Vaccines and Global Health: The Week in Review is a weekly digest  summarizing news, events, announcements, peer-reviewed articles and research in the global vaccine ethics and policy space. Content is aggregated from key governmental, NGO, international organization and industry sources, key peer-reviewed journals, and other media channels. This summary proceeds from the broad base of themes and issues monitored by the Center for Vaccine Ethics & Policy in its work: it is not intended to be exhaustive in its coverage. You are viewing the blog version of our weekly digest, typically comprised of between 30 and 40 posts below all dated with the current issue date

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

UN General Assembly
Resolution: A/RES/74/306
15 September 2020 :: 14 pages
74/306. Comprehensive and coordinated response to the coronavirus disease (COVID-19) pandemic
[Excerpts]
…6. Calls upon Member States to put in place a whole-of-government and whole-of-society response, outlining both immediate and long-term actions, with a view to sustainably strengthening their health system and social care and support systems, and preparedness and response capacities, engaging with communities and collaborating with relevant stakeholders, and also calls upon Member States to maintain the continued functioning of the health system and strengthening of primary health care in all relevant aspects necessary for an effective public health response to the COVID-19 pandemic and other ongoing epidemics, and the uninterrupted and safe provision of population- and individual-level services, for, inter alia, communicable diseases, including by ensuring the continuation of undisrupted vaccination programmes, neglected tropical disease prevention and control, non-communicable diseases, mental health and mother and child health, and to promote access to safe and affordable drinking water and adequate and equitable sanitation and hygiene for all and safe, sufficient and nutritious food and the enjoyment of a diversified, balanced and healthy diet, recognizing in this regard the importance of increased domestic financing and development assistance where needed in the context of achieving universal health coverage;

…11. Calls upon international organizations and other relevant stakeholders to support all countries, upon their request, in the implementation and review of their multisectoral national action plans and in strengthening their health systems to respond to the COVID-19 pandemic, and in maintaining the safe provision of all other essential public health functions and services;

12. Urges Member States to enable all countries to have unhindered, timely access to quality, safe, efficacious and affordable diagnosis, therapeutics, medicines and vaccines, and essential health technologies, and their components, as well as equipment, for the COVID-19 response;

13. Recognizes the role of extensive immunization against COVID-19 as a global public good for health in preventing, containing and stopping transmission in order to bring the pandemic to an end, once safe, quality, efficacious, effective, accessible and affordable vaccines are available;

14. Calls upon Member States, with support from the United Nations system, to coordinate efforts to develop a science- and evidence-based, cooperative and comprehensive approach to allocating scarce resources for combating the COVID-19 pandemic based on public health needs;

15. Encourages Member States to work in partnership with all relevant stakeholders to increase research and development funding for vaccines and medicines, leverage digital technologies, and strengthen scientific international cooperation necessary to combat COVID-19 and to bolster coordination, including with the private sector, towards rapid development, manufacturing and distribution of diagnostics, therapeutics, medicines, including antiviral medicines and medical science-based treatment protocols, and vaccines, and personal protective equipment, and explore ways to consider integrating, as appropriate, safe and evidence-based traditional and complementary medicine services, according to national context and priorities, adhering to the objectives of efficacy, safety, equity, accessibility, and affordability, while taking into account and supporting existing mechanisms, tools and initiatives, such as the Access to COVID-19 Tools Accelerator, and relevant pledging appeals;

…21. Calls upon Member States to ensure protection for those most affected, women, children, youth, persons with disabilities, people living with HIV/AIDS, older persons, indigenous peoples, refugees and internally displaced persons and migrants, and the poor, vulnerable and marginalized segments of the population, and prevent all forms of discrimination, especially in the context of timely, universal, inclusive, equitable and non-discriminatory access to safe, quality, effective and affordable health care and services and medical supplies and equipment, including diagnostics, therapeutics, medicine and vaccines, and to leave no one behind, with an endeavour to reach the furthest behind first, founded on the dignity of the human person and reflecting the principles of equality and non-discrimination;…

Milestones :: Perspectives :: Research

Joint Statement
Managing the COVID-19 infodemic: Promoting healthy behaviours and mitigating the harm from misinformation and disinformation
WHO, UN, UNICEF, UNDP, UNESCO, UNAIDS, ITU, UN Global Pulse, and IFRC
23 September 2020 The Coronavirus disease (COVID-19) is the first pandemic in history in which technology and social media are being used on a massive scale to keep people safe, informed, productive and connected. At the same time, the technology we rely on to keep connected and informed is enabling and amplifying an infodemic that continues to undermine the global response and jeopardizes measures to control the pandemic.

An infodemic is an overabundance of information, both online and offline. It includes deliberate attempts to disseminate wrong information to undermine the public health response and advance alternative agendas of groups or individuals. Mis- and disinformation can be harmful to people’s physical and mental health; increase stigmatization; threaten precious health gains; and lead to poor observance of public health measures, thus reducing their effectiveness and endangering countries’ ability to stop the pandemic.

Misinformation costs lives. Without the appropriate trust and correct information, diagnostic tests go unused, immunization campaigns (or campaigns to promote effective vaccines) will not meet their targets, and the virus will continue to thrive.

Furthermore, disinformation is polarizing public debate on topics related to COVID-19; amplifying hate speech; heightening the risk of conflict, violence and human rights violations; and threatening long-terms prospects for advancing democracy, human rights and social cohesion.

In this context, the UN Secretary- General launched the United Nations Communications Response initiative to combat the spread of mis- and disinformation in April 2020. The UN also issued a Guidance Note on Addressing and Countering COVID-19 related Hate Speech (11 May 2020)…

EMERGENCIES

Coronavirus [COVID-19]
Public Health Emergency of International Concern (PHEIC)

Weekly Epidemiological and Operational updates
last update: 11 September 2020, 20:00 GMT-4
Confirmed cases :: 32 429 965 [week ago: 30 369 778]
Confirmed deaths :: 985 823 [week ago: 948 795]
Weekly Operational Update 
Coronavirus disease 2019 (COVID-19)
25 September 2020 :: 13 pages

Weekly Epidemiological Update 
Coronavirus disease 2019 (COVID-19)
21 September 2020 : 23 pages
Global epidemiological situation
To date, over 30.6 million COVID-19 cases and 950 000 deaths have been reported to WHO.
From 14 through 20 September, there were almost 2 million new cases of COVID-19, which represents a 6% increase compared to the previous week, and the highest number of reported cases in a single week since the beginning of the epidemic. During the same period, there was a 10% decrease in the number of deaths, with 36 764 deaths reported in the past seven days

With the exception of the African Region, an increase in the weekly case incidence was reported across all WHO regions in the last seven days (Table 1, Figure 2). Overall, the Region of the Americas continues to carry the highest burden of COVID-19 globally, accounting for over 38% of all new cases reported in the past seven days, although the region has reported a 22% decrease in new deaths. The WHO European Region showed the greatest rise in deaths in the past week, with a 27% increase compared to the previous week.

The WHO South-East Asia Region has continued to report an increase in new COVID-19 deaths, with over 9000 deaths in the past week, accounting for 25% of all reported deaths and surpassing 100 000 total COVID-19 deaths since the beginning of the pandemic. In addition, the region accounts for 35% of new cases reported in the past week. The Eastern Mediterranean and Western Pacific regions have both reported a slight increase in reported cases and deaths over the last three weeks. The African Region continues to show a marked decline with decreases of 12% and 16% in reported cases and deaths respectively in the past week.

Key weekly updates
:: As the world comes together at an unprecedented mostly virtual 75th UN General Assembly from 15-31 September, WHO has three messages to share:
1. Equitable access to COVID-19 tools. WHO calls on world leaders to support the Access to COVID-19 Tools (ACT)-Accelerator, a unique international collaboration to fast-track the development, production and equitable access to COVID-19 tests, treatments, and vaccines globally, while strengthening health systems.
2. Maintain the momentum towards achieving the Sustainable Development Goals. The pandemic risks unravelling decades of gains made in health and development. According to a recent WHO survey, 90% of countries are experiencing disruptions to essential health services.
3. We must prepare for the next pandemic together, now. A year ago the independent Global Preparedness Monitoring Board warned of the threat of a pandemic, calling for global leaders to take urgent, united action to prepare. Last week, the Board issued its 2020 report, ‘A World in Disorder’, which outlined five urgent actions to be taken: responsible leadership; engaged citizenship; strong and agile systems for health security; sustained investment; and robust global governance of preparedness.

:: WHO Director-General Dr Tedros, in his regular media briefing on Friday, highlighted that this is a critical moment for countries. As cases and deaths have started to spike again, he called upon leaders to put targeted measures in place which can help suppress the spread of the virus and ensure that health systems and workers are protected. Individuals must also practise physical distancing, clean their hands frequently, wear a mask as advised, cough and sneeze safely away from others, avoid crowds, and keep windows and doors open when they can’t meet friends and family outside.

:: WHO has published new guidance on school-related public health measures that examines considerations for school operations, and the measures needed to minimize the risk to students and staff of COVID-19.

:: On 17 September, we celebrated World Patient Safety Day to raise global awareness of the importance of health worker safety and its interlinkages with patient safety. The COVID-19 pandemic has exerted unprecedented pressure on health systems worldwide. Health systems can only function with health workers, and a knowledgeable, skilled and motivated health workforce is critical for the provision of safe care to patients.

:: WHO has released a slide set on ‘What we know about the long-term effects of COVID-19’. Typically people recover from COVID-19 after two to six weeks; however, for some people, including young adults and persons with no underlying medical conditions who were not hospitalized, symptoms may linger or recur for weeks or months following initial recovery. Some patients develop medical complications that may have lasting health effects. Much is still unknown, and more time and research are needed to understand the long-term effects of COVID-19.

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WHO Director-General’s opening remarks at the media briefing on COVID-19 – 25 September 2020
:: Today, WHO and our partners are publishing a detailed strategic plan and investment case for the urgent scale-up phase of the ACT Accelerator, building on the success of the start-up phase.
:: By the end of next year, the ACT Accelerator aims to deliver 2 billion doses of vaccine; 245 million courses of treatment; and 500 million diagnostic tests to low- and middle-income countries.
:: The number of countries joining the COVAX facility grows every day. As of today, 67 high-income countries have formally joined and another 34 are expected to sign, joining 92 lower-income countries who are eligible for financial support through Gavi.
:: The current financing gap for the ACT Accelerator stands at 35 billion dollars. Of the 35 billion dollars, 15 billion dollars is needed immediately to exploit the ACT-A progress to fund research and development, scale up manufacturing, secure procurement and strengthen delivery systems.

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WHO Emergencies Press Conference on coronavirus disease outbreak – 25 September 2020
{Excerpts]
00:22:04
Thank you. First of all let me emphasise that countries have autonomy according to their national regulations and legislation to issue emergency use authorisations for any health product and China and other countries have already done so for different products and WHO has emergency use listing provisions and has listed already several products for diagnostics.
We have not yet issued provisions for EUL of vaccines but today I have good news for you because we have just published, put out for comments the draft criteria for assessment of COVID-19 vaccines for emergency use listing or pre-qualification and this will help manufacturers understand the criteria.

This is up for public comments until 8th October – organisations, manufacturers and individuals – because this will help all partners to understand what’s necessary to put a product that’s both safe and effective into the market and what are the elements that will make it eligible for either an emergency use listing by WHO or a pre-qualification. Thank you.

RO The world is approaching one million deaths from COVID-19. Is it unthinkable that two million might die before a vaccine becomes widely available?
FC Thank you, Robin. Dr Ryan will take your question. Thank you.
MR It’s certainly unimaginable but it’s not impossible because if we look at losing a million people in nine months and then we just look at the realities of getting vaccine out there in the next nine months it’s a big task for everyone involved. Mariangela’s just outlined the issues of listening.

There’s the issue of scale-up; there’s the issue of funding these vaccines; there’s the issue of distributing these vaccines and then the issues of acceptance and beyond that with the work we
still have to do in controlling this disease.

Remember, we have things we can do now to drive transmission down and drive down the number of deaths. We’re seeing clinical case fatality rates slowly drop, we’re seeing doctors and nurses making better use of oxygen, better use of intensive care, better use of dexamethasone, which again was referred to in the DG’s speech and which the ACT Accelerator will provide a lot of focus on, and other therapeutics as they come online.

00:25:09
One million is a terrible number and I think we need to reflect on that before we start considering a second million. There is a lot that can be done to save lives, both in terms of disease control, existing life-saving measures and the innovations that are coming down the pipe.

The real question is, are we prepared collectively to do what it takes to avoid that number, are we prepared to fully engage in the surveillance and testing and tracing, in managing our own risks at society and community level, governments supporting communities to take that action?

Are we willing to make the investments now that are needed in the ACT Accelerator, especially in COVAX? Because these are, number one, the investments we need to make and the actions
we need to take at all levels of our society, sub-nationally, nationally and internationally. Are we willing to take the multilateral action, the collective global action to take control of this virus rather than this virus controlling our destinies?

00:26:15
If we don’t take those actions and we don’t continue to escalate and evolve the nature and scale and intensity of our co-operation then yes, we will be looking at that number and sadly a number much higher.

So the time for action is now on every single aspect of this strategic approach. The DG has said it again and again and again; not just this, not just test and trace, not just clinical care, not just social distancing, not just hygiene, not just masks, not just vaccines; do it all.

Unless we do it all the numbers you speak about are not only imaginable but unfortunately and sadly very likely.

FC Thank you, Dr Ryan. Dr Aylward has something to add.
BA Thank you very much and thanks for the question, Robin. I think we have to be super-clear; whether another million people die of COVID-19 is not a function of whether or not we have a vaccine. It’s a function of whether or not we put the tools, approaches and knowledge that we have today to work to save lives and prevent transmission; it’s as simple as that.

00:27:27
If we start thinking about it as a function of the vaccine people will unnecessarily and unacceptably die as we wait for a vaccine.

We should not be waiting. We have made incredible progress in terms of reducing mortality from this disease, in terms of preventing the most vulnerable and highest-risk from getting
infected by this disease.

It’s unacceptable, it’s unnecessary and it should be unimaginable and it should not be a function of whether or not we have a vaccine. It’s a function of whether or not we as individuals – as Mike emphasised – do what we can, our part to prevent transmission of this disease.
FC Thank you, Dr Aylward.

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Public consultation for review of draft Considerations for the Assessment of COVID-19 Vaccines for Listing by WHO
Organizations and individuals are invited to review and provide comments/suggestions on the draft Document “Considerations for the assessment of Covid-19 vaccines”

Please provide your comments in writing to WHO no later than 08 October 2020, 18:00 CEST by email at the following address WHOEUL@who.int.

:: CONSIDERATIONS FOR EVALUATION OF COVID19 VACCINES – Points to consider for manufacturers of COVID19 vaccines pdf, 406kb
:: Comments Form doc, 136kb

This document provides advice to manufacturers on both the process and the criteria that will be used by the World Health Organization (WHO) to evaluate COVID-19 vaccines that are submitted either for prequalification (PQ) or for Emergency Use Listing (EUL). The current status of development of a candidate Covid-19 vaccine, the extent of the available quality, safety and efficacy data and regulatory approvals by relevant NRAs will guide WHO’s decision on which pathway (PQ or EUL) to follow for each vaccine.

The submission and review processes are described. Only vaccines that have undergone phase IIb or phase III studies and have received authorization from a reference NRA should be submitted for consideration. Criteria that will be used to assess clinical trial design, endpoints, and statistical criteria are described. Specific data that should be submitted to answer programmatically relevant questions are outlined. Manufacturing, quality control and labelling requirements are summarized, as are non-clinical data to address the potential for vaccine-associated enhanced disease. Post-authorization commitments are specified.

This document should be read in conjunction with the following:
:: “Procedure for assessing the acceptability, in principle, of vaccines for purchase by United Nations agencies”, WHO Technical Report Series 978, Annex 6, 2013 (1)
:: WHO EUL document (2)
:: “Guidelines on clinical evaluation of vaccines: regulatory expectations”, WHO Technical Report Series 1004, Annex 9, 2017 (3)
:: COVAX SAGE Compendium of Covid-19 vaccine research questions (4)
:: “Guidelines for assuring the quality, safety, and efficacy of plasmid DNA vaccines” adopted by the Seventy-first Meeting of the World Health Organization Expert Committee on Biological Standardization, 24–28August 2020. (5)
:: “Points to Consider for assuring the quality, safety and efficacy of RNA vaccines” (6)
:: “WHO Target Product Profiles for COVID-19 Vaccines” (7)

(1) http://www.who.int/immunization_standards/vaccine_quality/TRS_978_61st_report_Annex_6_PQ_vaccine_procedure.pdf
(2) https://www.who.int/medicines/regulation/prequalification/prequal-vaccines/EUL_PQ_Vaccines/en/
(3) http://www.who.int/biologicals/expert_committee/WHO_TRS_1004_web_Annex_9.pdf
(4) COVAX SAGE Compendium of Covid-19 vaccine research questions
(5) https://www.who.int/publications/m/item/DNA-post-ECBS-1-sept-2020
(6) Currently under development and to be published at https://www.who.int/biologicals
(7) https://www.who.int/publications/m/item/who-target-product-profiles-for-covid-19-vaccines

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NIH [to 26 Sep 2020]
http://www.nih.gov/news-events/news-releases
Selected News Releases
Fourth large-scale COVID-19 vaccine trial begins in the United States
September 23, 2020 — Trial evaluating investigational Janssen COVID-19 vaccine.
A fourth Phase 3 clinical trial evaluating an investigational vaccine for coronavirus disease 2019 (COVID-19) has begun enrolling adult volunteers. The trial is designed to evaluate if the investigational Janssen COVID-19 vaccine (JNJ-78436725) can prevent symptomatic COVID-19 after a single dose regimen. Up to 60,000 volunteers will be enrolled in the trial at up to nearly 215 clinical research sites in the United States and internationally.

The Janssen Pharmaceutical Companies of Johnson & Johnson developed the investigational vaccine (also known as Ad.26.COV2.S) and is leading the clinical trial as regulatory sponsor. Janssen, the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, and the Biomedical Advanced Research and Development Authority (BARDA), part of the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response, are funding the trial.

U.S. and international trial sites part of the NIAID-supported COVID-19 Prevention Network(link is external) (CoVPN) will participate in the trial. The CoVPN is composed of existing NIAID-supported clinical research networks with infectious disease expertise and designed for rapid and thorough evaluation of vaccine candidates and monoclonal antibodies for the prevention of COVID-19.

“Four COVID-19 vaccine candidates are in Phase 3 clinical testing in the United States just over eight months after SARS-CoV-2 was identified. This is an unprecedented feat for the scientific community made possible by decades of progress in vaccine technology and a coordinated, strategic approach across government, industry and academia,” said NIAID Director Anthony S. Fauci, M.D. “It is likely that multiple COVID-19 vaccine regimens will be required to meet the global need. The Janssen candidate has showed promise in early-stage testing and may be especially useful in controlling the pandemic if shown to be protective after a single dose.”…

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Johnson & Johnson Initiates Pivotal Global Phase 3 Clinical Trial of Janssen’s COVID-19 Vaccine Candidate
:: First participants dosed in Phase 3 trial (ENSEMBLE) evaluating safety and efficacy of Janssen’s COVID-19 vaccine candidate, JNJ-78436735, also known as Ad26.COV2.S
Sep 23, 2020

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Serum Institute of India Initiates Manufacturing of Codagenix’s Intranasal Live-Attenuated COVID-19 Vaccine Candidate
:: Phase 1 clinical trial of CDX-005 expected to initiate prior to year-end 2020
:: Serum Institute to ramp-up manufacturing for large-scale safety and efficacy studies and to meet global vaccine supply requirements
Sep 22, 2020

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Canada Exercises Increased Option for 20 Million Doses of mRNA Vaccine Against COVID-19 (mRNA-1273)
September 22, 2020
:: Canadian Government maintains option for an additional 36 million doses
:: Agreement underscores growing global confidence in mRNA platform and progress of Phase 3 study of mRNA-1273

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Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)

Polio this week as of 23 September 2020
:: The GPEI would like to congratulate Dr. Tunji Funsho, Rotary’s Nigeria National PolioPlus Committee Chair for being named one of TIME’s 100 Most Influential People in the world. Dr. Funsho’s leadership within Rotary and the GPEI partnership has been instrumental in eradicating wild polio in Nigeria and the African region. Read More…

:: The World Health Organization has opened a call for nomination of experts to serve on the who polio eradication advisory panel on sabin-ipv and polio vlp vaccine development. Read more…

:: “I started working with the Polio Eradication Programme four years ago and I am happy to say that we have made a lot of progress here. This is my neighbourhood; this is where I grew up and this helps me immensely. People here listen to me, especially the women, and I know most of the children by name,” Read more about Samreen, a polio worker in Pakistan.

Summary of new WPV and cVDPV viruses this week (AFP cases and environmental samples):
:: Afghanistan: one WPV1 case, one cVDPV2 case and 20 cVDPV2 positive environmental samples
:: Pakistan: three WPV1 cases, 11 WPV1 positive environmental samples and two cVDPV2 cases
:: Cameroon: one cVDPV2 positive environmental sample
:: Chad: three cVDPV2 cases
:: Guinea: three cVDPV2 cases
:: Nigeria: one cVDPV2 positive environmental sample
:: South Sudan: three cVDPV2 cases

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WHO Grade 3 Emergencies [to 26 Sep 2020]

Democratic Republic of the Congo – No new digest announcements identified
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 26 Sep 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
Iran floods 2019 – No new digest announcements identified
Iraq – 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
Mozambique – 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
HIV in Pakistan – No new digest announcements identified
Sao Tome and Principe Necrotizing Cellulitis (2017) – No new digest announcements identified
Sudan – No new digest announcements identified
Ukraine – No new digest announcements identified
Zimbabwe – No new digest announcements identified

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WHO Grade 1 Emergencies [to 26 Sep 2020]

Chad – No new digest announcements identified
Djibouti – Page not responding at inquiry
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: COVID-19 Response Update No. 10 – 23 September 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.
COVID-19
::  Coronavirus disease 2019 (COVID-19) Situation Report 45: occupied Palestinian territory, issued 24 September 2020, information for period: 5 March – 24 September 2020

East Africa Locust Infestation
– No new digest announcements identified

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WHO & Regional Offices [to 26 Sep 2020]

Informing vaccination programs: a guide to the design and conduct of dengue serosurveys
Guidance
25 September 2020 :: 50 pages
Overview
In this document, considerations are provided on designing and implementing a cross-sectional serosurvey using school-based sampling to estimate age-specific DENV seroprevalence to inform a country’s national dengue vaccination program. The document includes suggestions for methods for planning and conducting serosurveys, including survey design, specimen collection, laboratory testing, data analysis, and the interpretation and reporting of results.

23 September 2020 Joint News Release
COVID-19 pandemic: countries urged to take stronger action to stop spread of harmful information
The World Health Organization (WHO) together with the UN, specialised agencies and partners today called on countries to develop and implement action plans to promote the timely dissemination of science-based information and prevent the spread of false information while respecting freedom of expression.
WHO, the UN, UNICEF, UNAIDS, the UN Development Programme (UNDP), UNESCO, the International Telecommunication Union (ITU), the UN Global Pulse initiative and the International Federation of the Red Cross and Red Crescent Societies  (IFRC), together with the governments of Indonesia, Thailand and Uruguay held a webinar on the margins of the 75th UN General Assembly to draw attention to the harm being done by the spread of misinformation and disinformation, the latter being deliberate misinformation to advance an agenda.
“As soon as the virus spread across the globe, inaccurate and even dangerous messages proliferated wildly over social media, leaving people confused, misled and ill-advised”, said UN Secretary-General António Guterres. ”Our initiative, called “Verified”, is fighting misinformation with truth. We work with media partners, individuals, influencers and social media platforms to spread content that promotes science, offers solutions and inspires solidarity. This will be especially critical as we work to build public confidence in the safety and efficacy of future COVID-19 vaccines. We need a ‘people’s vaccine’ that is affordable and available to all.”…

23 September 2020 Statement
Managing the COVID-19 infodemic: Promoting healthy behaviours and mitigating the harm from misinformation and disinformation
Joint statement by WHO, UN, UNICEF, UNDP, UNESCO, UNAIDS, ITU, UN Global Pulse, and IFRC
[See COVID-19 above for detail]

23 September 2020 News release
UNGA Virtual high-level side event on mitigating the impact of COVID-19

22 September 2020 News release
Tobacco responsible for 20% of deaths from coronary heart disease

21 September 2020 News release
Boost for global response to COVID-19 as economies worldwide formally sign up to COVAX facility
:: 64 higher income economies have now joined the COVAX Facility, with a further 38 economies expected to sign in the coming days
:: These self-financing economies, which include 29 from ‘Team Europe’ participating as part of an agreement with the European Commission, join 92 lower income economies eligible for financial support through the Gavi COVAX Advance Market Commitment
:: This means a total of 156 economies, representing nearly two-thirds of the global population, are now committed to or eligible to receive vaccines through the Facility Click here for the list of economies

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Weekly Epidemiological Record, 25 September 2020, vol. 95, 39 (pp. 461–476)
:: Neglected tropical diseases: impact of COVID-19 and WHO’s response
:: Summary of global update on implementation of preventive chemotherapy against neglected tropical diseases in 2019
COVID-19 update
:: Monthly report on dracunculiasis cases, January–July 2020

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WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: Social, environmental factors seen behind Africa’s low COVID-19 cases 24 September 2020
COVID-19 transmission in Africa has been marked by relatively fewer infections, which have been on the decline over the past two months, owing to a variety of socio-ecological factors as well as early and strong public health measures taken by governments across the region.

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 deploys help to refugees and migrants in Lesvos’s fire-burned camp in the midst of COVID-19 outbreak 24-09-2020
:: WHO launches guide to boost children’s health and well-being in Russian-speaking countries 23-09-2020
:: WHO/Europe’s Regional Director begins visit to Russian Federation with commitment to global solidarity in fight against COVID-19 22-09-2020

WHO Eastern Mediterranean Region EMRO
:: EU/WHO deliver emergency supplies to flood-affected areas in Somalia 23 September 2020
:: Cancer patients in Yemen face compounded pain of disease and conflict 20 September 2020

WHO Western Pacific Region
No new digest content identified

CDC/ACIP [to 26 Sep 2020]
http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html
Latest News Releases, Announcements
ACIP Meeting Registration – October 28-30, 2020
No Registration is required for the October ACIP Meeting.
The October 28-30, 2020 ACIP Meeting will be a virtual meeting with no in-person attendance.

Administration Announces $200 million from CDC to Jurisdictions for COVID-19 Vaccine Preparedness
Wednesday, September 23, 2020
The Department of Health and Human Services (HHS) is announcing upcoming action by the Centers for Disease Control and Prevention (CDC) to provide $200 million to jurisdictions for COVID-19 vaccine preparedness.
Funding from the Coronavirus Aid, Relief, and Economic Security Act (CARES) will provide critical infrastructure support to existing grantees through CDC’s immunization cooperative agreement. CDC is awarding $200 million to 64 jurisdictions through the existing Immunizations and Vaccines for Children cooperative agreement. These funds, along with the previous support CDC has provided, will help states prepare for the COVID-19 vaccine.
“By building on close partnerships with the states and other jurisdictions we have worked with for years on vaccination programs, we have the ability to begin distributing and administering safe and effective COVID-19 vaccines as soon as they are authorized and available,” said HHS Secretary Alex Azar. “With these $200 million in new funds, jurisdictions can develop and update plans for the eventual distribution and administration of the safe and effective vaccines that will help bring this pandemic to an end. The federal government, including experts from CDC and the Department of Defense, is ready to assist where necessary.”…

MMWR News Synopsis Friday, September 25, 2020
Characteristics and Maternal and Birth Outcomes of Hospitalized Pregnant Women with Laboratory-Confirmed COVID-19 — COVID-NET, 13 States, March 1–August 22, 2020 (Early release September 16, 2020)

SARS-CoV-2 Infection Among Hospitalized Pregnant Women: Reasons for Admission and Pregnancy Characteristics — Eight U.S. Health Care Centers, March 1–May 30, 2020 (Early release September 16, 2020)

COVID-19 Contact Tracing in Two Counties — North Carolina, June–July 2020 (Early release September 22, 2020)

Update: Characteristics of Health Care Personnel with COVID-19 — United States, February 12–July 16, 2020

Disparities in COVID-19 Incidence, Hospitalizations, and Testing, by Area-Level Deprivation — Utah, March 3–July 9, 2020

Africa CDC [to 26 Sep 2020]
http://www.africacdc.org/
News
Workshop on promoting manufacturing of personal protective equipment in Africa
21 September 2020

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/
News
Sept 26: Daily briefing on novel coronavirus cases in China
On Sept 25, 31 provincial-level regions and the Xinjiang Production and Construction Corps on the Chinese mainland reported 15 new cases of confirmed infections.

China firmly supports WHO’s leading role in battling COVID-19: Xi
Updated: 2020-09-24 Xinhua
BEIJING — Chinese President Xi Jinping said on Sept 23 that China firmly supports the key leadership of the United Nations (UN) system, especially the World Health Organization, in battling COVID-19.
Xi made the remarks during a videoconference with UN Secretary-General Antonio Guterres.

Announcements

Paul G. Allen Frontiers Group [to 26 Sep 2020]
https://alleninstitute.org/what-we-do/frontiers-group/news-press/
News
SCANning for coronavirus
The SCAN study launched to track Covid-19 in the Seattle area led by Allen Discovery Center leader Dr. Jay Shendure
September 23, 2020

BARDA – U.S. Department of HHS [to 26 Sep 2020]
https://www.phe.gov/about/barda/Pages/default.aspx
BARDA News
No new digest content identified.

BMGF – Gates Foundation [to 26 Sep 2020]
http://www.gatesfoundation.org/Media-Center/Press-Releases
SEPTEMBER 21, 2020
Gates Foundation Honors Director of Africa CDC With 2020 Global Goalkeeper Award
Foundation also announces three Global Goals award winners and launches two innovative partnerships to address COVID-19 impacts in Kenya
…“Dr. Nkengasong and his team at Africa CDC are deeply deserving of this award,” said Bill Gates, co-chair of the Bill & Melinda Gates Foundation. “Their commitment to securing the latest innovations from elsewhere in the world—as well as developing them themselves—will go a long way towards ensuring that the continent has the vaccines and medicines it needs to fight COVID-19.”
In addition to Dr. Nkengasong, this year’s awards went to Hauwa Ojeifo of Nigeria, Bonita Sharma of Nepal, and the MASH Project Foundation based in India. Each was recognized for playing a role in addressing the effects of COVID-19 in their communities. More details about each of the awards and their winners follows…

Bill & Melinda Gates Medical Research Institute [to 26 Sep 2020]
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 26 Sep 2020]
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.
09.22.2020  |
CARB-X funds GSK to develop a new drug for urinary tract infections (UTI) caused by Escherichia coli bacteria
CARB-X is awarding up to US$7.51 million to GlaxoSmithKline (NYSE: GSK), to develop a new drug to treat and prevent recurrent urinary tract infections (UTIs) caused by the Escherichia coli (E. coli) bacteria.

CEPI – Coalition for Epidemic Preparedness Innovations [to 26 Sep 2020]
http://cepi.net/
Latest News
Boost for global response to COVID-19 as economies worldwide formally sign up to COVAX Facility
21 Sep 2020
> 64 higher income economies have now joined the COVAX Facility, with a further 38 economies expected to sign in the coming days
> These self-financing economies, which include 29 from ‘Team Europe’ participating as part of an agreement with the European Commission, join 92 lower income economies eligible for financial support through the Gavi COVAX Advance Market Commitment
> This means a total of 156 economies, representing nearly two-thirds of the global population, are now committed to or eligible to receive vaccines through the Facility Click here for the list of economies

EDCTP [to 26 Sep 2020]
http://www.edctp.org/
The European & Developing Countries Clinical Trials Partnership (EDCTP) aims to accelerate the development of new or improved drugs, vaccines, microbicides and diagnostics against HIV/AIDS, tuberculosis and malaria as well as other poverty-related and neglected infectious diseases in sub-Saharan Africa, with a focus on phase II and III clinical trials
Latest news
No new digest content identified.

Emory Vaccine Center [to 26 Sep 2020]
http://www.vaccines.emory.edu/
Vaccine Center News
No new digest content identified.

European Medicines Agency [to 26 Sep 2020]
http://www.ema.europa.eu/ema/
News & Press Releases
News: Guideline on registry-based studies – launch of public consultation
Last updated: 24/09/2020
EMA has published its draft  Guideline on registry-based studies for a three-month public consultation today. The new draft guidance aims to optimise the use of registry-based studies as a source of real-world evidence.
Patient registries are databases containing quantitative and qualitative data about patients who are affected by a particular condition.
The guideline addresses methodological, legal and operational aspects in the use of registry-based studies to support regulatory decision-making.Stakeholders are invited to send their comments via a online form by 31 December 2020…

European Vaccine Initiative [to 26 Sep 2020]
http://www.euvaccine.eu/
Latest News
No new digest content identified.

FDA [to 26 Sep 2020]
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
Press Announcements
September 25, 2020 – Coronavirus (COVID-19) Update: Daily Roundup September 25, 2020
:: The FDA issued an updated FDA COVID-19 Response At-A-Glance Summary which provides a quick look at facts, figures and highlights of the agency’s response efforts.
Testing updates:
:: As of today, 255 tests are authorized by FDA under EUAs; these include 204 molecular tests, 47 antibody tests, and 4 antigen tests.

September 24, 2020 – Coronavirus (COVID-19) Update: Daily Roundup September 24, 2020
:: FDA developed new health education materials that have been culturally and linguistically tailored for diverse consumers. These materials are intended for health care professionals to share with their patients to help stimulate dialogue and answer pressing questions about FDA’s response to COVID-19. The materials provide information on the different areas of the FDA’s response to the pandemic, including health fraud, medical product supply, therapeutics, vaccine development, and diagnostic and antibody testing.

September 23, 2020 – Coronavirus (COVID-19) Update: FDA Authorizes First Point-of-Care Antibody Test for COVID-19

September 23, 2020 – Coronavirus (COVID-19) Update: Daily Roundup September 23, 2020
:: FDA Commissioner Stephen M. Hahn, M.D., testified before the Senate Committee on Health, Education, Labor and Pensions at a hearing entitled, “COVID-19: An Update on the Federal Response.”
:: FDA today posted a document summarizing updated evidence to support the emergency use of COVID-19 Convalescent Plasma. The agency will continue to review the circumstances and appropriateness of the authorization for emergency use. To make this information accessible to the public, the document posted on the web presents FDA’s review in relatively plain language.

September 22, 2020 – FDA Launches the Digital Health Center of Excellence
Today, the U.S. Food and Drug Administration announced it is launching the Digital Health Center of Excellence within the Center for Devices and Radiological Health (CDRH). The launch of the Digital Health Center of Excellence is an important step in furthering the agency’s overarching dedication to the advancement of digital health technology, including mobile health devices, Software as a Medical Device (SaMD), wearables when used as a medical device, and technologies used to study medical products…

September 21, 2020 – Coronavirus (COVID-19) Update: Daily Roundup September 21, 2020
:: A new video entitled, Beware of Fraudulent Coronavirus Tests, Vaccines and TreatmentsExternal Link Disclaimer, explains to consumers that there are currently no FDA-approved drugs or vaccines to treat or prevent COVID-19. Products that fraudulently claim to cure, treat, diagnose, or prevent COVID-19 haven’t been evaluated by the FDA for safety and effectiveness for such use, and they might be dangerous to you and your family.
:: The FDA has added content to the question-and-answer appendix in its guidance titled “Conduct of Clinical Trials of Medical Products during COVID-19 Public Health Emergency.” The updated guidance includes a new question-and-answer regarding a clinical trial investigator’s responsibility to review all investigational new drug application safety reports, including reports that will not result in a change to the investigator brochure, informed consent, or protocol.

Fondation Merieux [to 26 Sep 2020]
http://www.fondation-merieux.org/
News, Events
Rodolphe Mérieux Laboratory
Training at the Rodolphe Mérieux Laboratory in Goma, a key player in the fight against COVID-19 in the DRC
September 25, 2020 – DRC
From September 8 to 15, the team at the Rodolphe Mérieux Laboratory of the National Institute of Biomedical Research (INRB) in Goma, and staff from the INRB in Kinshasa, received training on diagnostic testing, including COVID-19, from Mérieux Foundation experts

Gavi [to 26 Sep 2020]
https://www.gavi.org/
News releases
25 September 2020
Experimental approaches to address post-transition risks
After transitioning out of Gavi support in 2017, the Republic of Moldova is mobilising champions and advocates to strengthen vaccine confidence – which is crucial to the success and sustainability of immunisation programmes.

24 September 2020
Typhoid: immunising against antimicrobial resistance
In November 2019, Pakistan took a big step forward to protect future generations when it became the first country to introduce typhoid conjugate vaccine (TCV) into its routine immunisation programme. Spread through contaminated food and water, typhoid is a preventable disease that disproportionately affects young people and under-served communities in Asia and sub-Saharan Africa. It is often associated with poorer urban areas where there is little access to sanitation or clean water…

23 September 2020
Gavi at UNGA: Global solidarity to defeat COVID-19 and create a better world for all
September 2020 marks the 75th anniversary of the United Nations General Assembly (UNGA). This year, the focus of the high-level General Debate is the importance of effective multilateralism: “The future we want, the United Nations we need: reaffirming our collective commitment to multilateralism – confronting COVID-19 through effective multilateral action.”
A typically very busy time of the year at the UN Headquarters in New York is reimagined as a series of virtual discussions, with COVID-19 high on the agenda – as economies continue to grapple with the health, social and economic fallout from the crisis, and its impact on the Sustainable Development Goals. Being a central player in the COVID-19 response as a co-lead of COVAX, Gavi is working to end the acute phase of the pandemic through urgent and collaborative action…

GHIT Fund [to 26 Sep 2020]
https://www.ghitfund.org/newsroom/press
GHIT was set up in 2012 with the aim of developing new tools to tackle infectious diseases that No new digest content identified.

Global Fund [to 26 Sep 2020]
https://www.theglobalfund.org/en/news/
News/Updates
No new digest content identified.

Global Research Collaboration for Infectious Disease Preparedness [GloPID-R] [to 26 Sep 2020]
https://www.glopid-r.org/news/
News
No new digest content identified.

Hilleman Laboratories [to 26 Sep 2020]
http://www.hillemanlabs.org/
No new digest content identified.

Human Vaccines Project [to 26 Sep 2020]
http://www.humanvaccinesproject.org/media/press-releases/
Press Releases, Events
Global COVID Lab Meeting
The Next Great Frontier: COVID Vaccine Development
Oct 01, 2020

Global COVID Lab Meeting
October 8th speaker: Emanuele Andreano
Oct 08, 2020

IAVI [to 26 Sep 2020]
https://www.iavi.org/newsroom
No new digest content identified.

International Coalition of Medicines Regulatory Authorities [ICMRA]
http://www.icmra.info/drupal/en/news
Selected Statements, Press Releases, Research
No new digest content identified.

International Generic and Biosimilar Medicines Association [IGBA]
https://www.igbamedicines.org/
News
Global Roadmap for Tailored Clinical Biosimilar Development: Instrumental for Sustainable Access to Biologics (24 September 2020)
Following its first peer-reviewed scientific paper on biosimilar medicines development: the Path Towards Tailored Clinical Biosimilar Development (Biodrugs), the International Generic and Biosimilar medicines Association (IGBA), which represents global manufacturers of generic and biosimilar medicines, today released a new policy paper:
“Developing a Regulatory Framework Supporting Biosimilar Competition: The Opportunity for Tailored Clinical Biosimilar Development”

IFFIm
http://www.iffim.org/
Announcements
No new digest content identified.

IFRC [to 26 Sep 2020]
http://media.ifrc.org/ifrc/news/press-releases/
Selected Press Releases, Announcements
Global
At least 51.6 million people doubly hit by climate-related disasters and COVID-19, new analysis by IFRC reveals
New York, Geneva, 23 September 2020 – New analysis published today by the International Federation of Red Cross and Red Crescent Societies (IFRC) and the Red Cross Red Crescent Climate Centre reveals that at least 51.6 million people worldwide have bee …
23 September 2020

IRC International Rescue Committee [to 26 Sep 2020]
http://www.rescue.org/press-release-index
Media highlights [Selected]
Press Release
25 Years Following the Beijing Platform for Action Finds Widening Gaps in Gender Equality for Women and Girls in Conflict Settings
September 24, 2020

Press Release
Deadly malaria and cholera outbreaks grow amongst refugees as COVID pandemic strains health systems, warns IRC
September 22, 2020

Press Release
As the U.S. reaches 200,000 COVID-19 deaths, IRC expresses concern for U.S. ability to protect vulnerable populations at home and abroad
September 20, 2020

IVAC [to 26 Sep 2020]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
Updates; Events
No new digest content identified.

IVI [to 26 Sep 2020]
http://www.ivi.int/
Selected IVI News & Announcements
No new digest content identified.

JEE Alliance [to 26 Sep 2020]
https://www.jeealliance.org/
Selected News and Events
No new digest content identified.

MSF/Médecins Sans Frontières [to 26 Sep 2020]
http://www.msf.org/
Latest [Selected Announcements]
Iraq
COVID-19 outbreak in Baghdad is “very alarming”
Project Update 24 Sep 2020

South Sudan
Heavy floods threaten the lives of thousands of people in Greater Pibor
Project Update 23 Sep 2020

Coronavirus COVID-19 pandemic
Ten-fold increase in COVID-19 cases adds new challenges in northwest S…
Project Update 22 Sep 2020

Palestine
Tackling COVID-19 in Hebron, the epicentre of the outbreak in Palestine
Project Update 21 Sep 2020

Coronavirus COVID-19 pandemic
COVID-19 and rural South Africa
org.za 21 Sep 2020

National Vaccine Program Office – U.S. HHS [to 26 Sep 2020]
https://www.hhs.gov/vaccines/about/index.html\
NVAC Meetings
Agenda
September 23, 2020 – September 24, 2020
This meeting was held virtually.

NIH [to 26 Sep 2020]
http://www.nih.gov/news-events/news-releases
Selected News Releases
Scientists discover genetic and immunologic underpinnings of some cases of severe COVID-19
September 24, 2020 — NIH investigator co-led international research effort.
New findings by scientists at the National Institutes of Health and their collaborators help explain why some people with COVID-19 develop severe disease. The findings also may provide the first molecular explanation for why more men than women die from COVID-19.

The researchers found that more than 10% of people who develop severe COVID-19 have misguided antibodies―autoantibodies―that attack the immune system rather than the virus that causes the disease. Another 3.5% or more of people who develop severe COVID-19 carry a specific kind of genetic mutation that impacts immunity. Consequently, both groups lack effective immune responses that depend on type I interferon, a set of 17 proteins crucial for protecting cells and the body from viruses. Whether these proteins have been neutralized by autoantibodies or―because of a faulty gene―were produced in insufficient amounts or induced an inadequate antiviral response, their absence appears to be a commonality among a subgroup of people who suffer from life-threatening COVID-19 pneumonia.

These findings are the first published results from the COVID Human Genetic Effort(link is external), an international project spanning more than 50 genetic sequencing hubs and hundreds of hospitals. The effort is co-led by Helen Su, M.D., Ph.D., a senior investigator at the National Institute of Allergy and Infectious Diseases (NIAID), part of NIH; and Jean-Laurent Casanova, M.D., Ph.D., head of the St. Giles Laboratory of Human Genetics of Infectious Diseases at The Rockefeller University in New York. Major contributions were made by Luigi Notarangelo, M.D., chief of the NIAID Laboratory of Clinical Immunology and Microbiology (LCIM); Steven Holland, M.D., director of the NIAID Division of Intramural Research and senior investigator in the NIAID LCIM; clinicians and investigators in hospitals in the Italian cities of Brescia, Monza and Pavia, which were heavily hit by COVID-19; and researchers at the Uniformed Services University of the Health Sciences in Bethesda, Maryland…

Fourth large-scale COVID-19 vaccine trial begins in the United States
September 23, 2020 — Trial evaluating investigational Janssen COVID-19 vaccine.
[See COVID-19 above for detail]

NIH expands clinical trials to test convalescent plasma against COVID-19
September 22, 2020 — Rigorous studies to build on earlier efforts to test the experimental treatment
Two randomized, placebo-controlled clinical trials funded by the National Institutes of Health (NIH) are expanding enrollment to further evaluate convalescent plasma as a treatment for patients hospitalized with COVID-19. Preliminary observational studies indicate that convalescent plasma may improve outcomes among severely ill and hospitalized patients with COVID-19. Prospective, well-controlled randomized trials are needed to generate sufficient data on whether convalescent plasma is effective and safe for the treatment of COVID-19…

PATH [to 26 Sep 2020]
https://www.path.org/media-center/
Press Releases
No new digest content identified.

Sabin Vaccine Institute [to 26 Sep 2020]
http://www.sabin.org/updates/pressreleases
Statements and Press Releases
No new digest content identified.

UNAIDS [to 26 Sep 2020]
http://www.unaids.org/en
Selected Press Releases/Reports/Statements
25 September 2020
HIV recency testing programme launched in eastern Europe and central Asia

24 September 2020
How the Jamaica transgender community is surviving COVID-19

22 September 2020
By any means necessary: defending human rights in Uganda in the time of COVID-19

21 September 2020
“Physical distance, not social distance”: supporting Jamaican women living with HIV during COVID-19

21 September 2020
90–90–90: good progress, but the world is off-track for hitting the 2020 targets

UNICEF [to 26 Sep 2020]
https://www.unicef.org/media/press-releases
Press release
09/25/2020
Remarks by Henrietta Fore, UNICEF Executive Director, at the launch of the Every Woman Every Child Progress report [delivered on her behalf by Omar Abdi, Deputy Executive Director for Programmes]

Press release
09/24/2020
Conflict, climate crisis and COVID-19 pose great threats to the health of women and children

Statement
09/23/2020
As classrooms for half the world’s schoolchildren remain closed, UNICEF and EU urge countries to prioritize schools in re-opening plans
Statement by EU High Representative for Foreign Affairs and Security Policy Josep Borrell, EU Vice-President Dubravka Šuica, and UNICEF Executive Director Henrietta Fore on the occasion of Digital Cooperation Action Day at the UN General Assembly, and ahe

Statement
09/23/2020
Managing the COVID-19 infodemic: Promoting healthy behaviours and mitigating the harm from misinformation and disinformation
Joint statement by WHO, UN, UNICEF, UNDP, UNESCO, UNAIDS, ITU, UN Global Pulse, and IFRC

Press release
09/23/2020
COVID-19 pandemic: countries urged to take stronger action to stop spread of harmful information

Statement
09/23/2020
Statement by UNICEF Executive Director Henrietta Fore on the European Commission’s proposed Pact on Migration and Asylum

Press release
09/22/2020
Boost for global response to COVID-19 as economies worldwide formally sign up to COVAX Facility
64 higher income economies have now joined the COVAX Facility, with a further 38 economies expected to sign in the coming days

Press release
09/21/2020
Time to re-open schools in Eastern & Southern Africa, as the cost for children escalates in learning, protection and nutrition

Unitaid [to 26 Sep 2020]
https://unitaid.org/
Featured News
No new digest content identified.

Vaccination Acceptance Research Network (VARN) [to 26 Sep 2020]
https://vaccineacceptance.org/news.html#header1-2r
Announcements
No new digest content identified.

Vaccine Confidence Project [to 26 Sep 2020]
http://www.vaccineconfidence.org/
Research and Reports
Online Event: CSIS Book Launch with Heidi J. Larson – Stuck
19 Sep 2020

Vaccine Education Center – Children’s Hospital of Philadelphia [to 26 Sep 2020]
http://www.chop.edu/centers-programs/vaccine-education-center
September 2020
Vaccine Update for Providers
:: Announcements: Updated VEC materials
:: Recent interviews with Dr. Offit
While Dr. Offit has been busy giving a variety of interviews, a couple of recent conversations may be of particular interest:
The Race to a COVID-19 Vaccine with Dr. Paul Offit, University of Pennsylvania, Perry World House, Sept. 1, 2020
Paul Offit’s Biggest Concern about COVID Vaccines, Medscape, Sept. 9, 2020
The VEC’s Current Issues in Vaccines webinar, “Making a COVID-19 Vaccine at Warp Speed,” scheduled for noon ET on Sept. 23 and will be archived on this page by Sept. 25.
:: News & views – COVID-19 and kids — What do we know?
Charlotte A. Moser, Assistant Director, and Paul A. Offit, Director, Vaccine Education Center at Children’s Hospital of Philadelphia

Wellcome Trust [to 26 Sep 2020]
https://wellcome.ac.uk/news
Explainer | 25 September 2020
What are human infection studies and why do we need them?
Human infection studies (also known as human challenge trials and controlled human infection models) have the power to rapidly accelerate the development of much-needed vaccines and treatments, including for Covid-19.

Explainer | 23 September 2020
From equality to global poverty: how Covid-19 is affecting societies and economies
The Covid-19 pandemic is a social and an economic crisis just as much as it is a health crisis – its repercussions, severe and far-reaching, are being felt across the world.

The Wistar Institute [to 26 Sep 2020]
https://www.wistar.org/news/press-releases
Press Releases
No new digest content identified.

WFPHA: World Federation of Public Health Associations [to 26 Sep 2020]
https://www.wfpha.org/
Latest News
No new digest content identified.

World Organisation for Animal Health (OIE) [to 26 Sep 2020]
https://www.oie.int/en/for-the-media/press-releases/2020/
Press Releases
No new digest content identified.

::::::

ARM [Alliance for Regenerative Medicine] [to 26 Sep 2020]
https://alliancerm.org/press-releases/
Press Releases
No new digest content identified.

BIO [to 26 Sep 2020]
https://www.bio.org/press-releases
Press Releases
BIO Presents Leadership and Legacy Award to Sharon Bomer Lauritsen
Washington, D.C. (September 22, 2020) –The Biotechnology Innovation Organization (BIO) today presented Sharon Bomer Lauritsen, founder of AgTrade Strategies LLC, former Assistant United States Trade Representative for Agricultural Affairs and Commodity Policy, and a past leader of BIO’s Food and Agriculture Section, with the fifth annual BIO Leadership and Legacy Award.

DCVMN – Developing Country Vaccine Manufacturers Network [to 26 Sep 2020]
http://www.dcvmn.org/
News; Upcoming events
No new digest content identified.

ICBA – International Council of Biotechnology Associations [to 26 Sep 2020]
https://internationalbiotech.org/
News
No new digest content identified.

IFPMA [to 26 Sep 2020]
http://www.ifpma.org/resources/news-releases/
Selected Press Releases, Statements, Publications
Innovative health industries united in welcoming UNGA Resolution on “Comprehensive and Coordinated Response to the COVID-19 Pandemic
22 September 2020
Joint Statement – Global Innovative Health Industries Alliance
Innovative health industries united in welcoming United Nations General Assembly Resolution on “Comprehensive and Coordinated Response to the COVID-19 Pandemic “
On behalf of global biopharmaceutical and medical technologies companies, the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), the International Council of Biotechnology Associations (ICBA), the Global Diagnostic Imaging, Healthcare IT & Radiation Therapy Trade Association (DITTA), and the Global Self-Care Federation (GSCF) welcome the adoption of Omnibus Resolution [1]highlighting the need for global response and effective international cooperation to ensure that no one is left behind in the race against COVID-19.

We share the view that a well-coordinated, inclusive, multi-stakeholder approach and solidarity are the only possible solutions to help solve the COVID-19 global public health emergency. We welcome the encouragement expressed in the Resolution to cooperate with the private sector, and to promote public-private partnerships to contain, mitigate and defeat the pandemic and its consequences, including by exchanging information, scientific knowledge and best practices. As WHO’s Director General recently stated, “the private sector has an essential role to play in combating this public health crisis through their expertise, innovation, and resources.” We believe that being an equal partner in all coordination efforts and actively participating in multi-stakeholder’ platforms is the only way forward.

We fully endorse the call to put in place a whole of government and whole of society response, with a view to sustainably strengthening the health system, social care and support systems, preparedness, and response capacities, engaging with communities and collaborating with relevant stakeholders. This pandemic showed that strengthening health systems, effective emergency preparedness, and ensure continued investments in global health are measures of critical importance. Our members are working to secure the continuity of supply for all essential medicines, and vaccines for patients with other life-threatening diseases, urging governments to implement policies and decisions that facilitate access for all those in need.

We reaffirm our commitment as an essential partner, in terms of investing in medicines, vaccines and medical technologies development and pursuing approaches to expand access, equal and fair distribution of solutions globally. Since the early days of this pandemic, private sector stakeholders responded through many initiatives aimed at providing and prioritizing delivery of needed critical products to tackle COVID-19 while also addressing research and development of innovative health technologies including preventive tools, diagnostics, treatment, medicines, and vaccines, motivated by a strong sense of responsibility to act together, in partnership with WHO and governments, to support health systems across the world in a concerted and collective response. Access to COVID-19 vaccines is a collective responsibility that calls for highly coordinated and collaborative action by public and private actors’ alike and global solidarity to solve the COVID-19 pandemic. We are fully supportive of the work of the ACT-Accelerator and fully committed to the goals of the COVAX pillar to accelerate development, production, and equitable access to safe, quality effective COVID-19 vaccines, leaving no one behind.

The decades-long investments our industries have made in new technology research, underpinned by sound intellectual property protection, have prepared us to act swiftly to respond to the crisis. Our member companies are pushing the boundaries of science, developing workable solutions, and ensuring there is capacity to scale up. They are also re-directing manufacture of urgently needed products once solutions are found, while at the same time, ensuring continuity of global supply for critical products.

Focusing on these critical components, including reinforcing the mindset of systems thinking and international cooperation, will better prepare and equip our societies for future crises. Regular communication and coordination between governments and industry is the fastest and surest path to success. A strong partnership is essential now, and in the weeks and months to come.

Finally we would like to underline the full recognition given in the resolution for the critical role of and efforts made by health workers, and other frontline and essential workers, including humanitarian personnel, around the world aimed at addressing the pandemic through measures to protect the health, safety and well-being of people. Their remarkable work should serve as motivation for others who are key for tackling this pandemic.

We look forward to continuing good cooperation and collaboration with all relevant stakeholders and welcome the adoption of this overarching resolution as an impetus to strive for an open channel of communication and to working constructively to overcome obstacles and promote timely access to prevention, diagnosis, treatment and after care.
[1] A/RES/74/306

Innovative vaccine and medicine industry applaud country commitments to COVAX Facility
21 September 2020
Vaccine makers, and biopharmaceutical industry more generally, are encouraged to see the broad international support the COVAX Facility has received today.

The 156 economies committed to participate in the Facility, including 64 higher income economies, represent the best chance the world has to ensure that by 2021, 64% of the global population has access to safe and effective COVID-19 vaccines. In so doing, wealthier countries are showing their solidarity towards others. Vaccine makers reaffirm their unstinting support for this most ambitious pandemic-response initiative ever conceived.

IFPMA, the body representing the biopharmaceutical industry globally is a founding member of the ACT-Accelerator of which the COVID-19 Vaccine Global Access Facility (COVAX) is a key pillar. The vaccine industry has a seat at the table in acknowledgement of the industry’s key role in research, development and its expertise in being able to scale up manufacturing to unprecedented levels.

“It is very encouraging to see so many countries move from talk to full commitment. The Facility can only work, and equitable access can only be achieved, if there is solidarity between rich and poorer countries. Today vaccine makers who have the unique skills and expertise to scale up manufacturing to levels never seen before, stand ready, together, to take up the challenge of providing two billion doses of yet unknown COVID-19 vaccines. This is no mean feat, as it requires doubling existing capacity in record time. Today, marks a significant step forward, and is a historic mark of solidarity which has the power to bring the acute phase of this pandemic to an end; and we are proud to be part of this unique endeavour to leave no one behind” said Thomas Cueni, Director General of the IFPMA.

From day one, vaccine makers have stepped up in an unprecedented manner, with leading innovative companies devoting resources, expertise, know-how and intellectual assets to developing potential vaccines. However, we are deeply aware that science and innovation are only part of the equation. As part of our responsibility towards society, we must also ensure equitable global access to safe, high quality, effective, and affordable COVID-19 vaccines. This is why it is so important to partner with multilateral organizations like the WHO and Gavi, the Vaccine Alliance and CEPI to identify the global need and, along with donor governments and philanthropic foundations, address the unique challenges faced by low-income and middle-income countries.

COVID-19 is cruelly driving home a tough lesson: facing any global health challenge, in particular of such unprecedented scale, requires solidarity and inclusive cooperation. Governments are all understandably eager to protect their citizens, and their investments have contributed to the much-needed acceleration of development and upscaling of manufacturing capacity that the world needs.

The COVAX Facility has a unique objective of making sure that all countries have access to the broadest portfolio of COVID-19 vaccine candidates across a range of technologies, regardless of their ability to pay. It is specifically designed to maximize the chances of success by investing in the development and manufacture of a large number of vaccine candidates at the same time.

As we continue working towards a common shared goal of bringing the pandemic to an end, we must also prepare for the obstacles that we face in reaching vulnerable populations in each corner of the world. This includes manufacturing at risk billions of doses of a yet unknown vaccine thus doubling if not tripling current capacity, as well as preparing for a massive distribution of vaccines that may have unique logistical attributes.

PhRMA [to 26 Sep 2020]
http://www.phrma.org/
Selected Press Releases, Statements
Growth in innovative, value-based contracts holds promise for the health system and for patients
Katie Koziara   |     September 24, 2020

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 focu-s 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 Medical Ethics
http://www.biomedcentral.com/bmcmedethics/content
(Accessed 26 Sep 2020)

Ethical and human rights considerations in public health in low and middle-income countries: an assessment using the case of Uganda’s responses to COVID-19 pandemic
Authors: John Barugahare, Fredrick Nelson Nakwagala, Erisa Mwaka Sabakaki, Joseph Ochieng and Nelson K Sewankambo
Content type: Debate
22 September 2020
In response to COVID-19 pandemic, the Government of Uganda adopted public health measures to contain its spread in the country. Some of the initial measures included refusal to repatriate citizens studying in China, mandatory institutional quarantine, and social distancing. Despite being a public health emergency, the measures adopted deserve critical appraisal using an ethics and human rights approach. The goal of this paper is to formulate an ethics and human rights criteria for evaluating public health measures and use it to reflect on the ethical propriety of those adopted by the government of Uganda to contain the spread of COVID-19.

BMC Medical Ethics
http://www.biomedcentral.com/bmcmedethics/content
(Accessed 26 Sep 2020)

Structural coercion in the context of community engagement in global health research conducted in a low resource setting in Africa
Authors: Deborah Nyirenda, Salla Sariola, Patricia Kingori, Bertie Squire, Chiwoza Bandawe, Michael Parker and Nicola Desmond
Content type: Research article
21 September 2020
The results showed that structural coercion arose due to an interplay of factors pertaining to social-economic context, study design and power relations among research stakeholders. The involvement of community leaders, government stakeholders, and power inequalities among research stakeholders affected some participants’ ability to make autonomous decisions about research participation. These results have been presented under the themes of perception of research as development, research participants’ motivation to access individual benefits, the power of vernacular translations to influence research participation, and coercive power of leaders.

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 26 Sep 2020)

Prevalence and genotype distribution of genital human papillomavirus infection in female sex workers in the world: a systematic review and meta-analysis
Female sex workers (FSWs) are amongst the most susceptible groups to acquire human papillomavirus (HPV) infection and consequently, to develop cervical intraepithelial neoplasia and cervical cancer. This is th…
Authors: Mohammad Farahmand, Mohsen Moghoofei, Abolfazl Dorost, Saeedeh Abbasi, Seyed Hamidreza Monavari, Seyed Jalal Kiani and Ahmad Tavakoli
Citation: BMC Public Health 2020 20:1455
Content type: Research article
Published on: 25 September 2020

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 26 Sep 2020)

Parents’ knowledge, attitude and practice towards children’s vaccination in Lebanon: role of the parent-physician communication
One of the most effective public health interventions in the world is immunization. However, some parents doubt its usefulness and safety. Many factors influence their decision to vaccinate, including their so…
Authors: Perla Matta, Rayane El Mouallem, Marwan Akel, Souheil Hallit and Marie-Claude Fadous Khalife
Citation: BMC Public Health 2020 20:1439
Content type: Research article
Published on: 22 September 2020

The European Journal of Public Health
Volume 30, Issue Supplement_4, September 2020
https://academic.oup.com/eurpub/issue/30/Supplement_4

Commentary
A public health approach to health workforce policy development in Europe
Natasha Azzopardi-Muscat
European Journal of Public Health, Volume 30, Issue Supplement_4, September 2020, Pages iv3–iv4, https://doi.org/10.1093/eurpub

Gates Open Research
https://gatesopenresearch.org/browse/articles
[Accessed 26 Sep 2020]

Research Article metrics AWAITING PEER REVIEW
Impact of pneumococcal conjugate vaccine uptake on childhood pneumonia mortality across income levels in Brazil, Colombia, and Peru [version 1; peer review: awaiting peer review]
Kayoko Shioda, Cristiana M. Toscano, Maria Tereza Valenzuela, William Valdez Huarcaya, Joshua L. Warren, Daniel M. Weinberger, Lucia H. de Oliveira

Globalization and Health
http://www.globalizationandhealth.com/

Articles
Social capital and public health: responding to the COVID-19 pandemic
As countries continue to respond to the COVID-19 pandemic, the importance of ensuring that fair and equal access to healthcare for all is more urgent than ever. Policies that promote social capital building al…
Authors: Anna S. Y. Wong and Jillian C. Kohler
Citation: Globalization and Health 2020 16:88
Content type: Commentary
Published on: 25 September 2020

International Journal of Community Medicine and Public Health
Vol 7, No 10 (2020) October 2020
https://www.ijcmph.com/index.php/ijcmph/issue/view/67

Original Research Articles
Factors influencing incomplete immunization among under five years old children at CHUK hospital, Nyarugenge district, Rwanda
Chinenye Mercy Nwankwo, Elizabeth Orua
DOI: 10.18203/2394-6040.ijcmph20204340

JAMA Network
COVID-19 Update September 26, 2020

These articles on COVID-19 were published across the JAMA Network in the last week.

JAMA
September 22/29, 2020, Vol 324, No. 12, Pages 1123-1255
https://jamanetwork.com/journals/jama/currentissue

Research Letter
Geographic Distribution of US Cohorts Used to Train Deep Learning Algorithms
Amit Kaushal, MD, PhD; Russ Altman, MD, PhD; Curt Langlotz, MD, PhD
JAMA. 2020;324(12):1212-1213. doi:10.1001/jama.2020.12067
This study describes the US geographic distribution of patient cohorts used to train deep learning algorithms in published radiology, ophthalmology, dermatology, pathology, gastroenterology, and cardiology machine learning articles published in 2015-2019.

Journal of Community Health
Volume 45, issue 5, October 2020
https://link.springer.com/journal/10900/volumes-and-issues/45-5

Articles
Prevent and Protect: A Vaccination Initiative for Uninsured Patients at a Student-Run Free Clinic
Authors (first, second and last of 9)
Toaa Abuelenen, Sabrina Khalil, Eduardo Gonzalez, Content type: Original Paper
Published: 18 March 2020

Journal of Community Health
Volume 45, issue 5, October 2020
https://link.springer.com/journal/10900/volumes-and-issues/45-5

Food Insecurity and Influenza and Pneumonia Vaccines Uptake Among Community-Dwelling Older Adults in the United States
Authors (first, second and last of 5)
Asos Mahmood, Hyunmin Kim, Meredith Ray, Content type: Original Paper
Published: 26 March 2020

Journal of Community Health
Volume 45, issue 5, October 2020
https://link.springer.com/journal/10900/volumes-and-issues/45-5

Using Peer Health Educators to Conduct Community Level Surveillance of HPV Vaccination Status: Findings Among Women Who Live in Medically Underserved Areas of Chicago
Authors (first, second and last of 4)
Jessica M. Madrigal, Camille A. Johnson, Ashlesha Patel, Content type: Original Paper
Published: 14 May 2020

Journal of Community Health
Volume 45, issue 5, October 2020
https://link.springer.com/journal/10900/volumes-and-issues/45-5

Parent-Level Barriers and Facilitators to HPV Vaccine Implementation in Santo Domingo, Dominican Republic
Authors (first, second and last of 6)
Erica Liebermann, Nancy Van Devanter, Cheryl Healton
Content type: Original Paper
Published: 11 May 2020

Journal of Medical Ethics
October 2020 – Volume 46 – 10
http://jme.bmj.com/content/current

Ethical framework for adult social care in COVID-19 (7 August, 2020) Free
Charlotte Bryony Elves, Jonathan Herring

Journal of Medical Ethics
October 2020 – Volume 46 – 10
http://jme.bmj.com/content/current

Immunity passports, fundamental rights and public health hazards: a reply to Brown et al (9 September, 2020)
Iñigo de Miguel Beriain, Jon Rueda

Journal of Medical Ethics
October 2020 – Volume 46 – 10
http://jme.bmj.com/content/current

Passport to freedom? Immunity passports for COVID-19 (15 August, 2020)
Rebecca C H Brown, Julian Savulescu, Bridget Williams, Dominic Wilkinson

Journal of Medical Ethics
October 2020 – Volume 46 – 10
http://jme.bmj.com/content/current

Tragic choices in intensive care during the COVID-19 pandemic: on fairness, consistency and community (7 August, 2020)
Chris Newdick, Mark Sheehan, Michael Dunn

Journal of Medical Ethics
October 2020 – Volume 46 – 10
http://jme.bmj.com/content/current

Covid 19 Current Controversies
Revisiting the equity debate in COVID-19: ICU is no panacea (22 June, 2020) Free
Angela Ballantyne, Wendy A Rogers, Vikki Entwistle, Cindy Towns

Journal of Pharmaceutical Policy and Practice
https://joppp.biomedcentral.com/
[Accessed 26 Sep 2020]

Community pharmacist-administered seasonal influenza vaccination: a national customer survey
In Switzerland, the influenza vaccination is recommended for high-risk groups and people who have contact with high-risk groups. Since 2015, Swiss pharmacists are allowed to vaccinate healthy adults after acqu…
Authors: Dominik Stämpfli, Adrian Martinez-De la Torre, Sophie Du Pasquier, Danielle Stegmann, Andrea Brügger and Andrea M. Burden
Citation: Journal of Pharmaceutical Policy and Practice 2020 13:57
Content type: Research
Published on: 25 September 2020

Journal of Pharmaceutical Policy and Practice
https://joppp.biomedcentral.com/
[Accessed 26 Sep 2020]

The use of remdesivir outside of clinical trials during the COVID-19 pandemic
With a scientific background from filoviruses, paramyxoviruses, SARS-CoV, and MERS-CoV, remdesivir entered into the COVID-19 battle to become one of the favorable therapeutic candidates with potential antivira…
Authors: Vesa Halimi, Armond Daci, Nevenka Ridova, Irina Panovska-Stavridis, Milena Stevanovic, Venko Filipce, Aleksandar Dimovski and Aleksandra Grozdanova
Citation: Journal of Pharmaceutical Policy and Practice 2020 13:61
Content type: Commentary
Published on: 21 September 2020

The Lancet
Sep 26, 2020 Volume 396 Number 10255 p867-934, e41-e52
https://www.thelancet.com/journals/lancet/issue/current

Editorial
COVID-19 in India: the dangers of false optimism
The Lancet

The Lancet
Sep 26, 2020 Volume 396 Number 10255 p867-934, e41-e52
https://www.thelancet.com/journals/lancet/issue/current

Comment
COVID-19 vaccines: early success and remaining challenges
Naor Bar-Zeev, Tom Inglesby

The Lancet
Sep 26, 2020 Volume 396 Number 10255 p867-934, e41-e52
https://www.thelancet.com/journals/lancet/issue/current

It is time to get serious about vaccine confidence
Daniel A Salmon,
Matthew Z Dudley

The Lancet
Sep 26, 2020 Volume 396 Number 10255 p867-934, e41-e52
https://www.thelancet.com/journals/lancet/issue/current

Offline: COVID-19 is not a pandemic
Richard Horton
As the world approaches 1 million deaths from COVID-19, we must confront the fact that we are taking a far too narrow approach to managing this outbreak of a new coronavirus. We have viewed the cause of this crisis as an infectious disease. All of our interventions have focused on cutting lines of viral transmission, thereby controlling the spread of the pathogen. The “science” that has guided governments has been driven mostly by epidemic modellers and infectious disease specialists, who understandably frame the present health emergency in centuries-old terms of plague. But what we have learned so far tells us that the story of COVID-19 is not so simple. Two categories of disease are interacting within specific populations—infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and an array of non-communicable diseases (NCDs). These conditions are clustering within social groups according to patterns of inequality deeply embedded in our societies. The aggregation of these diseases on a background of social and economic disparity exacerbates the adverse effects of each separate disease. COVID-19 is not a pandemic. It is a syndemic. The syndemic nature of the threat we face means that a more nuanced approach is needed if we are to protect the health of our communities.

The notion of a syndemic was first conceived by Merrill Singer, an American medical anthropologist, in the 1990s. Writing in The Lancet in 2017, together with Emily Mendenhall and colleagues, Singer argued that a syndemic approach reveals biological and social interactions that are important for prognosis, treatment, and health policy. Limiting the harm caused by SARS-CoV-2 will demand far greater attention to NCDs and socioeconomic inequality than has hitherto been admitted. A syndemic is not merely a comorbidity. Syndemics are characterised by biological and social interactions between conditions and states, interactions that increase a person’s susceptibility to harm or worsen their health outcomes. In the case of COVID-19, attacking NCDs will be a prerequisite for successful containment. As our recently published NCD Countdown 2030 showed, although premature mortality from NCDs is falling, the pace of change is too slow. The total number of people living with chronic diseases is growing. Addressing COVID-19 means addressing hypertension, obesity, diabetes, cardiovascular and chronic respiratory diseases, and cancer. Paying greater attention to NCDs is not an agenda only for richer nations. NCDs are a neglected cause of ill-health in poorer countries too. In their Lancet Commission, published last week, Gene Bukhman and Ana Mocumbi described an entity they called NCDI Poverty, adding injuries to a range of NCDs—conditions such as snake bites, epilepsy, renal disease, and sickle cell disease. For the poorest billion people in the world today, NCDIs make up over a third of their burden of disease. The Commission described how the availability of affordable, cost-effective interventions over the next decade could avert almost 5 million deaths among the world’s poorest people. And that is without considering the reduced risks of dying from COVID-19.

The Lancet
Sep 26, 2020 Volume 396 Number 10255 p867-934, e41-e52
https://www.thelancet.com/journals/lancet/issue/current

Mapping global trends in vaccine confidence and investigating barriers to vaccine uptake: a large-scale retrospective temporal modelling study
Alexandre de Figueiredo, Clarissa Simas, Emilie Karafillakis, Pauline Paterson, Heidi J Larson
There is growing evidence of vaccine delays or refusals due to a lack of trust in the importance, safety, or effectiveness of vaccines, alongside persisting access issues. Although immunisation coverage is reported administratively across the world, no similarly robust monitoring system exists for vaccine confidence. In this study, vaccine confidence was mapped across 149 countries between 2015 and 2019.

The Lancet
Sep 26, 2020 Volume 396 Number 10255 p867-934, e41-e52
https://www.thelancet.com/journals/lancet/issue/current

Articles
Safety and immunogenicity of an rAd26 and rAd5 vector-based heterologous prime-boost COVID-19 vaccine in two formulations: two open, non-randomised phase 1/2 studies from Russia
Denis Y Logunov, et al

The Lancet
Sep 26, 2020 Volume 396 Number 10255 p867-934, e41-e52
https://www.thelancet.com/journals/lancet/issue/current

Perspectives
Profile
Heidi Larson: shifting the conversation about vaccine confidence
Pamela Das

The Lancet
Sep 26, 2020 Volume 396 Number 10255 p867-934, e41-e52
https://www.thelancet.com/journals/lancet/issue/current

Offline: COVID-19 is not a pandemic

Richard Horton

As the world approaches 1 million deaths from COVID-19, we must confront the fact that we are taking a far too narrow approach to managing this outbreak of a new coronavirus. We have viewed the cause of this crisis as an infectious disease. All of our interventions have focused on cutting lines of viral transmission, thereby controlling the spread of the pathogen. The “science” that has guided governments has been driven mostly by epidemic modellers and infectious disease specialists, who understandably frame the present health emergency in centuries-old terms of plague. But what we have learned so far tells us that the story of COVID-19 is not so simple. Two categories of disease are interacting within specific populations—infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and an array of non-communicable diseases (NCDs). These conditions are clustering within social groups according to patterns of inequality deeply embedded in our societies. The aggregation of these diseases on a background of social and economic disparity exacerbates the adverse effects of each separate disease. COVID-19 is not a pandemic. It is a syndemic. The syndemic nature of the threat we face means that a more nuanced approach is needed if we are to protect the health of our communities.

The notion of a syndemic was first conceived by Merrill Singer, an American medical anthropologist, in the 1990s. Writing in The Lancet in 2017, together with Emily Mendenhall and colleagues, Singer argued that a syndemic approach reveals biological and social interactions that are important for prognosis, treatment, and health policy. Limiting the harm caused by SARS-CoV-2 will demand far greater attention to NCDs and socioeconomic inequality than has hitherto been admitted. A syndemic is not merely a comorbidity. Syndemics are characterised by biological and social interactions between conditions and states, interactions that increase a person’s susceptibility to harm or worsen their health outcomes. In the case of COVID-19, attacking NCDs will be a prerequisite for successful containment. As our recently published NCD Countdown 2030 showed, although premature mortality from NCDs is falling, the pace of change is too slow. The total number of people living with chronic diseases is growing. Addressing COVID-19 means addressing hypertension, obesity, diabetes, cardiovascular and chronic respiratory diseases, and cancer. Paying greater attention to NCDs is not an agenda only for richer nations. NCDs are a neglected cause of ill-health in poorer countries too. In their Lancet Commission, published last week, Gene Bukhman and Ana Mocumbi described an entity they called NCDI Poverty, adding injuries to a range of NCDs—conditions such as snake bites, epilepsy, renal disease, and sickle cell disease. For the poorest billion people in the world today, NCDIs make up over a third of their burden of disease. The Commission described how the availability of affordable, cost-effective interventions over the next decade could avert almost 5 million deaths among the world’s poorest people. And that is without considering the reduced risks of dying from COVID-19.

The most important consequence of seeing COVID-19 as a syndemic is to underline its social origins. The vulnerability of older citizens; Black, Asian, and minority ethnic communities; and key workers who are commonly poorly paid with fewer welfare protections points to a truth so far barely acknowledged—namely, that no matter how effective a treatment or protective a vaccine, the pursuit of a purely biomedical solution to COVID-19 will fail. Unless governments devise policies and programmes to reverse profound disparities, our societies will never be truly COVID-19 secure. As Singer and colleagues wrote in 2017, “A syndemic approach provides a very different orientation to clinical medicine and public health by showing how an integrated approach to understanding and treating diseases can be far more successful than simply controlling epidemic disease or treating individual patients.” I would add one further advantage. Our societies need hope. The economic crisis that is advancing towards us will not be solved by a drug or a vaccine. Nothing less than national revival is needed. Approaching COVID-19 as a syndemic will invite a larger vision, one encompassing education, employment, housing, food, and environment. Viewing COVID-19 only as a pandemic excludes such a broader but necessary prospectus.

New England Journal of Medicine
September 24, 2020 Vol. 383 No. 13
http://www.nejm.org/toc/nejm/medical-journal

Perspective
Competing Visions for the Future of Health Policy
Matthew Fiedler, Ph.D.
Beyond Covid-19, two other health policy issues are poised to feature prominently in the 2020 U.S. elections: what role government should play in ensuring broad health insurance coverage, and how to cope with the lack of competition in many health care provider markets.

PharmacoEconomics
Volume 38, issue 10, October 2020
https://link.springer.com/journal/40273/volumes-and-issues/38-10

Artilces
Future of Data Analytics in the Era of the General Data Protection Regulation in Europe
Authors (first, second and last of 5)
Katarzyna Kolasa, W. Ken Redekop, Carl V. Asche
Content type: Current Opinion
Published: 08 June 2020

PharmacoEconomics
Volume 38, issue 10, October 2020
https://link.springer.com/journal/40273/volumes-and-issues/38-10

Cost of Nine Pediatric Infectious Illnesses in Low- and Middle-Income Countries: A Systematic Review of Cost-of-Illness Studies
Authors (first, second and last of 6)
Gatien de Broucker, So Yoon Sim, Dagna O. Constenla, Content type:
Systematic Review
Open Access
Published: 04 August 2020

PNAS – Proceedings of the National Academy of Sciences of the United States of America
http://www.pnas.org/content/early/

Article
The rise of COVID-19 cases is associated with support for world leaders
Kai Chi Yam, Joshua Conrad Jackson, Christopher M. Barnes, Jenson Lau, Xin Qin, and Hin Yeung Lee
PNAS first published September 24, 2020. https://doi.org/10.1073/pnas.2009252117
Significance
Amid the present COVID-19 pandemic, we find that many citizens around the world “rally ‘round the flag” and increase their support for their respective political leaders. We observe these findings among countries that are culturally and geographically diverse, and even among leaders who are strongly disliked by citizens prior to the pandemic. Our findings could have important voting implications during or immediately after the pandemic. As an example, the Korean ruling party won the most seats in the house by any party since 1960 in an election held during the pandemic in April 2020. COVID-19 might thus serve as a catalyst to help some incumbent governments.

Revista Panamericana de Salud Pública/Pan American Journal of Public Health (RPSP/PAJPH)
https://www.paho.org/journal/en

23 Sep 2020
Epidemiological profile of extensively drug-resistant tuberculosis in Peru, 2013-2015
Original research | Spanish |

Revista Panamericana de Salud Pública/Pan American Journal of Public Health (RPSP/PAJPH)
https://www.paho.org/journal/en

Latest articles
25 Sep 2020
Social inequalities in the progression of COVID-19 in the Mexican population
Original research | Spanish |

Science
25 September 2020 Vol 369, Issue 6511
http://www.sciencemag.org/current.dtl

Self-experimentation, ethics, and regulation of vaccines
By Christi J. Guerrini, Jacob S. Sherkow, Michelle N. Meyer, Patricia J. Zettler

Science25 Sep 2020 : 1570-1572
DIY COVID-19 vaccines raise legal and ethical questions
Summary
As the coronavirus disease 2019 (COVID-19) pandemic continues to sweep the globe, several groups have been working to develop and self-administer unapproved, unproven interventions that they describe as vaccines for COVID-19 (1–4). Some of the interest in these do-it-yourself (DIY) approaches apparently stems from a belief that self-experimentation is never subject to time-consuming ethics board review or regulation, such as by the U.S. Food and Drug Administration (FDA). This belief is legally and factually incorrect, and the misunderstanding has potentially important public health implications. Any failure by the FDA to regulate DIY vaccines would permit vaccines of dubious safety and effectiveness to endanger public health and would signal a lowering of standards that—in an age blighted by vaccine skepticism and during a highly politicized pandemic—could undermine public trust in all vaccines, however developed (5). Further, some self-experimentation can qualify as human subjects research that is required to undergo ethics review, by law or institutional policy. Even when ethics review is not required, citizen scientists must take seriously their heightened ethical responsibilities when promoting DIY interventions, especially those with potentially serious public health and societal effects, such as COVID-19 vaccines. Given the proliferation of citizen science efforts to fight COVID-19 and the general confusion (even among sophisticated scientists) that surrounds the regulation of DIY research, regulatory leadership is badly needed.

Science
25 September 2020 Vol 369, Issue 6511
http://www.sciencemag.org/current.dtl

Review
The science and medicine of human immunology
By Bali Pulendran, Mark M. Davis
Science25 Sep 2020
Immunology through a human lens
The coronavirus disease 2019 (COVID-19) pandemic has underscored the critical need to better understand the human immune system and how to unleash its power to develop vaccines and therapeutics. Much of our knowledge of the immune system has accrued from studies in mice, yet vaccines and drugs that work effectively in mice do not always translate into humans. Pulendran and Davis review recent technological advances that have facilitated the study of the immune system in humans. They discuss new insights and how these can affect the development of drugs and vaccines in the modern era.
Abstract
Although the development of effective vaccines has saved countless lives from infectious diseases, the basic workings of the human immune system are complex and have required the development of animal models, such as inbred mice, to define mechanisms of immunity. More recently, new strategies and technologies have been developed to directly explore the human immune system with unprecedented precision. We discuss how these approaches are advancing our mechanistic understanding of human immunology and are facilitating the development of vaccines and therapeutics for infection, autoimmune diseases, and cancer.

Science
25 September 2020 Vol 369, Issue 6511
http://www.sciencemag.org/current.dtl

Self-experimentation, ethics, and regulation of vaccines
By Christi J. Guerrini, Jacob S. Sherkow, Michelle N. Meyer, Patricia J. Zettler

Science Translational Medicine
23 September 2020 Vol 12, Issue 562
https://stm.sciencemag.org/

Editorial
We’re on our own
By H. Holden Thorp
Science Translational Medicine23 Sep 2020
The failure of U.S. government scientists in the Trump administration to follow the science around COVID-19 has left the medical community to fend for itself.