EMERGENCIES

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

Editor’s Note:
We certainly recognize the velocity of global developments in the COVID-19 pandemic. While we have concentrated the most current key reports just below, COVID-19 announcements, analysis and commentary will be found throughout this issue, in all sections.
Beyond the considerable continuing coverage in the global general media, the WHO’s authoritative guidance is available here:
:: Daily WHO situation reports here: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports

:: WHO Coronavirus disease (COVID-2019) daily press briefings here: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/media-resources/press-briefings

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Situation report – 75 [WHO]
Novel Coronavirus (COVID-19)
4 April 2020
[Excerpts]
SITUATION IN NUMBERS
Globally
1 051 635 confirmed (79 332)
56 985 deaths (6664)

Western Pacific Region
110 362 confirmed (1432)
3809 deaths (49)

European Region
583 141 confirmed (41 333)
42 334 deaths (5231)

South-East Asia Region
6528 confirmed (647)
267 deaths (22)

Eastern Mediterranean Region
65 903 confirmed (3667)
3592 deaths (154)

Region of the Americas
279 543 confirmed (32 070)
6802 deaths (1202)

African Region
5446 confirmed (183)
170 deaths (6)
 

WHO RISK ASSESSMENT
Global Level – Very High

HIGHLIGHTS

:: One new country/territory/area reported cases of COVID-19 in the past 24 hours: Bonaire, Sint Eustatius and Saba.

:: As worldwide cases climb above 1 million and deaths over 50 000, Dr Tedros stressed that the best way for countries to end restrictions and ease their economic effects was to attack the virus with an aggressive and comprehensive package of measures. His speech can be found here.

:: WHO has released new technical guidance recommending universal access to public hand hygiene stations and making their use obligatory on entering and leaving any public or private commercial building and any public transport facility. It also recommends that healthcare facilities improve access to and practice of hand hygiene. Find more here.

:: WHO/Europe has received a €30 million contribution from the European Commission for 6 WHO European Region Member States – Armenia, Azerbaijan, Belarus, Georgia, the Republic of Moldova and Ukraine – to meet immediate needs in their responses to COVID-19. More information is available here.

Emergencies

Ebola – DRC+
Public Health Emergency of International Concern (PHEIC)

Ebola Outbreak in DRC 86: 31 March 2020
[Excerpts]
Situation Update WHO Health Emergencies Programme Page 2
There have been no new cases of Ebola virus disease (EVD) reported since 17 February 2020. The last individual confirmed to have Ebola was discharged from an Ebola Treatment Centre on 3 March after recovering and testing negative for the virus twice. On 9 March, the last contacts finished their follow-up period. These developments are significant milestones in this outbreak. However, there is still a high risk of re-emergence of EVD, and it is critical to maintain response activities to rapidly detect and respond to any new cases, and to continue ongoing support and health monitoring operations for EVD survivors – as outlined in the WHO recommended criteria for declaring the end of the EVD outbreak.
There is ongoing surveillance, pathogen detection, and clinical management activities in previously affected areas, including alert validation, rapid diagnosis of suspected cases, and building partnerships with community members to strengthen investigation of potential EVD deaths in communities. Insecurity remains a challenge in continuing response activities, which could delay the detection of potential flare-ups.

…Conclusion
Due to challenges related to continued insecurity and population displacement in previous hotspots and potential shortages of resources required to carry out response activities amidst other local and global emergencies, there remains a high risk of re-emergence of EVD in the period leading up to the declaration of the end of the outbreak, as well as for several months following that declaration. In order to mitigate the risk of re-emergence, it is critical to maintain surveillance and rapid detection and response capacities, prioritize survivor care, and maintain cooperative relationships with survivors’ associations.

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Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)

Polio this week as of 01 April 2020
Summary of new viruses this week (AFP cases and ES positives):
:: Afghanistan: one WPV1 case
:: Pakistan: four WPV1 cases, nine WPV1 positive environmental samples and eight cVDPV2 cases
:: Benin: one cVDPV2 case
:: Democratic Republic of the Congo (DR Congo) – two cVDPV2 cases
:: Ethiopia: five cVDPV2 cases
:: Ghana: five cVDPV2 cases and four cVDPV2 positive environmental samples
:: Malaysia: 15 cVDPV1 positive environmental samples and four cVDPV2 positive environmental samples
:: Togo: five cVDPV2 cases

::::::

Call to action to support COVID-19 response
Polio Oversight Board Statement
02/04/2020
The COVID-19 pandemic response requires worldwide solidarity and an urgent global effort.  The Global Polio Eradication Initiative (GPEI) stands ready to respond.

GPEI’s response to COVID-19 is driven by two principles.  The first is our public health imperative to ensure that the polio programme fully plays its part in the COVID-19 response, supported by our second, underlying principle that when the emergency ends we will be ready to end polio with urgency and determination.

GPEI assets at service of COVID-19 response
The Polio Oversight Board (POB) has agreed that for the next four to six months, GPEI programmatic and operational assets and human resources, from global to country level, will be made available to enable a strong response to COVID-19, while maintaining critical polio functions, such as surveillance and global vaccine supply management.

GPEI will continue to deploy polio-funded personnel to the COVID-19 response and make available coordination mechanisms, such as emergency operations centers, and physical assets such as transportation or IT hardware.  Through our extensive front-line worker networks in many countries, we will ensure the collection of information to provide evidence-informed guidance in line with WHO recommendations. At country level, the polio surveillance network is being trained on COVID-19 case detection, case and contact tracing, laboratory testing and data management.   Our data management systems and front-line staff are already ramping up action in many countries, and wherever the polio programme has a presence we will continue to serve the response.

GPEI will also seek assurances that when GPEI staff is supporting COVID-19 front line activities, they will be provided with the necessary training, materials, equipment and logistics support to do so safely, in line with infection prevention and control measures. The GPEI is conscious that women, who make up most caregivers and health workers, are likely to bear a heavier burden as the pandemic plays out in polio-affected countries. Their health and safety are a priority and we are working on ways to mitigate impact including making sure that their voices are heard in management and leadership positions.

Pause in immunization campaigns
All countries planning to conduct poliovirus preventative campaigns are advised to temporarily postpone these campaigns until the second half of 2020. Countries which were planning to conduct poliovirus outbreak response campaigns are advised to postpone these campaigns until 1 June 2020 and then reevaluate based on the status of the COVID-19 pandemic…

Download the full statement

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WHO Grade 3 Emergencies [to 28 Mar 2020]

Democratic Republic of the Congo
:: Ebola Outbreak in DRC 86: 31 March 2020
[See Ebola above for detail]

Mozambique floods
:: World Health Organization: 10 cases of COVID-19 confirmed in Mozambique
02 April 2020

Nigeria – No new digest announcements identified
Somalia – No new digest announcements identified
South Sudan – No new digest announcements identified
Syrian Arab Republic – No new digest announcements identified
Yemen – No new digest announcements identified

::::::

WHO Grade 2 Emergencies [to 28 Mar 2020]
Iraq
:: The fight to contain COVID-19 in Iraq April 1, 2020

Afghanistan – No new digest announcements identified
Angola – No new digest announcements identified
Burkina Faso [in French] – No new digest announcements identified
Burundi – No new digest announcements identified
Cameroon – No new digest announcements identified
Central African Republic – No new digest announcements identified
Ethiopia – No new digest announcements identified
HIV in Pakistan – No new digest announcements identified
Iran – No new digest announcements identified
Libya – No new digest announcements identified
Malawi – No new digest announcements identified
Measles in Europe – No new digest announcements identified
MERS-CoV – No new digest announcements identified
Myanmar – No new digest announcements identified
Niger – No new digest announcements identified
occupied Palestinian territory – No new digest announcements identified
Sudan – No new digest announcements identified
Ukraine – No new digest announcements identified
Zimbabwe – No new digest announcements identified

::::::

WHO Grade 1 Emergencies [to 28 Mar 2020]

Chad – No new digest announcements identified
Djibouti – No new digest announcements identified
Kenya – No new digest announcements identified
Mali – No new digest announcements identified
Namibia – viral hepatitis – No new digest announcements identified
Tanzania – No new digest announcements identified

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

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: COVID-19 Update No. 04 – 2 April 2020
HIGHLIGHTS
:: Number of people confirmed by the Ministry of Health to have COVID-19: 16 (including two fatalities)
:: Areas of concern: Densely populated areas, notably Damascus/Rural Damascus and those living in camps, collective shelters and informal settlements in northeast Syria (NES), as well as areas where hostilities may be ongoing making sample collection more challenging.
:: Populations of concern: All groups are susceptible to the virus. However, the elderly (those 60 years and above) and people with underlying health conditions are particularly at risk; as are vulnerable refugee and IDP populations and healthcare workers with inadequate personal protective equipment (PPE).

Yemen
::  Yemen: Flash Floods in southern governorates – Flash Update No. 1 (As of 31 March 2020)

::::::

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.
CYCLONE IDAI and Kenneth – No new digest announcements identified
EBOLA OUTBREAK IN THE DRC – No new digest announcements identified

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::::::

WHO & Regional Offices [to 28 Mar 2020]
3 April 2020 News release
WHO and UNICEF to partner on pandemic response through COVID-19 Solidarity Response Fund

2 April 2020 News release
IPA, WHO and UNICEF launch Read the World on International Children’s Book Day to support children and young people in isolation

31 March 2020 News release
Medical Product Alert N°3/2020
[See Milestones above for detail]

30 March 2020 News release
WHO releases guidelines to help countries maintain essential health services during the COVID-19 pandemic
The COVID-19 pandemic is straining health systems worldwide. The rapidly increasing demand on health facilities and health care workers threatens to leave some health systems overstretched and unable to operate effectively.
Previous outbreaks have demonstrated that when health systems are overwhelmed, mortality from vaccine-preventable and other treatable conditions can also increase dramatically. During the 2014-2015 Ebola outbreak, the increased number of deaths caused by measles, malaria, HIV/AIDS, and tuberculosis attributable to health system failures exceeded deaths from Ebola [1,2].
“The best defense against any outbreak is a strong health system,” stressed WHO Director-General Tedros Adhanom Ghebreyesus. “COVID-19 is revealing how fragile many of the world’s health systems and services are, forcing countries to make difficult choices on how to best meet the needs of their people.”
To help countries navigate through these challenges, the World Health Organization (WHO) has updated operational planning guidelines in balancing the demands of responding directly to COVID-19 while maintaining essential health service delivery, and mitigating the risk of system collapse. This includes a set of targeted immediate actions that countries should consider at national, regional, and local level to reorganize and maintain access to high-quality essential health services for all…

30 March 2020 Statement
Joint Statement by QU Dongyu, Tedros Adhanom Ghebreyesus and Roberto Azevedo, Directors-General of the Food and Agriculture Organization of the United Nations (FAO), the World Health Organization (WHO) and the World Trade Organization (WTO)

29 March 2020 Statement
Information sharing on COVID-19 [Taiwan]

::::::

Weekly Epidemiological Record, 3 April 2020, vol. 95, 14/15 (pp. 133–144)
Control of epidemic meningitis in countries in the African meningitis belt, 2019

::::::

WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
No new digest content identified.

WHO Region of the Americas PAHO
:: PAHO Director calls for private sector cooperation in COVID-19 response in the Americas (04/03/2020)
:: PAHO launches searchable database on COVID-19 guidance and research (04/02/2020)
:: PAHO appeals for $95 million to help Latin America and the Caribbean cope with the COVID-19 pandemic (04/02/2020)
:: Time is of the essence – Countries of the Americas must act now to slow the spread of COVID-19 (03/31/2020)

WHO South-East Asia Region SEARO
:: COVID19: WHO calls for stronger whole of society approach in South-East Asia Region
3 April 2020 News release Amidst rapid spread of COVID19 and continuing challenges, the World Health Organization today emphasized on a stronger whole of society and whole of government effort in South-East …

WHO European Region EURO
:: “China shows COVID-19 responses must be tailored to the local context” 03-04-2020
:: WHO project on cultural contexts of health and well-being adopted in the United States 03-04-2020
:: Supporting older people during the COVID-19 pandemic is everyone’s business 03-04-2020
:: WHO releases guidelines to help European countries maintain essential health services during the COVID 19 pandemic 02-04-2020
:: Health System Response Monitor: new tool to analyse COVID-19 response measures across European countries launched 02-04-2020

WHO Eastern Mediterranean Region EMRO
:: The fight to contain COVID-19 in Iraq 1 April 2020
:: Meeting the needs of the most vulnerable in Yemen 30 March 2020

WHO Western Pacific Region
:: Virtual press conference on COVID-19 in the Region 31 March 2020
Opening remarks of Dr Takeshi Kasai, WHO Regional Director for the Western Pacific

CDC/ACIP [to 28 Mar 2020]
http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html
Latest News Releases
COVID-19-Related Phone Scams and Phishing Attacks
Friday, April 3, 2020
[Editor’s Note: No other COVID-19 announced identified on CDC site]

Africa CDC [to 28 Mar 2020]
http://www.africacdc.org/
News
No new digest content identified.

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

National Health Commission of the People’s Republic of China
http://en.nhc.gov.cn/
News
April 4: Daily briefing on novel coronavirus cases in China
2020-04-04
On April 3, 31 provincial-level regions on the Chinese mainland as well as the Xinjiang Production and Construction Corps reported 19 new cases of confirmed infections (18 imported cases and 1 indigenous case in Hubei province), 11 new cases of suspected infections (all are imported cases), and 4 deaths (all in Hubei). 180 patients were released from hospital after being cured. 2,346 people who had had close contact with infected patients were freed from medical observation. Serious cases decreased by 48…

Xi vows to aid developing nations’ fight
2020-04-04
China to help countries that have weak health systems prepare, respond to virus
China vowed on April 3 to help enhance the preparedness and response of developing countries with weak public health systems amid the COVID-19 pandemic that has infected more than a million people worldwide.
President Xi Jinping made the remark in two separate phone conversations, with his Namibian and Lao counterparts, part of his busy diplomatic schedule. He has made dozens of phone calls to world leaders since the pandemic’s outbreak.
While talking with President of Namibia Hage Geingob, Xi said China will continue to step up assistance, share experience and strengthen public health cooperation with Namibia and other African countries to secure the final victory against the virus.
China has overcome its own difficulties, provided epidemic prevention materials to the African Union and African countries and organized videoconferences for experts to share experience. Some Chinese companies and nongovernmental institutions have also offered a hand, Xi said.
All these are reflections of a China-Africa community with a shared future, he added…

Announcements
 
 
Paul G. Allen Frontiers Group    [to 28 Mar 2020]
https://alleninstitute.org/what-we-do/frontiers-group/news-press/
Press Release
No new digest content identified.
 
 
BMGF – Gates Foundation  [to 28 Mar 2020]
http://www.gatesfoundation.org/Media-Center/Press-Releases
No new digest content identified.
 
 
Bill & Melinda Gates Medical Research Institute    [to 28 Mar 2020]
https://www.gatesmri.org/
The Bill & Melinda Gates Medical Research Institute is a non-profit biotech organization. Our mission is to develop products to fight malaria, tuberculosis, and diarrheal diseases—three major causes of mortality, poverty, and inequality in developing countries. The world has unprecedented scientific tools at its disposal; now is the time to use them to save the lives of the world’s poorest people
No new digest content identified.
 
 
CARB-X   [to 28 Mar 2020]
https://carb-x.org/
CARB-X is a non-profit public-private partnership dedicated to accelerating antibacterial research to tackle the global rising threat of drug-resistant bacteria.
No new digest content identified.
 
 
CEPI – Coalition for Epidemic Preparedness Innovations  [to 28 Mar 2020]
http://cepi.net/
Latest News
Norway intensifies COVID-19 fight with NOK2.2 billion donation to CEPI
01 Apr 2020
 
 
Clinton Health Access Initiative, Inc. (CHAI)  [to 28 Mar 2020]
https://clintonhealthaccess.org/
News & Press Releases
No new digest content identified.
 
 EDCTP    [to 28 Mar 2020]
http://www.edctp.org/
The European & Developing Countries Clinical Trials Partnership (EDCTP) aims to accelerate the development of new or improved drugs, vaccines, microbicides and diagnostics against HIV/AIDS, tuberculosis and malaria as well as other poverty-related and neglected infectious diseases in sub-Saharan Africa, with a focus on phase II and III clinical trials
Latest news
3 April 2020
Emergency funding of COVID-19 research among EDCTP 2020 calls for proposals
Today, EDCTP is publishing seven 2020 calls for proposals to support clinical research on poverty-related diseases, including neglected infectious diseases, and research capacity development in sub-Saharan Africa. The calls represent an investment of more than €80 million.

1 April 2020
Professor Gita Ramjee passed away on 31 March 2020
Yesterday, Professor Gita Ramjee, Chief Scientific Officer of the Aurum Institute in South Africa, passed away due to complications of a COVID-19 infection. Many in the EDCTP General Assembly, the Scientific Advisory Committee and the Secretariat worked with her and…
 
 
Emory Vaccine Center    [to 28 Mar 2020]
http://www.vaccines.emory.edu/
No new digest content identified.
 
 
European Medicines Agency  [to 28 Mar 2020]
http://www.ema.europa.eu/ema/
News & Press Releases ·
Press release: EMA provides recommendations on compassionate use of remdesivir for COVID-19
CHMP, Last updated: 03/04/2020

News: International regulators discuss available knowledge supporting COVID-19 medicine development
Last updated: 03/04/2020

News: COVID-19: chloroquine and hydroxychloroquine only to be used in clinical trials or emergency use programmes
Last updated: 01/04/2020

News: EU recommendations for 2020/2021 seasonal flu vaccine composition
CHMP, Last updated: 01/04/2020

Press release: Advancing regulatory science in the EU – new strategy adopted
Last updated: 31/03/2020

Press release: Update on treatments and vaccines against COVID-19 under development
Last updated: 31/03/2020
 
 
European Vaccine Initiative  [to 28 Mar 2020]
http://www.euvaccine.eu/news-events
Latest News
No new digest content identified.
 
 
FDA [to 28 Mar 2020]
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
Press Announcements
April 3, 2020 – Coronavirus (COVID-19) Update: Daily Roundup April 3, 2020

…The FDA announced that it is leading an effort, working collaboratively with government, industry and academic partners, to develop and implement a protocol that will provide convalescent plasma to patients in need across the country who may not have access to institutions with clinical trials in place.  Convalescent plasma has the potential to lessen the severity or shorten the length of illness caused by COVID-19. This collaboration, involving BARDA, the American Red CrossExternal Link Disclaimer and the Mayo ClinicExternal Link Disclaimer, will allow for a simplified process for health care providers that will help ensure patient safety while allowing for the collection of needed information about product efficacy. The FDA anticipates that the effort will be able to move thousands of units of plasma to patients who need them in the coming weeks… 

April 3, 2020 – Coronavirus (COVID-19) Update: FDA Coordinates National Effort to Develop Blood-Related Therapies for COVID-19

April 2, 2020 – Coronavirus (COVID-19) Update: FDA Provides Updated Guidance to Address the Urgent Need for Blood During the Pandemic
 
 
Fondation Merieux  [to 28 Mar 2020]
http://www.fondation-merieux.org/
News, Events
No new digest content identified.
 
 
Gavi [to 28 Mar 2020]
https://www.gavi.org/
Top Stories
COVID-19: massive impact on lower-income countries threatens more disease outbreaks
:: At least 13.5 million people to miss out on vaccinations due to postponement of campaigns and interruptions in routine vaccinations, with millions more likely to follow
:: Gavi, the Vaccine Alliance is urgently providing support for countries’ COVID-19 response and in addition is ready to support mass vaccination campaigns once lockdowns finish
:: Dr Seth Berkley: “The legacy of COVID-19 must not include the global resurgence of other killers like measles and polio.”
Geneva, 3 April 2020

Modelling suggests suppression strategy will save more lives from COVID-19 in poor countries
Imperial model of the spread of COVID-19 implies a suppression strategy could be most effective.
1 April 2020
 
 
GHIT Fund   [to 28 Mar 2020]
https://www.ghitfund.org/newsroom/press
GHIT was set up in 2012 with the aim of developing new tools to tackle infectious diseases that March 31, 2020
GHIT Fund Announces New Investments: A Total of 3.29 Billion Yen in Drugs for Malaria, Tuberculosis, Chagas Disease, Lymphatic Filariasis, and Onchocerciasis, Vaccines for Malaria, and Diagnostics for Leishmaniasis and Mycetoma

March 31, 2020
Statement: The Global Health Innovative Technology Fund and Unitaid collaboration to accelerate access to innovative solutions
 
 
Global Fund  [to 28 Mar 2020]
https://www.theglobalfund.org/en/news/
News & Stories
Funding Model
COVID-19 Response: Adaptations, Guidelines and Flexibilities for Countries
03 April 2020
 
 
Funding Model
COVID-19 Response: Continued Principal Recipient Reporting
02 April 2020

Funding Model
Funding Request Submission Dates Updated
31 March 2020

Sourcing & Management of Health Products
COVID-19 Impact on Supply Chain Logistics: Assessment and Recommendations
30 March 2020
 
 
Hilleman Laboratories   [to 28 Mar 2020]
http://www.hillemanlabs.org/
No new digest content identified.
 
 
Human Vaccines Project   [to 28 Mar 2020]
http://www.humanvaccinesproject.org/media/press-releases/
Press Releases
No new digest content identified.
 
 
IAVI  [to 28 Mar 2020]
https://www.iavi.org/newsroom
Press Releases
April 1, 2020
IAVI Welcomes W. Ripley Ballou, M.D., as ADVANCE Program Lead and Principal Investigator
NEW YORK – APRIL 1, 2020 – IAVI, a nonprofit scientific research organization dedicated to addressing urgent, unmet global health challenges, is pleased to announce the appointment of W. Ripley (“Rip”) Ballou, M.D., as ADVANCE Program Lead and Principal Investigator. This groundbreaking global initiative to accelerate the development of vaccines and new technologies to combat the AIDS epidemic in partnership with Africa is funded by the U.S. Agency for International Development (USAID) through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR)…
 
 
International Coalition of Medicines Regulatory Authorities [ICMRA]
http://www.icmra.info/drupal/en/news
Selected Statements, Press Releases, Research
No new digest content identified.
 
 
International Generic and Biosimilar Medicines Association [IGBA]
https://www.igbamedicines.org/
News
IGBA urgent recommendations to keep medicine supply chains flowing
27 March 2020
[See Milestones above for detail]
 
 
IFFIm
http://www.iffim.org/
Press Releases
No new digest content identified.
 
 
IFRC   [to 28 Mar 2020]
http://media.ifrc.org/ifrc/news/press-releases/
Selected Press Releases, Announcements
No new digest content identified.
 
 
IVAC  [to 28 Mar 2020]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
Updates
No new digest content identified.
 
 
IVI   [to 28 Mar 2020]
http://www.ivi.int/
Selected IVI News & Announcements
USask VIDO-InterVac and International Vaccine Institute collaborate on COVID-19 work
The International Vaccine Institute (IVI) of South Korea, a world-renowned international organization founded by the United Nations Development Programme, is collaborating with VIDO-InterVac at the University of Saskatchewan (USask) to better understand the virus causing the COVID-19 pandemic and to develop vaccines and potential treatments.
USask Research Profile and Impact
Mar 27, 2020
 
 
JEE Alliance  [to 28 Mar 2020]
https://www.jeealliance.org/
Selected News and Events
No new digest content identified.
 
 
MSF/Médecins Sans Frontières  [to 28 Mar 2020]
http://www.msf.org/
Latest [Selected Announcements]
France
Ensuring medical care for vulnerable people in and around Paris as …
Project Update 3 Apr 2020

Nigeria
Borno state: In the face of the COVID-19 pandemic, other dise…
Project Update 3 Apr 2020

Belgium
COVID-19: MSF launches its largest ever response in Belg…
Project Update 3 Apr 2020

Syria
Northwest Syria: “COVID-19 adds another layer of com…
Project Update 2 Apr 2020

Italy
COVID-19 pandemic brings new challenges to well-developed hea…
Interview 31 Mar 2020

Coronavirus disease COVID-19
MSF steps up COVID-19 response in Europe
Press Release 30 Mar 2020
 
National Vaccine Program Office – U.S. HHS  [to 28 Mar 2020]
https://www.hhs.gov/vaccines/about/index.html
NVAC 2020 Meetings
June 9-10, 2020 NVAC Meeting
September 23-24, 2020 Meeting (Virtual)
 
 
NIH  [to 28 Mar 2020]
http://www.nih.gov/news-events/news-releases
Selected News Releases
No new digest content identified.
 
 
PATH  [to 28 Mar 2020]
https://www.path.org/media-center/
Selected Announcements
PATH-led study finds commercially available reference diagnostic detects malaria with whole blood sample
April 1, 2020 by PATH
Commercially available diagnostic can effectively detect all malaria parasites, including cases with suspected gene mutations, with a whole blood sample.
 
 
Sabin Vaccine Institute  [to 28 Mar 2020]
http://www.sabin.org/updates/pressreleases
Statements and Press Releases
Sabin Vaccine Institute Names David Salisbury, Jeffrey P. Libson to Board of Trustees, Philip K. Russell Retires to Advisory Role
Thursday, April 2, 2020
Past Chair & President Philip K. Russell Retires as Trustee, Assumes Advisory Role
WASHINGTON, D.C. – The Sabin Vaccine Institute (Sabin) today announced that Professor David Salisbury and Jeffrey P. Libson have been named to the Board of Trustees and Retired Major General Philip K. Russell will transition from Trustee to Special Advisor after more than 25 years of service to the organization.

Each with some 40 years of experience, Salisbury and Libson bring additional global immunization policy and legal expertise to Sabin’s board. Salisbury is a well-respected leader in immunization program policy, vaccine research and disease eradication and Libson is a corporate and transactional attorney to the life sciences community who has also provided legal expertise to a number of non-profit life science organizations…
 
 
UNAIDS [to 28 Mar 2020]
http://www.unaids.org/en
Selected Press Releases/Reports/Statements
2 April 2020
People living with HIV in the Republic of Moldova to receive free home delivery of antiretroviral therapy

1 April 2020
A tribute to Gita Ramjee
 
 
UNICEF  [to 28 Mar 2020]
https://www.unicef.org/media/press-releases

Press release
WHO and UNICEF to partner on pandemic response through COVID-19 Solidarity Response Fund
Unprecedented fund an ‘all hands on deck’ approach to tackle COVID-19 pandemic
03/04/2020

Press release
IPA, WHO and UNICEF launch Read the World on International Children’s Book Day to support children and young people in isolation
Geronimo Stilton author to kickstart exclusive children’s book reading initiative amid COVID-19 pandemic
01/04/2020

Statement
COVID-19 pandemic could devastate refugee, migrant and internally displaced populations without urgent international action
Statement by UNICEF Executive Director Henrietta Fore
NEW YORK, 1 April 2020 – “COVID-19 will almost certainly gain a foothold in refugee camps, crowded reception centers or detention facilities holding migrant families. Given how quickly the virus is spreading, such a scenario is looking imminent.
“Even absent a pandemic, uprooted children and families – those living as refugees, migrants or internally displaced – face immense barriers to accessing healthcare and preventative services like proper handwashing and sanitation facilities. So, when an infectious disease hits, their risk is compounded.

“An outbreak of a respiratory disease like COVID-19 could spread easily through the overcrowded confines and unsafe conditions typical of many camps or settlements. Families in these environments would be more likely to get sick and less capable of fighting off the disease because of inadequate services.

“We are not talking about a small number of people either. Today, there are 31 million children who have been uprooted from their homes, including over 17 million internally displaced, 12.7 million refugees and 1.1 million asylum seekers. All of them need some form of assistance. Most of them do not have the luxury of calling a doctor when sick, of washing their hands whenever they need to, or of practicing physical distancing to stop disease transmission.

“Any public health response to the pandemic should reach the most vulnerable, including refugees, migrants and those who are internally displaced. This means ensuring equitable access to testing and treatment as well as access to prevention information and to water and sanitation services. There should be plans in place for safe, family-based care and support for children separated from their caregivers or whose caregivers die.

“It also means that containment measures, like border closures and movement restrictions, should not block children’s right to seek asylum and reunite with family members. Nor should it hinder aid agencies’ efforts to provide humanitarian aid. Uprooted children and families should be moved quickly out of harm’s way to adequate accommodations where they have access to water, soap, physical distancing and safety.

“UNICEF is working with partners to prevent the spread of the disease among refugee, migrant and displaced populations. This includes promoting hygiene practices that help prevent transmission in shelters, camps and other accommodation sites. It includes developing accurate, child friendly information on COVID-19 and materials to fight stigma and promote positive parenting. It also includes distributing hygiene supplies and providing access to water.

“But we cannot do this alone. Now, more than ever, governments and the international community should come together to protect the most vulnerable in these unprecedented times.”

Press release
Children in the Democratic Republic of the Congo at risk from killer measles, cholera epidemics
COVID-19 latest challenge facing battered health services
31/03/2020

Press release
UNICEF supplies arrive in Italy to support COVID-19 response
30/03/2020

Press release
Greater support needed for working families as COVID-19 takes hold – UNICEF and ILO
Newly released recommendations for businesses aim to help employers strengthen support for families during the pandemic
 
 
Unitaid  [to 28 Mar 2020]
https://unitaid.org/#en
Unitaid is a global development agency, hosted by the World Health Organization and its major donors are France, the United Kingdom, Brazil, Norway, Chile, the Republic of Korea, Spain and the Bill & Melinda Gates Foundation.

03 April 2020 | Statements

Medicines Patent Pool and Unitaid respond to access efforts for COVID-19 treatments and technologies

The Board of the Medicines Patent Pool (MPP) has decided to temporarily expand its mandate to include any health technology that could contribute to the global response to COVID-19 and where licensing could facilitate innovation and access. With the support of Unitaid, this will allow MPP to offer its intellectual property and licensing expertise to the World Health Organization (WHO) to assist the global effort in any way it can.

Both MPP and Unitaid underline their commitment to jointly ensure equitable and timely access to medicines and diagnostics by the most vulnerable populations, as stressed in the G20 Leaders’ 26 March 2020 Statement.

Marie-Paule Kieny, Chair of the MPP Governance Board, said, “In these difficult times, the MPP Board recognises the important role that MPP can play to increase access to life-saving products for those who need them most. And importantly, with time of the essence, to ensure that we make use of the expertise and mechanisms that already exist.”…
 
 
Vaccination Acceptance Research Network (VARN)  [to 28 Mar 2020]
https://vaccineacceptance.org/news.html#header1-2r
Announcements
No new digest content identified.
 
 
Vaccine Confidence Project  [to 28 Mar 2020]
http://www.vaccineconfidence.org/
Latest News & Archive
No new digest content identified.
 
 
 
Vaccine Education Center – Children’s Hospital of Philadelphia  [to 28 Mar 2020]
http://www.chop.edu/centers-programs/vaccine-education-center
Coronavirus Updates
Frequently Asked Questions about Coronavirus Disease 2019 (COVID-19)
Last Updated: March 19, 2020
Get some fast facts about the coronavirus from CHOP and the CDC. The CDC will provide updated information as it becomes available.
 
 
 
Wellcome Trust  [to 28 Mar 2020]
https://wellcome.ac.uk/news
News | 31 March 2020
Wellcome joins the UK government, industry and universities in a step-change to COVID-19 testing

Wellcome is supporting a step-change in COVID-19 testing by the UK government. This is a collaborative project, with partners including the NHS, Public Health England, diagnostics companies Thermo Fisher Scientific, QIAGEN and Randox, UK universities, Boots, Royal Mail and Amazon.
 
 
The Wistar Institute   [to 28 Mar 2020]
https://www.wistar.org/news/press-releases
Press Releases
Apr. 1, 2020

The Wistar Institute Signs Lease at 3.0 University Place

Signed lease agreement of up to 10 years for 8,000 sf with options for additional space to support long-term needs. In addition to their own Wistar Discovery Center lab space, Wistar will launch programming and curate lab partnerships​ ​in the new facility and throughout the life sciences sector.

3.0 University Place will provide 250,000 sf of lab and office space, specifically targeting biomedical research and advanced life science companies, with estimated delivery of Q3 2021…
 
 
WFPHA: World Federation of Public Health Associations  [to 28 Mar 2020]
https://www.wfpha.org/
Latest News
No new digest content identified.
 
 
World Organisation for Animal Health (OIE)   [to 28 Mar 2020]
https://www.oie.int/en/for-the-media/press-releases/2020/
Press Releases
No new digest content identified.
 
 
ARM [Alliance for Regenerative Medicine]  [to 28 Mar 2020]
https://alliancerm.org/press-releases/
Press Releases
The Alliance for Regenerative Medicine to Host FDA Representatives for Webinar on Clinical Trial Guidance During COVID-19 on April 10, 2020
April 2, 2020
WASHINGTON, DC
 
 
BIO    [to 28 Mar 2020]
https://www.bio.org/press-releases
Press Releases
2020 BIO International Convention Now Fully Digital
April 3, 2020
The Biotechnology Innovation Organization (BIO) announced today it will be moving the 2020 BIO International Convention scheduled for June 8-11 in San Diego to an online platform, in lieu of an in-person event for this year. The decision was based…
 
 
DCVMN – Developing Country Vaccine Manufacturers Network  [to 28 Mar 2020]
http://www.dcvmn.org/
News
No new digest content identified.
 
 
IFPMA   [to 28 Mar 2020]
http://www.ifpma.org/resources/news-releases/
Selected Press Releases, Statements, Publications
IFPMA Backgrounder – COVID-19
03 April 2020
[See COVID-19 for detail]
 
 
PhRMA    [to 28 Mar 2020]
http://www.phrma.org/

Selected Press Releases, Statements

The biopharmaceutical industry’s unique role in responding to COVID-19

Richard Moscicki, M.D.  April 2, 2020

As the outbreak of COVID-19, a disease caused by a novel strain of coronavirus, evolves in the United States and around the globe, both the private and public sectors are working around the clock to find solutions. America’s biopharmaceutical companies are working tirelessly to develop ways to diagnose, prevent and treat those with coronavirus.

Here is a closer look at four key ways the biopharmaceutical industry is fighting COVID-19:

1. Developing Potential New Treatments and Vaccines

As part of its commitment to finding solutions for patients with COVID-19 and preventing others from becoming infected, PhRMA members have been donating investigational compounds that may have potential to treat coronavirus for emergency use and in clinical trials, including compounds formerly tested on other viral pathogens such as Ebola and HIV.

Companies are also deploying their own clinical trials as quickly as possible to test promising investigational antiviral agents.  Other members are researching novel and existing vaccine candidates to identify promising candidates that have the ability to protect people from coronavirus infection. Importantly, biopharmaceutical industry research and development programs are pursuing a wide diversity of approaches to the development of treatments and vaccines and are also seeking to reduce the most severe of related symptoms associated with COVID-19.

Multiple avenues to preventive measures include a variety of vaccine approaches including mRNA and DNA vaccines, vaccines using synthetic materials and therapeutic antibodies that could be used not only to treat COVID-19 but also as a temporary preventive treatment in the absence of a vaccine.

Treatments under investigation include antiviral approaches such as protease inhibitors and nucleotide analogs to slow or reduce viral infections and treatments to reduce the severity of pulmonary manifestations of COVID-19 such as IL-6 inhibitors to reduce the risk of “cytokine storm” and antibacterials and vaccines to reduce the risk of secondary pneumococcal pneumonia.  It is not just the number of shots on goal, but also the wide variety of approaches being taken, that optimizes the chances of finding successful disease treatment and prevention.

Companies are also leveraging existing technologies to provide the ability to rapidly upscale production once a potential vaccine candidate is identified. Many companies are already investing heavily to increase production capacity. Similar efforts are underway for small molecule and antibody treatments.

2. Engaging with Public Partners to share knowledge

Responding effectively to a public health emergency requires close collaboration between public and private organizations around the world to share insights that could accelerate treatment and prevention strategies. Leading PhRMA member companies are collaborating with relevant U.S. and global public health authorities, including the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO), as well as public health authorities in China and Europe, to understand how pandemic preparedness platforms can be tailored to address the current emergency, and how to accelerate the development of potential treatments. Members are also sharing the learnings from clinical trials in real time with governments and other companies to advance the development of additional therapies

3. Advancing Past Learnings

Up until the outbreak began, COVID-19, a disease caused by a novel strain of coronavirus, did not exist. The rapid pace at which researchers have been able to understand this strain and get medicines into human clinical trials is a testament to the lessons learned from past public health emergencies. Furthermore, the biopharmaceutical industry has the unparalleled advantage of decades of scientific research cultivated from experience with similar viruses, such as MERS, SARS and influenza. These previous public health emergencies have helped put the infrastructure and partnerships in place to enable a more rapid response to emerging threats.

4. Manufacturing Production

Innovative biopharmaceutical companies have the capacity to manufacture and broadly disseminate vaccines and treatments to patients worldwide. America’s biopharmaceutical companies are already ramping up production capacity in anticipation of the discovery of an effective treatment or vaccine. They are also protecting the integrity of the pharmaceutical supply chain and keeping plants open to maintain a steady supply of medicines for patients. All the while, our member companies are staying in constant communication with the U.S. Food and Drug Administration.

The biopharmaceutical industry is committed to developing solutions to address this global public health emergency just as it has in the past. PhRMA member companies not only bring decades of expertise in infectious diseases, including other strains of coronavirus, but bring the infrastructure and technologies to allow them to quickly advance potential vaccine and treatment candidates to clinical trials and have the manufacturing capabilities and expertise to allow for quick scale up.

Read more about the industry’s contributions to the COVID-19 pandemic and our principles here.

Journal Watch
Vaccines and Global Health: The Week in Review continues its weekly scanning of key peer-reviewed journals to identify and cite articles, commentary and editorials, books reviews and other content supporting our focu-s on vaccine ethics and policy. Journal Watch is not intended to be exhaustive, but indicative of themes and issues the Center is actively tracking. We selectively provide full text of some editorial and comment articles that are specifically relevant to our work. Successful access to some of the links provided may require subscription or other access arrangement unique to the publisher.
If you would like to suggest other journal titles to include in this service, please contact David Curry at: david.r.curry@centerforvaccineethicsandpolicy.org

American Journal of Infection Control
April 2020 Volume 48, Issue 4, p355-470
http://www.ajicjournal.org/current

Major Articles
Trend of influenza vaccine Facebook posts in last 4 years: a content analysis
Chintan K. Gandhi, Jayesh Patel, Xiang Zhan
p361–367
Published online: February 22, 2020

American Journal of Infection Control
April 2020 Volume 48, Issue 4, p355-470
http://www.ajicjournal.org/current

Compliance with immunization and a biological risk assessment of health care workers as part of an occupational health surveillance program: The experience of a university hospital in southern Italy
Francesco Paolo Bianchi, Luigi Vimercati, Francesca Mansi, Sara De Nitto, Pasquale Stefanizzi, Letizia Alessia Rizzo, Grazia Rita Fragnelli, Enza Sabrina Silvana Cannone, Luigi De Maria, Angela Maria Vittoria Larocca, Silvio Tafuri
p368–374
Published online: November 18, 2019

American Journal of Tropical Medicine and Hygiene
Volume 102, Issue 4, April 2020
http://www.ajtmh.org/content/journals/14761645/102/4

Editorial
Estimating Malaria Incidence through Modeling Is a Good Academic Exercise, but How Practical Is It in High-Burden Settings?
Yazoume Ye and Andrew Andrada
Pages: 701–702
https://doi.org/10.4269/ajtmh.20-0120

American Journal of Tropical Medicine and Hygiene
Volume 102, Issue 4, April 2020
http://www.ajtmh.org/content/journals/14761645/102/4

Meeting Report
Developing a Road Map to Spread Genomic Knowledge in Africa: 10th Conference of the African Society of Human Genetics, Cairo, Egypt
Ghada Y. El-Kamah, Amal M. Mohamed, Yehia Z. Gad, Sonia Abdelhak, Branwen J. Hennig, Raj S. Ramesar, Guida Landouré, Amadou Gaye, Melanie J. Newport, Scott M. Williams and Michèle Ramsay
Pages: 719–723
https://doi.org/10.4269/ajtmh.19-0408
The tenth conference of the African Society of Human Genetics was held in Egypt with the theme “Human Genetics and Genomics in Africa: Challenges for Both Rare and Common Genetic Disorders.” Current research was presented, and we discussed visions for the future of genomic research on the African continent. In this report, we summarize the presented scientific research within and relevant to Africa as presented by both African and non-African scientists. We also discuss the current situation concerning genomic medicine and genomic research within the continent, difficulties in implementing genetic services and genomic medicine in Africa, and a road map to overcome those difficulties and meet the needs of the African researchers and patients.

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 28 Mar 2020)

Effect of age at vaccination on the measles vaccine effectiveness and immunogenicity: systematic review and meta-analysis
The objectives of this review were to evaluate the effect of age at administration of the first dose of a measles-containing vaccine (MCV1) on protection against measles and on antibody response after one- and…
Authors: Sara Carazo, Marie-Noëlle Billard, Amélie Boutin and Gaston De Serres
Citation: BMC Infectious Diseases 2020 20:251
Content type: Research article
Published on: 29 March 2020

BMC Research Notes
http://www.biomedcentral.com/bmcresnotes/content
(Accessed 28 Mar 2020)

The fiscal value of human lives lost from coronavirus disease (COVID-19) in China
Authors: Joses M. Kirigia and Rose Nabi Deborah Karimi Muthuri
Citation: BMC Research Notes 2020 13:198
Content type: Research note
Published on: 1 April 2020
Abstract
Objective
According to the WHO coronavirus disease (COVID-19) situation report 35, as of 24th February 2020, there was a total of 77,262 confirmed COVID-19 cases in China. That included 2595 deaths. The specific objective of this study was to estimate the fiscal value of human lives lost due to COVID-19 in China as of 24th February 2020.
Results
The deaths from COVID-19 had a discounted (at 3%) total fiscal value of Int$ 924,346,795 in China. Out of which, 63.2% was borne by people aged 25–49 years, 27.8% by people aged 50–64 years, and 9.0% by people aged 65 years and above. The average fiscal value per death was Int$ 356,203. Re-estimation of the economic model alternately with 5% and 10 discount rates led to a reduction in the expected total fiscal value by 21.3% and 50.4%, respectively. Furthermore, the re-estimation of the economic model using the world’s highest average life expectancy of 87.1 years (which is that of Japanese females), instead of the national life expectancy of 76.4 years, increased the total fiscal value by Int$ 229,456,430 (24.8%).

Bulletin of the World Health Organization
Volume 98, Number 4, April 2020, 229-296
https://www.who.int/bulletin/volumes/98/4/en/

EDITORIALS
Balancing risks and benefits of artificial intelligence in the health sector
— Kenneth Goodman, Diana Zandi, Andreas Reis & Effy Vayena
http://dx.doi.org/10.2471/BLT.20.253823

Bulletin of the World Health Organization
Volume 98, Number 4, April 2020, 229-296
https://www.who.int/bulletin/volumes/98/4/en/

Towards a global strategy on digital health
— Bernardo Mariano
http://dx.doi.org/10.2471/BLT.20.253955

Bulletin of the World Health Organization
Volume 98, Number 4, April 2020, 229-296
https://www.who.int/bulletin/volumes/98/4/en/

How do we reimagine health in a digital age?
— Flavia Bustreo & Marcel Tanner
http://dx.doi.org/10.2471/BLT.19.235358

Bulletin of the World Health Organization
Volume 98, Number 4, April 2020, 229-296
https://www.who.int/bulletin/volumes/98/4/en/

POLICY & PRACTICE
Defining ethical standards for the application of digital tools to population health research
— Gabrielle Samuel & Gemma Derrick
http://dx.doi.org/10.2471/BLT.19.237370
There is growing interest in population health research, which uses methods based on artificial intelligence. Such research draws on a range of clinical and non-clinical data to make predictions about health risks, such as identifying epidemics and monitoring disease spread. Much of this research uses data from social media in the public domain or anonymous secondary health data and is therefore exempt from ethics committee scrutiny. While the ethical use and regulation of digital-based research has been discussed, little attention has been given to the ethics governance of such research in higher education institutions in the field of population health. Such governance is essential to how scholars make ethical decisions and provides assurance to the public that researchers are acting ethically. We propose a process of ethics governance for population health research in higher education institutions. The approach takes the form of review after the research has been completed, with particular focus on the role artificial intelligence algorithms play in augmenting decision-making. The first layer of review could be national, open-science repositories for open-source algorithms and affiliated data or information which are developed during research. The second layer would be a sector-specific validation of the research processes and algorithms by a committee of academics and stakeholders with a wide range of expertise across disciplines. The committee could be created as an off-shoot of an already functioning national oversight body or health technology assessment organization. We use case studies of good practice to explore how this process might operate.

Bulletin of the World Health Organization
Volume 98, Number 4, April 2020, 229-296
https://www.who.int/bulletin/volumes/98/4/en/

Artificial intelligence and the ongoing need for empathy, compassion and trust in healthcare
— Angeliki Kerasidou
http://dx.doi.org/10.2471/BLT.19.237198
Empathy, compassion and trust are fundamental values of a patient-centred, relational model of health care. In recent years, the quest for greater efficiency in health care, including economic efficiency, has often resulted in the side-lining of these values, making it difficult for health-care professionals to incorporate them in practice. Artificial intelligence is increasingly being used in health care. This technology promises greater efficiency and more free time for health-care professionals to focus on the human side of care, including fostering trust relationships and engaging with patients with empathy and compassion. This article considers the vision of efficient, empathetic and trustworthy health care put forward by the proponents of artificial intelligence. The paper suggests that artificial intelligence has the potential to fundamentally alter the way in which empathy, compassion and trust are currently regarded and practised in health care. Moving forward, it is important to re-evaluate whether and how these values could be incorporated and practised within a health-care system where artificial intelligence is increasingly used. Most importantly, society needs to re-examine what kind of health care it ought to promote.

Bulletin of the World Health Organization
Volume 98, Number 4, April 2020, 229-296
https://www.who.int/bulletin/volumes/98/4/en/

Artificial intelligence in health care: accountability and safety
— Ibrahim Habli, Tom Lawton & Zoe Porter
http://dx.doi.org/10.2471/BLT.19.237487
The prospect of patient harm caused by the decisions made by an artificial intelligence-based clinical tool is something to which current practices of accountability and safety worldwide have not yet adjusted. We focus on two aspects of clinical artificial intelligence used for decision-making: moral accountability for harm to patients; and safety assurance to protect patients against such harm. Artificial intelligence-based tools are challenging the standard clinical practices of assigning blame and assuring safety. Human clinicians and safety engineers have weaker control over the decisions reached by artificial intelligence systems and less knowledge and understanding of precisely how the artificial intelligence systems reach their decisions. We illustrate this analysis by applying it to an example of an artificial intelligence-based system developed for use in the treatment of sepsis. The paper ends with practical suggestions for ways forward to mitigate these concerns. We argue for a need to include artificial intelligence developers and systems safety engineers in our assessments of moral accountability for patient harm. Meanwhile, none of the actors in the model robustly fulfil the traditional conditions of moral accountability for the decisions of an artificial intelligence system. We should therefore update our conceptions of moral accountability in this context. We also need to move from a static to a dynamic model of assurance, accepting that considerations of safety are not fully resolvable during the design of the artificial intelligence system before the system has been deployed.

Bulletin of the World Health Organization
Volume 98, Number 4, April 2020, 229-296
https://www.who.int/bulletin/volumes/98/4/en/

How to achieve trustworthy artificial intelligence for health
— Kristine Bærøe, Ainar Miyata-Sturm & Edmund Henden
http://dx.doi.org/10.2471/BLT.19.237289
Artificial intelligence holds great promise in terms of beneficial, accurate and effective preventive and curative interventions. At the same time, there is also awareness of potential risks and harm that may be caused by unregulated developments of artificial intelligence. Guiding principles are being developed around the world to foster trustworthy development and application of artificial intelligence systems. These guidelines can support developers and governing authorities when making decisions about the use of artificial intelligence. The High-Level Expert Group on Artificial Intelligence set up by the European Commission launched the report Ethical guidelines for trustworthy artificial intelligence in 2019. The report aims to contribute to reflections and the discussion on the ethics of artificial intelligence technologies also beyond the countries of the European Union (EU). In this paper, we use the global health sector as a case and argue that the EU’s guidance leaves too much room for local, contextualized discretion for it to foster trustworthy artificial intelligence globally. We point to the urgency of shared globalized efforts to safeguard against the potential harms of artificial intelligence technologies in health care.

Bulletin of the World Health Organization
Volume 98, Number 4, April 2020, 229-296
https://www.who.int/bulletin/volumes/98/4/en/

Ensuring trustworthy use of artificial intelligence and big data analytics in health insurance
— Calvin W L Ho, Joseph Ali & Karel Caals
http://dx.doi.org/10.2471/BLT.19.234732
Technological advances in big data (large amounts of highly varied data from many different sources that may be processed rapidly), data sciences and artificial intelligence can improve health-system functions and promote personalized care and public good. However, these technologies will not replace the fundamental components of the health system, such as ethical leadership and governance, or avoid the need for a robust ethical and regulatory environment. In this paper, we discuss what a robust ethical and regulatory environment might look like for big data analytics in health insurance, and describe examples of safeguards and participatory mechanisms that should be established. First, a clear and effective data governance framework is critical. Legal standards need to be enacted and insurers should be encouraged and given incentives to adopt a human-centred approach in the design and use of big data analytics and artificial intelligence. Second, a clear and accountable process is necessary to explain what information can be used and how it can be used. Third, people whose data may be used should be empowered through their active involvement in determining how their personal data may be managed and governed. Fourth, insurers and governance bodies, including regulators and policy-makers, need to work together to ensure that the big data analytics based on artificial intelligence that are developed are transparent and accurate. Unless an enabling ethical environment is in place, the use of such analytics will likely contribute to the proliferation of unconnected data systems, worsen existing inequalities, and erode trustworthiness and trust.

Bulletin of the World Health Organization
Volume 98, Number 4, April 2020, 229-296
https://www.who.int/bulletin/volumes/98/4/en/

PERSPECTIVES
Safeguards for the use of artificial intelligence and machine learning in global health
— Amy K Paul & Merrick Schaefer
http://dx.doi.org/10.2471/BLT.19.237099

Bulletin of the World Health Organization
Volume 98, Number 4, April 2020, 229-296
https://www.who.int/bulletin/volumes/98/4/en/

Ethical implications of conversational agents in global public health
— David D Luxton
http://dx.doi.org/10.2471/BLT.19.237636

Bulletin of the World Health Organization
Volume 98, Number 4, April 2020, 229-296
https://www.who.int/bulletin/volumes/98/4/en/

Artificial intelligence, diagnostic imaging and neglected tropical diseases: ethical implications
— Alon Vaisman, Nina Linder, Johan Lundin, Ani Orchanian-Cheff, Jean T Coulibaly, Richard KD Ephraim & Isaac I Bogoch
http://dx.doi.org/10.2471/BLT.19.237560

Bulletin of the World Health Organization
Volume 98, Number 4, April 2020, 229-296
https://www.who.int/bulletin/volumes/98/4/en/

Four equity considerations for the use of artificial intelligence in public health
— Maxwell J Smith, Renata Axler, Sally Bean, Frank Rudzicz & James Shaw
http://dx.doi.org/10.2471/BLT.19.237503

Bulletin of the World Health Organization
Volume 98, Number 4, April 2020, 229-296
https://www.who.int/bulletin/volumes/98/4/en/

Ethical barriers to artificial intelligence in the national health service, United Kingdom of Great Britain and Northern Ireland
— Claire Louise Thompson & Heather May Morgan
http://dx.doi.org/10.2471/BLT.19.237230

Emerging Infectious Diseases
Volume 26, Number 4—April 2020
http://wwwnc.cdc.gov/eid/

Expedited Articles
Identifying Locations with Possible Undetected Imported Severe Acute Respiratory Syndrome Coronavirus 2 Cases by Using Importation Predictions
P. De Salazar et al. July 2020

Emerging Infectious Diseases
Volume 26, Number 4—April 2020
http://wwwnc.cdc.gov/eid/

Public Mental Health Crisis during COVID-19 Pandemic, China
L. Dong and J. Bouey July 2020

Emerging Infectious Diseases
Volume 26, Number 4—April 2020
http://wwwnc.cdc.gov/eid/

Policy Decisions and Use of Information Technology to Fight 2019 Novel Coronavirus Disease, Taiwan
C. Lin et al. July 2020

Emerging Infectious Diseases
Volume 26, Number 4—April 2020
http://wwwnc.cdc.gov/eid/

Asymptomatic and Human-to-Human Transmission of SARS-CoV-2 in a 2-Family Cluster, Xuzhou, China
C. Li et al. July 2020

Emerging Infectious Diseases
Volume 26, Number 4—April 2020
http://wwwnc.cdc.gov/eid/

Severe Acute Respiratory Syndrome Coronavirus 2 RNA Detected in Blood Donations
L. Chang et al. July 2020

Emerging Infectious Diseases
Volume 26, Number 4—April 2020
http://wwwnc.cdc.gov/eid/

Severe Acute Respiratory Syndrome Coronavirus 2 Shedding by Travelers, Vietnam, 2020
T. Le et al. July 2020

Emerging Infectious Diseases
Volume 26, Number 4—April 2020
http://wwwnc.cdc.gov/eid/

COVID-19 Outbreak Associated with Air Conditioning in Restaurant, Guangzhou, China, 2020
J. Lu et al. July 2020

Humanitarian Exchange Magazine
Number 77, March 2020
https://odihpn.org/magazine/the-crisis-in-yemen/

Responding to Ebola in the Democratic Republic of Congo
by Humanitarian Practice Network
This edition of Humanitarian Exchange, co-edited with Anne Harmer, focuses on the response to the Ebola outbreak in the Democratic Republic of Congo (DRC). Although at the time of publication the outbreak appeared to have ended, over its course it claimed 2,200 lives, with more than 3,300 infected, making this the world’s second largest outbreak ever.

In the lead article, Natalie Roberts reflects on the extent to which humanitarian actors have applied learning from the outbreak in West Africa in 2014–2016. Richard Kojan and colleagues report on the NGO ALIMA’s flexible, patient-centred approach to reducing mortality, Marcela Ascuntar reflects on lessons learned from community feedback and Bernard Balibuno, Emanuel Mbuna Badjonga and Howard Mollett highlight the crucial role faith-based organisations have played in the response. In their article, Theresa Jones, Noé Kasali and Olivia Tulloch outline the work of the Bethesda counselling centre in Beni, which provides support to grieving families. Reflecting on findings from a recent assessment by Translators without Borders, Ellie Kemp describes the challenges involved in providing clear and accessible information on Ebola and the response, and Sung Joon Park and colleagues explain how humane care and treatment can help increase trust and confidence in the response. Stephen Mugamba and his co-authors highlight the importance of community involvement in Ebola research, and Gillian McKay and her co-authors examine the impact of the Ebola outbreak and response on sexual and reproductive health services.

Stacey Mearns, Kiryn Lanning and Michelle Gayer present an Ebola Readiness Roadmap to support NGOs in preparing for an outbreak, while Edward Kumakech, Maurice Sadlier, Aidan Sinnott and Dan Irvine report on a Gap Analysis tool looking at the communication, community engagement and compliance tracking activities that need to be in place before an Ebola vaccine is deployed. Emanuele Bruni and colleagues describe the development of a new monitoring and evaluation framework for strategic response planning. The edition ends with an article by Adelicia Fairbanks, who argues for an acceptance strategy in the DRC to improve security and access for responding agencies.

JAMA
March 24/31, 2020, Vol 323, No. 12, Pages 1111-1216
http://jama.jamanetwork.com/issue.aspx

Online First
April 1, 2020
Viewpoint
Potential Legal Liability for Withdrawing or Withholding Ventilators During COVID-19Assessing the Risks and Identifying Needed Reforms
I. Glenn Cohen, JD; Andrew M. Crespo, JD; Douglas B. White, MD, MAS
free access has active quiz
JAMA. Published online April 1, 2020. doi:10.1001/jama.2020.5442
This Viewpoint discusses the legal risks to health care workers and hospital systems from withdrawing or withholding ventilation from COVID-19 patients and cites a Maryland statute that offers legal immunity to clinicians making good faith decisions under emergency conditions as an example for other states to follow.

JAMA
March 24/31, 2020, Vol 323, No. 12, Pages 1111-1216
http://jama.jamanetwork.com/issue.aspx

Viewpoint
March 27, 2020
A Framework for Rationing Ventilators and Critical Care Beds During the COVID-19 Pandemic
Douglas B. White, MD, MAS; Bernard Lo, MD
free access is active quiz has multimedia online first
JAMA. 2020; doi: 10.1001/jama.2020.5046
This Viewpoint describes a framework for rationing ventilators during the COVID-19 pandemic should intensive care units find themselves with more patients than they can care for, using a score-based system that incorporates patients’ likelihood of surviving to hospital discharge and beyond and their role in the public health response to the outbreak.

Journal of Epidemiology & Community Health
April 2020 – Volume 74 – 4
https://jech.bmj.com/content/74/4

Commentary
Giving patients a voice: implementing patient and public involvement to strengthen research in sub-Saharan Africa (31 January, 2020)
Carol Bedwell, Tina Lavender
…Active involvement in research and healthcare is very much expected and is well established within many high-income settings. However, in low-income settings, PPI is in its infancy, with few researchers understanding the concept.⁴ This may lead to a failure to match health need with appropriate research,⁵ particularly when the research agenda is set by others, leading to acknowledged power imbalances.⁶ In such settings, empowerment of individuals is low and patients are not included in research design or conduct. In sub-Saharan Africa, gender inequalities mean that women have limited input into both healthcare-related decisions and research.⁷ Experience of working in these settings highlighted that this is the case even in research which is women-centred, such as maternity care…

The Lancet
Apr 04, 2020 Volume 39 5Number 10230 p1089-1166, e62-e63
https://www.thelancet.com/journals/lancet/issue/current

Editorial
Redefining vulnerability in the era of COVID-19
The Lancet
What does it mean to be vulnerable? Vulnerable groups of people are those that are disproportionally exposed to risk, but who is included in these groups can change dynamically. A person not considered vulnerable at the outset of a pandemic can become vulnerable depending on the policy response. The risks of sudden loss of income or access to social support have consequences that are difficult to estimate and constitute a challenge in identifying all those who might become vulnerable. Certainly, amid the COVID-19 pandemic, vulnerable groups are not only elderly people, those with ill health and comorbidities, or homeless or underhoused people, but also people from a gradient of socioeconomic groups that might struggle to cope financially, mentally, or physically with the crisis.

The strategies most recommended to control the spread of COVID-19—social distancing and frequent handwashing—are not easy for the millions of people who live in highly dense communities with precarious or insecure housing, and poor sanitation and access to clean water. Often people living in these settings also have malnutrition, non-communicable diseases, and infectious diseases such as HIV/AIDS and tuberculosis. In South Africa, 15 million people live in townships where the incidence of HIV is around 25%. These immunocompromised populations are at greater risk to Covid-19. Another concern in African countries is that the response to COVID-19 will come at the expense of treating other diseases. For example, in the Democratic Republic of the Congo, the response to Ebola resulted in the resurgence of measles.

The effect of the policy response on children in the fight against COVID-19 is also a concern. On March 23, UNICEF reported that in Latin America and the Caribbean over 154 million children are temporarily out of school because of COVID-19. The impact of this policy is more far-reaching than just the loss of education—in this region, school food programmes benefit 85 million children, and the UN Food and Agriculture Organization assessed that these programmes constitute one of the most reliable daily sources of food for around 10 million children.

Questioning whether appropriate evidence exists to support the reduction of transmission through school closures, Richard Armitage and Laura Nellums considered the long-term risks of deepening social, economic, and health inequities for children in a letter published in The Lancet Global Health. A 2015 UN report analysing the socioeconomic effects of Ebola in Africa also highlighted the increased risks of pregnancy in young girls, school dropout, and child abuse.

The most vulnerable children are part of families in which parents have informal jobs and are not able to work from home. This predicament is particularly concerning in countries like India, where over 80% of its workforce is employed in the informal sector and a third of people work as casual labourers. In socioeconomically fragile settings, a lockdown policy can exacerbate health inequalities and the consequences need careful consideration to avoid reinforcing the vicious cycle between poverty and ill health. Human Rights Watch has reported that the lockdown in India has disproportionately affected marginalised communities because of the loss of livelihood and lack of food, shelter, health, and other basic necessities. Under this unprecedented challenge, governments must be mindful that strategies to address the pandemic should not further marginalise or stigmatise affected communities.

Vulnerable groups and health inequalities are also evident in developed countries. The USA is a stark reminder of the divide that exists in countries without a universal health-care system. For people who do not have private medical insurance, this pandemic might see them face the choice of devastating financial hardship or poor health outcomes, or both. During the 2009 H1N1 influenza pandemic in the USA, individuals with poorer health outcomes were those in the lowest socioeconomic groups. This same group of vulnerable people have now been caught in the middle of a major health emergency as a result of long-standing differences in affluence.

While responding to COVID-19, policy makers should consider the risk of deepening health inequalities. If vulnerable groups are not properly identified, the consequences of this pandemic will be even more devastating. Although WHO guidance should be followed, a one-size-fits-all model will not be appropriate. Each country must continually assess which members of society are vulnerable to fairly support those at the highest risk.

The Lancet
Apr 04, 2020 Volume 39 5Number 10230 p1089-1166, e62-e63
https://www.thelancet.com/journals/lancet/issue/current

COVID-19 will not leave behind refugees and migrants
The Lancet
Never has the “leave no one behind” pledge felt more urgent. As nations around the world implement measures to control the spread of SARS-CoV-2, including lockdowns and restrictions on individuals’ movements, they must heed their global commitments. When member states adopted the UN 2030 Agenda for Sustainable Development, they promised to ensure no one will be left behind. Chief among the world’s most vulnerable people are refugees and migrants. The COVID-19 crisis puts these groups at enormous risk. Yet global pandemic efforts have so far failed in their duty of care to refugees and migrants.

There are millions of refugees and migrants in camps and detention centres worldwide. Resettlement procedures have been suspended by the UN. UNHCR reports that 34 countries hosting substantial refugee populations have seen local transmission of SARS-CoV-2. The often appalling conditions of migrant camps are fertile for infectious disease outbreaks. With few latrines and water supplies, basic hygiene to prevent spread is difficult. With extreme overcrowding, physical distancing is impossible.

In Europe, tens of thousands of migrants live in densely packed camps along the Mediterranean, without adequate medical personnel and infrastructure to cope. With no emergency COVID-19 plan in place by governments, Médicins san Frontières has demanded evacuation of 42 000 asylum seekers on the Greek islands to suitable accommodation. In a Lancet Comment, WHO leaders appeal for more attention for refugees and migrants, including in humanitarian settings, which are facing disruption of essential supplies of food, medicines, and aid workers.

The worst might be yet to come. 80% of refugees live in low-income and middle-income countries, the sites of the expected fourth wave of COVID-19 behind China, Europe, and the USA. Already, these settings have weak health-care systems, scarce protective equipment, and poor testing and treatment capacity. They need enormous global support to prepare for an impending crisis. This virus disregards all borders. COVID-19 responses must not overlook refugees and migrants.

The Lancet
Apr 04, 2020 Volume 39 5Number 10230 p1089-1166, e62-e63
https://www.thelancet.com/journals/lancet/issue/current

Comment
Preparedness is essential for malaria-endemic regions during the COVID-19 pandemic
Jigang Wang, et al.

The Lancet
Apr 04, 2020 Volume 39 5Number 10230 p1089-1166, e62-e63
https://www.thelancet.com/journals/lancet/issue/current

Mass gathering events and reducing further global spread of COVID-19: a political and public health dilemma
Brian McCloskey, et al. on behalf of the WHO Novel Coronavirus-19 Mass Gatherings Expert Group

The Lancet
Apr 04, 2020 Volume 39 5Number 10230 p1089-1166, e62-e63
https://www.thelancet.com/journals/lancet/issue/current

Articles
First known person-to-person transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the USA
Isaac Ghinai, et al. for the Illinois COVID-19 Investigation Team

The Lancet
Apr 04, 2020 Volume 39 5Number 10230 p1089-1166, e62-e63
https://www.thelancet.com/journals/lancet/issue/current

Viewpoint
The case for replacing live oral polio vaccine with inactivated vaccine in the Americas
Jorge A Alfaro-Murillo, et al
Abstract
Before the development of the inactivated poliovirus vaccine (IPV) and live oral poliovirus vaccine (OPV), sporadic outbreaks of poliomyelitis were reported to cause as many as 18 000 cases of paralysis and over 3000 deaths in the USA alone.¹ The straightforward oral administration, high effectiveness, and relatively low cost of OPV was fundamental to the substantial reduction in polio achieved by mass vaccination campaigns. Wild polioviruses were certified by WHO to be eliminated throughout the Americas in 1994 . However, an adverse effect of OPV is vaccine-associated paralytic polio. Among the countries exclusively using OPV in 2012, an estimated 400 cases of vaccine-associated paralytic polio occurred that year.² This burden is more than double the incidence of wild polio in 2019. ³ Vaccine-derived polioviruses (VDPV) can also spread from person to person, a process that led to more than 250 additional cases of paralysis during 2019. ⁴ The risk of paralytic polio associated with OPV spurred many countries to switch to the safer IPV. While IPV elicits a much weaker mucosal immune response than OPV, ⁵ and is thus less effective at averting transmission, it is very protective against disease. In the Americas, Canada transitioned to exclusive IPV use in 1995, the USA in 2000, Costa Rica in 2010, and Uruguay in 2012. However, the remaining 31 countries in the Americas ( appendix) continue to administer at least one dose of OPV.

Lancet Global Health
Apr 2020 Volume 8 Number 4 e451-e611
http://www.thelancet.com/journals/langlo/issue/current

Comment
The burden of viral respiratory infections in young children in low-resource settings
Uduak Okomo, Olubukola T Idoko, Beate Kampmann

Lancet Global Health
Apr 2020 Volume 8 Number 4 e451-e611
http://www.thelancet.com/journals/langlo/issue/current

Maximising the potential of HPV vaccines
Jos Luttjeboer, et al

Lancet Global Health
Apr 2020 Volume 8 Number 4 e451-e611
http://www.thelancet.com/journals/langlo/issue/current

Articles
Feasibility of controlling COVID-19 outbreaks by isolation of cases and contacts
Joel Hellewell, et al Centre for the Mathematical Modelling of Infectious Diseases COVID-19 Working Group,

Lancet Global Health
Apr 2020 Volume 8 Number 4 e451-e611
http://www.thelancet.com/journals/langlo/issue/current

Global burden of respiratory infections associated with seasonal influenza in children under 5 years in 2018: a systematic review and modelling study
Xin Wang,et al. for the Respiratory Virus Global Epidemiology Network

Lancet Global Health
Apr 2020 Volume 8 Number 4 e451-e611
http://www.thelancet.com/journals/langlo/issue/current

Trends in premature avertable mortality from non-communicable diseases for 195 countries and territories, 1990–2017: a population-based study
Ramon Martinez, et al.