Milestones :: Perspectives

Milestones :: Perspectives
Region of the Americas eliminates maternal and neonatal tetanus
Joint press release
WASHINGTON/NEW YORK, 21 September 2017 – The Region of the Americas has eliminated maternal and neonatal tetanus (MNT), a disease that used to be responsible for the deaths of more than 10,000 newborns every year in the Americas.

The elimination of the disease was declared this year in Haiti, which made it possible to reach the regional goal. MNT is the sixth vaccine-preventable disease to be eliminated from the Americas, following the regional eradication of smallpox in 1971, poliomyelitis in 1994, rubella and congenital rubella syndrome in 2015, and measles in 2016.

“The elimination of maternal and neonatal tetanus is proof again that vaccines work to save the lives of countless mothers and babies,” said Carissa F. Etienne, director of the Pan American Health Organization/World Health Organization (PAHO/WHO). “Let us continue to protect the people of our Region by investing in strong national immunization programs that are capable of vaccinating all individuals and quickly identifying vaccine-preventable diseases.”

Unlike other vaccine-preventable diseases, MNT is considered eliminated when there is an annual rate of less than one case of neonatal tetanus per 1,000 live births at the district level. Tetanus cannot be fully eradicated because the bacterium that causes the disease, Clostridium tetani, exists throughout the environment in soil and the feces of many different animals.

Before widespread modern vaccination against MNT began in the 1970s, neonatal tetanus was responsible for the deaths of more than 10,000 newborns every year in the Americas – a number considered low by experts due to severe underreporting of cases. According to data from WHO, neonatal tetanus killed about 34,000 newborn children in 2015, a 96% reduction from 1988, when an estimated 787,000 newborn babies died of tetanus within their first month of life…

Recent progress in global elimination has led to 43 countries, including Haiti, eliminating MNT between 2000 and June 2017. There are 16 countries worldwide that have yet to eliminate the disease…

Most countries of the Region were able to eliminate MNT by the early 2000s. Starting in 2003, special efforts were made in Haiti to achieve MNT elimination. The country vaccinated all women of reproductive age against tetanus, regardless of whether they were previously vaccinated. Pregnant women were also vaccinated against the disease as part of the routine schedule. Furthermore, neonatal tetanus surveillance was incorporated with surveillance for other vaccine-preventable diseases like measles, rubella, polio, diphtheria, and pertussis. Additionally, the country focused on increasing the number of clean births and deliveries and practicing proper umbilical care.

Following field visits in Haiti in June 2016, experts determined that MNT elimination could be possible in the country. To confirm, a survey was carried out in the South Department, which was considered to have the highest risk of MNT, to determine how many neonatal deaths were due to tetanus in a one-year period. As no neonatal death due to tetanus was found during the survey, MNT was considered eliminated…

PAHO is encouraging all countries in the Region to strengthen their efforts to maintain coverage of maternal immunization against tetanus at the recommended 95%, as several have fallen short of this goal during recent years.

“Because tetanus can never be eradicated, a single case of newborn tetanus in the Americas could still happen,” said Cuauhtemoc Ruiz, head of PAHO’s Comprehensive Family Immunization Program. “In this case, countries should carry out a thorough evaluation to determine how the case could have been averted in order to prevent new cases.”

Key partners involved in in the effort to eliminate MNT at the Regional level include the ministries of health of PAHO/WHO’s Member States, the CDC, and the Brazilian government. In Haiti, UNICEF collaborated with the Government of Canada, UNFPA, WHO, UNICEF National Committees, and the private sector for MNT elimination efforts.
The world is running out of antibiotics, WHO report confirms
WHO News release
Report: Antibacterial agents in clinical development – an analysis of the antibacterial clinical development pipeline, including tuberculosis
Report: Prioritization of pathogens to guide discovery, research and development of new antibiotics for drug-resistant bacterial infections, including tuberculosis
20 September 2017 | Geneva – A new report launched today by WHO shows a serious lack of new antibiotics under development to combat the growing threat of antimicrobial resistance.
Most of the drugs currently in the clinical pipeline are modifications of existing classes of antibiotics and are only short-term solutions. The report found very few potential treatment options for those antibiotic-resistant infections identified by WHO as posing the greatest threat to health, including drug-resistant tuberculosis which kills around 250 000 people each year.

“Antimicrobial resistance is a global health emergency that will seriously jeopardize progress in modern medicine,” says Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “There is an urgent need for more investment in research and development for antibiotic-resistant infections including TB, otherwise we will be forced back to a time when people feared common infections and risked their lives from minor surgery.”

In addition to multidrug-resistant tuberculosis, WHO has identified 12 classes of priority pathogens – some of them causing common infections such as pneumonia or urinary tract infections – that are increasingly resistant to existing antibiotics and urgently in need of new treatments.

The report identifies 51 new antibiotics and biologicals in clinical development to treat priority antibiotic-resistant pathogens, as well as tuberculosis and the sometimes deadly diarrhoeal infection Clostridium difficile.

Among all these candidate medicines, however, only 8 are classed by WHO as innovative treatments that will add value to the current antibiotic treatment arsenal.

There is a serious lack of treatment options for multidrug- and extensively drug-resistant M. tuberculosis and gram-negative pathogens, including Acinetobacter and Enterobacteriaceae (such as Klebsiella and E.coli) which can cause severe and often deadly infections that pose a particular threat in hospitals and nursing homes.

There are also very few oral antibiotics in the pipeline, yet these are essential formulations for treating infections outside hospitals or in resource-limited settings.

“Pharmaceutical companies and researchers must urgently focus on new antibiotics against certain types of extremely serious infections that can kill patients in a matter of days because we have no line of defence,” says Dr Suzanne Hill, Director of the Department of Essential Medicines at WHO.

To counter this threat, WHO and the Drugs for Neglected Diseases Initiative (DNDi) set up the Global Antibiotic Research and Development Partnership (known as GARDP). On 4 September 2017, Germany, Luxembourg, the Netherlands, South Africa, Switzerland and the United Kingdom of Great Britain and Northern Ireland and the Wellcome Trust pledged more than €56 million for this work.

“Research for tuberculosis is seriously underfunded, with only two new antibiotics for treatment of drug-resistant tuberculosis having reached the market in over 70 years,” says Dr Mario Raviglione, Director of the WHO Global Tuberculosis Programme. “If we are to end tuberculosis, more than US$ 800 million per year is urgently needed to fund research for new antituberculosis medicines”.

New treatments alone, however, will not be sufficient to combat the threat of antimicrobial resistance. WHO works with countries and partners to improve infection prevention and control and to foster appropriate use of existing and future antibiotics. WHO is also developing guidance for the responsible use of antibiotics in the human, animal and agricultural sectors.
Editor’s Note:
   We continue to monitor chorea outbreaks, with a special focus on the widely varying role OCV in playing in responses. Indeed, the Yemen outbreak response and the variable narratives on OCV from WHO have, in our view, become suspect [see second item below].
   Equally puzzling are parallel announcements by Gavi and MSF [further below] regarding the outbreak response in Nigeria: Gavi speaks of almost nothing but the OCV campaign launch, while MSF’s announcement does not mention OCV at all.
Yemen Humanitarian Bulletin Issue 27 | 20 September 2017
… Nearly 700,000 suspected cholera cases and over 2,000 associated deaths have been reported since 27 April…
WHO urges Yemen to accept vaccines as cholera crisis deepens
18 September 2017 – 17H40
GENEVA (AFP) – The World Health Organization on Monday urged Yemen to approve cholera vaccinations it has offered to help contain an epidemic that could affect nearly a million people by year’s end.

Yemen, where a multinational conflict has caused a humanitarian crisis, had asked the UN health agency earlier this year for doses of the vaccine, said Dominique Legros, the agency’s cholera specialist.

The WHO sent a million doses in June only to see the Yemeni government change its mind, leading the United Nations to reassign the vaccines to Somalia and Sudan, Legros told reporters in Geneva.

Asked about Yemen’s reversal, Legros said only that discussions with countries about vaccinations could be “complicated”, noting the lack of familiarity with them in affected communities, especially in the case of newer vaccines like the one for cholera.

“We are still in negotiation with the government in Yemen to make sure we can also use (vaccines) to help control” the outbreak, he said.

Last week, the International Committee of the Red Cross (ICRC) said the rampant cholera crisis in Yemen had reached “colossal proportions”, warning that it could affect 850,000 people by the end of the year.

More than 2,000 people have perished from the disease, according to the WHO.

The epidemic has put further strain on a ravaged health system in Yemen, where less than half of healthcare facilities are functioning as the conflict drags on.

Since March 2015, a Saudi-led coalition has been waging a war on behalf of the internationally recognised government against Iran-backed Huthi rebels.

More than 8,000 people have been killed, including at least 1,500 children, and millions displaced in the conflict which has pushed the impoverished country to the brink of famine.

MSF/Médecins Sans Frontières  [to 23 September 2017]
Press release
Nigeria: MSF Scales Up Activities as Cholera Outbreak Continues to Spread Across Borno State
September 18, 2017
As new cases of cholera emerge in Monguno, Dikwa, and Maiduguri, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) continues to scale up its response in Borno state, including recently opening an additional cholera treatment unit (CTU) near Muna Garage camp.
MSF is closely coordinating its efforts with the Borno Ministry of Health, the World Health Organisation (WHO) and other humanitarian organizations in the prevention and treatment of cholera, including providing training for their health workers….
Gavi [to 23 September 2017]
18 September 2017
Cholera vaccination campaign begins in north-eastern Nigeria
Mass vaccination effort will target over 915,000 people to contain cholera outbreak in Borno state.
Maiduguri, 18 September 2017 – A major vaccination campaign to halt the spread of cholera starts in Nigeria’s Borno state today.

Gavi, the Vaccine Alliance, WHO and partners delivered 915,005 doses of Oral Cholera Vaccine to the country last week.

The Government of Nigeria, supported by WHO and partners, plan to vaccinate everyone over the age of one – more than 915 000 people – over the next few days. The campaign will take place in Muna internally displaced persons (IDPs) camp in Maiduguri as well as Jere, Monguno and Dikwa local government areas (LGAs).

“The Federal Government of Nigeria through the Nigeria Centre for Disease Control (NCDC) and the National Primary Health Care Development Agency (NPHCDA) in collaboration with the WHO, UNICEF and other partners are all supporting the Borno State Ministry of Health in leaving no stone unturned to ensure that the current cholera outbreak in some parts of Borno state is contained shortly,” said NCDC Chief Executive Officer Dr. Chikwe Ihekweazu. “The Government at all levels is working closely with partners to improve the sanitation situation, conducting hygiene promotion and disinfection of the affected areas including Muna, Custom house, Monguno and Farm centre IDPs camp, Dikwa, Konduga, Jere LGAs and Maiduguri Municipal Council.”

Following heavy rainfall and lack of access to safe water, more than 2600 suspected cholera cases have been reported, as of 16 September, in Borno state with more than 40 deaths since the first case was confirmed in mid-August. The majority of cases have been detected in the Muna IDP camp on the outskirts of Borno state’s capital Maiduguri, which houses 20,000 people who have fled the Boko Haram conflict. The number of suspected cholera cases has also increased dramatically in Dikwa and Monguno areas in the past few weeks.

The decision to send cholera vaccines from the global stockpile was taken on 7 September by the International Coordinating Group (ICG) for Vaccine Provision.

“Thousands of people in these camps have already left their homes to flee violence and terror. They now find themselves at risk of cholera,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. ”These lifesaving vaccines will play a vital role in slowing the spread of the disease, buying valuable time to put the right water, sanitation and hygiene infrastructure in place to stop the root causes of this outbreak,” he added.

“WHO and partners are already making a difference by alerting people of the risks of cholera, supporting the early detection of cases, treating cases and taking other steps to end the outbreak,” said Dr Wondi Alemu, WHO Representative in Nigeria. “We are focusing on delivering a single dose to vaccinate as many people as quickly as possible. As we proceed with this vaccination campaign, we hope to contain this outbreak, and support the collective commitment by partners from the health sector and other sectors to help people in Borno state. Then we can move forward with addressing the myriad of other pressing health needs in Borno.”

Gavi, WHO and partners are working with the NCDC and Borno State Ministry of Health to make the vaccine available free-of-cost to affected populations, while supporting ongoing cholera prevention and preparedness.


Public Health Emergency of International Concern (PHEIC)
Polio this week as of 20 September 2017 [GPEI]
:: Summary of newly-reported viruses this week:  Pakistan: one new wild poliovirus type 1 (WPV1) positive environmental sample; Syria: one new circulating vaccine-derived poliovirus type 2 (cVDPV2) case; and, Democratic Republic of Congo:  one new cVDPV2 case.


Situation reports on the polio outbreak in Syria [WHO]
Situation update 19 September 2017
:: One new case of cVDPV2 confirmed this week, from Mayadeen district, Deir Ez-Zor governorate. The case, a 9-month-old boy with no polio vaccination history, had onset of paralysis 19 June 2017.
:: The total number of cVDPV2 cases is 40. All confirmed cases to date have had onset of paralysis before 14 July 2017.
:: Preparations for the second Raqqa round continue.
:: Micro-plans are being updated for each of Raqqa’s districts. Pre-round C4D activities have started.
:: IPV vaccination for children missed in the second Deir Ez-Zor round continues through health facilities.
:: An IPV campaign targeting children aged between 2 and 23 months in Aleppo, Idlib and Hama is being planned to boost population immunity.


WHO Grade 3 Emergencies  [to 23 September 2017]
:: Cholera vaccination campaign begins in north-eastern Nigeria  18 September 2017
[See Cholera below for more detail]
The Syrian Arab Republic
:: Situation reports on the polio outbreak in Syria 19 September 2017
:: WHO responds to critical health needs of displaced populations in Al-Tabqa city, Ar-Raqqa Governorate   18 September 2017

:: [Cholera] Daily epidemiology bulletin, 19 September 2017
South Sudan
:: WHO and partners respond to flood crises in the former Northern Bahr el Ghazal and Upper Nile States of South Sudan  18 September 201

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
:: 22 Sep 2017  1.2 million children affected by Syrian crisis are benefiting from education through Education Above All Foundation and partners
:: Under-Secretary-General and Emergency Relief Coordinator Mr. Mark Lowcock: Remarks at High-level Meeting on Syria in Margins of the General Assembly  Report  UN Headquarters, New York, New York, September 21, 2017

:: OCHA Iraq | Hawiga Flash Update #1: Hawiga Humanitarian Response, 21 September 2017
:: Iraq: Returnees face new, unimaginable hardships  22 Sep 2017  Report from UN Office for the Coordination of Humanitarian Affairs

:: Yemen Humanitarian Bulletin Issue 27 | 20 September 2017
… Nearly 700,000 suspected cholera cases and over 2,000 associated deaths have been reported since 27 April.
…1.7 million people in acute need live in districts with highest access constraints.
..78 per cent of households are economically worse off than they were two years ago.
..8,530 people have been killed since March 2015, and 48,848 injured. More than 1,500 schools are damaged or destroyed.


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.
:: US$ 9.9 million urgently needed to respond to cholera outbreak in North-East Nigeria
18 September, 2017
The United Nations and its partners are urgently appealing for $9.9 million to respond to the current cholera outbreak in Borno State, north-east Nigeria, and prevent further outbreaks in high-risk areas. A Cholera Response and Prevention plan has been developed to address the immediate needs of 3.7 million people that could be affected by the outbreak…
Bangladesh Restricts Rohingya Refugees, Starts Immunization
New York Times/AP | 17 September 2017
COX’S BAZAR, Bangladesh — Bangladeshi authorities are taking steps to restrict the movement of Muslim Rohingya refugees living in crowded border camps after fleeing violence in Myanmar, whose military chief maintains that the chaos was the work of extremists seeking a stronghold in the country.
Bangladesh has been overwhelmed with more than 400,000 Rohingya who fled their homes in the last three weeks amid a crisis the U.N. describes as ethnic cleansing..
…With the U.N. saying there are some 240,000 children among the refugees living in dire conditions, Bangladeshi authorities have kicked off a massive immunization drive. Abdus Salam, the top government administrator in the Cox’s Bazar district hospital, said that some 150,000 children would be immunized over seven days for measles, rubella and polio.
“There are a lot of weak and malnourished children among the new arrivals,” UNICEF’s representative in Bangladesh, Edouard Beigbeder, said in an email. “If proper preventive measures are not taken, highly infectious diseases, especially measles, could even cause an outbreak…
Editor’s Note:
We will cluster these recent emergencies as below and continue to monitor the WHO webpages for updates and key developments.
MERS-CoV [to 23 September 2017]
Middle East respiratory syndrome coronavirus (MERS-CoV) – United Arab Emirates
21 September 2017 [One additional case]

WHO & Regional Offices & CDC/ACIP [to 23 September 2017]

WHO & Regional Offices [to 23 September 2017]

Promoting migrant health – striving for peace and decent life for all
22 September 2017 – WHO Director-General Dr Tedros’ remarks at the UN General Assembly on migrant health

Leaders at United Nations General Assembly step up end malaria for good
September 2017 – Country leaders and senior officials from across Africa, Europe, Asia Pacific and the Americas announced new political and financial commitments to accelerate the global fight towards eliminating malaria – a disease that claims the life of a child every two minutes and puts half the world at risk.

WHO condemns attacks on hospitals and health workers in Syria
September 2017 – Multiple reported attacks on health facilities and personnel today in Syria have killed and injured health workers and disrupted health services for thousands of people.

Cambodia and the Lao People’s Democratic Republic wipe out trachoma
September 2017 – Trachoma is the leading infectious cause of blindness worldwide. WHO congratulated the Kingdom of Cambodia and the Lao People’s Democratic Republic on eliminating trachoma as a public health problem.

WHO provides critical support to step-up health services delivery in Cox’s Bazar, Bangladesh
September 2017 – Since 25 August more than 400 000 people are estimated to have crossed from Myanmar to Bangladesh following violence in Rakhine state, Myanmar. WHO is providing governments of Bangladesh and Myanmar essential drugs and medical supplies, cholera kits, and emergency medical kits.


Weekly Epidemiological Record, 22 September 2017, vol. 92, 38 (pp. 557–572)
:: Global leishmaniasis update, 2006–2015: a turning point in leishmaniasis surveillance
:: Control of visceral leishmaniasis in Somalia: achievements in a challenging scenario, 2013–2015
WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: WHO with funding from the Government of Canada inaugurates newly constructed maternity complexes in Awiel and Kuajok  21 September 2017
:: Mitigating health risks in the wake of disaster  21 September 2017
Borno applauds WHO’s response to cholera outbreak.  20 September 2017
:: Polio eradication: Experts say Nigeria not ‘out of the woods yet’.  20 September 2017
:: One year after Nigeria emergency declaration.  19 September 2017
: WHO and partners respond to flood crises in the former Northern Bahr el Ghazal and Upper Nile States of South Sudan  19 September 2017
:: Cholera vaccination campaign begins in north-eastern Nigeria 18 September 2017
WHO supports capacity building for enforcement of and compliance with tobacco control regulations in Zanzibar  18 September 2017
: WHO convenes experts to enhance capacity for schistosomiasis control across the sub-Sahara Region  18 September 2017

WHO Region of the Americas PAHO
:: Region of the Americas eliminates maternal and neonatal tetanus (09/21/2017)
:: WHO launches new NCDs Progress Monitor (09/18/2017)

WHO European Region EURO
:: WHO receives British Medical Association (BMA) Medical Book Awards 21-09-2017
:: Prevention and control of NCDs: a business case in Kyrgyzstan 21-09-2017
:: RC67 concludes: “Our message is reaching further and higher” 18-09-2017
:: Chikungunya outbreak confirmed in Italy 18-09-2017

WHO Eastern Mediterranean Region EMRO
:: Regional launch of the third Patient Safety Challenge: Medication without harm
21 September 2017 – The regional launch of the third Patient Safety Challenge: “Medication without harm”, was held in Muscat, Oman, from 17 to 18 September 2017. The focus of the challenge is on strengthening health systems to reduce medication errors with the goal of reducing the level of severe, avoidable harm related to medications by 50% over 5 years.

WHO Western Pacific Region
:: Cambodia and the Lao People’s Democratic Republic wipe out trachoma—leading infectious cause of blindness
MANILA | 19 September 2017 – The World Health Organization (WHO) today congratulated the Kingdom of Cambodia and the Lao People’s Democratic Republic on eliminating trachoma as a public health problem. Trachoma is an eye disease caused by infection with Chlamydia trachomatis bacteria. It is the leading infectious cause of blindness worldwide.

CDC/ACIP [to 23 September 2017]
Press Release
Sustaining Global Health Security is Critical to Protecting America’s National Security – Digital Press Kit Thursday, September 21, 2017

MMWR News Synopsis for September 21, 2017
:: HIV Care Outcomes Among Men Who Have Sex With Men With Diagnosed HIV Infection — United States, 2015
:: Trends in Cervical Cancer Screening in Title X Funded Health Centers — United States, 2005-2015
: Update to CDC’s U.S. Medical Eligibility Criteria for Contraceptive Use, 2016: Revised Recommendations for the Use of Hormonal Contraception Among Women at High Risk for HIV Infection


BMGF – Gates Foundation  [to 23 September 2017] Releases
SEPTEMBER 20, 2017
Bill and Melinda Gates Host Inaugural ‘Goalkeepers’ Event to Engage a New Generation of Leaders in the Fight Against Poverty and Disease
Prime Minister Trudeau and President Obama join other leaders from business, technology, media and entertainment to help speed progress toward the ‘Global Goals’

EDCTP    [to 23 September 2017]
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
20 September 2017
Nigeria becomes 29th member of EDCTP
EDCTP is pleased to welcome Nigeria as its 29th member country.  As a member of the EDCTP Association, it will…
Gavi [to 23 September 2017]
18 September 2017
Cholera vaccination campaign begins in north-eastern Nigeria
Mass vaccination effort will target over 915,000 people to contain cholera outbreak in Borno state.
[See Cholera above for more detail]
GHIT Fund   [to 23 September 2017]
GHIT was set up in 2012 with the aim of developing new tools to tackle infectious diseases that devastate the world’s poorest people. Other funders include six Japanese pharmaceutical ·
Event Report: World Leaders for Universal Health Coverage (UHC): A High-Level Discussion at the United Nations on Achieving the SDGs Through Health for All

On September 18, leaders from the GHIT Fund attended, an event convened on the sidelines of the 72nd United Nations General Assembly in New York City. Dr. Kiyoshi Kurokawa, Chair of the GHIT Fund, served as a featured speaker.
MSF/Médecins Sans Frontières  [to 23 September 2017]
Press release
Nigeria: MSF Scales Up Activities as Cholera Outbreak Continues to Spread Across Borno State
September 18, 2017
As new cases of cholera emerge in Monguno, Dikwa, and Maiduguri, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) continues to scale up its response in Borno state, including recently opening an additional cholera treatment unit (CTU) near Muna Garage camp.
NIH  [to 23 September 2017]
September 20, 2017
Immune cells may heal bleeding brain after strokes
NIH-funded preclinical rodent study points to neutrophils for potential treatment options.

September 20, 2017
Three-in-one antibody protects monkeys from HIV-like virus
NIH and Sanofi scientists prepare to test antibody in people.
PATH  [to 23 September 2017]
Press release | September 17, 2017
New global coalition will boost access to medicines and products for chronic diseases
The coalition, led by PATH, brings together multisectoral partners to reduce the toll of noncommunicable diseases, including diabetes, hypertension, and cardiovascular disease.
New York, September 18, 2017—A multisectoral partnership today launched a first-of-its-kind global coalition dedicated to increasing access to essential medicines and health products to prevent and treat noncommunicable diseases (NCDs) and conditions, including diabetes, hypertension, and cardiovascular disease.
The new Coalition for Access to NCD Medicines & Products brings together governments, the private sector, philanthropic and academic institutions, and nongovernmental organizations to tackle barriers countries face in procuring, supplying, and distributing essential medicines and technologies and ensuring they are used effectively. PATH will serve as the coalition secretariat.
The coalition will partner with countries to help them achieve the World Health Organization target of 80 percent availability of affordable technologies and essential medicines, including generics, required to treat NCDs in both public and private facilities.
The launch event, alongside the United Nations General Assembly in New York, features an interactive panel of global health leaders and influencers from across sectors sharing their perspectives on the opportunities ahead to reduce the toll of NCDs….

UNAIDS [to 23 September 2017]
Press release
New high-quality antiretroviral therapy to be launched in South Africa, Kenya and over 90 low-and middle-income countries at reduced price
   [Undated] New York – A breakthrough pricing agreement has been announced which will accelerate the availability of the first affordable, generic, single-pill HIV treatment regimen containing dolutegravir (DTG) to public sector purchasers in low- and middle-income countries (LMICs) at around US$75 per person, per year. The agreement is expected to accelerate treatment rollout as part of global efforts to reach all 36.7 million people living with HIV with high-quality antiretroviral therapy. UNAIDS estimates that in 2016, just over half (19.5 million) of all people living with HIV had access to the lifesaving medicines.
DTG, a best-in-class integrase inhibitor, is widely used in high-income countries and is recommended by the World Health Organization (WHO) as an alternative first-line HIV regimen, as well as a preferred treatment by the U.S. Department of Health and Human Services Panel on Antiretroviral Guidelines for Adults and Adolescents, among many others. In addition to improving treatment quality and retention, widespread use of DTG is expected to lower the cost of first-line HIV treatment regimens while also reducing the need for more expensive second- and third-line regimens. In July 2017, WHO issued guidance to countries on how to safely and rapidly transition to DTG-based antiretroviral treatment.
This agreement, announced by the governments of South Africa and Kenya, together with the Joint United Nations Programme on HIV/AIDS (UNAIDS), the Clinton Health Access Initiative (CHAI), the Bill & Melinda Gates Foundation (BMGF), Unitaid, the United Kingdom’s Department for International Development (DFID), the United States President’s Emergency Plan for AIDS Relief (PEPFAR), the U.S. Agency for International Development (USAID), and the Global Fund to Fight AIDS, Tuberculosis and Malaria, with Mylan Laboratories Limited and Aurobindo Pharma, takes an important step toward ensuring the availability of worldwide high-quality treatment for HIV.
“This agreement will improve the quality of life for millions of people living with HIV,” said UNAIDS Executive Director Michel Sidibé. “To achieve the 90-90-90 treatment targets, newer, affordable and effective treatment options must be made available—from Baltimore to Bamako—without any delay.”…

Press release
UNAIDS calls to quicken the pace of action to end AIDS
World leaders come together to renew the urgency around ending AIDS as part of the Sustainable Development Goals
GENEVA/NEW YORK, 21 September 2017—The President of Uganda, Yoweri Museveni, in collaboration with UNAIDS, brought together six heads of state or government to accelerate action and get countries on the Fast-Track to end AIDS. World leaders joined around 500 partners from government, the private sector and civil society on the sidelines of the United Nations General Assembly to reinvigorate political leadership around HIV.
The Fast-Track approach is saving more and more lives. In 2016, 19.5 million people—more than half the 36.7 million people living with HIV—were accessing life-saving treatment. The number of people who died from AIDS-related illnesses has been reduced by nearly half since 2005, and the global number of new HIV infections has been reduced by 11% since 2010.
However, the pace of action is still not enough to end the AIDS epidemic as a public health threat by 2030…

UNICEF  [to 23 September 2017]
23 September 2017
Education at risk for thousands of children after successive earthquakes in Mexico – UNICEF
MEXICO CITY/NEW YORK, 23 September 2017 – Nearly 5,100 schools have been damaged or destroyed in Mexico following two powerful earthquakes that struck less than two weeks apart, threatening access to education for thousands of children – UNICEF said today.

Region of the Americas eliminates maternal and neonatal tetanus
WASHINGTON/NEW YORK, 21 September 2017 – The Region of the Americas has eliminated maternal and neonatal tetanus (MNT), a disease that used to be responsible for the deaths of more than 10,000 newborns every year in the Americas.
[See Milestones above for more detail]

Only 15 countries worldwide have three essential national policies that support families with young children – UNICEF
NEW YORK, 21 September 2017 – Only 15 countries worldwide have three basic national policies that help guarantee the time and resources parents need to support their young children’s healthy brain development, UNICEF said today in a new report. Worse, 32 countries – home to one in eight of the world’s children under five – have none of these policies in place.

The Vaccine Confidence Project  [to 23 September 2017]
Confidence Commentary:
Harnessing innovation in public health
17 Sep 2017
The second Raffles Dialogue, hosted last week by the National University of Singapore schools of medicine, public health and public policy along with the National University Health System (NUHS), focused on “The Critical Role of Innovation” in the context of the broader theme of “Human Well-being and Security in 2030”.
It was attended by more than 100 global health experts and international participants.
In his opening address looking forward to 2030, Professor John Wong, chief executive of NUHS, urged the audience to consider Charles Darwin’s theory of natural selection, published in the mid-1800s, which emphasised that neither intelligence nor physical strength was the critical factor for survival.
Instead, the key to survival is the ability to adapt to change. More than 200 years later, this need to adapt is more pressing than ever…
The dialogue explored innovations in health, information and big data, financing and global governance. In the face of fast paced change, how will all this innovation weave together? How can societies ensure that the innovations are harnessed for positive disruptions, and not negative ones? How can these innovations help to advance equity, rather than drive inequities, with some benefiting more than others?
Wellcome Trust  [to 23 September 2017]
News / Published: 21 September 2017
Superbug’s spread to Vietnam threatens malaria control
A highly drug-resistant strain of malaria has spread from western Cambodia to southern Vietnam.
Wellcome researchers warn that the spread of artemisinin drug-resistant Plasmodium falciparum C580Y is leading to alarming failure rates for Vietnam’s first-line malaria treatment – dihydroartemisinin (DHA)-piperaquine.
In a letter published in The Lancet Infectious Diseases (opens in a new tab), the scientists say the spread of the malaria superbug across the entire Mekong Sub-region, from western Cambodia to north-eastern Thailand, southern Laos and now into southern Vietnam, poses an urgent threat to malaria control…
News / Published: 20 September 2017
Genome editing sheds light on human embryo development
Researchers have used genome editing technology to reveal the role of a key gene in human embryos in the first few days of development.
It’s the first time that editing of the genome – the complete set of genes in a cell or organism – has been used to study gene function in human embryos.
The research could help scientists to better understand the biology of our early development…
Opinion / Published: 20 September 2017
Director’s update: sustaining a historically high spending level for Wellcome
In the next year, Wellcome will support more science, research and public engagement than ever before, spending over £1 billion on the people, places and projects that advance our mission of improving health by helping great ideas to thrive…
DCVMN – Developing Country Vaccine Manufacturers Network  [to 23 September 2017]
25 September 2017 to 28 September 2017
DCVMN Annual General Meeting
Seoul / Korea
Download the Agenda

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:

Progress and outcomes of health systems reform in the United Arab Emirates: a systematic review

BMC Health Services Research
(Accessed 23 September 2017)

Research article
Progress and outcomes of health systems reform in the United Arab Emirates: a systematic review
The United Arab Emirates (UAE) government aspires to build a world class health system to improve the quality of healthcare and the health outcomes for its population. To achieve this it has implemented extens…
Erik Koornneef, Paul Robben and Iain Blair
BMC Health Services Research 2017 17:672
Published on: 20 September 2017

Variation in loss of immunity shapes influenza epidemics and the impact of vaccination

BMC Infectious Diseases
(Accessed 23 September 2017)

Research Article
Variation in loss of immunity shapes influenza epidemics and the impact of vaccination
Protective antibody immunity against the influenza A virus wanes in 2–7 years due to antigenic drift of the virus’ surface proteins. The duration of immune protection is highly variable because antigenic evolu… The models illustrate that variation in the duration of immunity impacts the long-term effectiveness of vaccination, and that vaccine effectiveness cannot be judged for each year in isolation. Our findings have implications for vaccination strategies that aim to maximize the vaccination coverage while extending the age range of persons eligible for vaccination.
Rutger G. Woolthuis, Jacco Wallinga and Michiel van Boven
BMC Infectious Diseases 2017 17:632
Published on: 19 September 2017