Continued HPV vaccination in the face of unexpected challenges: A commentary on the rationale for an extended interval two-dose schedule

Vaccine
Volume 39, Issue 6 Pages 865-1024 (5 February 2021)
https://www.sciencedirect.com/journal/vaccine/vol/39/issue/6

 

Discussion No access
Continued HPV vaccination in the face of unexpected challenges: A commentary on the rationale for an extended interval two-dose schedule
Hilary S. Whitworth, John Schiller, Lauri E. Markowitz, Mark Jit, … Deborah Watson-Jones
Pages 871-875

Immunogenicity, duration of protection, effectiveness and safety of rubella containing vaccines: A systematic literature review and meta-analysis

Vaccine
Volume 39, Issue 6 Pages 865-1024 (5 February 2021)
https://www.sciencedirect.com/journal/vaccine/vol/39/issue/6

 

Review article Abstract only
Immunogenicity, duration of protection, effectiveness and safety of rubella containing vaccines: A systematic literature review and meta-analysis
Jossy van den Boogaard, Brechje de Gier, Priscila de Oliveira Bressane Lima, Shalini Desai, … Irene K. Veldhuijzen
Pages 889-900

Healthcare Workers’ (HCWs) attitudes towards mandatory influenza vaccination: A systematic review and meta-analysis

Vaccine
Volume 39, Issue 6 Pages 865-1024 (5 February 2021)
https://www.sciencedirect.com/journal/vaccine/vol/39/issue/6

 

Review article Abstract only
Healthcare Workers’ (HCWs) attitudes towards mandatory influenza vaccination: A systematic review and meta-analysis
Maria Rosaria Gualano, Alessio Corradi, Gianluca Voglino, Dario Catozzi, … Roberta Siliquini
Pages 901-914

Effect of educational and financial incentive-based interventions on immunization attitudes, beliefs, intentions and receipt among close contacts of pregnant women

Vaccine
Volume 39, Issue 6 Pages 865-1024 (5 February 2021)
https://www.sciencedirect.com/journal/vaccine/vol/39/issue/6

 

Research article Abstract only
Effect of educational and financial incentive-based interventions on immunization attitudes, beliefs, intentions and receipt among close contacts of pregnant women
Matthew Z. Dudley, Michael S. Taitel, Renae Smith-Ray, Tanya Singh, … Daniel A. Salmon

Vaccine coverage in children born to migrant mothers in Australia: A population-based cohort study

Vaccine
Volume 39, Issue 6 Pages 865-1024 (5 February 2021)
https://www.sciencedirect.com/journal/vaccine/vol/39/issue/6

 

Research article Abstract only
Vaccine coverage in children born to migrant mothers in Australia: A population-based cohort study
Ikram Abdi, Heather Gidding, Robert Neil Leong, Hannah C. Moore, … Robert Menzies
Pages 984-993

Effect of provider recommendation style on the length of adolescent vaccine discussions

Vaccine
Volume 39, Issue 6 Pages 865-1024 (5 February 2021)
https://www.sciencedirect.com/journal/vaccine/vol/39/issue/6

 

Research article Abstract only
Effect of provider recommendation style on the length of adolescent vaccine discussions
Anny T.H.R. Fenton, Chelsea Orefice, Terresa J. Eun, Dea Biancarelli, … Rebecca B. Perkins
Pages 1018-1023

Internet Survey of Awareness and Behavior Related to HPV Vaccination in Japan

Vaccines — Open Access Journal
http://www.mdpi.com/journal/vaccines
(Accessed 30 Jan 2021)

 

Open Access Article
Internet Survey of Awareness and Behavior Related to HPV Vaccination in Japan
by Risa Kudo et a;
Vaccines 2021, 9(2), 87; https://doi.org/10.3390/vaccines9020087 – 25 Jan 2021
Abstract
Recommendations for HPV vaccines were suspended in 2013 due to unfounded safety fears in Japan. We aimed to clarify the differences between vaccinated and unvaccinated females in their awareness, knowledge, and behaviors toward cervical cancer, HPV vaccination and sex. Questionnaires were administered online […]

Media/Policy Watch

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

 

The Atlantic
http://www.theatlantic.com/magazine/
Accessed 30 Jan 2021
[No new, unique, relevant content]

 

BBC
http://www.bbc.co.uk/
Accessed 30 Jan 2021
[No new, unique, relevant content]

 

The Economist
http://www.economist.com/
Accessed 30 Jan 2021
[No new, unique, relevant content]

 

Financial Times
https://www.ft.com/
Accessed 30 Jan 2021
Coronavirus treatment
EU pledges vaccine controls will not hit UK supplies
Von der Leyen vows BioNTech/Pfizer orders from Belgium will not be disrupted during tense call with Johnson
30 Jan 2021
Ursula von der Leyen has promised Boris Johnson that future EU controls on vaccines will not disrupt contracted supplies of the Belgian-made BioNTech/Pfizer vaccine to Britain.
The European Commission president made the commitment to the prime minister in a tense Friday night call, which followed the Commission’s controversial plan — hastily abandoned — to impose emergency border controls on vaccines entering Northern Ireland from the EU.
Ms von der Leyen tweeted that the talks with Mr Johnson had been “constructive”, adding: “We agreed on the principle that there should not be restrictions on the export of vaccines by companies where they are fulfilling contractual responsibilities.”…

Covid-19 vaccines
Moderna cuts deliveries to Italy and France in new blow to EU vaccination plans
…Vaccine manufacturer Moderna has told Italy and France it will deliver fewer doses than expected in February, in another blow to struggling coronavirus vaccination plans in the EU…
January 29, 2021

Explainer Coronavirus treatment
Brussels publishes EU-AstraZeneca vaccine contract
…Brussels has published its coronavirus vaccine contract with AstraZeneca in the latest gambit in the escalating row between the two over a delivery shortfall. The company agreed to disclose a redacted…
January 29, 2021

Top of Form
Bottom of Form

 

Forbes
http://www.forbes.com/
Accessed 30 Jan 2021
Breaking  |
6 hours ago
Vaccine Plan For Gitmo Paused After Outrage From Republicans
Vaccinations could have started next week, according to reports.
By Nicholas Reimann Forbes Staff

7 hours ago
Vaccination Passports Set To Happen–But Are They Fair?
Vaccination or Immunity passports seem like the logical next step after negative Covid-19 tests to get the travel sector up and running, and they look set to happen–but are they ethical?
By Alex Ledsom Senior Contributor

Breaking  |
Jan 29, 2021
WHO: Vaccine Hoarding Would Be A “Catastrophic Moral Failure” That Keeps “Pandemic Burning”
The WHO said that affluent countries “fighting over the cake” are in danger of neglecting frontline health workers in developing countries that “don’t even have access to the crumbs.”
By Tommy Beer Forbes Staff

 

Foreign Affairs
http://www.foreignaffairs.com/
Accessed 30 Jan 2021
Snapshot January 28, 2021
Why the World Lost to the Pandemic
Two new developments have exacerbated the impact of and response to the pandemic: politicization and securitization.
Yanzhong Huang

 

Foreign Policy
http://foreignpolicy.com/
Accessed 30 Jan 2021
Argument
Europe’s Vaccine Disaster Isn’t Lack of Supply
As the EU tries to acquire more vaccines, it’s failing to effectively use the ones it already has.
Jacob Funk Kirkegaard

Argument
The Global Vaccine Rollout Is Failing—and That Puts Everyone, Everywhere, In Danger
The selfish reasons the United States and Europe must help poor countries deal with COVID-19.
By Jonathan Tepperman
| January 28, 2021

Argument
Blocking Undocumented Immigrants From Vaccination Is Self-Sabotage
A crucial and vulnerable population needs rapid access to the COVID-19 vaccine.
By Eillen Martinez, Zackary Berger
| January 28, 2021

 

The Guardian
http://www.guardiannews.com/
Accessed 30 Jan 2021
WHO urges Britain to pause Covid jabs after treating vulnerable
The World Health Organization has urged the UK to pause its vaccination programme after vulnerable groups have received their jabs to help ensure the global rollout of doses is fair.
Boris Johnson has said he aims to offer all adults in the UK a first dose by autumn. However, the WHO said countries should be aiming for 2bn doses to be “fairly distributed” around the world by the end of 2021.
A WHO spokeswoman, Margaret Harris, said she wanted to appeal to people in the UK, telling them: “You can wait” because ensuring equitable global distribution is “clearly morally the right thing to do”…

 

New Yorker
http://www.newyorker.com/
Accessed 30 Jan 2021
Q. & A.
Why Rich Countries Should Subsidize Vaccination Around the World
The economists Selva Demiralp and Muhammed A. Yildirim say there is an economic as well as a moral case for getting COVID-19 vaccines into the arms of the world’s people.
By Isaac Chotiner 6:00 A.M.

 

New York Times
http://www.nytimes.com/
Accessed 30 Jan 2021
World
Tanzania’s president says ‘vaccines don’t work,’ earning a rebuff from the W.H.O.
By Abdi Latif Dahir Jan. 28

World
Germany says vaccine shortages are likely to last another 10 weeks, and other news from around the world.
By Melissa Eddy, Richard C. Paddock, Javier C. Hernández, Mike Ives and Amy Chang Chien Jan. 28

Asia Pacific
To Avoid an Outbreak, China Cancels Lunar New Year for Millions of Migrants
China has added restrictions, offered incentives and appealed to a sense of filial and national responsibility, in an effort to prevent about 300 million migrant workers from going home for the holiday.
By Javier C. Hernández and Alexandra Stevenson Jan. 28

 

Washington Post
https://www.washingtonpost.com/
Accessed 30 Jan 2021
Algeria starts COVID-19 vaccination drive with Russian shots
Associated Press · Jan 30, 2021

Think Tanks et al

Think Tanks et al

Brookings
http://www.brookings.edu/
Accessed 30 Jan 2021
TechStream
Building robust and ethical vaccination verification systems
Baobao Zhang, Laurin Weissinger, Johannes Himmelreich, Nina McMurry, Tiffany Li, Naomi Schinerman, and Sarah Kreps
Tuesday, January 26, 2021
 
 
Center for Global Development [to 30 Jan 2021]
http://www.cgdev.org/page/press-center
How to Make COVID-19 Vaccination a Success? Policy Priorities and Implementation from Israel and Around the World
Event 1/26/21
This panel of renowned experts will discuss policy options and strategies for expedited mass vaccination, the extent the current lockdowns support these strategies while impacting the economy, and what constitutes real success – and ultimately victory – over the virus around the globe.
 
 
Chatham House [to 30 Jan 2021]
https://www.chathamhouse.org/
Accessed 30 Jan 2021
[No new relevant content]

 
 
CSIS
https://www.csis.org/
Accessed 30 Jan 2021
Transcript
Online Event: Trusting a COVID-19 Vaccine: The Role of the Media and Misinformation
January 29, 2021

On Demand Event
Online Event: The State of Immunization Under Covid-19
January 29, 2021

Commentary
Vaccine Diplomacy Is Biden’s First Test in Southeast Asia
January 28, 2021 | By Gregory B. Poling, Simon Tran Hudes

 

Council on Foreign Relations
http://www.cfr.org/
Accessed 30 Jan 2021
[No new relevant content]

 

Kaiser Family Foundation
https://www.kff.org/search/?post_type=press-release
Accessed 30 Jan 2021
January 27, 2021 News Release
Vaccine Monitor: Nearly Half of the Public Wants to Get a COVID-19 Vaccine as Soon as They Can or Has Already Been Vaccinated, Up across Racial and Ethnic Groups Since December
Most Convincing Messages to Promote Vaccination Highlight Effectiveness at Preventing Illness and a Return to Normal Life; Hearing about Rare Allergic Reactions and Side Effects May Discourage Some New KFF Dashboard Features Key Data and Insights from the Vaccine Monitor With millions of Americans getting their first COVID-19 vaccinations, the…

World Economic Forum [to 30 Jan 2021]
https://agenda.weforum.org/news/
Media
Cooperation Vital to Uphold as Pandemic Challenges Continue
News 29 Jan 2021

Vaccines and Global Health: The Week in Review :: 23 January 2021

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

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

– pdf version A pdf of the current issue is available here: 

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

– Twitter:  Readers can also follow developments on twitter: @vaxethicspolicy.
.
– Links:  We endeavor to test each link as we incorporate it into any post, but recognize that some links may become “stale” as publications and websites reorganize content over time. We apologize in advance for any links that may not be operative. We believe the contextual information in a given post should allow retrieval, but please contact us as above for assistance if necessary.

Support this knowledge-sharing service: Your financial support helps us cover our costs and to address a current shortfall in our annual operating budget. Click here to donate and thank you in advance for your contribution.

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

WHO – 148th session of the Executive Board EB148

WHO – 148th session of the Executive Board EB148

18-26 January 2021

:: Webcast

:: Main Documents

:: EB148/1 Rev.1   Agenda
:: EB148/1(annotated)  Provisional agenda (annotated)

[Editor’s Note: EB148 continues through 26 January 2021. In our next edition we will provide key resolutions/ decisions/updates]

::::::

Statement to the 148th Executive Board by the Chair of the Review Committee on the Functioning of the International Health Regulations (2005) during the COVID-19 Response

Professor Lothar H. Wieler, President of the Robert Koch Institute, Germany

19 January 2021   Statement

…Thank you once again for the opportunity to provide you with an update on the work of the Review Committee on the Functioning of the International Health Regulations (2005) during COVID-19.

As you know, this Committee was convened by the Director-General on 8 September 2020, in line with World Health Assembly Resolution WHA73.1. The Committee is composed of experts with a wide range of expertise and with adequate gender and geographical representation. I have the honour to be the Chair of this Committee and am ably supported by our Vice-Chair, Professor Lucille Blumberg of South Africa and our Rapporteur, Professor Preben Aavitsland, from Norway.

Our mandate is to review the functioning of the International Health Regulations (2005) during the COVID-19 response and the status of implementation of the relevant recommendations of previous IHR Review Committees and to make technical recommendations to the Director-General, including any potential amendments.

We convened for 16 closed meetings so far, and we continue to work through three sub-groups: preparedness, alert, and response. I take this opportunity to reiterate my thanks to our three subgroup leads. We also convened 5 open meetings, when we provided updates on our work and listened to the submissions and questions raised by Member States, international agencies and non-governmental organizations in official relation to WHO. These open meetings continue to be attended by numerous designated representatives.

I reported on our progress to the 73rd World Health Assembly on 9 November 2020. And I continue to interact regularly with the Co-Chairs of the Independent Panel for Pandemic Preparedness and Response and the Chair of the Independent Oversight Advisory Committee.

Let me now turn to the substance of our work. I invite you to read our Interim Progress Report, document EB148/19. It details our preliminary findings as of December 2020, which were reached following numerous interviews, discussions and the review of a wealth of documentation.

Let me point out the most important ones:

[1] Member States and experts overwhelmingly support the IHR as a cornerstone of international public health and health security law, but several areas need improving if we are to be better prepared for the next pandemic. While we have not finalized our article-by-article assessment, there is a growing belief in the Committee that most of the necessary improvements can be achieved through more effective implementation of the existing provisions of the IHR, and do not require at this point changes to the design of the IHR.

[2] National IHR Focal Points need to be further empowered, including where necessary through national legislation. National Focal Points play a critical role in the timely sharing of information, but their limited authority and status often lead to delays in notification. The Committee noted that effective IHR implementation requires many functions that are not within the narrow mandate of the national IHR focal points, such as multisectoral coordination for preparedness and response and collaborative risk assessment. The absence of a dedicated national entity with sufficient authority and a clear mandate to take ownership and leadership is considered a significant limitation to effective implementation of the IHR at national and subnational levels. At country level, national IHR focal points need to be integrated in the national emergency plan as well as the national health committee or similar body.

[3] The possible need for an intermediate level of alert before a Public Health Emergency of International Concern (PHEIC) is declared, is also under consideration. The previous review committee on the Ebola response recommended such an intermediate level, but this recommendation was not taken up. The 5th open meeting of the Committee on 12 January 2021 discussed issues surrounding the possible introduction of a grading system. The different views expressed by Member States and the advantages and potential disadvantages of a new system will be further studied by the Committee. It is clear, that global preparedness, alert and response actions need to start much earlier and more decisively than they did during COVID-19. But it is far from certain, that introducing an intermediate level of alert would result in such earlier action. The Committee is considering how regular global and regional risk assessments can be used better to drive earlier and more targeted response measures at all levels. The aim, the Committee feels, should be to react early and strongly enough so as to prevent the need to declare a PHEIC.

[4] Compliance with IHR provisions remains a challenge in several areas, from setting up core capacities to implementing travel measures during health emergencies. The Committee is mindful of the lack of teeth in the IHR. We are therefore looking at new ways to monitoring and evaluating adherence to the IHR – both in preparedness and response – and to strengthen existing tools without overburdening countries. Considering a peer-review mechanism similar to the Universal Periodic Review used by the Human Rights Council, may be useful in improving preparedness and response. For example, the Universal Periodic Review has been shown to foster intersectoral coordination and whole-of-government approaches, to encourage good practices, and to link implementation of its recommendations with other government agendas – all of which are vital to strengthening IHR implementation. It is in this context that the Director-General has proposed the Universal Health and Preparedness Review initiative which is currently being pilot tested.

[5] Last but far from least, political support and resources for IHR implementation remain insufficient and irregular at all levels. In this context, the Committee is awaiting further detailed information on the funding mechanisms for IHR implementation.

I would like to clearly state my conviction that we need more meaningful cooperation during and in-between health emergencies; more transparency, more regular detailed exchange of real-time data and experiences at all levels, more reliability of interaction, and greater speed in sharing data and samples. Fortunately, digital technology supporting such developments is increasingly becoming available, from data mining to find disease outbreaks early, to next generation sequencing to follow a pathogen around the globe, to virtual conferencing that makes human interaction easier.

To come to the conclusion, the deadline for our final report is the 74th World Health Assembly in May 2021. However, as we all know, the COVID-19 pandemic will be far from over in 4 months’ time, and therefore our findings and recommendations will not necessarily be complete. Further deliberations may be needed later…

Global Burden of Animal Diseases

Milestones :: Perspectives :: Research

 

Global Burden of Animal Diseases

Launch of the multi-year, multi-partner Global Burden of Animal Diseases programme
Animal health leaders and researchers from the Global Burden of Animal Diseases (GBADs) programme have secured US$7 million from the Bill & Melinda Gates Foundation and UK’s Foreign, Commonwealth and Development Office, to rollout a framework on measuring animal health burdens and their impacts on human lives and economies. The information provided by GBADs will guide public policy and private sector strategy, contributing to improve animal health and welfare more effectively. It will also be a basis for further academic research.

Paris,19 January 2021 – Across the world, livestock production and aquaculture are critical to human nutrition and health. These animals play critical roles in society, providing income and food, but also clothing, building materials, fertilizer and draught power. However, the presence of endemic and emerging diseases, as well as other factors, negatively impact them, jeopardising their contributions.

 

Every year, hundreds of millions of dollars are invested globally on disease mitigation in order to improve livestock health and productivity. Yet, a systematic way to determine the burden of animal disease on the health and wellbeing of people is not available. It is still unknown how the burden is apportioned between smallholders and the commercial sector, or across regions and gender. Consequently, decision makers lack the information to accurately assess whether their investments target the animal health issues that have the most significant impact on human wellbeing.

Measure to improve the management of animal diseases: A new programme
The GBADs programme, led by the World Organisation for Animal Health (OIE), the University of Liverpool, and a partnership of international institutions, will enable the examination of animal health and the disease burden from a different perspective. By assessing the global burden in economic terms, the programme will help identify the individuals and communities which are the most impacted, demonstrating how animal health is intrinsically linked to agricultural productivity, smallholder household income, the empowerment of women and the equitable provision of a safe, affordable, nutritious diet.

“It is more evident now for everyone that animal health and public health are interconnected and play an essential role in building a sustainable and healthy planet. Especially, if we succeed in incorporating the environmental and socioeconomic components”, said Dr Monique Eloit, OIE Director General.

“The GBADs programme is a key part of our commitment to deploying our research capacity toward the welfare of humankind. The GBADs programme is crucial in building a world with zero hunger, good health, and equality for all, an urgent mission in which we are proud to play our part. We are grateful for the support of the Bill and Melinda Gates Foundation and UK’s Foreign, Commonwealth and Development Office, who are supporting this work in partnership with the OIE. Together, we will realise a brighter future for animal and human wellbeing”, highlighted professor Dame Janet Beer, Vice-Chancellor, University of Liverpool.

The new partnership announced today will support the implementation of the GBADs programme. In a world where 1.25 billion people work in agriculture, this programme will have a positive impact on the Sustainable Development Goals contributing to Zero Hunger, Good Health and Well-being, Gender Equality; Decent Work and Economic Growth; and Responsible Consumption and Production.

NOTES FOR THE EDITOR:
GBADs is led by the World Organisation for Animal Health (OIE), the University of Liverpool, and a partnership of international institutions including: the Commonwealth Scientific and Industrial Research Organisation (CSIRO) Australia; University of Guelph, Canada; the Institute for Health Metrics and Evaluation, University of Washington, United States; the International Livestock Research Institute (ILRI), Ethiopia; Murdoch University, Australia; Sciensano, Belgium; Washington State University, United States; University of Zurich, Switzerland; and the Food and Agriculture Organization of the United Nations (FAO).

The GBADs programme has also received funding from the Australian Centre for International Agricultural Research (ACIAR), Brooke and DG-Sante European Commission.
ACIAR has supported a feasibility study in Indonesia leading to proposal submission for a multi-year case study.

Brooke is a global animal welfare organisation which uses international development approaches to improve the lives of working livestock and the people who rely on them. As part of the GBAD project, Brooke is funding and co-supervising a four-year PhD study on ‘Burden of Animal Diseases of Working Equids’, together with the University of Liverpool. DG-Sante is responsible for the European Union Commission’s policies on health and food safety and will support GBADs case studies in the European Region in 2021.

COVAX announces new agreement, plans for first deliveries

Milestones :: Perspectives :: Research

 

COVID – COVAX

COVAX announces new agreement, plans for first deliveries
:: COVAX announced the signing of an advance purchase agreement for up to 40 million doses of the Pfizer-BioNTech vaccine; rollout to commence with successful execution of supply agreements

:: Additionally, COVAX announced that, pending WHO emergency use listings, nearly 150 million doses of the AstraZeneca/Oxford candidate are anticipated to be available in Q1 2021, via existing agreements with the Serum Institute of India (SII) and AstraZeneca

:: COVAX is therefore on track to deliver at least 2 billion doses by the end of the year, including at least 1.3 billion doses to 92 lower income economies in the Gavi COVAX AMC

:: Click here for the latest COVAX supply forecast
[Editor’s text-bolding]
Geneva/Oslo 22 January 2021 – COVAX, the global initiative to ensure rapid and equitable access to COVID-19 vaccines for all countries, regardless of income level, today announced the signing of an advance purchase agreement with Pfizer for up to 40 million doses of the Pfizer-BioNTech vaccine candidate, which has already received WHO Emergency Use Listing. Rollout will commence with the successful negotiation and execution of supply agreements.

In further support of its mission to expedite early availability of vaccines to lower-income countries and help bring a rapid end to the acute stage of the COVID-19 pandemic, COVAX also confirmed today that it will exercise an option – via an existing agreement with Serum Institute of India (SII) – to receive its first 100 million doses of the AstraZeneca/Oxford University-developed vaccine manufactured by SII.

Of these first 100 million doses, the majority are earmarked for delivery in the first quarter of the year, pending WHO Emergency Use Listing. The WHO review process, which is currently underway, follows approval for restricted use in emergency situations by the Drugs Controller General of India earlier this month, and is a critical aspect of ensuring that any vaccine procured through COVAX is fully quality assured. According to the latest WHO update, a decision on this vaccine candidate is anticipated in the middle of February at the earliest.

COVAX also anticipates that, via an existing agreement with AstraZeneca, at least 50 million further doses of the AstraZeneca/Oxford vaccine will be available for delivery to COVAX participants in Q1 2021, pending regulatory approval by the WHO of the COVAX-specific manufacturing network for these doses. A decision on this candidate is anticipated by WHO in the second half of February at the earliest.

“Today marks another milestone for COVAX: pending regulatory approval for the AstraZeneca/Oxford candidate and the successful conclusion of the supply agreement for the Pfizer-BioNTech vaccine, we expect to be able to begin deliveries of life-saving COVID-19 vaccines February. This is not just significant for COVAX, it is a major step forward for equitable access to vaccines, and an essential part of the global effort to beat this pandemic. We will only be safe anywhere if we are safe everywhere,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance, which leads COVAX procurement and delivery.

 

Preparations, led by WHO, UNICEF and Gavi, are already well under way for COVAX to deliver vaccines to economies eligible for support via the COVAX AMC, with Gavi making US$ 150 million available from its core funding as initial, catalytic support for preparedness and delivery.

“The urgent and equitable rollout of vaccines is not just a moral imperative, it’s also a strategic and economic imperative,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “This agreement with Pfizer will help to enable COVAX to save lives, stabilize health systems and drive the global economic recovery.”

Building on the work of the past months supporting country readiness efforts, a “Country Readiness Portal” will be launched by WHO this month, which will allow AMC participants to submit final national deployment and vaccination plans (NDVPs). This is a vital step before allocations can be made, to ensure that delivered doses are able to be effectively deployed and to identify where, if necessary, further support is needed.

“These purchase agreements open the door for these lifesaving vaccines to become available to people in the most vulnerable countries,” said UNICEF Executive Director Henrietta Fore. “But at the same time we are securing vaccines we must also ensure that countries are ready to receive them, deploy them, and build trust in them.”

The COVAX Facility intends to provide all 190 participating economies with an indicative allocation of doses in one week’s time. This indicative allocation will provide interim guidance to participants – offering a minimum planning scenario to enable preparations for the final allocation of the number of doses each participant will receive.

 

Supply update
COVAX now has agreements in place to access just over two billion doses of several promising vaccine candidates. Negotiations continue for further doses to be secured through existing R&D agreements by COVAX co-lead the Coalition for Epidemic Preparedness Innovations (CEPI), through evaluations of new products with promising results and through contributions from donors.

Based on this, COVAX anticipates being able to provide participating economies doses of safe and effective vaccines – enough to protect health care and other frontline workers as well as some high-risk individuals – beginning in Q1 2021. The aim is to protect at least 20% of each participating population by the end of the year – unless a participant has requested a lower percentage of doses. At least 1.3 billion of these doses will be made available to the 92 economies eligible for the Gavi COVAX AMC by the end of 2021.

To meet its goal of securing two billion safe and effective vaccines in 2021, COVAX has built a diverse portfolio of vaccine candidates which mitigates the risk of a product failing in the development process, and ensures availability of products suitable for various contexts and settings. This work will continue at pace to enable further supply of vaccines suitable for use across a wide range of populations and settings in 2021 and beyond.

“The progress in vaccine development so far has been extraordinary, and it is clear that we are now assembling the tools we need to bring the acute phase of the pandemic to an end. But we cannot afford to slow our efforts given the speed with which this pandemic continues to wreak havoc,” said Dr Richard Hatchett, CEO of CEPI. “The emergence of new variants of COVID-19 puts into sharp focus the need for us to be one step ahead of the virus by continuing to invest in vaccine R&D – specifically for next-generation vaccine candidates and to be ready for strain changes in existing vaccines – to ensure we have the tools to meet the needs of all populations in all countries for the long term.”

 

::::::

Remarks by Henrietta Fore, UNICEF Executive Director, at press briefing on COVAX
Statement as delivered
01/22/2021
“…“UNICEF is currently assessing a series of bids in the COVID-19 vaccine tender launched in November. We are negotiating long-term supply agreements with a number of manufacturers – agreements that will pave the way for the world’s poorest countries to access doses of quality-assured vaccines.
“As part of this effort, I’m pleased to announce that UNICEF has awarded Pfizer a contract following the tender, and we are now in discussions to finalize the supply agreement.
“Thanks to UNICEF’s negotiations and our decades of experience procuring and delivering vaccines in every corner of the world, we have the expertise and know-how to do the job.
“Although today represents a milestone moment, important challenges remain for the unprecedented logistical exercise of rolling out vaccines in every corner of the globe.
“UNICEF and our partners are working with governments around the clock to ensure that countries are ready to receive the vaccines, with appropriate cold chain equipment in place and health workers trained to dispense them. UNICEF is also playing a lead role in efforts to foster trust in vaccines by tracking and addressing misinformation.
“In the coming weeks, UNICEF will begin transporting vaccines, together with syringes and safety boxes, to countries around the world. We will work with airlines, and freight and logistics providers to ensure safe and timely delivery…”

Pfizer and BioNTech Reach Agreement with COVAX for Advance Purchase of Vaccine to Help Combat COVID-19

Milestones :: Perspectives :: Research

 

Pfizer and BioNTech Reach Agreement with COVAX for Advance Purchase of Vaccine to Help Combat COVID-19
:: Initial agreement provides up to 40 million doses to COVAX in 2021
:: First deliveries are expected to take place in Q1 2021 subject to the execution of supply agreements under the COVAX Facility structure
:: For the COVAX Advanced Market Commitment 92 countries, Pfizer and BioNTech will provide the vaccine to COVAX at a not-for-profit price.

January 22, 2021
NEW YORK & MAINZ, Germany–(BUSINESS WIRE)–Pfizer and BioNTech SE today announced an advance purchase agreement with COVAX for up to 40 million doses of the Pfizer-BioNTech COVID-19 Vaccine. The doses will be delivered throughout 2021.

COVAX is a global initiative coordinated by the Global Alliance for Vaccines and Immunization (GAVI), the Coalition for Epidemic Preparedness Innovations (CEPI) and the World Health Organization (WHO), to ensure equitable access to COVID-19 vaccines for all countries, regardless of income levels. COVAX includes an Advanced Market Commitment (AMC) financial mechanism that aims to ensure that 92 low- and lower-middle-income countries will be able to secure access to COVID-19 vaccines at the same time as higher-income countries.

The first doses are expected to be delivered in the first quarter of 2021, subject to the negotiation and execution of supply agreements under the COVAX Facility structure.

For the COVAX Advanced Market Commitment 92 countries, Pfizer and BioNTech will provide the vaccine to COVAX at a not-for-profit price.

“At Pfizer, we believe that every person deserves to be seen, heard and cared for. That’s why from the very beginning of our vaccine development program, Pfizer and BioNTech have been firmly committed to working toward equitable and affordable access of COVID-19 vaccines for people around the world,” said Pfizer Chairman & CEO Albert Bourla. “We share the mission of COVAX and are proud to work together so that developing countries have the same access as the rest of the world, which will bring us another step closer to ending this global pandemic and proving that Science Will Win for everyone, everywhere.”…

ICMRA statement for healthcare professionals: How COVID-19 vaccines will be regulated for safety and effectiveness

Milestones :: Perspectives :: Research

 

ICMRA statement for healthcare professionals: How COVID-19 vaccines will be regulated for safety and effectiveness
Statement from the International Coalition of Medicines Regulatory Authorities
EMA has endorsed the joint statement published today by the International Coalition of Medicines Regulatory Authorities (ICMRA) to inform and help healthcare professionals answer questions about the evaluation, approval and monitoring of safe, effective and high-quality COVID-19 vaccines.
Purpose
This International Coalition of Medicines Regulatory Authorities (ICMRA) statement aims to inform and help healthcare professionals answer questions about the role of regulators in the oversight of COVID-19 vaccines.  It explains how vaccines undergo robust scientific evaluation to determine their safety, efficacy and quality and how safety will continue to be closely monitored after approval.
People who are not vaccinated remain at risk of spreading the virus. Herd immunity through vaccination occurs when the majority of population has been vaccinated and can no longer give the virus to others, hence protecting themselves as well as those who cannot be vaccinated.  Achieving ‘herd immunity’ and reducing the effective reproduction number of infection disease as much as possible is important.  If ‘herd immunity’ is not achieved by enough people being vaccinated this could seriously affect vulnerable people, including immunocompromised people who cannot receive vaccines, or those who respond poorly to vaccination and therefore are more readily infected. Herd immunity requires a combination of high vaccination coverage with vaccines that are both effective and provide a reasonable duration of protection.  Achieving ‘herd immunity’ will allow a return to normal societal functioning and re-opening of economies.
About ICMRA
ICMRA brings together the heads of 30 medicines regulatory authorities* from every region in the world, with the WHO as an observer.  Medicines regulators recognise their important role in facilitating the provision of access to safe and effective high-quality medicinal products that are essential to human health and well-being.  This includes ensuring that the benefits of vaccines outweigh their risks.

White House

Milestones :: Perspectives :: Research

 

White House

National Strategy for the COVID-19 Response and Pandemic Preparedness
January 2021 :: 200 pages
The American people deserve an urgent, robust, and professional response to the growing public health and economic crisis caused by the coronavirus (COVID-19) outbreak. President Biden believes that the federal government must act swiftly and aggressively to help protect and support our families, small businesses, first responders, and caregivers essential to help us face this challenge, those who are most vulnerable to health and economic impacts, and our broader communities – not to blame others or bail out corporations.
The Biden-Harris administration will always:
:: Listen to science
:: Ensure public health decisions are informed by public health professionals
:: Promote trust, transparency, common purpose, and accountability in our government
Plan PDF: https://www.whitehouse.gov/wp-content/uploads/2021/01/National-Strategy-for-the-COVID-19-Response-and-Pandemic-Preparedness.pdf

 

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Executive Order on Establishing the COVID-19 Pandemic Testing Board and Ensuring a Sustainable Public Health Workforce for COVID-19 and Other Biological Threats
January 21, 2021 • Presidential Actions

Readout of Vice President Harris’s Call with World Health Organization Director-General Dr. Tedros Adhanom Ghebreyesus
January 21, 2021 • Presidential Actions

National Security Directive on United States Global Leadership to Strengthen the International COVID-19 Response and to Advance Global Health Security and Biological Preparedness
January 21, 2021 • Presidential Actions
… Section 1.  Strengthening and Reforming the World Health Organization.  On January 20, 2021, the United States reversed its decision to withdraw from the World Health Organization (WHO) by submitting a letter to the United Nations Secretary-General informing him of the President’s decision that the United States will remain a member of the organization.  Accordingly, the Assistant to the President for National Security Affairs (APNSA) shall, in coordination with the Secretary of State, the Secretary of Health and Human Services (HHS), the heads of other relevant executive departments and agencies (agencies), and the Coordinator of the COVID-19 Response and Counselor to the President (COVID-19 Response Coordinator), provide to the President within 30 days of the date of this directive recommendations on how the United States can:  (1) exercise leadership at the WHO and work with partners to lead and reinvigorate the international COVID-19 response; (2) participate in international efforts to advance global health, health security, and the prevention of future biological catastrophes; and (3) otherwise strengthen and reform the WHO…

Executive Order on Ensuring an Equitable Pandemic Response and Recovery
January 21, 2021 • Presidential Actions

Executive Order on a Sustainable Public Health Supply Chain
January 21, 2021 • Presidential Actions

Memorandum to Extend Federal Support to Governors’ Use of the National Guard to Respond to COVID-19 and to Increase Reimbursement and Other Assistance Provided to States
January 21, 2021 • Presidential Actions

Executive Order on Ensuring a Data-Driven Response to COVID-19 and Future High-Consequence Public Health Threats
January 21, 2021 • Presidential Actions

Executive Order on Improving and Expanding Access to Care and Treatments for COVID-19
January 21, 2021 • Presidential Actions

Executive Order on Promoting COVID-19 Safety in Domestic and International Travel
January 21, 2021 • Presidential Actions

Executive Order on Organizing and Mobilizing the United States Government to Provide a Unified and Effective Response to Combat COVID-19 and to Provide United States Leadership on Global Health and Security
January 20, 2021 • Presidential Actions

 

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Janet Woodcock M.D.
Acting Commissioner of Food and Drugs – Food and Drug Administration
Janet Woodcock was named Acting Commissioner of Food and Drugs on January 20, 2021.
As Acting Commissioner, Dr. Woodcock oversees the full breadth of the FDA portfolio and execution of the Federal Food, Drug, and Cosmetic Act and other applicable laws. This includes assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices; the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation; and the regulation of tobacco products…

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

Milestones :: Perspectives :: Research

 

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

 

Weekly Epidemiological and Operational updates
Last update: 23 January 2021
Confirmed cases :: 96 877 399 [week ago: 92 506 811] [two weeks ago: 87 589 206]
Confirmed deaths :: 2 098 879 [week ago: 2 001 773] [two weeks ago: 1 906 606]
Countries, areas or territories with cases :: 224

19 January 2021
Weekly epidemiological update – 19 January 2021
Globally, 4.7 million new cases were reported in the past week, a decline of 6% from last week, and the number of new deaths has climbed to a record high at 93 000, a 9% increase from last week. This brings the cumulative numbers to over 93 million reported cases and over 2 million deaths globally since the start of the pandemic.
In this edition of the COVID-19 Weekly Epidemiological Update, special focus updates are provided on: Children, COVID-19, and transmission in schools, as well as on SARS-CoV-2 variants of concern.

19 January 2021
Weekly operational update on COVID-19 – 19 January 2021

 

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How contributions support WHO’s work in ongoing fight of COVID-19 pandemic around the world
22 January 2021

Governments push for Universal Health Coverage as COVID-19 continues to devastate communities and economies
18 January 2021

New York Times :: Coronavirus Vaccine Tracker

Milestones :: Perspectives :: Research

 

New York Times :: Coronavirus Vaccine Tracker
21 Jan 2021

New additions and recent updates
Jan. 21
Gamaleya begins testing a single-dose version called “Sputnik Light.”
Jan. 21
Turkey’s Erciyes University moves to Phase 2.
Jan. 20
Korea’s Genexine moves to Phase 1/2.
Jan. 21
Gamaleya begins testing a single-dose version called “Sputnik Light.”

High-income countries are hedging their bets while low-income countries are left out

Milestones :: Perspectives :: Research

 

Duke Global Health Innovation Center
Launch and Scale Speedometer
January 19, 2021

High-income countries are hedging their bets while low-income countries are left out
These direct deals made by high-income (and some middle-income) countries result in a smaller piece of the pie available for equitable global allocation. This pattern results in a majority of vaccines going to high-income countries and fewer doses available for low- and middle-income countries and for equity-focused partnerships like COVAX.

 



Updated: January 19, 2021


High-income countries currently hold a confirmed 4.2 billion doses, upper middle-income countries hold 1.1 billion doses, and lower middle-income countries hold 411 million doses, and low-middle income countries hold 270 million.
Many high-income countries have hedged their bets by advance purchasing enough doses to vaccinate their population several times over. Since none of these candidates are approved, some of the purchased vaccine candidates may prove to be unsuccessful.

 

Updated: January 19, 2021

While this makes sense from the perspective of an individual country, it leads to deep inequities in terms of global allocation. While some middle- and lower-middle income countries are represented here with direct deals, none of them have enough to vaccinate their entire populations. At the same time, Canada has purchased enough to vaccinate its population five times over. (Again, it is important to remember that not all of these vaccines will necessarily receive approval and move to market.)

CEPI, one of the COVAX founding partners, is negotiating with self-financing countries to ensure that, once a certain percentage of their population has been vaccinated, a percentage of the doses secured through bilateral deals would be shared through the COVAX Facility. These negotiations are ongoing; however, high-income countries have little incentive to share from their advance purchase stock.

COVID Vaccines Development/Procurement/Distribution/Policy – Russia, China

Milestones :: Perspectives :: Research

 

COVID Vaccines Development/Procurement/Distribution/Policy – Russia, China

Russia: Sputnik V – “the first registered COVID-19 vaccine” [to 23 Jan 2021]
https://sputnikvaccine.com/newsroom/pressreleases/
Press Releases
Hungary becomes the first country in EU to authorize the Sputnik V vaccine
Press release, 21.01.2021 12:20:00
…The vaccine was approved under the emergency use authorization procedure. The approval is based on the results of the clinical trials of Sputnik V in Russia and a comprehensive assessment of the vaccine by experts in Hungary…

Ministry of Health of the UAE has approved the use of Sputnik V vaccine
Press release, 21.01.2021
…The vaccine was registered under the emergency use authorization procedure based on the results of the Russian Phase III clinical trials which included over 33,000 subjects. Moreover, local Phase III clinical trials of Sputnik V in the UAE are ongoing under the supervision of the MOHAP and Department of Health (DOH) of Abu Dhabi with 1,000 volunteers already enrolled into the study. Medical protocols are handled by the public health provider, the Abu Dhabi Health Services Company, SEHA…

Turkmenistan has become the first country in Central Asia to register Sputnik V vaccine
Press release, 18.01.2021
…The vaccine was approved under the emergency use authorization procedure without additional clinical trials in Turkmenistan…

RDIF and the Gamaleya Center announce creation of International scientific advisory board on Sputnik V vaccine represented by leading scientists from 9 countries
Moscow, January 18, 2021 – The Russian Direct Investment Fund (RDIF, Russia’s sovereign wealth fund) and The National Research Center for Epidemiology and Microbiology named after N.F. Gamaleya (Gamaleya Center) announce the creation of an International Scientific Advisory Board on the Sputnik V vaccine – the world’s first registered vaccine against coronavirus.
Leading scientists in virology, microbiology, genetics and biotechnology from Argentina, Croatia, France, Germany, India, Russia, Sweden, UK and USA, representing top research and medical centers, have joined the Board.
The list of participants of the International scientific advisory board on Sputnik V vaccine:
1. Carlos Zala, Adjunct Professor, Department of Microbiology, University of Buenos Aires, School of Medicine, Argentina;
2. Omar Sued, President of the society of infectologists, Argentina;
3. Dragomira Majhen, Dr.Sc., Senior research associate, Scientist, Laboratory for Cell Biology and Signalling Division of Molecular Biology Ruđer Bošković Instiute, Croatia;
4. Cecil Czerkinsky, PhD, M.D., Research Director, Institute of Molecular and Cellular Pharmacology, France
5. Wibke Bayer, Privatdozentin, Principal Investigator on Vaccine Development, the Institute for Virology of the University Hospital in Essen, University Duisburg-Essen, Germany;
6. Vasanthapuram Ravi, MBBS, M.D. Microbiology, Dean, Basic Sciences, National Institute of Mental Health and Neurosciences (NIMHANS), India;
7. Niklas Arnberg, Professor of Virology, Umeå University, Sweden;
8. David Livermore, Professor of Medical Microbiology at the University of East Anglia, UK;
9. Len Seymour, Professor of Gene Therapies in the Department of Oncology at the University of Oxford, UK;
10. Hildegund C.J. Ertl, M.D., Professor, Vaccine & Immunotherapy Center, The Wistar Institute, USA;
11. Ronald Rodriguez, M.D., Ph.D., Professor of Urology, University of Texas Health Science Center at San Antonio, USA;
12. David A. Ornelles, Ph.D., Associate Professor of Microbiology & Immunology, Wake Forest School of Medicine Biotech Place, USA;
13. Alexander Gintsburg, RAS Academician, Professor, Director of the Gamaleya Center;
14. Denis Logunov, RAS Corresponding Member, Doctor of Biological Sciences, Deputy Director for Science of the Gamaleya Center;
15. Sergey Tsarenko, Professor, Faculty of Medicine, Lomonosov Moscow State University, Deputy Chief Physician for Anesthesiology and Reanimation at Hospital No. 52 in Moscow;
16. Alexander Rumyantsev, President of Dmitry Rogachev National Research Center, RAS Academician, M.D., Professor.

 

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China: COVID-19 Vaccines – Announcement/Regulatory Actions/Deployment

National Health Commission of the People’s Republic of China [to 23 Jan 2021]
http://en.nhc.gov.cn/
China calls for international vaccine cooperation to defeat COVID-19 pandemic
2021-01-21
BEIJING — China calls on the international community to work together to contribute to the equitable distribution and use of COVID-19 vaccines around the world and help defeat the pandemic, a foreign ministry spokesperson said on Jan 20.

Spokesperson Hua Chunying made the remarks in response to a question about China’s expectations of promoting international cooperation on COVID-19 vaccines.

“We have always maintained that the virus knows no borders and humanity shares a common destiny. Solidarity and cooperation are the most powerful weapon to defeat the COVID-19 pandemic. It is also the common consensus of the international community,” Hua said at a press briefing.

China is at the forefront of vaccine research and development globally, with one vaccine for conditional marketing and several others being in clinical trials at different stages, Hua said, adding that this has provided significant support for China’s fight against the pandemic and its participation in international cooperation on vaccines.

Currently, China has started the vaccination of key groups, and the domestic demand for vaccines is huge, Hua said, adding that while meeting domestic demand, China has overcome difficulties and made every effort to carry out international cooperation on vaccines with other countries, especially developing countries, in different ways, and provided support and assistance within China’s capabilities according to their needs.

Chinese enterprises are conducting joint vaccine research and development with partners in more than 10 countries, including clinical trials and production. As part of the cooperation, Chinese enterprises have provided vaccines to partner countries, Hua said.

Chinese companies have started to export to countries that urgently need vaccines, have approved Chinese vaccines, and have authorized the emergency use of Chinese vaccines in their countries. “Most of them are developing countries,” she added.

China has joined the WHO-led COVAX initiative to support the G20 in promoting international cooperation on vaccines and multilateral cooperation to promote the equitable global distribution of vaccines, the spokesperson said…

POLIO – Public Health Emergency of International Concern (PHEIC); WHO/OCHA Emergencies

Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)

Polio this week as of 20 January 2021
:: The 148th session of the Executive Board (EB) is currently underway with Member States meeting virtually to discuss the most pressing global health issues including COVID-19 and Polio. The EB reports on both polio eradication and on polio transition planning/post-certification are available here under “148 Executive Board”. These reports will help inform the discussions on polio eradication by Member States.

Summary of new WPV and cVDPV viruses this week (AFP cases and ES positives):
:: Pakistan: 10 WPV1 and three cVDPV2 positive environmental samples
:: Afghanistan: 15 cVDPV2 cases and two cVDPV2 positive environmental samples
:: Burkina Faso: one cVDPV2 case
:: Chad: four CVDPV2 cases
:: Guinea: three cVDPV2 cases
:: Sudan: four cVDPV2 cases

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::::::

Editor’s Note:
Continuing with this edition, we include information about the last apparent update evident on the WHO emergency country webpages, recognizing almost universal and significant interims between such updates regardless of the level of the emergency listed.

WHO Grade 3 Emergencies [to 23 Jan 2021]

Democratic Republic of the Congo – No new digest announcements [Last apparent update: 12 Jan 2021]
Mozambique floods – No new digest announcements identified [Last apparent update: 3 November 2020]
Nigeria – No new digest announcements identified [Last apparent update: 29 Jun 2020]
Somalia – No new digest announcements identified [Last apparent update: 17 July 2020]
South Sudan – No new digest announcements identified [Last apparent update: 4 February 2020]
Syrian Arab Republic – No new digest announcements identified [Last apparent update: 24 October 2020]
Yemen – No new digest announcements identified [Last apparent update: 30 June 2020]

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WHO Grade 2 Emergencies [to 23 Jan 2021]
Afghanistan – No new digest announcements identified [Last apparent update: 5 July 2020]
Angola – No new digest announcements identified [Last apparent update: 03 December 2020]
Burkina Faso – No new digest announcements identified [Last apparent update: 17 décembre 2020]
Burundi – No new digest announcements identified [Last apparent update: 04 July 2019]
Cameroon – No new digest announcements identified [Last apparent update: 22 August 2019]
Central African Republic – No new digest announcements identified [Last apparent update: 12 June 2018]
Ethiopia – No new digest announcements identified [Last apparent update: 22 August 2019]
Iran floods 2019 – No new digest announcements identified [Last apparent update: 12 March 2020]
Iraq – No new digest announcements identified [Last apparent update: 16 December 2020]
Libya – No new digest announcements identified [Last apparent update: 7 October 2019]
Malawi Floods – No new digest announcements identified [Last apparent update: 09 October 2019]
Measles in Europe – No new digest announcements identified [Last apparent update: 16-12-2020]
MERS-CoV – No new digest announcements identified [Last apparent update: 8 July 2019]
Mozambique – No new digest announcements identified [Last apparent update: 03 November 2020]
Myanmar No new digest announcements identified [Last apparent update: :: 3 January 2021
Niger – No new digest announcements identified [Last apparent update: 29 December 2020]
occupied Palestinian territory – No new digest announcements identified [Last apparent update: 4 September 2019]
HIV in Pakistan – No new digest announcements identified [Last apparent update: 27 August 2019]
Sao Tome and Principe Necrotizing Cellulitis (2017) – No new digest announcements
Sudan – No new digest announcements identified [Last apparent update: 24 June 2020]
Ukraine – No new digest announcements identified [Last apparent update: 1 May 2019]
Zimbabwe – No new digest announcements identified [Last apparent update: 10 May 2019]

::::::

WHO Grade 1 Emergencies [to 23 Jan 2021]

Chad – No new digest announcements identified [Last apparent update: 30 June 2018]
Djibouti – No new digest announcements identified [Last apparent update: 25 novembre 2020]
Kenya – No new digest announcements identified [Last apparent update: 11 December 2020]
Mali – No new digest announcements identified [Last apparent update: 3 May 2017]
Namibia – viral hepatitis – No new digest announcements identified [Last apparent update: 20 July 2018]
Tanzania – No new digest announcements identified [Last apparent update: 21 October 2020]

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::::::

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

::::::

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 (COVID-19): Weekly Epidemiological Update (17 January 2021)

East Africa Locust Infestation
:: Desert Locust situation update – 22 January 2021

::::::
::::::

WHO & Regional Offices [to 23 Jan 2021]

WHO & Regional Offices [to 23 Jan 2021]

Weekly Epidemiological Record, Vol. 96, No. 03, pp. 13–20 22 January 2021
:: Report of the Meeting of the WHO Global Advisory Committee on Vaccine Safety (GACVS), 1–3 December 2020

 

::::::

WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: Seven things to know about COVID-19 variants in Africa 22 January 2021
New COVID-19 variants have emerged in Africa as the continent records a new peak in infections. While virus mutations are not unusual, those that are more infectious are worrisome. Professor Francisca Mutapi, Professor in Global Health Infection and Immunity, University of Edinburgh, explains the implications of SARS-CoV-2 variants and what African countries can do to respond.

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
:: Scaling up telemedicine services in Romania post COVID-19 19-01-2021
:: New WHO report: population-based screening for cardiovascular disease risk factors does not reduce CVD mortality 19-01-2021
:: Reaching Turkey’s health policy goals could avert thousands of deaths says research from WHO/Europe 19-01-2021
:: Family physicians’ crucial role in mental health 18-01-2021
:: Universal health coverage high on the political agenda during the Regional Director’s visit to Georgia 18-01-2021

WHO Eastern Mediterranean Region EMRO
:: Afghanistan commences first polio vaccination campaign of 2021 18 January 2021
:: WHO and KSRelief continue fight against child malnutrition in Yemen 18 January 2021

WHO Western Pacific Region
:: 19 January 2021 | Feature story
WHO and DHL team up to get health-care equipment to the Pacific
Delivering supplies to Pacific islands during a global pandemic is no easy task. Reduced flight schedules and other logistical challenges mean that shipments of life-saving goods must be carefully coordinated to ensure that Pacific islanders receive vital health-care equipment.
:: 18 December 2020 | News release
WHO and EU join together to support COVID-19 response and systems strengthening in Asia
This week, the World Health Organization (WHO) and the European Union (EU) agreed to join forces to support eight South East Asian countries in their response to COVID-19 and to strengthen preparedness for future pandemics.
:: 17 December 2020 | News release
From containment to suppression: WHO and Lancet COVID-19 Commission highlight lessons from the Western Pacific Region
Professor Jeffrey D. Sachs, Dr Takeshi Kasai and expert panellists across Asia and the Pacific explored lessons from coronavirus disease 2019 (COVID-19) suppression at a forum jointly hosted today by the Lancet COVID-19 Commission and the World Health Organization (WHO).

CDC/ACIP [to 23 Jan 2021]

CDC/ACIP [to 23 Jan 2021]

http://www.cdc.gov/media/index.html

https://www.cdc.gov/vaccines/acip/index.html

Latest News Releases, Announcements

Media Statement from Rochelle P. Walensky, MD, MPH, CDC Director and ATSDR Administrator

Wednesday, January 20, 2021

   It is truly a privilege to join the world’s premier public health agency. For 75 years, CDC has carried out a mission to protect America’s safety, health, and security at home and abroad.

   I am proud to join this agency, and I recognize the seriousness of the moment. The toll that the COVID-19 pandemic has had on America is truly heartbreaking — for the loss of our loved ones and our beloved ways of life. At Massachusetts General Hospital, I saw firsthand the many difficulties this pandemic brings to our frontline workers and first responders, hospitals and public health systems, communities, and loved ones…

MMWR News Synopsis

Friday, January 22, 2021

:: Vaccination Coverage with Selected Vaccines and Exemption Rates Among Children in Kindergarten — United States, 2019–20 School Year

:: COVID-19 Case Investigation and Contact Tracing Efforts from Health Departments — United States, June 25–July 24, 2020

:: COVID-19 Trends Among Persons Aged 0–24 Years — United States, March 1–December 12, 2020 (Early Release January 13, 2021)

:: Emergence of SARS-CoV-2 B.1.1.7 Lineage — United States, December 29, 2020–January 12, 2021 (Early Release January 15, 2021)

Coronavirus Disease 2019 (COVID-19)– CDC

Selected Resources

:: Requirement for Proof of Negative COVID-19 Test or Recovery from COVID-19 for All Air Passengers Arriving in the United States Saturday, January 23, 2021

:: COVID-19 Vaccination Toolkits Friday, January 22, 2021

:: CDC Strategy for Global Response to COVID-19 (2020-2023)

Updated Wednesday, January 20, 2021

This strategy provides an overarching framework for the U.S. Centers for Disease Control and Prevention’s global response to the coronavirus (COVID-19) pandemic. The CDC strategy aligns with the U.S. Government (USG) strategy and the U.S. National Security Strategic goals to protect the American people and ensure the U.S. health security by mitigating the spread of infectious disease threats abroad.

The strategy defines CDC’s program priorities and guides development of criteria for monitoring and evaluating achievements and impact on health security at home and abroad. The strategy also addresses the urgent need to prioritize our global response work to reduce the global burden of COVID-19, while continuing to build global capacity to prevent, prepare for and control future pandemics. CDC’s response work supports countries and vulnerable populations, while providing global public health leadership in furthering the science and technical experience with COVID-19.

CDC will focus on mitigating the global impacts of COVID-19 and using CDC’s scientific and technical expertise to support our global health platform and program successes. In alignment with the USG strategy, CDC will implement activities using a phased approach to the pandemic that accounts for immediate and long-term public health needs, including anticipating and preparing for future global public health emergencies.

Goals

The goals of CDC’s strategy for global response to COVID-19 are to:

[1] Limit transmission of COVID-19;

[2] Minimize the impact of COVID-19 in vulnerable populations;

[3] Reduce specific health threats that pose current and future risk to the United States;

[4] Increase the scientific knowledge about SARS-CoV-2 (the virus responsible for COVID-19) and provide global public health leadership; and

[5] Support the development of long-term health security in low- and middle-income countries…

Africa CDC [to 23 Jan 2021]

Africa CDC [to 23 Jan 2021]
http://www.africacdc.org/
News
Press Releases
Kenya adopts Trusted Travel digital tool for COVID-19 test result verification
21 January 2021
On 9 January 2021, the Government of the Republic of Kenya announced the launch of its Trusted Travel platform, based on the Africa CDC Trusted Travel platform, becoming the first country to adopt the platform for managing travels during the COVID-19 pandemic.

“The ministry has collaborated with the African Union and Africa CDC, with technical support from PanaBIOS to implement an online system to authenticate and verify laboratory test certificates for travellers,” said Mr Mutahi Kagwe, Cabinet Secretary for the Ministry of Health.

In October 2020, the African Union officially launched the Trusted Travel platform as part of the overall Trusted Travel Initiative during a joint ministerial meeting of the ministers of health, transport, and information and communication of African Union Member States.

Developed by PanaBIOS Consortium and Econet Group as a public-private partnership with Africa CDC, Trusted Travel is a top-class digital solution to support Member States in verifying COVID-19 test certificates for travellers and to help harmonize entry and exit screening across the continent…

Press Releases
AMSP opens COVID-19 vaccines pre-orders for 55 African Union Member States
JOHANNESBURG, SOUTH AFRICA, 19 JANUARY 2021. Following the announcement by the African Union Chairperson, President Cyril Ramaphosa, on 14 January 2021 that the African Union has secured a provisional 270 million COVID-19 vaccine doses for Africa through its COVID-19 African Vaccine Acquisition Task Team (AVATT), the Africa Medical Supplies Platform (AMSP), on behalf of the Africa Centres for Disease Control and Prevention (Africa CDC), today commenced the COVID-19 vaccines pre-order programme for all African Union Member States. The African Export-Import Bank (Afreximbank) will facilitate payments by providing advance procurement commitment guarantees of up to US$2 billion to the manufacturers on behalf of the Member States.

While AVATT has secured a provisional 270 million COVID-19 vaccines doses from Pfizer, Johnson & Johnson and AstraZeneca, AMSP – the single-source platform enabling faster, more transparent and cost-effective access to COVID-19 supplies – has opened today pre-orders, offering an equitable access to COVID-19 vaccines doses for the 55 African Union Member States.

“These are historical times. For the first time in history, Africa has secured access to millions of vaccine doses in the middle of a pandemic as most of Western countries,” said African Union Special Envoy Strive Masiyiwa. “There is still a huge shortage of vaccine doses and that is why this continental collaboration has designed a fair allocation coupled with timely and equitable access of COVID-19 vaccines across the continent.”…

China CDC

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

National Health Commission of the People’s Republic of China [to 23 Jan 2021]
http://en.nhc.gov.cn/
News
Jan 23: Daily briefing on novel coronavirus cases in China
On Jan 22, 31 provincial-level regions and the Xinjiang Production and Construction Corps on the Chinese mainland reported 107 new cases of confirmed infections.

Shanghai completes vaccination of about 820,000 people
Updated: 2021-01-20 chinadaily.com.cn
Nearly 820,000 individuals working in epidemic prevention and control roles in Shanghai have received their COVID-19 vaccinations as of Monday, a senior health official in the municipality said on Jan 19.
Of these individuals, nearly 240,000 have received the required two shots.
No severe adverse reactions have been reported for individuals aged between 18 to 59, said Sun Xiaodong, deputy director of the Shanghai Municipal Center for Disease Control and Prevention.
Sun pointed out that every individual who faces a high risk of being exposed to the virus, such as workers dealing with imported cold-chain products at airports and customs, and those who work in international transportation, has already been vaccinated…

National Medical Products Administration [to 23 Jan 2021]
http://english.nmpa.gov.cn/news.html
News
Chinese mainland reports 94 new locally transmitted COVID-19 cases
2021-01-22
The Chinese mainland on Thursday reported 103 newly confirmed COVID-19 cases, including 94 locally transmitted and nine arriving from outside the mainland, the National Health Commission said on Jan 22.

China calls for international vaccine cooperation to defeat COVID-19 pandemic
2021-01-21
[See COVID – CHINA above for detail]

Over 15 mln doses of COVID-19 vaccine administered in China
2021-01-21
More than 15 million doses of COVID-19 vaccine have been administered in China since the country launched its vaccination program in December last year, China’s health authorities said on Jan 20.

Organization Announcements

Organization Announcements

 

Paul G. Allen Frontiers Group [to 23 Jan 2021]
https://alleninstitute.org/what-we-do/frontiers-group/news-press/
News
No new digest content identified.

 

BARDA – U.S. Department of HHS [to 23 Jan 2021]
https://www.phe.gov/about/barda/Pages/default.aspx
BARDA News
No new digest content identified.

 

BMGF – Gates Foundation [to 23 Jan 2021]
http://www.gatesfoundation.org/Media-Center/Press-Releases
Press Releases and Statements
No new digest content identified.

 

Bill & Melinda Gates Medical Research Institute [to 23 Jan 2021]
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 23 Jan 2021]
https://carb-x.org/
News
No new digest content identified.

 

Center for Vaccine Ethics and Policy – GE2P2 Global Foundation [to 23 Jan 2021]
https://centerforvaccineethicsandpolicy.net/
News/Analysis/Statements
No new digest content identified.

 

CEPI – Coalition for Epidemic Preparedness Innovations [to 23 Jan 2021]
http://cepi.net/
Latest News
COVAX announces new agreement, plans for first deliveries
22 Jan 2021
[See Milestones above for detail]

Upcoming CEPI-CIHR grant funding opportunity for Canadian researchers
19 Jan 2021 By Jodie Rogers
CEPI and the Canadian Institutes of Health Research (CIHR) Institute of Infection and Immunity (III) will soon launch a new grant funding opportunity for researchers in Canada to pursue projects advancing CEPI’s work to expedite the development of vaccines against emerging infectious diseases, including COVID-19.

 

EDCTP [to 23 Jan 2021]
http://www.edctp.org/
The European & Developing Countries Clinical Trials Partnership (EDCTP) aims to accelerate the development of new or improved drugs, vaccines, microbicides and diagnostics against HIV/AIDS, tuberculosis and malaria as well as other poverty-related and neglected infectious diseases in sub-Saharan Africa, with a focus on phase II and III clinical trials
No new digest content identified.

 

Emory Vaccine Center [to 23 Jan 2021]
http://www.vaccines.emory.edu/
Vaccine Center News
No new digest content identified.

 

European Medicines Agency [to 23 Jan 2021]
http://www.ema.europa.eu/ema/
News & Press Releases
News: Extra dose from vials of Comirnaty COVID-19 vaccine (updated)
Last updated: 20/01/2021
EMA’s human medicines committee (CHMP) has recommended updating the product information for Comirnaty to clarify that each vial contains 6 doses of the vaccine…

 

 

News: Global regulators highlight key role of healthcare professionals in fostering confidence in COVID-19 vaccines
Last updated: 19/01/2021
EMA has endorsed a joint statement published today by the International Coalition of Medicines Regulatory Authorities (ICMRA) to inform and help healthcare professionals answer questions about the evaluation, approval and monitoring of safe, effective and high-quality COVID-19 vaccines…
[See COVID above for detail]

 

European Vaccine Initiative [to 23 Jan 2021]
http://www.euvaccine.eu/
Latest News
No new digest content identified.

 

FDA [to 23 Jan 2021]
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
Press Announcements /Selected Details
January 22, 2021 – Coronavirus (COVID-19) Update: January 22, 2021
:: The FDA’s Office of Criminal Investigations recently investigated a case that has led to an arrest and the filing of a criminal complaint by the U.S. Department of Justice for introducing misbranded drugs into interstate commerce. The criminal investigation found that in a variety of online postings from as early as March 2020, the defendant, Johnny T. Stine, claimed to have a COVID-19 vaccine that he offered to inject in customers for $400-$1000 each. Stine’s company, North Coast Biologics, had previously received a warning letter from the agency for promoting an unapproved COVID-19 vaccine product.
“Unproven injectable vaccines purported to prevent or treat COVID-19, made from unknown substances under unknown conditions, present significant health risks in and of themselves. They also can lead consumers to make lifestyle choices that increase their actual risk of infection with COVID-19, or to delay or stop appropriate medical treatment,” said Special Agent in Charge Lisa L. Malinowski, FDA Office of Criminal Investigations Los Angeles Field Office. “The FDA will continue to investigate fraudulent COVID-19 treatments and bring to justice those who try to profit from the pandemic by offering unproven and illegally marketed coronavirus products.”

January 21, 2021 – FDA Approves First Extended-Release, Injectable Drug Regimen for Adults Living with HIV

January 19, 2021 – Coronavirus (COVID-19) Update: January 19, 2021
:: The FDA updated its “Investigational COVID-19 Convalescent Plasma” guidance and corresponding webpage. The revisions provide recommendations regarding when individuals who have received an investigational COVID-19 vaccine as a participant in a clinical trial, or received an authorized or licensed COVID-19 vaccine, qualify as convalescent plasma donors. In addition, the agency has extended the period of enforcement discretion described in the guidance.

 

FDA – COVID-19 Vaccines [to 23 Jan 2021]
www.fda.gov/covid19vaccines
News and Updates; Upcoming Events
No new digest content identified.

 

Fondation Merieux [to 23 Jan 2021]
http://www.fondation-merieux.org/
News, Events
No new digest content identified.

 

Gavi [to 23 Jan 2021]
https://www.gavi.org/
News releases
COVAX announces new agreement, plans for first deliveries
22 Jan 2021
[See Milestones above for detail]

 

GHIT Fund [to 23 Jan 2021]
https://www.ghitfund.org/newsroom/press
GHIT was set up in 212 with the aim of developing new tools to tackle infectious diseases that
Press Releases
No new digest content identified.

 

Global Fund [to 23 Jan 2021]
https://www.theglobalfund.org/en/news/
News
No new digest content identified.

 

Global Research Collaboration for Infectious Disease Preparedness [GloPID-R] [to 23 Jan 2021]
https://www.glopid-r.org/news/
News
No new digest content identified.

 

Hilleman Laboratories [to 23 Jan 2021]
http://www.hillemanlabs.org/
No new digest content identified.

 

Human Vaccines Project [to 23 Jan 2021]
http://www.humanvaccinesproject.org/media/press-releases/
Press Releases
HVP COVID Report
Issue 25: Can President Biden’s Team Speed Vaccine Delivery?
Jan 22, 2021
By Michael Osterholm, Ph.D.
Professor, University of Minnesota and Director of the Center for Infectious Disease Research and Policy

 

IAVI [to 23 Jan 2021]
https://www.iavi.org/newsroom
PRESS RELEASES/FEATURES
January 19, 2021
IAVI at HIVR4P Virtual 2021
IAVI to participate in major HIV prevention research conference beginning January 27

January 13, 2021
Researchers demonstrate protection offered by novel TB vaccine candidate in animal model
:: A study of MTBVAC efficacy in a macaque model of tuberculosis shows that the vaccine candidate protects against aerosol infection with Mycobacterium tuberculosis.
:: Researchers from Europe and the U.S. demonstrate that the MTBVAC vaccine protects better than the current BCG vaccine in a model of tuberculosis in macaques and compare the immunological patterns to those conferred by MTBVAC in clinical trials.

 

 

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
Press Releases/Announcements
No new digest content identified.

 

 

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

 

IFRC [to 23 Jan 2021]
http://media.ifrc.org/ifrc/news/press-releases/
Selected Press Releases, Announcements
No new digest content identified.

 

Institut Pasteur [to 23 Jan 2021]
https://www.pasteur.fr/en/press-area
Press release 19.01.2021
COVID-19: a lentiviral vaccine candidate for intranasal administration provides sterilizing protection in animal models
Scientists from the Institut Pasteur-TheraVectys Joint Laboratory recently published in Cell Host & Microbe1 the results of tests, in two preclinical models, of a COVID-19 vaccine candidate using a lentiviral vector administered by nasal route. Their study demonstrates that the vaccine candidate induces antibody response with strong neutralizing activity against SARS-CoV-2, as well as substantial cell-mediated responses. Intranasal vaccination with this vector drastically reduces lung viral loads and prevents pathogenic pulmonary inflammation. This research proves the high vaccine efficacy and the fact that its intranasal administration attracts the effectors from the protective immune response into the upper respiratory tract through which the virus enters the body.

 

IRC International Rescue Committee [to 23 Jan 2021]
http://www.rescue.org/press-release-index
Media highlights [Selected]
Press Release
New IRC report: Nine ways Biden can help 235 million of world’s most vulnerable, restoring “soul of America,” and advancing US interests
January 21, 2021

Press Release
The IRC applauds the Biden Administration’s measures on Day One to restore US humanity and leadership; urges action on refugee resettlement
January 20, 2021

 

IVAC [to 23 Jan 2021]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
Updates; Events
No new digest content identified.

 

IVI [to 23 Jan 2021]
http://www.ivi.int/
Selected IVI News, Announcements, Events
No new digest content identified.

 

JEE Alliance [to 23 Jan 2021]
https://www.jeealliance.org/
Selected News and Events
No new digest content identified.

 

Johns Hopkins Center for Health Security [to 23 Jan 2021]
https://www.centerforhealthsecurity.org/news/center-news/
Center News
No new digest content identified.

 

MSF/Médecins Sans Frontières [to 23 Jan 2021]
http://www.msf.org/
Latest [Selected Announcements]
Rohingya refugee crisis
Relocations, reduced services leave Rohingya communities at breaking point in Bangladesh
Project Update 21 Jan 2021

Brazil
COVID-19 leaves Amazonas health system saturated, overloaded and struggling
Project Update 21 Jan 2021

South Sudan
Falling international funding exposes communities in Jonglei to a lack of healthcare
Project Update 19 Jan 2021

Yemen
Yemen: “These sanctions have to make clear that they do not apply to humanitarian aid”
Interview 18 Jan 2021

 

National Vaccine Program Office – U.S. HHS [to 23 Jan 2021]
https://www.hhs.gov/vaccines/about/index.html
Upcoming Meetings/Latest Updates
No new digest content identified.

 

NIH [to 23 Jan 2021]
http://www.nih.gov/news-events/news-releases
News Releases
Full-dose blood thinners decreased need for life support and improved outcome in hospitalized COVID-19 patients
January 22, 2021 — Full doses of blood thinners, in addition to being safe, were superior to the doses normally given to prevent blood clots in hospitalized patients.

 

PATH [to 23 Jan 2021]
https://www.path.org/media-center/
Press Release
No new digest content identified

 

Sabin Vaccine Institute [to 23 Jan 2021]
http://www.sabin.org/updates/pressreleases
Statements and Press Releases
No new digest content identified.

 

UNAIDS [to 23 Jan 2021]
http://www.unaids.org/en
Selected Press Releases/Reports/Statements
21 January 2021
Remembering Andrew Mosane, AIDS activist and progressive “radical”

20 January 2021
Challenge the stigma, pursue your right to health

19 January 2021
The road to PrEP in Guyana

19 January 2021
Modelling shows the value of favourable societal environments

 

UNHCR Office of the United Nations High Commissioner for Refugees [to 23 Jan 2021]
http://www.unhcr.org/en-us/media-centre.htmlS
Selected Announcements
No new digest content identified.

 

UNICEF [to 23 Jan 2021]
https://www.unicef.org/media/press-releases
Selected Press releases, Statements
Press release
01/22/2021
COVAX announces new agreement, plans for first deliveries
[See Milestones above for detail]

Statement
01/22/2021
Remarks by Henrietta Fore, UNICEF Executive Director, at press briefing on COVAX
As delivered
[See Milestones above for detail]

Press release
01/20/2021
UN agencies warn economic impact of COVID-19 and worsening inequalities will fuel malnutrition for billions in Asia and the Pacific — FAO-UNICEF-WFP-WHO
Child and maternal diets particularly vulnerable

 

Unitaid [to 23 Jan 2021]
https://unitaid.org/
Featured News
22 January 2021
Cost of rapid COVID-19 tests halved as global investment ensures availability of high volumes for low- and middle-income countries
:: Over 250 million antigen rapid tests (Ag RDTs) every year to be made available for low- and middle-income countries for a unit price of less than US$2.50, thanks to set of new agreements, the first of which with Premier Medical Corporation (PMC) of India who will provide up to 120 million tests
:: Agreements follow an open call for Expressions of Interest (EOI), launched last year by FIND and Unitaid on behalf of the Access to COVID-19 Tools (ACT) Accelerator, to drive equitable access to fit-for-purpose Ag RDTs for COVID-19
:: Further announcements focused on technology transfer and scale up of regional manufacturing capacity expected in the coming weeks

 

Vaccination Acceptance Research Network (VARN) [to 23 Jan 2021]
https://vaccineacceptance.org/news.html#header1-2r
Announcements
No new digest content identified.

 

Vaccine Confidence Project [to 23 Jan 2021]
http://www.vaccineconfidence.org/
News, Research and Reports
No new digest content identified.

 

Vaccine Education Center – Children’s Hospital of Philadelphia [to 23 Jan 2021]
http://www.chop.edu/centers-programs/vaccine-education-center
News
No new digest content identified.

 

Wellcome Trust [to 23 Jan 2021]
https://wellcome.ac.uk/news
News
Explainer | 22 January 2021
When will the world be vaccinated against Covid-19?
…Current estimates are that it will probably take well into 2023-24 for everyone who needs a vaccine to receive one(opens in a new tab)….

Explainer | 22 January 2021
Principles and guidelines for reporting on Covid-19 vaccines

Explainer | 22 January 2021
What are ‘adverse events’ and ’emergency use authorisation’ in relation to vaccination?

Explainer | 21 January 2021
How have Covid-19 vaccines been made quickly and safely?

 

The Wistar Institute [to 23 Jan 2021]
https://www.wistar.org/news/press-releases
Press Releases
Jan. 21, 2021
Wistar Scientists Make Pivotal Discovery on the Mechanism of Epstein-Barr Virus Latent Infection
A previously unknown enzymatic function of the EBNA1 viral protein might instruct new approaches for EBV-associated cancer.

 

WFPHA: World Federation of Public Health Associations [to 23 Jan 2021]
https://www.wfpha.org/
Latest News
WFPHA Welcomes the Entry into Force of the Treaty on the Prohibition of Nuclear Weapons
Jan 21, 2021 | News

WFPHA at EB148: Statement on Oral Health
Jan 20, 2021 | News

WFPHA at EB148: Statement on COVID-19 Response
Jan 19, 2021 | News
“…To protect people’s lives, an effective and safe COVID-19 immunization should be considered a global public good, and vaccines should be produced at larger volumes, distributed equitably between countries, and provided at no cost to the user. Furthermore, without an equitable distribution of COVID-19 vaccines between countries, the world economy will not recover, causing greater human suffering and premature mortality.
Unless governments and the pharmaceutical industry take urgent action to ensure that enough COVID-19 vaccine doses are produced, 92 low- and middle-income countries will be able to vaccinate against COVID-19 only one in five people in 2021. On the other hand, high-income countries, which account for just 14% of the world’s population, have already purchased 48% of the 8.6 billion doses of the most promising vaccines.
This can be achieved by waiving intellectual property rights to vaccines, tests, and treatments related to COVID-19, openly sharing the vaccines’ technology and intellectual property through the WHO, fully funding COVAX, stopping bilateral deals, and investing in WHO efforts and in the strengthening of national health systems…”

 

World Organisation for Animal Health (OIE) [to 23 Jan 2021]
https://www.oie.int/en/for-the-media/press-releases/2021/
Press Releases
Launch of the multi-year, multi-partner Global Burden of Animal Diseases programme
Animal health leaders and researchers from the Global Burden of Animal Diseases (GBADs) programme have secured US$7 million from the Bill & Melinda Gates Foundation and UK’s Foreign, Commonwealth and Development Office, to rollout a framework on measuring animal health burdens and their impacts on human lives and economies. The information provided by GBADs will guide public policy and private sector strategy, contributing to improve animal health and welfare more effectively. It will also be a basis for further academic research.
19 January 2021
[See Milestones above for detail]

 

 

::::::

 

ARM [Alliance for Regenerative Medicine] [to 23 Jan 2021]
Press Releases – Alliance for Regenerative Medicine (alliancerm.org)
Press Releases
No new digest content identified.

 

BIO [to 23 Jan 2021]
https://www.bio.org/press-releases
Press Releases
BIO Welcomes U.S. Involvement in COVAX, ACT Accelerator Programs
January 21, 2021
The Biden administration just announced its intent for the United States to join the COVAX vaccine facility, which aims to deliver COVID-19 vaccines to poor and under-developed countries… “As the organization representing U.S. biotechnology companies who are leading the world in the of development COVID vaccines and therapeutics, BIO welcomes Dr. Anthony Fauci’s statement today that the United States will be joining the global COVAX and ACT Accelerator programs, which are the chief international efforts charged with getting COVID treatments to patients around the world…:

Biotechnology’s Leading Trade Group Restructures for the Future
January 19, 2021
Washington, DC –  The Biotechnology Innovation Organization (BIO), which announced its transition to a new CEO in June to Dr. Michelle McMurry-Heath, is announcing a new leadership team and organizational structure that promises to provide long-term stability for the organization’s ambitious agenda. Some staff reductions were made to align the organization for the new strategic direction…

BIO Applauds Incoming Administration’s Decision Elevating Key White House Science Post to Cabinet-level Agency
January 16, 2021

 

DCVMN – Developing Country Vaccine Manufacturers Network [to 23 Jan 2021]
http://www.dcvmn.org/
News; Upcoming events
No new digest content identified.

 

ICBA – International Council of Biotechnology Associations [to 23 Jan 2021]
https://internationalbiotech.org/news/
News
No new digest content identified.

 

IFPMA [to 23 Jan 2021]
http://www.ifpma.org/resources/news-releases/
Selected Press Releases, Statements, Publications
Biopharmaceutical global body kicks off 2021 with new CEO leadership line up
21 January 2021
The biopharmaceutical global industry, represented by the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), is pleased to announce that Jean-Christophe Tellier, UCB Chief Executive Officer & Chairman of the Executive Committee has assumed the role of IFPMA President. Jean-Christophe Tellier succeeds David A. Ricks, Chairman and Chief Executive Officer, Eli Lilly and Company. Albert Bourla, Chairman and CEO of Pfizer, has been appointed IFPMA Vice President and will together with Isao Teshirogi, President and CEO of Shionogi, complement the IFPMA CEO leadership team. They will serve as the Chair and Vice Chairs of the IFPMA CEO Steering Committee…

IFPMA, GSCF, ICBA Joint Statement on the item 14.2 Strengthening preparedness for health emergencies: implementation
20 January 2021
“…The COVID-19 pandemic has highlighted the importance of timely pathogen sharing in the context of public health emergencies. The criticality of fast, timely and unrestricted access to pathogen information in allowing the development of medical countermeasures and understanding the genomic epidemiology of the virus has been recognised by both the Committee’s interim report, under paragraph 42, and the Director-General’s report on the ‘Public Health Implications of Implementation of the Nagoya Protocol’, under paragraph 3.
Though the preamble to the Nagoya Protocol recognises the IHR and “the importance of ensuring access to human pathogens for public health preparedness and response purposes”, currently, the global ability to share pathogen samples and their related data in a timely manner is being impacted due to the inefficient and bureaucratically burdensome bilateral system envisaged under the same Protocol, most notably for seasonal influenza viruses. Navigating a system in which each country has different access requirements that must be negotiated bilaterally is simply not feasible when dealing with the emergence of a novel pathogen.
In light of this, IFPMA fully supports the Committee’s approach of “conducting an article-by-article analysis” and “considering how the Regulations could facilitate the rapid sharing of scientific findings and samples within the global scientific community under Article 6.”

IFPMA Statement for EB148 agenda item 14.1 Covid-19 Response
19 January 2021
We share the deep sense of responsibility that together we have to end this pandemic and are proud to be a founding member of the ACT A. We are keenly 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 and therapeutics. The biopharmaceutical industry has shown its openness to new approaches and numerous collaborations with all stakeholders to respond to the urgent needs of the pandemic. This, however, should not come at the cost of diluting quality and safety of vaccines and medicines, nor should it impact key incentives that foster innovation, namely intellectual property rights. The existing IP framework has enabled the pharmaceutical industry to respond swiftly to the global crisis and develop several new vaccines with remarkable speed, by engaging in new collaborations to leverage both new approaches and existing molecules. This scientific excellence would not have been possible without the important incentives such as those provided by IP rights. Indeed, our expertise and risk-taking ability has allowed us to roll out several new vaccines in less than a year…”

 

PhRMA [to 23 Jan 2021]
http://www.phrma.org/
Selected Press Releases, Statements
Research shows gene therapies can offer cost savings potential of up to $1.8M over five years for patients with certain blood diseases
January 15, 2021
A recent analysis by Health Advances looks at two particularly burdensome hematological (or blood) diseases — hemophilia A and beta thalassemia — and finds that potential gene therapies in the pipeline could reduce per patient costs by as much as 41% and 90%, respectively, over five years. Research-based knowledge gained in recent years about the genetic foundation for these diseases has facilitated the pursuit of several promising gene therapy approaches.
Blog Post

Journal Watch

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

Convalescent Plasma for the Treatment of COVID-19: Perspectives of the National Institutes of Health COVID-19 Treatment Guidelines Panel

Annals of Internal Medicine
January 2021 Volume 174, Issue 1
http://annals.org/aim/issue

Special Articles
Convalescent Plasma for the Treatment of COVID-19: Perspectives of the National Institutes of Health COVID-19 Treatment Guidelines Panel
FREE
Alice K. Pau, PharmD, Judith Aberg, MD, Jason Baker, MD, MS, Pamela S. Belperio, PharmD, … et al.
Pages:93–95

Uganda’s increasing dependence on development partner’s support for immunization – a five year resource tracking study (2012 – 2016)

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles

 

Research
Uganda’s increasing dependence on development partner’s support for immunization – a five year resource tracking study (2012 – 2016)
In Uganda, there are persistent weaknesses in obtaining accurate, reliable and complete data on local and external investments in immunization to guide planning, financing, and resource mobilization. This study aimed to measure and describe the financial envelope for immunization from 2012 to 2016 and analyze expenditures at sub-national level.
Authors: Carol Kamya, Christabel Abewe, Peter Waiswa, Gilbert Asiimwe, Faith Namugaya, Charles Opio, Immaculate Ampeire, Stephen Lagony and Charlotte Muheki
Citation: BMC Public Health 2021 21:160
Content type: Research article
Published on: 19 January 2021

The Competing Demands of Patient Privacy and Clinical Research

Ethics & Human Research
Volume 43, Issue 1 January–February 2021
https://onlinelibrary.wiley.com/toc/25782363/current

The Competing Demands of Patient Privacy and Clinical Research
Connie M. Ulrich, Christine Grady, George Demiris, Therese S. Richmond

 

Pages: 25-31
First Published: 19 January 2021
ABSTRACT
Privacy and confidentiality of personal medical information are cornerstones of ethical clinical care and ethical research. But real‐world research has challenged traditional ways of thinking about privacy and confidentiality of information. In today’s world of “big data” and learning health care systems, researchers and others are combining multiple sources of information to address complex problems. We present a case study that highlights the ethical concerns that arise when a patient who is employed by an academic medical center learns through a research invitational letter that her private information was accessed at this center without her consent. We discuss the ethical challenges of balancing patient privacy with advancing clinical research and ask, what level of privacy and confidentiality can and should patients expect from their clinician providers, fellow research colleagues, and institutions?
Essay

Should the Regulation of Research Misconduct Be Integrated with the Ethics Framework Promulgated in The Belmont Report?

Ethics & Human Research
Volume 43, Issue 1 January–February 2021
https://onlinelibrary.wiley.com/toc/25782363/current

Should the Regulation of Research Misconduct Be Integrated with the Ethics Framework Promulgated in The Belmont Report?
Barbara K. Redman, Arthur L. Caplan

 

Pages: 37-41
First Published: 19 January 2021
ABSTRACT
The federal research misconduct regulations finalized in 2005 did not incorporate important principles regarding human subjects protections articulated in The Belmont Report, yet research misconduct can involve harms to research subjects and to subsequent patients whose treatments are based on false research findings. Consistency with the Belmont principles would require assuring regular monitoring to detect research misconduct, tracing effects of research misconduct on trial participants and informing them of these effects, and assuring timely correction of published reports of research findings if research misconduct related to the study was subsequently discovered. Research misconduct has historically been viewed as a matter for the scientific community to manage; it is actually a threat to the welfare of human subjects and ethically ought to be treated as such.

Lockdowns and low- and middle-income countries: building a feasible, effective, and ethical COVID-19 response strategy

Globalization and Health
http://www.globalizationandhealth.com/
[Accessed 23 Jan 2021]

 

Lockdowns and low- and middle-income countries: building a feasible, effective, and ethical COVID-19 response strategy
Lockdowns can be an effective pandemic response strategy that can buy much needed time to slow disease transmission and adequately scale up preventative, diagnostic, and treatment capacities. However, the broad restrictive measures typically associated with lockdowns, though effective, also comes at a cost – imposing significant social and economic burdens on individuals and societies, especially for those in low- and middle-income countries (LMICs)… In response to the urgent need for more policy development around the contextual challenges involved in employing such measures, we propose some strategies LMICs could adopt for safe and responsible lockdown entrance/exit or to avoid re-imposing coercive restrictive lockdown measures altogether.
Authors: Oghenowede Eyawo, A. M. Viens and Uchechukwu Chidiebere Ugoji
Content type: Commentary
20 January 2021

The state of health research governance in Africa: what do we know and how can we improve?

Health Research Policy and Systems
http://www.health-policy-systems.com/content
[Accessed 23 Jan 2021]

 

The state of health research governance in Africa: what do we know and how can we improve?
The developments in global health, digital technology, and persistent health systems challenges, coupled with global commitments like attainment of universal health coverage, have elevated the role of health r…
Authors: Juliet Nabyonga-Orem, James Avoka Asamani and Micheal Makanga
Citation: Health Research Policy and Systems 2021 19:11
Content type: Research
Published on: 22 January 2021

Prioritizing knowledge translation in low- and middle-income countries to support pandemic response and preparedness

Health Research Policy and Systems
http://www.health-policy-systems.com/content
[Accessed 23 Jan 2021]

 

Prioritizing knowledge translation in low- and middle-income countries to support pandemic response and preparedness
The COVID-19 pandemic has created urgent demand around the world for knowledge generation about a novel coronavirus, its transmission, and control, putting academic institutions at the frontline of politics. W…
Authors: Yodi Mahendradhata and Anna Kalbarczyk
Citation: Health Research Policy and Systems 2021 19:5
Content type: Commentary
Published on: 18 January 2021

Gene and Cell Therapy for Inherited and Acquired Immune Deficiency

Human Gene Therapy
Volume 32, Issue 1-2 / January 2021
https://www.liebertpub.com/toc/hum/32/1-2

 

Special Issue: Gene and Cell Therapy for Inherited and Acquired Immune Deficiency
Guest Editor: Adrian J. Thrasher, PhD
Guest Co-Editors: Uta Griesenbach, PhD , Andrew H. Baker, PhD , Hildegard Büning, PhD
Editorial
Gene and Cell Therapy for Inherited and Acquired Immune Deficiency
Hildegard Büning, Andrew H. Baker, Uta Griesenbach, Terence R. Flotte, and Adrian J. Thrasher
Pages:1–3
Published Online:18 January 2021

Bringing Gene Therapies for HIV Disease to Resource-Limited Parts of the World

Human Gene Therapy
Volume 32, Issue 1-2 / January 2021
https://www.liebertpub.com/toc/hum/32/1-2

 

Commentaries
Open Access
Bringing Gene Therapies for HIV Disease to Resource-Limited Parts of the World
Joseph M. McCune, Emily H. Turner, Adam Jiang, and Brian P. Doehle
Pages:21–30
Published Online:30 October 2020
Initiated by the Bill & Melinda Gates Foundation in 2019, the HIV Frontiers Program aims to move work on HIV cure toward interventions that will ultimately be available to all, most especially those in resource-limited parts of the world where the prevalence of disease is high (Fig. 1). It starts with the premise that the journey will be long (15–25 years) and that it will ultimately yield a “single-shot cure,” that is, a product that is delivered percutaneously (in vivo) in a single encounter, safely, and effectively modifying selected cells in the body so that viral replication and spread are suppressed and reinfection blocked.

Gene Editing for the Treatment of Primary Immunodeficiency Diseases

Human Gene Therapy
Volume 32, Issue 1-2 / January 2021
https://www.liebertpub.com/toc/hum/32/1-2

 

Reviews Open Access
Gene Editing for the Treatment of Primary Immunodeficiency Diseases
Rajeev Rai, Adrian J. Thrasher, and Alessia Cavazza
Pages:43–51
Published Online:16 October 2020
https://doi.org/10.1089/hum.2020.185
With conventional treatments for primary immunodeficiency diseases (PIDs), such as allogeneic stem cell transplantation or autologous gene therapy, still facing important challenges, the rapid development of genome editing technologies to more accurately …

HIV Gene Therapy: An Update

Human Gene Therapy
Volume 32, Issue 1-2 / January 2021
https://www.liebertpub.com/toc/hum/32/1-2

 

HIV Gene Therapy: An Update
Tatjana I. Cornu, Claudio Mussolino, Matthias C. Müller, Claudia Wehr, Winfried V. Kern, and Toni Cathomen
Pages:52–65
Published Online:21 December 2020
https://doi.org/10.1089/hum.2020.159
Progress in antiretroviral therapy has considerably reduced mortality and notably improved the quality of life of individuals infected with HIV since the pandemic began some 40 years ago. However, drug resistance, treatment-associated toxicity, adherence …

Disability inclusion in humanitarian action

Humanitarian Exchange Magazine
Number 78, October 2020
https://odihpn.org/magazine/inclusion-of-persons-with-disabilities-in-humanitarian-action-what-now/

 

Disability inclusion in humanitarian action
by HPN October 2020
The theme of this edition of Humanitarian Exchange, co-edited with Sherin Alsheikh Ahmed from Islamic Relief Worldwide, is disability inclusion in humanitarian action. Persons with disabilities are not only disproportionately impacted by conflicts, disasters and other emergencies, but also face barriers to accessing humanitarian assistance. At the same time, global commitments and standards and the IASC Guidelines on the inclusion of persons with disabilities in humanitarian action all emphasise how persons with disabilities are also active agents of change. Disability and age-focused organisations have led on testing and demonstrating how inclusion can be done better. Yet despite this progress, challenges to effective inclusion remain.

As Kirstin Lange notes in the lead article, chief among these challenges is humanitarian agencies’ lack of engagement with organisations of persons with disabilities. Simione Bula, Elizabeth Morgan and Teresa Thomson look at disability inclusion in humanitarian response in the Pacific, and Kathy Al Jubeh and Alradi Abdalla argue for a ‘participation revolution’, building on learning from the gender movement. Tchaurea Fleury and Sulayman AbdulMumuni Ujah outline how the Bridge Article 11 training initiative is encouraging constructive exchange between humanitarian and disability actors. The lack of good, disaggregated data is highlighted by Sarah Collinson; Frances Hill, Jim Cranshaw and Carys Hughes emphasise the need for training resources in local languages and accessible formats; and Sophie Van Eetvelt and colleagues report on a review of the evidence on inclusion of people with disabilities and older people.

Rebecca Molyneux and co-authors analyse the findings of a review of a DFID programme in north-east Nigeria, while Carolin Funke highlights the importance of strategic partnerships between disability-focused organisations, drawing on her research in Cox’s Bazar. Sherin Alsheikh Ahmed describes Islamic Relief Worldwide’s approach to mainstreaming protection and inclusion, while Pauline Thivillier and Valentina Shafina outline IRC’s Client Responsive Programming. The edition ends with reflections by Mirela Turcanu and Yves Ngunzi Kahashi on CAFOD’s SADI approach.

The Ethics of Continuing Placebo in SARS-CoV-2 Vaccine Trials

JAMA
January 19, 2021, Vol 325, No. 3, Pages 205-316
https://jamanetwork.com/journals/jama/currentissue

 

Viewpoint
The Ethics of Continuing Placebo in SARS-CoV-2 Vaccine Trials
Annette Rid, MD; Marc Lipsitch, DPhil; Franklin G. Miller, PhD
free access has active quiz has multimedia has audio
JAMA. 2021;325(3):219-220. doi:10.1001/jama.2020.25053
This Viewpoint proposes that prioritizing all placebo-group participants in coronavirus vaccine trials as vaccine first receivers could perpetuate health inequities and compromise the chance to learn from their participation, proposing instead to limit prioritization to placebo participants who would be prioritized for vaccination anyway under NASEM or ACIP frameworks.
Conversations with Dr Bauchner: Coronavirus Vaccine FDA Update
Conversations with Dr Bauchner: COVID-19 Vaccines and Herd Immunity

Evaluating SARS-CoV-2 Vaccines After Emergency Use Authorization or Licensing of Initial Candidate Vaccines

JAMA
January 19, 2021, Vol 325, No. 3, Pages 205-316
https://jamanetwork.com/journals/jama/currentissue

 

Evaluating SARS-CoV-2 Vaccines After Emergency Use Authorization or Licensing of Initial Candidate Vaccines
Steven Joffe, MD, MPH
free access has active quiz has multimedia has audio
JAMA. 2021;325(3):221-222. doi:10.1001/jama.2020.25127
This Viewpoint discusses the ethics of including a placebo arm in randomized trials of coronavirus vaccines once authorized vaccines have become widely available, and proposes use of adaptive platform trial designs as an optimal approach to nimbly and ethically compare future investigational COVID-19 vaccines with proven effective ones.

Public Health Messaging in an Era of Social Media

JAMA
January 19, 2021, Vol 325, No. 3, Pages 205-316
https://jamanetwork.com/journals/jama/currentissue

 

Public Health Messaging in an Era of Social Media
Raina M. Merchant, MD, MSHP; Eugenia C. South, MD, MSHP; Nicole Lurie, MD, MSPH
free access has active quiz has audio
JAMA. 2021;325(3):223-224. doi:10.1001/jama.2020.24514
This Viewpoint discusses the rapid spread of scientific misinformation on social media platforms throughout the COVID-19 pandemic and proposes strategies to counteract its adverse effects including surveillance of digital data and partnering with trusted messengers to engage the public and advance scientifically sound public health measures.

Health Care Is a Right, Not a Privilege – A New Series on US Health Care and Health Policy

JAMA
January 19, 2021, Vol 325, No. 3, Pages 205-316
https://jamanetwork.com/journals/jama/currentissue

 

Editorial
Health Policy
Health Care Is a Right, Not a Privilege – A New Series on US Health Care and Health Policy
Howard Bauchner, MD; Phil B. Fontanarosa, MD, MBA; Karen Joynt Maddox, MD, MPH
Two fundamental questions about health care in the US remain unanswered: is health care a right or a privilege and, relatedly, is the US committed to ensuring that every individual has access to some form of health insurance like in every other modern high-resource country.1,2 President Obama, despite the success of the Affordable Care Act (ACA) in increasing the number of individuals with health insurance in this country, seldom addressed this issue directly, even in a wide-ranging special communication in JAMA.3 President Trump has done little with respect to increasing the number of individuals with insurance; instead, his administration has challenged the legality of various aspects of the ACA in court, although overturning it would reduce health coverage significantly. However, there has been encouraging, if incomplete, movement at the state level. In total, 39 states have now expanded Medicaid under the auspices of the ACA, including a number of states, such as Oklahoma and Louisiana, with a historically conservative populace.