Vaccines and Global Health: The Week in Review :: 31 August 2019

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

Gavi sets ambitious goal to immunise 300 million people by 2025, leaving no one behind 

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Gavi sets ambitious goal to immunise 300 million people by 2025, leaving no one behind 
Yokohama/Geneva, 30 August 2019 – Gavi, the Vaccine Alliance has called on donors to back plans to immunise an additional 300 million children, saving up to eight million lives, in developing countries between 2021 and 2025, launching a fundraising drive of at least US$ 7.4 billion. A total of US$ 3.6 billion will be invested by developing country governments in their own vaccine programmes over the period, up from US$ 1.6 billion in 2016-2020.

The Investment Opportunity sets out how Gavi will provide the most comprehensive and cost-effective preventive health package in history. In Gavi’s first phase, beginning in 2000, it supported six basic vaccines; by 2025 this will rise to 18, including new support for inactivated polio vaccine (IPV), rabies and multivalent meningococcal vaccines, as well as funding for an Ebola vaccine stockpile once it is prequalified by the WHO. In its next phase the Vaccine Alliance will protect children against childhood diseases, adolescents against cervical cancer through the scaling up of human papillomavirus (HPV) vaccine support, and the world against deadly outbreaks of Ebola, cholera, yellow fever and meningitis through support for vaccine stockpiles.

The 2021-25 Investment Opportunity was launched at a special event at the Seventh Tokyo International Conference on African Development (TICAD) in Yokohama co-hosted by the Japanese government, which has supported Gavi with around US$ 150 million since 2011. Access to vaccination was also included in the Osaka G20 Leaders’ Declaration in June. TICAD 7 has brought together representatives of African countries, international organisations, development partners, private companies, civil society and others under the theme of ‘advancing Africa’s development through people, technology and innovation’…

European Region loses ground in effort to eliminate measles

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European Region loses ground in effort to eliminate measles
Press release, WHO Europe
Copenhagen 29 August 2019
Following several years of steady progress toward elimination of measles in the WHO European Region, the number of countries having achieved or sustained elimination of the disease has declined. This was the conclusion of the European Regional Verification Commission for Measles and Rubella Elimination (RVC) based on an assessment of annual status updates for 2018 submitted by the 53 Member States of the Region.

 

The RVC determined that for the first time since the verification process began in the Region in 2012, 4 countries (Albania, Czechia, Greece and the United Kingdom) lost their measles elimination status.

“Re-establishment of measles transmission is concerning. If high immunization coverage is not achieved and sustained in every community, both children and adults will suffer unnecessarily and some will tragically die,” says Dr Günter Pfaff, Chair of the RVC.

The RVC was, on the other hand, pleased to conclude that Austria and Switzerland attained elimination status, having demonstrated the interruption of endemic transmission for at least 36 months.

For the Region as a whole, as of the end of 2018, 35 countries are considered to have achieved or sustained measles elimination (compared to 37 for 2017), 2 have interrupted the endemic transmission of measles (for 12–35 months), 12 remain endemic for measles and 4 that had previously eliminated the disease have re-established measles transmission.

The surge in cases that began in 2018 has continued into 2019, with approximately 90 000 cases reported for the first half of the year. This is already more than that recorded for the whole of 2018 (84,462)…

Gavi and Japanese growth equity fund collaborate to support innovative startups for immunisation 

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Gavi and Japanese growth equity fund collaborate to support innovative startups for immunisation 
:: Vaccine Alliance launches US$ 7.4 billion fundraising drive to deliver highest return on investment to date offering broad protection against 18 diseases, saving up to eight million lives from 2021-25
:: Developing countries set to make largest investment in their own vaccine programmes in history, more than doubling the amount invested in the 2016-2020 period
:: Sustained investment needed to secure prosperity for the next generation, prevent resurgence of diseases and protect from frequent outbreaks made worse by climate change, urbanisation and conflicts

Yokohama, 28 August 2019 – Gavi, the Vaccine Alliance and Asia Africa Investment and Consulting (AAIC), a Japanese growth equity fund based in Singapore, have agreed to a collaboration that will help companies offering innovations to improve the delivery and availability of vaccines in developing countries. Gavi and AAIC signed the agreement at the Seventh Tokyo International Conference on African Development (TICAD), where Gavi is unveiling its 2021 to 2025 Investment Opportunity.

AAIC will provide funding of up to US$ 3 million for two years to companies that AAIC identifies through Gavi’s accelerator programme, Innovation for Uptake, Scale and Equity in Immunisation, or INFUSE. The funding from AAIC will focus on INFUSE finalists, known as Pacesetters, that are supporting early- and growth-stage health care companies operating in Africa to scale new cost-effective immunisation products and services…

Pinterest takes the right step toward curbing misinformation on vaccines

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Opinion
Pinterest takes the right step toward curbing misinformation on vaccines
Washington Post
The Post’s View by Editorial Board
August 30 at 6:04 PM
HOW TO explain that one of the most effective medical innovations of all time is experiencing a crisis of confidence? That’s the situation with vaccines, which save millions of lives every year and especially help children fight disease.

A tide of “vaccine hesitancy,” reluctance to get inoculated because of unfounded fears and misinformation, is rising in the United States and throughout the world. The World Health Organization has identified vaccine hesitancy as one of the 10 most urgent public health challenges of this year.

The WHO director-general, Tedros Adhanom Ghebreyesus, pointed out recently that 20 million children worldwide simply lack access to vaccines because of war, weak primary health-care systems, poverty or unstable governments. But hesitancy among those who do have access is often the result of misinformation on social media, which can spread quickly.

For example, last spring, panic spread among parents in Pakistan because of a scaremongering video on Twitter that showed children seemingly collapsing after getting an expired vaccine. The video was obviously fake, but the panic was not, and it forced the suspension of a national immunization campaign.

Social media has also been responsible for spreading misinformation about vaccines for measles, a highly contagious illness that can have serious complications. So far this year in the United States, there have been 1,215 individual cases of measles, mostly unvaccinated individuals, the highest number of cases since 1992.

Last year, Pinterest, the social media platform, disabled search for terms such as “vaccines” or “cancer cure” because it realized the results were filled with misinformation. The platform says it discovered that, online, “anti-vaccine content is contagious” — it spreads quickly because it is more accessible, more visually compelling and more widely spread than scientific data.

Now, the platform has taken a laudable step toward changing this dynamic. On Aug. 28, Pinterest announced that it will provide information from only leading public health institutions, including the WHO, the Centers for Disease Control and Prevention, the American Academy of Pediatrics and the WHO-established Vaccine Safety Net, “a global network of websites providing reliable vaccine safety information.” Moreover, it won’t show comments, recommendations or ads, so this is not just a case of displaying correct information next to the dodgy, but rather a genuine effort to present authoritative data to its 300 million monthly users.

The principle here is worthy: With free speech comes responsibility, in this case, to not spread misinformation that can lead to illness and death. Other social media platforms are also acting against anti-vaccination information, but Pinterest is bolder and should be emulated.

As both the Ebola and polio inoculation campaigns have shown lately, having an effective vaccine is only part of the battle. Populations must trust the vaccine and those who administer it. Social media should not provide a stage for misguided people to destroy that trust, and digital platforms can do much to help rebuild it.

News: Global public meeting on draft ICH guideline on clinical trials

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News: Global public meeting on draft ICH guideline on clinical trials
News 30/08/2019 European Medicines Agency
The global guidance for the conduct of clinical trials is currently undergoing a major revision. As part of the worldwide consultation process, the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) is organising a public meeting to review its draft E8 (R1) Guideline ‘General Considerations for Clinical Trials’. EMA is encouraging its stakeholders to register for this meeting, which will be held on 31 October 2019 at the United States Food and Drug Administration (FDA) headquarters in Silver Spring, Maryland, United States of America. Participants will be able to attend in person or via webcast.

The ICH E8 guideline sets out general scientific principles for the conduct, performance and control of clinical trials. In recent years, clinical trials have undergone a radical transformation with a wider range of both trial designs and data sources being used in drug development. Therefore, ICH initiated a revision of the E8 guideline to address all the aspects that were not covered by the current version of the guidance.

The revision aims to provide up-to-date and flexible guidance on clinical trial designs and data sources that can support regulatory and other health-policy decisions while ensuring that fundamental principles, such as the protection of clinical trial participants and assurance of data quality, are maintained.

This is the first step outlined in the process of renovation of good clinical practice (GCP), described in the ICH reflection paper on GCP “Renovation”. The reflection paper contains the ICH proposal for further modernisation of the ICH guidelines related to clinical trial design, planning, management, and conduct. The scope of the proposed renovation includes the current E8 guideline and further revision to the E6 Guideline for Good Clinical Practice.

The draft revised E8 guideline was released for public consultation in May 2019 and it will remain open until 30 September 2019.

The purpose of the public meeting is to provide information and gather feedback from a broad range of stakeholder groups not represented in ICH. The viewpoints and concerns expressed by external stakeholders will feed into the revision process of this fundamental guideline.

The meeting will be held on 31 October 2019, 8:30 – 18:00, at the FDA headquarters in Silver Spring, Maryland, USA. Participants can register to attend in person or via webcast, on a first-come, first-served basis. More information, including on how to register, is available on the ICH website

Featured Journal Content

Featured Journal Content

 

Epidemics
Volume 28 September 2019
https://www.sciencedirect.com/journal/epidemics/vol/28/suppl/C
Research article Open access
Real-time predictions of the 2018–2019 Ebola virus disease outbreak in the Democratic Republic of the Congo using Hawkes point process models
J. Daniel Kelly, Junhyung Park, Ryan J. Harrigan, Nicole A. Hoff, … Frederic Paik Schoenberg
Article 100354
Highlights
:: Current 2018–2019 Ebola outbreak in DRC is the second largest ever with over 1600 cases as of 10 May 2019.
:: Evidence of an increase in the estimated transmission rates in health zones with recently reported violence versus those without (p = 0.008) in time series analysis.
:: The average R was estimated as between 0.61 and 0.86 in regions not affected by recent violence.
:: Estimated the increase in R between 0.17 and 0.53.
:: Violence is contributing to the continued transmission and the ongoing nature of this outbreak.