Think Tanks et al

Brookings
http://www.brookings.edu/
Accessed 8 Jun 2019
[No new relevant content]

Center for Global Development
http://www.cgdev.org/page/press-center
[No new relevant content]

CSIS
https://www.csis.org/
Accessed 8 Jun 2019
[No new relevant content]

Council on Foreign Relations
http://www.cfr.org/
Accessed 8 Jun 2019
[No new relevant content]

Kaiser Family Foundation
https://www.kff.org/search/?post_type=press-release
Accessed 8 Jun 2019
[No new relevant content]

Milestones :: Perspectives :: Research

DRC – Ebola/Cholera/Measles

Major cholera vaccination campaign begins in North Kivu in the Democratic Republic of the Congo
Agencies warn of unprecedented situation in the DRC as cholera and measles epidemics compound Ebola challenges
Geneva / Goma 27 May 2019 – More than 800,000 people will be immunised against cholera in North Kivu in the Eastern part of the Democratic Republic of the Congo (DRC) following the launch of a major vaccination campaign today.

The campaign will be implemented by the DRC Ministry of Health with support from the World Health Organization (WHO) and partners, and funded by Gavi, the Vaccine Alliance. A total of 835,183 people in Binza, Goma, Kayina, Karisimbi, Kibirizi, Kirotshe and Rutshuru areas will be vaccinated by 1 June 2019. The campaign will administer the first of two doses of oral cholera vaccine (OCV) to people in these areas. Following successful implementation, a campaign to administer the second dose will take place at a later stage to provide full protection against cholera.

Over 10,000 cases of cholera have been reported in the country since January 2019, leading to more than 240 deaths. In addition, over 80,000 suspected cases of measles have led to over 1,400 deaths so far this year while a case of circulating vaccine-derived poliovirus type 2 was reported in Kasai province earlier this month.

“The DRC is confronted with an unprecedented combination of deadly epidemics,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. “While the Ebola outbreak continues to cause untold misery in the East, measles and cholera epidemics are claiming the lives of thousands of people throughout the country. That’s why we are stepping up our response, through this cholera vaccination campaign, through ongoing measles vaccinations in health zones affected by measles outbreaks, as well as through our continued support for Ebola vaccinations in both the DRC and neighbouring countries. We cannot allow this needless suffering to continue.”…

::::::

43: Situation report on the Ebola outbreak in North Kivu
28 May2019
…Implementation of ring vaccination protocol
:: As of 25 of May 2019, 124,825 people at risk have consented to and received the rVSV-ZEBOV-GP Ebola vaccine. Of those, 33,046 are contacts and 87,886 contacts of contacts. The total number of vaccines includes 31,016 HCWs/FLWs and 34 522 children 1-17 years of age.

:: In the last week (i.e. 13-20 May 2019), the ring vaccination teams were active in 55 different Aires de Santé and administered 800-1200 doses per day.

:: Despite the challenges in the field and considering the cases reported between 30 April 2019 and 20 May 2019, only 31/337 (9.2%) of the cases do not have a ring defined and their contacts and contacts of contacts vaccinated. For 113/337 (33.5%) of the cases the ring vaccination was completed and for 193/337 (57.2%) ring vaccination is ongoing at the time of writing this report. This important progress is the result of the use of innovative delivery strategies (i.e. pop-up vaccination and targeted geographic vaccination) and strong community negotiations and engagement…

Disease Outbreak News (DONs)
Ebola virus disease – Democratic Republic of the Congo
30 May 2019
A decline in the number of confirmed Ebola virus disease (EVD) cases has been reported this week (22 to 28 May). Over the past seven days, a total of 73 new confirmed cases were reported compared to the previous where 127 new confirmed cases were reported. This should be interpreted with caution given the complex operating environment and fragility of the security situation…

Milestones :: Perspectives :: Research

Featured Media Content

Epidemics
Volume 27 Pages 1-132 (June 2019)
https://www.sciencedirect.com/journal/epidemics/vol/27/suppl/C
Research article Open access
Control of Ebola virus disease outbreaks: Comparison of health care worker-targeted and community vaccination strategies
Alexis Robert, Anton Camacho, W. John Edmunds, Marc Baguelin, … Rosalind M. Eggo
Pages 106-114

Research article Open access
Efficient vaccination strategies for epidemic control using network information
Yingrui Yang, Ashley McKhann, Sixing Chen, Guy Harling, Jukka-Pekka Onnela
Pages 115-122

Research article Open access
Analyzing and forecasting the Ebola incidence in North Kivu, the Democratic Republic of the Congo from 2018–19 in real time
Andrei R. Akhmetzhanov, Hyojung Lee, Sung-mok Jung, Taishi Kayano, … Hiroshi Nishiura
Pages 123-131

Featured Media Content

Milestones :: Perspectives :: Research

72nd World Health Assembly

72nd World Health Assembly Closes with Adoption of Resolution on Public Health Topics
Geneva, 28 May 2019 (PAHO/WHO) – The 72nd World Health Assembly ended today with the adoption of several resolutions on the world’s most relevant public health issues.

Over the past 9 days, Member States adopted a new global strategy on health, environment and climate change, and committed to invest in safe water, sanitation and hygiene services in health facilities. The countries adopted a landmark agreement to enhance the transparency of pricing for medicines, vaccines and other health products. The new WHO programme budget was approved and a common approach to antimicrobial resistance was agreed upon.

Patient safety was recognized as a global health priority and the 11th Edition of the International Classification of Diseases was adopted. The countries adopted three resolutions on universal health coverage with a focus on primary healthcare, the role of community health workers, and the High-Level Meeting on Universal Health Coverage in New York in September 2019.

“I cannot emphasize strongly enough what a decisive moment for public health the High-Level Meeting could be. A strong declaration, with strong political support, could transform the lives of billions of people, in realizing what we have always advocated for – health for all,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General, in his closing remarks at the 72nd World Health Assembly.

We are going to face many challenges in implementing the commitments that we made, Dr. Tedros cautioned. Some of our countries are deeply divided. Some are in severe economic crises. Some are still suffering from years of conflict,” he added. The WHO Director-General urged the countries to translate the adopted resolutions into policies and programs that deliver results.

Tedros said that to achieve the Sustainable Development Goals, the Member States and WHO should also commit to regular accountability regarding the progress and challenges they face in the implementation of these policies. When they return next year, he asked the delegations to be ready to report on the steps they have taken and the progress they have made on primary health care and universal health coverage. Speech

Approved resolutions
Migrant and refugee health
Member States agreed on a five-year global action plan to promote the health of refugees and migrants. The plan focuses on achieving universal health coverage and the highest attainable standard of health for refugees and migrants, as well as for host populations.

The plan includes short and long-term steps to mainstream refugee and migrant health care, enhance partnerships, strengthen health monitoring and information systems, and counter misperceptions about migrant and refugee health.

Member States are requesting that the Director-General report back on progress at the 74th World Health Assembly in 2021. Reports at the 74th and 76th World Health Assemblies to be held in 2021 and 2023 will also include information voluntarily provided by Member States and UN agencies, as appropriate.

Globally, the number of international migrants has grown. In the period 2000–2017, the total number of international migrants rose from 173 million to 258 million, an increase of 49%. The number of forcibly displaced people, 68.5 million, is also the highest ever, and includes 25.4 million refugees. Ten million stateless people lack a nationality and do not have access to basic rights such as education, health care, employment and freedom of movement.

Access to medicines
The World Health Assembly today adopted a resolution on improving the transparency of markets for medicines, vaccines, and other health products in an effort to expand access.

The resolution urges Member States to enhance public sharing of information on actual prices paid by governments and other buyers for health products, and greater transparency on pharmaceutical patents, clinical trial results, and other determinants of pricing along the value chain from laboratory to patient.

It asks the WHO Secretariat to support efforts towards transparency and to monitor the impact of transparency on affordability and availability of health products, including the effect of differential pricing.

The aim is to help Member States make more informed decisions when purchasing health products, negotiate more affordable prices, and ultimately expand access to health products for populations.

Nagoya Protocol
The Health Assembly asked the Director-General to broaden engagement with Member States, the Secretariat of the Convention on Biological Diversity, relevant international organizations and relevant stakeholders, in order to provide information on current pathogen-sharing practices and arrangements, the implementation of access and benefit-sharing measures, as well as potential public health outcomes and other implications.

The request followed a review of the WHO Secretariat’s report on the public health implications of implementing the Nagoya Protocol, an international agreement on access to genetic resources and the fair and equitable sharing of benefits arising from their utilization.

Other resolutions
On previous days, delegations of the member countries adopted several resolutions, including the following:
:: Delegations at the World Health Assembly adopted three resolutions on universal health coverage, with a focus on: primary health care, the role of community health workers, and the United Nations General Assembly High-Level Meeting on Universal Health Coverage that will be held in September.

:: The countries agreed to adopt the eleventh revision of the International Classification of Diseases (ICD-11) that will become effective on 1 January 2022. The ICD is the foundation for the identification of health trends and statistics globally, and the international standard for reporting diseases and health conditions. It is the diagnostic classification standard for all clinical and research purposes. ICD defines the universe of diseases, disorders, injuries, and other health conditions.

:: They also agreed to recognize patient safety as a key health priority and to take concerted action to reduce patient harm in healthcare settings. An estimated 134 million adverse events occur annually due to unsafe care in hospitals in low- and middle-income countries, contributing to 2.6 million deaths.

:: The countries also adopted a resolution to improve safe water, sanitation, and hygiene (WASH) services in health facilities around the world. To prevent the spread of infections, reduce maternal and newborn deaths, and achieve universal health coverage, the resolution urges Member States to prioritize WASH interventions for safer health care worldwide.

:: A resolution was adopted urging Member States to strengthen infection prevention and control measures including water sanitation and hygiene; enhance participation in the Global Antimicrobial Surveillance System; ensure prudent use of quality-assured antimicrobials; and support the multisectoral annual self-assessment survey.

:: The countries approved a new global strategy on health, environment and climate change, which provides a vision and way forward on how the world needs to respond to environmental health risks and challenges until 2030. They also agreed on a plan of action on climate change and health in small island developing states.

:: Among others, the delegations adopted a resolution to accelerate and scale up action to prevent and treat noncommunicable diseases, primarily cancer, diabetes and heart and lung diseases, and to meet global targets to reduce the number of people who die too young from these diseases. .

28 May 2019 WHO News release
World Health Assembly Update, 28 May 2019
Access to medicines
The World Health Assembly today adopted a resolution on improving the transparency of markets for medicines, vaccines and other health products in an effort to expand access.
The resolution urges Member States to enhance public sharing of information on actual prices paid by governments and other buyers for health products, and greater transparency on pharmaceutical patents, clinical trial results and other determinants of pricing along the value chain from laboratory to patient.

It requests the WHO secretariat to support efforts towards transparency and monitor the impact of transparency on affordability and availability of health products, including the effect of differential pricing.

The aim is to help Member States to make more informed decisions when purchasing health products, negotiate more affordable prices and ultimately expand access to health products for the populations.

Assuring access to medicines is key to advancing universal health coverage. Member States also expressed wide support for the WHO Access Roadmap for Medicines, Vaccines and other health products, which will determine WHO’s work on this issue for the next five years.

Nagoya Protocol
The Health Assembly requested the Director-General to broaden engagement with Member States, the Secretariat of the Convention on Biological Diversity, relevant international organizations and relevant stakeholders, to provide information on current pathogen-sharing practices and arrangements, the implementation of access and benefit-sharing measures, as well as the potential public health outcomes and other implications. The request followed a review of the WHO’s Secretariat’s report on the public health implications of implementation of the Nagoya Protocol, an international agreement on access to genetic resources and the fair and equitable sharing of benefits arising from their utilization.

27 May 2019 WHO News release
World Health Assembly Update, 27 May 2019
Member States have agreed a five-year global action plan to promote the health of refugees and migrants. The plan focuses on achieving universal health coverage – and the highest attainable standard of health – for refugees and migrants and for host populations.

The plan includes short and long-term steps to mainstream refugee and migrant health care; enhance partnerships;  strengthen health monitoring and information systems and counter misperceptions about migrant and refugee health.

Member States are requesting that the Director-General report back on progress at the 74th World Health Assembly. Reports to the 74th and 76th World Health Assemblies will also include information provided by Member States on a voluntary basis, and UN agencies as appropriate.

Globally, the number of international migrants has grown. During the period 2000–2017, the total number of international migrants rose from 173 million to 258 million, an increase of 49%. The number of forcibly displaced people, 68.5 million, is also the highest ever, and includes 25.4 million refugees. Ten million stateless people lack a nationality and access to basic rights such as education, health care, employment and freedom of movement.

72nd session of the World Health Assembly
20-28 May 2019, Geneva
Main documents

Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 15 May 2019
:: Health leaders at the World Health Assembly last week in Geneva, Switzerland, welcomed the new Polio Endgame Strategy 2019-2023, and acknowledged that while a lot had been accomplished, more efforts were needed in order to achieve a lasting polio-free world by 2023.

:: Following the group’s meeting earlier this month, the latest report of the International Health Regulations (IHR) Emergency Committee is available.  The Committee evaluated the latest global poliovirus epidemiology and concluded that the effort to eradicate polio remained a Public Health Emergency of International Concern (PHEIC).  More.

:: In Cameroon, a circulating vaccine-derived poliovirus type 2 (cVDPV2) was detected from an environmental sample collected on 20 April 2019 in Extreme Nord.  The virus was detected in an environmental sample only – no associated cases of paralysis have been detected.

Summary of new viruses this week:
:: Pakistan – two wild poliovirus type 1 (WPV1) cases and six WPV1-positive environmental samples;
:: Afghanistan – one WPV1-positive environmental sample; Nigeria – two circulating vaccine-derived poliovirus type 2 (cVDPV2)-positive environmental samples;
:: Somalia – one cVDPV2 case;
:: Cameroon – one cVDPV2-positive environmental sample; and, Iran – one WPV1-positive environmental sample.

Polio: Statement of the Twenty-first IHR Emergency Committee
Regarding the International Spread of Poliovirus
29 May 2019 Statement Geneva
The twenty-first meeting of the Emergency Committee under the International Health Regulations (2005) (IHR) regarding the international spread of poliovirus was convened by the Director-General on 14 May 2019 at WHO headquarters with members, advisers and invited Member States attending via teleconference, supported by the WHO secretariat.

The Emergency Committee reviewed the data on wild poliovirus (WPV1) and circulating vaccine derived polioviruses (cVDPV). The Secretariat presented a report of progress for affected IHR States Parties subject to Temporary Recommendations. The following IHR States Parties provided an update on the current situation and the implementation of the WHO Temporary Recommendations since the Committee last met on 19 February 2019: Afghanistan, DR Congo, Indonesia, Nigeria, Pakistan and Somalia.

The committee commended all countries that presented on the quality of information provided, and the transparency with which countries discussed their challenges.

Wild poliovirus
The Committee is gravely concerned by the significant further increase in WPV1 cases globally in 2019, particularly in Pakistan where 15 cases have already been reported. In Pakistan transmission continues to be widespread, as indicated by the number of positive environmental isolates in many areas of the country, and the proportion of samples that detect WPV1 is rising. The recent cluster of cases in Lahore also indicates that vulnerabilities still exist outside the high-risk corridors. Notably, the increased rate of infection during what is usually the low season may herald even higher rates of infection in the coming high season unless urgent remedial steps are taken. The committee was very concerned about attacks on vaccinators and on the police protecting them. The increasing refusal by individuals and communities to accept vaccination also needs to be actively addressed. While the committee understood that the recent elections and political transition may have adversely affected delivery of the polio program, it is now essential that the new government renews its efforts, noting that the eradication program in the country is no longer on-track.

Highlighting these concerns, the committee noted the recent detection of WPV1 in sewage in Iran in an area close to the international border with Pakistan. Based on genetic sequencing, the virus is most closely linked to viruses found recently in Karachi, Pakistan. While there is no evidence currently that transmission has occurred in Iran and routine immunization coverage is high there, this finding together with the resumption of WPV1 international spread between Pakistan and Afghanistan suggests that rising transmission in Pakistan correlates with increasing risk of WPV1 exportation beyond the single epidemiological block formed by the two countries. The Iran event is the first such exportation detected since 2014 and signals that the hard fought gains of recent years can easily be reversed…

Vaccine derived poliovirus 
The multiple cVDPV2 outbreaks on the continent of Africa are as concerning as the WPV1 situation in Asia. The emergence of new strains of cVDPV2 in areas where mOPV2 has been used, the recent spread of cVDPV2 into southern Nigeria, including the densely populated Lagos region, and evidence of missed transmission in Nigeria and Somalia suggests that the situation continues to deteriorate. Insufficient coverage with IPV exacerbates the growing vulnerability on the continent to cVDPV2 transmission. Early detection of any international spread from the five currently infected countries and prioritized use of mOPV2 is essential to mitigate further depletion of the limited mOPV2 supply. Repeatedly, cases have occurred in border districts (in Nigeria, close to Benin, in DR Congo close to Angola, in Somalia, close to Ethiopia, and in Mozambique, close to Malawi)…

Conclusion
The Committee unanimously agreed that the risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC) and recommended the extension of Temporary Recommendations for a further three months. The Committee considered the following factors in reaching this conclusion:

Rising risk of WPV1 international spread: The progress made in recent years appears to be reversing, with the committee’s assessed risk of international spread the highest since 2014 when the PHEIC was declared. This risk assessment is based on the following:
:: the first WPV1 exportation outside of the single epidemiological block of Afghanistan and Pakistan since 2014;
:: rising number of WPV1 cases in Pakistan;
:: rising proportion of environmental samples that are positive for WPV1 in Afghanistan and Pakistan;
:: widespread detection of WPV1 in Pakistan in environmental samples;
:: clusters of cases in areas not considered high risk such as Lahore;
:: the fact that all of these observations have been made during the part of the year normally considered as low transmission season;
:: increasing community and individual resistance to the polio program.

Rising risk of cVDPV spread: The newly emerged strains of cVDPV2 in Nigeria and DR Congo, and the increased number of infected states / provinces in these two countries, together with evidence of missed transmission in Nigeria, Somalia and Indonesia also suggests the risk of international spread of cVDPV, especially type 2, is rising.

Falling PV2 immunity: Global population immunity to type 2 polioviruses (PV2) continues to fall, as the cohort of children born after OPV2 withdrawal grows, exacerbated by poor coverage with IPV particularly in some of the cVDPV infected countries. Protracted outbreaks: The difficulty in rapidly controlling cVDPV outbreaks in Nigeria and DR Congo is another risk.

Weak routine immunization: Many countries have weak immunization systems that can be further impacted by various humanitarian emergencies, and the number of countries in which immunization systems have been weakened or disrupted by conflict and complex emergencies poses a growing risk, leaving populations in these fragile states vulnerable to outbreaks of polio.

Surveillance gaps: The appearance of highly diverged VDPVs in Somalia and Indonesia are examples of inadequate polio surveillance, heightening concerns that transmission could be missed in various countries. Similar gaps exist in Lake Chad countries and around the Horn of Africa.

Lack of access: Inaccessibility continues to be a major risk, particularly in several countries currently infected with WPV or cVDPV, i.e. Afghanistan, Nigeria, Niger, Somalia and Papua, Indonesia, which all have sizable populations that have been unreached with polio vaccine for prolonged periods.

Population movement: The risk is amplified by population movement, whether for family, social, economic or cultural reasons, or in the context of populations displaced by insecurity and returning refugees. There is a need for international coordination to address these risks. A regional approach and strong cross-border cooperation is required to respond to these risks, as much international spread of polio occurs over land borders….

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

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 1 Jun 2019]

Democratic Republic of the Congo
:: Major cholera vaccination campaign begins in North Kivu in the Democratic Republic of the Congo 27 May 2019
:: 43: Situation report on the Ebola outbreak in North Kivu 28 May2019
:: Disease Outbreak News (DONs) Ebola virus disease – Democratic Republic of the Congo
30 May 2019
[See Ebola DRC above for detail]

South Sudan
:: In South Sudan, grandmothers breastfeed malnourished grandchildren 28 May 2019
:: The Government of Japan and WHO donate six ambulances to boost health service delivery in South Sudan 28 May 2019

Yemen
:: Donations from Saudi Arabia and United Arab Emirates provide access to health care for millions in Yemen
27 May 2019, Aden/Sana’a — The World Health Organization (WHO) expressed its gratitude to Saudi Arabia and United Arab Emirates for a grant of US$ 20 million, which will support ongoing efforts to stop the spread of cholera in Yemen…

Bangladesh – Rohingya crisis – No new digest announcements identified
Mozambique floods – No new digest announcements identified
Myanmar – No new digest announcements identified
Nigeria – No new digest announcements identified
Somalia – No new digest announcements identified
Syrian Arab Republic – No new digest announcements identified

::::::

WHO Grade 2 Emergencies [to 1 Jun 2019]

Libya
:: Photo essay: WHO emergency teams at work in Libya 26 May 2019

occupied Palestinian territory
:: The Gaza trauma response: One-year analysis of trauma injuries in Gaza 29 May 2019
:: Overcoming barriers to health care access in the West Bank with mobile clinics 27 May 2019

Brazil (in Portugese) – No new digest announcements identified
Cameroon – No new digest announcements identified
Central African Republic – No new digest announcements identified
Cyclone Idai – No new digest announcements identified
Ethiopia – No new digest announcements identified
Iran floods 2019 – No new digest announcements identified
Iraq – No new digest announcements identified
Malawi floods – No new digest announcements identified
MERS-CoV – No new digest announcements identified
Niger – 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 1 Jun 2019]

Afghanistan – No new digest announcements identified
Angola – No new digest announcements identified
Chad – No new digest announcements identified
Djibouti – No new digest announcements identified
Indonesia – Sulawesi earthquake 2018 – 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
:: Syria: Situation Report 3: Recent Developments in Northwestern Syria (as of 31 May 2019)
HIGHLIGHTS
:: Over the past week, airstrikes, shelling and ground fighting intensified across the demilitarized zone in northwest Syria, exacerbating the impact of the conflict on civilians, civilian infrastructure, and humanitarian service provision in northern Hama, southern Idleb, and western Aleppo governorates.
:: Almost 270,000 displacements from northern Hama and southern Idleb governorates were recorded between 1 and 22 May.
:: A total of 24 health facilities, 35 schools, four facilities providing protection services, three IDP settlements, and one refugee camp were reportedly affected by hostilities in recent weeks…

:: Syria: Humanitarian Response in Al Hol camp, Situation Report No. 4 – As of 29 May 2019 [EN/AR]

Yemen – No new digest announcements identified

::::::

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

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

WHO & Regional Offices [to 1 Jun 2019]
29 May 2019 News release
WHO highlights huge scale of tobacco-related lung disease deaths

::::::

Weekly Epidemiological Record, 31 May 2019, vol. 94, 22/23 (pp. 261–280)
Meeting of the Strategic Advisory Group of Experts on immunization, April 2019 – conclusions and recommendations

::::::

WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: WHO welcomes end of emergency phase of the 2019 Lassa fever outbreak but calls on partners to remain mobilized 01 June 2019
:: The Regional Commission for the Verification of Measles Elimination reviewed the progress from five countries 31 May 2019
:: Ethiopia promotes effective early childhood interventions to ensure all children survive, develop and reach their full potential 31 May 2019
:: Over 18 million dollars spent to prepare for Ebola Virus Disease in Uganda 30 May 2019
:: Major cholera vaccination campaign begins in North Kivu in the Democratic Republic of the Congo 27 May 2019
:: Strengthening Zimbabwe’s capacity for supply chain logistics management during Public Health Emergencies 27 May 2019
:: Meeting of the AFRO 11 project National Steering Committee to strengthen national capacity for innovative implementation of IVM for disease prevention and control 27 May 2019

WHO Region of the Americas PAHO
:: Tobacco kills one person every 34 seconds in the Americas (05/30/2019)
:: 72nd World Health Assembly Closes with Adoption of Resolutions on Public Health Topics (05/28/2019)
:: Individuals and organizations from across the Americas to receive WHO World No Tobacco Day Award  (05/28/2019)
:: Delegations adopted resolutions on patient safety, emergency and trauma care, water and sanitation, and on the ICD-11 (05/27/2019)

WHO South-East Asia Region SEARO
No new digest content identified.

WHO European Region EURO
:: WHO honours tobacco control champions in the European Region 31-05-2019
:: 90% of lung cancers can be avoided by eliminating tobacco use, new WHO report reveals 29-05-2019

WHO Eastern Mediterranean Region EMRO
:: WHO declares countries measles and rubella free
Amman, Jordan, 28 May 2019 – The Regional Verification Commission for Measles and Rubella Elimination (RVC) in the Eastern Mediterranean Region has declared that measles and rubella have been eliminated from both Bahrain and Oman, and that Islamic Republic of Iran has eliminated rubella and is about to eliminate measles. The RVC met in Amman, Jordan, on 15–16 May 2019 to…

WHO Western Pacific Region
No new digest content identified.

CDC/ACIP [to 1 Jun 2019]
http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html
Thursday, May 30, 2019
U.S. measles cases in first five months of 2019 surpass total cases per year for past 25 years
Today, CDC is reporting 971 cases of measles in the United States thus far in 2019.  This is the greatest number of cases reported in the U.S. since 1992, when 963 cases were reported for the entire year.
CDC continues to work with affected state and local health departments to get ongoing outbreaks under control.
“Measles is preventable and the way to end this outbreak is to ensure that all children and adults who can get vaccinated, do get vaccinated. Again, I want to reassure parents that vaccines are safe, they do not cause autism. The greater danger is the disease the vaccination prevents,” said CDC Director Dr. Robert Redfield, M.D. “Your decision to vaccinate will protect your family’s health and your community’s well-being. CDC will continue working with public health responders across our nation to bring this outbreak to an end.”
Outbreaks in New York City and Rockland County, New York have continued for nearly 8 months.  If these outbreaks continue through summer and fall, the United States may lose its measles elimination status. That loss would be a huge blow for the nation and erase the hard work done by all levels of public health.  The measles elimination goal, first announced in 1966 and accomplished in 2000, was a monumental task. Before widespread use of the measles vaccine, an estimated 3 to 4 million people got measles each year in the United States, along with an estimated 400 to 500 deaths and 48,000 hospitalizations…

MMWR News Synopsis for Friday, May 31, 2019
Scaling Up Testing for Human Immunodeficiency Virus Infection Among Contacts of Index Patients — 20 Countries, 2016–2018
Index testing is an HIV case-finding strategy targeting the exposed contacts of HIV-positive people for HIV testing. With an HIV positive rate that is more than twice that of all HIV testing approaches combined, index testing was found to be a more efficient approach to HIV case finding.
A new report summarizes data on the index testing approach in 20 countries supported by CDC through the President’s Emergency Plan for AIDS Relief during October 1, 2016–March 31, 2018. During this period, the index testing approach led to more than 1.7 million HIV tests. The positivity rate for index testing was 9.8% among adults aged 15 and older and 1.5% among children younger than 15. Scale-up of index testing could help increase the number of HIV-positive people who know their status and receive antiretroviral treatment, and as a result, reduce the number of people who can transmit the virus.

Using Social Media To Increase HIV Testing Among Men Who Have Sex with Men — Beijing, China, 2013–2017
Online technology such as social media platforms may be an effective way to promote HIV testing among hard-to-reach populations such as men who have sex with men (MSM), particularly in settings in which this population faces high levels of stigma.
In China, MSM bear a disproportionate burden of HIV infection, and stigmatization of same-sex behaviors presents challenges for HIV prevention and treatment efforts. Effective HIV testing in communities with a high risk of HIV infection is an entry point for an HIV response. “Blued” is a popular gay dating app with over 27 million Chinese registered users. Between 2015 and December 2017, to encourage HIV testing among MSM in Beijing, Blued launched an HIV testing campaign through its online promotion functionality and geolocation capabilities.. A sharp increase in HIV testing followed the campaign, indicating that leveraging social media platforms might be useful in increasing HIV testing among MSM, particularly young adult MSM.

Africa CDC [to 1 Jun 2019]
https://au.int/en/africacdc
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/
No new digest content identified.

Announcements

Paul G. Allen Frontiers Group [to 1 Jun 2019]
https://alleninstitute.org/what-we-do/frontiers-group/news-press/
No new digest content identified.

BMGF – Gates Foundation [to 1 Jun 2019]
http://www.gatesfoundation.org/Media-Center/Press-Releases
No new digest content identified.

Bill & Melinda Gates Medical Research Institute [to 1 Jun 2019]
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 1 Jun 2019]
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 1 Jun 2019]
http://cepi.net/
29 May 2019
CEPI partners with Brighton Collaboration to support safety assessment of vaccine candidates
The Safety Platform for Emergency vACcines (SPEAC) Project will harness the expertise of the Brighton Collaboration to help assess the safety of various CEPI-funded vaccine candidates undergoing clinical trials.

Clinton Health Access Initiative, Inc. (CHAI) [to 1 Jun 2019]
https://clintonhealthaccess.org/about/
No new digest content identified.

EDCTP [to 1 Jun 2019]
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
No new digest content identified.

Emory Vaccine Center [to 1 Jun 2019]
http://www.vaccines.emory.edu/
No new digest content identified.

European Medicines Agency [to 1 Jun 2019]
http://www.ema.europa.eu/ema/
News and press releases
29/05/2019
Meeting highlights from the Committee for Medicinal Products for Human Use (CHMP) 27-29 May 2019
[No vaccine act
ions]

European Vaccine Initiative [to 1 Jun 2019]
http://www.euvaccine.eu/news-events
No new digest content identified.

FDA [to 1 Jun 2019]
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
No new digest content identified.

Fondation Merieux [to 1 Jun 2019]
http://www.fondation-merieux.org/
Event
6th Annual Meeting of the Global Task Force on Cholera Control (GTFCC)
June 3 – 4, 2019 – Les Pensières Center for Global Health, Veyrier du Lac (France)

Gavi [to 1 Jun 2019]
https://www.gavi.org/
31 May 2019
Immunisation as a catalyst for women’s health, education, and economic empowerment
2019 Grassroots advocates and world leaders will gather in Vancouver, Canada, from 3-6 June for the Women Deliver conference to explore solutions to achieve a more gender equal world under the theme “Power. Progress. Change.” The meeting will be the world’s largest conference on gender equality and the health, rights, and wellbeing of girls and women. As a gender equal health intervention, immunisation plays a key role in keeping girls, adolescents and women healthy

Kingdom of Norway contributes NOK 600 million to IFFIm
29 May 2019

Major cholera vaccination campaign begins in North Kivu in the Democratic Republic of the Congo
27 May 2019
[See DRC Ebola/Cholera above for detail]

GHIT Fund [to 1 Jun 2019]
https://www.ghitfund.org/newsroom/press
GHIT was set up in 2012 with the aim of developing new tools to tackle infectious diseases that devastate the world’s poorest people. Other funders include six Japanese pharmaceutical
No new digest content identified.

Global Fund [to 1 Jun 2019]
https://www.theglobalfund.org/en/news/
No new digest content identified.

Hilleman Laboratories [to 1 Jun 2019]
http://www.hillemanlabs.org/
No new digest content identified.

Human Vaccines Project [to 1 Jun 2019]
http://www.humanvaccinesproject.org/media/press-releases/
No new digest content identified.

IAVI [to 1 Jun 2019]
https://www.iavi.org/newsroom
No new digest content identified.

IFFIm
http://www.iffim.org/library/news/press-releases/
29 May 2019
Kingdom of Norway contributes NOK 600 million to IFFIm
New donation will back Vaccine Bonds to fund CEPI’s fight against deadly diseases.
Geneva, 29 May 2019 – The Kingdom of Norway has agreed to donate NOK 600 million to the International Finance Facility for Immunisation (IFFIm). The donation is intended to support the Coalition for Epidemic Preparedness Innovation (CEPI). In a novel arrangement approved by Gavi, the Vaccine Alliance, IFFIm is planning to issue bonds on international capital markets, backed by the donation from Norway, which hosts CEPI…

IFRC [to 1 Jun 2019]
http://media.ifrc.org/ifrc/news/press-releases/
Selected Press Releases, Announcements
Media Advisory: Women Deliver Conference: Gender inequality in humanitarian crises, deadly gender divide in Ebola
Vancouver/Geneva, 31 May 2019 – The global head of the world’s largest humanitarian network will highlight the deadly consequences of gender inequality in the wake of disasters and conflicts, during a high-profile plenary session at the Women Deliver C …
31 May 2019

Bosnia and Herzegovina
Migrants in Bosnia and Herzegovina dying while seeking safety
Thousands of people trapped in Bosnia and Herzegovina desperately need humanitarian assistance and some are dying while trying to find shelter, says the International Federation of Red Cross and Red Crescent Societies (IFRC).
30 May 2019

Americas, Argentina
Major humanitarian conference to explore regional crises, migration
Buenos Aires/Panama/Geneva, 17 May 2018 – Red Cross leaders from across the Americas and around the world are gathering in Buenos Aires from 21-

IVAC [to 1 Jun 2019]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
No new digest content identified.

IVI [to 1 Jun 2019]
http://www.ivi.int/
IVI News & Announcements
New push to develop world’s first vaccine against the deadly Strep A bacteria killing hundreds of thousand
30 May 2019, SEOUL, South Korea – The International Vaccine Institute (IVI) and Australia’s Murdoch Children’s Research Institute (MCRI) will coordinate a global push to free the world of Group A Streptococcus (Strep A), the contagious bacteria that kills half a million people every year and is developing resistance to antibiotics.
The British biomedical research foundation, the Wellcome Trust, has granted $2.25 million to IVI and MCRI to coordinate world efforts to develop a vaccine against Strep A and find manufacturers…

IVI´s Board of Trustees welcomes new members at annual meeting
24 May 2019, SEOUL, Korea — The International Vaccine Institute (IVI) held its first face-to-face meeting of the Board of Trustees (BOT) for 2019 in Seoul, Korea on May 23-24. In addition to reviewing IVI’s achievements and activities of the past year, the Board discussed and delineated this year’s plans for further accelerating IVI’s growing impact on global health.
The meeting brought together 16 members or designees of the Board from around the globe, including Board Chairman Mr. George Bickerstaff, the Managing Director of M.M. Dillon & Co.; Dr. Jerome Kim, Director General of IVI; and representatives from IVI’s signatory countries. The Board also welcomed three new members:
Dr. Catharina Maijgren Steffensson, representing Sweden on the BOT, is currently the Associate Director/Medical Director Nordics at Sarepta Therapeutics. She has a solid background in gene therapy & HIV research and has previously worked at the Swedish International Development Agency (Sida) and Gilead.
Prof. Ziad Ahmed A. Memish, is currently a Professor at the College of Medicine, AlFaisal University; Senior Consultant, Infectious Diseases in the Department of Medicine and Director of the Research Department at Prince Mohamed Bin Abdulaziz Hospital in Saudi Arabia, and Adjunct Professor in the Hubert Department of Global Health Rollins School of Public Health, Emory University in the U.S. He has served as the Deputy Minister of Health for Public Health, with the Saudi Ministry of Health, and served on many national, regional and international boards including: Chairman of the Board of Directors of the Saudi Center for Disease Control and Prevention, and Member of the Executive Board of WHO and the Executive Council of International Society of Infectious Diseases.
  Dr. Anthony Ford-Hutchinson is currently a Board Member or Scientific Advisor to multiple startup companies, including the position of CSO of Rbonova Inc, as well as not for profit organizations, the Hepatitis B Foundation, SAGE Bionetworks, the Wellcome Trust, CARB-X and CEPI. He has over 40 years of experience in pharmaceuticals, including an extensive tenure at Merck & Co with positions including Executive Vice President of Basic Research and Senior Vice President of Vaccine R&D…

JEE Alliance [to 1 Jun 2019]
https://www.jeealliance.org/
Selected News and Events
No new digest content identified.

MSF/Médecins Sans Frontières [to 1 Jun 2019]
http://www.msf.org/
Selected News; Project Updates, Reports
Yemen
A day treating wounded in Yemen’s Al Salakhana hospital
Project Update 30 May 2019

DRC Ebola outbreaks
Crisis update – May 2019
Crisis Update 30 May 2019

Honduras
MSF expands efforts to control dengue epidemic in northern Honduras
Project Update 29 May 2019

Ethiopia
Bringing healthcare to places where no health posts exist
Project Update 27 May 2019

NIH [to 1 Jun 2019]
http://www.nih.gov/news-events/news-releases
May 29, 2019
Experimental drug completely effective against Nipah virus infection in monkeys
— Nipah virus can cause neurological and respiratory disease; the mortality rate is about 70%.

The Human Microbiome Project expands the toolbox for studying host and microbiome interactions
May 29, 2019 — New studies provide a framework for future studies of the role of the microbiome in health and disease.

PATH [to 1 Jun 2019]
https://www.path.org/media-center/
May 30, 2019 by PATH
New diagnostic will help propel development of improved malaria tests and support surveillance
Seattle, WA, and Logan, UT, May 30, 2019—PATH and Quansys Biosciences, Inc. have announced the launch of a new diagnostic tool designed to help researchers develop more sensitive and reliable malaria rapid diagnostic tests (RDTs) and to support public health surveillance. The Q-Plex™ Human Malaria Array (5-Plex) is a quantitative immunoassay that simultaneously measures multiple malaria antigens.
With almost half of the world’s population at risk for malaria and more than 200 million cases annually, the disease is a public health priority. Accurate diagnostics are critical to both disease management and public health surveillance. RDTs are a critical tool in malaria case management, particularly in remote settings, providing access to prompt diagnosis…

Sabin Vaccine Institute [to 1 Jun 2019]
http://www.sabin.org/updates/pressreleases
No new digest content identified.

UNAIDS [to 1 Jun 2019]
http://www.unaids.org/en
Selected Press Releases/Reports/Statements
31 May 2019
The little-known links between cervical cancer and HIV

29 May 2019
Voluntary medical male circumcision accelerating in Malawi

UNICEF [to 1 Jun 2019]
https://www.unicef.org/media/press-releases
Selected Statements, Press Releases, Reports
Statement
Joint statement: 1 UN for family leave and childcare
31/05/2019

Statement
UNICEF Executive Director Henrietta Fore gives remarks during the Third International Conference on Safe Schools
As delivered
28/05/2019

Press release
Attack in Taiz leaves 7 children dead, brings total child casualties in Yemen to 27 in just over 10 days
Statement by UNICEF Executive Director Henrietta Fore
26/05/2019

Vaccine Confidence Project [to 1 Jun 2019]
http://www.vaccineconfidence.org/
Posted on 28 May 2019
Article pick of the Week: How the anti-vaccine movement crept into the GOP mainstream
Published in POLITICO    27 May 2019 By Arthur Allen
The anti-vaccine movement, which swelled with discredited theories that blamed vaccines for autism and other ills, has morphed and grown into a libertarian political rebellion that is drawing in state…

Vaccine Education Center – Children’s Hospital of Philadelphia [to 1 Jun 2019]
http://www.chop.edu/centers-programs/vaccine-education-center
No new digest content identified.

Wellcome Trust [to 1 Jun 2019]
https://wellcome.ac.uk/news
News | 31 May 2019
Wellcome updates open access policy to align with cOAlition S
Following a large consultation, we have updated our open access (OA) policy so it now aligns with Plan S. The changes will apply from 1 January 2021.

The Wistar Institute [to 1 Jun 2019]
https://www.wistar.org/news/press-releases
No new digest content identified.

World Organisation for Animal Health (OIE) [to 1 Jun 2019]
http://www.oie.int/en/for-the-media/press-releases/2019/
No new digest content identified.

::::::

BIO [to 1 Jun 2019]
https://www.bio.org/insights/press-release
May 31 2019
BIO Releases 5th Annual Emerging Therapeutic Company Trend Report Showing Record Year for Venture Capital Funding
Washington, D.C. (May 31, 2019) – Today, the Biotechnology Innovation Organization (BIO) released the 2019 Emerging Therapeutic Company Trend Report, highlighting ten years (2009-2018) of biotechnology funding and deal making across five areas: venture capital, Initial Public Offerings (IPOs), follow-on public offerings, licensing, and acquisitions. The report also contains a 2019 snapshot of the industry’s clinical pipeline to highlight the significant contribution of emerging companies.

May 29 2019
BIO Honors Dr. Emil D. Kakkis with 2019 Henri A. Termeer Biotechnology Visionary Award
BIO announces the winner of this year’s Henri A. Termeer Biotechnology Visionary Award: Emil D. Kakkis, MD, PhD, President and Chief Executive Officer, Ultragenyx (NASDAQ: RARE) and Founder, EveryLife Foundation for Rare Diseases. The award, which will be presented to Dr. Kakkis on June 5 during the BIO 2019 International Convention keynote session, recognizes Dr. Kakkis’ transformative work to accelerate research and development of novel treatments for rare diseases.

DCVMN – Developing Country Vaccine Manufacturers Network [to 1 Jun 2019]
http://www.dcvmn.org/
News
LG Chem received a $33.4 million grant from the Bill & Melinda Gates Foundation to develop a 6-in-1 combination vaccine to prevent childhood diseases

IFPMA [to 1 Jun 2019]
http://www.ifpma.org/resources/news-releases/
No new digest content identified.

PhRMA [to 1 Jun 2019]
http://www.phrma.org/press-room
No new digest content identified.

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

American Journal of Infection Control
June 2019 Volume 47, Issue 6, p601-734
http://www.ajicjournal.org/currentMajor Articles

Major Articles
Consumer knowledge and attitudes toward public reporting of health care–associated infection data
Philip L. Russo, Robin Digby, Tracey Bucknall
p656–660
Published online: January 10, 2019

American Journal of Infection Control
June 2019 Volume 47, Issue 6, p601-734
http://www.ajicjournal.org/currentMajor Articles

State of the Science Review
Dissemination and implementation science for infection prevention: A primer
Heather M. Gilmartin, Amanda J. Hessels
p688–692
Published online: March 5, 2019

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 1 Jun 2019)

Research article
Immune persistence 17 to 20 years after primary vaccination with recombination hepatitis B vaccine (CHO) and the effect of booster dose vaccination
To assess the immune persistence conferred by a Chinese hamster ovary (CHO)-derived hepatitis B vaccine (HepB) 17 to 20 years after primary immunization during early life.
Authors: Yu-Liang Zhao, Bi-Hua Han, Xin-Jiang Zhang, Lu-Lu Pan, Hai-Song Zhou, Zhao Gao, Zhi-Yong Hao, Zhi-Wei Wu, Tian-Li Ma, Feng Wang, Qi Li, Sheng-Li Bi and Jing-Chen Ma
Citation: BMC Infectious Diseases 2019 19:482
Published on: 30 May 2019

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 1 Jun 2019)

Research article
Oral and anal high-risk human papilloma virus infection in HIV-positive men who have sex with men over a 24-month longitudinal study: complexity and vaccine implications
Few studies focused on longitudinal modifications over time of high-risk HPV (HR-HPV) at anal and oral sites in HIV+ men who have sex with men (MSM).
Authors: Saverio Giuseppe Parisi, Monica Basso, Renzo Scaggiante, Samantha Andreis, Carlo Mengoli, Mario Cruciani, Claudia Del Vecchio, Nicola Menegotto, Daniela Zago, Loredana Sarmati, Massimo Andreoni and Giorgio Palù
Citation: BMC Public Health 2019 19:645
Published on: 28 May 2019

Bulletin of the World Health Organization
Volume 97, Number 6, June 2019, 377-440
https://www.who.int/bulletin/volumes/97/6/en/

EDITORIALS
Health systems research in fragile settings
— Alastair Ager, Shadi Saleh, Haja Wurie & Sophie Witter
http://dx.doi.org/10.2471/BLT.19.233965
Population health indicators have improved in recent decades. Deaths in children younger than five years have declined from over 16 million in 1970 to around 5 million in 2016¹ and life expectancy at birth has increased from 58 to over 70 years in the same period.²
However, a major constraint to such progress, and in some contexts a potential source of reversal, is fragility. Of the 10 countries with the highest rates of infant mortality, seven are classified as fragile states. Of the 20 countries with the weakest progress on reducing maternal mortality from 1990 to 2015, 14 were fragile.³ However, fragility is increasingly recognized as a phenomenon that is not limited to countries that meet the profile of fragile and conflict-affected states.⁴ Of those countries that currently meet the Organisation for Economic Cooperation and Development criteria of experiencing significant fragility, comprising political, societal, economic, environmental and security dimensions of instability, almost half are middle-income countries.⁵
A better understanding of the implications of health-care provision in contexts of fragility is necessary. We have, therefore, established a research unit on health in situations of fragility at Queen Margaret University, Edinburgh, Scotland. This unit is supported by the National Institute for Health Research and builds on the experiences of several institutions in post-conflict health reconstruction strategy, recovery from the Ebola virus disease outbreak in West Africa and response to political instability in the Eastern Mediterranean Region. In our analysis of how the concept of fragility is used in the global health literature, we found that fragility is most often used to describe the circumstances of states or their public health systems; however, it also increasingly addresses the relationship with communities. Where the state’s agenda and communities’ needs are poorly aligned, the strained or ruptured relationship between the two has direct implications for health.
Understanding the weaknesses of health systems and how systems strengthening strategies may address these weaknesses must remain a core component of any approach to secure improvements in population health. However, in contexts of fragility, a key focus is needed on threats to the interface between public health provision and community processes. This exercise inevitably requires a systems for health approach⁶ that sees community, civil society, private sector actors and the state as key agents within a complex system adjusting to the prevailing drivers of fragility.
Earlier work on health systems resilience in contexts of fragility^7,8 repeatedly pointed to the importance of this interface with communities. We are now exploring this further in three countries: El Salvador, Lebanon and Sierra Leone. In each setting, our focus is on the prevention and treatment of noncommunicable diseases and mental health and psychosocial support. Providing a response to these health needs requires an effective connection over time between diverse service providers, patients, carers and communities.
Scoping reviews in each of these fragile settings have identified recurrent challenges at this interface. When fragile settings experience acute shocks, there is a risk that the surge of local provision supported by international agencies will not strengthen health systems in the long-term. Lack of knowledge of available services, uncertain or restricted access, financial barriers or perceptions of health-care settings not constituting a safe place are also repeatedly identified across fragile settings at the community-service interface.⁹
Participatory group model building¹⁰ is a promising method for exploring the connections between the various actors of the systems for health in these fragile settings, and for identifying potential strategies to make these actors’ engagement more effective. Policy-level and health systems interventions are clearly relevant, but it is at the interface of public health provision and community processes that major barriers persist.
Mapping of social connection and trust¹¹ can also clarify key processes supporting or inhibiting engagement within and between communities and health services in contexts of fragility.
We plan to develop a series of studies of strategic interventions designed to secure high-quality and accessible service provision in contexts of fragility. Therefore, we encourage other researchers to engage in this framing of strategic health interventions in such settings. The core goal must be achieving forms of service design and community engagement that prove durable and effective in circumstances of fragility. To the extent that these strategies are effective in building trust and social connection between (and within) the state and local communities, they may also prove of value in addressing the drivers of fragility itself.¹²

Bulletin of the World Health Organization
Volume 97, Number 6, June 2019, 377-440
https://www.who.int/bulletin/volumes/97/6/en/

The Nagoya protocol and research on emerging infectious diseases
— Sascha Knauf, Lena Abel & Luisa K Hallmaier-Wacker
http://dx.doi.org/10.2471/BLT.19.232173

Bulletin of the World Health Organization
Volume 97, Number 6, June 2019, 377-440
https://www.who.int/bulletin/volumes/97/6/en/

Research
Comparison of essential medicines lists in 137 countries
— Nav Persaud, Maggie Jiang, Roha Shaikh, Anjli Bali, Efosa Oronsaye, Hannah Woods, Gregory Drozdzal, Yathavan Rajakulasingam, Darshanand Maraj, Sapna Wadhawan, Norman Umali, Ri Wang, Marcy McCall, Jeffrey K Aronson, Annette Plüddemann, Lorenzo Moja, Nicola Magrini & Carl Heneghan
http://dx.doi.org/10.2471/BLT.18.222448
Abstract
Objective
To compare the medicines included in national essential medicines lists with the World Health Organization’s (WHO’s) Model list of essential medicines, and assess the extent to which countries’ characteristics, such as WHO region, size and health care expenditure, account for the differences.
Methods
We searched the WHO’s Essential Medicines and Health Products Information Portal for national essential medicines lists. We compared each national list of essential medicines with both the 2017 WHO model list and other national lists. We used linear regression to determine whether differences were dependent on WHO Region, population size, life expectancy, infant mortality, gross domestic product and health-care expenditure.
Findings
We identified 137 national lists of essential medicines that collectively included 2068 unique medicines. Each national list contained between 44 and 983 medicines (median 310: interquartile range, IQR: 269 to 422). The number of differences between each country’s essential medicines list and WHO’s model list ranged from 93 to 815 (median: 296; IQR: 265 to 381). Linear regression showed that only WHO region and health-care expenditure were significantly associated with the number of differences
Conclusion
The substantial differences between national lists of essential medicines are only partly explained by differences in country characteristics and thus may not be related to different priority needs. This information helps to identify opportunities to improve essential medicines lists.

Emerging Infectious Diseases
Volume 25, Number 6—June 2019
http://wwwnc.cdc.gov/eid/

Research
Assessment of Economic Burden of Concurrent Measles and Rubella Outbreaks, Romania, 2011–2012 [PDF – 720 KB – 9 pages]

Epidemics
Volume 27 Pages 1-132 (June 2019)
https://www.sciencedirect.com/journal/epidemics/vol/27/suppl/C

Research article Open access
Control of Ebola virus disease outbreaks: Comparison of health care worker-targeted and community vaccination strategies
Alexis Robert, Anton Camacho, W. John Edmunds, Marc Baguelin, … Rosalind M. Eggo
Pages 106-114

Epidemics
Volume 27 Pages 1-132 (June 2019)
https://www.sciencedirect.com/journal/epidemics/vol/27/suppl/C

Research article Open access
Efficient vaccination strategies for epidemic control using network information
Yingrui Yang, Ashley McKhann, Sixing Chen, Guy Harling, Jukka-Pekka Onnela
Pages 115-122

Epidemics
Volume 27 Pages 1-132 (June 2019)
https://www.sciencedirect.com/journal/epidemics/vol/27/suppl/C

Research article Open access
Efficient vaccination strategies for epidemic control using network information
Yingrui Yang, Ashley McKhann, Sixing Chen, Guy Harling, Jukka-Pekka Onnela
Pages 115-122

Epidemics
Volume 27 Pages 1-132 (June 2019)
https://www.sciencedirect.com/journal/epidemics/vol/27/suppl/C

Research article Open access
Analyzing and forecasting the Ebola incidence in North Kivu, the Democratic Republic of the Congo from 2018–19 in real time
Andrei R. Akhmetzhanov, Hyojung Lee, Sung-mok Jung, Taishi Kayano, … Hiroshi Nishiura
Pages 123-131

The European Journal of Public Health
Volume 29, Issue 3, June 2019
https://academic.oup.com/eurpub/issue/29/3

Infectious disease
Stronger responders—uptake and decline of HPV-vaccination in Denmark
Charlotte Lynderup Lübker; Elsebeth Lynge
European Journal of Public Health, Volume 29, Issue 3, June 2019, Pages 500–505, https://doi.org/10.1093/eurpub/cky235

The European Journal of Public Health
Volume 29, Issue 3, June 2019
https://academic.oup.com/eurpub/issue/29/3

Populist politics and vaccine hesitancy in Western Europe: an analysis of national-level data
Jonathan Kennedy
European Journal of Public Health, Volume 29, Issue 3, June 2019, Pages 512–516, https://doi.org/10.1093/eurpub/ckz004
… Results
There is a highly significant positive association between the percentage of people in a country who voted for populist parties and who believe that vaccines are not important (R = 0.7923, P = 0.007) and effective (R = 0.7222, P = 0.0035). The percentage of people who think vaccines are unsafe just misses being significant at the 5% level (R = 0.5027, P = 0.0669).
Conclusions
Vaccine hesitancy and political populism are driven by similar dynamics: a profound distrust in elites and experts. It is necessary for public health scholars and actors to work to build trust with parents that are reluctant to vaccinate their children, but there are limits to this strategy. The more general popular distrust of elites and experts which informs vaccine hesitancy will be difficult to resolve unless its underlying causes—the political disenfranchisement and economic marginalisation of large parts of the Western European population—are also addressed.

Health Research Policy and Systems
http://www.health-policy-systems.com/content
[Accessed 1 Jun 2019]

Commentary
|   29 May 2019
The intersections of industry with the health research enterprise
Authors: Elie A. Akl and Assem M. Khamis
Abstract
There is increased awareness of the negative impact of large multinational corporations – the ‘industry’ – on public health. These corporations have established different types of relationships with a number of actors in the field of health research. This Commentary explores the different types of relationships between the industry and the actors of health research, how they intersect with the different research steps, and how these relationships allow the industry to exert influence. The types of relationships discussed consist of funding of research, direct relationships with the actors of research (namely advocacy groups, funding agencies, experts, professional organisations, regulatory agencies and health practitioners), and the influencing research standards. The potentially influenced research steps either precede the research (i.e. the prioritisation of research question), relate to it directly (i.e. its planning, conduct, reporting, dissemination and evaluation), or build on it (i.e. regulatory approval, integration into guidelines and adoption into practice). In conclusion, the industry has successfully fostered relationships with almost every actor of the health research enterprise and is using these relationships to influence the different steps of health research. The degree of influence the industry is having on health research calls for more work on managing the relationships discussed herein.

Infectious Diseases of Poverty
http://www.idpjournal.com/content
[Accessed 1 Jun 2019]

Commentary
The 2017 Oslo conference report on neglected tropical diseases and emerging/re-emerging infectious diseases – focus on populations underserved
In 2017, the Centre for Global Health (CGH) at the University of Oslo in collaboration with the Coalition for Epidemic Preparedness Innovations (CEPI) and the Norwegian Agency for Development Cooperation (Nora…
Authors: Katharina Klohe, John Amuasi, Joyce Moriku Kaducu, Ingeborg Haavardsson, Ekaterina Bogatyreva, Kristine Husøy Onarheim, Wendy Harrison, Frederik Kristensen, Clarissa Prazeres da Costa and Andrea S. Winkler
Citation: Infectious Diseases of Poverty 2019 8:40
Published on: 28 May 2019

JAMA
May 28, 2019, Vol 321, No. 20, Pages 1953-2040
http://jama.jamanetwork.com/issue.aspx

Viewpoint
Safe Vaccinations for a Healthy Nation – Increasing US Vaccine Coverage Through Law, Science, and Communication
Lawrence O. Gostin, JD; Scott C. Ratzan, MD, MPA, MA; Barry R. Bloom, PhD
JAMA. 2019;321(20):1969-1970. doi:10.1001/jama.2019.4270
This Viewpoint discusses public distrust of vaccinations fueled by false information on vaccine safety spread through social media, and discusses the ways in which physicians, public health authorities, states, and social media platforms can help curb the spread of misinformation and instead provide information on the safety and importance of vaccines.

JAMA
May 28, 2019, Vol 321, No. 20, Pages 1953-2040
http://jama.jamanetwork.com/issue.aspx

Health Concerns in Urban SlumsA Glimpse of Things to Come?
Allen G. P. Ross, MD, PhD, DSc, FRCP(Edin), FRCPath, FACTM; Khalequ Zaman, MBBS, PhD; John D. Clemens, MD
free access
JAMA. 2019;321(20):1973-1974. doi:10.1001/jama.2019.3774
In this Viewpoint, authors from the International Center for Diarrheal Disease Research in Bangladesh discuss rapid urbanization in low- and middle-income countries and the associated challenges of meeting the basic health care needs of growing urban slum populations.

JAMA
May 28, 2019, Vol 321, No. 20, Pages 1953-2040
http://jama.jamanetwork.com/issue.aspx

Serving Individuals and Populations Within Integrated Health SystemsA Bridge Too Far?
Hamilton Moses III, MD; David H. M. Matheson, JD, MBA; George Poste, DVM, PhD, FRS
JAMA. 2019;321(20):1975-1976. doi:10.1001/jama.2019.2929
This Viewpoint discusses the realities that keep integrated health systems (IHSs) from providing a full range of patient care services from primary through quaternary care, and outlines strategic considerations important for IHS stakeholders to account for if they are to effectively serve their patient communities in a shifting technological and regulatory environment.

JAMA
May 28, 2019, Vol 321, No. 20, Pages 1953-2040
http://jama.jamanetwork.com/issue.aspx

Serving Individuals and Populations Within Integrated Health SystemsA Bridge Too Far?
Hamilton Moses III, MD; David H. M. Matheson, JD, MBA; George Poste, DVM, PhD, FRS
JAMA. 2019;321(20):1975-1976. doi:10.1001/jama.2019.2929
This Viewpoint discusses the realities that keep integrated health systems (IHSs) from providing a full range of patient care services from primary through quaternary care, and outlines strategic considerations important for IHS stakeholders to account for if they are to effectively serve their patient communities in a shifting technological and regulatory environment.

Journal of Adolescent Health
June 2019 Volume 64, Issue 6, p673-812
https://www.jahonline.org/issue/S1054-139X(18)X0008-1

Original Articles
Predictors of Human Papillomavirus Vaccine Completion Among Low-Income Latina/o Adolescents
Mary A. Gerend, Yesenia P. Stephens, Michelle M. Kazmer, Elizabeth H. Slate, Elena Reyes
p753–762
Published online: February 15, 2019

The Lancet
Jun 01, 2019 Volume 393Number 10187p2175-2274
https://www.thelancet.com/journals/lancet/issue/current

Comment
Offline: WHO—the story so far…
Richard Horton
… WHO is also opening up. Past Director-Generals have viewed the agency as a handmaiden to member states. They have been reluctant to strike out alone, to set agendas, and to challenge governments—they have been reluctant to lead. They have feared the backlash of countries suspicious of multilateral institutions, countries that can hold WHO hostage by threatening to withhold its budget. The agency has therefore become profoundly risk averse. But there is evidence of change. Tedros has invited critical voices to address usually austere Assembly delegates. This year, he gave a platform to 18-year-old Natasha Mwansa from Zambia, who insisted that whatever was to be discussed by Ministers of Health would not be delivered successfully without the full participation of young people. She spoke about the importance of education in unleashing the potential of nations—“Ignorance is the deadliest disease we can ever fight.” And Tedros himself spoke about issues that his predecessors have avoided. The importance of sexual and reproductive health and rights. The necessity of partnering with civil society. And finding ways to bypass member-state funding shortfalls through innovative financing mechanisms, such as a new WHO Foundation. He was explicit. WHO was now in the business of managing, not avoiding, risk…

The Lancet
Jun 01, 2019 Volume 393Number 10187p2175-2274
https://www.thelancet.com/journals/lancet/issue/current

Articles
Past, present, and future of global health financing: a review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995–2050
Comprehensive and comparable estimates of health spending in each country are a key input for health policy and planning, and are necessary to support the achievement of national and international health goals. Previous studies have tracked past and projected future health spending until 2040 and shown that, with economic development, countries tend to spend more on health per capita, with a decreasing share of spending from development assistance and out-of-pocket sources. We aimed to characterise the past, present, and predicted future of global health spending, with an emphasis on equity in spending across countries.
Global Burden of Disease Health Financing Collaborator Network
Open Access

The Lancet
Jun 01, 2019 Volume 393Number 10187p2175-2274
https://www.thelancet.com/journals/lancet/issue/current

Viewpoint
Trickle-down innovation and the longevity of nations
Dhruv Khullar, Josephine Fisher, Amitabh Chandra
The association between income and life expectancy is so robust and persistent across countries that it has a name, the Preston Curve, named after the economist who first described it. The strength of the association begs the question: must citizens of poorer countries wait for their economies to grow before they can expect to enjoy the life expectancies of wealthier nations? Or can longevity improve, even in the absence of economic gains? The answer has important implications for human wellbeing around the world.

The Lancet Child & Adolescent Health
Jun 2019 Volume 3Number 6p365-436, e4
https://www.thelancet.com/journals/lanchi/issue/current

Editorial
Partnership between health and education in early childhood
The Lancet Child & Adolescent Health

Lancet Infectious Diseases
Jun 2019 Volume 19 Number 6p559-670, e187-e224
http://www.thelancet.com/journals/laninf/issue/current

Editorial
Malaria vaccination: a major milestone
The Lancet Infectious Diseases

Lancet Infectious Diseases
Jun 2019 Volume 19 Number 6p559-670, e187-e224
http://www.thelancet.com/journals/laninf/issue/current

Comment
A step further in a vaccine for Escherichia coli
Florian ME Wagenlehner,
Kurt G Naber

Lancet Infectious Diseases
Jun 2019 Volume 19 Number 6p559-670, e187-e224
http://www.thelancet.com/journals/laninf/issue/current

Preparing for the next Ebola outbreak: in-country genomic capacity in Africa
Anise N Happi, Chinedu A Ugwu, Christian T Happi

Lancet Infectious Diseases
Jun 2019 Volume 19 Number 6p559-670, e187-e224
http://www.thelancet.com/journals/laninf/issue/current

The use of vaccines to safeguard patients with haematological malignancies
Onisillos Sekkides

Lancet Infectious Diseases
Jun 2019 Volume 19 Number 6p559-670, e187-e224
http://www.thelancet.com/journals/laninf/issue/current

Articles
Safety and immunogenicity of a vaccine for extra-intestinal pathogenic Escherichia coli (ESTELLA): a phase 2 randomised controlled trial
Robert W Frenck Jr. et al

Lancet Infectious Diseases
Jun 2019 Volume 19 Number 6p559-670, e187-e224
http://www.thelancet.com/journals/laninf/issue/current

2018 Ebola virus disease outbreak in Équateur Province, Democratic Republic of the Congo: a retrospective genomic characterisation
Placide Mbala-Kingebeni et al,

Lancet Infectious Diseases
Jun 2019 Volume 19 Number 6p559-670, e187-e224
http://www.thelancet.com/journals/laninf/issue/current

2018 Ebola virus disease outbreak in Équateur Province, Democratic Republic of the Congo: a retrospective genomic characterisation
Placide Mbala-Kingebeni et al,

Lancet Infectious Diseases
Jun 2019 Volume 19 Number 6p559-670, e187-e224
http://www.thelancet.com/journals/laninf/issue/current

Medical countermeasures during the 2018 Ebola virus disease outbreak in the North Kivu and Ituri Provinces of the Democratic Republic of the Congo: a rapid genomic assessment
Placide Mbala-Kingebeni et al

Lancet Infectious Diseases
Jun 2019 Volume 19 Number 6p559-670, e187-e224
http://www.thelancet.com/journals/laninf/issue/current

Series
Vaccination and haematological malignancies
Vaccination of patients with haematological malignancies who did not have transplantations: guidelines from the 2017 European Conference on Infections in Leukaemia (ECIL 7)
Malgorzata Mikulska et al, on behalf of the European Conference on Infections in Leukaemia group

Lancet Infectious Diseases
Jun 2019 Volume 19 Number 6p559-670, e187-e224
http://www.thelancet.com/journals/laninf/issue/current

Vaccination and haematological malignancies
Vaccination of haemopoietic stem cell transplant recipients: guidelines of the 2017 European Conference on Infections in Leukaemia (ECIL 7)
Catherine Cordonnier et al, on behalf of the European Conference on Infections in Leukaemia group

Lancet Infectious Diseases
Jun 2019 Volume 19 Number 6p559-670, e187-e224
http://www.thelancet.com/journals/laninf/issue/current

Personal View
Assessing a drug for an eradicated human disease: US Food and Drug Administration review of tecovirimat for the treatment of smallpox
Kirk M Chan-Tack et al

Nature
Volume 569 Issue 7758, 30 May 2019
http://www.nature.com/nature/current_issue.html

Perspective | 29 May 2019 | open
The Integrative Human Microbiome Project
Over ten years, the Human Microbiome Project has provided resources for studying the microbiome and its relationship to disease; this Perspective summarizes the key achievements and findings of the project and its relationship to the broader field.
Lita M. Proctor, Heather H. Creasy[…] & Curtis Huttenhower

Nature Genetics
Volume 51 Issue 6, June 2019
https://www.nature.com/ng/volumes/51/issues/5

Editorial | 31 May 2019
Pathogen genomics leading to vaccines
In the field of infectious diseases, genomics can be a useful tool for guiding vaccine development. Given the inevitability and increasing prevalence of antibiotic resistance, vaccines against pathogenic microbes can be even more valuable than antibiotics as a strategy to prevent serious or deadly infectious diseases. Genomic resources from global analysis of large numbers of clinical isolates can serve as a basis for identifying appropriate candidates for vaccine antigens, and we encourage continued efforts in the generation of pan-genome sequences for bacterial or viral pathogens