Vaccines and Global Health: The Week in Review 14 April 2018

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

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

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

Nearly one billion people in Africa to be protected against yellow fever by 2026

Milestones :: Perspectives
Nearly one billion people in Africa to be protected against yellow fever by 2026
Joint press release
ABUJA, 10 April 2018 — Nearly one billion people will be vaccinated against yellow fever in 27 high-risk African countries by 2026 with support from the World Health Organization (WHO), Gavi – the Vaccine Alliance, UNICEF and more than 50 health partners.

The commitment is part of the Eliminate Yellow fever Epidemics (EYE) in Africa strategy, which was launched by Dr Tedros Adhanom Ghebreyesus, WHO Director-General, Professor Isaac Folorunso Adewole, Nigeria’s Minister of Health and partners at a regional meeting in Abuja, Nigeria on Tuesday (10 April).

“The world is facing an increased risk of Yellow fever outbreaks and Africa is particularly vulnerable,” said Dr Tedros. “With one injection we can protect a person for life against this dangerous pathogen. This unprecedented commitment by countries will ensure that by 2026 Africa is free of Yellow fever epidemics.”

During the three-day EYE strategy regional launch meeting representatives from key African countries, WHO, UNICEF, Gavi, and other partners are developing a roadmap on how to roll-out the EYE strategy at national level. This implementation effort follows the endorsement of the strategy by African Ministers of Health at the 67th WHO regional committee in September 2017.

“This comprehensive, global strategy offers an unprecedented opportunity to end the devastating Yellow fever epidemics that periodically impact Africa,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. “Ensuring that the most vulnerable communities have access to the vaccine through routine systems plays a central role in making this happen. Vaccine manufacturers and Gavi partners have worked hard to improve the global vaccine supply situation in recent years to make sure there is enough vaccine to respond to outbreaks, allow preventive campaigns and that routine immunization functions at full capacity.”

The three objectives of the strategy include protecting at-risk populations through preventive mass vaccination campaigns and routine immunization programmes, preventing international spread, and containing outbreaks rapidly. Developing strong surveillance with robust laboratory networks is key to these efforts.

UNICEF will make vaccines available, advocate for greater political commitment and provide support in vaccinating children through routine immunization as well as during outbreaks of the disease.

“Today, the threat of yellow fever looms larger than ever before, especially for thousands of children across Africa,” said Stefan Peterson, UNICEF’s Chief of Health. “Given that almost half of the people to be vaccinated are children under 15 years of age, this campaign is critical to saving children’s lives, and would go a long way toward stamping out this disease.”

Brazil is currently battling its worst outbreak of Yellow fever in decades with more than 1,000 confirmed cases. The ease and speed of population movements, rapid urbanization and a resurgence of mosquitoes due to global warming have significantly increased the risk of urban outbreaks with international spread.

Experience in West Africa demonstrates that the EYE strategy can work. When Yellow fever re-emerged as a public health issue in the early 2000s, countries in the region controlled the epidemics through preventive mass campaigns combined with routine immunization. No yellow fever epidemics have been recorded since in countries which successfully implemented this approach.

Note to Editors
The EYE strategy partners include GAVI the Vaccine Alliance, Endemic and New Technologies Franchise Sanofi Pasteur, Sealy Center for Vaccine Development at the University of Texas, GE Foundation, United Nations Children’s Fund (UNICEF), United States Agency for International Development (USAID), Agence de Médecine Préventive (AMP), School of Veterinary Medicine University of Surrey, Bio Manguinhos/Fiocruz, Department for International Development (DFID), Institut Pasteur Dakar, ExxonMobil, Save the Children, ArcelorMittal, Wellcome Trust, Imperial College London, Centers for Disease Control and Prevention (CDC), United Nations High Commissioner for Refugees (UNHCR), Sanofi Pasteur, Department of Tropical Medicine University of Hawaii, Medair, Chumakov Federal Scientific Center for Research & Development of Immune-and-Biological Products Russian Academy  of Medical Sciences, China National Biotech Group, Skoll Global Threats Fund, Bill & Melinda Gates Foundation, International Federation of Red Cross and Red Crescent Societies (IFRC), National Institutes of Health (NIH), BioProtection Systems/NewLikn Genetics Corp., Robert Koch-Institut, Regional Immunization Technical Advisory Group (RITAG), PATH – Center for Vaccine Innovation and Access, Department of Entomology University of California, World Meteorological Organization (WMO), Vaccinology and Immunology Unit University Hospitals Geneva, Nigerian Academy of Science, Médecins Sans Frontières (MSF), Instituto Evandro Chagas (IEC), International Organization for Migration (IOM) and European Centre for Disease Prevention and Control (ECDC).

Inovio Awarded up to $56 Million from CEPI to Advance DNA Vaccines Against Lassa Fever and MERS

Milestones :: Perspectives

Inovio Awarded up to $56 Million from CEPI to Advance DNA Vaccines Against Lassa Fever and MERS
Major investment by Coalition for Epidemic Preparedness Innovations (CEPI) to advance vaccine development and manufacturing on two of CEPI’s highest priority infectious diseases
PLYMOUTH MEETING, Pa. (USA) and OSLO, Norway – April 11, 2018 – Inovio Pharmaceuticals, Inc. (NASDAQ: INO) and CEPI – the Coalition for Epidemic Preparedness Innovations — today announced a partnership under which Inovio will develop vaccine candidates against Lassa fever and Middle East Respiratory Syndrome (MERS).

CEPI will fund up to $56,000,000 to support Inovio’s pre-clinical and clinical advancement through Phase 2 of INO-4500, its Lassa fever vaccine, and INO-4700, its MERS vaccine. The shared goal of Inovio and CEPI is for the Lassa and MERS vaccines to be available as soon as possible for emergency use.

This is the second company agreement CEPI has signed since its launch in 2017. These partnerships represent an innovative approach to funding vaccine development, unlocking research and development potential so that vaccines are ready for efficacy studies during an outbreak. The agreement will enable funding for Inovio’s development efforts over a five-year period. The partnership agreement also includes options, not counted in the total above, to establish investigational stockpiles of both vaccines….

Richard Hatchett, CEO of CEPI said: “Epidemics don’t respect borders; they destroy lives and devastate economies and we need to move swiftly to prepare for them. “Partnering with Inovio is a considerable move forward for CEPI’s vaccine portfolio and developing a global insurance policy against these diseases.”

CEPI’s funding will support development up to the end of Phase 2, providing clinical safety and immunological data, and the establishment of investigational stockpiles that will be ready for clinical efficacy trial testing during outbreaks.

CEPI’s portfolio of investments will provide additional benefits to the wider vaccine community through the development of assays, reference standards and associated knowledge that may accelerate the development of other vaccines and medical counter measures against Lassa fever and MERS…

Inovio will develop these DNA vaccines employing its ASPIRE™ (Antigen SPecific Immune REsponses) platform. This platform delivers optimized synthetic antigenic genes into cells, where they are translated into protein antigens that activate an individual’s immune system to generate robust targeted T cell and antibody responses. Inovio’s immunotherapies function exclusively in vivo, and have generated an antigen-specific immune response against targeted diseases in all clinical trials to date…

Inovio is advancing MERS and Lassa vaccines with the support of its collaborators: The Wistar Institute, Laval University, the NIH’s Rocky Mountain Laboratories, U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), VGXI/GeneOne Life Science and the International Vaccine Institute.




Public Health Emergency of International Concern (PHEIC)
Polio this week as of 3 April 2018 [GPEI]
:: New on Bill Gates and Aliko Dangote support polio eradication efforts in Nigeria. We talk with Professor Rose Leke, Chair of the African Regional Certification Commission, and with Dr Ondrej Mach, who explains why we are developing new polio vaccines for the post-eradication era.
:: The report following the February meeting of the Global Commission for Certification of Poliomyelitis Eradication (GCC) is now published and available here. The GCC came together to review the criteria that will need to be met to achieve global certification of eradication.
:: In Kenya, advance notification of a circulating vaccine-derived poliovirus type 2 (cVPDV2) detected from an environmental sample is being investigated (to be officially reflected in next week’s global data). A cVDPV2 was isolated from an environmental sample collected on 21 March 2018 from Nairobi, linked to the cVDPV2 confirmed from Mogadishu, Somalia. No cases of paralysis associated with this virus have been detected, however a risk assessment is ongoing as is planning for a potential regional response.

Summary of newly-reported viruses this week:
Afghanistan: Two new wild poliovirus type 1 (WPV1)  positive environmental samples have been reported in Kandahar province.
Pakistan: One new wild poliovirus type 1 (WPV1)  positive environmental sample has been reported in Sindh province

Global Commission for the Certification of the Eradication of Poliomyelitis – Report from the Seventeenth Meeting
Geneva, Switzerland, 26 – 27 February 2018 :: 23 pages
The Global Commission for the Certification of Poliomyelitis Eradication (GCCPE/GCC) met in February 2018. It noted that although no WPV paralytic cases had been reported in Pakistan since November 2017 and fewer cases were being reported from Afghanistan for comparable periods in earlier years, considerable numbers of positive environmental samples were being reported from both countries implying that there was still significant ongoing transmission. This circulation of WPVs has implications for the commencement and conclusion of the process of certification of interruption of transmission.

The GCC has previously asked for development of a risk assessment tool that can be used by National Certification Committees and Regional Certification Commissions allowing the GCC to compare risks and their mitigation between countries and across Regions. The GCC noted the progress being made with this tool and hopes that it will be introduced shortly in all Regions.

The GCC considered the possibility that there may still be cVDPV outbreaks in the approach to certification and agreed conditions for the process of certification in such circumstances. The GCC also reviewed the surveillance standards that it will require countries to fulfil according to the systems in place (AFP, environmental and enterovirus surveillance or combinations of these). The GCC’s Terms of Reference were reviewed since it had been many years since this was last done. The GCC has previously recommended that countries should undertake outbreak simulation exercises and proposed that the GCC should undertake a certification exercise. This could be done using the example of certification of WPV3 eradication. Finally, the GCC asked for a time line for its activities to be presented regularly and updated as circumstances on the interruption of transmission and containment change.

The GCC will meet next in approximately six months.
Prof. David M. Salisbury CB
Chair, GCC


WHO Grade 3 Emergencies  [to 14 April 2018]

WHO concerned about suspected chemical attacks in Syria
11 April 2018 – WHO is deeply alarmed by reports of the suspected use of toxic chemicals in Douma city, East Ghouta.

WHO Grade 2 Emergencies  [to 14 April 2018]

UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises. 
Syrian Arab Republic
:: Syrian Arab Republic: Response to the East Ghouta Crisis in Rural Damascus Situation Report No. 3 (3 April – 11 April 2018) 11 Apr 2018
:: Turkey | Syria: Situation in North-western Syria – Situation Report No.2 (as of 10 April 2018)

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.
:: Ethiopia Humanitarian Bulletin Issue 50 | 26 March – 08 April 2018

Rohinga Refugee Crisis 
:: ISCG Situation Report: Rohingya Refugee Crisis, Cox’s Bazar | 12 April 2018
Editor’s Note:
We will cluster these recent emergencies as below and continue to monitor the WHO webpages for updates and key developments.

Yellow Fever  [to 14 April 2018]
:: Nearly one billion people in Africa to be protected against yellow fever by 2026  10 April 2018
[See Milestones/Perspectives above for more detail]

WHO & Regional Offices [to 14 April 2018]

WHO & Regional Offices [to 14 April 2018]
Latest News
Guidance to promote breastfeeding in health facilities
11 April 2018 – Breastfeeding all babies for the first 2 years would save the lives of more than 820,000 children under age 5 annually.

Denmark hosts the WHO Global Dialogue on Partnerships for Sustainable Financing of Noncommunicable Disease Prevention and Control
April 2018 – Noncommunicable diseases are responsible for 40 million deaths globally every year. Tackling NCDs is a global priority, but despite this, investment is still lacking and action is needed to reach the United Nations Sustainable Development Goal target 3.4 of reducing premature deaths from NCDs by one third by 2030. In response, Denmark is co-hosting the WHO Global Dialogue in Copenhagen from 9 to 11 April 2018
Weekly Epidemiological Record, 13 April 2018, vol. 93, 15 (pp. 185–200)
:: Surveillance to track progress towards polio eradication worldwide, 2016–2017
:: Performance of acute flaccid paralysis (AFP) surveillance and incidence of poliomyelitis, 2018
:: Monthly report on dracunculiasis cases, January-February 2018

SAGE call for nominations
Deadline for applications: 31 May 2018
WHO is soliciting proposals for nominations of experts to serve on its Strategic Advisory Group of Experts (SAGE) on immunization.
SAGE is the principal advisory group to WHO for vaccines and immunization. SAGE reports to the Director-General of WHO and advises on global policies and strategies, ranging from vaccine R&D and vaccination recommendations to delivery of immunization, its linkages with other health interventions and integration into health systems. Its remit is not restricted to childhood immunization but extends to all vaccine-preventable diseases for all age groups.
Please see this link for further information:

WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
Selected Featured News
:: Tanzania rolls out vaccination against cervical cancer  12 April 2018
:: Nearly one billion people in Africa to be protected against yellow fever by 2026  10 April 2018

WHO European Region EURO
:: Multidisciplinary primary care teams in Spain provide person-centred care 11-04-2018
:: Surveillance teams risk all to track disease outbreaks in northern Syria 11-04-2018
:: Northern Syria: access to primary health care gives hope to malnourished child 10-04-2018
:: Bringing health services closer to people in Kyrgyzstan 05-04-2018

WHO Eastern Mediterranean Region EMRO
:: WHO concerned about suspected chemical attacks in Syria  11 April 2018

CDC/ACIP [to 14 April 2018]

MMWR News Synopsis for April 12, 2018
Surveillance Systems to Track Progress Toward Polio Eradication — Worldwide, 2016–2017
While 2017 saw the fewest number of polio cases ever recorded globally, continued improvements to national surveillance systems are necessary to ensure timely detection of cases and accurate certification of polio-free status. As the world moves closer to eliminating polio, it is more important than ever to have strong surveillance systems in place. Only 22 wild poliovirus (WPV) cases were reported in 2017, the fewest ever reported globally. Despite this improvement, the number of vaccine-derived poliovirus (cVPDVs) cases increased to 96 in 2017, due to outbreaks in Syria and in Democratic Republic of the Congo. While surveillance performance is improving at the country level, gaps remain within countries largely because of conflict and inaccessibility in some regions. Rapid improvements in surveillance systems are needed. As long as polioviruses continue to circulate in any country, all countries remain at risk.



Bill & Melinda Gates Medical Research Institute    [to 14 April 2018]
   The Bill & Melinda Gates Medical Research Institute is a non-profit research organization dedicated to combating diseases that impact the world’s poorest. We strive to combat inequities in health by accelerating progress in translational science to ensure life-saving products are available and accessible to everyone. We consider ourselves pioneers dedicated to uncovering radical solutions that will close the gap between cutting-edge scientific innovation and its application to challenges in global health.
No new digest content identified.

CEPI – Coalition for Epidemic Preparedness Innovations  [to 14 April 2018]
Posted on 11TH APR 2018 by Rachel Grant
Inovio Awarded up to $56 Million from CEPI to Advance DNA Vaccines Against Lassa Fever and MERS
Major investment by Coalition for Epidemic Preparedness Innovations (CEPI) to advance vaccine development and manufacturing on two of CEPI’s highest priority infectious diseases
[See Milestones/Perspectives above for more detail]

IVAC  [to 14 April 2018]
IVAC Welcomes Dr. Naor Bar-Zeev
Posted 4/10/18
The International Vaccine Access Center (IVAC) is pleased to announce that Naor Bar-Zeev, MBBS(Hons), MPH, MBiostat, PhD, has joined the IVAC team as an Associate Professor in the Department of International Health at the Johns Hopkins Bloomberg School of Public Health.

MSF/Médecins Sans Frontières  [to 14 April 2018]
April 13, 2018
Central African Republic: MSF Treats Wounded Amid Violence in Bangui
MSF has treated 80 wounded patients amid violence in Bangui over the past week. In the early morning of April 8, United Nations and Central African Republic security forces launched a joint operation in the PK5 neighborhood in Bangui, which involved heavy fighting and resulted in dozens of people injured.

Press release
Syria: Displaced People From Eastern Ghouta Need Treatment
April 13, 2018
Roughly 60,000 people have been displaced from eastern Ghouta, near Damascus, to northwestern Syria in the past month. A significant number of these men, women, and children are injured or sick and in need of medical care. Doctors Without Borders/Médecins Sans Frontières (MSF) supports the main hospital in charge of triaging and treating these patients at a location known as the “zero point,” where people arrive on buses.

NIH  [to 14 April 2018]
April 9, 2018
NIH scientists develop macaque model to study Crimean-Congo hemorrhagic fever
— CCHF is a viral disease spread by ticks in the Middle East, Asia, Africa and parts of Europe.
PATH  [to 14 April 2018]
Press release | April 12, 2018
New study results from Uganda strengthen the case for contraceptive self-injection
Study finds that self-administration enables women to use injectable contraception longer

Announcement | April 10, 2018
PATH names Anthony Okoth as Country Director for Kenya office

UNICEF  [to 14 April 2018]
Selected Press Releases
11 April, 2018
WHO and UNICEF issue new guidance to promote breastfeeding in health facilities globally
GENEVA – The World Health Organization (WHO) and UNICEF today issued new ten-step guidance to increase support for breastfeeding in health facilities that provide maternity and newborn services. Breastfeeding all babies for the first two years would save the lives of more than 820,000 children under age 5 annually.

Nearly one billion people in Africa to be protected against yellow fever by 2026
ABUJA, 10 April 2018 — Nearly one billion people will be vaccinated against yellow fever in 27 high-risk African countries by 2026 with support from the World Health Organization (WHO), Gavi – the Vaccine Alliance, UNICEF and more than 50 health partners.
[See Milestones/Perspectives above for more detail]

High risk of disease outbreaks in earthquake-hit Papua New Guinea – UNICEF and WHO
PORT MORESBY, 9 April 2018 – UNICEF and the World Health Organization (WHO) have cautioned about the high potential of waterborne and vaccine-preventable disease outbreaks in earthquake-affected areas of Papua New Guinea.

Wellcome Trust  [to 14 April 2018]
Published: 12 April 2018
How to make sense of the brain’s billions of neurons
A unique global collaboration is attempting to transform the way we study the brain. If it succeeds, it could start to address longstanding unanswered questions about how brain disorders alter our neural circuits.

Genetic changes linked to adult kidney cancer can occur in childhood
News / Published: 12 April 2018
Researchers at the Wellcome Sanger Institute have discovered that key genetic changes which may lead to kidney cancer can occur as early as childhood or adolescence. This can be up to 50 years before the disease is diagnosed

How we’ve defined what success looks like for Wellcome’s work
Explainer / Published: 10 April 2018
Chonnettia Jones, our Director of Insight and Analysis, explains how developing a success framework is leading to new ways of thinking and working across Wellcome

The Wistar Institute   [to 14 April 2018]
Press Release   Apr. 12 2018
Novel Combination Therapy Effective for NRAS Mutant and Therapy Resistant Melanoma
Co-targeting BET and MEK holds promise as a salvage therapy for melanoma resistant to targeted therapy and immunotherapy.

DCVMN – Developing Country Vaccine Manufacturers Network  [to 14 April 2018]
14 April 2018
Regional workshop: Optimization of vaccines’ manufacturing, containers and testing for global supply
7 May 2018 to 10 May 2018
Hyderabad / India
Industry Watch    [to 14 April 2018]
:: Boehringer Ingelheim to invest €65 million in avian vaccines
Boehringer Ingelheim is set to invest almost €65 million in a high-tech building at its Lyon Porte-des-Alpes site in Saint-Priest, France (Rhône), to meet the growing demand worldwide for avian vaccines
The Group has thus confirmed its commitment to making France, and Lyon in particular, one of its major growth drivers in the animal health market
April 11, 2018

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 focus on vaccine ethics and policy. Journal Watch is not intended to be exhaustive, but indicative of themes and issues the Center is actively tracking. We selectively provide full text of some editorial and comment articles that are specifically relevant to our work. Successful access to some of the links provided may require subscription or other access arrangement unique to the publisher.

If you would like to suggest other journal titles to include in this service, please contact David Curry at: