Vaccines and Global Health: The Week in Review 17 March 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

Milestones :: Perspectives :: Diphtheria vaccination campaign for 2.7 million children concludes in Yemen

Milestones :: Perspectives

Diphtheria vaccination campaign for 2.7 million children concludes in Yemen
SANA’A, YEMEN, 16 March 2018 — The World Health Organization (WHO), UNICEF and national health authorities have completed a large-scale vaccination campaign to control the spread of diphtheria in Yemen.

The campaign targeted nearly 2.7 million children aged 6 weeks to 15 years in 11 governorates. It focused on locations reporting suspected cases of diphtheria and areas at high risk of spread of the infectious respiratory disease. More than 6000 health workers were mobilized during the campaign, including for community engagement and the administration of the vaccine.
First reported in October 2017, the outbreak has spread rapidly across the country, infecting more than 1300 people and killing over 70. Almost 80% of the caseload is children and young adults below 25 years of age.

“We are in a race against time to control this outbreak and save lives,” says Dr Nevio Zagaria, WHO Representative to Yemen. “The almost collapsed health system and the conflict has severely hampered the response, but we have managed to deliver urgently needed antibiotics and diphtheria anti-toxins (DAT) to support treatment, and are now scaling up vaccination efforts to stop the outbreak from spreading even further.”

The rapid spread of diphtheria in Yemen highlights major gaps in routine vaccination coverage in recent years and signifies a collapsing health system. Only 50% of all health facilities are partially or fully functioning.

In November and December 2017, WHO and UNICEF vaccinated almost 450,000 children under 7 years of age against diphtheria in Ibb – the worst affected governorate accounting for nearly 35% of all cases reported.

The vaccination campaign is part of a larger response plan to control diphtheria implemented by national health authorities, UNICEF and WHO. Parallel activities include strengthening surveillance and case detection, enhancing laboratory testing capacity, procuring and distributing the DAT to the Diphtheria Isolation Units in health facilities, and training and deploying Rapid Response Teams to trace contacts and provide preventative antibiotics in the community. Health education and awareness campaigns are also being conducted to inform communities on how to protect themselves against diphtheria and other infectious diseases…

Milestones :: Perspectives :: PAHO urges countries to vaccinate against measles to maintain its elimination in the Americas

Milestones :: Perspectives

PAHO urges countries to vaccinate against measles to maintain its elimination in the Americas
Maintaining high and homogeneous immunization coverage, strengthening surveillance and quickly responding to suspected cases are some of the suggested measures to maintain measles elimination in the Americas
Washington, DC, 16 March 2018 (PAHO/WHO)-  The Pan American Health Organization/World Health Organization (PAHO/WHO) warned that in the face of ongoing measles outbreaks in the Americas, countries should redouble efforts to vaccinate their populations, strengthen surveillance to detect possible patients, and implement measures to quickly respond to any suspected cases, according to an epidemiological update released today.
Measles was declared eliminated from the Americas in 2016, following the declaration of rubella and CRS elimination in 2015. The Region was the first in the world to have eliminated all three diseases, culminating a 22-year effort involving mass vaccination against measles, mumps, and rubella throughout the Americas. However, the highly contagious nature of the measles virus and the fact that both it and the rubella virus continue to circulate in the rest of the world mean that the Region is at risk of outbreaks.
In the first months of 2018, there were night countries in the Region reporting confirmed cases: Antigua and Barbuda (1 case), Brazil (14 cases), Canada (4 cases), Guatemala (1 case), Mexico (4 cases), Peru (2 cases), the United States (13 cases), and Venezuela (886 cases in total, 159 cases in 2018), according to the epidemiological update

Milestones :: Perspectives :: Delhi TB Summit: WHO South-East Asia countries commit to intensified efforts, concrete progress to End TB

Milestones :: Perspectives

Delhi TB Summit: WHO South-East Asia countries commit to intensified efforts, concrete progress to End TB
New Delhi, 14 March 2018: Tracking progress to eliminate tuberculosis, Member countries of WHO South-East Asia Region today committed to further intensifying efforts to ensure rapid and concrete progress to End TB by 2030.

In a statement adopted at the Delhi End TB Summit here, member countries unanimously agreed to actualizing and intensifying essential actions agreed to in the Delhi Call to Action which was adopted in March last year to accelerate efforts to End TB in the Region, host to one fourth of the global population but a disproportionate 46% of the global TB burden.

“Progress against TB in this Region will have a major impact on the progress globally,” said Dr Tedros Adhanom Ghebreyesus, Director-General, World Health Organization. “Too much is at stake, we cannot afford to fail. We must remember that the war against TB will be won in communities. It will be won by nurses, doctors, community health workers and others at the frontlines. We must give them the resources they need to find every last person with TB, to diagnose them, to treat them, and to cure them,” he said.

Welcoming the statement, Dr Poonam Khetrapal Singh, Regional Director for WHO South-East Asia, said, “it gives shape to our momentum and aspirations, and does so by setting out a series of strategic priorities which include establishing strong leadership of TB programmes at the national level; increasing budgetary and human resource allocations to TB programmes from domestic and global sources; enabling each and every TB patient to access the best possible care available; and supplementing medical care for TB with social and financial protection.”

Reviewing efforts being made to end TB since the adoption of the Delhi Call for Action on 16 March 2017, Member countries noted that though efforts have been strengthened with increased attention, investments and initiatives; the stepped-up response was falling short of what was required to reach the critical thresholds for ending TB.

The Member countries of the Region stressed their firm intent to collectively reach out to 2 million missing TB cases and 150 000 multidrug-resistance cases by 2020 and implement a response that is demonstrably adequate for ending TB.

In the statement, the countries committed to multisectoral and empowered national initiatives, reporting to the highest levels of government, to lead the TB programme…

The Summit sets the stage for the September 2018 United Nations High-Level Meeting on TB. For the first time TB will be discussed in the UN General Assembly at the Heads of State level. The UN high-level meeting is expected to endorse an ambitious set of goals to put the world on course to ending TB.

Perspective: Vaccinating Against Poverty


Vaccinating Against Poverty
Project Syndicate | 12 March 2018
By Seth Berkley
A new study shows that developing countries could reduce poverty by targeting higher vaccination rates in poorer and more marginalized communities. Moreover, by making affordable, quality health care available to everyone, regardless of their income, immunization programs are an important step toward universal health-care coverage.
For most people, the choice between a life-threatening disease and a lifetime of crippling debt is no choice at all. Yet every year, hundreds of millions of people around the world are forced to make it, owing to the prohibitive cost of medical treatment. And, paradoxically, the hardest-hit people are not those with the largest medical bills, but rather those living in the poorest parts of the world.
Although countries like the United States have notoriously high treatment costs, with medical debt being one of the leading causes of personal bankruptcy, people living in poor countries actually spend more on health care costs relative to their income. And, because medical insurance is unavailable or too expensive, and because bankruptcy protection is not usually an option, too often they and their families end up being pushed into poverty.
But this tragedy – befalling some of the world’s most vulnerable people – could in many cases be entirely avoided. A new study, published in February in the journal Health Affairs, suggests that there is another option: in many cases, the medical bills can be preempted by prevention, through the widespread and affordable use of vaccines:.

Perspective: The Equity Impact Vaccines May Have On Averting Deaths And Medical Impoverishment In Developing Countries

Health Affairs
Vol. 37, No. 2: February 2018

Diffusion Of Innovation
The Equity Impact Vaccines May Have On Averting Deaths And Medical Impoverishment In Developing Countries
Angela Y. Chang1, Carlos Riumallo-Herl2, Nicole A. Perales3, Samantha Clark4, Andrew Clark5,
Dagna Constenla6, Tini Garske7, Michael L. Jackson8, Kévin Jean9, Mark Jit10, Edward O. Jones11, Xi Li12, Chutima Suraratdecha13, Olivia Bullock14, Hope Johnson15, Logan Brenzel16, and Stéphane Verguet17
PUBLISHED: February 2018
Open Access
With social policies increasingly directed toward enhancing equity through health programs, it is important that methods for estimating the health and economic benefits of these programs by subpopulation be developed, to assess both equity concerns and the programs’ total impact. We estimated the differential health impact (measured as the number of deaths averted) and household economic impact (measured as the number of cases of medical impoverishment averted) of ten antigens and their corresponding vaccines across income quintiles for forty-one low- and middle-income countries. Our analysis indicated that benefits across these vaccines would accrue predominantly in the lowest income quintiles. Policy makers should be informed about the large health and economic distributional impact that vaccines could have, and they should view vaccination policies as potentially important channels for improving health equity. Our results provide insight into the distribution of vaccine-preventable diseases and the health benefits associated with their prevention.

Perspective: Working together for the health and welfare of humankind


Working together for the health and welfare of humankind
Joint Statement of INCB, UNODC and WHO in Implementation of the UNGASS 2016 Recommendations
12 March 2018 – 61st session of the Commission on Narcotic Drugs

  1. We, the Heads of the International Narcotics Control Board, the United Nations Office on Drugs and Crime and the World Health Organization are committed to support our Member States to effectively address and counter the world drug problem.

We agree that if we are to achieve the 2030 Sustainable Development Goals, including its health targets, we need to vigorously address the world drug problem with a greater focus on the health and well-being of people. We need a balanced, comprehensive and multidisciplinary approach that puts people at the centre of the response and in particular those who are the most vulnerable.

This is in line with the objectives of the three international drug control conventions, to which we are committed. This is also aimed at facilitating implementation of the outcome document of the 30th Special Session of the General Assembly, entitled “Our joint commitment to effectively addressing and countering the world drug problem”. It is also consistent with the aim to achieve universal health coverage, where all people receive the health services they need, including people who use drugs and their families.

Our three entities complement one another, given the different roles they play and the mandates entrusted to them. By working together, we can “deliver as one” to serve people, communities and countries as a whole. We are committed to strengthen this collaboration, to advocate and to promote quality programmes and policies that improve public health and support high-impact actions that leave no one behind, are driven by science, and champion equity and human rights.

We recognize the challenges that lie ahead, but also the opportunities that we should embrace. We reaffirm our support for the full implementation of the outcome document of UNGASS 2016 and we also recognize that the world is a rapidly changing place and that urgent action is required to address emerging threats.

We will focus our joint efforts on addressing the following priorities:
:: improving equitable access to controlled medicines in particular for the management of pain and for palliative care;
:: scaling up effective prevention of non-medical drug use, and treatment services and interventions for drug use disorders;
:: confronting the ‘opioid crisis’ that is devastating so many communities;
:: intensifying delivery to people who use drugs of a comprehensive set of effective and scientific evidence-based measures aimed at minimizing the adverse public health and social consequences of drug abuse laid out in the technical guide issued by WHO, UNODC and UNAIDS 1, towards eliminating AIDS, tuberculosis and viral hepatitis epidemics;

  1. We therefore will work to proactively support countries:

:: to implement public health and social welfare measures as key elements of our response to the world drug problem;
:: to enhance information-sharing and early warning mechanisms in support of a scientific evidence-based review of the most prevalent, persistent and harmful new psychoactive substances and precursors to facilitate informed scheduling decisions by the Commission on Narcotic Drugs;
:: to ensure and improve access to and quality of:
…internationally controlled medicines including to manage pain and for palliative care while preventing their misuse;
…evidence-based prevention of drug use, and treatment services for drug use disorders with special focus on youth, families and communities;
…comprehensive services to prevent, diagnose and treat viral hepatitis, HIV and tuberculosis infections among people who use drugs.
:: to help monitor the progress in addressing the world drug problem and implementation of the UNGASS 2016 operational recommendations.

  1. We stress the importance of Member States taking action to:

:: strengthen their public health systems and their national coordination efforts to address the drug problem and dedicate appropriate resources and capacity for the successful implementation of their comprehensive drug-related policies;
:: advance universal health coverage efforts, by taking action to improve access to controlled medicines and effective and ethical prevention of drug use, and treatment services for people with drug use disorders and associated health conditions, including HIV, viral hepatitis and tuberculosis;
: facilitate information exchange and share the relevant data and information with our three entities to enable us to perform our respective treaty-based core functions; and
:: enhance political support and adequate resources to enable our three entities to deliver on these commitments and advance the achievement of the UN 2030 Agenda for Sustainable Development.