Vaccine
Volume 37, Issue 21 Pages 2765-2870 (9 May 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/21

Research article Abstract only
Mandatory vaccination and no fault vaccine injury compensation schemes: An identification of country-level policies
Katie Attwell, Shevaun Drislane, Julie Leask
Pages 2843-2848

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

Papillomavirus Research
2019 Apr 30. pii: S2405-8521(18)30120-4. doi: 10.1016/j.pvr.2019.04.013. [Epub ahead of print]
Japanese physicians’ attitudes and intentions regarding human papillomavirus vaccine compared with other adolescent vaccines.
T Katsuta, CA Moser, PA Offit, KA Feemster – (Amsterdam …, 2019
Abstract
INTRODUCTION:
Japan has experienced extremely low human papillomavirus vaccine (HPVV) coverage following the suspension of proactive governmental recommendations in 2013. Several studies have reported that recommendations from physicians increase adolescents’ vaccine acceptance. In this survey, we evaluated the attitudes and intentions of Japanese physicians related to adolescent immunizations, particularly HPVV.
METHODS:
We conducted a cross-sectional study using a mailed questionnaire targeting 330 Japanese physicians including 78 pediatricians, 225 internists and 27 obstetricians and gynecologists (OB/GYNs) in Kawasaki City, Japan in 2016. The survey measured physicians’ reported frequency of educating adolescents about vaccines as well as their own perceptions and intentions related to adolescent immunizations.
RESULTS:
Valid responses were obtained from 148 (45%) physicians. Though 53% agreed that the HPVV should be recommended, only 21% reported educating about HPVV. The majority of respondents (90%) agreed that they would restart HPVV for adolescents if the government reinstated its recommendation.
CONCLUSIONS:
Although Japanese physicians reported support for adolescent immunizations, they were less likely to recommend or discuss HPVV compared with other adolescent vaccines. Responses indicated this was, at least in part, due to the lack of governmental support for HPVV, indicating that their recommendations would improve with government endorsement of the vaccine.

Media/Policy Watch
This watch section is intended to alert readers to substantive news, analysis and opinion from the general media and selected think tanks and similar organizations on vaccines, immunization, global public health and related themes. Media Watch is not intended to be exhaustive, but indicative of themes and issues CVEP is actively tracking. This section will grow from an initial base of newspapers, magazines and blog sources, and is segregated from Journal Watch above which scans the peer-reviewed journal ecology.
We acknowledge the Western/Northern bias in this initial selection of titles and invite suggestions for expanded coverage. We are conservative in our outlook in adding news sources which largely report on primary content we are already covering above. Many electronic media sources have tiered, fee-based subscription models for access. We will provide full-text where content is published without restriction, but most publications require registration and some subscription level.

The Atlantic
http://www.theatlantic.com/magazine/
Accessed 11 May 2019
[No new, unique, relevant content]

BBC
http://www.bbc.co.uk/
Accessed 11 May 2019
10 May 2019
Instagram blocks vaccine hoax hashtags
Instagram says it will block hashtags being used to spread “verifiably false” information about vaccinations.

The Economist
http://www.economist.com/
Accessed 11 May 2019
[No new, unique, relevant content]

Financial Times
http://www.ft.com/home/uk
Accessed 11 May 2019
[No new, unique, relevant content]

Forbes
http://www.forbes.com/
Accessed 11 May 2019
May 9, 2019
Texas Lawmaker Makes Sorcery Claims About A Top Vaccine Expert
Rep. Jonathan Stickland, a Republican member of the Texas House of Representatives, made some Harry Potter-esque claims about Dr. Peter Hotez,
By Bruce Y. Lee Contributor

May 9, 2019
Vaccines Are Critical To Public Health, And Are Cost-Effective, Too
Joshua Cohen, Contributor

Foreign Affairs
http://www.foreignaffairs.com/
Accessed 11 May 2019
[No new, unique, relevant content]

Foreign Policy
http://foreignpolicy.com/
Accessed 11 May 2019
[No new, unique, relevant content]

The Guardian
http://www.guardiannews.com/
Accessed 11 May 2019
[No new, unique, relevant content]

New Yorker
http://www.newyorker.com/
Accessed 11 May 2019
[No new, unique, relevant content]

New York Times
http://www.nytimes.com/
Accessed 11 May 2019
Health
May 8
Brother and Sister of Robert F. Kennedy Jr. Accuse Him of Spreading Misinformation on Vaccines
The relatives say the family has for decades been committed to vaccines and that Mr. Kennedy’s anti-vaccine messages are putting children at risk.

Washington Post
http://www.washingtonpost.com/
Accessed 11 May 2019
Washington state limits exemptions for measles vaccine
Gillian Flaccus and Rachel La Corte | AP · May 10, 2019

Can your boss require vaccinations for measles?
Jena McGregor · May 9, 2019

Student who sued over chickenpox vaccination has the disease
Associated Press · National · May 8, 2019

‘He is wrong’: Robert F. Kennedy Jr.’s family calls him out for anti-vaccine conspiracy theories
Kayla Epstein · May 8, 2019

A German answer to the measles epidemic: Fine parents who don’t vaccinate
Emily Tamkin · May 7, 2019

Think Tanks et al

Brookings
http://www.brookings.edu/
Accessed 11 May 2019
[No new relevant content]

Center for Global Development
http://www.cgdev.org/page/press-center
[No new relevant content]

CSIS
https://www.csis.org/
Accessed 11 May 2019
The Future of Polio Surveillance
[No new relevant content]

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

Kaiser Family Foundation
https://www.kff.org/search/?post_type=press-release
Accessed 11 May 2019
[No new relevant content]

Milestones :: Perspectives :: Research

Dengue

First FDA-approved vaccine for the prevention of dengue disease in endemic regions
FDA News Release
May 1, 2019
The U.S. Food and Drug Administration announced today the approval of Dengvaxia, the first vaccine approved for the prevention of dengue disease caused by all dengue virus serotypes (1, 2, 3 and 4) in people ages 9 through 16 who have laboratory-confirmed previous dengue infection and who live in endemic areas. Dengue is endemic in the U.S. territories of American Samoa, Guam, Puerto Rico and the U.S. Virgin Islands.

“Dengue disease is the most common mosquito-borne viral disease in the world and global incidence has increased in recent decades,” said Anna Abram, FDA deputy commissioner for policy, legislation, and international affairs. “The FDA is committed to working proactively with our partners at the U.S. Centers for Disease Control and Prevention, as well as international partners, including the World Health Organization, to combat public health threats, including through facilitating the development and availability of medical products to address emerging infectious diseases. While there is no cure for dengue disease, today’s approval is an important step toward helping to reduce the impact of this virus in endemic regions of the United States.”

The CDC estimates more than one-third of the world’s population is living in areas at risk for infection by dengue virus which causes dengue fever, a leading cause of illness among people living in the tropics and subtropics. The first infection with dengue virus typically results in either no symptoms or a mild illness that can be mistaken for the flu or another viral infection. A subsequent infection can lead to severe dengue, including dengue hemorrhagic fever (DHF), a more severe form of the disease that can be fatal. Symptoms may include stomach pain, persistent vomiting, bleeding, confusion and difficulty breathing. Approximately 95 percent of all severe/hospitalized cases of dengue are associated with second dengue virus infection. Because there are no specific drugs approved for the treatment of dengue disease, care is limited to the management of symptoms.

Each year, an estimated 400 million dengue virus infections occur globally according to the CDC. Of these, approximately 500,000 cases develop into DHF, which contributes to about 20,000 deaths, primarily among children. Although dengue cases are rare in the continental U.S., the disease is regularly found in American Samoa, Puerto Rico, Guam, the U.S. Virgin Islands, as well as Latin America, Southeast Asia and the Pacific islands.

“Infection by one type of dengue virus usually provides immunity against that specific serotype, but a subsequent infection by any of the other three serotypes of the virus increases the risk of developing severe dengue disease, which may lead to hospitalization or even death,” said Peter Marks, M.D., director of the FDA’s Center for Biologics Evaluation and Research. “As the second infection with dengue is often much more severe than the first, the FDA’s approval of this vaccine will help protect people previously infected with dengue virus from subsequent development of dengue disease.”

The safety and effectiveness of the vaccine was determined in three randomized, placebo-controlled studies involving approximately 35,000 individuals in dengue-endemic areas, including Puerto Rico, Latin America and the Asia Pacific region. The vaccine was determined to be approximately 76 percent effective in preventing symptomatic, laboratory-confirmed dengue disease in individuals 9 through 16 years of age who previously had laboratory-confirmed Dengue disease. Dengvaxia has already been approved in 19 countries and the European Union.

The most commonly reported side effects by those who received Dengvaxia were headache, muscle pain, joint pain, fatigue, injection site pain and low-grade fever. The frequency of side effects was similar across Dengvaxia and placebo recipients and tended to decrease after each subsequent dose of the vaccine.

Dengvaxia is not approved for use in individuals not previously infected by any dengue virus serotype or for whom this information is unknown. This is because in people who have not been infected with dengue virus, Dengvaxia appears to act like a first dengue infection – without actually infecting the person with wild-type dengue virus – such that a subsequent infection can result in severe dengue disease. Therefore, health care professionals should evaluate individuals for prior dengue infection to avoid vaccinating individuals who have not been previously infected by dengue virus. This can be assessed through a medical record of a previous laboratory-confirmed dengue infection or through serological testing (tests using blood samples from the patient) prior to vaccination. 

Dengvaxia is a live, attenuated vaccine that is administered as three separate injections, with the initial dose followed by two additional shots given six and twelve months later.

The FDA granted this application Priority Review and a Tropical Disease Priority Review Voucher under a program intended to encourage development of new drugs and biologics for the prevention and treatment of certain tropical diseases. The approval was granted to Sanofi Pasteur…

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Sanofi U.S. News Release
FDA approves Dengvaxia® for the prevention of dengue in individuals ages 9 through 16 living in U.S. endemic areas
[Editor’s text bolding]
BRIDGEWATER, N.J., May 1, 2019 /PRNewswire/ — The U.S. Food and Drug Administration (FDA) approved Dengvaxia® (Dengue Tetravalent Vaccine, Live) for the prevention of dengue disease caused by serotypes 1 – 4 of the virus in individuals 9 through 16 years of age living in endemic areas of the U.S. with a laboratory-documented prior infection. Dengvaxia is the first and only vaccine approved for protection against dengue in endemic areas of the U.S…

…Dengvaxia is also approved for use in several endemic countries in Latin America and Asia where reducing the human and economic burden of dengue is a public health priority. In December 2018, the European Commission granted marketing authorization for Dengvaxia to prevent dengue in individuals living in endemic areas with a documented prior infection.

Indication for Dengvaxia® (Dengue Tetravalent Vaccine, Live)
Dengvaxia is a vaccine given to people 9 through 16 years of age to help prevent dengue infection due to dengue virus serotypes 1, 2, 3 and 4. Dengvaxia should only be given to people who have previously had a dengue infection, and live in areas where dengue is endemic.

Your child should not receive Dengvaxia if he or she has not had a previously confirmed dengue infection, or if this information is unknown. People who have not had a previous dengue infection are at increased risk for severe dengue when vaccinated with Dengvaxia and later infected with a dengue virus. Previous dengue infection can be verified by a medical record of a previous laboratory confirmed dengue infection, or by testing for dengue before vaccination.

It is unknown whether Dengvaxia is safe or protective for people living in areas where dengue is not endemic who travel to dengue endemic areas.

Important Safety Information for Dengvaxia (Dengue Tetravalent Vaccine, Live)
Dengvaxia vaccine should not be given to anyone with a history of severe allergic reaction to a previous dose of Dengvaxia or to any component of Dengvaxia.

Dengvaxia should not be given to people with a severely suppressed or compromised immune system.

Before your child can receive Dengvaxia, your child’s health care professional must determine whether your child has had a confirmed dengue infection.

Currently, no available tests have been cleared by the Food and Drug Administration (FDA) to determine a previous dengue infection. Talk with your health care professional about available tests. For the month after receiving Dengvaxia, tuberculosis skin tests may be falsely negative. If you undergo tuberculosis skin testing in the month after vaccination, tell the health care professional performing the test that you received Dengvaxia.

The most common side effects of Dengvaxia include headache, pain at the injection site, general discomfort, tiredness, and muscle aches. Other side effects can occur.

It is recommended to continue personal protection measures against mosquito bites after vaccination since vaccination with Dengvaxia may not protect all people.

Please see the full Prescribing Information for Dengvaxia (Dengue Tetravalent Vaccine, Live).

Milestones :: Perspectives :: Research

AMR

Press Release
New report calls for urgent action to avert antimicrobial resistance crisis
International organizations unite on critical recommendations to combat drug-resistant infections and prevent staggering number of deaths each year.
New York, 29 April 2019 – The United Nations, international agencies and experts today released a groundbreaking report demanding immediate, coordinated and ambitious action to avert a potentially disastrous drug-resistance crisis.

If no action is taken – warns the UN Ad hoc Interagency Coordinating Group on Antimicrobial Resistance who released the report – drug-resistant diseases could cause 10 million deaths each year by 2050 and damage to the economy as catastrophic as the 2008-2009 global financial crisis. By 2030, antimicrobial resistance could force up to 24 million people into extreme poverty.

Currently, at least 700,000 people die each year due to drug-resistant diseases, including 230,000 people who die from multidrug-resistant tuberculosis. More and more common diseases, including respiratory tract infections, sexually transmitted infections and urinary tract infections, are untreatable; lifesaving medical procedures are becoming much riskier, and our food systems are increasingly precarious.

The world is already feeling the economic and health consequences as crucial medicines become ineffective. Without investment from countries in all income brackets, future generations will face the disastrous impacts of uncontrolled antimicrobial resistance.

Recognizing that human, animal, food and environmental health are closely interconnected, the report calls for a coordinated, multisectoral “One Health” approach.

It recommends countries:
:: prioritize national action plans to scale-up financing and capacity-building efforts;
:: put in place stronger regulatory systems and support awareness programs for responsible and prudent use of antimicrobials by professionals in human, animal and plant health;
:: invest in ambitious research and development for new technologies to combat antimicrobial resistance;
:: urgently phase out the use of critically important antimicrobials as growth promoters in agriculture.

Report
No Time to Wait: Securing the future from drug-resistant infections
IACG – Interagency Coordination Group on Antimicrobial Resistance
REPORT TO THE SECRETARY-GENERAL OF THE UNITED NATIONS
APRIL 2019 : 28 pages
KEY MESSAGES IN THIS REPORT
Antimicrobial resistance is a global crisis that threatens a century of progress in health and achievement of the Sustainable Development Goals.
:: Antimicrobial (including antibiotic, antiviral, antifungal and antiprotozoal) agents are critical tools for fighting diseases in humans, terrestrial and aquatic animals and plants, but they are becoming ineffective.
:: Alarming levels of resistance have been reported in countries of all income levels, with the result that common diseases are becoming untreatable, and lifesaving medical procedures riskier to perform.
:: Antimicrobial resistance poses a formidable challenge to achieving Universal Health Coverage and threatens progress against many of the Sustainable Development Goals, including in health, food security, clean water and sanitation, responsible consumption and production, and poverty and inequality.
:: Misuse and overuse of existing antimicrobials in humans, animals and plants are accelerating the development and spread of antimicrobial resistance.
:: Inadequate access to clean water, sanitation and hygiene in health care facilities, farms, schools, households and community settings; poor infection and disease prevention; lack of equitable access to affordable and quality-assured antimicrobials, vaccines and diagnostics; and weak health, food and feed production, food safety and waste management systems are increasing the burden of infectious disease in animals and humans and contributing to the emergence and spread of drug-resistant pathogens.

There is no time to wait. Unless the world acts urgently, antimicrobial resistance will have disastrous impact within a generation.
:: Drug-resistant diseases already cause at least 700,000 deaths globally a year, including 230,000 deaths from multidrug-resistant tuberculosis, a figure that could increase to 10 million deaths globally per year by 2050 under the most alarming scenario if no action is taken. Around 2.4 million people could die in high-income countries between 2015 and 2050 without a sustained effort to contain antimicrobial resistance.
:: The economic damage of uncontrolled antimicrobial resistance could be comparable to the shocks experienced during the 2008-2009 global financial crisis as a result of dramatically increased health care expenditures; impact on food and feed production, trade and livelihoods; and increased poverty and inequality.
:: In higher-income countries, a package of simple interventions to address antimicrobial resistance could pay for itself due to costs averted. In lower-income countries, additional but still relatively modest investments are urgently needed.
:: If investments and action are further delayed, the world will have to pay far more in the future to cope with the disastrous impact of uncontrolled antimicrobial resistance.

Because the drivers of antimicrobial resistance lie in humans, animals, plants, food and the environment, a sustained One Health response is essential to engage and unite all stakeholders around a shared vision and goals.
:: National Antimicrobial Resistance Action Plans are at the heart of a multisectoral One Health response, but financing and capacity constraints in many countries need to be urgently addressed to accelerate implementation.
:: Strengthening infection prevention and control in health care facilities and farms using available tools and ensuring access to clean water, sanitation and hygiene in health facilities, farms, schools, household and community settings are central to minimizing disease transmission and the emergence and transmission of antimicrobial resistance in humans, animals, plants, food and the environment.
:: Strengthening surveillance, regulatory frameworks, professional education and oversight of antimicrobial prescription and use, and increasing awareness among all stakeholders are also significant challenges that need to be urgently addressed to ensure the responsible use of antimicrobials and to minimize resistance in humans, animals, plants, food and the environment.
:: Immediately stopping the use of the antimicrobials on the WHO List of Highest Priority Critically Important Antimicrobial Agents for Human Medicine as growth promoters is an essential first step towards completely phasing out the use of antimicrobials for growth promotion.
:: Additional effort, investments and incentives are needed to spur innovation in antimicrobial medicines, diagnostics, vaccines, waste management tools, safe and effective alternatives to antimicrobials and alternative practices, as well as operational and implementation research, in human, animal and plant health.
:: Many people around the world still do not have access to antimicrobials. Ensuring equitable and affordable access to quality antimicrobial agents and their responsible and sustainable use is an essential component of the global response to antimicrobial resistance.
:: Stronger political leadership, advocacy, coordination and accountability are needed at all levels to enable a sustained One Health response to antimicrobial resistance. All stakeholder groups – including governments, civil society and the private sector – need to be engaged and to collaborate in an unprecedented effort across the human, animal, plant, food and feed production and environmental sectors, based on a shared vision and goals.
:: The challenges of antimicrobial resistance are complex and multifaceted, but they are not insurmountable. Implementation of the recommendations in this report will help to save millions of lives, maintain economic and other development gains, and secure the future from drug-resistant diseases.

Milestones :: Perspectives :: Research

DRC – Ebola

Ebola situation worsening while support lags
Statement from WHO High-Level Mission to Butembo, DRC
30 April 2019
WHO Director-General Dr Tedros Adhanom Ghebreyesus and WHO Regional Director for Africa, Dr Matshidiso Moeti, have concluded a visit to Butembo, in the Democratic Republic of the Congo. It was in Butembo on 19 April that WHO epidemiologist Dr Richard Mouzoko was killed by armed men while he and colleagues were working on the Ebola response.

“Dr Mouzoko’s death moved me profoundly. On this mission, he was on my mind the whole time as we met with other dedicated colleagues. I am also profoundly worried about the situation. Cases are increasing because of violent acts that set us back each time. We have already begun to adjust our response.”

Dr Tedros and Dr Moeti traveled to Butembo to express their gratitude and show support to WHO and partner organization staff, while also assessing the next steps needed to strengthen both security and the Ebola response effort. They also met with local political, business and religious leaders, and called on them to accelerate their efforts to stabilize the surrounding environment.

They urged the international community to step up support to contain the Ebola outbreak, including filling the funding gap that threatens to stymie the Ebola response.

Most Ebola response activities, including community engagement, vaccination, and case investigation, have been re-launched following a slowdown in the wake of the attack that left Dr. Mouzoko dead and two people injured. However, they expressed deep concern that a rise in reported cases in recent weeks is straining resources even further.

“My pride and respect for my extraordinary colleagues has only grown,” said Dr Moeti. “They have been through something unimaginable and yet are willing to continue this vital work. We need the security situation to be under control for them and for the local people. During our mission, we had fruitful discussions with the partners who provide security cover to see what more could be done. Meanwhile, we will continue to work with various groups and embed our response at the community level.”

The delegation met the Mayor of Butembo, Sylvain Kanyamanda Mbusa, the US Ambassador, Michael A. Hammer, the Deputy Special Representative of the peacekeeping mission to the DRC (MONUSCO), David Gressly, and other UN partners, business, religious and political leaders, and NGOs active in the response.

“We are entering a phase where we will need major shifts in the response,” said Dr Tedros. WHO and partners cannot tackle these challenges without the international community stepping in to fill the sizeable funding gap.”

Only half of the currently requested funds have been received, which could lead to WHO and partners rolling back some activities precisely when they are most needed.

“We will continue to adjust the response, as we have done for each context in each community,” said Dr Moeti. “This worrisome rise in cases is a further call to action. In the end, it is only through the ownership by all the affected communities that the outbreak will end. Some would have Ebola drive us apart. We can only defeat it if we all work together.”

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39: Situation report on the Ebola outbreak in North Kivu
30 April 2019
Situation Update
…As of 28 April 2019, a total of 1466 EVD cases, including 1400 confirmed and 66 probable cases, were reported. A total of 957 deaths were reported (overall case fatality ratio 65%), including 891 deaths among confirmed cases. Of the 1466 confirmed and probable cases with known age and sex, 56% (815) were female, and 28% (416) were children aged less than 18 years. The number of healthcare workers affected has risen to 92, including 33 deaths…

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Disease Outbreak News (DONs)
Ebola virus disease – Democratic Republic of the Congo
2 May 2019
The operating environment has become increasingly insecure and socio-politically complex. Insecurity remains a major impediment to ensuring timely response interventions in the affected communities. Ebola virus disease (EVD) response activities in Butembo and Katwa remained limited; however, these are gradually resuming following a comprehensive reinforcement of security measures and community engagement efforts. The overall security situation, nevertheless, remains volatile. While no significant injuries or damages are reported this week, access and activities in parts of Mandima, Masereka, Kalunguta and Vuhovi, remain irregular due to the presence of armed groups and other security concerns. New EVD cases are expected to continue to increase, in tandem with incidents of insecurity in these hotspot areas over the coming weeks, placing significant strain on response teams and the security resources available to secure their movements.
Incidence of EVD cases in the Democratic Republic of the Congo this week saw a considerable, although not unexpected, rise compared to the week prior. This observation is in line with previous instances where a disruption to response activities was followed by a spike in the number of new cases…
…As part of the continued efforts to empower communities to be more actively engaged in the EVD response, requests received from the numerous dialogues with local residents are being reviewed to aid the transfer of some of the response ownership back to the community. Recent dialogues have focused on addressing community-related incidents of reluctance or mistrust. Some notable successes from this effort have resulted, including some previously resistant contacts coming forward to re-engage with response activities, and pledging to assist by utilising their influence in the community to encourage greater cooperation with EVD response teams…

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WHO hero laid to rest
4 May 2019, Bafia – With overwhelming grief and respect, Dr Richard Valery Mouzoko Kiboung, a devoted doctor, epidemiologist, husband and father who had worked with the World Health Organization (WHO) for the past five years was buried today in his native Cameroon.

Dr Mouzoko, 41, died from a gunshot wound sustained during an assailants’ attack on 19 April 2019 at Butembo University Hospital, where he was chairing a meeting with front-line health workers battling the Ebola virus disease in the North Kivu Province of the Democratic Republic of the Congo (DRC).

A man described as “ready to fly instantly to help his neighbour”, Dr Mouzoko was leading the WHO response team at the Butembo University Hospital’s Ebola treatment centre, in one of the worst Ebola hot spots in the country.

“The passing of Dr Richard is an enormous loss for WHO and the people of the DRC he was serving when his life was so brutally and senselessly taken away. It’s also an enormous loss for Cameroon, and most of all for his family, who have lost a husband, a father, a son and a brother,” WHO Director-General Dr Tedros Adhanom Ghebreyesus told hundreds of mourners…

Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 2 May 2019
:: On 30 April 2019, the Polio Endgame Strategy 2019-2023 was launched. The strategy will guide the Global Polio Eradication Initiative and its partners to overcome final hurdles to eradication and stay the course for a polio-free world. Read the statement.
:: Polio News April 2019 is now online, covering all the happenings, news and the latest on polio eradication efforts around the world.

Summary of new viruses this week:
:: Afghanistan— one wild poliovirus type 1 (WPV1) case;
:: Pakistan — two WPV1 cases and 11 WPV1-positive environmental samples;
:: Nigeria— one cVDPV2-positive environmental sample

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The Polio Endgame Strategy 2019-2023
GPEI statement on the strategy to achieve and sustain a polio-free world
30/04/2019
Today, the Global Polio Eradication Initiative (GPEI) launched the Polio Endgame Strategy 2019-2023, which will guide the programme and its partners to overcome the final hurdles to eradication and move toward sustaining a polio-free future.

The new plan hones in on addressing today’s most pressing obstacles to end poliovirus transmission imminently, integrate polio programme resources into health and development programmes globally, and certify the world polio-free. In addition to building on the programme’s core strategies to expand access to vaccination and improve surveillance around the world, the 2019-2023 Endgame Strategy offers responsive and innovative solutions tailored to communities’ needs. These include establishing a regional hub in Amman, Jordan to enhance coordinated support to Afghanistan and Pakistan and creating permanent Rapid Response Teams to accelerate the programme’s response to outbreaks.

The programme will also work to improve immunisation coverage and support basic development needs through strengthened collaboration with immunisation partners such as Gavi, the Vaccine Alliance and the humanitarian and emergency response communities.

To reach its goals and achieve eradication, the Endgame Strategy requires a US$4.2 billion budget, of which US$3.27 billion is to be raised by the GPEI. In support of the Strategy and to encourage additional commitments, a pledging event will be hosted this November at the Reaching the Last Mile Forum in Abu Dhabi, a gathering of leaders from across the global health space held once every two years. The pledging event will be hosted by the GPEI, with the support of His Highness Sheikh Mohamed bin Zayed Al Nahyan, Crown Prince of Abu Dhabi, a longtime champion of the polio programme.

The 2019-2023 Endgame Strategy builds on the 2013-2018 Strategic Plan, which brought the world to the brink of polio eradication. Despite this impressive progress, the last steps to eradication have proved to be the most difficult.

Wild poliovirus transmission continues in Afghanistan and Pakistan, and circulating vaccine-derived poliovirus outbreaks are ongoing in several countries across Africa and Asia. To overcome these challenges, the new Strategy must be fully implemented with sufficient resources and commitments from governments, donors, multilateral organisations, and local communities.

The Polio Endgame Strategy 2019-2023 will be discussed at the upcoming 2019 World Health Assembly in Geneva, Switzerland during the week of 20 May.

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Editor’s Note:
WHO has posted a refreshed emergencies page which presents an updated listing of Grade 3,2,1 emergencies as below.

WHO Grade 3 Emergencies [to 4 May 2019]

Democratic Republic of the Congo
:: Ebola situation worsening while support lags 30 April 2019
:: 39: Situation report on the Ebola outbreak in North Kivu 30 April 2019
:: Disease Outbreak News (DONs) Ebola virus disease – Democratic Republic of the Congo
2 May 2019
[See Ebola DRC above for detail]

Syrian Arab Republic
:: WHO condemns the attack on three health facilities in north-west Syrian Arab Republic
3 May 2019 The World Health Organization (WHO) strongly condemns the consecutive reported attacks on three health facilities in north-west Syria on 28 and 30 April. The attacks resulted in damage to infrastructure, putting them out of service.
Of the three attacked facilities, two were hospitals located in northern Hama providing life-saving medical services to thousands of vulnerable populations affected by increased hostilities over the past weeks…

Nigeria
:: Braving the waves to reach underserved populations with immunization services in the Niger Delta 28 April 2019
…“The difficulty of accessing healthcare services is due to suboptimal and expensive coastal and waterway transportation from the distant communities to healthcare centers, hence, innovative strategies are being employed to reach the underserved and vulnerable population with vaccination and other health interventions especially during Supplemental Immunization Activities (SIAs)”, says Dr Edmund Egbe, WHO State Coordinator in Bayelsa…

South Sudan
:: South Sudan intensifies efforts to control an ongoing measles outbreak 29 April 2019
…To date, more than 310 582 children aged 6 months – 15 years have been vaccinated.
South Sudan is among the countries experiencing an upsurge of measles cases. Since the beginning of 2019, measles outbreaks have been confirmed in 11 counties and three Protection of Civilian sites (POCs) housing displaced populations, affecting over 908 children and claiming at least seven lives…

Bangladesh – Rohingya crisis – No new digest announcements identified
Cyclone Idai – No new digest announcements identified
Myanmar – No new digest announcements identified
Somalia – No new digest announcements identified
Yemen – No new digest announcements identified

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WHO Grade 2 Emergencies [to 4 May 2019]

Libya
:: WHO Libya teams saving lives on Tripoli’s front lines 30 April 2019
…WHO Libya has deployed 3 teams with different specialties, including general surgeons, orthopedic surgeons, a vascular surgeon and anaesthesiologists, to 3 hospitals receiving the wounded from the front lines.

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
Iraq – No new digest announcements identified
MERS-CoV – No new digest announcements identified
Niger – No new digest announcements identified
occupied Palestinian territory – No new digest announcements identified
Sudan – No new digest announcements identified
Ukraine – No new digest announcements identified
Zimbabwe – No new digest announcements identified

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WHO Grade 1 Emergencies [to 4 May 2019]
Afghanistan – No new digest announcements identified
Chad – No new digest announcements identified
Indonesia – Sulawesi earthquake 2018 – No new digest announcements identified
Kenya – No new digest announcements identified
Lao People’s Democratic Republic – No new digest announcements identified
Mali – No new digest announcements identified
Namibia – viral hepatitis – No new digest announcements identified
Peru – No new digest announcements identified
Philippines – Tyhpoon Mangkhut – No new digest announcements identified
Tanzania – No new digest announcements identified

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

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UN OCHA – Corporate Emergencies
When the USG/ERC declares a Corporate Emergency Response, all OCHA offices, branches and sections provide their full support to response activities both at HQ and in the field.
CYCLONE IDAI and Kenneth
:: 28 Apr 2019
CERF allocates US$13M to provide a lifeline to people hit by Tropical Cyclone Kenneth in Comoros and Mozambique

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WHO & Regional Offices [to 4 May 2019]
5 May 2019 | News Release
WHO calls for more investment in primary health care

4 May 2019 | News Release
WHO hero laid to rest
[See Ebola – DRC for detail]

02 May 2019
Malaria vaccine pilot launched in Ghana
Health officials and community leaders gather to celebrate the landmark launch
WHO Ghana welcomed the Ministry of Health’s launch of the world’s first malaria vaccine in a landmark pilot programme. Top health officials, WHO representatives, community leaders, and mothers and children gathered on 30 April 2019 to officially begin the vaccine rollout. The country-led phased vaccine introduction is supported by WHO and national and global health partners.
Ghana is one of three African countries in which the vaccine, known as RTS,S, will be made available to children up to 2 years of age…

2 May 2019 | News Release
At least 188 676 people require assistance after Cyclone Kenneth pummels Mozambique

30 April 2019 – Statement
Ebola situation worsening while support lags

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2 May 2019
GIN April 2019 pdf, 1.58Mb

3 May 2019
Consultant: Acceptance and demand for vaccination pdf, 297kb
Deadline for applications: 24 May 2019

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Weekly Epidemiological Record, 3 May 2019, vol. 94, 18 (pp. 213–224)
:: Progress towards measles elimination in the WHO European Region, 2009–2018

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WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: WHO hero laid to rest 04 May 2019
:: Uganda receives 10 motorcycles to boost surveillance and Community engagement in Ebola preparedness  03 May 2
:: At least 188 676 people require health assistance after Cyclone Kenneth pummels north-eastern Mozambique 02 May 2019
:: Malaria vaccine pilot launched in Ghana 02 May 2019
:: South Sudan’s Ebola preparedness activities strengthen overall outbreak readiness 02 May 2019
:: Braving the waves to reach underserved populations with immunization services in the Niger Delta 30 April 2019
:: South Sudan intensifies efforts to control an ongoing measles outbreak 30 April 2019
:: International Partners Meet in Kampala to Discuss Ebola Preparedness and Response
30 April 2019
:: The African Vaccination Week Integrated in the Mother and Child Health Week in Rwanda
29 April 2019
:: East and Southern African countries wind up EPI Managers’ Meeting and craft Recommendations to improve Immunization coverage 29 April 2019

WHO Region of the Americas PAHO
:: New Action Plan on Health and Climate Change calls for health to be front and center of climate change planning in the Caribbean (05/03/2019)
WHO South-East Asia Region SEARO
:: Information on Avian Influenza A (H5N1) Identified in Human in Nepal May 2 | Kathmandu

WHO European Region EURO
:: Nurse and midwife leaders delivering health for all in the WHO European Region 03-05-2019
:: Clean care – the everyday measure to prevent, prepare for, respond to and recover from health emergencies 02-05-2019
:: New WHO studies: Europe battles childhood obesity and experts confirm breastfeeding protects against child obesity 30-04-2019

WHO Eastern Mediterranean Region EMRO
:: WHO Libya teams saving lives on Tripoli’s front lines 30 April 2019

WHO Western Pacific Region
No new digest content identified.

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CDC/ACIP [to 4 May 2019]
http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html
Monday, April 29, 2019
CDC Telebriefing: National Update on Measles Transcript
HHS SECRETARY ALEX AZAR: …This year, we’re celebrating 25 years of national infant immunization week.  When this observance was established in 1994, health departments and immunization programs were facing significant challenges.  The nation was in the midst of a serious measles outbreak and communities across the United States were seeing decreasing immunizations rates among children.  Today, the overwhelming majority of parents choose to protect their kids with vaccines.  However, we’re very concerned about the recent troubling rise in cases of measles, which was declared eliminated from our country in 2000.  Today, CDC is reporting 704 cases of measles from 22 states.  This is the greatest number of cases reported in the U.S. since measles was eliminated.  While most parents are getting their children vaccinated, the vast majority of cases involve children who have not been accivnated.  Everyone should be vaccinated against measles and other vaccine-preventable diseases…

Monday, April 29, 2019
CDC Media Statement from Dr. Redfield on National Infant Immunization Week, Safety and Effectiveness of Vaccines
As CDC Director and as a physician, I have and continue to wholeheartedly advocate for infant immunization.  More importantly, as a father and grandfather I have ensured all of my children and grandchildren are vaccinated on the recommended schedule. Vaccines are safe. Vaccines do not cause autism. Vaccine-preventable diseases are dangerous.

More than 94% of parents vaccinate their children to protect them from the harmful effects of measles and other vaccine- preventable diseases. CDC is working to reach the small percentage of vaccine-hesitant individuals so they too understand the importance of vaccines. It is imperative that we correct misinformation and reassure fearful parents so they protect their children from illnesses with long-lasting health impacts.  Roughly 1.3 percent, or 100,000 children, in this country under the age of two have not been vaccinated making them vulnerable to the current measles outbreak.

I call upon healthcare providers to encourage parents, and expectant parents, to vaccinate their children for their own protection and to avoid the spread of vaccine-preventable diseases within their families and communities.  We must join together as a Nation to once again eliminate measles and prevent future disease outbreaks.

MMWR News Synopsis for Friday, May 3, 2019
Progress Toward Measles Elimination — European Region, 2009–2018
In the World Health Organization European Region, measles cases tripled from 2017 to 2018. Immunization programs need to vaccinate 95% of their populations to protect individuals and communities, stop measles outbreaks from occurring, and achieve elimination. A new report describes progress toward measles elimination in the European Region (EUR) during 2009-2018. After a low of 4,240 measles cases in 2016, measles cases tripled from 2017 to 2018 with 82,596 cases reported (37% among adults), including 179 deaths. Ukraine reported the highest number of measles cases in 2018 at 53,218. Other countries reporting large outbreaks in 2018 were France, Georgia, Greece, Israel, Italy, the Russian Federation, and Serbia. Several factors have caused this resurgence, including measles virus transmission in countries with weak immunization programs, an accumulation of susceptible young children in marginalized communities, prevalent anti-vaccine sentiment, and a growing population of young adults who had not received measles vaccine.

Africa CDC [to 4 May 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 [4 May 2019]

Announcements

Paul G. Allen Frontiers Group [to 4 May 2019]
https://www.alleninstitute.org/news-press/
May 3, 2019
Q&A: A former experimental psychologist with a passion for data governance
…As more and more new technologies come on the scene, researchers’ ability to generate and store massive datasets is on the rise. But doing something with that data is a different question.
It’s a massive engineering challenge to package, store and present biological data so that other scientists can use it to glean new insights.
Paul Meijer, Ph.D., Director of Software Development at the newly launched Allen Institute for Immunology, is up for that challenge. Beyond the standard “data governance issues” that modern biology presents, the Allen Institute for Immunology has some formidable data challenges of its own. Meijer and his team will need to coordinate anonymized data from hundreds of different patients and healthy volunteers gathered by the Institute’s five different research partner organizations, allowing the partners and the broader scientific community to understand, access — and ultimately analyze — all that data…

BMGF – Gates Foundation [to 4 May 2019]
http://www.gatesfoundation.org/Media-Center/Press-Releases
No new digest content identified.

Bill & Melinda Gates Medical Research Institute [to 4 May 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 4 May 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.
04.30.2019
CARB-X launches new Funding Rounds to support the development of antibiotics, vaccines, diagnostics and other life-saving products that target drug-resistant bacteria
CARB-X announced today its 2019 rounds of funding to support the development of antibiotics, vaccines, biotherapeutics, diagnostics and other life-saving products to address the rising threat of drug-resistant bacteria. There are four funding rounds representing CARB-X’s most ambitious call for proposals from product developers seeking financial, scientific and business support to accelerate the development of innovative products targeting the most dangerous superbugs.

CEPI – Coalition for Epidemic Preparedness Innovations [to 4 May 2019]
http://cepi.net/
No new digest content identified.

Clinton Health Access Initiative, Inc. (CHAI) [to 4 May 2019]
https://clintonhealthaccess.org/about/
No new digest content identified.

EDCTP [to 4 May 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
No new digest content identified.

Emory Vaccine Center [to 4 May 2019]
http://www.vaccines.emory.edu/
No new digest content identified.

European Medicines Agency [to 4 May 2019]
http://www.ema.europa.eu/ema/
News and press releases
News: EMA annual report 2018 published
03/05/2019

European Vaccine Initiative [to 4 May 2019]
http://www.euvaccine.eu/news-events
No new digest content identified.

FDA [to 4 May 2019]
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
May 1, 2019
First FDA-approved vaccine for the prevention of dengue disease in endemic regions
[See Milestones above for detail]

Fondation Merieux [to 4 May 2019]
http://www.fondation-merieux.org/
No new digest content identified.

Gavi [to 4 May 2019]
https://www.gavi.org/
No new digest content identified.

GHIT Fund [to 4 May 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 4 May 2019]
https://www.theglobalfund.org/en/news/
News
Global Fund Selects Donald Kaberuka as Board Chair and Roslyn Morauta as Vice Chair
03 May 2019
… Dr. Kaberuka was president of the African Development Bank and chairman of its board of directors from 2005-2015. Prior to that he was finance minister of Rwanda from 1997-2005… Lady Roslyn Morauta currently serves as alternate board member for the Western Pacific Region constituency. She has a long association with the Global Fund having served as Chair of the Papua New Guinea Country Coordinating Mechanism…

News
European Commission Signs Funding Agreement with the Global Fund
29 April 2019
The European Commission and the Global Fund today signed an agreement for the final €73 million of the EC’s pledge for the current funding cycle. The EC is the sixth-largest donor to the Global Fund, and today’s agreement brings the EC’s total commitment to more than €2 billion since 2002…

News
In Early Pledge, Portugal More than Triples its Commitment to the Global Fund
29 April 2019
The Global Fund applauds Portugal’s pledge of €750,000 to the Global Fund’s Sixth Replenishment, which is more than triple its previous commitment…

Hilleman Laboratories [to 4 May 2019]
http://www.hillemanlabs.org/
No new digest content identified.

Human Vaccines Project [to 4 May 2019]
http://www.humanvaccinesproject.org/media/press-releases/
May 2019 – Update

IAVI [to 4 May 2019]
https://www.iavi.org/newsroom
No new digest content identified.

IFFIm
http://www.iffim.org/library/news/press-releases/
No new digest content identified.

IFRC [to 4 May 2019]
http://media.ifrc.org/ifrc/news/press-releases/
Selected Press Releases, Announcements
Africa, Democratic Republic of the Congo
Ebola death toll passes 1,000 as outbreak continues to worsen
Kinshasa/Nairobi/Geneva, 4 May 2019 – The Ebola outbreak in North Kivu is worsening as the death toll surpasses 1,000 on the back of an alarming number of cases reported in recent days across multiple hotspots. In the past week, 23 cases were reported …
4 May 2019

IVAC [to 4 May 2019]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
No new digest content identified.

IVI [to 4 May 2019]
http://www.ivi.int/
IVI News & Announcements
29 April 2019
WHO health economist Dr. Raymond Hutubessy addresses ‘The Full Public Health Value of Vaccines’ at IVI Seminar

JEE Alliance [to 4 May 2019]
https://www.jeealliance.org/
Selected News and Events
No new digest content identified.

MSF/Médecins Sans Frontières [to 4 May 2019]
http://www.msf.org/
Selected News; Project Updates, Reports [as presented on website]
Mozambique
MSF responds as second cyclone hits Mozambique
Project Update 1 May 2019

Iran
Flash floods in Iran wash away homes, roads and livelihoods
Voices from the Field 29 Apr 2019

NIH [to 4 May 2019]
http://www.nih.gov/news-events/news-releases
No new digest content identified.

PATH [to 4 May 2019]
https://www.path.org/media-center/
April 29, 2019 by PATH
Sharing lessons learned from Vietnam’s national electronic immunization registry to improve global vaccination coverage
Hanoi, Vietnam, April 29, 2019 – For almost ten years, PATH has supported Vietnam’s efforts to develop and scale a national electronic immunization registry (EIR). As the country prepares to close the paper logbooks for the final time, PATH is providing assistance to ensure that no child is left behind and to document Vietnam’s journey to a national EIR so that others may learn from its successes and challenges…

Sabin Vaccine Institute [to 4 May 2019]
http://www.sabin.org/updates/pressreleases
No new digest content identified.

UNAIDS [to 4 May 2019]
http://www.unaids.org/en
Selected Press Releases/Reports/Statements
2 May 2019
Recognizing the achievements of the Thai Red Cross AIDS Research Centre

UNICEF [to 4 May 2019]
https://www.unicef.org/media/press-releases
Selected Statements, Press Releases, Reports
Press release
Geneva Palais Briefing Note: Education for Rohingya children in Bangladesh
This is a summary of what was said by UNICEF spokesperson Christophe Boulierac – to whom quoted text may be attributed – at today’s press briefing at the Palais des Nations in Geneva.
03/05/2019

Press release
With deadly cyclones on the rise, UNICEF raises concern about impact of climate change on children
1.1 million children affected in wake of cyclones Kenneth and Idai in Mozambique; 10 million children live in path of Cyclone Fani in India
03/05/2019

Statement
Five children reportedly executed in the Islamic Republic of Iran and the Kingdom of Saudi Arabia
From Geert Cappelaere, UNICEF Regional Director in the Middle East and North Africa
02/05/2019

Press release
Keep children in Venezuela protected at all times
Statement by UNICEF Executive Director Henrietta Fore on the situation in Venezuela
01/05/2019

Press release
More than 300,000 Venezuelan children in Colombia need humanitarian assistance – UNICEF
UNICEF seeks to increase its current response budget from $5.7 million to $29 million
29/04/2019

Vaccine Confidence Project [to 4 May 2019]
http://www.vaccineconfidence.org/
3 May 2019
Story of the week – The FDA Approved a Dengue Fever Vaccine—Here’s What You Need to Know
Heidi Larson

Vaccine Education Center – Children’s Hospital of Philadelphia [to 4 May 2019]
http://www.chop.edu/centers-programs/vaccine-education-center
No new digest content identified.

Wellcome Trust [to 4 May 2019]
https://wellcome.ac.uk/news
No new digest content identified.

The Wistar Institute [to 4 May 2019]
https://www.wistar.org/news/press-releases
No new digest content identified.

World Organisation for Animal Health (OIE) [to 4 May 2019]
http://www.oie.int/en/for-the-media/press-releases/2019/
26/04/19
New report calls for urgent action to avert antimicrobial resistance crisis
[See Milestones above for detail]

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BIO [to 4 May 2019]
https://www.bio.org/insights/press-release
No new digest content identified.

DCVMN – Developing Country Vaccine Manufacturers Network [to 4 May 2019]
http://www.dcvmn.org/
No new digest content identified.

IFPMA [to 4 May 2019]
http://www.ifpma.org/resources/news-releases/
No new digest content identified.

PhRMA [to 4 May 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

American Journal of Tropical Medicine and Hygiene
Volume 100, Issue 5, 2019
http://www.ajtmh.org/content/journals/14761645/100/5

Review Articles
Falsified and Substandard Drugs: Stopping the Pandemic
Gaurvika M. L. Nayyar, Joel G. Breman, Tim K. Mackey, John P. Clark, Mustapha Hajjou, Megan Littrell and James E. Herrington
https://doi.org/10.4269/ajtmh.18-0981
Abstract
Falsified and substandard medicines are associated with tens of thousands of deaths, mainly in young children in poor countries. Poor-quality drugs exact an annual economic toll of up to US$200 billion and contribute to the increasing peril of antimicrobial resistance. The WHO has emerged recently as the global leader in the battle against poor-quality drugs, and pharmaceutical companies have increased their roles in assuring the integrity of drug supply chains. Despite advances in drug quality surveillance and detection technology, more efforts are urgently required in research, policy, and field monitoring to halt the pandemic of bad drugs. In addition to strengthening international and national pharmaceutical governance, in part by national implementation of the Model Law on Medicines and Crime, a quantifiable Sustainable Development Goal target and an international convention to insure drug quality and safety are urgent priorities.

American Journal of Tropical Medicine and Hygiene
Volume 100, Issue 5, 2019
http://www.ajtmh.org/content/journals/14761645/100/5

Stories from the Field
Frontier Warriors—Combating Cholera in Rural India
Rajlakshmi Viswanathan and Anuj Kumar
https://doi.org/10.4269/ajtmh.19-0027

American Journal of Tropical Medicine and Hygiene
Volume 100, Issue 5, 2019
http://www.ajtmh.org/content/journals/14761645/100/5

Feasibility of a Comprehensive Targeted Cholera Intervention in The Kathmandu Valley, Nepal
Mellisa Roskosky, Bhim Acharya, Geeta Shakya, Kshitij Karki, Kazutaka Sekine, Deepak Bajracharya, Lorenz von Seidlein, Isabelle Devaux, Anna Lena Lopez, Jacqueline Deen and David A. Sack
https://doi.org/10.4269/ajtmh.18-0863

BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content
(Accessed 4 May 2019)

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 4 May 2019)
Research article
Anti-Ebola therapy for patients with Ebola virus disease: a systematic review
Management of Ebola virus disease (EVD) has historically focused on infection prevention, case detection and supportive care. Several specific anti-Ebola therapies have been investigated, including during the …
Authors: James S. Lee, Neill K. J. Adhikari, Henry Y. Kwon, Koren Teo, Reed Siemieniuk, François Lamontagne, Adrienne Chan, Sharmistha Mishra, Srinivas Murthy, Peter Kiiza, Jan Hajek, Elhadj I. Bah, Marie-Claire Lamah, Raymond Kao and Robert A. Fowler
Citation: BMC Infectious Diseases 2019 19:376
Published on: 2 May 2019

BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content
(Accessed 4 May 2019)

Research article
Hepatitis B vaccination uptake in hard-to-reach populations in London: a cross-sectional study
In the UK, hepatitis B virus (HBV) incidence is associated with migrants from particular high-burden countries and population groups deemed ‘hard-to-reach’ by standard healthcare services: the homeless, people…
Authors: Josephine E. B. Taylor, Julian Surey, Jennifer MacLellan, Marie Francis, Ibrahim Abubakar and Helen R. Stagg
Citation: BMC Infectious Diseases 2019 19:372
Published on: 2 May 2019

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 4 May 2019)

Research article
Knowledge, attitudes and practices of cervical cancer prevention among Zambian women and men
In Zambia, cervical cancer screening was started in 2006 and the human papillomavirus vaccine was piloted in 2013. Nevertheless, cervical cancer remains the leading cancer. It is assumed that knowledge, social…
Authors: Anayawa Nyambe, Jarl K. Kampen, Stridutt K. Baboo and Guido Van Hal
Citation: BMC Public Health 2019 19:508
Published on: 4 May 2019

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 4 May 2019)

Research article
Effect of an educational intervention on HPV knowledge and attitudes towards HPV and its vaccines among junior middle school students in Chengdu, China
Little is known about the knowledge and attitudes towards human papillomavirus (HPV) and its vaccines among adolescents in mainland China. Also, limited information has been available on how to improve their k…
Authors: Chun-Rong Liu, Hao Liang, Xi Zhang, Chen Pu, Qin Li, Qiao-Ling Li, Fei-Yang Ren and Jing Li
Citation: BMC Public Health 2019 19:488
Published on: 2 May 2019

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 4 May 2019)

Research article
Influenza epidemiology and influenza vaccine effectiveness during the 2016–2017 season in the Global Influenza Hospital Surveillance Network (GIHSN)
The Global Influenza Hospital Surveillance Network (GIHSN) aims to determine the burden of severe influenza disease and Influenza Vaccine Effectiveness (IVE). This is a prospective, active surveillance and hos…
Authors: Víctor Baselga-Moreno, Svetlana Trushakova, Shelly McNeil, Anna Sominina, Marta C. Nunes, Anca Draganescu, Serhat Unal, Parvaiz Koul, Jan Kyncl, Tao Zhang, Ainagul Kuatbayeva, Afif Ben-Salah, Elena Burtseva, Joan Puig-Barberà and Javier Díez-Domingo
Citation: BMC Public Health 2019 19:487
Published on: 2 May 2019

BMC Research Notes
http://www.biomedcentral.com/bmcresnotes/content
(Accessed 4 May 2019)

Research note
Detection and characterization of polioviruses originating from urban sewage in Yaounde and Douala, Cameroon 2016–2017
Transmission of wild polioviruses (WPVs) and vaccine-derived polioviruses (VDPVs) have been interrupted in Cameroon since July 2014. Subsequently, Cameroon withdrew Sabin type 2 from routine immunization in Ap…
Authors: Daniel Kamga Njile, Serge Alain Sadeuh-Mba, Marie-Claire Endegue-Zanga, Marcellin Nimpa Mengouo, Marlise Dontsop Djoumetio, Franky Baonga Ba Pouth, Ousmane Madiagne Diop and Richard Njouom
Citation: BMC Research Notes 2019 12:248
Published on: 2 May 2019

BMC Research Notes
http://www.biomedcentral.com/bmcresnotes/content
(Accessed 4 May 2019)

Research note
Incomplete childhood vaccination and associated factors among children aged 12–23 months in Gondar city administration, Northwest, Ethiopia 2018
Despite the fact that immunization services are offered free of charge in Ethiopia but the coverage of complete vaccination is still low. The aim of the study is to determine incomplete vaccination and associa…
Authors: Ayenew Engida Yismaw, Nega Tezera Assimamaw, Netsanent Habetie Bayu and Shegaye Shumet Mekonen
Citation: BMC Research Notes 2019 12:241
Published on: 29 April 2019

Bulletin of the World Health Organization
Volume 97, Number 5, May 2019, 309-376
https://www.who.int/bulletin/volumes/97/5/en/

EDITORIALS
Providing health care in conflict settings: a call for papers
— Flavio Salio & Altaf Musani
http://dx.doi.org/10.2471/BLT.19.232769
People living in conflict-affected areas incur physical and psychological trauma. They are also vulnerable to disease outbreaks and disruptions in the supply of food and water, medicines and health services. High-quality, accessible medical care is very difficult to provide in such settings. The Geneva Conventions hold warring parties accountable for the provision of care to civilians and combatants. However, these parties may not be willing or able to provide medical assistance to conflict-affected populations. Recent major conflicts, such as in Mosul, Iraq and Al Raqqa, Syrian Arab Republic, have moved health and humanitarian assistance closer to the frontline and challenged the risk-averse approach of traditional responders.
Accountability to affected populations, as defined by the Inter-Agency Standing Committee,1 requires humanitarian responders to provide quality assistance in a timely manner while upholding best practices. Medical ethics and international humanitarian law also bind health practitioners to an operational and accountability framework. When warring parties fail to provide care and assistance to civilians, there is still an imperative to save lives and reduce suffering.
The recent experiences of humanitarian responders show that operational guidance on the provision of trauma care in conflict settings is needed. These experiences also constitute valuable lessons, from which best practices can be identified and future responses improved. An assessment of response in Mosul found that the “WHO-coordinated efforts helped address critical needs in the provision of trauma care for wounded civilians and saved lives.”2,3 However, the referral pathway used in this response created a complex system of care that could not be used by all humanitarian actors because of proximity to the frontlines and to military personnel.2 WHO recognized the operational, technical and ethical dilemmas of the response, trying to balance battlefield care and medical ethics with the humanitarian principles of neutrality, impartiality, humanity and independence.4 WHO emphasized its role as a provider of last resort, and called for partners to work closer to the frontlines. The debate generated by the referral pathway shows that research is needed on issues of quality of, and access to, timely trauma care, on prevention of attacks on health-care workers, transport, patients and facilities, as well as on outbreak prevention and response.
Most research on trauma care in conflict settings has been done in the context of symmetric warfare, when humanitarian agencies have equal access to all warring parties and the wounded, and where the military is the main provider of care. This research led to changes in care provision at the frontline, where the risk of functional impairment is usually highest. Rapid evacuation from the location of injury to the care facility is needed to save lives and reduce disabilities. Despite hard-won experience gathered by many military, United Nations, nongovernmental, civilian and humanitarian actors, there is very limited research on health-care provision and civilian protection in asymmetric warfare, where humanitarian agencies have no access to one or more warring party.
To build the evidence base for future responses, the Bulletin of the World Health Organization encourages submissions to its research, policy-and-practice and lessons-from-the-field sections to shape policy and improve health outcomes in conflict settings.

Bulletin of the World Health Organization
Volume 97, Number 5, May 2019, 309-376
https://www.who.int/bulletin/volumes/97/5/en/

Ensuring access to life-saving medicines as countries shift from Global Fund support
— Mercedes Tatay & Els Torreele
http://dx.doi.org/10.2471/BLT.19.234468
he Global Fund to Fight AIDS, Tuberculosis and Malaria has helped the scale-up of life-saving treatments through affordable, quality-assured medicines and diagnostics. However, faced with stagnating donor health funding,1 in recent years the Global Fund has revised its allocation model2 and its sustainability, transitions and co-financing policies.3

These policies are driving changes that can have negative implications for people with human immunodeficiency virus (HIV), tuberculosis or malaria. Higher prices of medicines, more use of medicines of unknown quality and more unstable supplies increase the risk of more deaths from these three preventable, treatable diseases, and exacerbate the growing global health challenge of serious drug-resistant infections.4 The changes also risk undermining opportunities to scale up life-saving innovations. Such innovations include the first new tuberculosis drugs in 40 years,5 the most effective first-line antiretroviral regimen,6 and a combination diagnostic platform for HIV, tuberculosis and other pathologies.7

The Global Fund’s revised allocation model continues to prioritize countries with the highest disease burdens and lowest incomes, but presses deprioritized countries to more rapidly mobilize alternative (especially domestic) funds to avoid reversing progress in access to life-saving medicines. Furthermore, the revised sustainability, transitions and co-financing policy requires all countries, even those with the lowest incomes, to increase their co-financing of disease programmes, including through purchasing medicines and diagnostics. Consequently, many countries shift sooner than anticipated from Global Fund-supported procurement mechanisms to national procurement processes. However, the shift to increased national procurement risks sacrificing the lower prices, quality assurance and sustainable supplies that come with Global Fund procurement.

The benefits of Global Fund-supported procurement have been achieved largely through the pooled procurement mechanism for HIV and malaria, and the Global Drug Facility for tuberculosis. These pooled, high-volume orders aggregate demand and have therefore attracted multiple suppliers offering competitive prices. In contrast, single countries need smaller volumes, which fragments demand and draws fewer suppliers or fails to interest manufacturers altogether. National procurement therefore often leaves countries with reduced negotiating power, less competition and higher prices.

Negative effects of these shifts are already apparent in some countries. From October 2016 to October 2018, 21 low- and middle-income countries paid higher prices for tuberculosis drugs and diagnostics than they would have through the Global Drug Facility procurement, while 15 countries shifting to national procurement experienced tuberculosis drug stock-outs.8

Another negative consequence of the Global Fund’s policy shifts relates to medicine quality. Medicines procured with Global Fund support are approved by the World Health Organization’s (WHO) pre-qualification programme or a stringent regulatory authority, such as the United States of America Food and Drug Administration. Most national procurement processes do not require WHO’s pre-qualification or regulatory authority approval, and some domestic regulatory authorities may not have the capacity to fully assess the quality and safety of medicines. Therefore, these processes introduce the risk of purchasing products of unknown quality. Between 2016 and 2018, 29 low- and middle-income countries purchased tuberculosis medicines of unknown quality and five purchased diagnostics of unknown quality.8

Finally, Global Fund-supported procurement circumvents the problem of pharmaceutical companies failing to register products in countries considered unattractive markets. Without the import waivers given to products procured from the Global Fund, the lack of local registration risks leading to failed tenders and lack of availability, as has already happened in some countries.

We suggest that the Global Fund, its partners and governments should undertake several steps to address this issue. The Global Fund should conduct risk and readiness assessments for countries shifting to national procurement, exempting them from such co-financing commitments if problems are identified. Donor countries should meet funding targets of the Global Fund,9 support affected countries in establishing strong procurement practices, and fund mechanisms that help countries optimize procurement. Countries should also revise their procurement requirements to allow the use of global and pooled mechanisms for certain life-saving products. Lastly, national tenders should adopt quality assurance requirements.

The Global Fund and WHO’s governing bodies could address these issues at their upcoming meetings in May. Their joint action is needed to avoid setbacks in scaling up affordable, quality medical tools that can prevent the deaths of people with HIV, tuberculosis or malaria.

Bulletin of the World Health Organization
Volume 97, Number 5, May 2019, 309-376
https://www.who.int/bulletin/volumes/97/5/en/

POLICY & PRACTICE
Fractional-dose inactivated poliovirus vaccine, India
— Pradeep Haldar, Pankaj Agrawal, Pankaj Bhatnagar, Rajiv Tandon, Sarah McGray, Darin Zehrung, Courtney Jarrahian & Jennifer Foster
http://dx.doi.org/10.2471/BLT.18.218370

Bulletin of the World Health Organization
Volume 97, Number 5, May 2019, 309-376
https://www.who.int/bulletin/volumes/97/5/en/
Access to insulin: applying the concept of security of supply to medicines
— David Beran, Zafar Mirza & Jicui Dong
http://dx.doi.org/10.2471/BLT.18.217612

Contemporary Clinical Trials
Volume 80 Pages 1-62 (May 2019)
https://www.sciencedirect.com/journal/contemporary-clinical-trials/vol/80/suppl/C

Research article Abstract only
Evaluation of worldwide clinical trials by gender: An FDA perspective
Emily Ayuso, Ruth J. Geller, Junyang Wang, John Whyte, Marjorie Jenkins
Pages 16-21
Abstract
Introduction
The US Food and Drug Administration (FDA) has undertaken efforts to promote representation of women in clinical trials. The objectives of this research are to assess women’s participation in clinical trials from a global perspective and to analyze the demographic characteristics of clinical trial participants.
Methods
FDA’s Center for Drug Evaluation and Research-Professional Affairs and Stakeholder Engagement (CDER/PASE) and Office of Women’s Health (OWH) collaborated to evaluate demographic data (race, ethnicity, gender, and age) of pivotal trials of New Molecular Entities (NMEs) approved in 2015–2016 by geographic location. One hundred fifty-four pivotal clinical trials supporting 66 NMEs were identified, and the research team analyzed demographic characteristics of 131,749 participants from 70 countries.
Results
U.S. sites contributed 31% of the 131,749 study participants. On the country level, the United States contributed the largest number of participants and other individual countries contributed 5% or less of the total trial population. Overall, 43% (n = 56,272) of the 131,747 clinical trial participants were women. Of the 40,833 U.S. participants, 49% were women as compared to 40% of the 90,914 non-U.S. participants. Similar levels of participation were seen after the exclusion of sex-specific drug indications, and by therapeutic area for U.S. and non-U.S. sites.
Conclusions
Clinical trials are becoming increasingly multi-national, and the increasing representation of women across countries is promising. FDA approval processes ensure that global data used in the drug approval process meets regulatory standards and that data can be generalized to the U.S. population.

Infectious Diseases of Poverty
http://www.idpjournal.com/content
[Accessed 4 May 2019]

Commentary
|   28 April 2019
Greater political commitment needed to eliminate malaria
Authors: Minghui Ren
Abstract
Malaria-related mortality has a very high association with poverty rates, and the disease is most prevalent in low- and middle-income countries. To achieve the malaria-specific targets of the Sustainable Development Goals, malaria-endemic countries and development partners need to take concerted action to reduce malaria cases and deaths. Reaching all affected communities with malaria interventions requires strong political commitment and a significant expansion of international and domestic financial resources. World Malaria Day 2019 is an opportunity to review progress and challenges in this field.

International Journal of Infectious Diseases
April 2019 Volume 81, p1-254
https://www.ijidonline.com/issue/S1201-9712(19)X0004-1

Original Reports
Carriage of penicillin-non-susceptible pneumococci among children in northern Tanzania in the 13-valent pneumococcal vaccine era
Matilda Emgård, Sia E. Msuya, Balthazar M. Nyombi, Dominic Mosha, Lucia Gonzales-Siles, Rickard Nordén, Shadi Geravandi, Victor Mosha, Josefine Blomqvist, Sofie Franzén, Fredrika Sahlgren, Rune Andersson, Susann Skovbjerg
p156–166
Published online: January 24, 2019

Journal of Immigrant & Refugee Studies
Volume 17, 2019 Issue 2
https://www.tandfonline.com/toc/wimm20/current

Editorial
Governing Irregular and Return Migration in the 2020s: European Challenges and Asian Pacific Perspectives
Anna Triandafyllidou & Alexandra Ricard-Guay
Pages: 115-127
Published online: 23 Feb 2019

Journal of Pharmaceutical Policy and Practice
https://joppp.biomedcentral.com/
[Accessed 4 May 2019]

Journal of Public Health Management & Practice
May/June 2019 – Volume 25 – Issue 3
https://journals.lww.com/jphmp/pages/currenttoc.aspx
Research Full Report
Varicella Vaccination Among US Adolescents: Coverage and Missed Opportunities, 2007-2014
Leung, Jessica; Reagan-Steiner, Sarah; Lopez, Adriana; More
Journal of Public Health Management and Practice. 25(3):E19-E26, May/June 2019.

Journal of Travel Medicine
Volume 26, Issue 2, 2019
https://academic.oup.com/jtm/issue/26/2

Editorial
Venezuela’s migration crisis: a growing health threat to the region requiring immediate attention
Jaime R Torres; Julio S Castro
Journal of Travel Medicine, Volume 26, Issue 2, 2019, tay141, https://doi.org/10.1093/jtm/tay141
As Venezuela’s humanitarian crisis worsens, Venezuelans are fleeing massively. South American countries unprepared to receiving such large migration flows, are struggling to respond to the needs of this population. Risk of spillover of various infectious diseases from Venezuela to other countries is a real health threat that requires immediate attention…

Journal of Travel Medicine
Volume 26, Issue 2, 2019
https://academic.oup.com/jtm/issue/26/2

Definitions matter: migrants, immigrants, asylum seekers and refugees
P Douglas; M Cetron; P Spiegel
Journal of Travel Medicine, Volume 26, Issue 2, 2019, taz005, https://doi.org/10.1093/jtm/taz005
“Migrants can be defined in legal, administrative, research and statistical perspectives. While the term refugee is clear, migrants are a heterogeneous group with a lack of consensus in the definition. This means that the public perception of states being flooded with “migrants” in a world where national borders are disappearing, leads to the humanitarian aspects to migration being diluted. As health professionals clarity around the different migrant groups assists in the manner we undertake work and our advocacy role.”.

Journal of Travel Medicine
Volume 26, Issue 2, 2019
https://academic.oup.com/jtm/issue/26/2

Embracing the challenges of migration medicine
Christina Greenaway, MD, MSc; Francesco Castelli, MD, FRCP (Lond), FFTM RCPS (Glasg), FESCMID
Journal of Travel Medicine, Volume 26, Issue 2, 2019, taz009, https://doi.org/10.1093/jtm/taz009
International migration is a global phenomenon that is growing in scope, complexity and impact. Migrants have several health disparities and promoting migrant health is increasingly recognized as a global public health priority. At this critical point in history we have the responsibility and opportunity to promote the health of the migrant population and to present a positive migrant narrative. This process has started and we need to continue the momentum.

Journal of Travel Medicine
Volume 26, Issue 2, 2019
https://academic.oup.com/jtm/issue/26/2

Perspective
Enhancing the health and safety of migrant workers
Yuka Ujita, MD, PhD; Paul J Douglas, MBBS, FRACMA; Masatoki Adachi, MD, MSc
Journal of Travel Medicine, Volume 26, Issue 2, 2019, tay161, https://doi.org/10.1093/jtm/tay161
Migrant workers typically commence the migration process as healthy individuals. However, diverse circumstances throughout migration cycle may render them highly vulnerable to poor physical and mental health outcome. This Perspective explores current data, global health policies regarding health of migrant workers, and roles travel health providers can play.

Journal of Travel Medicine
Volume 26, Issue 2, 2019
https://academic.oup.com/jtm/issue/26/2

Review
Reducing infectious disease inequities among migrants
Anita E Heywood, BSc., MPH, PhD; Rogelio López-Vélez, MD, PhD, DTM&H, Assoc. Prof
Journal of Travel Medicine, Volume 26, Issue 2, 2019, tay131, https://doi.org/10.1093/jtm/tay131

Journal of Travel Medicine
Volume 26, Issue 2, 2019
https://academic.oup.com/jtm/issue/26/2

Infectious diseases at different stages of migration: an expert review
Christina Greenaway, MD, MSc; Francesco Castelli, MD, FRCP (Lond), FFTM RCPS (Glasg), FESCMID
Journal of Travel Medicine, Volume 26, Issue 2, 2019, taz007, https://doi.org/10.1093/jtm/taz007

The Lancet
May 04, 2019 Volume 393Number 10183p1773-1910
https://www.thelancet.com/journals/lancet/issue/current

Comment
Local trends in immunisation coverage across Africa
Alexandre de Figueiredo, Fredrick Were
… In The Lancet, Jonathan Mosser and colleagues7 report estimates of diphtheria-pertussis-tetanus (DPT) vaccine coverage across the African continent at highly localised scales. With use of large-scale public health data from 49 African countries between 2000 and 2016, the authors identified local heterogeneities in DPT coverage and dropout between the first (DPT1) and third (DPT3) doses of the programme. The authors highlighted regions with persistently low coverage and high vaccine dropout rates and assessed coverage with a focus on the 80% coverage target for administrative-level units set by the Global Vaccine Action Plan (GVAP). Although geospatial models have been used previously for subnational coverage estimation in Africa,8 this analysis represents a major leap in both the breadth (a continental analysis) and the volume of data used.
Mosser and colleagues used almost 1 million immunisation records from 49 African countries by use of 183 household surveys hosted at the Global Health Data Exchange. Local coverage estimates were obtained with a Bayesian geostatistical model allowing coverage to be inferred at spatiotemporal points across Africa. Through this inference of yearly, spatially resolved estimates, Mosser and colleagues revealed novel insights in the geographical distribution of DPT coverage across Africa…

The Lancet
May 04, 2019 Volume 393Number 10183p1773-1910
https://www.thelancet.com/journals/lancet/issue/current

Articles
Mapping diphtheria-pertussis-tetanus vaccine coverage in Africa, 2000–2016: a spatial and temporal modelling study
Jonathan F Mosser, William Gagne-Maynard, Puja C Rao, Aaron Osgood-Zimmerman, Nancy Fullman, Nicholas Graetz, Roy Burstein, Rachel L Updike, Patrick Y Liu, Sarah E Ray, Lucas Earl,
Aniruddha Deshpande, Daniel C Casey, Laura Dwyer-Lindgren, Elizabeth A Cromwell, David M Pigott, Freya M Shearer, Heidi Jane Larson, Daniel J Weiss, Samir Bhatt, Peter W Gething, Christopher J L Murray, Stephen S Lim, Robert C Reiner Jr, Simon I Hay
Open Access

The Lancet
May 04, 2019 Volume 393Number 10183p1773-1910
https://www.thelancet.com/journals/lancet/issue/current

The Lancet Commissions
The legal determinants of health: harnessing the power of law for global health and sustainable development
Lawrence O Gostin, John T Monahan, Jenny Kaldor, Mary DeBartolo, Eric A Friedman, Katie Gottschalk, Susan C Kim, Ala Alwan, Agnes Binagwaho, Gian Luca Burci, Luisa Cabal, Katherine DeLand, Timothy Grant Evans, Eric Goosby, Sara Hossain, Howard Koh, Gorik Ooms, Mirta Roses Periago, Rodrigo Uprimny, Alicia Ely Yamin
Key messages
1 Law affects global health in multiple ways, by structuring, perpetuating, and mediating the social determinants of health.
2 Although law has been central to major public health achievements in the past, its capacity to advance global health with justice remains substantially underutilised, particularly among professionals in the fields of health and science.
3 The right to health, a legally binding norm, provides a foundation for advancing global health with justice and should underpin health-related legal reforms.
4 Every human being has a right to affordable, high quality health services. By embedding equity and accountability in all health systems, the law and the rule of law can achieve health coverage that is truly universal—delivering the Sustainable Development Goals’ promise to leave no one behind.
5 Although the ability to enforce compliance with international legal obligations is generally limited, and largely dependent on power dynamics and political will, creative mechanisms can foster compliance and help establish impetus for action.
6 Law can address the pressing health concerns of the 21st century, across diverse areas. From tobacco control, non-communicable diseases, and road safety, to health emergencies, law can implement fair, evidence-based interventions to save lives. The global health community should champion evidence-based legal interventions and build the research case for legal action.
7 Laws that stigmatise or discriminate against marginalised populations are especially harmful and exacerbate health disparities. The global health community must oppose laws that undermine the right to health and to equity.
8 To realise the full potential of law to advance global health with justice, the global health community should build legal capacity and establish a sustained dialogue with legislators, regulators, judges, civil society, and researchers.

The Lancet Child & Adolescent Health
May 2019 Volume 3Number 5p281-364
https://www.thelancet.com/journals/lanchi/issue/current

Editorial
Vaccine hesitancy: a generation at risk
The Lancet Child & Adolescent Health
…Vaccine hesitancy is threatening the historical achievements made in reducing the burden of infectious diseases, which have plagued humanity for centuries. Only a collaborative effort between paediatricians, family doctors, parents, public health officials, governments, the technology sector, and civil society will allow myths and misinformation around vaccination to be dispelled. If we fail, the future health of unvaccinated children and their communities will suffer greatly.

Nature
Volume 569 Issue 7754, 2 May 2019
http://www.nature.com/nature/current_issue.html

Editorial | 01 May 2019
Build a sustainable Belt and Road
China’s vast Belt and Road Initiative [BRI] is on course to reshape research in the global south. Science leaders everywhere must work to make it transparent, green and free of conflicts of interest…. The BRI is the single largest project to build infrastructure worldwide since the Marshall Plan to rebuild Europe after the Second World War. Even conservative estimates suggest that the total cost will run to around US$1 trillion…

Nature
Volume 569 Issue 7754, 2 May 2019
http://www.nature.com/nature/current_issue.html

World View | 25 April 2019
How to shape research to advance global health
Soumya Swaminathan explains how the World Health Organization’s new science division can promote universal health coverage in all countries.
Soumya Swaminathan

Nature Genetics
Volume 51 Issue 5, May 2019
https://www.nature.com/ng/volumes/51/issues/5

Editorial | 01 May 2019
Advancing cancer genomics
The field of cancer genomics is currently in an exciting and fast-paced era. With advances in sequencing technologies, computational approaches and tumor models, understanding of cancer processes is at an all-time high, and the application of new methods to studying cancer holds great promise for developing important breakthroughs in cancer treatment and prevention.

Pediatrics
May 2019, VOLUME 143 / ISSUE 5
https://pediatrics.aappublications.org/content/143/4?current-issue=y

Articles
Postvaccination Febrile Seizure Severity and Outcome
Lucy Deng, Heather Gidding, Kristine Macartney, Nigel Crawford, Jim Buttery, Michael Gold, Peter Richmond, Nicholas Wood
Pediatrics May 2019, 143 (5) e20182120; DOI: 10.1542/peds.2018-2120
This prospective cohort study is used to examine FSs in children aged ≤6 years in Australia, comparing severity and outcomes of VP-FSs to NVP-FSs.

Pediatrics
May 2019, VOLUME 143 / ISSUE 5
https://pediatrics.aappublications.org/content/143/4?current-issue=y

Missed Opportunities for Rotavirus Vaccination
Bethany K. Sederdahl, Walter A. Orenstein, Jumi Yi, Evan J. Anderson, Robert A. Bednarczyk
Pediatrics May 2019, 143 (5) e20182498; DOI: 10.1542/peds.2018-2498
Using the 2014 NIS, we describe risk factors for being unvaccinated for rotavirus as well as missed opportunities for rotavirus vaccination.

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 4 May 2019)

Editorial
Addressing critical needs in the fight to end tuberculosis with innovative tools and strategies
Mark Hatherill, Richard E. Chaisson, Claudia M. Denkinger
| published 30 Apr 2019 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1002795

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 4 May 2019)

Research Article
Evaluation of a social protection policy on tuberculosis treatment outcomes: A prospective cohort study
Tuberculosis (TB) still represents a major public health problem in Latin America, with low success and high default rates. Poor adherence represents a major threat for TB control and promotes emergence of drug-resistant TB. Expanding social protection programs could have a substantial effect on the global burden of TB; however, there is little evidence to evaluate the outcomes of socioeconomic support interventions. This study evaluated the effect of a conditional cash transfer (CCT) policy on treatment success and default rates in a prospective cohort of socioeconomically disadvantaged patients.
Karen Klein, Maria Paula Bernachea, Sarah Irribarren, Luz Gibbons, Cristina Chirico, Fernando Rubinstein
| published 30 Apr 2019 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1002788