C — Universalism, Local Production, and Patents
Elize M. da Fonseca, Ph.D., Kenneth Shadlen, Ph.D., and Francisco I. Bastos, M.D., Ph.D.
Brazil’s strategy for addressing hepatitis C, which combines evidence-based treatment protocols and innovative initiatives for local production of generic direct-acting antiviral drugs, needs to be considered in light of ongoing conflicts over pharmaceutical patents.

PharmacoEconomics & Outcomes News
Volume 821, Issue 1, February 2019
https://link.springer.com/journal/40274/821/1

Clinical study
Global forecast on medicine use
IQVIA Institute. The Global Use of Medicine in 2019 and Outlook to 2023. Internet Document : 29 Jan 2019. Available from: URL: https://www.iqvia.com/institute/reports/the-global-use-of-medicine-in-2019-and-outlook-to-2023

PLoS One
http://www.plosone.org/
[Accessed 16 Feb 2019]

Research Article
Barriers to effective uptake and provision of immunization in a rural district in Uganda
Oliver Ombeva Malande, Deogratias Munube, Rachel Nakatugga Afaayo, Kisakye Annet, Bongomin Bodo, Andrew Bakainaga, Elizabeth Ayebare, Sam Njunwamukama, Edison Arwanire Mworozi, Andrew Munyalo Musyoki
Research Article | published 14 Feb 2019 PLOS ONE
https://doi.org/10.1371/journal.pone.0212270

PLoS One
http://www.plosone.org/
[Accessed 16 Feb 2019]

The impact of supplementary immunization activities on routine vaccination coverage: An instrumental variable analysis in five low-income countries
Averi Chakrabarti, Karen A. Grépin, Stéphane Helleringer
Research Article | published 14 Feb 2019 PLOS ONE
https://doi.org/10.1371/journal.pone.0212049

Prehospital & Disaster Medicine
Volume 34 – Issue 1 – February 2019
https://www.cambridge.org/core/journals/prehospital-and-disaster-medicine/latest-issue

Guest Editorial
Character Disorders among Autocratic World Leaders and the Impact on Health Security, Human Rights, and Humanitarian Care
Frederick M. Burkle
https://doi.org/10.1017/S1049023X18001280
Published online: 15 January 2019, pp. 2-7
Abstract
The development of autocratic leaders in history reveals that many share severe character disorders that are consistently similar across borders and cultures. Diplomats and humanitarians negotiating for access to populations in-need and security of their programs, especially in health, must understand the limitations placed on the traditional negotiation process. These shared character traits stem from a cognitive and emotional developmental arrest in both childhood and adolescence resulting in fixed, life-long, concrete thinking patterns. They fail to attain the last stage of mental and emotional development, that of abstract thinking, which is necessary for critical reasoning that allows one to consider the broader significance of ideas and information rather than depend on concrete details and impulses alone. These autocratic leaders have limited capacity for empathy, love, guilt, or anxiety that become developmentally permanent and guide everyday decision making. Character or personality traits that perpetuate the lives of autocratic leaders are further distinguished by sociopathic and narcissistic behaviors that self-serve to cover their constant fear of insecurity and the insatiable need for power. Human rights, humanitarian care, and population-based health security are examples of what has consistently been sacrificed under autocratic rule. Today, with the worst global loss of democratic leadership ever seen since WWII, leaders with these character traits now rule in major countries of the world. While history teaches us of battles and conflicts that result from such flawed leadership, it lacks explanations of why autocratic behaviors consistently emerge and dominate many societies. Building multidisciplinary capacity and capability in societies among democracies to limit or cease such authoritarian dominance first begins with a developmental understanding of why autocrats exist and persist in externalizing their pathological behaviors on unsuspecting and vulnerable populations, and the limitations they place on negotiations.

Science         
15 February 2019  Vol 363, Issue 6428
http://www.sciencemag.org/current.dtl

In Depth 
DOE to limit foreign research collaborations
By Jeffrey Mervis
Science15 Feb 2019 : 675-676 Restricted Access
Recent memos describe crackdown on grantees and on lab scientists with foreign ties.

Science         
15 February 2019  Vol 363, Issue 6428
http://www.sciencemag.org/current.dtl

Controversial flu studies can resume, U.S. panel says
By Jocelyn Kaiser
Science15 Feb 2019 : 676-677 Restricted Access
Critics complain of lack of transparency in decision that allows efforts to create potentially risky virus strains.

Science         
15 February 2019  Vol 363, Issue 6428
http://www.sciencemag.org/current.dtl

Measles epidemic in Ukraine drove troubling European year
By Meredith Wadman
Science15 Feb 2019 : 677-678 Restricted Access
War and distrust of vaccines seeded ongoing outbreak

Science Translational Medicine
13 February 2019  Vol 11, Issue 479
http://stm.sciencemag.org/

Focus
Biology, biography, and the translational gap
By Pamela Summers-Trio, Allison Hayes-Conroy, Burton Singer, Ralph I. Horwitz
Science Translational Medicine13 Feb 2019 Full Access
Medicine-based evidence integrates biology and biography to help eliminate the translational gap between research and the clinic.

Social Science & Medicine
Volume 222  Pages 1-376 (February 2019)
https://www.sciencedirect.com/journal/social-science-and-medicine/vol/221/suppl/C

Research article  Abstract only
Exploring the meaning of pro-vaccine activism across two countries
Samantha Vanderslott
Pages 59-66
Abstract
While vaccine-critical activism has been widely documented and discussed, comparatively little has been said about the concerted response of pro-vaccine activists defending the majority view. This paper explores two case studies of pro-vaccine activism in Australia and the United States (US). It shows how pro-vaccine views and behaviours can take varying forms due to different aims and methods of engagement – oppositional counteractivities in favour of vaccination in Australia, and issue-based advocacy as part of a political alliance in the US. The focus in Australia comes from a pro-science stance and includes ‘skeptics’ against pseudoscience directly opposing vaccine-critical groups. In the US, the focus takes the form of an issue-specific campaign that has arisen from existing pro-vaccine parent blogs and discussion groups pushing for policy change rather than public confrontation. These case studies exemplify how pro-vaccine activism can take varying forms of either reinforcing the mainstream view or countering digression from it. Drawing on qualitative research, this paper aims to examine the types of practices and strategies employed by activists to voice their support of vaccination, and discusses the means, messages, and motivations of pro-vaccine activism. It ends with an argument for why a study – of public support for in addition to studying public opposition to vaccination – can help to better understand vaccination views and behaviours. These findings have wider implications for the study of counter-activism and the polarisation of civil society groups.

Vaccine
Volume 37, Issue 10  Pages 1255-1376 (28 February 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/10

Research article  Abstract only
Effectiveness of an intervention campaign on influenza vaccination of professionals in nursing homes: A cluster-randomized controlled trial
France Borgey, Liliane Henry, Josiane Lebeltel, Pascale Lescure, … Pascal Thibon
Pages 1260-1265

Vaccine
Volume 37, Issue 10  Pages 1255-1376 (28 February 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/10
Research article  Abstract only

Research article  Abstract only
A pathway to developing and testing quality measures aimed at improving adult vaccination rates in the United States
Angela K. Shen, Amy V. Groom, Diane L. Leach, Carolyn B. Bridges, … Litjen Tan
Pages 1277-1283

Vaccine
Volume 37, Issue 10  Pages 1255-1376 (28 February 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/10

Research article  Abstract only
A population-based study of maternal and infant factors influencing influenza vaccination among young children born in Colorado from 2008 to 2016
Suchitra Rao, Musheng Alishahi, Lauren De Crescenzo, Amanda F. Dempsey
Pages 1293-1298

Vaccine
Volume 37, Issue 10  Pages 1255-1376 (28 February 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/10

Research article  Abstract only
Parent report of provider HPV vaccine communication strategies used during a randomized, controlled trial of a provider communication intervention
A.F. Dempsey, J. Pyrzanowski, E.J. Campagna, S. Lockhart, S.T. O’Leary
Pages 1307-1312

From Google Scholar & other sources: Selected Journal Articles, Newsletters, Dissertations, Theses, Commentary

No new digest content identified.

Media/Policy Watch

This watch section is intended to alert readers to substantive news, analysis and opinion from the general media and selected think tanks and similar organizations on vaccines, immunization, global public health and related themes. Media Watch is not intended to be exhaustive, but indicative of themes and issues CVEP is actively tracking. This section will grow from an initial base of newspapers, magazines and blog sources, and is segregated from Journal Watch above which scans the peer-reviewed journal ecology.

We acknowledge the Western/Northern bias in this initial selection of titles and invite suggestions for expanded coverage. We are conservative in our outlook in adding news sources which largely report on primary content we are already covering above. Many electronic media sources have tiered, fee-based subscription models for access. We will provide full-text where content is published without restriction, but most publications require registration and some subscription level.

 
 
The Atlantic
http://www.theatlantic.com/magazine/
Accessed 16 Feb 2019
[No new, unique, relevant content]
 
 
BBC
http://www.bbc.co.uk/
Accessed 16 Feb 2019
[No new, unique, relevant content]
 
 
CNN
https://www.cnn.com/
Accessed 16 Feb 2019
Amid measles outbreaks, Facebook considering how to reduce spread of anti-vaccine content
By Jacqueline Howard, CNN
Updated 2:28 PM ET, Fri February 15, 2019
(CNN)Facebook is looking into suppressing certain anti-vaccine messaging on its social platform, a move that raises questions about free speech and public health.
“We’ve taken steps to reduce the distribution of health-related misinformation on Facebook, but we know we have more to do. We’re currently working with outside experts on additional changes that we’ll be announcing soon,” a representative for the social media giant said Friday.
In recent years, anti-vaccination groups have been vocal on Facebook, frequently sharing and posting information against vaccines and their safety. At the same time, there has been a rise in cases of measles and other infectious diseases across the United States…
…Arthur Caplan, a professor and founding head of the Division of Medical Ethics at NYU Langone Health in New York, said that he is “very supportive” of Facebook’s new efforts to police anti-vaccine messaging.
“They don’t have to be a platform for lying, for fearmongering, for inaccuracy, especially when children are put at risk,” said Caplan, who has written about anti-vaccination groups’ social media presence in the journal Human Vaccines & Immunotherapeutics.
“I’m not trying to say that somebody can’t take positions against vaccines on Facebook,” he said. “I know people are going to say this is an intrusion into free speech — many anti-vaxxers will say that — but no one is saying you can’t be anti-vaccination. What we’re saying is, you can’t lie. You can’t fearmonger.”…
 
 
The Economist
http://www.economist.com/
Accessed 16 Feb 2019
[No new, unique, relevant content]
 
 
Financial Times
http://www.ft.com/home/uk
Accessed 16 Feb 2019
[No new, unique, relevant content]
 
 
Forbes
http://www.forbes.com/
Accessed 16 Feb 2019
Is There Any Benefit Of “Natural Immunity” When It Comes To Infections Like Measles?
In the midst of one of the largest worldwide measles outbreaks since the initiation of the measles vaccine, those with large social media platforms are spreading inaccurate medical information regarding the safety and efficacy of immunization…
By  Nina Shapiro  Contributor
 
 
Foreign Affairs
http://www.foreignaffairs.com/
Accessed 16 Feb 2019
[No new, unique, relevant content]
 
 
Foreign Policy
http://foreignpolicy.com/
Accessed 16 Feb 2019
[No new, unique, relevant content]
 
 
The Guardian
http://www.guardiannews.com/
Accessed 16 Feb 2019
Vaccines and immunisation
Measles: WHO says cases have jumped 50%
Falsehoods spread by ‘anti-vax’ movement in part to blame for backsliding in progress against potentially deadly illness, experts say
Rebecca Ratcliffe and agencies
Fri 15 Feb 2019
Anti-vaccine scepticism, conflict and poor access fuelled a 50% increase in measles cases last year, according to the World Health Organization.
The UN health agency said the resurgence was happening at a global level, including in wealthy nations where vaccination coverage has historically been high.
“Our data is showing that there is a substantial increase in measles cases. We’re seeing this in all regions,” said Katherine O’Brien, WHO’s director of immunisation and vaccines. “We’re having outbreaks that are protracted, that are sizeable and that are growing,. This is not an isolated problem.”
The figures are a worrying sign of the vast reach of vaccine-scepticism, said Heidi Larson, director of the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine. “It’s very serious. Historically measles outbreaks go up and down but this is a pretty dramatic increase.”…
 
 
New Yorker
http://www.newyorker.com/
Accessed 16 Feb 2019
[No new, unique, relevant content]
 
 
New York Times
http://www.nytimes.com/
Accessed 16 Feb 2019
U.S.
Washington Lawmakers Advance Limits on Vaccine Exemptions
Washington state lawmakers advanced a measure Friday that would remove parents’ ability to claim a personal or philosophical exemption to vaccinating their school-age children for measles as the Pacific Northwest struggles with an outbreak of the contagious virus.
Feb. 15
 
 
Africa
Nearly 1,000 Madagascar Children Dead of Measles Since October: WHO
At least 922 children and young adults have died of measles in Madagascar since October, despite a huge emergency vaccination program, the World Health Organization (WHO) said on Thursday.
Feb. 15
 
 
Wall Street Journal
http://online.wsj.com/home-page?_wsjregion=na,us&_homepage=/home/us
Accessed 16 Feb 2019
Review & Outlook
Didn’t We Already Beat Measles?
By The Editorial Board
Feb. 12, 2019 7:06 pm ET
Fifty-three cases are now confirmed, most in unvaccinated kids.
 
 
Washington Post
http://www.washingtonpost.com/
Accessed 16 Feb 2019
Anti-vaxxers are spreading conspiracy theories on Facebook, and the company is struggling to stop them
By Taylor Telford
February 13
As a disturbing number of measles outbreaks crop up across the United States, Facebook is facing challenges combating widespread misinformation about vaccinations on its platform, which has become a haven for the anti-vaccination movement

Think Tanks et al
 
Brookings
http://www.brookings.edu/
Accessed 16 Feb 2019
[No new relevant content]

Center for Global Development  
http://www.cgdev.org/page/press-center
February 7, 2019
Gavi Going Forward: Immunization for Every Child Everywhere?
In December 2018, the Gavi Alliance hosted a mid-term review to assess progress towards its core purpose: “reach every child everywhere with vaccines against preventable diseases.” The good news is that there’s been advances on new vaccine introductions, and an estimated 65 million children were immunized with Gavi-supported new and underutilized vaccines in 2017.     The bad news? There is still huge variability on the measure that counts most for building herd immunity and reducing vaccine-preventable disease: full vaccination for age among children under 2 years old.
Amanda Glassman and Liesl Schnabel

CSIS
https://www.csis.org/
Accessed 16 Feb 2019
Transcript
Saving Lives in a Time of Crisis: Why the Global Humanitarian System Matters
February 14, 2019

Council on Foreign Relations
http://www.cfr.org/
Accessed 16 Feb 2019
[No new relevant content]

Kaiser Family Foundation
https://www.kff.org/search/?post_type=press-release
Accessed 16 Feb 2019
February 15, 2019 News Release
Analysis Finds that Medications for Hepatitis C and HIV/AIDS Are the Costliest Group of Outpatient Prescription Drugs for Medicaid, While Diabetes Drugs Have Posted the Sharpest Rise in Costs 
Antiviral medications, including those that treat hepatitis C and HIV/AIDS, cost the Medicaid program more money (before rebates) than any other group of outpatient prescription drugs for each year from 2014 to 2017, according to a new KFF analysis.

Milestones :: Perspectives

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Measles in Europe: record number of both sick and immunized
7 February 2019 | WHO Europe News release
More children in the WHO European Region are being vaccinated against measles than ever before; but progress has been uneven between and within countries, leaving increasing clusters of susceptible individuals unprotected, and resulting in a record number of people affected by the virus in 2018. In light of measles data for the year 2018 released today, WHO urges European countries to target their interventions to those places and groups where immunization gaps persist.

Measles killed 72 children and adults in the European Region in 2018. According to monthly country reports for January to December 2018 (received as of 01 February 2019), 82 596 people in 47 of 53 countries contracted measles. In countries reporting hospitalization data, nearly 2/3 (61%) of measles cases were hospitalized. The total number of people infected with the virus in 2018 was the highest this decade: 3 times the total reported in 2017 and 15 times the record low number of people affected in 2016.

The surge in measles cases in 2018 followed a year in which the European Region achieved its highest ever estimated coverage for the second dose of measles vaccination (90% in 2017). More children in the Region received the full two-dose series on time, according to their countries’ immunization schedules, in 2017 than in any year since WHO started collecting data on the second dose in 2000. Coverage with the first dose of the vaccine also increased slightly to 95%, the highest level since 2013. However, progress in the Region, based on achievements at the national level, can mask gaps at subnational levels, which are often not recognized until outbreaks occur.

“The picture for 2018 makes it clear that the current pace of progress in raising immunization rates will be insufficient to stop measles circulation. While data indicate exceptionally high immunization coverage at regional level, they also reflect a record number affected and killed by the disease. This means that gaps at local level still offer an open door to the virus,” says Dr Zsuzsanna Jakab. “We cannot achieve healthier populations globally, as promised in WHO’s vision for the coming five years, if we do not work locally. We must do more and do it better to protect each and every person from diseases that can be easily avoided.”…