The Lancet
Mar 23, 2019  Volume 393Number 10177p1177-1260, e35
https://www.thelancet.com/journals/lancet/issue/current

Editorial
Venezuelans’ right to health crumbles amid political crisis
The Lancet
The rising prosperity of Venezuela during the 20th century helped to consolidate gains in health outcomes made over decades. Now, a country rich in natural resources is submerged in a complex humanitarian emergency due to the politico-economic crisis that started in 2008, progressively destroying the health-care system.

In this issue, Page and colleagues discuss the current situation in Venezuela and explain how the crisis has threatened the nation’s public health, resulting in increases in morbidity and mortality. The authors also report on the observations they made when visiting the Venezuelan borders with Colombia and Brazil, where the movement of Venezuelan migrants has already resulted in a strain on both countries’ health-care systems. Another worrying implication of the movement of migrants into neighbouring countries is the quick dissemination of infectious diseases, such as malaria and Chagas. A Review in The Lancet Infectious Diseases analysed the return of vector-borne diseases and the implications for spillover in the region. For example, the number of malaria cases increased by 359% between 2000 and 2015, and by a further 71% in 2017 (411 586 cases). Dengue incidence increased by more than four times between 1990 and 2016. These epidemics are exacerbated by the decline in public health programmes, such as childhood immunisation, insufficient potable water, and poor sanitation conditions.

In 2018, 82% of people in Venezuela (about 28·5 million people) and 75% of health centres around the country did not have a continuous supply of water, according to a report on the right to water published by five Venezuelan non-governmental organisations (NGOs). Running water is provided sporadically (in some areas this can be once every 20 days) and the water that does reach the population is of poor quality or not potable. To aggravate the situation, shortages of electricity have been recurrently reported over more than 3 months and have culminated in a widespread blackout between March 7 and March 11, leaving homes and hospitals in the dark. Failures in the electricity supply system were reported as causing the death of 79 patients between Nov 16, 2018, and Feb 9, 2019, in the 40 main hospitals of the country. These data are from a national survey, Encuesta Nacional de los Hospitales 2019 which also notes that 1557 patients died because of insufficient hospital supplies. The medical NGO that published these data explained that these are conservative estimates as many deaths are not reported.

In the meantime, hyperinflation (estimated by the International Monetary Fund to be at 10 million % in 2019) puts the cost of daily food out of reach for nine in ten Venezuelans, according to the ENCOVI (Living Conditions survey) 2017. The food crisis is further exacerbated by absence of food diversity and collapse of food infrastructure (production, distribution, and access to food). As a result, between 2016 and 2018, the proportion of the population that is undernourished increased from 5% to 12%, according to a report on the right to food published by three Venezuelan NGOs. Poor nutrition between conception and 2 years of age is threatening the physical, mental, and social development of new generations. Venezuela is the only country in Latin America showing a deterioration in child survival back to the levels of the 1990s. According to estimates in a recent study in The Lancet Global Health, the infant mortality rate reached 21·1 deaths per 1000 livebirths in 2016, almost 40% higher than in 2008.

Vowing to improve the situation, on March 1, the UN security council voted on two resolutions related to Venezuela but failed to pass either of them because the USA, Russia, and China clashed over the issue. The USA recognises Juan Guaido, leader of the National Assembly, as the country’s president, whereas China and Russia continue to recognise Nicolás Maduro as leader of the country. While the divisive debate regarding last year’s disputed presidential elections continues to rage, Venezuela is struggling with hunger and preventable diseases.

As we went to press, a UN team was visiting the country on an official human rights mission following a surprising invitation from Maduro, who has been reluctant to accept humanitarian aid. There is hope that Maduro will be transparent with the UN team and allow them to observe the true complexity of the situation. The UN human rights team is also scheduled to speak with members of Guaido’s party. Whatever the outcome of the UN’s mission, the urgent implementation of effective measures to facilitate the coordinated international response to the Venezuelans’ plight cannot come soon enough. The right to health and to food cannot be politicised and the international community is failing if these universal rights are not restored in Venezuela.

The Lancet
Mar 23, 2019  Volume 393Number 10177p1177-1260, e35
https://www.thelancet.com/journals/lancet/issue/current

Review
Venezuela’s public health crisis: a regional emergency
Kathleen R Page, Shannon Doocy, Feliciano Reyna Ganteaume, Julio S Castro, Paul Spiegel,
Chris Beyrer
Summary
The economic crisis in Venezuela has eroded the country’s health-care infrastructure and threatened the public health of its people. Shortages in medications, health supplies, interruptions of basic utilities at health-care facilities, and the emigration of health-care workers have led to a progressive decline in the operational capacity of health care. The effect of the crisis on public health has been difficult to quantify since the Venezuelan Ministry of Health stopped publishing crucial public health statistics in 2016. We prepared a synthesis of health information, beyond what is available from other sources, and scholarly discussion of engagement strategies for the international community. Data were identified through searches in MEDLINE, PubMed, and the grey literature, through references from relevant articles, and governmental and non-governmental reports, and publicly available databases. Articles published in English and Spanish until Dec 1, 2018, were included. Over the past decade, public health measures in Venezuela have substantially declined. From 2012 to 2016, infant deaths increased by 63% and maternal mortality more than doubled. Since 2016, outbreaks of the vaccine-preventable diseases measles and diphtheria have spread throughout the region. From 2016 to 2017, Venezuela had the largest rate of increase of malaria in the world, and in 2015, tuberculosis rates were the highest in the country in 40 years. Between 2017 and 2018, most patients who were infected with HIV interrupted therapy because of a lack of medications. The Venezuelan economic crisis has shattered the health-care system and resulted in rising morbidity and mortality. Outbreaks and expanding epidemics of infectious diseases associated with declines in basic public health services are threatening the health of the country and the region.

The Milbank Quarterly
A Multidisciplinary Journal of Population Health and Health Policy
Volume 97, Issue 1  Pages: 1-367  March 2019

https://onlinelibrary.wiley.com/toc/14680009/current
Original Scholarship
Free Access
Access by Design, Benefits if Convenient: A Closer Look at the Pandemic Influenza Preparedness Framework’s Standard Material Transfer Agreements
MICHELLE F. ROURKE
Pages: 91-112
First Published: 13 January 2019
Policy Points
:: Securing access to pathogen samples for research purposes is crucial for pandemic preparedness and responding to infectious disease outbreaks.
:: The Pandemic Influenza Preparedness Framework (PIP Framework) is the only pathogen‐specific international access and benefit‐sharing (ABS) instrument.
: This analysis reveals that during an influenza pandemic, the PIP Framework will safeguard access to virus samples but may not be as effective in delivering the associated benefits, like vaccines and antivirals, to countries in need.
:: The PIP Framework’s deficiencies must be addressed before an influenza pandemic and before this ABS model is extended to other human pathogens.

Nature 
Volume 567 Issue 7748, 21 March 2019
http://www.nature.com/nature/current_issue.html

Editorial | 20 March 2019
It’s time to talk about ditching statistical significance
Looking beyond a much used and abused measure would make science harder, but better.

Nature 
Volume 567 Issue 7748, 21 March 2019
http://www.nature.com/nature/current_issue.html

Comment | 20 March 2019
Scientists rise up against statistical significance
Valentin Amrhein, Sander Greenland, Blake McShane and more than 800 signatories call for an end to hyped claims and the dismissal of possibly crucial effects.
Valentin Amrhein, Sander Greenland & Blake McShane

Nature 
Volume 567 Issue 7748, 21 March 2019
http://www.nature.com/nature/current_issue.html

Research Highlight | 08 March 2019
Thousands of measles deaths averted by Indian vaccination campaign
Programme’s success shows that the country could end mortality from the disease.

Nature 
Volume 567 Issue 7748, 21 March 2019
http://www.nature.com/nature/current_issue.html

Books & Arts | 19 March 2019
Evolving society: why humanity coheres
Agustín Fuentes compares three books on the origins, trajectory and implications of our group behaviour.

Nature 
Volume 567 Issue 7748, 21 March 2019
http://www.nature.com/nature/current_issue.html

The rise and fall of scientific authority — and how to bring it back
Robert P. Crease harks back to the shapers of our scientific infrastructure and what they can tell us about how to handle the threat we now face.
Robert P. Crease

New England Journal of Medicine
March 21, 2019   Vol. 380 No. 12
http://www.nejm.org/toc/nejm/medical-journal

Perspective
Public–Private Partnerships in Global Health — Driving Health Improvements without Compromising Values
Some global health policymakers increasingly look at public–private partnerships with suspicion. The controversy surrounding this issue was magnified when the Global Fund partnered with Heineken to use the company’s supply-chain expertise to deliver medicines in Africa.

PLoS Genetics
https://journals.plos.org/plosgenetics/

Viewpoints
Collateral damage and CRISPR genome editing
Mark Thomas, Gaetan Burgio, David J. Adams, Vivek Iyer
| published 14 Mar 2019 PLOS Genetics
https://doi.org/10.1371/journal.pgen.1007994
Abstract
The simplicity and the versatility of clustered regularly interspaced short palindromic repeats/CRISPR-associated protein (CRISPR-Cas) systems have enabled the genetic modification of virtually every organism and offer immense therapeutic potential for the treatment of human disease. Although these systems may function efficiently within eukaryotic cells, there remain concerns about the accuracy of Cas endonuclease effectors and their use for precise gene editing. Recently, two independent reports investigating the editing accuracy of the CRISPR-Cas9 system were published by separate groups at the Wellcome Sanger Institute; our study—Iyer and colleagues [1]—defined the landscape of off-target mutations, whereas the other by Kosicki and colleagues [2] detailed the existence of on-target, potentially deleterious deletions. Although both studies found evidence of large on-target CRISPR-induced deletions, they reached seemingly very different conclusions.

PLoS One
http://www.plosone.org/
[Accessed 23 Mar 2019]

Research Article
Optimal media reporting intensity on mitigating spread of an emerging infectious disease
Weike Zhou, Yanni Xiao, Jane Marie Heffernan
| published 21 Mar 2019 PLOS ONE
https://doi.org/10.1371/journal.pone.0213898

Public Health  
Volume 168, Pages A1-A2, 1-172 (March 2019)
https://www.sciencedirect.com/journal/public-health/vol/168/suppl/C

Travel Health
Edited by Dipti Patel, Hilary Simons
Review article  Abstract only
Evidence of factors influencing self-medication with antibiotics in low and middle-income countries: a systematic scoping review
N.F. Torres, B. Chibi, L.E. Middleton, V.P. Solomon, T.P. Mashamba-Thompson
Pages 92-101

Public Health  
Volume 168, Pages A1-A2, 1-172 (March 2019)
https://www.sciencedirect.com/journal/public-health/vol/168/suppl/C

Themed Papers
Research article  Abstract only
Changes to country-specific hepatitis A travel vaccination recommendation for UK travellers in 2017—responding to a vaccine shortage in the national context

1. Petersen, J. Freedman, L. Ford, M. Gawthrop, … D. Patel

Pages 150-156

Science         
22 March 2019   Vol 363, Issue 6433
http://www.sciencemag.org/current.dtl

Policy Forum
Adversarial attacks on medical machine learning
By Samuel G. Finlayson, John D. Bowers, Joichi Ito, Jonathan L. Zittrain, Andrew L. Beam, Isaac S. Kohane
Science22 Mar 2019 : 1287-1289 Restricted Access
Emerging vulnerabilities demand new conversations
Summary
With public and academic attention increasingly focused on the new role of machine learning in the health information economy, an unusual and no-longer-esoteric category of vulnerabilities in machine-learning systems could prove important. These vulnerabilities allow a small, carefully designed change in how inputs are presented to a system to completely alter its output, causing it to confidently arrive at manifestly wrong conclusions. These advanced techniques to subvert otherwise-reliable machine-learning systems—so-called adversarial attacks—have, to date, been of interest primarily to computer science researchers (1). However, the landscape of often-competing interests within health care, and billions of dollars at stake in systems’ outputs, implies considerable problems. We outline motivations that various players in the health care system may have to use adversarial attacks and begin a discussion of what to do about them. Far from discouraging continued innovation with medical machine learning, we call for active engagement of medical, technical, legal, and ethical experts in pursuit of efficient, broadly available, and effective health care that machine learning will enable.

Vaccine
Volume 37, Issue 14  Pages 1905-2042 (28 March 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/14

Short communication  Abstract only
Hospital outbreak of measles – Evaluation and costs of 10 occupational cases among healthcare worker in Germany, February to March 2017
Ute Hiller, Annette Mankertz, Norbert Köneke, Sabine Wicker
Pages 1905-1909

Vaccine
Volume 37, Issue 14  Pages 1905-2042 (28 March 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/14

Research article  Abstract only
Influenza vaccination of pregnant women: Engaging clinicians to reduce missed opportunities for vaccination
Joseph G. Giduthuri, Vidula Purohit, Nicolas Maire, Abhay Kudale, … Mitchell G. Weiss
Pages 1910-1917

Vaccine
Volume 37, Issue 14  Pages 1905-2042 (28 March 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/14

Research article  Open access
Knowledge and attitudes on pediatric vaccinations and intention to vaccinate in a sample of pregnant women from the City of Rome
Annalisa Rosso, Azzurra Massimi, Corrado De Vito, Giovanna Adamo, … Paolo Villari
Pages 1954-1963

Vaccine
Volume 37, Issue 14  Pages 1905-2042 (28 March 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/14

Research article  Abstract only
Polio vaccination coverage and seroprevalence of poliovirus antibodies after the introduction of inactivated poliovirus vaccines for routine immunization in Japan
Hiroshi Satoh, Keiko Tanaka-Taya, Hiroyuki Shimizu, Akiko Goto, … Kazunori Oishi
Pages 1964-1971

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

No new 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 Associated Press
https://apnews.com/
Accessed 23 Mar 2019
[No new, unique, relevant content]

The Atlantic
http://www.theatlantic.com/magazine/
Accessed 23 Mar 2019
Technology
Instagram Is the Internet’s New Home for Hate
As other social networks wage a very public war against misinformation, it’s thriving on Instagram.
…Instagram is teeming with these conspiracy theories, viral misinformation, and extremist memes, all daisy-chained together via a network of accounts with incredible algorithmic reach and millions of collective followers—many of whom, like Alex, are very young. These accounts intersperse TikTok videos and nostalgia memes with anti-vaccination rhetoric, conspiracy theories about George Soros and the Clinton family, and jokes about killing women, Jews, Muslims, and liberals…

BBC
http://www.bbc.co.uk/
Accessed 23 Mar 2019
[No new, unique, relevant content]
 
 
The Economist
http://www.economist.com/
Accessed 23 Mar 2019
An epidemic of violence
Why are Ebola clinics in Congo being attacked?
Mar 21st 2019
…The province of North Kivu is no stranger to misery—it has long been home to some 120 militia groups that regularly rape and terrorise. Now it is also the site of the world’s second-largest outbreak of Ebola, a virus that makes people gush blood from every orifice. Since being detected seven months ago, the virus has spread to nearly 1,000 people and probably killed 600. Its emergence in what is in effect a war zone makes it hard to contain. Health workers are often unable to isolate the infected, or to vaccinate everyone who has touched them. Some villages are deemed too dangerous for vaccinators to visit…

Financial Times
http://www.ft.com/home/uk
Accessed 23 Mar 2019
[No new, unique, relevant content]
 
 
Forbes
http://www.forbes.com/
Accessed 23 Mar 2019
Mar 23, 2019
Why Chickenpox Parties Are A Bad Idea
Kentucky Governor Matt Bevin said that his kids “got the chickenpox on purpose.”
By Bruce Y. Lee   Contributor

Mumps Outbreak at Temple University: What Is The Latest
The outbreak has already resulted in close to 100 cases and is spreading elsewhere in the Philadelphia area.
By Bruce Y. Lee Contributor

Mar 21, 2019
Is Your Child’s Teammate (Or Opponent) Vaccinated?
A Kentucky lawsuit by an anti-vaccination high school basketball player highlights how there are increasing number of kids not being inoculated.
By Bob Cook Contributor

Foreign Affairs
http://www.foreignaffairs.com/
Accessed 23 Mar 2019
[No new, unique, relevant content]
 
 
Foreign Policy
http://foreignpolicy.com/
Accessed 23 Mar 2019
[No new, unique, relevant content]
 
 
The Guardian
http://www.guardiannews.com/
Accessed 23 Mar 2019
[No new, unique, relevant content]
 
 
New Yorker
http://www.newyorker.com/
Accessed 23 Mar 2019
[No new, unique, relevant content]
 
 
New York Times
http://www.nytimes.com/
Accessed 23 Mar 2019
U.S.
Kentucky Anti-Vaxxer Gets Hearing Over Chickenpox Ban
March 22, 2019
An unvaccinated student in Kentucky will get his day in court after suing because he can’t participate in extracurricular activities during a chickenpox outbreak.

Business
UPS Eyes In-Home Health Services With U.S. Vaccine Project
By Lisa Baertlein and Michael Erman
March 22, 2019
LOUISVILLE, Ky. – United Parcel Service Inc wants to get beyond U.S. doorsteps with a new push into healthcare.
The world’s largest package delivery firm is preparing to test a U.S. service that dispatches nurses to vaccinate adults in their homes, Reuters has learned, as the company and its healthcare clients work to fend off cost pressures and competitive threats from Amazon.com.
UPS did not disclose which vaccines it would be using in the project, but drug and vaccine maker Merck & Co told Reuters it is looking at partnering with the company for the initiative…

Wall Street Journal
http://online.wsj.com/home-page?_wsjregion=na,us&_homepage=/home/us
Accessed 23 Mar 2019
[No new, unique, relevant content]

 
 
Washington Post
http://www.washingtonpost.com/
Accessed 23 Mar 2019
A GOP governor doesn’t believe in chickenpox vaccines. He took his nine kids to a pox party
Eli Rosenberg · Mar 20, 2019

Censorship or social responsibility? Amazon removes some books peddling vaccine misinformation.
Lindsey Bever · Mar 18, 2019

Think Tanks et al
 
Brookings
http://www.brookings.edu/
Accessed 23 Mar 2019
[No new relevant content]

Center for Global Development  
http://www.cgdev.org/page/press-center
March 20, 2019
Gavi@20: What’s Next for Global Immunization Efforts
The Board of Gavi, The Vaccine Alliance, will retreat next week to discuss a new strategy and replenishment. My colleagues and I have put together a preliminary set of six short notes that examine different dimensions of Gavi’s work and make recommendations for ways to address identified issues.
Amanda Glassman

Gavi From the Country Perspective: Assessing Key Challenges to Effective Partnership
Publication
3/20/19
In this note, we explore some of the challenges facing Gavi-eligible countries. We then propose procedural improvements or adaptations to Gavi’s operations to better support the needs of country governments and other partners.

Gavi’s Approach to Health Systems Strengthening: Reforms for Enhanced Effectiveness and Relevance in the 2021–2025 Strategy
Publication
3/20/19
In this note, we highlight the results of Gavi HSS evaluations, how Gavi has responded to identified challenges and limitations in the HSS proposal and implementation process, and what options are available to enhance the effectiveness of HSS support for Gavi’s core mandate. We also discuss the importance of 4G (Gavi, the Global Fund, the Global Financing Facility, and the World Bank Group) collaboration.

Gavi’s Role in Market Shaping and Procurement: Progress, Challenges, and Recommendations for an Evolving Approach
Publication
3/20/19
In this note, we diagnose key challenges that will strain Gavi’s model during the 2021–2025 period and beyond. We then offer recommendations for an evolving approach, which closely align with Gavi’s goal to maximize the impact of countries’ current and future domestic investments.

New Gavi Modalities for a Changing World
Publication
3/20/19
In this note, we summarize the changing context and its relevance for Gavi, exploring the specific issues relevant to transitioning countries, never-eligible MICs, and countries dealing with complex emergencies or large-scale protracted displacement. We then offer four recommendations to increase Gavi’s relevance and effectiveness in a changing world.

Vaccine Introduction and Coverage in Gavi-Supported Countries 2015-2018: Implications for Gavi 5.0
Publication
3/20/19
With a vision of “creating equal access to new and underused vaccines,” Gavi set several coverage-specific targets for 2020 as part of its Phase IV strategy, including the immunization of an additional 300 million children, increased pentavalent 3 and measles-containing vaccine (MCV) 1 coverage, and greater equity in coverage across wealth quintiles. In this note, we explore these coverage challenges in greater detail and offer recommendations for how Gavi can address them in its 5.0 strategy.

Gavi 5.0: Five Challenges and Five Ideas for Reform
Publication
3/20/19
This overview note lays out five challenges and summarizes some of our ideas to address them; backing up each is a standalone note that provides greater detail and options for action. An accompanying note looks at the full set of issues through a country lens.

CSIS
https://www.csis.org/
Accessed 23 Mar 2019
[No new relevant content]

Council on Foreign Relations
http://www.cfr.org/
Accessed 23 Mar 2019
March 21, 2019
Democratic Republic of Congo
Ebola in DRC Spreads to Urban Areas Amid Conflict
A case of Ebola, the deadly hemorrhagic fever with terrifying symptoms, has been found in the second-largest city in eastern Democratic Republic of Congo (DRC). The city, Bunia, has a population of almost one million. The disease has already been identified in Butembo and Beni, the former with a population slightly larger than Bunia, the latter slightly smaller. The disease is now urban and rural in eastern Congo.
Blog Post by John Campbell

Kaiser Family Foundation
https://www.kff.org/search/?post_type=press-release
Accessed 23 Mar 2019
[No new relevant content]

Syria

UN Welcomes $7 billion donor pledge for Syrians and the region in 2019
(Brussels, 14 March 2019) – International donors today pledged a record US$6.97 billion to support millions of people in need of humanitarian aid in Syria as well as to refugees and host communities in the neighbouring countries. Part of the overall pledge, $2.5 billion, is for the EU Facility for Refugees in Turkey this year.

In 2017, donors pledged $6 billion in Brussels and in 2018, $4.4 billion. Total fundraising for 2018 reached just over $6 billion by the end of the year.

“I am pleased with this important signal of the international community’s solidarity with the people in Syria and with Syria’s neighbours who are hosting huge numbers of refugees, and feeling the strain of their generosity,” UN humanitarian chief Mark Lowcock said…

Human Rights – Drug Policy

Human Rights and Drug Policy
Posted on March 15, 2019
Vienna – A coalition of UN Member States, UN entities and leading human rights experts meeting at the Commission on Narcotic Drugs launched today, a landmark set of international legal standards to transform and reshape global responses to the world drug problem.

The International Guidelines on Human Rights and Drug Policy introduces a comprehensive catalogue of human rights standards. Grounded in decades of evidence, they are a guide for governments to develop human rights compliant drug policies, covering the spectrum of cultivation to consumption. Harnessing the universal nature of human rights, the document covers a range of policy areas from development to criminal justice to public health.

The guidelines come at an important moment when high-level government representatives are convening at the Commission on Narcotic Drugs to shape a new global strategy on drugs. Under the mounting weight of evidence that shows the systemic failures of the dominant punitive paradigm, including widespread human rights violations, governments are facing growing calls to shift course.

“Drug control policies intersect with much of the 2030 Agenda for Sustainable Development and the pledge by Member States to leave no one behind. Approaches that violate human rights and fail to curb the illicit drug trade are leaving a trail of human suffering,” said Mandeep Dhaliwal, Director of UNDP’s HIV, Health and Development Group. “For countries who are ready to place human dignity and sustainable development at the heart of their drug control policy, these guidelines offer valuable guidance to promote more effective and humane drug control policy.”

Seeking to promote the rule of law, the guidelines feature recommendations across the administration of justice—from discriminatory policing practices, to arbitrary arrest and detention, to decriminalisation of drugs for personal use—the guidelines articulate the global state of human rights law in relation to drug policy, which includes ending the death penalty for drug-related offenses.

At least 25 national governments – from Argentina to South Africa – have scrapped criminal penalties for possession of drugs for personal, non-medical use, either in law or practice, setting an example for others to follow. The United Nations system has jointly called for decriminalization as an alternative to conviction and punishment in appropriate cases…

U.S. Budgetary Allocations

Leading Humanitarian, Development, and Global Health Organizations Urge Congress to Reject Cuts to Foreign Assistance
March 11, 2019
Leading humanitarian, development, and global health organizations Bread for the World, CARE, Catholic Relief Services, InterAction, International Rescue Committee, Mercy Corps, ONE, Oxfam, PATH, Save the Children, and World Vision, are calling on Members of Congress to protect the International Affairs budget in Fiscal Year 2020 (FY20) despite the Administration’s proposed 24 percent cuts. American leadership is critical in the face of daunting global challenges, from conflict to mass displacement, from food insecurity to global health crises.

More than 132 million people are projected to need humanitarian assistance in 2019 given an unprecedented number of humanitarian crises. Natural disasters, atrocities, gender-based violence, and protracted armed conflict have resulted in more than 68 million displaced persons, including more than 25 million refugees. Now is not the time to slash effective, life-saving programs that help create a safer and more secure world.

In addition, the Administration’s proposal to significantly modify and repeal the refugee mandate and resources of the Department of State’s humanitarian bureau, coupled with a 34 percent cut to humanitarian assistance, is unwise, especially given historic levels of displacement.

Foreign assistance funding is fundamental to America’s global leadership and essential to shaping a world where our national interests will thrive. The International Affairs budget is roughly 1% of the federal budget, and an even smaller portion is dedicated to achieving humanitarian, development, and health outcomes for the world’s most marginalized children, women and men. This small portion of our budget is molding the face of our world’s future and building a better and more stable world with prospering economies. Cuts will have life-and-death consequences for the poorest people in the world and will reduce the life-saving and economic impacts that we see every day.

The organizations, which together operate in nearly every country across the globe, often work in partnership with the U.S. government and have produced important and demonstrable results. From providing education, health, good governance and economic assistance that forms the building blocks of many growing nations, to addressing humanitarian disasters, preventing conflict and containing deadly pandemics – aid delivers. The budget’s proposed cuts of 23 percent to development assistance and economic assistance and 28 percent to global health flies in the face of these facts.

Time and time again, Congress has acted in a bipartisan and bicameral manner to support smart American global engagement through programs, budgets and policies that demonstrate American values while advancing our national interest. Leading humanitarian, development, and global health organizations urge Congress to support no less than $60 billion for the International Affairs Budget in FY20.

To ensure U.S. leadership, Congress must reject any proposed cuts to these vital programs and fight against removing crucial tools from our foreign policy toolkit when they are needed more than ever.

::::::

March 11, 2019
Fiscal Year 2020 Development and Humanitarian Assistance Budget Request
Fact Sheet
The President’s Fiscal Year (FY) 2020 Budget Request for USAID continues to advance our efforts to strengthen U.S. national security through strategic investments that promote the Journey to Self-Reliance. The Budget envisions the day when USAID’s development assistance is no longer needed. USAID supports governments, civil society, and the private sector in partner countries to build self-reliance, defined as the ability of a country to plan, finance, and implement solutions to its own development challenges. The FY 2020 Budget also upholds the President’s commitment to serve the needs of American citizens, ensure their safety, and defend their values, as outlined in the President’s National Security Strategy. The Budget includes significant investments to reduce the reach of conflict; prevent the spread of pandemic disease; and counteract the drivers of violence, instability, transnational crime, and other security threats.

U.S. – International Criminal Court

Remarks to the Press [referencing the International Criminal Court]
Michael R. Pompeo, Secretary of State
Press Briefing Room, Washington, DC
March 15, 2019
[Excerpt]
… Since 1998, the United States has declined to join the ICC because of its broad, unaccountable prosecutorial powers and the threat it poses to American national sovereignty. We are determined to protect the American and allied military and civilian personnel from living in fear of unjust prosecution for actions taken to defend our great nation. We feared that the court could eventually pursue politically motivated prosecutions of Americans, and our fears were warranted.

November of 2017, the ICC prosecutor requested approval to initiate investigation into, quote, “the situation in Afghanistan,” end of quote. That could illegitimately target American personnel for prosecutions and sentencing. In September of 2018, the Trump administration warned the ICC that if it tried to pursue an investigation of Americans there would be consequences. I understand that the prosecutor’s request for an investigation remains pending.

Thus today, persistent to existing legal authority to post visa restrictions on any alien, quote, “whose entry or proposed activities in the United States would have potentially serious adverse foreign policy consequences,” end of quote, I’m announcing a policy of U.S. visa restrictions on those individuals directly responsible for any ICC investigation of U.S. personnel. This includes persons who take or have taken action to request or further such an investigation. These visa restrictions may also be used to deter ICC efforts to pursue allied personnel, including Israelis, without allies’ consent. Implementation of this policy has already begun. Under U.S. law, individual visa records are confidential, so I will not provide details as to who has been affected and who will be affected.

But you should know if you’re responsible for the proposed ICC investigation of U.S. personnel in connection with the situation in Afghanistan, you should not assume that you will still have or will get a visa, or that you will be permitted to enter the United States. The United States will implement these measures consistent with applicable law, including our obligations under the United Nations Headquarters Agreement. These visa restrictions will not be the end of our efforts. We are prepared to take additional steps, including economic sanctions if the ICC does not change its course…

::::::

Statement by the President of the Assembly, O-Gon Kwon, reiterating strong support for the ICC
Press Release : 15 March 2019
In relation to the statement made today by the United States Secretary of State regarding the International Criminal Court (ICC), I would like to reiterate that the Court has the strong support of the Assembly of States Parties to the Rome Statute.

The Assembly is comprised of over 120 States Parties. At its seventeenth session in December 2018, the States Parties reconfirmed their unwavering support for the Court as an independent and impartial judicial institution, and reiterated their commitment to uphold and defend the principles and values enshrined in the Rome Statute and to preserve its integrity undeterred by any threats against the Court, its officials and those cooperating with it. This unwavering support continues today.

The Assembly also renewed its resolve to stand united against impunity. The International Criminal Court is an independent and impartial judicial institution crucial for ensuring accountability for the most serious crimes of concern to the international community.

The Court is non-political and acts strictly within the legal framework of the Rome Statute, its founding treaty. One of the cornerstones of the Rome Statute system is that it recognizes the primary jurisdiction of States to investigate and prosecute atrocity crimes. The jurisdiction of the Court is complementary to domestic jurisdictions.

The Assembly of States Parties is the management oversight and legislative body of the ICC. It is comprised of representatives of States that have ratified or acceded to the Rome Statute. President Kwon was elected President of the Assembly for a three year mandate in December 2017.

Development – Philanthropic/Funding Strategies

$150 Million in Catalytic Capital to Help Address Critical Social Challenges
March 12, 2019 | Press Release
MacArthur today launched the Catalytic Capital Consortium, dedicating $150 million to help address financing gaps in impact investing, particularly for funds and intermediaries that are not a fit for conventional investment. MacArthur is joined in this effort by leading impact investors The Rockefeller Foundation and Omidyar Network, who will add their expertise and financial resources to the Catalytic Capital Consortium. MacArthur’s first investment is $30 million to expand and accelerate The Rockefeller Foundation’s Zero Gap innovative finance portfolio, matched by $30 million from The Rockefeller Foundation.

Catalytic capital is investment capital that is patient, risk-tolerant, concessionary, and flexible in ways that differ from conventional investment. According to Catalytic Capital: Unlocking More Investment and Impact, a report released today by the consulting firm Tideline, catalytic capital is an essential component to achieving the United Nations’ Sustainable Development Goals (SDGs). As the SDGs face an annual $5 trillion to $7 trillion financing gap, catalytic capital can help meet the demand for more capital across the risk-return spectrum, complement and pave the way for conventional investment, and mobilize additional capital through a range of blended finance solutions. The Catalytic Capital Consortium will increase awareness, understanding, and use of catalytic capital as an investment tool, ultimately helping more enterprises secure the financial support they need to grow and scale social and environmental solutions that could improve millions of lives.

“Catalytic capital is needed for impact investing to realize its full potential,” said MacArthur President Julia Stasch, who announced the Consortium at the Global Impact Investing Network Investors’ Council Annual Meeting, alongside the leaders of The Rockefeller Foundation and Omidyar Network. “While impact investing is growing rapidly, much of the attention focuses on market-rate returns, leaving a serious gap in financing opportunities for many promising impact enterprises and funds that could help address critical social challenges. The Catalytic Capital Consortium will help more investors appreciate the importance of this type of capital in yielding deeper, more sustainable impact for people and the planet.”

Since it was launched in 2015, The Rockefeller Foundation’s Zero Gap grant portfolio has grown to nearly 50 unique financial structures across 28 countries. MacArthur’s matching investment in Zero Gap builds on this work, marking a unique impact investing collaboration between two foundations, where each will invest $30 million with the aim of catalyzing at least $1 billion in new capital to help meet the SDGs. These funds will be managed by The Rockefeller Foundation’s new impact investment management platform, Rockefeller Foundation Impact Investment Management, which aims to tap into mainstream markets and investors, scaling up investments into promising new finance vehicles that help to close the SDG funding gap…

Governance – Agency Performance Assessment

MOPAN assessed the performance of UNESCO
15 March 2019
In 2017-18, MOPAN, the Multilateral Organisation Performance Assessment Network, assessed the performance of UNESCO. The assessment looked at UNESCO’s organisational effectiveness (strategic, operational, relationship and performance aspects) and the results it achieved against its objectives. This was the first MOPAN assessment of UNESCO.

Key findings of MOPAN Assessment of UNESCO:
MOPAN has just released its assessment report of UNESCO – the first ever – providing a snapshot of UNESCO’s performance over 2016 to mid-2018 covering strategic, operational, relationship and performance management as well as results. Overall the report is rather positive, with an overall rating of “Highly satisfactory” or “satisfactory” for the vast majority of indicators.

Key findings of the assessment show that:
:: “UNESCO has a clear strategic vision aligned to global normative frameworks, including the 2030 Agenda for Sustainable Development and the Paris Agreement on Climate Change”.

:: “Despite the notable constraints, there has been no change to the expectations on UNESCO’s mandate and range of activities, and in spite of difficulties, UNESCO has protected its normative work and raised additional funds to finance programmatic work.”

:: “The organisation combines its normative and programmatic roles in ways that provide a mutually reinforcing interplay, ensuring that its work in both roles is relevant and targeted.”

:: “MOPAN’s survey of external partners confirms that stakeholders value UNESCO’s contribution to promoting cross-cutting agendas, with gender equality being a particular strength.”

:: “UNESCO is unique for having the mandate and space to bring together experts, practitioners, citizens and governments to develop solutions to the global problems embedded in the SDGs. It has rare expertise and a degree of authority that enables it to influence governments across the world.”

:: “UNESCO is recognised for its distinct interdisciplinary and participatory approach to programming, most notably in the design phase.”

:: “Notwithstanding the challenging environment, UNESCO has been able to drive through impressive improvements in areas such as results-based management and to provide high-quality services, most notably within its internal oversight, including evaluation and internal audit.”

:: “UNESCO continues to face an extended and damaging budget crisis, with the need for further prioritisation.”

:: “The institutional architecture at headquarters reflects UNESCO’s mandate; yet global field presence is unnecessarily complex, which compromises agility and relevance.”

:: “UNESCO has a strong appreciation of these challenges and is working to position itself to be more efficient and effective in the future through ongoing reforms.”

The assessment identified the following six strengths and seven areas for improvement
Strengths
. UNESCO is central to the SDGs
. UNESCO is a global leader in knowledge and practice
. Education is a notable strength of UNESCO
. UNESCO is effective in mainstreaming gender equality, good governance, environment sustainability and human rights
. UNESCO is committed to RBM and RBB and is progressing well in these areas
. UNESCO has a high-quality central evaluation service

Areas for improvement
. Prioritization of the overall work programme remains limited
. A number of corporate systems remain outdated
. Rationalizing the gratuitously complex global field network remains a priority
. Tracking poor performance and addressing inefficiency is a challenge for UNESCO
. Refining the treatment of results and tracking impact is necessary to demonstrate continued relevance and sustainability
. The quality of decentralized evaluations and evidence-base for normative work requires dedicated resources
. Communicating externally

About the Multilateral Organisation Performance Assessment Network (MOPAN):
The MOPAN is a network created in 2002, which is currently composed of 18 member countries with a common interest in assessing the effectiveness of the major multilateral organisations they fund.
MOPAN’s mission is to:
:: Enhance accountability by supporting its members to assess organisational and development effectiveness of funded multilateral organisations.
:: Promote learning by informing strategic engagement and dialogue among multilateral organisations and development partners.

Credibility of assessments is ensured through an impartial, systematic and rigorous approach (MOPAN 3.0 methodology (link is external)). Members of MOPAN use the outcomes of these assessments to, inter alia, inform strategic decision-making and engagement with the assessed organisations. UNESCO is one of the 14 organisations assessed by MOPAN in 2017-2018 period.

Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 13 March 2019
:: On the occasion of the International Women’s Day on 8 March 2019, the Global Polio Eradication Initiative featured stories of women on-ground working for polio eradication efforts. Read all the IWD news here.

:: Wild poliovirus continues to transmit in Afghanistan—one of the most challenging geographical and socio-political landscapes—but GPEI is working with the partners and the government to make concrete gains in eliminating the disease. More on the efforts here.

:: Real-time disease surveillance is the future of disease of surveillance, which is being rolled-out at the World Health Organization’s Regional Office for Africa in collaboration with the Bill & Melinda Gates Foundation. Read more.

Summary of new viruses this week:
:: Pakistan – nine WPV1-positive environmental samples;
:: Nigeria – one circulating vaccine-derived poliovirus type 2 (cVDPV2)- positive community contact case and three cVDPV2-positive environmental samples.

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

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 Mar 2019]
Democratic Republic of the Congo
::  32: Situation report on the Ebola outbreak in North Kivu  12 March 2019
:: DONS – Ebola virus disease – Democratic Republic of the Congo   14 March 2019

Syrian Arab Republic
:: 8 ways WHO supports health in Syria   14 March 2019
The Syrian crisis is one of the world’s biggest and most complex humanitarian emergencies. 8 years of conflict have taken a huge toll on a health system that was once among the best in the region. Here are 8 things to know about how WHO works in Syria to save lives and support health despite immense challenges.

Bangladesh – Rohingya crisis – No new digest announcements identified  
Myanmar – No new digest announcements identified  
Nigeria – No new digest announcements identified  
Somalia – No new digest announcements identified
South Sudan – No new digest announcements identified  
Yemen – No new digest announcements identified  

::::::

 
WHO Grade 2 Emergencies  [to 16 Mar 2019]
MERS-CoV
:: Disease Commodity Package for MERS-CoV  pdf, 149kb  March 2019

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
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 Mar 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 and Emergencies Bulletin – Week 10/2019
Week 10: 04 – 10 March 2019
The WHO Health Emergencies Programme is currently monitoring 59 events in the region. This week’s edition covers key new and ongoing events, including:
:: Plague in Uganda
:: Ebola virus disease in the Democratic Republic of the Congo
:: Hepatitis in Namibia
:: Lassa fever in Nigeria

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

UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises. 
Syrian Arab Republic   – No new digest announcements identified
Yemen – 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

 
::::::
::::::

Milestones :: Perspectives

American Medical Association – Letter to Tech Company CEOs on Vaccination  
 
March 13, 2019

Facebook – Attn: Mark Zuckerberg, CEO
Pinterest – Ben Silbermann, Co-Founder and CEO
Amazon – Jeffrey Bezos, CEO, President and Chairman
Google –  Sundar Pichai, CEO
YouTube –  Susan Wojcicki, CEO
Twitter  – Jack Dorsey, CEO

Dear CEOs of Leading Technology Companies:

At a time when vaccine-preventable diseases, particularly measles, are reemerging in the United States and threatening communities and public health, physicians across the country are troubled by reports of anti-vaccine related messages and advertisements targeting parents searching for vaccine information on your platforms. As physicians, we are concerned that the proliferation of this type of health-related misinformation will undermine sound science, further decrease vaccinations, and persuade people to make medical decisions that could spark the spread of easily preventable diseases.

With public health on the line and with social media serving as a leading source of information for the American people, we urge you to do your part to ensure that users have access to scientifically valid information on vaccinations, so they can make informed decisions about their families’ health. We also urge you to make public your plans to ensure that users have access to accurate, timely, scientifically sound information on vaccines.

We applaud companies that have already taken action, but encourage you to continue evaluating the impact of these policies and take further steps to address the issue as needed.

The overwhelming scientific evidence shows that vaccines are among the most effective and safest interventions to both prevent individual illness and protect public health. When immunization rates are high, people who cannot be protected directly by the vaccines are protected because they are not exposed to the disease. This includes children too young to receive vaccinations and people with medical contraindications.

The reductions we have seen in vaccination coverage threaten to erase many years of progress as nearly eliminated and preventable diseases return, resulting in illness, disability and death. In order to protect our communities’ health, it is important that people be aware not just that these diseases still exist and can still debilitate and kill, but that vaccines are a safe, proven way to protect against them.

As evident from the measles outbreaks currently impacting communities in several states, when people decide not to be immunized as a matter of personal preference or misinformation, they put themselves and others at risk of disease. That is why it is extremely important that people who are searching for information about vaccination have access to accurate, evidence-based information grounded in science.

Thank you for your attention to this critical, public health matter. We look forward to hearing from you.

Sincerely,

James L. Madara, MD
Executive Vice President, CEO
AMA

Milestones :: Perspectives

Global influenza strategy 2019-2030
WHO
March 2019 :: 31 pages   ISBN 9789241515320

News Release
WHO launches new global influenza strategy
11 March 2019,  Geneva

WHO today released a Global Influenza Strategy for 2019-2030 aimed at protecting people in all countries from the threat of influenza. The goal of the strategy is to prevent seasonal influenza, control the spread of influenza from animals to humans, and prepare for the next influenza pandemic.

“The threat of pandemic influenza is ever-present.” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “The on-going risk of a new influenza virus transmitting from animals to humans and potentially causing a pandemic is real.   The question is not if we will have another pandemic, but when.  We must be vigilant and prepared – the cost of a major influenza outbreak will far outweigh the price of prevention.”

Influenza remains one of the world’s greatest public health challenges. Every year across the globe, there are an estimated 1 billion cases, of which 3 to 5 million are severe cases, resulting in 290 000 to 650 000 influenza-related respiratory deaths. WHO recommends annual influenza vaccination as the most effective way to prevent influenza. Vaccination is especially important for people at higher risk of serious influenza complications and for health care workers.

The new strategy is the most comprehensive and far-reaching that WHO has ever developed for influenza.  It outlines a path to protect populations every year and helps prepare for a pandemic through strengthening routine programmes. It has two overarching goals:
Build stronger country capacities for disease surveillance and response, prevention and control, and preparedness. To achieve this, it calls for every country to have a tailored influenza programme that contributes to national and global preparedness and health security.

Develop better tools to prevent, detect, control and treat influenza, such as more effective vaccines, antivirals and treatments, with the goal of making these accessible for all countries.

“With the partnerships and country-specific work we have been doing over the years, the world is better prepared than ever before for the next big outbreak, but we are still not prepared enough,” said Dr Tedros. “This strategy aims to get us to that point. Fundamentally, it is about preparing health systems to manage shocks, and this only happens when health systems are strong and healthy themselves.”

To successfully implement this strategy, effective partnerships are essential.  WHO will expand partnerships to increase research, innovation and availability of new and improved global influenza tools to benefit all countries.  At the same time WHO will work closely with countries to improve their capacities to prevent and control influenza.

The new influenza strategy builds on and benefits from successful WHO programmes.  For more than 65 years, the Global Influenza Surveillance and Response System (GISRS), comprised   of WHO Collaborating Centres and national influenza centres, have worked together to monitor seasonal trends and potentially pandemic viruses. This system serves as the backbone of the global alert system for influenza.

Important to the strategy is the on-going success of the Pandemic Influenza Preparedness Framework, a unique access and benefit sharing system that supports the sharing of potentially pandemic viruses, provides access to life saving vaccines and treatments in the event of a pandemic and supports the building of pandemic preparedness capacities in countries through partnership contributions from industry.

The strategy meets one of WHO’s mandates to improve core capacities for public health, and increase global preparedness and was developed through a consultative process with input from Member States, academia, civil society, industry, and internal and external experts.

Supporting countries to strengthen their influenza capacity will have collateral benefits in detecting infection in general, since countries will be able to better identify other infectious diseases like Ebola or Middle East respiratory syndrome-related coronavirus (MERS-CoV).

Through the implementation of the new WHO global influenza strategy, the world will be closer to reducing the impact of influenza every year and be more prepared for an influenza pandemic and other public health emergencies.
Read the Global Influenza Strategy 

More about influenza

Milestones :: Perspectives

DRC – Ebola

 
WHO Director General: Press Briefing on Ebola  14 March 2019
Audio [48:26]: https://we.tl/t-Jew0cI2DaL
Transcript 11 pages]: https://www.who.int/ebola/WHO-BROLL_Ebola_DR_Congo_presser_UNOG_TEDROS_14MAR2019_final.pdf
[Excerpts]

TAG [Tedros]:  …I would just like to say a few words on the situation. The latest data from the Ministry of Health; we have 927 confirmed and probable cases, 584 deaths and we have vaccinated more than 87,000 people, including 27,000 health workers in DRC and 5,000 in surrounding countries; more than 400 patients treated with novel therapeutics and we’re happy that people are surviving.

More than 58,000 contact registered and more than 4,200 currently being monitored for signs of illness and there are half as many new cases per week now as there were in January. In January there were 50 cases per week; now we have an average of 25 cases per week so there is a decline in the number of cases per week.

Despite the incredibly difficult situation the outbreak has been contained in 11 out of the [20] communities that have had cases. We have been able to stop transmission in Beni, Mangina, Komanda, Oicha. Now the Ebola virus is concentrated in Butembo and Katwa so the cases are now shrinking in a certain geographic area…

Selected Media Q&A

:: Laurent Sierrot, Swiss News Agency. Last week the president of Doctors Without Borders, Joanne Liu, made a few remarks and among them she said that in the communities there are a lot of people who don’t understand why they can’t access the vaccine and why the vaccine is now just for the people who have been affected or the contacts or the contacts of contacts. Do you think there is still a lack of education in that regard? What steps could you do more of or better in that regard?

TAG Can you repeat the question? I’m sorry.

LA She says that there is a lack of education in the communities towards the need to focus only on a few, a bunch of people affected, contacts and contacts of contacts for the vaccination and that a lot of people don’t understand that. How could things be made better in that regard?

TAG Yes, thank you. That’s the strategy we follow now, what we call the ring vaccination and we vaccinate contacts and contacts of contacts. I can understand that there will be a need to increase awareness of the communities of why we’re doing that. In other areas, by the way, the community has started to understand after our explanation to communities, especially through engagement. I hope we can address this problem too in the Butembo and Katwa area.

:: Cathrine for France 24. I would like to know if the attacks on the different treatment centres have affected your ring vaccination; are you running out of vaccines? That’s my first question. My second one is, how do you collaborate with Uganda, which is the closest country to the two places that you’ve mentioned to Butembo and Katwa?

TAG Thank you. With regard to the amount of vaccines we have, with the current epidemiologic situation and the strategy we follow, the ring vaccination, we have enough stock of vaccines. Not only that, we’re in regular contact with the manufacturer of the vaccine, Merck; I’m personally in contact and they’re doing everything to boost when needed.

…TAG: So by any account there is progress but of course a delicate one and we have to continue to push and push until we finish the job. But one thing I would like to stress on that; you know what the community said; why are you so aggressive in terms of Ebola – they’re right – we have malaria, we have cholera, we have other health problems and you shouldn’t just say Ebola, Ebola, help us with the other things.

That’s why I said in my opening statement, not just to fight Ebola; we will stay there to address the concerns and demands of the community, the other demands because there are other serious problems, not just Ebola and I would like to call upon the international community to link the outbreak control now, Ebola, with developing the health system. That’s a big challenge. Otherwise we will appear as if we’re preventing Ebola from getting into other countries and we don’t care about the demands of the community, the additional demands.

The most important thing here is we care not just about Ebola, we care to address the other challenges the communities face and that’s the challenge not only for WHO but for all the international community, while fighting Ebola to start development, to start rehabilitating the health systems of DRC, to start showing to the communities of those affected by Ebola, we’re with you to address the other problems too, we’re not here only to prevent Ebola because it goes to other neighbouring countries.

We shouldn’t really stay there if that’s our goal. Our goal should be to help them with not only Ebola but with the development of the health system. Sorry I’m taking a lot of your time here but it’s because that’s what I believe. That’s what they’re asking; that’s what we should do, and

the international community should also be prepared to help for the long haul of really developing the health system as per the requests from the community and we should be on their side. That’s what we’re focused on now.

Then on the strategic response plan, it addresses the second issue you raised. The focus should be community engagement. The focus should be local capacity-building and that’s the shift we have already made, and I fully agree if that’s what our partners like MSF say; I really fully agree and that’s what we have already included in our new strategic response plan. Thank you….

:: TO   Thanks. I have a couple of questions, Dr Tedros, about the outlook. The easy first question is, when will you be able to tell us something about the success of the therapeutics that you’re trying? And also, about the future, is it possible that this outbreak, this disease could linger in the area for years, are you preparing for that?

And a related question about vaccines; obviously at the moment you’re using the Merck vaccine and there’s this ring vaccination programme going on but there’s the possibility, I guess, in future that there could be a change in the available options like it could be licensed for a general vaccination campaign or another vaccine could come online. Is there a point at which you can foresee the response changing because you have a new vaccine option available? Thanks.

TAG Yes, I would actually look for that day, when we have a vaccine that can be used at large scale and is easier to manage in terms of the cold-chain requirements that we have now. We’re encouraging institutions to really give us more options and we will be happy to work with those who have additional options to offer so in the future it will be just one of the vaccines in a routine that can be used in health facilities rather than using it on a small scale as in the ring vaccination only…

Emergencies

POLIO

Public Health Emergency of International Concern (PHEIC)

Polio this week as of 13 March 2019

:: On the occasion of the International Women’s Day on 8 March 2019, the Global Polio Eradication Initiative featured stories of women on-ground working for polio eradication efforts. Read all the IWD news here.

:: Wild poliovirus continues to transmit in Afghanistan—one of the most challenging geographical and socio-political landscapes—but GPEI is working with the partners and the government to make concrete gains in eliminating the disease. More on the efforts here.

:: Real-time disease surveillance is the future of disease of surveillance, which is being rolled-out at the World Health Organization’s Regional Office for Africa in collaboration with the Bill & Melinda Gates Foundation. Read more.

Summary of new viruses this week:
:: Pakistan – nine WPV1-positive environmental samples;
:: Nigeria – one circulating vaccine-derived poliovirus type 2 (cVDPV2)- positive community contact case and three cVDPV2-positive environmental samples.

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

 
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 Mar 2019]
Democratic Republic of the Congo
::  32: Situation report on the Ebola outbreak in North Kivu  12 March 2019
:: DONS – Ebola virus disease – Democratic Republic of the Congo   14 March 2019

Syrian Arab Republic
:: 8 ways WHO supports health in Syria   14 March 2019

The Syrian crisis is one of the world’s biggest and most complex humanitarian emergencies. 8 years of conflict have taken a huge toll on a health system that was once among the best in the region. Here are 8 things to know about how WHO works in Syria to save lives and support health despite immense challenges.

Bangladesh – Rohingya crisis – No new digest announcements identified  
Myanmar – No new digest announcements identified  
Nigeria – No new digest announcements identified  
Somalia – No new digest announcements identified
South Sudan – No new digest announcements identified  
Yemen – No new digest announcements identified  

::::::

 
WHO Grade 2 Emergencies  [to 16 Mar 2019]
MERS-CoV
:: Disease Commodity Package for MERS-CoV  pdf, 149kb  March 2019

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
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 Mar 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 and Emergencies Bulletin – Week 10/2019
Week 10: 04 – 10 March 2019
The WHO Health Emergencies Programme is currently monitoring 59 events in the region. This week’s edition covers key new and ongoing events, including:
:: Plague in Uganda
:: Ebola virus disease in the Democratic Republic of the Congo
:: Hepatitis in Namibia
:: Lassa fever in Nigeria.
 

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

 
UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises. 
Syrian Arab Republic   – No new digest announcements identified
Yemen – 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 Mar 2019]
http://www.who.int/ebola/en/
::  32: Situation report on the Ebola outbreak in North Kivu  12 March 2019
:: DONS – Ebola virus disease – Democratic Republic of the Congo   14 March 2019

MERS-CoV [to 16 Mar 2019]
http://who.int/emergencies/mers-cov/en/
– No new digest announcements identified.

Yellow Fever [to 16 Mar 2019]
http://www.who.int/csr/disease/yellowfev/en/
– No new digest announcements identified.

Zika virus [to 16 Mar 2019]
http://www.who.int/csr/disease/zika/en/
– No new digest announcements identified.

WHO & Regional Offices [to 16 Mar 2019]

WHO launches new global influenza strategy
11 March 2019,  Geneva News Release
WHO today released a Global Influenza Strategy for 2019-2030 aimed at protecting people in all countries from the threat of influenza. The goal of the strategy is to prevent seasonal influenza, control the spread of influenza from animals to humans, and prepare for the next influenza pandemic
[See Milestones above for detail]

::::::
 
Weekly Epidemiological Record, 15 March 2019, vol. 94, 11 (pp. 129–140)
:: Strengthening governance, partnerships and transparency to secure global health: the International Coordinating Group on Vaccine Provision and its impact in 2018

::::::

 
GIN January 2019  pdf, 1.81Mb 8 March 2018

Selected Press Releases, Announcements
WHO African Region AFRO
:: Over 2 million Nigerian children receive treatment against parasitic worms   15 March 2019
:: Ethiopia is making significant progress in the implementation of International Health Regulation (IHR) core capacities: The country plans to launch the National Action Plan costed at over 368 million USD  13 March 2019
:: Nigerian women are penetrating enclaves to reach children and vulnerable populations.
13 March 2019

WHO Region of the Americas PAHO
:: President of Paraguay and PAHO Director address the country’s health priorities (03/12/2019)
 
WHO South-East Asia Region SEARO
– No new digest announcements identified.

WHO European Region EURO
:: 8 ways WHO supports health in Syria 15-03-2019
:: New WHO study shows more action needed to monitor and limit digital marketing of unhealthy products to children 13-03-2019

WHO Eastern Mediterranean Region EMRO
:: Prosthetic rehabilitation centre brings hope for patients in Iraq  12 March 2019
:: Driving change for Somali mothers and children  11 March 2019
:: Children’s survival rates in Dohuk see significant improvement  11 March 2019

WHO Western Pacific Region
– No new digest announcements identified.

CDC/ACIP [to 16 Mar 2019]

http://www.cdc.gov/media/index.html

https://www.cdc.gov/vaccines/acip/index.html

No new digest content identified.

Africa CDC   [to 16 Mar 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 Mar 2019]

Announcements

Paul G. Allen Frontiers Group    [to 16 Mar 2019]
https://www.alleninstitute.org/news-press/
No new digest content identified.

BMGF – Gates Foundation  [to 16 Mar 2019]
http://www.gatesfoundation.org/Media-Center/Press-Releases
No new digest content identified.
 
 
Bill & Melinda Gates Medical Research Institute    [to 16 Mar 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 Mar 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.
03.14.2019
Germany joins CARB-X partnership in the fight against deadly drug-resistant superbugs
CARB-X announced today it has signed a partnership agreement with Germany’s Federal Ministry of Education and Research (BMBF) to invest €39 million over four years in the early development of antibiotics, vaccines, and diagnostics to combat drug-resistant bacteria. Under the agreement, BMBF will also provide an additional €1 million in direct support to a consortium of the German Center for Infection Research (DZIF), the Federal Institute for Vaccines and Biomedicines (PEI) and the Federal Institute for Drugs and Medical Devices (BfArM), which is joining the CARB-X Global Accelerator Network, a network of 10 accelerators around the world to support CARB-X funded projects. CARB-X is a global non-profit partnership housed at Boston University.
 
 
CEPI – Coalition for Epidemic Preparedness Innovations  [to 16 Mar 2019]
http://cepi.net/
13 Mar 2019  Blog
The global economy is woefully unprepared for biological threats. This is what we need to do
 
 
EDCTP    [to 16 Mar 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

13 March 2019
ASAAP clinical study of malaria treatment for children has started
A large clinical study evaluating a triple plus combination of antimalarials for children has started in Ghana. The study is coordinated by Dr. Oumou Maiga-Ascofare of the Kumasi Centre for Collaborative Research at the Kwame Nkrumah University of Science and…

 
 
Emory Vaccine Center    [to 16 Mar 2019]
http://www.vaccines.emory.edu/
No new digest content identified.
 
 
European Medicines Agency  [to 16 Mar 2019]
http://www.ema.europa.eu/ema/
News and press releases
No new digest content identified.
 
 
European Vaccine Initiative  [to 16 Mar 2019]
http://www.euvaccine.eu/news-events
Latest news
No new digest content identified.
 
 
FDA [to 16 Mar 2019]
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
March 14, 2019
Statement by FDA Commissioner Scott Gottlieb, M.D., on new strategies to modernize clinical trials to advance precision medicine, patient protections and more efficient product development

Modernizing clinical trials is an agency wide priority. As more diseases are being redefined based on genomic subtype, researchers have more novel targets and more opportunities to precisely modulate or even repair the basic biological drivers of illness. Precision guided medicines can demonstrate strong efficacy signals in early clinical trials, including in trials where small groups of patients are selected based on biomarkers or other criteria suggesting they’re likely to benefit. These trials can potentially allow earlier regulatory assessment of benefit and risk. When the agency can make a positive approval decision, patients can gain earlier access to important new therapeutic options. To take advantage of these innovations, the agency is also seeking new ways to modernize its approaches to accommodate these novel opportunities.

The FDA isn’t alone. The advent of precision medicine is challenging the entire medical research ecosystem to develop more efficient approaches to testing and developing diagnostics and therapeutics, to harness the full potential of science to reduce the suffering, death, and disability caused by complex human illnesses. The agency is committed to developing a regulatory framework for precision medicine that generates robust evidence of product safety and efficacy as efficiently as possible, including frameworks that are more carefully suited to the kinds of precision technologies that underpin new treatments.

But these opportunities can be delayed or stymied by a clinical research enterprise that is often extraordinarily complex and expensive. Efforts to streamline medical product development based on advancing science can be frustrated by legacy business models that discourage collaboration and data sharing, and the adoption of disruptive technologies that make clinical research more effective. Without a more agile clinical research enterprise capable of testing more therapies or combinations of therapies against an expanding array of targets more efficiently and at lower total cost, important therapeutic opportunities may be delayed or discarded because we can’t afford to run trials needed to validate them…

 
 
Fondation Merieux  [to 16 Mar 2019]
http://www.fondation-merieux.org/
No new digest content identified.
 
 
Gavi [to 16 Mar 2019]
https://www.gavi.org/
Latest News
Pneumoccocal vaccine price drops for third year running
In agreement with Gavi, Pfizer reduces price of pneumococcal vaccine to US$ 2.90 per dose for Gavi-eligible countries.
Geneva, 14 March 2019 – Pfizer has reduced the price of its pneumococcal vaccine (PCV) for 73 developing countries by five cents to US$ 2.90 per dose.

The price drop, a result of negotiations between Pfizer and Gavi, the Vaccine Alliance, is Pfizer’s third for its PCV vaccine since January 2017 and is expected to lead to savings to Gavi and developing country governments of US$ 4.1 million this year alone.

The reduction is the result of strong ongoing implementation of pneumococcal vaccine national programs and builds on efficiencies achieved through the introduction of the PCV four-dose vial (4-D MDV) as well as stable country volumes over the past three years. In 2017 the price of Pfizer’s PCV single dose vial (SDV) was US$ 3.30 per dose.

“Pneumonia remains the single largest cause of death for children worldwide and pneumococcal vaccine is one of our best weapons against it,” said Dr Seth Berkley, CEO of Gavi. “We have worked hard to boost access to this lifesaver in the world’s poorest countries – coverage rates in lower income, Gavi-eligible countries are now approaching the global average.  Lower prices, a result of our important partnership with Pfizer, have played a critical role in this effort…

Gavi and Zenysis Technologies to bring data and artificial intelligence to immunisation programmes

Geneva, 12 March 2019 – Gavi, the Vaccine Alliance and Zenysis Technologies, a Silicon Valley startup, have established a new strategic partnership that will help low-income countries harness the power of big data and artificial intelligence to improve childhood vaccination programs around the world.

Zenysis Technologies was identified by Gavi, through the INFUSE (Innovation for Uptake, Scale and Equity in Immunisation) yearly call for innovation. INFUSE aims to identify proven solutions which, when brought to scale, have the greatest potential to modernise global health and immunisation delivery.

A two-year partnership will provide countries with the Zenysis’ software platform, analytical training and IT skills development. Countries will use the platform’s capabilities to integrate data from their fragmented information systems and help decision-makers see where children are not receiving vaccines. Advanced analytics will then help countries decide how to target their limited resources for maximum impact.

“Weak immunisation data leads to poor planning, often meaning that children, whether they live in urban slums or remote rural outposts, miss out on lifesaving vaccines. Digital transformation of immunisation data and analytics is key to making sure that all children are protected from vaccine-preventable diseases,” said Gavi CEO Dr Seth Berkley. “Our partnership with Zenysis has the potential to increase efficiency and reduce costs for developing countries but, most importantly, it could save lives.”…
 
 
GHIT Fund   [to 16 Mar 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 Mar 2019]
https://www.theglobalfund.org/en/news/
News
No new digest content identified.
 
 
Hilleman Laboratories   [to 16 Mar 2019]
http://www.hillemanlabs.org/
No new digest content identified.
 
 
Human Vaccines Project   [to 16 Mar 2019]
http://www.humanvaccinesproject.org/media/press-releases/
No new digest content identified.
 
 
IAVI  [to 16 Mar 2019]
https://www.iavi.org/newsroom
Iavi and partner scientific publications
March 12, 2019
Simulated vaccine efficacy trials to estimate HIV incidence for actual vaccine clinical trials in key populations in Uganda
PMID: 30857933
Abstract: Fisherfolks (FF) and female sex workers (FSW) in Uganda could be suitable key populations for HIV vaccine efficacy trials because of the high HIV incidence and good retention in observational cohorts. However, the observed HIV incidence may differ in participants who enroll into a trial. We used simulated vaccine efficacy trials (SiVET) nested within observational cohorts in these populations to evaluate this difference.
PMID Author: Abaasa A, Nash S, Mayanja Y, Price M, Fast PE, Kamali A, Kaleebu P, Todd J
 
 
IFFIm
http://www.iffim.org/library/news/press-releases/
No new digest content identified.
 
 
IFRC   [to 16 Mar 2019]
http://media.ifrc.org/ifrc/news/press-releases/
Press Releases 
Asia Pacific, Philippines
Millions of children at risk as death toll rises in Philippines measles outbreak
An estimated 3.7 million children under five in the Philippines are at risk during a measles outbreak that has already claimed 286 lives, most of them children or babies, the Red Cross is warning.
14 March 2019

Europe
Ukraine: Red Cross deployed to help contain largest measles outbreak in Europe in four years
Budapest/Geneva, 5 March 2019 – Ukrainian Red Cross Society volunteers are being deployed to help contain a measles outbreak that has affected more than 75,000 people, making it the largest outbreak in Europe since 2015.  This includes 54,000 measles c …
5 March 2019

 
 
IVAC  [to 16 Mar 2019]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
No new digest content identified.

 
 
IVI   [to 16 Mar 2019]
http://www.ivi.int/
IVI News & Announcements
No new digest content identified.
 
 
JEE Alliance  [to 16 Mar 2019]
https://www.jeealliance.org/
Selected News and Events
Strategic Partnership for International Health Regulations (2005) and Health Security
12.3.2019   Article
The implementation of the International Health Regulations (2005) Monitoring and Evaluation Framework will draw on WHO’s convening role to facilitate strategic cooperation and generate collaborative…
 
 
MSF/Médecins Sans Frontières  [to 16 Mar 2019]
http://www.msf.org/
Selected News; Project Updates, Reports [as presented on website]
Mali
Conflict, curfew and floods put healthcare out of reach in Mopti
Project Update 12 Mar 2019
 
 
NIH  [to 16 Mar 2019]
http://www.nih.gov/news-events/news-releases
No new digest content identified.
 
 
PATH  [to 16 Mar 2019]
https://www.path.org/media-center/
March 11, 2019
Leading humanitarian, development, and global health organizations urge Congress to reject cuts to foreign assistance

Washington, D.C., March 11, 2019 — Leading humanitarian, development, and global health organizations Bread for the World, CARE, Catholic Relief Services, Interaction, International Rescue Committee, Mercy Corps, ONE, Oxfam, PATH, Save the Children, and World Vision, are calling on Members of Congress to protect the International Affairs budget in Fiscal Year 2020 (FY20) despite the Administration’s proposed 24 percent cuts. American leadership is critical in the face of daunting global challenges, from conflict to mass displacement, from food insecurity to global health crises.

More than 132 million people are projected to need humanitarian assistance in 2019 given an unprecedented number of humanitarian crises. Natural disasters, atrocities, gender-based violence, and protracted armed conflict have resulted in more than 68 million displaced persons, including more than 25 million refugees. Now is not the time to slash effective, life-saving programs that help create a safer and more secure world.

In addition, the Administration’s proposal to significantly modify and repeal the refugee mandate and resources of the Department of State’s humanitarian bureau, coupled with a 34 percent cut to humanitarian assistance, is unwise, especially given historic levels of displacement…
 
 

Sabin Vaccine Institute  [to 16 Mar 2019]
http://www.sabin.org/updates/pressreleases
No new digest content identified.
 
 
UNAIDS [to 16 Mar 2019]
http://www.unaids.org/en
Selected Press Releases/Reports/Statements
11 March 2019
HIV prevention: not hitting the mark

The number of new HIV infections globally continues to fall. Modelled estimates show that new infections (all ages) declined from a peak of 3.4 million [2.6 million–4.4 million] in 1996 to 1.8 million [1.4 million–2.4 million] in 2017—the year for which the most recent data are available. However, progress is far slower than that required to reach the 2020 target of fewer than 500 000 new HIV infections
 
 
UNICEF  [to 16 Mar 2019]
https://www.unicef.org/media/press-releases
Selected Press Releases/Reports/Statements
Statement
Intensification of fighting impeding humanitarian access and displacing thousands in Hajjah, Yemen
Statement by UNICEF Executive Director Henrietta Fore
13/03/2019

Press release
260,000 children suffering from severe acute malnutrition in the Kasai region of the Democratic Republic of the Congo – UNICEF
Humanitarian situation in Kasai remains precarious following recent influx of Congolese families returning from Angola
12/03/2019

Statement
2018 deadliest year yet for children in Syria as war enters 9th year
Statement by UNICEF Executive Director Henrietta Fore
10/03/2019

 
 
Vaccine Confidence Project [to 16 Mar 2019]
http://www.vaccineconfidence.org/
No new digest content identified.
 
 
Vaccine Education Center – Children’s Hospital of Philadelphia [to 16 Mar 2019]
http://www.chop.edu/centers-programs/vaccine-education-center
No new digest content identified.
 
 
Wellcome Trust [to 16 Mar 2019]
https://wellcome.ac.uk/news
No new digest content identified.

The Wistar Institute [to 16 Mar 2019]
https://www.wistar.org/news/press-releases
No new digest content identified.

World Organisation for Animal Health (OIE)   [to 16 Mar 2019]
http://www.oie.int/en/for-the-media/press-releases/2019/
07/03/19
FAO, OIE, and WHO launch a guide for countries on taking a One Health approach to addressing zoonotic diseases
Zoonotic diseases continue to be a threat to global health, causing millions of deaths and economic losses every year. To support countries to control these diseases, the Tripartite organisations (FAO, OIE and WHO) today launched a guide entitled ‘Taking a Multisectoral, One Health Approach: A Tripartite Guide to Addressing Zoonotic Diseases in Countries’.

::::::

BIO [to 16 Mar 2019]
https://www.bio.org/insights/press-release
No new digest content identified.

DCVMN – Developing Country Vaccine Manufacturers Network [to 16 Mar 2019]
http://www.dcvmn.org/
No new digest content identified.

IFPMA [to 16 Mar 2019]
http://www.ifpma.org/resources/news-releases/
No new digest content identified.

PhRMA [to 16 Mar 2019]
http://www.phrma.org/press-room
No new digest content identified.

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

BMJ Global Health
March 2019 – Volume 4 – 2
https://gh.bmj.com/content/4/2

Editorial
Public health in Democratic People’s Republic of Korea (9 March, 2019)
Douglas James Noble

BMJ Global Health
March 2019 – Volume 4 – 2
https://gh.bmj.com/content/4/2

Research
Systematic review of evidence on public health in the Democratic People’s Republic of Korea (9 March, 2019)
John J Park, Ah-Young Lim, Hyung-Soon Ahn, Andrew I Kim, Soyoung Choi, David HW Oh, Owen Lee-Park, Sharon Y Kim, Sun Jae Jung, Jesse B Bump, Rifat Atun, Hee Young Shin, Kee B Park

BMJ Global Health
March 2019 – Volume 4 – 2
https://gh.bmj.com/content/4/2

Analysis
Investing in health R&D: where we are, what limits us, and how to make progress in Africa (4 March, 2019)
Victoria Simpkin, Evelyn Namubiru-Mwaura, Lorcan Clarke, Elias Mossialos

BMJ Global Health
March 2019 – Volume 4 – 2
https://gh.bmj.com/content/4/2

Practice
How is implementation research applied to advance health in low-income and middle-income countries? (7 March, 2019)
Olakunle Alonge, Daniela Cristina Rodriguez, Neal Brandes, Elvin Geng, Ludovic Reveiz, David H Peters

BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content
(Accessed 16 Mar 2019)

Research article
Consideration of sex and gender in Cochrane reviews of interventions for preventing healthcare-associated infections: a methodology study
Healthcare-associated infections (HAIs) are common and increase morbidity, mortality, and healthcare costs. Their control continues to be an unresolved issue worldwide. HAIs epidemiology shows sex/gender diffe…
Authors: Jesús López-Alcalde, Elena Stallings, Sheila Cabir Nunes, Abelardo Fernández Chávez, Mathilde Daheron, Xavier Bonfill Cosp and Javier Zamora
Citation: BMC Health Services Research 2019 19:169
Published on: 15 March 2019

BMC Medicine
http://www.biomedcentral.com/bmcmed/content
(Accessed 16 Mar 2019)

Research article
Repeated clinical malaria episodes are associated with modification of the immune system in children
There are over 200 million reported cases of malaria each year, and most children living in endemic areas will experience multiple episodes of clinical disease before puberty. We set out to understand how freq…
Authors: Yaw Bediako, Rhys Adams, Adam J. Reid, John Joseph Valletta, Francis M. Ndungu, Jan Sodenkamp, Jedidah Mwacharo, Joyce Mwongeli Ngoi, Domtila Kimani, Oscar Kai, Juliana Wambua, George Nyangweso, Etienne P. de Villiers, Mandy Sanders, Magda Ewa Lotkowska, Jing-Wen Lin…
Citation: BMC Medicine 2019 17:60
Published on: 13 March 2019

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

Research article
Social inequities in vaccination coverage among infants and pre-school children in Europe and Australia – a systematic review
Herd immunity levels of vaccine uptake are still not reached in some high-income countries, usually in countries with persisting social inequities in uptake. Previous studies have focused on factors within one health care system. This study takes a broader health care systems approach by reviewing the socioeconomic distribution of vaccination coverage on the national level in light of structural and organizational differences of primary care for children.
Authors: Arzu Arat, Bo Burström, Viveca Östberg and Anders Hjern
Citation: BMC Public Health 2019 19:290
Published on: 12 March 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 5
http://www.tandfonline.com/toc/rgph20/current

Article
Surveillance in the field: Over-identification of Ebola suspect cases and its contributing factors in West African at-risk contexts

1. Desclaux, M. S. Malan, M. Egrot, K. Sow for EBSEN Study Group & F. Akindès for EBO-CI Study Group

Pages: 709-721
Published online: 13 Oct 2018

Health Affairs
Vol. 38 , No. 3 March 2019
https://www.healthaffairs.org/toc/hlthaff/current
Patients As Consumers

Overview  Patients & Consumers

Patient Engagement In Research: Early Findings From The Patient-Centered Outcomes Research Institute
Laura P. Forsythe, Kristin L. Carman, Victoria Szydlowski, Lauren Fayish, …
Abstract
Charged with ensuring that research produces useful evidence to inform health decisions, the Patient-Centered Outcomes Research Institute (PCORI) requires investigators to engage patients and other health care stakeholders, such as clinicians and payers, in the research process. Many PCORI studies result in articles published in peer-reviewed journals that detail research findings and engagement’s role in research. To inform practices for engaging patients and others as research partners, we analyzed 126 articles that described engagement approaches and contributions to research. PCORI projects engaged patients and others as consultants and collaborators in determining the study design, selecting study outcomes, tailoring interventions to meet patients’ needs and preferences, and enrolling participants. Many articles reported that engagement provided valuable contributions to research feasibility, acceptability, rigor, and relevance, while a few noted trade-offs of engagement. The findings suggest that engagement can support more relevant research through better alignment with patients’ and clinicians’ real-world needs and concerns.

Health Affairs
Vol. 38 , No. 3 March 2019
https://www.healthaffairs.org/toc/hlthaff/current
Patients As Consumers

Research Article   Patients & Consumers
Understanding What Information Is Valued By Research Participants, And Why
Consuelo H. Wilkins, Brandy M. Mapes, Rebecca N. Jerome, Victoria Villalta-Gil, …
Abstract
There is growing public demand that research participants receive all of their results, regardless of whether clinical action is indicated. Instead of the standard practice of returning only actionable results, we propose a reconceptualization called “return of value” to encompass the varied ways in which research participants value specific results and more general information they receive beyond actionable results. Our proposal is supported by a national survey of a diverse sample, which found that receiving research results would be valuable to most (78.5 percent) and would make them more likely to trust researchers (70.3 percent). Respondents highly valued results revealing genetic effects on medication response and predicting disease risk, as well as information about nearby clinical trials and updates on how their data were used. The information most valued varied by education, race/ethnicity, and age. Policies are needed to enable return of information in ways that recognize participants’ differing informational needs and values.