Milestones :: Perspectives :: Research

New 2021-2025 high level strategy to leave no-one behind with immunisation approved by Gavi Board
Equitable and sustainable use of vaccines, support for health systems and healthier markets to drive Gavi’s work
Geneva, 27 June 2019 – The Gavi Board today approved a new strategy to guide the Vaccine Alliance’s work over the 2021-2025 period, prioritising reaching communities with immunisation that are currently missed, such as those in urban slums, remote areas and conflict settings.

“Gavi has achieved an incredible amount since it was founded in 2000,” said Dr Ngozi Okonjo-Iweala, Chair of the Gavi Board. “Over those two decades hundreds of millions of children have been protected against some of the world’s deadliest diseases, vaccine prices have dropped and new vaccines for diseases like pneumonia and cervical cancer have reached countries they otherwise wouldn’t have, all thanks to support from the Vaccine Alliance. For the next five-year period equity will be the Alliance’s key guiding principle. This will mean focussing on those left behind, whether they be girls and women, refugees or remote communities, to ensure nobody goes without lifesaving vaccines.”

The new strategy, which is the culmination of 18 months of consultations with stakeholders, analysis and discussion, will be anchored in the Sustainable Development Goals, echoing its driving mission to leave no one behind. To do this it will target four goals to save lives and protect people’s health by increasing the equitable and sustainable use of vaccines:

1. To introduce and scale-up vaccines
Since 2000, Gavi has supported countries to conduct more than 400 introductions of new and under-used vaccines. In Gavi’s first phase the Alliance began by supporting vaccines that protect against six infectious diseases. By 2025 this will have increased to at least 18, including the inactivated polio vaccine (IPV) and new vaccines like rabies, hepatitis B birth dose and multivalent meningococcal. Gavi will also support vaccines, like those for Ebola, cholera and typhoid, that tackle outbreaks, fight antimicrobial resistance and boost global health security. Given the increasing number of Gavi-supported vaccines, the Alliance will help countries to prioritise vaccines based on local epidemiology, national capacity and sustainability considerations.

2. Strengthen health systems to increase equity in immunisation
Gavi-supported countries reached a record 64 million children with a full course of basic vaccines in 2017, up from 41 million in 2000. Yet still as many as one in ten children in Gavi-supported countries receive no routine vaccines. To reach these missing millions Gavi will bring a much stronger focus on reaching those most marginalised, by strengthening primary healthcare systems, building and sustaining community demand, and using innovation to ensure that immunisation services reach these children. It will also bring a greater focus and enhanced approach to tackle gender-related barriers that stand in the way of reaching every child.

3. Improve sustainability of immunisation programmes
Gavi actively works with supported countries so they co-finance and gradually take over the financing of their vaccines as they get wealthier. In this regard, countries transition out of Gavi support over time, with the Alliance supporting them so their immunisation programmes remain strong. From 2011 to 2018, countries have increased the amount they themselves spend on Gavi-supported vaccines from US$ 36 million to US$ 475 million, and 19 countries are expected to have transitioned out of Gavi support completely by 2020. Gavi will continue its work building political support and increasing domestic public resources for immunisation and primary health care, as well as supporting countries as they move away from Gavi funding to self-finance their vaccine programmes.

4. Ensure healthy markets for vaccines and related products
Since Gavi was founded in 2000, its market shaping work has helped increase the number of vaccine manufacturers supplying Gavi-eligible countries has expanded from 5 to 17 and prices have reduced dramatically. In recent years the Alliance has widened the focus of its market shaping work towards building healthy markets for each of its vaccines, as well as related products like cold-chain equipment. Gavi will continue to work on balancing all the elements necessary to ensure healthy market dynamics for vaccines and immunisation-related products, focusing on reliable, consistent and affordable supply as an overarching objective. It will also bring a more purposeful approach to driving innovation for immunisation-related products and services.

“For Gavi, the 2021-25 period will mean new vaccines, new technologies and new approaches to help build healthier, wealthier communities across the developing world,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. “With this new strategy we will make the millions of children around the world who are missing out on vaccines our absolute priority. By bringing immunisation to these missed communities the Alliance will also be extending primary health care systems, building a foundation for Universal Health Coverage. We will be bringing all the economic benefits that come with a healthier population, and we will provide a first line of defence against deadly outbreaks, boosting global health security. That’s why this strategy will help ensure that immunisation makes a powerful contribution to the success of the Sustainable Development Goals.”

To support the global effort to eradicate polio and mitigate the risk of the disease re-emerging, the Board also agreed a cost-sharing approach for the inactivated polio vaccine (IPV). Gavi will fully-finance the vaccine for the very poorest countries, however other countries which receive Gavi support for IPV will need to use the amount they currently spend on bivalent oral polio vaccine (bOPV) – roughly US$ 0.60 per child – for IPV once bOPV is withdrawn after eradication is certified. Gavi will provide the remaining finance.

In addition, the Board requested that the Gavi Secretariat explore approaches to engaging with self-financing lower middle-income countries in recognition of major challenges in those countries.

As part of the Gavi Board meeting, which took place in Geneva on 26-27 June, the Board also exceptionally approved an extension of Papua New Guinea’s (PNG) accelerated transition phase until the end of 2025. The country had been due to transition out of Gavi support at the end of 2020. But it remains extremely fragile, with a very weak health system, the lowest vaccine coverage in the region, high child mortality and recent outbreaks of polio and measles despite considerable economic growth driven by the extractive industries. The Board therefore agreed that this exceptional situation warranted an extension to the country’s transition, subject to the government setting out and committing to reforms to the health sector.

The plans set out in the strategy, including funding for all vaccines, are dependent on a successful replenishment for the 2021-25 period, which will culminate in a pledging event next summer in London. The replenishment process will begin at a high-level event hosted by the Japanese government on the occasion of TICAD 7 in Yokohama in August 2019, where Gavi will launch its investment opportunity for the next period. Richard Clarke, Director General for Policy, Research and Humanitarian at the UK Department for International Development (DFID), and Masashi Nakagome, Minister at the Permanent Mission of Japan in Geneva, both addressed the Board meeting to discuss these events and the road to replenishment.

Gavi’s unique public-private partnership model means it needs predictable financing to allow manufacturers and implementing countries to forecast demand over a five-year period. This helps to drive value for money and maximise the impact of every dollar invested in the Vaccine Alliance. The upcoming 2021-25 strategic period will be Gavi’s fifth.

Milestones :: Perspectives :: Research

DRC – Ebola/Measles/Cholera/Polio

Disease Outbreak News (DONs}
Ebola virus disease – Democratic Republic of the Congo
27 June 2019
The Ebola virus disease (EVD) outbreak in the North Kivu and Ituri provinces continues at a stable pace this week. Although response operations were temporarily interrupted in Beni following two days of insecurity in the surrounding areas, operations have largely resumed. However, in the town of Musienene, violent threats persist against healthcare workers (HCW) and local security forces providing assistance to the response efforts. Furthermore, response activities in Kambau health area, Manguredjipa health zone were also suspended following security incidents.
Of growing concern this week, are the current hotspots of Mabalako, particularly the Aloya health area, and Mandima (Figure 1), which were the first health zones to report EVD cases in August/September 2018. Sporadic reintroduction events in areas such as Vuhovi, which had not reported any new cases in the past 24 days, further compound the evolving situation. Other areas experiencing a similar resurgence in EVD cases after a period of prolonged absence include Komanda and Masereka…

47: Situation report on the Ebola outbreak in North Kivu
25 June 2019
…Implementation of ring vaccination protocol
:: As of 22 June 2019, 140 794 people at risk have consented to and received the rVSV-ZEBOV-GP Ebola vaccine. Of those, 37 373 are contacts and 67 756 contacts-of-contacts. The total number of vaccines includes 31 016 HCWs/FLWs and 34 522 children 1-17 years of age.

:: Five new rings were opened around nine confirmed cases on 18 June 2019, another four new rings were opened around seven new cases on 17 June 2019 and an additional ring around two cases reported on 22 June 2019.

:: Despite the challenges in the field and considering the cases reported between 30 April 2019 and 20 May 2019, only 31/337 (9.2%) of the cases do not have a ring defined and their contacts and contacts-of-contacts vaccinated. For 113/337 (33.5%) of the cases the ring vaccination was completed and for 193/337 (57.2%) ring vaccination was ongoing at the time of writing this report. This important progress is the result of the use of innovative delivery strategies (i.e. pop-up vaccination and targeted geographic vaccination) and strong community negotiations and engagement.

Risk communication, social mobilization and community engagement
:: Mass communication on the Ebola outbreak situation and the response activities are being aired on over 100 radio stations, particularly in outbreak hotspots to update the public on the situation in their localities and to urge their collaboration in stopping the outbreak. Discussions on Ebola are also regularly organized to address community concerns and clarify misinformation that may be spreading through various social media or other platforms.

:: Community Ebola committees have been actively engaged in the Ebola response in 20 localities in Butembo, Katwa and Vuhovi. These areas were previously difficult to reach due to security and other challenges.

:: To expand community ownership of the Ebola response to other Ebola-affected and non-affected areas in and around North Kivu and Ituri, a Community Animation Committee (CAC), which is a community participation platform for health, is being established in 1600 areas over the next weeks.

:: Social scientists are working with local communities in Mangina and other areas to better understand the local practices that can influence a community’s health./..

Polio this week as of 26 June 2019 – GPEI
:: Two new cVDPV2 emergences are reported this week in DR Congo; one from Sankuru province and one from Kasai province. Sankuru province is in the centre of the country and had previously not participated in mOPV2 outbreak response campaigns.  However, it is neighboring known infected provinces, where mOPV2 response continues to be implemented.  Kasai had already been participating in mOPV2 outbreak campaigns, as it had already been affected by a separate cVDPV2.  Currently, total six, genetically-distinct cVDPV2 outbreaks affecting the country.

Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 26 June 2019
:: Two new cVDPV2 emergences are reported this week in DR Congo; one from Sankuru province and one from Kasai province. Sankuru province is in the centre of the country and had previously not participated in mOPV2 outbreak response campaigns.  However, it is neighboring known infected provinces, where mOPV2 response continues to be implemented.  Kasai had already been participating in mOPV2 outbreak campaigns, as it had already been affected by a separate cVDPV2.  Currently, total six, genetically-distinct cVDPV2 outbreaks affecting the country.
:: One of the major factors that determines whether a child will receive vaccinations is the primary caregiver’s receptiveness to immunization.  The decision to vaccinate is a complex interplay of various socio-cultural, religious, and political factors. Read how everyday people in Pakistan are advocating for vaccinations.
:: Bayelsa State in the Niger Delta, Nigeria, is a riverine state with precarious transportation and rivers crisscrossing the land. Thanks to healthcare workers, community engagement and innovations in immunization practices, Bayelsa State jumped from one of the most poor-performing states in terms of routine immunization to be the second best in the country. Read more here.
Summary of new viruses this week:

Summary of new viruses this week:
:: Afghanistan — two wild poliovirus type 1 (WPV1) cases;
:: Pakistan — three WPV1 cases;
:: Nigeria — one circulating vaccine-derived poliovirus type 2 (cVDPV2) case;
:: DRC— four cVDPV2 cases;
:: Ethiopia— three cVDPV2 isolated from healthy community contacts.

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

WHO Grade 3 Emergencies [to 29 Jun 2019]

Democratic Republic of the Congo
:: Winning the hearts of communities fearful of Ebola 24 June 2019
:: 47: Situation report on the Ebola outbreak in North Kivu 25 June 2019
:: Disease Outbreak News (DONs} Ebola virus disease – Democratic Republic of the Congo
27 June 2019
[See DRC Ebola above for detail]

Mozambique floods
:: 200 000 people lack access to health services in Mozambique 21 June 2019

Nigeria
:: States in Nigeria’s South West zone conclude second round of outbreak response
26 June 2019 All six States in the South West Zone have completed the ‘2nd Outbreak Response’ (OBR2) to the circulating Vaccine Derived Polio Virus (cVDPV2) with varying degrees of success. The exercise, implemented on 15 – 24 June, was in response to confirmed reports by the Lagos State Government of environmental strains of Polio Virus in Makoko, Itire and Maracana canals, as well as in Imeko Afon LGA of Ogun State.
Initial large-scale zonal supplementary immunization activities were coordinated across all States (Lagos, Ogun, Osun, Oyo, Ondo and Ekiti), during the OBR1 conducted on 18 -21 May, 2019. Polio eradication teams on the ground covered 89,841 settlements. The teams maximized the impact of available resources and ensured that oral polio vaccine be administered to 9,927,112 under-five year old children in all the States…

Somalia
:: WHO and UNICEF Somalia and partners call on all Somalis to vaccinate children against polio
25 June 2019

Myanmar – No new digest announcements identified
South Sudan – No new digest announcements identified
Syrian Arab Republic – No new digest announcements identified
Yemen – No new digest announcements identified

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WHO Grade 2 Emergencies [to 29 Jun 2019]

Bangladesh – Rakhine conflict
:: Bi‐weekly Situation Report 12 – 20 June 2019

Libya
:: Mental health support in a time of war 25 June 2019
:: Mental illness: training Libya’s health workers 24 June 2019

Afghanistan – No new digest announcements identified
Cameroon – No new digest announcements identified
Central African Republic – No new digest announcements identified
Cyclone Idai – No new digest announcements identified
Ethiopia – No new digest announcements identified
Iran floods 2019 – No new digest announcements identified
Iraq – No new digest announcements identified
Malawi floods – 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 29 Jun 2019]

Angola – No new digest announcements identified
Chad – No new digest announcements identified
Djibouti – No new digest announcements identified
Indonesia – Sulawesi earthquake 2018 – No new digest announcements identified
Kenya – No new digest announcements identified
Mali – No new digest announcements identified
Namibia – viral hepatitis – 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
:: Syrian Arab Republic: Recent Developments in Northwestern Syria Situation Report No. 6 – as of 28 June 2019

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.
Editor’s Note:
Ebola in the DRC has bene added as a OCHA “Corporate Emergency” this week:
CYCLONE IDAI and Kenneth
:: Assistant Secretary-General for Humanitarian Affairs and Deputy Emergency Relief Coordinator, Ursula Mueller – Opening remarks at ECOSOC Humanitarian Affairs Segment Side Event “Cyclone Idai: The Ongoing Needs,” 26 June 2019

EBOLA OUTBREAK IN THE DRC – No new digest announcements identified

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WHO & Regional Offices [to 29 Jun 2019]
27 June 2019 News release
Eliminating trachoma: WHO announces sustained progress with hundreds of millions of people no longer at risk of infection

27 June 2019 News release
A New WHO Goodwill Ambassador for Universal Health Coverage
Professor Keizo Takemi. Japan

26 June 2019
WHO advice for international travel in relation to measles
Measles is one of the world’s most contagious diseases and the best protection against the disease is through receiving two doses of the measles vaccine.
Over recent months, spikes in measles case numbers have occurred including in countries with high overall vaccination coverage as the disease has spread fast among clusters of unvaccinated people.

25 June 2019 News release
WHO and UNICEF Somalia and partners call on all Somalis to vaccinate children against polio
Mogadishu, 25 June 2019 – Health authorities rolled out a polio campaign yesterday in Puntland and Somaliland to vaccinate more than 940,000 children under 5 years of age to stop an ongoing outbreak of a strain of poliovirus.
The campaign runs from 24 to 27 June 2019, with support from the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF). It targets all children in 12 districts in Somaliland and 9 districts in Puntland.
By the numbers:
:: 945,480 children to be vaccinated
:: 3160 vaccinators knocking on doors
:: 677 team supervisors taking part
:: 1558 social mobilizers sharing messages on vaccination and children’s health
:: 15 children have been infected with the polioviruses so far, since outbreaks began

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Weekly Epidemiological Record, 28 June 2019, vol. 94, 26 (pp. 293–300)
:: Index of countries/areas
:: Index, Volume 94, 2019, Nos. 1–26
:: Weekly Epidemiological Record, 24 May 2019, vol. 94, SPECIAL ISSUE (pp. i–xlviii)
:: Validation of elimination of maternal and neonatal tetanus in Chad

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WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: Ethiopia sets new standards for the management of acute malnutrition 28 June 2019
:: Behind the scenes in the Ebola response : The call centre manager 27 June 2019
:: WHO Regional Director commends Uganda’s Ebola preparedness response 26 June 2019
:: Winning the hearts of communities fearful of Ebola 24 June 2019

WHO Region of the Americas PAHO
:: PAHO Executive Committee concludes sessions with agreements on advancing health in the Region of the Americas
Washington, DC, June 28, 2019 (PAHO/WHO) – The Executive Committee of the Pan American Health Organization (PAHO) concluded its 164th session on June 27, following discussions and deliberations on a variety of strategies, actions plans and policies that address a number of key health challenges for the population in the Americas.
Issues that were advanced during the Committee include: strategies and action plans to improve quality of care in health service delivery; to ensure donations and equitable access to organ, tissue and cell transplants; on ethnicity and health; and on health promotion within the context of the Sustainable Development Goals. The Executive Committee also addressed issues around the elimination of industrially produced trans-fatty acids, and the strengthening of information systems for health, as well as a PAHO disease elimination initiative for an integrated approach to communicable disease…

WHO South-East Asia Region SEARO
No new digest content identified.

WHO European Region EURO
:: Alongside European Development Days, WHO and the European Commission reinforce cooperation to help countries move towards universal health coverage 26-06-2019

WHO Eastern Mediterranean Region EMRO
:: Ending cholera in Somalia 26 June 2019
:: Vaccines protect children from preventable diseases in Iraq 23 June 2019
:: Cholera vaccination drive begins in high-risk districts in Somalia 23 June 2019

WHO Western Pacific Region
– No new digest announcements identified

CDC/ACIP [to 29 Jun 2019]
http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html
Thursday, June 27, 2019
CDC Press Release: Most Americans Have Never Had an HIV Test, New Data Show
The CDC recommends that everyone between the ages of 13 – 64 years be screened at least once in their lifetime, yet less than 40% of people in the U.S. have ever been tested for HIV, according to a CDC report published today in the Morbidity and Mortality Weekly Report (MMWR).

The new data, released on National HIV Testing Day, underscore the urgent need to scale up HIV testing to end America’s HIV epidemic. The analysis of 2016-2017 data from a national population-based survey suggest most people are not getting the recommended screening, even in areas with a high burden of HIV. Highlights of the analysis include the following:
:: Overall, fewer than 40% of people in the United States have ever had an HIV test.
:: Nationally, less than 30% of people in the United States most at risk of acquiring HIV were tested in the past year.
:: In the 50 local jurisdictions where more than half of HIV diagnoses occur, less than 35% of people recommended for annual HIV testing were tested in the past year.
:: In states with rural areas that are particularly affected by HIV, just 26% of people recommended for annual HIV testing were tested in the past year…

MMWR News Synopsis for Friday, June 28, 2019
HIV Screening in 50 Local Jurisdictions Accounting for the Majority of New HIV Diagnoses and Seven States with Disproportionate Occurrence of HIV in Rural Areas, 2016–2017
CDC analysis demonstrates the urgent need to expand HIV testing as part of the proposed federal plan to end the U.S. HIV epidemic. CDC recommends that everyone ages 13-64 years be screened for HIV at least once in their lifetime. New CDC data show that fewer than 40% of people in the U.S. have ever been tested for HIV. The 2016-2017 data, from a national population-based survey, suggest that most people are not getting the recommended screening – even in areas with the greatest burden of HIV. Expanding HIV testing is a critical part of the proposed federal plan to end the U.S. HIV epidemic, as testing can be a gateway to prevention options like pre-exposure prophylaxis (PrEP) or can link a person with HIV to care and treatment that protects their health and prevents new infections.

Africa CDC [to 29 Jun 2019]
https://au.int/en/africacdc
June 24, 2019
Training of Trainers Workshop on Public Health Emergency Operations Centres Open
A nine-day training of trainers workshop on the management and operations of a Public Health Emergency Operations Centre (PHEOC) opened in Addis Ababa, Ethiopia, Monday 24 June 2019. Thirty-one trainees from 21 African Union Member States and Saudi Arabia are participating in the workshop, which is facilitated jointly by the West Africa Health Organization (WAHO), WHO Headquarters, WHO Regional Office for Africa, WHO Regional Office for the Eastern Mediterranean, US CDC and Africa CDC.

China CDC
http://www.chinacdc.cn/en/
No new digest content identified.

National Health Commission of the People’s Republic of China
http://en.nhc.gov.cn/
No new digest content identified.

China CDC
http://www.chinacdc.cn/en/
No new digest content identified.

National Health Commission of the People’s Republic of China
http://en.nhc.gov.cn/
No new digest content identified.

Announcements

Paul G. Allen Frontiers Group [to 29 Jun 2019]
https://alleninstitute.org/what-we-do/frontiers-group/news-press/
No new digest content identified.

BMGF – Gates Foundation [to 29 Jun 2019]
http://www.gatesfoundation.org/Media-Center/Press-Releases
No new digest content identified.

Bill & Melinda Gates Medical Research Institute [to 29 Jun 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 29 Jun 2019]
https://carb-x.org/
CARB-X is a non-profit public-private partnership dedicated to accelerating antibacterial research to tackle the global rising threat of drug-resistant bacteria.
No new digest content identified.

CEPI – Coalition for Epidemic Preparedness Innovations [to 29 Jun 2019]
http://cepi.net/
No new digest content identified.

Clinton Health Access Initiative, Inc. (CHAI) [to 29 Jun 2019]
https://clintonhealthaccess.org/about/
No new digest content identified.

EDCTP [to 29 Jun 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 29 Jun 2019]
http://www.vaccines.emory.edu/
No new digest content identified.

European Medicines Agency [to 29 Jun 2019]
http://www.ema.europa.eu/ema/
News and press releases
No new digest content identified.

European Vaccine Initiative [to 29 Jun 2019]
http://www.euvaccine.eu/news-events
No new digest content identified.

FDA [to 29 Jun 2019]
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
No new digest content identified.

Fondation Merieux [to 29 Jun 2019]
http://www.fondation-merieux.org/
No new digest content identified.

Gavi [to 29 Jun 2019]
https://www.gavi.org/
27 June 2019
New 2021-2025 high level strategy to leave no-one behind with immunisation approved by Gavi Board
[See Milestones above for detail]

GHIT Fund [to 29 Jun 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 29 Jun 2019]
https://www.theglobalfund.org/en/news/
News
Global Fund Praises UK for Increasing Pledge by 16 Percent
29 June 2019
The Global Fund congratulated the United Kingdom for demonstrating outstanding leadership in global health with a strong commitment to help end AIDS, tuberculosis and malaria and save millions of lives around the world

News
Global Fund Welcomes Japan’s Commitment to Save One Million Lives
24 June 2019

Hilleman Laboratories [to 29 Jun 2019]
http://www.hillemanlabs.org/
26 June 2019
Hilleman Laboratories licenses Oral Cholera Vaccine Hillchol® to Bharat Biotech
Collaboration seeks to accelerate the development, licensure, manufacture and supply of an affordable, next-generation Cholera vaccine to support access in low and middle-income coun-tries
New Delhi, 26th June 2019: Hilleman Laboratories, a global research and development organization focused on delivering high-impact and affordable vaccines, announced today that it has entered into a collaboration with Bharat Biotech International Ltd. (BBIL), a leading vaccine and biotechnology company in India for further development, manufacturing and commercialization of its next-generation Oral Cholera Vaccine, Hillchol®. This collaboration will strengthen the ability of both organizations towards prevention of Cholera through rapid and cost-effective deployment of vaccine doses in low and middle-income countries…
…Hillchol® was designed at the University of Gothenburg in Sweden and subsequently developed by Hilleman Labs including demonstration of safety and immunogenicity in an age de-escalating Phase I/II clinical trial conducted in Bangladesh with the assistance of icddr,b and Incepta Vac-cines Ltd. For further development of Hillchol®, Hilleman Labs has entered into a licensing and manufacturing agreement with BBIL, who will scale the manufacturing process to commercial stage and establish product specifications required for WHO pre-qualification…

Human Vaccines Project [to 29 Jun 2019]
http://www.humanvaccinesproject.org/media/press-releases/
No new digest content identified.

IAVI [to 29 Jun 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 29 Jun 2019]
http://media.ifrc.org/ifrc/news/press-releases/
Selected Press Releases, Announcements
No new digest content identified.

IVAC [to 29 Jun 2019]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
June 2019
IVAC-led PERCH study reveals viruses as new leading cause of global childhood pneumonia
Results from PERCH highlight the need for new vaccines, especially against respiratory syncytial virus

IVI [to 29 Jun 2019]
http://www.ivi.int/
IVI News & Announcements
No new digest content identified.

JEE Alliance [to 29 Jun 2019]
https://www.jeealliance.org/
Selected News and Events
No new digest content identified.

MSF/Médecins Sans Frontières [to 29 Jun 2019]
http://www.msf.org/
Selected News; Project Updates, Reports
Democratic Republic of Congo
Urgent humanitarian response needed on unprecedented crises in…
Press Release 27 Jun 2019
:: People in the northeastern DRC province of Ituri are currently facing an unprecedented four concurrent crises.
:: The needs among people are great, with high levels of disease, yet MSF’s previous calls for help have gone unheeded.
:: MSF calls for other humanitarian organisations to urgently commit to the long-term scale up of assistance to people in Ituri.

El Salvador
La Peralta: a community organised by health
Project Update 27 Jun 2019

Mexico
Life amidst the violence: the strong women of Guerrero
Voices from the Field 27 Jun 2019

Access to medicines
Gilead fails to keep promise on access to lifesaving drug for peop… liposomal amphotericin B (L-AmB)
Press Release 27 Jun 2019

Yemen
The indirect consequences of war for people in Yemen
Project Update 25 Jun 2019

NIH [to 29 Jun 2019]
http://www.nih.gov/news-events/news-releases
June 25, 2019
NIH launches large TB prevention trial for people exposed to multidrug-resistant TB
— Study will compare delamanid to isoniazid for preventing TB disease in at-risk contacts.
A large clinical trial to assess treatments for preventing people at high risk from developing multidrug-resistant tuberculosis (MDR-TB) has begun. The study is comparing the safety and efficacy of a new MDR-TB drug, delamanid, with the decades-old TB drug isoniazid for preventing active MDR-TB disease in children, adolescents and adults at high risk who are exposed to adult household members with MDR-TB. Study participants are at high risk for MDR-TB because they either have latent TB infection, immune systems suppressed by HIV or other factors, or are younger than age 5 years and therefore have a weak immune system…

PATH [to 29 Jun 2019]
https://www.path.org/media-center/
No new digest content identified.

Sabin Vaccine Institute [to 29 Jun 2019]
http://www.sabin.org/updates/pressreleases
No new digest content identified.

UNAIDS [to 29 Jun 2019]
http://www.unaids.org/en
Selected Press Releases/Reports/Statements
28 June 2019
No end to AIDS without respecting human rights

Positive movement: safety, trust and services for people who inject drugs

New modelling research shows partial progress in South Africa’s response to HIV

27 June 2019
Deported, denied access, discriminated against because of their HIV status

South Africa: pace really matters

26 June 2019
Civil society engagement in universal health coverage

25 June 2019
Pushing for harm reduction success in Burundi

UNICEF [to 29 Jun 2019]
https://www.unicef.org/media/press-releases
Selected Statements, Press Releases, Reports
UN Headquarters to host groundbreaking discussion on vaccine misinformation and growing distrust
Experts, UN officials and private sector representatives to convene to address drivers of vaccine hesitancy and stagnating immunization rates worldwide
27 June 2019

Press release
Migrant children in the U.S. lack protection and services needed to ensure their wellbeing
As two-year-old Valeria’s death shows, coordinated action urgently needed to address root causes of irregular migration and keep children safe – Statement from UNICEF Executive Director Henrietta Fore
26/06/2019

Press release
Access to basic sanitation still lagging for millions in East and Southern Africa
UNICEF convenes sanitation stakeholders to strengthen regional and local markets for equitable access for children and their families
25/06/2019

Vaccine Confidence Project [to 29 Jun 2019]
http://www.vaccineconfidence.org/
No new digest content identified.

Vaccine Education Center – Children’s Hospital of Philadelphia [to 29 Jun 2019]
http://www.chop.edu/centers-programs/vaccine-education-center
No new digest content identified.

Wellcome Trust [to 29 Jun 2019]
https://wellcome.ac.uk/news
Opinion | 27 June 2019
New programme to explore how innovation in health data can benefit everyone
James Thomas, Chief Technology Officer Wellcome
Artificial intelligence (AI) and data technologies are transforming research and healthcare. To ensure everyone can benefit from health data innovation, Wellcome is investing £75 million in a five-year programme on data for science and health

24 June 2019
Christiane Hertz-Fowler joining Wellcome to head our Infection and Immunobiology team

Funding Scheme: Impact of Vaccines on Antimicrobial Resistance
This scheme supports researchers investigating the impact of vaccines on antibiotic use and/or antimicrobial resistance. The aim is to support and inform vaccine decision-makers around the world and tackle antimicrobial resistance.
Scheme at a glance
:: Career stage: Leading a research program
:: Where your host organisation is based: Anywhere in the world
:: Level of funding: Small awards are up to £250,000. Large awards are £250,000 to £750,000.
:: Duration of funding: Flexible, depending on level of funding
:: Expressions of interest submitted by email
As soon as possible – no later than 6 September 2019, 17:00 BST
:: Invited full applications deadline
12 September 2019, 17:00 BST

The Wistar Institute [to 29 Jun 2019]
https://www.wistar.org/news/press-releases
No new digest content identified.

World Organisation for Animal Health (OIE) [to 29 Jun 2019]
http://www.oie.int/en/for-the-media/press-releases/2019/
No new digest content identified.

::::::

BIO [to 29 Jun 2019]
https://www.bio.org/insights/press-release
No new digest content identified.

DCVMN – Developing Country Vaccine Manufacturers Network [to 29 Jun 2019]
http://www.dcvmn.org/
No new digest content identified.

IFPMA [to 29 Jun 2019]
http://www.ifpma.org/resources/news-releases/
No new digest content identified.

PhRMA [to 29 Jun 2019]
http://www.phrma.org/press-room
No new digest content identified.

Industry Watch
:: CDC Advisory Committee on Immunization Practices (ACIP) Votes to Provisionally Recommend Shared Clinical Decision-Making for Vaccination of Adults Ages 27-45 with GARDASIL®9 & Harmonization of Catch-up Vaccination for Males and Females Through Age 26
June 26, 2019 04:45 PM Eastern Daylight Time
KENILWORTH, N.J.–(BUSINESS WIRE)–Merck (NYSE: MRK), known as MSD outside the United States and Canada, today announced the U.S. Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices (ACIP) voted to recommend HPV vaccination with GARDASIL®9 (Human Papillomavirus 9-valent Vaccine, Recombinant) based on shared clinical decision making for individuals 27 through 45 years of age who are not adequately vaccinated. The ACIP also voted to expand routine and catch-up recommendations for males through 26 years of age who are not adequately vaccinated. The CDC currently recommends routine vaccination of females and males 11-12 years of age, and vaccination can begin at age 9. If approved by the CDC, GARDASIL 9 recommendations would be expanded to include females and males 13-26 years of age who have not previously been vaccinated, and for adults 27-45 years of age the decision to vaccinate would be made between an individual and their healthcare provider.

Details of the ACIP recommendations for GARDASIL 9 will be available from the CDC. The provisional recommendations are reviewed by the director of the CDC and the Department of Health and Human Services and final recommendations will become official when published in the CDC’s Morbidity and Mortality Weekly Report (MMWR).

GARDASIL 9 is indicated for use in females aged 9-45 for the prevention of cervical, vulvar, vaginal and anal cancers caused by HPV types 16, 18, 31, 33, 45, 52 and 58, precancerous or dysplastic lesions caused by HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58, and genital warts caused by HPV types 6 and 11. GARDASIL 9 is also indicated for use in males aged 9-45 for the prevention of anal cancer caused by HPV types 16, 18, 31, 33, 45, 52 and 58, precancerous or dysplastic lesions caused by HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58, and genital warts caused by HPV types 6 and 11.

GARDASIL 9 is contraindicated in individuals with hypersensitivity, including severe allergic reactions to yeast, or after a previous dose of GARDASIL 9 or GARDASIL® [Human Papillomavirus Quadrivalent (Types 6, 11, 16 and 18) Vaccine, Recombinant].

In the U.S., almost half of new HPV infections occur in adults 25 years of age or older. Approximately 23,000 Americans are diagnosed with cervical, vaginal, vulvar, and anal cancers associated with HPV every year, according to latest published incidence from 2015. The nine types of HPV covered in GARDASIL 9 cause the majority of HPV-related cancers and other diseases in women and men. Even though adults may have already been exposed to some types of HPV covered by the vaccine, GARDASIL 9 may help protect against certain cancers and diseases caused by any of the nine HPV types to which someone has not yet been exposed.

“With more than a 100-year legacy in vaccines, Merck is deeply passionate about impacting public health through providing our broad portfolio of vaccines to people around the world,” said Dr. Richard M. Haupt, vice president and head of vaccines and infectious diseases, Global Medical Affairs at Merck. “We applaud the ACIP and the CDC for their continued efforts to address the significant burden of HPV-related cancers by continuously evaluating vaccination recommendations utilizing a comprehensive body of scientific evidence.”…

Journal Watch
Vaccines and Global Health: The Week in Review continues its weekly scanning of key peer-reviewed journals to identify and cite articles, commentary and editorials, books reviews and other content supporting our focus on vaccine ethics and policy. Journal Watch is not intended to be exhaustive, but indicative of themes and issues the Center is actively tracking. We selectively provide full text of some editorial and comment articles that are specifically relevant to our work. Successful access to some of the links provided may require subscription or other access arrangement unique to the publisher.
If you would like to suggest other journal titles to include in this service, please contact David Curry at: david.r.curry@centerforvaccineethicsandpolicy.org

BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content
(Accessed 29 Jun 2019)

Research article
Cost effectiveness of school-located influenza vaccination programs for elementary and secondary school children
Studies have noted variations in the cost-effectiveness of school-located influenza vaccination (SLIV), but little is known about how SLIV’s cost-effectiveness may vary by targeted age group (e.g., elementary …
Authors: Byung-Kwang Yoo, Stanley J. Schaffer, Sharon G. Humiston, Cynthia M. Rand, Nicolas P. N. Goldstein, Christina S. Albertin, Cathleen Concannon and Peter G. Szilagyi
Citation: BMC Health Services Research 2019 19:407
Published on: 24 June 2019

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 29 Jun 2019)

Research article
Assessing the cost-effectiveness of HPV vaccination strategies for adolescent girls and boys in the UK
Human papillomavirus (HPV) is the most widespread sexually transmitted infection worldwide. It causes several health consequences, in particular accounting for the majority of cervical cancer cases in women. I…
Authors: Samik Datta, Joshua Pink, Graham F. Medley, Stavros Petrou, Sophie Staniszewska, Martin Underwood, Pam Sonnenberg and Matt J. Keeling
Citation: BMC Infectious Diseases 2019 19:552
Published on: 24 June 2019

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 29 Jun 2019)

Research article
Observational study of a new strategy and management policy for measles prevention in medical personnel in a hospital setting
At the end of March 2018, a clustered outbreak of measles associated with health care workers occurred in northern Taiwan. Prior to this study, the policy for measles vaccination for physicians and nurses in M…
Authors: Chang-Pan Liu, Hsi-Peng Lu and Tainyi Luor
Citation: BMC Infectious Diseases 2019 19:551
Published on: 21 June 2019

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 29 Jun 2019)

Research article
HPV vaccination has not increased sexual activity or accelerated sexual debut in a college-aged cohort of men and women
The human papillomavirus (HPV) is the most common sexually transmitted infection and is linked to several types of cancer. HPV vaccination uptake in the U.S. is relatively low, despite the vaccine’s high effic…
Authors: Andrew F. Brouwer, Rachel L. Delinger, Marisa C. Eisenberg, Lora P. Campredon, Heather M. Walline, Thomas E. Carey and Rafael Meza
Citation: BMC Public Health 2019 19:821
Published on: 25 June 2019

Emerging Infectious Diseases
Volume 25, Number 7—July 2019
http://wwwnc.cdc.gov/eid/

Historical Review
Facility-Associated Release of Polioviruses into Communities—Risks for the Posteradication Era [PDF – 2.45 MB – 7 pages]
A. S. Bandyopadhyay et al.
Abstract
The Global Polio Eradication Initiative continues to make progress toward the eradication target. Indigenous wild poliovirus (WPV) type 2 was last detected in 1999, WPV type 3 was last detected in 2012, and over the past 2 years WPV type 1 has been detected only in parts of 2 countries (Afghanistan and Pakistan). Once the eradication of poliomyelitis is achieved, infectious and potentially infectious poliovirus materials retained in laboratories, vaccine production sites, and other storage facilities will continue to pose a risk for poliovirus reintroduction into communities. The recent breach in containment of WPV type 2 in an inactivated poliovirus vaccine manufacturing site in the Netherlands prompted this review, which summarizes information on facility-associated release of polioviruses into communities reported over >8 decades. Successful polio eradication requires the management of poliovirus containment posteradication to prevent the consequences of the reestablishment of poliovirus transmission.

Global Health: Science and Practice (GHSP)
June 2019 | Volume 7 | Number 2
http://www.ghspjournal.org/content/current

EDITORIALS
Open Access
Human-Centered Design and Sustainable Malaria Interventions
Michael Macdonald and Thomas Putzer
Global Health: Science and Practice June 2019, 7(2):148-149; https://doi.org/10.9745/GHSP-D-19-00189
Human-centered design provides a method to adapt malaria control interventions to be more closely aligned with a family’s convenience, comfort, and personal lifestyle, enabling a broader and more sustained culture of access and use.

Globalization and Health
http://www.globalizationandhealth.com/
[Accessed 24 Nov 2018]

Research
|   27 June 2019
Importance of the intellectual property system in attempting compulsory licensing of pharmaceuticals: a cross-sectional analysis
Authors: Kyung-Bok Son
Abstract
Background
Recently, interest in compulsory licensing of pharmaceuticals has been growing regardless of a country’s income- level. We aim to investigate the use of compulsory licensing as a legitimate part of the patent system and tool for the government to utilize by demonstrating that countries with a mature patent system were more likely to utilize compulsory licensing of pharmaceuticals.
Methods
We used a multivariate logistic model to regress attempts to issue compulsory licensing on the characteristics of the intellectual property system, controlling for macro context variables and other explanatory variables at a country level.
Results
A total 139 countries, selected from members of the World Trade Organization, were divided into a CL-attempted group (N = 24) and a non-CL-attempted group (N = 115). An attempt to issue compulsory licensing was associated with population (+) and a dummy variable for other regions, including Europe and North America (−). After controlling for macro context variables, mature intellectual property system was positively associated with attempting compulsory licensing.
Conclusions
Our study provided evidence of an association between attempting compulsory licensing and matured patent systems. This finding contradicts our current understanding of compulsory licensing, such as compulsory licensing as a measure to usurp traditional patent systems and sometimes diametrically opposed to the patent system. The findings also suggest a new role of compulsory licensing in current patent systems: compulsory licensing could be a potential alternative or complement to achieve access to medicines in health systems through manufacturing and exporting patented pharmaceuticals.

International Journal of Human Rights in Healthcare
Volume 12 Issue 3 2019
https://www.emeraldinsight.com/toc/ijhrh/12/3

Literature review
What do we know about maternal and perinatal mortality and morbidity audits in sub-Saharan Africa? A scoping literature review
Adelaide Lusambili, Joyline Jepkosgei, Jacinta Nzinga, Mike English (pp. 192 – 207)

Journal of Pharmaceutical Policy and Practice
https://joppp.biomedcentral.com/
[Accessed 29 Jun 2019]

Review
|   27 June 2019
Factors influencing pharmaceutical pricing – a scoping review of academic literature in health science
Authors: Maria Angelica Borges dos Santos, Leticia Lucia dos Santos Dias, Cláudia Du Bocage Santos Pinto, Rondineli Mendes da Silva and Claudia Garcia Serpa Osorio-de-Castro

The Lancet
Jun 29, 2019 Volume 393Number 10191p2563-2654, e45
https://www.thelancet.com/journals/lancet/issue/current

Editorial
Refugee health is a crisis of our own making
The Lancet
Another World Refugee Day has passed, and the number of displaced people around the world is at its highest ever. The wellbeing of those fleeing their homes because of persecution, poverty, and war to seek a better life elsewhere, although guaranteed by ratified international human rights standards and conventions, is still under attack. At last month’s World Health Assembly meeting, a report entitled Promoting the health of refugees and migrants: draft global action plan, 2019–2023 was discussed. By WHO estimates, 68 million people have been forcibly displaced across borders. Developing countries host 86% of the population of migrants who have suffered forced displacement and the UN estimates suggest 71 million people worldwide fled war in 2018 alone.

The WHO draft plan suggests six action points regarding the health of refugees, most of which cover advocacy and continuity of local health care. This guidance is, of course, welcome. Any greater visibility for the plight of refugees and migrants is a wholly worthwhile topic and WHO is right to focus its efforts on ensuring protection for one of the most vulnerable groups of people worldwide. Health is a right, not a privilege granted by circumstance of birthplace.

An action plan like this does not, however, cover the simple denial of the most basic human rights of individuals that is taking place in the USA. It used to be the case that America was able and proud to demonstrate its record on refugee resettlement. The USA marked World Refugee Day by highlighting the successes the country had in the integration of extremely vulnerable populations from around the world. That Canada, a country with a much smaller population, welcomed more refugees than the USA in 2018, with 28 100 refugees settled in Canada compared with 22 900 in the USA, does not tell the full story of what has happened since. This year, the USA marked World Refugee Day by the acting head of the US Citizenship and Immigration Services sending an email to asylum officers urging them to “stem the crisis and better secure the homeland”.

A leadership built on spiteful rhetoric towards those seeking a better life in a country of great opportunity and freedom has fallen further than anyone who brushed aside the xenophobia of the 2016 campaign trail could have thought. Even those who are only passingly familiar with the news will be aware of the perilous state of those detained in the so-called migrant camps, of the children separated from their parents at the border and lost in the system, and of migrants kept in solitary confinement and locked up without trial. A true illustration of the government’s mendacity in these matters came in front of the courts this week, when a government lawyer argued that detained migrant children were not entitled to soap or toothbrushes under a law requiring them to be kept in “safe and sanitary” conditions. Children recently lost access to legal aid, classes, and recreational activities for “budgetary reasons”. According to NBC, there are 50 000 people detained in Immigration and Customs Enforcement (ICE) facilities. 24 migrants have died under ICE custody so far.

The blatant nature of the Trump administration’s transgressions towards the vulnerable people it is required to protect is breathtaking. Let us instead focus on the positive results that immigration can bring to a nation. Former German president Christian Wulff said this week, regarding Germany’s resettlement of 900 000 migrants at the height of the crisis in 2015, that “the refugee move will be a stroke of luck in German history”. Wulff stated that, in a few years, Germany will look back on this decision with pride. The effect could be as pronounced as German reunification in the 1990s. He warned against blurring the line separating patriotism and nationalism.

Immigration strengthens a country, but even among immigration-positive politicians, the argument is lost in a flurry of caps on numbers and a tacit agreement that the argument for immigration is already lost. Accepting refugees and allowing them to live freely is itself lifesaving and of demonstrable economic and social benefit to a country. Forbidding them is damaging to us all.

The health, safety, and wellbeing of vulnerable populations must be uppermost in the mind of anyone who is a health professional. The prominence WHO has given to the health of refugees is welcome, and we can all do more to state the positive case for allowing migrants unfettered access to health care. The brutal treatment of refugees and migrants in many situations worldwide should be condemned in the strongest possible terms.

The Lancet
Jun 29, 2019 Volume 393Number 10191p2563-2654, e45
https://www.thelancet.com/journals/lancet/issue/current

Comment
Addressing the inactivated poliovirus vaccine shortage
Roland W Sutter, Michel Zaffran

The Lancet
Jun 29, 2019 Volume 393Number 10191p2563-2654, e45
https://www.thelancet.com/journals/lancet/issue/current

Articles
Immunogenicity of full and fractional dose of inactivated poliovirus vaccine for use in routine immunisation and outbreak response: an open-label, randomised controlled trial
Cynthia J Snider, Khalequ Zaman, Concepcion F Estivariz, Mohammad Yunus, William C Weldon, Kathleen A Wannemuehler, M Steven Oberste, Mark A Pallansch, Steven GF Wassilak,
Tajul Islam A Bari, Abhijeet Anand
Background
Intradermal administration of fractional inactivated poliovirus vaccine (fIPV) is a dose-sparing alternative to the intramuscular full dose. We aimed to compare the immunogenicity of two fIPV doses versus one IPV dose for routine immunisation, and also assessed the immunogenicity of an fIPV booster dose for an outbreak response.
Interpretation
fIPV appears to be an effective dose-sparing strategy for routine immunisation and outbreak responses.

The Lancet
Jun 29, 2019 Volume 393Number 10191p2563-2654, e45
https://www.thelancet.com/journals/lancet/issue/current

Viewpoint
Responding to the Ebola virus disease outbreak in DR Congo: when will we learn from Sierra Leone?
The Ebola Gbalo Research Group
In Sierra Leone, we found that community-level distrust was related to the nature of the response and the distance to the locus of operational decision making. Large and distant Ebola treatment centres were distrusted because families could not follow sick relatives and monitor their progress; rather, patients were seen to be taken away by hazmat-suited strangers to die in unknown locations (many bodies were never returned, their graves unknown). Village-based community care centres were preferred as triage facilities because community members knew the staff and could see into the centres. ¹⁰ Burial teams and contact tracing worked best when the recruits were local. Panic and confusion were alleviated when home carers were given clear instructions about how to care for their loved ones safely while waiting for help to arrive. ¹¹ Where local agents, including health personnel, government workers, and families, were strongly involved in planning and implementing the response it was more effective. Families were recognised as essential to the survival of their relatives, and local health personnel felt fully valued. Our findings suggest that in Bo and Moyamba districts the response succeeded when community and district leaders were fully engaged. The actors differed in each district; international responders need to work with district and traditional authorities, as well as health workers embedded in communities, to discover other local leaders and figures of influence, including women’s groups, secret societies and religious groups, traditional healers, citizen welfare groups, and youth organisations.

Lancet Digital Health
Jul 2019 Volume 1Number 3e100-e147
https://www.thelancet.com/journals/landig/issue/current

Editorial
Walking the tightrope of artificial intelligence guidelines in clinical practice
The Lancet Digital Health

Lancet Infectious Diseases
Jul 2019 Volume 19Number 7p671-788, e225-e258
http://www.thelancet.com/journals/laninf/issue/current

Editorial
HIV epidemics in Pakistan
The Lancet Infectious Diseases

Lancet Infectious Diseases
Jul 2019 Volume 19Number 7p671-788, e225-e258
http://www.thelancet.com/journals/laninf/issue/current

Comment
Rotavirus vaccine protection in low-income and middle-income countries
Girija Ramakrishnan, Jennie Z Ma, Rashidul Haque, William A Petri Jr
Open Access

Lancet Infectious Diseases
Jul 2019 Volume 19Number 7p671-788, e225-e258
http://www.thelancet.com/journals/laninf/issue/current

The economic case for typhoid conjugate vaccines in countries with medium and high incidence of infection
Youngji Jo, David W Dowdy

Lancet Infectious Diseases
Jul 2019 Volume 19Number 7p671-788, e225-e258
http://www.thelancet.com/journals/laninf/issue/current

The economic case for typhoid conjugate vaccines in countries with medium and high incidence of infection
Youngji Jo, David W Dowdy

Lancet Infectious Diseases
Jul 2019 Volume 19Number 7p671-788, e225-e258
http://www.thelancet.com/journals/laninf/issue/current

Measles resurgence in the USA: how international travel compounds vaccine resistance
Sahotra Sarkar, Aleksa Zlojutro, Kamran Khan, Lauren Gardner

Lancet Infectious Diseases
Jul 2019 Volume 19Number 7p671-788, e225-e258
http://www.thelancet.com/journals/laninf/issue/current

Articles
Tracking spending on malaria by source in 106 countries, 2000–16: an economic modelling study
Annie Haakenstad, et al.

Lancet Infectious Diseases
Jul 2019 Volume 19Number 7p671-788, e225-e258
http://www.thelancet.com/journals/laninf/issue/current

Efficacy of live oral rotavirus vaccines by duration of follow-up: a meta-regression of randomised controlled trials
Andrew Clark, et al.

Lancet Infectious Diseases
Jul 2019 Volume 19Number 7p671-788, e225-e258
http://www.thelancet.com/journals/laninf/issue/current

Cost-effectiveness of routine and campaign use of typhoid Vi-conjugate vaccine in Gavi-eligible countries: a modelling study
Joke Bilcke, et al.

Lancet Infectious Diseases
Jul 2019 Volume 19Number 7p671-788, e225-e258
http://www.thelancet.com/journals/laninf/issue/current

Personal View
Challenges and opportunities for the management of infectious diseases in Europes’ prisons: evidence-based guidance
Lara Tavoschi, Éamonn O’Moore, Dagmar Hedrich

Maternal and Child Health Journal
Volume 23, Issue 7, July 2019
https://link.springer.com/journal/10995/23/7

Review Paper
Socio-Structural Factors Influencing the Prevention of Mother-to-Child Transmission of HIV in the Democratic Republic of the Congo: A Systematic Review
Guy-Lucien S. Whembolua, Baraka Muvuka…

Nature
Volume 570 Issue 7762, 27 June 2019
http://www.nature.com/nature/current_issue.html

World View | 20 June 2019
Trump’s plan would make government stupid
Cuts to science advisory panels for federal agencies will haunt the United States long after the current administration finishes, says Gretchen T. Goldman.

Nature Reviews Immunology
Volume 19 Issue 7, July 2019
https://www.nature.com/nri/volumes/19/issues/7

Review Article | 02 April 2019
T cell-mediated immunity to malaria
John Harty and colleagues explain how different subsets of CD4+ T cells, CD8+ T cells and γδ T cells respond to the Plasmodium parasites that cause malaria. They discuss the major challenges that need to be overcome in order to harness T cell responses for malaria vaccines and therapies.
Samarchith P. Kurup, Noah S. Butler & John T. Harty

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 29 Jun 2019)

Editorial
Middle-income countries graduating from health aid: Transforming daunting challenges into smooth transitions
Gavin Yamey, Osondu Ogbuoji, Justice Nonvignon
| published 25 Jun 2019 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1002837
In the sustainable development goals (SDGs) era, the global health landscape is undergoing a rapid and profound set of transitions that threaten to stall or even derail progress in health improvement. These shifts are primarily affecting middle-income countries (MICs), where over 70% of the world’s poor now live [¹]. Sustaining global health progress will depend on how domestic and international health policymakers and actors navigate 4 transitions facing MICs: shifts in diseases, demography, development assistance for health, and domestic health financing, or the “4Ds” of global health transition…

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 29 Jun 2019)

Research Article
The Shan people’s health beliefs, knowledge and perceptions of dengue in Eastern Shan Special Region IV, Myanmar
Jian-Wei Xu, Hui Liu, Zadan Ai, Yan Yu, Bian Yu
| published 27 Jun 2019 PLOS Neglected Tropical Diseases
https://doi.org/10.1371/journal.pntd.0007498
Abstract
Sustainable dengue intervention requires the participation of communities. Therefore, understanding the health beliefs, knowledge and perceptions of dengue among the local people can help to design locally appropriate strategies for effective interventions. A combination of qualitative semi-structured in-depth interviews (SDIs) and quantitative household questionnaire surveys (HHSs) was used to investigate the beliefs, knowledge and perceptions of dengue among the Shan people in Eastern Shan Special Region IV (ESSR4), Myanmar. The SDI was administered to 18 key informants, and the HHS was administered to 259 respondents. Only 14.7% (95% CI: 10.6–19.6%) of the HHS respondents could confirm that mosquitoes transmit dengue; 14.3% (95% CI: 10.3–19.1%) knew that piebald or Aedes mosquitoes transmit dengue; and 24.3% (95% CI: 19.2–30.0%) believed that dengue-transmitting mosquitoes mainly lived in small ponds. Merely ten (0.4%) of the 259 respondents of the HHS thought that dengue-transmitting mosquitoes bite in the day time. The people in the villages where there were outbreaks of dengue had more knowledge about dengue. This study demonstrates that the health beliefs of the Shan people were closely associated with their lifestyles, social and natural environments. To stay healthy, the Shan people clean their houses and surroundings regularly. However, their knowledge about dengue was not adequate for effective dengue control because it was mostly learned from previous dengue experiences and in a context that lacks systematic health education. Thus, in this setting, with a weak public health structure, more international support should be provided to promote the knowledge of the Shan people about dengue and to increase their sensitive awareness to dengue, which might be beneficial for social mobilization and community participation during future dengue prevention.
Author summary
The burden of dengue has been increasing over the last five decades, and dengue fever (DF) has become one of the most rapidly spreading mosquito-borne diseases. DF has become another disease that threatens public health after malaria has become successfully controlled along the China-Myanmar border. However, it is currently not easy to contain epidemics of the dengue virus. As part of an integrated vector management approach, a community-based method is effective in the prevention of DF by tailoring the approach in a local context. Consequently, mixed methods comprising qualitative semi-structured in-depth interviews (SDIs) and quantitative household questionnaire surveys (HHSs) were used to study the health beliefs, knowledge and perceptions about dengue among the Shan people in Eastern Shan Special Region IV, Myanmar. This study found that the Shan people believed that their health was closely associated with their lifestyle and the social and physical environment in which they lived. Their beliefs originated from their primary social activities and cultural heritage. Most of their knowledge about DF was learned from previous outbreaks and interventions for the disease. The Shan people had a relatively higher level of knowledge about adult mosquito control, which they learned from previous malaria control programs, but they lacked knowledge on DF symptoms, transmission, vectors and Aedes larval breeding sites. Their knowledge about the methods of adult mosquito control could not effectively control DF. More sound health education is urgently needed to increase the local people’s knowledge of dengue and to rouse community awareness and participation in cleaning vector breeding sites. In the context of a lack of the necessary technical and financial resources, these interventions might rely more on international aid and help from neighboring countries, such as China.

PLoS One
http://www.plosone.org/
[Accessed 29 Jun 2019]

Research Article
The right to health as the basis for universal health coverage: A cross-national analysis of national medicines policies of 71 countries
S. Katrina Perehudoff, Nikita V. Alexandrov, Hans V. Hogerzeil
Research Article | published 28 Jun 2019 PLOS ONE
https://doi.org/10.1371/journal.pone.0215577
Abstract
Persistent barriers to universal access to medicines are limited social protection in the event of illness, inadequate financing for essential medicines, frequent stock-outs in the public sector, and high prices in the private sector. We argue that greater coherence between human rights law, national medicines policies, and universal health coverage schemes can address these barriers. We present a cross-national content analysis of national medicines policies from 71 countries published between 1990–2016. The World Health Organization’s (WHO) 2001 guidelines for developing and implementing a national medicines policy and all 71 national medicines policies were assessed on 12 principles, linking a health systems approach to essential medicines with international human rights law for medicines affordability and financing for vulnerable groups. National medicines policies most frequently contain measures for medicines selection and efficient spending/cost-effectiveness. Four principles (legal right to health; government financing; efficient spending; and financial protection of vulnerable populations) are significantly stronger in national medicines policies published after 2004 than before. Six principles have remained weak or absent: pooling user contributions, international cooperation, and four principles for good governance. Overall, South Africa (1996), Indonesia and South Sudan (2006), Philippines (2011–2016), Malaysia (2012), Somalia (2013), Afghanistan (2014), and Uganda (2015) include the most relevant texts and can be used as models for other settings. We conclude that WHO’s 2001 guidelines have guided the content and language of many subsequent national medicines policies. WHO and national policy makers can use these principles and the practical examples identified in our study to further align national medicines policies with human rights law and with Target 3.8 for universal access to essential medicines in the Sustainable Development Goals.

Science
28 June 2019 Vol 364, Issue 6447
http://www.sciencemag.org/current.dtl

Editorial
Science in South Asia
By Uttam Babu Shrestha, Anindita Bhadra
Science28 Jun 2019 : 1211
Summary
South Asian countries are often at odds with each other for political, economic, and emotional reasons. The conflicts are a frustrating contrast to the promise of the region. Covering only 3.5% of Earth’s landmass, but inhabited by 23.7% of humanity, the region has the highest rate of economic growth, is rich in knowledge-based institutions, and is home to many indigenous and technological innovations. Sadly, at the same time, South Asian countries have the highest poverty rate, lowest human development index (except for sub-Saharan Africa), the most polluted air, the greatest burden of diseases, and increased vulnerability to climate change. It’s time to reinvent science diplomacy in this part of the world to spur collaborations that can help resolve conflicts that are preventing South Asia from achieving its potential.

Science
28 June 2019 Vol 364, Issue 6447
http://www.sciencemag.org/current.dtl

In Depth
North Korea’s HIV epidemic emerges from the shadows
By Richard Stone
Science28 Jun 2019 : 1215-1216 Restricted Access
Nation has long denied the presence of the virus. But new report says it’s being spread by drug use and tainted blood.

Science
28 June 2019 Vol 364, Issue 6447
http://www.sciencemag.org/current.dtl

Plan to use second Ebola vaccine sparks debate
By Kai Kupferschmidt

Science28 Jun 2019 : 1221 Restricted Access
New shots could protect more people, but also create confusion and stretch resources.

Science Translational Medicine
26 June 2019 Vol 11, Issue 498
https://stm.sciencemag.org/

Focus
A decade of digital medicine innovation
By Eric J. Topol
Science Translational Medicine26 Jun 2019 Full Access
The field of digital medicine has matured over the past decade, but validation will require careful randomized, controlled clinical trials.

Social Science & Medicine
Volume 232 Pages 1-502 (July 2019)
https://www.sciencedirect.com/journal/social-science-and-medicine/vol/232/suppl/C

Discussion No access
Learning from failure? Political expediency, evidence, and inaction in global maternal health
Zubia Mumtaz, Alyssa Ferguson, Afshan Bhatti, Sarah Salway
Pages 427-431

Social Science & Medicine
Volume 232 Pages 1-502 (July 2019)
https://www.sciencedirect.com/journal/social-science-and-medicine/vol/232/suppl/C

Review article Abstract only
A comparative review of mobile health and electronic health utilization in sub-Saharan African countries
Brandford Bervell, Hosam Al-Samarraie

Social Science & Medicine
Volume 232 Pages 1-502 (July 2019)
https://www.sciencedirect.com/journal/social-science-and-medicine/vol/232/suppl/C

Review article Abstract only
Conceptual analysis of health systems resilience: A scoping review
Charlotte Pailliard Turenne, Lara Gautier, Stéphanie Degroote, Etienne Guillard, … Valéry Ridde
Pages 168-180

Social Science & Medicine
Volume 232 Pages 1-502 (July 2019)
https://www.sciencedirect.com/journal/social-science-and-medicine/vol/232/suppl/C

Review article Open access
Health financing in fragile and conflict-affected settings: What do we know, seven years on?
Maria Paola Bertone, Matthew Jowett, Elina Dale, Sophie Witter
Pages 209-219

Social Science & Medicine
Volume 232 Pages 1-502 (July 2019)
https://www.sciencedirect.com/journal/social-science-and-medicine/vol/232/suppl/C

Research article Abstract only
Research ethics for mobile sensing device use by vulnerable populations
Samantha Breslin, Martine Shareck, Daniel Fuller
Pages 50-57
Abstract
Devices equipped with sensors to track mobility, such as through Global Position Systems (GPS) and accelerometery, are increasingly being used for research. Following Canadian, US, and International guidelines there is a need to give special consideration when conducting research with vulnerable populations. This paper examines specific ethical concerns for conducting research with mobile sensing devices for use by vulnerable populations, considering aspects of both research design and research process. Drawing on insights from feminist design and aligned fields, such as participatory design and action research, we contend that any research design and process for working with vulnerable populations must be developed in collaboration with the particular groups and communities who are part of the research. As part of this process of collaborative research, we discuss risks in terms of the lack of control over data associated with choosing commercial devices, as well as practicality and obtrusiveness of devices for the wearer. We also discuss the significance of informed consent and refusal and issues relating to security and safety during research. As part of the collaborative research design and process, we argue that participants should be given as much control over their data as possible. Based on this discussion, we provide recommendations for researchers to consider, which are broadly relevant for research using mobile sensing devices but particularly significant in relation to vulnerable populations.

Systematic Reviews
https://systematicreviewsjournal.biomedcentral.com/articles
[Accessed 29 Jun 2019]

Research
Effect of mobile text message reminders on routine childhood vaccination: a systematic review and meta-analysis
The World Health Organization estimates that 29% of under-five mortality could be prevented with existing vaccines. However, non-consistent attendance for immunization appointments remains a global challenge t…
Authors: Zeleke Abebaw Mekonnen, Kassahun Alemu Gelaye, Martin C. Were, Kassahun Dessie Gashu and Binyam Chakilu Tilahun
Citation: Systematic Reviews 2019 8:154
Published on: 28 June 2019