Vaccines and Global Health: The Week in Review :: 18 January 2020

.– Request anEmail Summary:Vaccines and Global Health : The Week in Review is published as a single email summary, scheduled for release each Saturday evening before midnight (EDT in the U.S.). If you would like to receive the email version, please send your request to david.r.curry@centerforvaccineethicsandpolicy.org.

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– blog edition: comprised of the approx. 35+ entries posted below.

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

WHO :: Urgent health challenges for the next decade

Milestones :: Perspectives :: Research

 

WHO :: Urgent health challenges for the next decade
13 January 2020
As a new year and a new decade kick off, WHO is releasing a list of urgent, global health challenges. This list, developed with input from our experts around the world, reflects a deep concern that leaders are failing to invest enough resources in core health priorities and systems. This puts lives, livelihoods and economies in jeopardy. None of these issues are simple to address, but they are within reach. Public health is ultimately a political choice.

We need to realize that health is an investment in the future. Countries invest heavily in protecting their people from terrorist attacks, but not against the attack of a virus, which could be far more deadly, and far more damaging economically and socially. A pandemic could bring economies and nations to their knees. Which is why health security cannot be a matter for ministries of health alone.

All the challenges in this list demand a response from more than just the health sector. We face shared threats and we have a shared responsibility to act. With the deadline for the 2030 Sustainable Development Goals quickly approaching, the United Nations General Assembly has underscored that the next 10 years must be the “decade of action“.

This means advocating for national funding to address gaps in health systems and health infrastructure, as well as providing support to the most vulnerable countries. Investing now will save lives – and money – later. The cost of doing nothing is one we cannot afford.

Governments, communities, and international agencies must work together to achieve these critical goals. There are no shortcuts to a healthier world. 2030 is fast approaching, and we must hold our leaders accountable for their commitments.

Dr Tedros Adhanom Ghebreyesus, WHO Director-General 

Wuhan – Coronavirus

 

Milestones :: Perspectives :: Research

Wuhan – Coronavirus
 
CEPI Blog
Newly discovered coronavirus in Wuhan China
CEO, Richard Hatchett discusses how the rapid publication of the genetic sequence of the newly discovered beta coronavirus could help speed up the development of diagnostic tests, case…
17 Jan 2020
The world faces a new disease threat from a previously unknown pneumonia-causing virus in China – but the good news is scientists already have vital genetic data that will help speed the development of diagnostic tests, case detection and, potentially, a vaccine.

The decision by Chinese authorities to release the genetic sequence of the newly discovered beta coronavirus (labelled 2019-nCoV by the World Health Organization) for researchers worldwide exemplifies the transparency needed to tackle unfolding public health emergencies.

The rapid publication of genetic sequences, less than a month after the ‘mystery’ disease caused the first of a cluster of pneumonia cases in the Chinese city of Wuhan, demonstrates the speed we can now achieve in identifying and characterizing new threats (by comparison, the sequencing and sharing of Severe Acute Respiratory Syndrome (SARS) coronavirus took 6 months from initial case identification in November 2002).

Understanding the genetic make-up of 2019-nCoV is vital for learning how closely related it is to SARS and Middle East Respiratory Syndrome (MERS), the other beta coronaviruses that have presented significant epidemic threats in recent years. Sequencing facilitates the development of PCR-based diagnostics, which in turn will help hospitals and public health authorities test for new cases and track the global spread of the disease. The genome data is also essential as researchers seek to fast-track work on a vaccine using cutting-edge technology platforms. Such platforms use standard components as a backbone but can be adapted to fight specific diseases by plugging in their genetic sequences as this information becomes available.

Disease outbreaks present a unique opportunity for research, but this can only happen if experts in different countries share information promptly. China’s openness in this case is therefore hugely welcome.

So far, two people have died and dozens of others have been hospitalised with pneumonia in China. Over the past week, two confirmed cases have also been reported in Thailand, with an additional case in Japan. While there was no relation between cases, all three had recently visited Wuhan. With possible limited human-to-human transmission, the World Health Organization is braced for the possibility of 2019-nCoV spreading further, especially ahead of the Lunar New Year holiday, beginning on January 25, when many millions of Chinese citizens are expected to travel.

CEPI has been monitoring the situation since the outbreak was first reported and we are working closely with WHO, who is leading the development of a coordinated international response. Within CEPI, we have convened our response steering committee to explore how we can contribute to the global effort to better understand and fight this disease. Our Scientific Advisory Committee has met twice and advised that we take early steps in vaccine development in case the situation worsens, and we have kept the Executive and Investment Committee of CEPI’s Board apprised of both these recommendations and developments more generally.

While additional investigation into 2019-nCoV is now needed to ascertain transmission routes and the source of exposure, the decision by the Chinese Center for Disease Control and Prevention, the Chinese Academy of Science and the Chinese Academy of Medical Science to share the genome sequence of the new virus with the world is a model for how scientists and government agencies must collaborate to tackle future disease threats.

 
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CDC [U.S.] Public Health Screening to Begin at 3 U.S. Airports for 2019 Novel Coronavirus (“2019-nCoV”)
Friday, January 17, 2020
The Centers for Disease Control and Prevention (CDC) and the Department of Homeland Security’s Customs and Border Protection (CBP) will implement enhanced health screenings to detect ill travelers traveling to the United States on direct or connecting flights from Wuhan, China. This activity is in response to an outbreak in China caused by a novel (new) coronavirus (2019 nCoV), with exported cases to Thailand and Japan.

Starting January 17, 2020, travelers from Wuhan to the United States will undergo entry screening for symptoms associated with 2019-nCoV at three U.S. airports that receive most of the travelers from Wuhan, China: San Francisco (SFO), New York (JFK), and Los Angeles (LAX) airports.

“To further protect the health of the American public during the emergence of this novel coronavirus, CDC is beginning entry screening at three ports of entry. Investigations into this novel coronavirus are ongoing and we are monitoring and responding to this evolving situation,” said Martin Cetron, M.D., Director of CDC’s Division of Global Migration and Quarantine.

Based on current information, the risk from 2019-nCoV to the American public is currently deemed to be low. Nevertheless, CDC is taking proactive preparedness precautions.

Entry screening is part of a layered approach used with other public health measures already in place to detect arriving travelers who are sick (such as detection and reporting of ill travelers by airlines during travel and referral of ill travelers arriving at a US port of entry by CBP) to slow and reduce the spread of any disease into the United States.

CDC is deploying about 100 additional staff to the three airports (SFO, JFK, and LAX) to supplement existing staff at CDC quarantine stations located at those airports…

 
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13 January 2020   News release
WHO statement on novel coronavirus in Thailand
The World Health Organization (WHO) is working with officials in Thailand and China following reports of confirmation of the novel coronavirus in a person in Thailand.
The person was a traveler from Wuhan, China, and was identified by Thai officials on 8 January, and hospitalized that day. The person is recovering from the illness according to Thai officials.
The possibility of cases being identified in other countries was not unexpected, and reinforces why WHO calls for on-going active monitoring and preparedness in other countries. WHO has issued guidance on how to detect and treat persons ill with the new virus.
The genetic sequencing shared by China enables more countries to rapidly diagnose patients.
WHO reiterates that it is essential that investigations continue in China to identify the source of this outbreak and any animal reservoirs or intermediate hosts.
Given developments, WHO Director-General Dr Tedros Adhanom Ghebreyesus will consult with Emergency Committee members and could call for a meeting of the committee on short notice.

 

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Lack of new antibiotics threatens global efforts to contain drug-resistant infections
17 January 2020   WHO News release

Declining private investment and lack of innovation in the development of new antibiotics are undermining efforts to combat drug-resistant infections, says the World Health Organization (WHO).

Two new reports reveal a weak pipeline for antibiotic agents. The 60 products in development (50 antibiotics and 10 biologics) bring little benefit over existing treatments and very few target the most critical resistant bacteria (Gram-negative bacteria).

While pre-clinical candidates (those in early-stage testing) are more innovative, it will take years before they reach patients.

“Never has the threat of antimicrobial resistance been more immediate and the need for solutions more urgent,” says Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “Numerous initiatives are underway to reduce resistance, but we also need countries and the pharmaceutical industry to step up and contribute with sustainable funding and innovative new medicines.”

The reports (Antibacterial agents in clinical development – an analysis of the antibacterial clinical development pipeline and its companion publication, Antibacterial agents in preclinical development) also found that research and development for antibiotics is primarily driven by small- or medium-sized enterprises with large pharmaceutical companies continuing to exit the field…

 
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IAVI Makes Available Unique Dataset and Samples from Pioneering HIV/AIDS Study in Africa to Researchers

NEW YORK — 14 JANUARY 2020 — Today IAVI, a nonprofit scientific research organization dedicated to addressing urgent, unmet global health challenges, announces the launch of IAVI DataSpace, an open-access, online portal to a one-of-a-kind dataset from a study of early HIV infection in a unique sub-Saharan African cohort. Researchers from across the world are invited to interact with the data through powerful visualization tools that help them understand the interplay between HIV and the human immune system and the complex dynamics of HIV transmission. IAVI DataSpace, funded by the U.S. Agency for International Development (USAID), is backed by an extensive sample library also available to researchers.

The data and samples were collected in IAVI’s landmark USAID-funded Protocol C epidemiological study between 2006 and 2017. The study followed 613 participants newly infected with HIV in Eastern and Southern Africa, including heterosexual men and women with a regular HIV-positive sex partner; at-risk young women, including sex workers; and men who have sex with men. The data convey years of immunological events from the earliest stages of HIV infection. Aggregate data from the Protocol C cohort are freely available on the portal; researchers who wish to analyze anonymized participant-level data and samples may request access.

Professor Jill Gilmour, Ph.D., Executive Director, Human Immunology, and Principal Investigator, IAVI Human Immunology Laboratory (HIL) at Imperial College London, said, “We are gratified that USAID support is allowing us to make this truly unique dataset widely available to the HIV research community, and especially to researchers in Africa. These data represent diverse African populations, risk groups, and viral genetics of HIV acquired through various modes of transmission, giving researchers insights into the complexity of HIV transmission and infection. The fact that Protocol C researchers collected samples from a complete spectrum of viral control — from participants who had poor viral control to those called elite controllers — makes us hopeful that these data could drive discoveries eventually leading to new HIV prevention tools and even novel treatment approaches.”…

 
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Stronger Food and Drug Regulatory Systems Abroad
National Academies   15 Jan 2020
Overview
By recent estimates, unsafe food kills over 400,000 people a year—a third ofthem children under 5, mostly in low- and middle-income countries. In sub-Saharan Africa alone, poor quality medicines cause about 70,000 excess deaths from childhood pneumonia and roughly 8,500 to 20,000 deaths from malaria every year. Ensuring the safety and quality of food and medicines in a country is an important role of government and essential for public health.
The capacity of regulatory systems abroad is of special interest to the U.S. Food and Drug Administration (FDA) Office of Global Policy and Strategy, the office that commissioned this study and a similar one released in 2012. This report discusses changes in the field since the 2012 study and outlines a strategy to strengthen food and medical products regulatory systems in low- and middle-income countries, recommending actions at the global, national and agency levels (see condensed recommendations table).

PDF: http://www.nationalacademies.org/hmd/Reports/2020/stronger-food-and-drug-regulatory-systems-abroad.aspx?utm_source=HMD+Email+List&utm_campaign=6f808a19d4-ncpf-pw-Dec1_COPY_01&utm_medium=email&utm_term=0_211686812e-6f808a19d4-180590365&mc_cid=6f808a19d4&mc_eid=f3b6c2ba44

Emergencies

Emergencies

Ebola – DRC+
Public Health Emergency of International Concern (PHEIC)

Ebola Outbreak in DRC 75: 14 January 2020
Situation Update
From 6 to 12 January 2020, eight new confirmed cases of Ebola virus disease (EVD) were reported from Mabalako, Beni, and Musienene Health Zones in North Kivu Province in the Democratic Republic of the Congo. Of these cases, three were reported in Beni Health Zone, where no cases had been reported for 29 days, and one was reported in Musienene Health Zone, where no cases had been reported for 132 days. These four cases are linked to the transmission chain that originated in Aloya Health Area, Mabalako Health Zone, and were not unexpected given known links between Mabalako and Beni…

…Vaccines
:: From 8 August 2018 to 12 January 2020, 265 309 people were vaccinated with the rVSV-ZEBOV-GP Ebola vaccine.
:: Vaccination with the Ad26.ZEBOV/MVA-BN-Filo vaccine continued in Karisimbi Health Zone, with 5684 people vaccinated since its introduction on 14 November 2019.

…Risk communication, social mobilization and community engagement
:: Traditional healers and managers of private structures which had contact with suspected EVD cases participated in response activities after community dialogue in Aloya, Mabalako Health Zone.
:: A forum for popular expression was also organized with village chiefs and civil society leaders to address questions related to vaccination activities in Métal and Aloya Health Zones.
:: Teams continue to involve local actors in communication and vaccination activities in Lwemba and Biakato.

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DR Congo: Red Cross volunteers attacked during Ebola burial
Goma/Nairobi/Geneva, 15 January 2020 – Two volunteers from the Democratic Republic of Congo (DR Congo) Red Cross were seriously injured following an attack during a safe and dignified burial of a suspected Ebola case near Mambasa, in eastern DR Congo on Monday, 13 January. The volunteers are now in hospital, receiving medical care and psychosocial support.

DR Congo Red Cross teams have faced incidents of violence and aggression from communities resisting safe and dignified burial protocols since the start of the Ebola outbreak in North Kivu and Ituri.  In this most recent attack, the family had consented to the burial but rumours and panic quickly spread among the community resulting in a violent assault against the Red Cross team.

Grégoire Mateso Mbuta, President of the DR Congo Red Cross Society said: “This incident is a stark reminder of the serious risks our volunteers face when they carry out the dangerous task of safe and dignified burials. While we deplore any violence towards our volunteers or staff, we understand first hand, the fear and frustration that communities harbour and shall continue to render the needed services to the affected populations.”

The current Ebola outbreak, which began on 1 August 2018, is unfolding in an area affected by a two decades-long conflict that has claimed countless lives and raised fear and hostility towards responders.

Building community trust and acceptance has been at the core of the Red Cross’ Ebola response operations. This investment has paid off. Since the beginning of the outbreak nearly 20,000 successful safe and dignified burials have been conducted with a consistently high success rate.
Red Cross volunteers continue to work within affected communities, listening to concerns and gathering feedback that is then analysed and used to provide improved support to people in need. As a result, community resistance for safe and dignified burials has drastically declined over the course of the operation.

Nicole Fassina, Ebola Operations Manager for the International Federation of Red Cross and Red Crescent Societies (IFRC) said: “While we experienced an overall improvement in community’s acceptance of burials, this attack underscores why we cannot become complacent. The Red Cross will continue to engage and involve communities in the Ebola response if we want to bring this outbreak to end.”

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POLIO
Public Health Emergency of International Concern (PHEIC)
http://polioeradication.org/polio-today/polio-now/this-week/

Polio this week as of 14 January 2020
:: Pakistan intensifies cVDPV2 response efforts, focusing on comprehensive outbreak response, strengthened routine immunization, communication and enhanced surveillance.

Summary of new viruses this week (AFP cases and ES positives):
:: Pakistan:  seven WPV1 cases; and, five WPV1-positive environmental samples
:: Angola:  two cVDPV2 cases
:: Benin:  one cVDPV2 case
:: Central African Republic (CAR):  two cVDPV2 cases
:: Ghana:  one cVDPV2 case; and, six cVDPV2-positive environmental samples
:: Malaysia:  one cVDPV1-positive environmental sample; and, one cVDPV2-positive environmental sample
:: Philippines:  two cVDPV2 cases
:: Togo:  two cVDPV2 cases

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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 18 Jan 2020]

Democratic Republic of the Congo
:: Ebola Outbreak in DRC 75: 14 January 2020
[See Ebola above for detail]

Mozambique floods – No new digest announcements identified
Nigeria – No new digest announcements identified
Somalia – No new digest announcements identified
South Sudan – No new digest announcements identified
Syrian Arab Republic – No new digest announcements identified
Yemen – No new digest announcements identified

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WHO Grade 2 Emergencies [to 18 Jan 2020]
Iraq
:: WHO assesses capacity and preparedness of Al Jumhury Teaching Hospital for influenza
Erbil, Iraq, 14 January 2020

Afghanistan – No new digest announcements identified
Angola – No new digest announcements identified
Burkina Faso [in French] – No new digest announcements identified
Burundi – 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
HIV in Pakistan – No new digest announcements identified
Iran floods 2019 – No new digest announcements identified
Libya – No new digest announcements identified
Malawi floods – No new digest announcements identified
Measles in Europe – No new digest announcements identified
MERS-CoV – No new digest announcements identified
Myanmar – 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 18 Jan 2020]

Chad – No new digest announcements identified
Djibouti – 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 15 January 2020

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 – No new digest announcements identified
EBOLA OUTBREAK IN THE DRC – No new digest announcements identified

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WHO & Regional Offices [to 18 Jan 2020]

WHO & Regional Offices [to 18 Jan 2020]
17 January 2020 News release
From political commitment to concrete reality: moving ahead on UHC in 2020

17 January 2020 News release
Lack of new antibiotics threatens global efforts to contain drug-resistant infections

13 January 2020 News release
WHO statement on novel coronavirus in Thailand

 

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Weekly Epidemiological Record, 17 January 2020, vol. 95, 03 (pp. 13–24)
Report of the third Global Forum of Malaria-eliminating Countries, 18–20 June 2019, Wuxi, China

 

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WHO African Regions Immunization Technical Advisory Group (RITAG)
:: Call for nominations pdf, 147kb Deadline for applications: 28 February 2020
:: RITAG Terms of Reference pdf, 211kb
:: RITAG application annexes pdf, 91kb

 

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GIN November and December 2019 pdf, 2.83Mb
13 January 2020

 

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WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: Three African countries halt polio outbreaks 20 December 2019
Kenya, Mozambique and Niger have curbed polio outbreaks that erupted in different episodes over the past 24 months, allowing them to regain their polio-free status, World Health Organization (WHO) announced today.
:: WHO unveils plan to tackle rising HIV drug resistance in Africa 06 December 2019
WHO and partners unveil a five-year plan to monitor, prevent and respond to growing HIV drug resistance in Africa. HIV drug resistance is threatening the significant progress made in the global fight against the virus.

WHO Region of the Americas PAHO
No new digest content identified.

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

WHO European Region EURO
:: WHO/Europe and Norway discuss improving affordable access to innovative medicines 16-01-2020
:: Violence against children: tackling hidden abuse 13-01-2020

WHO Eastern Mediterranean Region EMRO
:: WHO responds to urgent health needs in El Geneina, West Darfur 14 January 2020
:: WHO assesses hospital’s influenza preparedness in Erbil 14 January 2020

WHO Western Pacific Region
:: China virus outbreak shows Asia needs to step up infection preparation
Region is safer after epidemic lessons but new diseases always arising 15 January 2020