Vaccines and Global Health: The Week in Review :: 10 November 2018

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

2018 Assessment Report of the Global Vaccine Action Plan – IMMUNIZATION TODAY AND IN THE NEXT DECADE

Milestones :: Perspectives

 
2018 Assessment Report of the Global Vaccine Action Plan IMMUNIZATION TODAY AND IN THE NEXT DECADE
SAGE/WHO | November 2018 :: 36 pages
[Selected excerpts; Text bolding from original]
EXECUTIVE SUMMARY

Immunization has proven the test of time as one of public health’s most cost-effective interventions. In 2017, the number of children immunized – 116.2 million – was the highest ever reported. The Region of the Americas achieved maternal and neonatal tetanus elimination, leaving only 15 countries yet to achieve elimination. Since 2010, 113 countries have introduced new vaccines, and more than 20 million additional children have been vaccinated.

Nevertheless, this year starkly illustrates how easily hard-won gains are lost. Because of low coverage nationally, or pockets of low coverage, multiple WHO regions have been hit with large measles and diphtheria outbreaks causing many deaths. The continued detection of circulating vaccine-derived poliovirus is further evidence that national immunization programmes are not achieving the goal of reaching every child.

To spur action, the Global Vaccine Action Plan set ambitious goals, and it remains the case that most targets will not be met by the end of the Decade of Vaccines in 2020. DTP3 and first-dose measles vaccine coverage have plateaued globally at 85%. Progress towards the eradication of wild poliovirus and the elimination of measles, rubella, and maternal and neonatal tetanus is currently too slow to be achieved by the end of the decade.

This picture provides a backdrop for discussions of the future of immunization after 2020, the final year of the Decade of Vaccines. The next decade is likely to be volatile and uncertain. Continuing mass urbanization and migration, population growth, geopolitical uncertainty and conflict, and natural disasters and environmental disruption will present major challenges to national immunization systems.

To meet these challenges, the immunization community must seek to maintain its hard-won gains but also aim to do more and to do things better, which may involve doing things differently. Equity must continue to be a strong driver, to ensure that everyone enjoys the benefits of immunization, including the most disadvantaged, marginalized and hard-to-reach populations, particularly those displaced or otherwise affected by natural disasters and conflict.

Integration will be central to achieving future goals. Partnerships have been key to the successes of the Global Vaccine Action Plan, and will be critical to the future. Immunization is a central pillar of universal health coverage, providing an infrastructure on which effective and equitable health systems can be constructed. Through this integration, immunization can contribute to multiple Sustainable Development Goals as well as global health security and the battle against antimicrobial resistance.

Countries will be at the heart of a future immunization strategy. Regions will have a key role to play in supporting the development of national immunization systems, while global immunization partners will continue working together to create an enabling environment for immunization.

As attention now turns to strengthening immunization post-2020, 2017’s outbreaks are a sobering reminder that no country can take its eye off the ball: effective national immunization systems require ongoing nurturing, political commitment and public support. All countries need to see immunization systems as core to their health systems, and all citizens need to see immunization as a basic human right. In their absence, countries, regions and the world as a whole are less healthy, less safe and less prosperous. We become complacent at our own peril…

  1. CONCLUSION

More people than ever before benefited from immunization in 2017. Although the world remains off track to reach many of the goals set out in the Global Vaccine Action Plan, these were designed to be ambitious and stretching, and it is important not to lose sight of the great progress that has been made. Even so, the consequences of not achieving global goals have been vividly illustrated with the resurgence of measles and diphtheria and the persistence of poliovirus and maternal and neonatal tetanus.

The final years of the Decade of Vaccines provide us with an opportunity to drive forward immunization in pursuit of the Global Vaccine Action Plan goals. Past successes illustrate what can be achieved by countries prioritizing immunization, producing integrated development plans, and working with national, regional and global partners on their implementation. Despite many challenges, between 2011 and 2017, an additional 20 million children were vaccinated – but we can do even better.

Now is the time to learn the lessons from the Decade of Vaccines to shape a post-2020 strategy that enables the world to sustain its hard-won gains and expand the benefits of immunization to those currently missing out and to older age groups. The next chapter of immunization must also be one of integration, with immunization consolidating its position as a pillar of universal health coverage and primary healthcare, and contributing to the safer, healthier and more prosperous world envisioned in the Sustainable Development Goals.

  1. RECOMMENDATIONS

Countries, regions and global immunization partners should commit to developing an integrated post-2020 global immunization strategy:

:: A comprehensive review should be undertaken of progress, impact and implementation of the Global Vaccine Action Plan to inform a post-2020 strategy.

:: The monitoring and evaluation framework for the Global Vaccine Action Plan should be reviewed to inform the development of a revised framework for a post-2020 strategy.

:: A post-2020 strategy should build on the lessons learned during the Decade of Vaccines and draw upon the key themes identified in this 2018 Assessment Report.

Global Vaccine Action Plan priorities, adapted to reflect changing contexts and lessons learned, should drive immunization activities until the end of the Decade of Vaccines:

:: A major focus should be tailored country support to build and sustain robust and effective national immunization systems aligned with national plans for achieving universal health coverage.

:: A best practice framework should be developed to ensure equitable access to immunization services for migrant, displaced and disadvantaged populations, including those affected by humanitarian emergencies.

:: Nurturing individual and community demand for immunization should be given high priority within countries.

The contributions of research to immunization should be enhanced and expanded:

:: Vaccine research and development (R&D): Connections between vaccine R&D and implementation communities should be further strengthened to ensure close collaboration in new product design, development and evaluation.

:: Immunization systems: More use should be made of implementation, operational and other research to improve the performance of national immunization systems, and to evaluate innovations in service delivery to reach underserved populations.

:: Immunization research capacity in low- and middle-income countries should be developed across all these areas.

 

Special focus on challenges and opportunities for the development and use of vaccines in Africa

Featured Journal Content

 Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 14, Issue 10, 2018
http://www.tandfonline.com/toc/khvi20/current
Editor’s Letter
In this issue of Human Vaccines & Immunotherapeutics we are delighted to present a Special Focus on Vaccination in Africa, which introduces recent work in vaccinology on the continent. We welcome you to read the Editorial Introduction by Dr. Shabir Madhi of University of the Witwatersrand, which provides an overview of, and the context for, the 15 articles in this section (Madhi, p. 2335)…

Editorial
Special focus on challenges and opportunities for the development and use of vaccines in Africa
Shabir A. Madhi & Helen Rees
Pages: 2335-2339
Published online: 27 Sep 2018
ABSTRACT
Immunization of children against vaccine-preventable diseases is one of the most cost-effective and potentially equitable public health interventions. Nevertheless, approximately 19.9 million of the world’s annual birth cohort are either under-immunized or have not been vaccinated at all. Understanding the factors contributing to under-immunization in settinsg such as sub-Saharan Africa which bears a disproportionate burden of vaccine preventable diseases is key to unlocking the full potential that vaccines offer in reducing under-5 morbidity and mortality. The series or articles in this issue of the Journal, mainly through systematic analysis of District Health Surveillance data bases from 35 countries, highlight the challenges faced in improving vaccination coverage rates in sub-Saharan Africa which has stagnated at approximately 72% for completion of the primary series of infant vaccines over the past decade. The reasons for under-immunization of children is sub-Saharan Africa is identified to be multi-factorial and may differ between and within countries. This highlights the need for country-specific, possibly at a district or sub-regional level, interrogation of factors contributing to under-immunization of children, to work toward providing Universal Health Coverage as envisioned in the Sustainable Development Goals.

 

 

United Nations humanitarian convoy to Rukban: UNICEF delivers lifesaving vaccines, medicines and nutritional supplies for 50,000 people

Featured Journal Content

United Nations humanitarian convoy to Rukban: UNICEF delivers lifesaving vaccines, medicines and nutritional supplies for 50,000 people

DAMASCUS 8 November 2018 – UNICEF, with United Nations partners and the Syrian Arab Red Crescent, concluded a six-day humanitarian aid convoy to Rukban camp in southeast Syria near the Jordanian border. This is the first convoy to the camp from within Syria, where nearly 50,000 people live, the majority of whom are women and children. The last aid delivery to the area was in January from Jordan.

UNICEF sent 21 trucks of humanitarian assistance as part of the convoy and supported 21 vaccinators with vaccines, cold chain equipment and medical supplies to immunize 10,000 children against measles, polio and other childhood diseases in the camp. This has been one of the most complex humanitarian operations in Syria with over 75 trucks and more than 100 humanitarian and logistics workers delivering aid to people in need in Syria south-eastern desert conditions.

“Children and women in Rukban have had extremely limited access to health services amid worsening conditions,” said Fran Equiza, UNICEF Representative in Syria. “UNICEF advocated extensively with all relevant parties to include vaccinators in the convoy to protect children against life-threatening diseases.”

“Most children under-five years old had never been vaccinated,” said Dr. Husam Eddine Baradee, UNICEF’s Health & Nutrition Officer who accompanied the convoy. “Despite the challenges we were able to vaccinate 5,100 children in the few days we had access to the camp, yet we absolutely need sustained access as thousands more children still need to be immunised.”

UNICEF staff described the conditions in the camp as dire with many people having to survive on just one meal a day. “I barely eat anything at all because my priority is to feed my children,” a mother told UNICEF “I get dizzy when I breastfeed these days.” She added UNICEF’s supplies sent with the convoy included much-needed health, nutrition, water and sanitation supplies in addition to winter clothing for children under-14 years old and basic medicines, including antibiotics.

UNICEF calls on all parties to the conflict to allow all those displaced to voluntarily return to their homes or a place of their choosing in safety and dignity and guarantee sustained humanitarian access to be able to deliver assistance to all children in need in Rukban and elsewhere in Syria.

 

World leaders pledge US$1 billion to transform health and nutrition of world’s poorest women, children and adolescents

Featured Journal Content

World leaders pledge US$1 billion to transform health and nutrition of world’s poorest women, children and adolescents

World Bank

Published on 06 Nov 2018

– Ten new investors—Burkina Faso, Côte d’Ivoire, Denmark, the European Commission, Germany, Japan, Laerdal Global Health, the Netherlands, Qatar and an anonymous donor—have joined since the launch of the Global Financing Facility replenishment. They join existing funders the Bill & Melinda Gates Foundation, Canada, MSD for Mothers, Norway, and the United Kingdom to fund the GFF to improve the health and nutrition of women, children and adolescents.

 

– US$1 billion pledged to the GFF Trust Fund in Oslo today is expected to link to an additional US$7.5 billion in IDA/IBRD resources for women, children and adolescents’ health and nutrition.

– Burkina Faso reaffirmed its commitment to allocating at least 15% of its annual budget to improve health; Côte d’Ivoire committed to increasing its health budget 15% annually; and Nigeria recommitted to investing US$150 million per year from its budget to sustainably finance health and nutrition of women, children and adolescents.

– US$1 billion will help the GFF partnership on the pathway toward expanding to as many as 50 countries with the greatest needs, to transform how health and nutrition are financed. Alongside other global health initiatives, this can contribute to saving and improving millions of lives by 2030.

OSLO, NORWAY – The Global Financing Facility (GFF) in Support of Every Woman Every Child today announced US$1.005 billion in contributions from the Bill & Melinda Gates Foundation, Burkina Faso, Canada, Côte d’Ivoire the European Commission, Denmark, Germany, Japan, Laerdal Global Health, the Netherlands, Norway, Qatar and the United Kingdom. This will help the GFF partnership on the pathway toward expanding to as many as 50 countries with the greatest health and nutrition needs and contribute to saving and improving millions of lives by 2030. The event today was an important milestone toward the goal of raising as much as US$2 billion to expand to a total of 50 countries; the GFF is expecting additional pledges from new and existing investors who are considering new multi-year commitments.

The GFF is a catalyst for health financing that is helping countries to transform how they invest in women, children and adolescents because for too long, their health and nutrition has been chronically and persistently de-prioritized and underfunded—resulting in the preventable deaths of 5 million women and children every year. The GFF helps countries in three specific ways:

[1] developing an investment case and implementation plan prioritizing reproductive, maternal, newborn, child and adolescent health and nutrition and a strong primary health care system;

[2] strengthening a country-led platform that aligns all key stakeholders around a prioritized health and nutrition plan; and

[3] working with countries to mobilize and coordinate the financial resources needed to accelerate progress for the most vulnerable populations in the hardest-to-reach regions.

…More than 2 billion people live in countries that spend less than $25 per capita on health. This is less than a third of what is needed for countries to provide basic, life-saving health services for their people. Through working with the GFF, Burkina Faso, Côte d’Ivoire, Nigeria and other GFF-supported countries have shown that it is possible for all countries to improve their future and invest in the most vulnerable people in their societies by increasing investment in health. It also demonstrates that generous, but relatively small financial contributions can—when aligned and spent catalytically and efficiently in support of national investment cases—have exponential impact by mobilizing additional financing and saving millions of lives…

…Today the World Bank, which hosts the GFF, announced that in just the last three years, US$482 million in funding from the GFF Trust Fund had been linked to US$3.4 billion in funding from the World Bank’s International Development Association (IDA) and International Bank for Reconstruction and Development (IBRD). The US$1.005 billion pledged to the GFF Trust Fund in Oslo today is expected to link to an additional US$7.5 billion in IDA/IBRD resources for women, children and adolescents’ health and nutrition.

Additionally, in partnership with the GFF, the World Bank announced that the World Bank Treasury had launched a series of Sustainable Development Bonds to raise awareness among investors of the significant and long-lasting benefits of investing in the health and nutrition of women, children and adolescents, and that these have raised US$935 million since June 2018. These bonds bring private capital into the IBRD financing pool and serve as an entry point for investors to become aware of the growing opportunities in sustainable investments. To reduce barriers for countries to access these funds, the GFF provides co-financing and loan buy-down grants that enable governments to catalyze public and private funds for investing in the health and nutrition of women, children and adolescents.

…The GFF was founded in 2015 by the World Bank, the governments of Canada and Norway, the United Nations and other partners. As a pathfinder for innovative financing of the SDGs the GFF is helping to address the unfinished agenda of women, children and adolescents’ health and nutrition and to close the financing gap.
About the Global Financing Facility

The Global Financing Facility (GFF) is a multi-stakeholder partnership that is helping countries tackle the greatest health and nutrition issues affecting women, children and adolescents. The GFF Trust Fund is supported by the Governments of Burkina Faso, Canada, Denmark, the European Commission, Germany, Japan, the Netherlands, Norway, Qatar, and the United Kingdom; the Bill & Melinda Gates Foundation; Laerdal Global Health; MSD for Mothers; and an anonymous donor. The GFF supports governments to bring partners together around a country-led plan, prioritizing high-impact but underinvested areas of health. The GFF Trust Fund acts as a catalyst for financing, with countries using modest GFF Trust Fund grants to significantly increase their domestic resources alongside the World Bank’s IDA and IBRD financing, aligned external financing, and private sector resources. Each relatively small external investment is multiplied by countries’ own commitments—generating a large return on investment, ultimately saving and improving lives. Learn more: www.globalfinancingfacility.org and @theGFF

 

Ebola – Democratic Republic of the Congo

Featured Journal Content

Ebola – Democratic Republic of the Congo

14: Situation report on the Ebola outbreak in North Kivu
6 November 2018
The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces, Democratic Republic of the Congo continues to be closely monitored by the Ministry of Health (MoH), WHO and partners. Since WHO’s last situation report issued on 30 October 2018 (External Situation Report 13) reporting on data as of 28 October, an additional 26 new confirmed EVD cases and 12 new deaths have been reported. Cases were reported from Beni (n=16), Butembo (n=6), Mabalako (n=2), Kalunguta (n=1) and Vuhovi (n=1) – a health zone between Beni and Butembo. The two cases reported in Mabalako are a mother and her new-born, residing and identified in Beni, who were transferred to the Mabalako Ebola treatment centre (ETC). Among the new confirmed cases from Beni were two nurses, thus bringing the number of affected health workers to 27, including 26 confirmed and three deaths. Among the 12 deaths reported, six occurred in ETCs and six occurred outside of ETCs (4 in Beni, 1 in Butembo, 1 in Vuhovi)…

DONs Ebola virus disease – Democratic Republic of the Congo
1 November 2018
[Excerpts]
Vaccination: As of 31 October, 174 vaccination rings have been defined, in addition to 38 rings of health and frontline worker. To date, 27 360 eligible and consented people have been vaccinated, including 9106 health and frontline workers and 7256 children…
WHO risk assessment
…As the risk of national and regional spread is very high, it is important for neighbouring provinces and countries to enhance surveillance and preparedness activities. The IHR Emergency Committee has advised that failing to intensify these preparedness and surveillance activities would lead to worsening conditions and further spread. WHO will continue to work with neighbouring countries and partners to ensure that health authorities are alerted and are operationally prepared to respond.
 

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New measures and strong partnership having positive impact on Ebola response in the Democratic Republic of the Congo
8 November 2018   WHO News Release
New measures to overcome challenges in the response to the Ebola outbreak in the Democratic Republic of the Congo (DRC) are having a positive impact, although the outbreak remains dangerous and unpredictable, the United Nations Department of Peacekeeping and the World Health Organization (WHO) said after a joint mission to assess the outbreak.

WHO Director-General Dr Tedros Adhanom Ghebreyesus and United Nations Under-Secretary-General for Peacekeeping Jean-Pierre Lacroix yesterday travelled with the Minister of Health, Dr Oly Ilunga Kalenga, to the city of Beni in eastern DRC, the epicentre of the outbreak, where they met health workers, civil society representatives, peacekeeping troops and local authorities.

The United Nations Stabilization Mission in the DRC, MONUSCO, has recently taken an active approach to armed groups operating in North Kivu, which has contributed to a period of calm in and around the city of Beni, although some attacks have continued in surrounding villages.

Under the leadership of the Ministry of Health, WHO and partners are also making greater use of community surveillance, in which community members are trained to conduct contact tracing activities in areas that outsiders have difficulty accessing. This has contributed to a decline in new cases over the past two weeks, although the situation remains of grave concern.

Mr Lacroix and Dr Tedros also met DRC Prime Minister Bruno Tshibala to share their observations and recommendations and to discuss how best to support the government’s response to the outbreak…

Since the outbreak began in August, there have been 308 cases and 191 deaths, about half of which have been in Beni, a city of 800,000 people. The current outbreak is the country’s 10th and is on track to surpass the previous largest outbreak, which was in Yambuku in 1976 when there were 318 cases and 280 people died.

MONUSCO has provided support to the Ebola response since the beginning of the outbreak through the provision of logistical support, office facilities, transportation, communication and security.

Ebola response teams have sometimes faced difficulties on the ground, with misinformation and mistrust due to decades of conflict contributing to a reluctance with some local populations to allow Ebola response teams to vaccinate, conduct contact tracing and perform safe and dignified burials. Community engagement activities have helped address concerns and most local communities have proven supportive and are keenly aware of the dangers of Ebola and the importance of ending the outbreak.

“The fact that we have so far prevented Ebola from spreading into neighbouring countries is a testament to the hard work and determination of staff from all partners,” said Dr Tedros.  “As complex and challenging as this outbreak is, I am confident that working together with the Ministry of Health, MONUSCO and all our partners, we can and will end it.”
WHO has almost 280 staff in North Kivu, supporting hundreds more from the Ministry of Health and partners.

Six treatment centres have been built, where 91 patients are currently being treated. The centres are operated by the Ministry of Health and partners including ALIMA, Médecins Sans Frontières and the International Medical Corps. Each treatment centre is supported by a mobile laboratory to rapidly diagnose cases and guide treatment.

To date, 27,000 people have been vaccinated against Ebola, and almost every new patient receives one of 4 investigational treatments, something which was never previously possible during an Ebola outbreak. While mourning those who have died, they noted that 91 people have recovered and returned to their communities thanks to the hard work and joint efforts of national and international responders.

Mr Lacroix and Dr Tedros paid tribute to the dedication of staff from WHO, MONUSCO, the Ministry of Health and all partners who are fighting a dangerous outbreak in extremely difficult conditions…

Emergencies

Emergencies
 
 
POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 06 November2018 [GPEI]
:: The Semi-Annual Status Report for January-June 2018 was recently published with detailed narrative for each of the Endgame Plan strategic objectives.
 
 
Summary of new viruses this week:
Democratic Republic of Congo – two new cases of circulating vaccine-derived poliovirus type 2 (cVDPV2)
Pakistan – Two new cases of wild poliovirus (WPV1) and two WPV1 positive environmental samples.
Niger- one new case of circulating vaccine-driven polio virus type 2 (cVDPV2).
Nigeria – four new cases of circulating vaccine-derived poliovirus type 2 (cVDPV2)
 
 
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Editor’s Note:
WHO has posted a refreshed emergencies page which presents an updated listing of Grade 3,2,1 emergencies as below.
 
 
WHO Grade 3 Emergencies  [to 10 Nov 2018 ]
Democratic Republic of the Congo
:: 14: Situation report on the Ebola outbreak in North Kivu  6 November 2018
:: DONs Ebola virus disease – Democratic Republic of the Congo   8 November 2018
[See Milestones above for more detail]
 
 
Bangladesh – Rohingya crisis
:: Weekly Situation Report 49 – 1 November 2018 pdf, 410kb
 
Nigeria
:: WHO supports cholera vaccination in critical States of the Northwest region
Zamfara, 6 November, 2018 – The World Health Organization (WHO) is supporting health authorities in Zamfara with the necessary preparation for the implementation of the first Oral Cholera Vaccination (OCV) campaigns.  Similar activity and assistance will be provided to Katsina and Kebbi States.
With financial support from GAVI, the Vaccine Alliance, these vaccination campaigns will directly protect 808,795 inhabitants of the three states who are aged one year and above from cholera. The campaigns will be implemented in two rounds for each state (14-18 November 2018 for the 1st round) and (11-16 December 2018 for the 2nd round). The intervention will complement efforts from the Federal Government and States in responding to the ongoing cholera outbreak and facilitate the prevention and control of cholera in Nigeria in the long term.
Nigeria is experiencing its largest cholera outbreak in recent years with over 42,466 suspected cases including 830 deaths reported from 01 January to 29 October 2018 in 20 states. The numbers sharply contrast 18,243 suspected cases reported in the country over the last three years (2015- 2017)…

 South Sudan
:: WHO enhances Ebola Rapid Response Readiness Capacities in South Sudan
Juba 1 November 2018 – The World Health Organization is supporting the Ministry of Health of South Sudan, to train a total of 214 members of the Rapid Response Teams at the national level and in all the Ebola virus disease (EVD) high-risk states.
\\These trainings are part of the ongoing efforts to strengthen the country’s preparedness capacities and mitigate the risk of EVD importation from the raging outbreak in North Kivu and Ituri in the Democratic Republic of Congo (DRC). The recent WHO EVD risk assessment raised the risk of regional spread from “high” to “very high” thus justifying all efforts aimed at enhancing national EVD readiness capacities…

 
Syrian Arab Republic
:: Hama National Hospital provides ray of hope for Syrian cancer patients  1 November 2018
 
Yemen
:: Statement on Yemen by Dr Ahmed Al-Mandhari, WHO Regional Director for the Eastern Mediterranean
Cairo, 8 November 2018 – The current violence in Al Hudaydah is placing tens of thousands of already vulnerable people at risk, and preventing WHO from reaching them with the help they urgently need. The violence, now in close proximity to the area hospitals, is affecting the movement and safety of health staff, patients and ambulances, as well as the functionality of health facilities, leaving hundreds without access to treatment.

With only 50% of health facilities functioning across the country and no doctors in 18% of districts in Yemen, we cannot afford for one more health worker to lose their life, or one more hospital to go out of service. In Hudaydah city, the hospitals are closest to the frontlines, which is alarming and is jeopardizing the lives of health care workers and patients alike.

Increased fighting is also affecting the port of Al Hudaydah, through which 85% of the country’s food supplies are normally imported. The people of Yemen are already on the brink of famine, with 1.8 million children under five and 1.1 million pregnant or breastfeeding women acutely malnourished. More than 400,000 severely acutely malnourished children rely on urgent and accessible medical care to stay alive.

   As the immune systems of millions of Yemenis fail due to hunger, thousands are dying of malnutrition, cholera and other diseases. People living in Al Hudaydah are some of the worst hit, with the highest rates of cholera reported since the beginning of the outbreak…
 
 
Somalia – No new announcements identified
 
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WHO Grade 2 Emergencies  [to 10 Nov 2018 ]
Myanmar
:: Weekly Situation Report 49 – 1 November 2018 pdf, 410kb
 
 
Iraq
:: WHO and the Ministry of Health intensify response to gastroenteritis outbreak amid water crisis in Basra  2 November 2018
 
 
Brazil (in Portugese) – No new announcements identified
Cameroon  – No new announcements identified
Central African Republic  – No new announcements identified
Ethiopia – No new announcements identified
Hurricane Irma and Maria in the Caribbean – No new announcements identified
occupied Palestinian territory – No new announcements identified
Libya – No new announcements identified
MERS-CoV – No new announcements identified
Niger – No new announcements identified
Sao Tome and Principe Necrotizing Cellulitis (2017) – No new announcements identified
Sudan – No new announcements identified
Ukraine – No new announcements identified
Zimbabwe – No new announcements identified
 
 
Outbreaks and Emergencies Bulletin, Week 44: 27 October – 02 November 2018
The WHO Health Emergencies Programme is currently monitoring 55 events in the region. This week’s edition covers key ongoing events, including:
:: Yellow fever in Ethiopia
:: Ebola virus disease in the Democratic Republic of the Congo
:: Cholera in Niger
:: Humanitarian crisis in Democratic Republic of the Congo
:: Humanitarian crisis in South Sudan

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WHO Grade 1 Emergencies  [to 10 Nov 2018 ]
Afghanistan
Angola (in Portuguese)
Chad
Kenya
Lao People’s Democratic Republic
Mali
Namibia – viral hepatitis
Papua New Guinea
Peru
Philippines – Tyhpoon Mangkhut

Tanzania
 
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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. 

Yemen
:: Yemen Humanitarian Update Covering 22 October – 6 November 2018 | Issue 31

KEY ISSUES:

:: UN calls for urgent action on five key points to avert an imminent humanitarian catastrophe in Yemen.
:: A total of 118 humanitarian partners operate in the 333 districts of Yemen providing assistance to as many as 8 million people per month.
:: Armed clashes, airstrikes and artillery shelling continued around the airport and Kilo 10 to the south and east of Al Hudaydah City; fighting was also reported on the Hays frontline.
:: Partners identified 80,763 displaced families from Al Hudaydah hosted in Al Hudaydah, Hajjah, Raymah and Al Mahwit governorates; 71,363 of these households have been assisted since June.
:: US$87 million has been allocated to 75 projects under the first Standard Allocation 2018 of the Yemen Humanitarian Fund, and will benefit over 3 million Yemenis in 19 governorates.

Syrian Arab Republic   No new announcements identified.

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UN OCHA – Corporate Emergencies

When the USG/ERC declares a Corporate Emergency Response, all OCHA offices, branches and sections provide their full support to response activities both at HQ and in the field.

Somalia  

:: Humanitarian Bulletin Somalia, 4 October – 5 November 2018

HIGHLIGHTS
:: Aid agencies step up livelihood, resilience support
:: Conflict related displacement spikes in Lower Shabelle
:: Evictions continue in Mogadishu
:: Major disease outbreaks contained
:: Polio immunization continues
:: Mental health care must be prioritized
:: Sustained funding needed to support the aid operation
Ethiopia  No new announcements identified.

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“Other Emergencies”
Indonesia: Central Sulawesi Earthquake
:: Central Sulawesi Earthquake & Tsunami: Humanitarian Country Team Situation Report #7 (as of 6 November 2018))

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Editor’s Note:

We will cluster these recent emergencies as below and continue to monitor the WHO webpages for updates and key developments.

EBOLA/EVD  [to 10 Nov 2018 ]
http://www.who.int/ebola/en/
[See Milestones above for more detail]

MERS-CoV [to 10 Nov 2018 ]
http://who.int/emergencies/mers-cov/en/
No new announcements identified.
 
 
Yellow Fever  [to 10 Nov 2018 ]
http://www.who.int/csr/disease/yellowfev/en/
No new announcements identified.
 
 
Zika virus  [to 10 Nov 2018 ]
http://www.who.int/csr/disease/zika/en/
No new announcements identified.