Announcements
 
 
BMGF – Gates Foundation  [to 26 Jan 2019]
http://www.gatesfoundation.org/Media-Center/Press-Releases
No new digest content identified.
 
 
Bill & Melinda Gates Medical Research Institute    [to 26 Jan 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 26 Jan 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 26 Jan 2019]
http://cepi.net/
22 Jan 2019
World Economic Forum press conference: CEPI – Building a Global Coalition to End Epidemics
This press conference visited the progress made and previewed the years ahead for CEPI to finance and coordinate the development of new vaccines to prevent and contain infectious disease epidemics.
The press conference was hosted by Richard Hatchett (CEO, CEPI), and he was joined by Paul Stoffels (Vice Chair of the Executive Committee and Chief Scientific Officer), Jeremy Farrar (Director, Wellcome Trust), Ryan Morhard (Project Lead, Global Health and Healthcare Industries, World Economic Forum), and Lydia Ogden (Associate Vice-President, Global Enterprise Policy, MSD).
The conference streamed live at 1130 (GMT) on Jan 22, 2019.
 
 
22 Jan 2019
UK pledges £10 million to support CEPI
UK has committed funds to support CEPI’s mission to develop new life-saving vaccines to combat emerging infectious diseases and prevent future epidemics
 
 
EDCTP    [to 26 Jan 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
Latest news
No new digest content identified.
 
 
Emory Vaccine Center    [to 26 Jan 2019]
http://www.vaccines.emory.edu/
No new digest content identified.
 
 
European Medicines Agency  [to 26 Jan 2019]
http://www.ema.europa.eu/ema/
News and press releases
No new digest content identified.
 
 
European Vaccine Initiative  [to 26 Jan 2019]
http://www.euvaccine.eu/news-events
24 January 2019
Training in vaccine research and development
3rd Call for TRANSVAC Training Modules now advertised

Three PhD fellowships within MMVC programme
22 January 2019
The Multi-Stage Malaria Vaccine Consortium (MMVC) offers 3 PhD Fellowships in Malaria Research
 
 
FDA [to 26 Jan 2019]
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
No new digest content identified.
 
 
Fondation Merieux  [to 26 Jan 2019]
http://www.fondation-merieux.org/
29 – 30 Jan 2019
Partner event
Global Vaccine Data Network meeting
Les Pensières Center for Global Health, Veyrier du Lac
 
 
Gavi [to 26 Jan 2019]
https://www.gavi.org/
No new digest content identified.
 
 
GHIT Fund   [to 26 Jan 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 26 Jan 2019]
https://www.theglobalfund.org/en/news/
25 January 2019
Measuring and Reporting Results
Smart, effective health investments through the Global Fund partnership have saved more than 27 million lives, and that remarkable success against the world’s deadliest infectious diseases could only be achieved by the collaborative efforts of many partners. We welcome all discussion and ideas on how best to measure and report the results of interventions in global health. Given the imperative to optimize impact from constrained resources – whether domestic or external – it is vital that we measure and communicate what’s working and what isn’t. Donors and domestic taxpayers want to know their money is being used to maximum effect. Implementers and technical partners need to know what to expand and what to modify.
 
 
Hilleman Laboratories   [to 26 Jan 2019]
http://www.hillemanlabs.org/
No new digest content identified.
 
 
Human Vaccines Project   [to 26 Jan 2019]
http://www.humanvaccinesproject.org/media/press-releases/
January 24, 2019
Welcoming Adaptive Biotechnologies’ Harlan Robins to Scientific Steering Committee
The Human Vaccines Project welcomes Harlan Robins, Ph.D., head of innovation and co-founder at Adaptive Biotechnologies, to the Project’s Scientific Steering Committee…
 
 
IAVI  [to 26 Jan 2019]
https://www.iavi.org/newsroom
No new digest content identified.
 
 
IFFIm
http://www.iffim.org/library/news/press-releases/
No new digest content identified.
 
 
IVAC  [to 26 Jan 2019]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
No new digest content identified.
 
 
IVI   [to 26 Jan 2019]
http://www.ivi.int/
IVI News & Announcements
No new digest content identified.
 
 
JEE Alliance  [to 26 Jan 2019]
https://www.jeealliance.org/
No new digest content identified.
 
 
MSF/Médecins Sans Frontières  [to 26 Jan 2019]
http://www.msf.org/
Selected News; Project Updates, Reports
 
Palestine
The challenge of filling gaps in the legs of Gaza’s wounded
Project Update 24 Jan 2019
 
Libya
Refugees returned to overcrowded Libyan detention centres
Project Update 23 Jan 2019
 
Mental health
Displaced and distressed: people’s mental health in East Africa
Project Update 22 Jan 2019
 
 
NIH  [to 26 Jan 2019]
http://www.nih.gov/news-events/news-releases
January 25, 2019
Investigational monoclonal antibody to treat Ebola is safe in adults
— Early-stage trial results show promise.
[See Milestones above for detail]
 
Wednesday, January 23, 2019
New fellowship program will support the next generation of African scientific leaders
NIH collaborates with African Academy of Sciences and Bill & Melinda Gates Foundation.
Dr. Michael Otto of NIH’s National Institute of Allergy and Infectious Diseases is hosting APTI fellow Dr. Nana Amissah of Ghana, who is studying Staphylococcus aureus.FIC/NIH
Ten African scientists have been selected for training at the National Institutes of Health as part of a new fellowship program to build research capacity in African countries and develop ongoing scientific partnerships. NIH, the African Academy of Sciences, and the Bill & Melinda Gates Foundation are collaborating to establish the African Postdoctoral Training Initiative.
The inaugural cohort will assume their positions in NIH host labs in early 2019. NIH will provide two years of training under principal investigators who share the fellows’ research interests. The African scientists will then return to their home institutions and receive two years of support to continue the research and establish themselves as independent investigators. NIH and the Gates Foundation are together providing about $4 million for the program…

Temperature-stable experimental tuberculosis vaccine enters clinical testing
January 23, 2019 — Tuberculosis remains the leading infectious cause of death worldwide.
Vaccinations have begun in a Phase 1 human clinical trial testing a freeze-dried, temperature-stable formulation of an experimental tuberculosis (TB) vaccine candidate. The trial is being conducted at the Saint Louis University School of Medicine Center for Vaccine Development and will enroll as many as 48 healthy adult volunteers aged 18 to 55 years. The experimental vaccine, called ID93, was developed by scientists at the Infectious Disease Research Institute (IDRI) in Seattle. The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, is supporting the trial through a contract to IDRI.
ID93 is a recombinant vaccine candidate made from four proteins of Mycobacterium tuberculosis (the bacterium that causes TB). Many vaccines require a temperature-controlled system during transport, which can be costly and logistically challenging. Freeze-dried powder vaccines can be distributed at a cheaper cost to remote, low-resource settings. The powder formulations are mixed with sterile water for administering with a needle and syringe…

Dengue immunity may be protective against symptomatic Zika, study finds
January 22, 2019 — Zika virus and dengue virus are both transmitted by Aedes aegypti mosquitoes and cause similar symptoms.
 
 
PATH  [to 26 Jan 2019]
https://www.path.org/media-center/
No new digest content identified.
 
 
Sabin Vaccine Institute  [to 26 Jan 2019]
http://www.sabin.org/updates/pressreleases
No new digest content identified.
 
 
UNAIDS [to 26 Jan 2019]
http://www.unaids.org/en
Selected Press Releases/Reports/Statements
No new digest content identified.
 
 
UNICEF  [to 26 Jan 2019]
https://www.unicef.org/media/press-releases
Selected Press Releases/Reports/Statements
Statement
UNICEF Statement on the situation in Venezuela
25/01/2019

Press release
More than 145,000 Rohingya refugee children return to school in Bangladesh refugee camps as new school year starts
24/01/2019

Statement
UNICEF statement on the impact of the ongoing turmoil and economic crisis on children in Sudan
Statement attributable to Geert Cappelaere, UNICEF Regional Director for the Middle East and North Africa
23/01/2019

Press release
Vital protection for refugee and migrant children making perilous sea journeys to Europe urgently needed – UNICEF
In first two weeks of 2019, more than 400 uprooted children reached European shores amid freezing temperatures and rough waters
 
 
Vaccine Confidence Project  [to 26 Jan 2019]
http://www.vaccineconfidence.org/
No new digest content identified.
 
 
Vaccine Education Center – Children’s Hospital of Philadelphia  [to 26 Jan 2019]
http://www.chop.edu/centers-programs/vaccine-education-center
No new digest content identified.
 
 
Wellcome Trust  [to 26 Jan 2019]
https://wellcome.ac.uk/news
Explainer | 22 January 2019
CEPI can develop new vaccines to fight epidemics – but it needs global funding
Developing new vaccines is challenging, costly and complex. The Coalition for Epidemic Preparedness Innovation (CEPI) is a new model for funding vaccine development which aims to change this.

News | 22 January 2019
Acting Director of Science announced
Mike Turner has been appointed Acting Director of Wellcome’s Science Division.
 
 
The Wistar Institute   [to 26 Jan 2019]
https://www.wistar.org/news/press-releases
Press Release    Jan. 24, 2019
Induction of Potent Anticancer Immunity Through Rapid Tumor Antigen Identification and Conversion to Personalized Synthetic DNA Vaccines
Custom synthetic DNA vaccines elicit efficacious killer T-cell responses that significantly delay tumor progression in lung and ovarian cancer preclinical models.
 
 
World Organisation for Animal Health (OIE)   [to 26 Jan 2019]
http://www.oie.int/en/for-the-media/press-releases/2018/
No new digest content identified.

::::::

BIO    [to 26 Jan 2019]
https://www.bio.org/insights/press-release
No new digest content identified.
 
 
DCVMN – Developing Country Vaccine Manufacturers Network  [to 26 Jan 2019]
http://www.dcvmn.org/
No new digest content identified.
 
 
IFPMA   [to 26 Jan 2019]
http://www.ifpma.org/resources/news-releases/
No new digest content identified.
 
 
PhRMA    [to 26 Jan 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

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 26 Jan 2019)

Research article
Epidemiological characteristics, clinical manifestations, and treatment outcome of 139 paediatric Ebola patients treated at a Sierra Leone Ebola treatment center
The West Africa Ebola Virus Disease (EVD) outbreak in 2014–2016 was declared by the World Health Organization (WHO) a public health emergency of international concern. Most of the previous studies done in Sier…
Authors: Jia Bainga Kangbai, Christian Heumann, Michael Hoelscher, Foday Sahr and Guenter Froeschl
Citation: BMC Infectious Diseases 2019 19:81
Published on: 24 January 2019
 

BMC Research Notes
http://www.biomedcentral.com/bmcresnotes/content
(Accessed 26 Jan 2019)

Research note
Health professionals’ willingness to pay and associated factors for human papilloma virus vaccination to prevent cervical cancer at College of Medicine and Health Sciences University of Gondar, Northwest Ethiopia
Preferences of health professionals’ for human papilloma virus vaccines was measured by monetary value through willingness to pay (WTP) approach that could help policy makers set priorities among alternative c…
Authors: Abebe Ayinalem Tarekegn and Ayenew Engida Yismaw
Citation: BMC Research Notes 2019 12:58
Published on: 24 January 2019

Clinical Trials
Volume 16 Issue 1, February 2019
https://journals.sagepub.com/toc/ctja/16/1

International Issues
Strategic inclusion of regions in multiregional clinical trials
Seung Yeon Song, Deborah Chee, EunYoung Kim
First Published November 16, 2018; pp. 98–105
Abstract
Background
With the recent publication of the International Conference on Harmonisation E17 guideline and major reforms in China underway, the platform for clinical trial conduct is expected to change. This study aims to assess the strategic inclusion of regions in clinical trials and its change in trends over the past decade.
Methods
The ClinicalTrials.gov registry was searched for clinical trials registered by the top 10 pharmaceutical companies between 1 January 2008 and 31 December 2017. Extracted data included phase, disease type, intervention, study start year, and region. Trial type was classified as either a local study or a multiregional clinical trial as per the International Conference on Harmonisation E17 guideline.
Results
Of 2488 phase I, 1855 phase II, and 1999 phase III trials included, the majority of phase I trials were local studies (76.8%), while the majority of phase II (66.0%) and phase III (72.2%) trials were multiregional clinical trials. The proportion of multiregional clinical trials showed an increasing trend for all phases (p < 0.01). Although North America and Europe remained the main locations, increasing trends of inclusion of other regions, such as East Asia, were noted.
Conclusion
Globalization of drug development is evident with the increasing trend of multiregional clinical trial. Regulatory authorities as well as the pharmaceutical industry should prepare for the evolving setting of clinical research and problems that can arise from these changes.

Ethics & Human Research
Volume 41, Issue 1  January-February 2019
https://onlinelibrary.wiley.com/journal/25782363

New Challenges and Unresolved Issues
The inaugural issue of Ethics & Human Research (E&HR) marks an exciting milestone in The Hastings Centers’ 40‐year history of publishing a journal that focuses on the ethical, regulatory, and policy issues related to research with humans. Like its predecessor, IRB: Ethics & Human Research, E&HR will publish conceptual and empirical analyses on a wide range of topics related to the human research enterprise.
The journal’s name change conveys to the global community of authors and readers that E&HR is not solely about issues related to institutional review boards (IRBs) in the United States. The title shift provides an opportunity to identify new ethical, policy, and regulatory challenges that rapid developments in science, medicine, and regulatory frameworks bring to the conduct and oversight of human subjects research in the United States and elsewhere. Along with publishing work that investigates new challenges, E&HR aims not only to draw attention to unresolved issues but also to broaden the scope of issues for investigation and analysis in the field of human research ethics. The pieces in this inaugural issue identify several new challenges and hint at some of the unresolved issues and broader topics that merit further attention.

Health Research Policy and Systems
http://www.health-policy-systems.com/content
[Accessed 26 Jan 2019]

Research
What, why and how do health systems learn from one another? Insights from eight low- and middle-income country case studies
All health systems struggle to meet health needs within constrained resources. This is especially true for low-income countries. It is critical that they can learn from wider contexts in order to improve their…
Authors: Sophie Witter, Ian Anderson, Peter Annear, Abiodun Awosusi, Nitin N. Bhandari, Nouria Brikci, Blandine Binachon, Tata Chanturidze, Katherine Gilbert, Charity Jensen, Tomas Lievens, Barbara McPake, Snehashish Raichowdhury and Alex Jones
Citation: Health Research Policy and Systems 2019 17:9
Published on: 21 January 2019

International Journal of Community Medicine and Public Health
Vol 6, No 2 (2019)  February 2019
https://www.ijcmph.com/index.php/ijcmph/issue/view/47

Original Research Articles
Assessment of immunization coverage in district Srinagar of Kashmir
Ambrine Ashraf, Sheema Samreen, S. M. Salim Khan, Inaamul Haq, Mariya Amin
DOI: 10.18203/2394-6040.ijcmph20190181

International Journal of Community Medicine and Public Health
Vol 6, No 2 (2019)  February 2019
https://www.ijcmph.com/index.php/ijcmph/issue/view/47

Process evaluation of mission Indradhanush immunization program in urban and rural communities of Ahmedabad district of Gujarat
Priyank D. Algotar, N. Lakshmi, Hardik B. Yagnik, Rinita Jain
DOI: 10.18203/2394-6040.ijcmph20190206

International Journal of Community Medicine and Public Health
Vol 6, No 2 (2019)  February 2019
https://www.ijcmph.com/index.php/ijcmph/issue/view/47

Evaluation of vaccine storage and cold chain management practices during intensified mission Indradhanush in community health centers of Tikamgarh district of Madhya Pradesh
Ram K. Panika, Pankaj Prasad, Sunil Nandeshwar
DOI: 10.18203/2394-6040.ijcmph20190215

JAMA
January 22, 2019, Vol 321, No. 3, Pages 217-316
http://jama.jamanetwork.com/issue.aspx

Viewpoint
Ebola and War in the Democratic Republic of Congo – Avoiding Failure and Thinking Ahead
Lawrence O. Gostin, JD; Matthew M. Kavanagh, PhD; Elizabeth Cameron, PhD
JAMA. 2019;321(3):243-244. doi:10.1001/jama.2018.19743
In this Viewpoint, Gostin and colleagues review recommendations developed by experts convened by Georgetown University on how the international community can respond to the 2018 Ebola outbreak in the Democratic Republic of Congo (DRC) in the midst of active conflict and insecurity from armed rebels.

Journal of Evidence-Based Medicine
Volume 12, Issue S1  Pages: 1-34  January 2019
https://onlinelibrary.wiley.com/toc/17565391/current

7th Meeting of the COMET Initiative (VII), Thursday 15th and Friday 16th November 2018, De Rode Hoed, Amsterdam
On the 15^th and 16^th November 2018, the Core Outcome Measures in Effectiveness Trials (COMET) Initiative held its seventh international meeting. After success at COMET VI, the COMET meeting returned to De Rode Hoed (The Red Hat) in Amsterdam for their second consecutive meeting. One‐hundred and fifteen participants gathered from around the world, coming from five continents and 18 countries.

The Lancet
Jan 26, 2019  Volume 393Number 10169p295-376, e3-e4
https://www.thelancet.com/journals/lancet/issue/current

Editorial
At the turn of the tide: human rights and health in 2019
The Lancet
A pattern of political turmoil, violence, and intolerance in all corners of the world, from Europe to Asia and the USA, is following a rise of populist leaders and authoritarian governments. Human rights are under autocratic threat. Once-influential rights defenders, such as the USA, have faded away, risking a void in the global defence of human rights. This gloomy reality is underscored in Human Rights Watch’s World Report 2019, released Jan 17, which summarises key human rights issues in nearly 100 countries and territories worldwide. This year’s annual report sends a clear message: that human rights violations propagated by autocratic leaders throughout 2018 continue to imperil the health of the world’s most vulnerable populations.

Inequality and discrimination fuelled much of the harm in 2018. Immigration became one of the most divisive issues among autocratic leaders in Europe. The failure to establish protective measures for people with migrant and refugee status restricted their access to health care. Some European governments, such as the Italian and Hungarian regimes, prevented migrants from entering their countries and fuelled rising anti-immigrant sentiment. In the USA, President Trump separated immigrant children from their parents. In southeast Asia, more than 1 million Rohingya Muslims remain locked in a cycle of poor child health, malnutrition, waterborne illness, and poor obstetric care after decades of discrimination—a situation that has worsened drastically because of a brutal crackdown by the Myanmar army.

Attacks in armed conflict zones against hospitals and threats to health-care staff continued to be problematic. In Yemen, in what UN officials describe as the world’s largest humanitarian crisis, bombings and blockade by Saudi-led coalitions hampered the movement and safety of health-care staff, patients, and ambulances. Similar examples of attacks on health-care facilities were reported in the Gaza Strip and in areas of war-ravaged Syria.

Restricted supply of food and basic medical supplies in countries experiencing financial turmoil have threatened the health and safety of their populations. Under President Nicolás Maduro’s leadership, Venezuela’s infrastructure has crumbled and an economic collapse has triggered a historic exodus of civilians. The country’s health-care system is decaying, triggering a rise in the rates of maternal and infant mortality and a spike in cases of malaria and diphtheria.

But there are reasons for hope. Unlike previous annual reports, World Report 2019 paints a brighter picture of the future. In his introductory essay, Executive Director Kenneth Roth explains that, amid political chaos and despite mounting pessimism around rights abuses and attacks on democracy by populists on both the far left and far right, 2018 was a remarkable year for human rights. This is not because of growing authoritarian tendencies, but because of resistance to them. “Important battles are being won, re-energising the global defence of human rights”, states Roth. The pushback to autocracy was striking because it took unexpected forms—from elections, street demonstrations by civilians, both regionally and nationally, to non-traditional coalitions between smaller countries and organisations, the UN, and the European Parliament. 2018 saw unprecedented international efforts to resist attacks on democracy in Europe and Africa, to halt the Saudi-led bombing and blockading of Yemeni civilians, to prevent further bloodshed in Syria, and to take measures that will one day bring to justice the perpetrators of attacks against Rohingya Muslims in Myanmar. Latin American governments united with Canada to urge the International Criminal Court to open an investigation of crimes in Venezuela. Democrat gains in the House of Representatives in the autumn midterm elections reflect, at least in part, a national dismay of Trump’s anti-immigrant rhetoric.

This rise of resistance against the autocracy must not lose momentum in 2019. Every day, in so many parts of the world, the health of women and children is attacked and reproductive rights are violated. In countries facing the consequences of pollution and climate change, or fighting outbreaks of infectious disease, vulnerable, marginalised, and minority populations are being overlooked. An access abyss in palliative care persists, and mental health is still neglected. Much of the pushback in the past year played out at the UN and the European Parliament, underlining the importance of solidarity and the collective voice. This global unity is a force that needs to be harnessed to truly shift the power dynamics in 2019 and to make it a year of triumph for both human rights and health. It will be a tough journey.

The Lancet
Jan 26, 2019  Volume 393Number 10169p295-376, e3-e4
https://www.thelancet.com/journals/lancet/issue/current

Editorial
Standing up for migration
The Lancet
WHO issued a report on the health of refugees and migrants in the WHO European Region on Jan 21, 2019. The report aims to provide an overview of the current health situation for refugees and migrants across the 53 countries of the region, by providing an evidence base for the approximately 258 million migrants in the area.

The report notes that “there are no global or region-wide indicators or standards for refugee and migrant health”. Although the global volume of refugees and migrants has remained relatively stable since 1990 (from 2·8% of global population then to 3·3% now), there has been a sharp rise in the proportion of displaced people over the same period, from five in 1000 in 1997 to nine in 1000 in 2017. This sizable population demands separate consideration, in part because their health concerns need promoting and defending in the face of increasing xenophobia across Europe.

Persistent myths about migrants and refugees have been allowed to propagate unchallenged in political discourse. Our recent Commission on Migration and Health highlighted some of these. Migrants contribute more to the wealth of host societies than they cost, and migrants have lower mortality than their host populations.

This new WHO Report and the recent Compact on Global Migration represent positive moves in an area of global health featuring some of the world’s most maligned and at-risk populations. Too often, however, the voices of the migrants and refugees themselves are silenced in the conversation. Migrants and refugees clearly have vital contributions to make in the debate over their treatment and health, but, frustratingly, the dialogue surrounding them seems limited to those in positions of institutional power. We urge political leaders to privilege migrants as essential participants in the public conversation about their important contributions to the health of our societies.

The Lancet
Jan 26, 2019  Volume 393Number 10169p295-376, e3-e4
https://www.thelancet.com/journals/lancet/issue/current

Seminar
Dengue
Annelies Wilder-Smith, Eng-Eong Ooi, Olaf Horstick, Bridget Wills
Summary
Mortality from severe dengue is low, but the economic and resource burden on health services remains substantial in endemic settings. Unfortunately, progress towards development of effective therapeutics has been slow, despite notable advances in the understanding of disease pathogenesis and considerable investment in antiviral drug discovery. For decades antibody-dependent enhancement has been the prevalent model to explain dengue pathogenesis, but it was only recently demonstrated in vivo and in clinical studies. At present, the current mainstay of management for most symptomatic dengue patients remains careful observation and prompt but judicious use of intravenous hydration therapy for those with substantial vascular leakage. Various new promising technologies for diagnosis of dengue are currently in the pipeline. New sample-in, answer-out nucleic acid amplification technologies for point-of-care use are being developed to improve performance over current technologies, with the potential to test for multiple pathogens using a single specimen. The search for biomarkers that reliably predict development of severe dengue among symptomatic individuals is also a major focus of current research efforts. The first dengue vaccine was licensed in 2015 but its performance depends on serostatus. There is an urgent need to identify correlates of both vaccine protection and disease enhancement. A crucial assessment of vector control tools should guide a research agenda for determining the most effective interventions, and how to best combine state-of-the-art vector control with vaccination.

Lancet Global Health
Feb 2019  Volume 7Number 2e160-e280
http://www.thelancet.com/journals/langlo/issue/current

Comment
Importance of tuberculosis vaccination targeting older people in China
Yue Wang, Weibing Wang

 
Lancet Global Health
Feb 2019  Volume 7Number 2e160-e280
http://www.thelancet.com/journals/langlo/issue/current
Comment
The role of pneumococcal conjugate vaccination in reducing pneumonia mortality
Mark Jit, Stefan Flasche

Lancet Global Health
Feb 2019  Volume 7Number 2e160-e280
http://www.thelancet.com/journals/langlo/issue/current

Articles
Age-targeted tuberculosis vaccination in China and implications for vaccine development: a modelling study
Rebecca C Harris, Tom Sumner, Gwenan M Knight, Tom Evans, Vicky Cardenas, Chen Chen,
Richard G White

Lancet Global Health
Feb 2019  Volume 7Number 2e160-e280
http://www.thelancet.com/journals/langlo/issue/current

Articles
Effect of pneumococcal conjugate vaccine introduction on childhood pneumonia mortality in Brazil: a retrospective observational study
Cynthia Schuck-Paim, Robert J Taylor, Wladimir J Alonso, Daniel M Weinberger, Lone Simonsen

Nature 
Volume 565 Issue 7740, 24 January 2019
http://www.nature.com/nature/current_issue.html

Editorial | 21 January 2019
Genomics can help to monitor cholera
Sequence data from whole genomes let researchers track the spread of strains worldwide.

Nature 
Volume 565 Issue 7740, 24 January 2019
http://www.nature.com/nature/current_issue.html

Comment | 22 January 2019
Where are the Ebola diagnostics from last time?
Analysis reveals commercial tests for Ebola are too hard to come by in the current outbreak — sustain investment, urge Lieselotte Cnops, Kevin K. Ariën and colleagues.
Lieselotte Cnops, Birgit De Smet[…] & Kevin K. Ariën

PharmacoEconomics & Outcomes News
Volume 820, Issue 1, January 2019
https://link.springer.com/journal/40274/820/1

Clinical study
Childhood pneumococcal vaccination cost effective in India
Krishnamoorthy Y, et al.

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 26 Jan 2019)

Evaluating strategies for control of tuberculosis in prisons and prevention of spillover into communities: An observational and modeling study from Brazil
Tarub S. Mabud, Maria de Lourdes Delgado Alves, Albert I. Ko, Sanjay Basu, Katharine S. Walter, Ted Cohen, Barun Mathema, Caroline Colijn, Everton Lemos, Julio Croda, Jason R. Andrews
Research Article | published 24 Jan 2019 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1002737

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 26 Jan 2019)

Prior dengue virus infection and risk of Zika: A pediatric cohort in Nicaragua
Aubree Gordon, Lionel Gresh, Sergio Ojeda, Leah C. Katzelnick, Nery Sanchez, Juan Carlos Mercado, Gerardo Chowell, Brenda Lopez, Douglas Elizondo, Josefina Coloma, Raquel Burger-Calderon, Guillermina Kuan, Angel Balmaseda, Eva Harris
Research Article | published 22 Jan 2019 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1002726

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 26 Jan 2019)

Research Article
Does prior dengue virus exposure worsen clinical outcomes of Zika virus infection? A systematic review, pooled analysis and lessons learned
Jennifer Masel, Michael K. McCracken, Todd Gleeson, Brian Morrison, George Rutherford, Allison Imrie, Richard G. Jarman, Michael Koren, Simon Pollett
| published 25 Jan 2019 PLOS Neglected Tropical Diseases
https://doi.org/10.1371/journal.pntd.0007060

PLoS One
http://www.plosone.org/
[Accessed 26 Jan 2019]

Research Article
Cost-effectiveness of influenza vaccine strategies for the elderly in South Korea
Jae-Won Yun, Min Joo Choi, Gyeong-Seon Shin, Jae-Ok Lim, Ji Yun Noh, Yun-Kyung Kim, Joon Young Song, Woo Joo Kim, Sang-Eun Choi, Hee Jin Cheong
Research Article | published 25 Jan 2019 PLOS ONE
https://doi.org/10.1371/journal.pone.0209643

PLoS One
http://www.plosone.org/
[Accessed 26 Jan 2019]

Can vaccination coverage be improved by reducing missed opportunities for vaccination? Findings from assessments in Chad and Malawi using the new WHO methodology
Ikechukwu Udo Ogbuanu, Anyie J. Li, Blanche-philomene Melanga Anya, Mbaihol Tamadji, Geoffrey Chirwa, Kwame W. Chiwaya, Mohamed El-Hafiz Djalal, Dah Cheikh, Zorodzai Machekanyanga, Joseph Okeibunor, Colin Sanderson, Richard Mihigo
Research Article | published 24 Jan 2019 PLOS ONE
https://doi.org/10.1371/journal.pone.0210648

PLoS One
http://www.plosone.org/
[Accessed 26 Jan 2019]

Completion of multiple-dose travel vaccine series and the availability of pharmacist immunizers: A retrospective analysis of administrative data in Alberta, Canada
Sherilyn K. D. Houle, Dean T. Eurich
Research Article | published 23 Jan 2019 PLOS ONE
https://doi.org/10.1371/journal.pone.0211006

Public Health Reports
Volume 134 Issue 1, January/February 2019
https://journals.sagepub.com/toc/phrg/134/1

Executive Perspective
Global Health Security: Protecting the United States in an Interconnected World
Rebecca E. Bunnell, PhD, MEd, Zara Ahmed, DrPH, MPP, Megan Ramsden, MPH, Karina Rapposelli, MPH, Madison Walter-Garcia, MPH, Eshita Sharmin, MPH, Nancy Knight, MD
First Published November 14, 2018; pp. 3–10

Research Ethics
Volume 15 Issue 1, January 2019
http://journals.sagepub.com/toc/reab/current

Original Article: Non-Empirical
Exploring the socioethical dilemmas in the use of a global health archive
Matthew James Vaughton Holmes, Isla-Kate Morris, Anthony Williams, Jennifer Le Blond, Victoria Cranna, Gail Davey
First Published November 1, 2018; pp. 1–9

Research Ethics
Volume 15 Issue 1, January 2019
http://journals.sagepub.com/toc/reab/current

Original Articles: Empirical
Ethical complexities in child co-research
Merle Spriggs, Lynn Gillam
First Published December 20, 2017; pp. 1–16
Abstract
Child co-research has become popular in social research involving children. This is attributed to the emphasis on children’s rights and is seen as a way to promote children’s agency and voice. It is a way of putting into practice the philosophy, common amongst childhood researchers, that children are experts on childhood. In this article, we discuss ethical complexities of involving children as co-researchers, beginning with an analysis of the literature, then drawing on data from interviews with researchers who conduct child co-research. We identify six ethical complexities, some of which are new findings which have not been mentioned before in this context. In light of these possible ethical complexities, a key finding is for researchers to be reflexive – to reflect on how the research may affect child co-researchers and participants before the research starts. A separate overriding message that came out in responses from the researchers we interviewed was the need for support and training for child co-researchers. We conclude by providing a list of questions for reflexive researchers to ask of themselves when they use child co-research methodology. We also provide important questions for human research ethics committees to ask when they review projects using child co-research.

Research Ethics
Volume 15 Issue 1, January 2019
http://journals.sagepub.com/toc/reab/current

Navigating research ethics in the absence of an ethics review board: The importance of space for sharing
Cécile Giraud, Giuseppe Davide Cioffo, Maïté Kervyn de Lettenhove, Carlos Ramirez Chaves
First Published January 1, 2018; pp. 1–17

Science         
25 January 2019  Vol 363, Issue 6425
http://www.sciencemag.org/current.dtl

Policy Forum
Toward unrestricted use of public genomic data
By Rudolf I. Amann, Shakuntala Baichoo, Benjamin J. Blencowe, Peer Bork, Mark Borodovsky, Cath Brooksbank, Patrick S. G. Chain, Rita R. Colwell, Daniele G. Daffonchio, Antoine Danchin, Victor de Lorenzo, Pieter C. Dorrestein, Robert D. Finn, Claire M. Fraser, Jack A. Gilbert, Steven J. Hallam, Philip Hugenholtz, John P. A. Ioannidis, Janet K. Jansson, Jihyun F. Kim, Hans-Peter Klenk, Martin G. Klotz, Rob Knight, Konstantinos T. Konstantinidis, Nikos C. Kyrpides, Christopher E. Mason, Alice C. McHardy, Folker Meyer, Christos A. Ouzounis, Aristides A. N. Patrinos, Mircea Podar, Katherine S. Pollard, Jacques Ravel, Alejandro Reyes Muñoz, Richard J. Roberts, Ramon Rosselló-Móra, Susanna-Assunta Sansone, Patrick D. Schloss, Lynn M. Schriml, João C. Setubal, Rotem Sorek, Rick L. Stevens, James M. Tiedje, Adrian Turjanski, Gene W. Tyson, David W. Ussery, George M. Weinstock, Owen White, William B. Whitman, Ioannis Xenarios
Science25 Jan 2019 : 350-352 Full Access
Publication interests should not limit access to public data
Summary
Despite some notable progress in data sharing policies and practices, restrictions are still often placed on the open and unconditional use of various genomic data after they have received official approval for release to the public domain or to public databases. These restrictions, which often conflict with the terms and conditions of the funding bodies who supported the release of those data for the benefit of the scientific community and society, are perpetuated by the lack of clear guiding rules for data usage. Existing guidelines for data released to the public domain recognize but fail to resolve tensions between the importance of free and unconditional use of these data and the “right” of the data producers to the first publication. This self-contradiction has resulted in a loophole that allows different interpretations and a continuous debate between data producers and data users on the use of public data. We argue that the publicly available data should be treated as open data, a shared resource with unrestricted use for analysis, interpretation, and publication.

Social Science & Medicine
Volume 221  Pages 1-132 (January 2019)
https://www.sciencedirect.com/journal/social-science-and-medicine/vol/221/suppl/C

Research article  Abstract only
“You don’t trust a government vaccine”: Narratives of institutional trust and influenza vaccination among African American and white adults
Amelia M. Jamison, Sandra Crouse Quinn, Vicki S. Freimuth
Pages 87-94

Vaccine
Volume 37, Issue 6  Pages 763-898 (4 February 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/6

Conference report
Conference info   Abstract only
Malaria vaccine trials in pregnant women: An imperative without precedent
Sara A. Healy, Michal Fried, Thomas Richie, Karin Bok, … Patrick E. Duffy
Pages 763-770
Abstract
Pregnant women are highly susceptible to Plasmodium falciparum malaria, leading to substantial maternal, perinatal, and infant mortality. While malaria vaccine development has made significant progress in recent years, no trials of malaria vaccines have ever been conducted in pregnant women. In December 2016, an expert meeting was convened at NIAID, NIH, in Rockville, Maryland to deliberate on the rationale and design of malaria vaccine trials in pregnant women. The discussions highlighted the progress made over recent years in the field of maternal immunization for other infectious diseases, and the evolving regulatory and ethical environment, all of which support a new emphasis on testing malaria vaccines that offer direct benefits to pregnant women. Initial safety and immunogenicity studies of malaria vaccines will be conducted in non-pregnant adult volunteers. Subsequently, efficacy trials involving pregnant women will likely be conducted in malaria-endemic and often resource-poor environments where sufficiently high malaria incidence will allow vaccine activity to be measured. Such trials will need to meet all international standards to ensure the safety of mother and offspring, under oversight of appropriate ethical and regulatory bodies. The convened experts drafted a clinical development plan to test a malaria vaccine product during pregnancy, using as a case study PfSPZ Vaccine being developed by Sanaria Inc. that is currently in phase 2 testing. Following the expert recommendations, a pregnancy registry has been initiated in Ouelessebougou, Mali, to provide baseline information on maternal and fetal outcomes as a context for evaluating PfSPZ Vaccine safety in the future, and new regimens are being assessed that will be suitable for evaluation in pregnant women.

Vaccine
Volume 37, Issue 6  Pages 763-898 (4 February 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/6

Research article  Abstract only
Rapid behavioral assessment of barriers and opportunities to improve vaccination coverage among displaced Rohingyas in Bangladesh, January 2018
Mohamed F. Jalloh, Sarah D. Bennett, Didarul Alam, Paryss Kouta, … Brent Wolff
Pages 833-838

Vaccine
Volume 37, Issue 6  Pages 763-898 (4 February 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/6

Research article   Abstract only
Provider time and costs to vaccinate adult patients: Impact of time counseling without vaccination
Angela Shen, Olga Khavjou, Grant King, Laurel Bates, … Benjamin Yarnoff
Pages 792-797

Vaccine
Volume 37, Issue 6  Pages 763-898 (4 February 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/6

Research article   Open access
Projected impact, cost-effectiveness, and budget implications of rotavirus vaccination in Mongolia
Munkh-Erdene Lusvan, Frédéric Debellut, Andrew Clark, Sodbayar Demberelsuren, … Clint Pecenka
Pages 798-807

Vaccine
Volume 37, Issue 6  Pages 763-898 (4 February 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/6

Research article  Open access
Oral cholera vaccination strategy: Self-administration of the second dose in urban Dhaka, Bangladesh
Ashraful Islam Khan, Muhammad Shariful Islam, Md. Taufiqul Islam, Azimuddin Ahmed, … Firdausi Qadri
Pages 827-832

Vaccine
Volume 37, Issue 6  Pages 763-898 (4 February 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/6

Research article   Abstract only
Development of a valid and reliable scale to assess parents’ beliefs and attitudes about childhood vaccines and their association with vaccination uptake and delay in Ghana
Aaron S. Wallace, Kathleen Wannemuehler, George Bonsu, Melissa Wardle, … Saad B. Omer
Pages 848-856

Vaccine
Volume 37, Issue 6  Pages 763-898 (4 February 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/6

Research article   Abstract only
Vaccine health beliefs and educational influences among pediatric residents
Gitanjli Arora, Deborah Lehman, Sandhya Charlu, Nicole Ross, … Pia S. Pannaraj
Pages 857-862

Vaccine
Volume 37, Issue 6  Pages 763-898 (4 February 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/6

Research article   Abstract only
A multilevel analysis of factors influencing the inaccuracy of parental reports of adolescent HPV vaccination status
Milkie Vu, Minh Luu, Regine Haardörfer, Carla J. Berg, … Robert A. Bednarczyk
Pages 869-876

From Google Scholar & other sources: Selected Journal Articles, Newsletters, Dissertations, Theses, Commentary

Asian Pacific Journal of Allergy and Immunology
2019 Jan 13. doi: 10.12932/AP-100518-0309. [Epub ahead of print]
Asian Pacific Journal of Allergy and Immunology
E Prompetchara, C Ketloy, SJ Thomas, K Ruxrungtham
Abstract
The first licensed dengue vaccine, CYD-TDV (Dengvaxia®), has received regulatory approval in a number of countries. However, this vaccine has some limitations. Its efficacy against DENV2 was consistently lower than other serotypes. Protective efficacy also depended on prior dengue sero-status of the vaccinees. Lower efficacy was observed in children with < 9 years old and dengue-na?ve individuals. More importantly, risk of hospitalization and severe dengue was increased in the youngest vaccine recipients (2-5 years) compared to controls. Thus, the quest of a better vaccine candidate continues. There are two live-attenuated vaccine candidates currently testing in phase III trial including DENVax, developed by US CDC and Inviragen (now licensed to Takeda) and TV003/TV005, constructed by US NIAID. In addition, there are several phase I-II as well as preclinical phase studies evaluating vaccines for safety and immunogenicity, this include other live-attenuated platform/strategy, purified-inactivated viruses formulated with adjuvants, DNA vaccine, subunit vaccine, viral vector and also heterologous prime/boost strategies. The major difficulties of dengue vaccine development are included the lack of the best animal model, various immune status of individual especially in endemic areas and clear cut off of protective immunity. Several research and development efforts are ongoing to find a better effective and accessible dengue vaccine for people needed.

Media/Policy Watch

This watch section is intended to alert readers to substantive news, analysis and opinion from the general media and selected think tanks and similar organizations on vaccines, immunization, global public health and related themes. Media Watch is not intended to be exhaustive, but indicative of themes and issues CVEP is actively tracking. This section will grow from an initial base of newspapers, magazines and blog sources, and is segregated from Journal Watch above which scans the peer-reviewed journal ecology.

We acknowledge the Western/Northern bias in this initial selection of titles and invite suggestions for expanded coverage. We are conservative in our outlook in adding news sources which largely report on primary content we are already covering above. Many electronic media sources have tiered, fee-based subscription models for access. We will provide full-text where content is published without restriction, but most publications require registration and some subscription level.

The Atlantic
http://www.theatlantic.com/magazine/
Accessed 26 Jan 2019
[No new, unique, relevant content]
 
 
BBC
http://www.bbc.co.uk/
Accessed 26 Jan 2019
[No new, unique, relevant content]
 
 
The Economist
http://www.economist.com/
Accessed 26 Jan 2019
Charlemagne –
The campaign against vaccination
Disease will be a major political battleground in the coming decades
Jan 19th 2019
 
 
Financial Times
http://www.ft.com/home/uk
Accessed 26 Jan 2019
Delivery innovation spreads vaccines’ benefits
22 January 2019
While some scientists seek vaccine breakthroughs for cancer, HIV and malaria, others are focusing on a more basic problem: ensuring that the vaccines we have reach those in need.
 
 
Forbes
http://www.forbes.com/
Accessed 26 Jan 2019
[No new, unique, relevant content]
 
 
Foreign Affairs
http://www.foreignaffairs.com/
Accessed 26 Jan 2019
[No new, unique, relevant content]
 
 
Foreign Policy
http://foreignpolicy.com/
Accessed 26 Jan 2019
[No new, unique, relevant content]
 
 
The Guardian
http://www.guardiannews.com/
Accessed 26 Jan 2019
[No new, unique, relevant content]
 
 
New Yorker
http://www.newyorker.com/
Accessed 26 Jan 2019
As Told To
Amid a Measles Outbreak, an Ultra-Orthodox Nurse Fights Vaccination Fears in Her Community
“We live in close quarters with extended family. So we should consider ourselves especially obligated to prevent harm to our fellow community members,” Blima Marcus said.
By Amanda Schaffer
January 25, 2019
 
 
New York Times
http://www.nytimes.com/
Accessed 26 Jan 2019
How to Inoculate Against Anti-Vaxxers
19 January 2019
…Thwarting this danger will require a campaign as bold and aggressive as the one being waged by the anti-vaccination contingent. And to launch such a campaign would require overcoming strong inertia: a waning public health apparatus, countervailing politics and a collective amnesia over the havoc the diseases in question once wrought. But to succeed would be to rescue from oblivion one of the greatest triumphs of human ingenuity over disease — and to save countless lives.
 
 
Wall Street Journal
http://online.wsj.com/home-page?_wsjregion=na,us&_homepage=/home/us
Accessed 26 Jan 2019
Health
Washington State Becomes Latest Hot Spot in Measles Outbreak
By Brianna Abbott
Jan. 23, 2019 5:06 pm ET
The U.S. is experiencing outbreaks of measles, largely due to a drop in vaccination rates in some areas. An outbreak in Washington state has sickened 23 people this month.
Appeared in the January 23, 2019, print edition as ‘Measles Breaks Out in the Northwest.’
 
 
Washington Post
http://www.washingtonpost.com/
Accessed 26 Jan 2019
Officials in anti-vaccination ‘hotspot’ near Portland declare an emergency over measles outbreak
Isaac Stanley-Becker  Jan 23, 2019
 
 
The Latest: Merck to ship 120,000 more Ebola vaccine doses
Associated Press   Jan 22, 2019

Think Tanks et al

 Brookings
http://www.brookings.edu/
Accessed 26 Jan 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 26 Jan 2019
[No new relevant content]

Council on Foreign Relations
http://www.cfr.org/
Accessed 26 Jan 2019
[No new relevant content]

 Kaiser Family Foundation
https://www.kff.org/search/?post_type=press-release
Accessed 26 Jan 2019
[No new relevant content]

Milestones :: Perspectives

::::::

WHO: Ten threats to global health in 2019

[Selected full text]
Air pollution and climate change
 
Noncommunicable diseases
 
Global influenza pandemic

The world will face another influenza pandemic – the only thing we don’t know is when it will hit and how severe it will be. Global defences are only as effective as the weakest link in any country’s health emergency preparedness and response system.

WHO is constantly monitoring the circulation of influenza viruses to detect potential pandemic strains: 153 institutions in 114 countries are involved in global surveillance and response.

Every year, WHO recommends which strains should be included in the flu vaccine to protect people from seasonal flu. In the event that a new flu strain develops pandemic potential, WHO has set up a unique partnership with all the major players to ensure effective and equitable access to diagnostics, vaccines and antivirals (treatments), especially in developing countries.

Fragile and vulnerable settings

More than 1.6 billion people (22% of the global population) live in places where protracted crises (through a combination of challenges such as drought, famine, conflict, and population displacement) and weak health services leave them without access to basic care.

Fragile settings exist in almost all regions of the world, and these are where half of the key targets in the sustainable development goals, including on child and maternal health, remains unmet.

WHO will continue to work in these countries to strengthen health systems so that they are better prepared to detect and respond to outbreaks, as well as able to deliver high quality health services, including immunization.

Antimicrobial resistance

The development of antibiotics, antivirals and antimalarials are some of modern medicine’s greatest successes. Now, time with these drugs is running out. Antimicrobial resistance – the ability of bacteria, parasites, viruses and fungi to resist these medicines – threatens to send us back to a time when we were unable to easily treat infections such as pneumonia, tuberculosis, gonorrhoea, and salmonellosis. The inability to prevent infections could seriously compromise surgery and procedures such as chemotherapy.

Resistance to tuberculosis drugs is a formidable obstacle to fighting a disease that causes around 10 million people to fall ill, and 1.6 million to die, every year. In 2017, around 600 000 cases of tuberculosis were resistant to rifampicin – the most effective first-line drug – and 82% of these people had multidrug-resistant tuberculosis.

Drug resistance is driven by the overuse of antimicrobials in people, but also in animals, especially those used for food production, as well as in the environment. WHO is working with these sectors to implement a global action plan to tackle antimicrobial resistance by increasing awareness and knowledge, reducing infection, and encouraging prudent use of antimicrobials.

Ebola and other high-threat pathogens

In 2018, the Democratic Republic of the Congo saw two separate Ebola outbreaks, both of which spread to cities of more than 1 million people. One of the affected provinces  is also in an active conflict zone.

This shows that the context in which an epidemic of a high-threat pathogen like Ebola erupts is critical –  what happened in rural outbreaks in the past doesn’t always apply to densely populated urban areas or conflict-affected areas.

At a conference on Preparedness for Public Health Emergencies held last December, participants from the public health, animal health, transport and tourism sectors focussed on the growing challenges of tackling outbreaks and health emergencies in urban areas. They called for WHO and partners to designate 2019 as a “Year of action on preparedness for health emergencies”.

WHO’s R&D Blueprint identifies diseases and pathogens that have potential to cause a public health emergency but lack effective treatments and vaccines. This watchlist for priority research and development includes Ebola, several other haemorrhagic fevers, Zika, Nipah, Middle East respiratory syndrome coronavirus (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS) and disease X, which represents the need to prepare for an unknown pathogen that could cause a serious epidemic.

Weak primary health care  

Vaccine hesitancy

Vaccine hesitancy – the reluctance or refusal to vaccinate despite the availability of vaccines – threatens to reverse progress made in tackling vaccine-preventable diseases. Vaccination is one of the most cost-effective ways of avoiding disease – it currently prevents 2-3 million deaths a year, and a further 1.5 million could be avoided if global coverage of vaccinations improved.

Measles, for example, has seen a 30% increase in cases globally. The reasons for this rise are complex, and not all of these cases are due to vaccine hesitancy. However, some countries that were close to eliminating the disease have seen a resurgence.

The reasons why people choose not to vaccinate are complex; a vaccines advisory group to WHO identified complacency, inconvenience in accessing vaccines, and lack of confidence are key reasons underlying hesitancy. Health workers, especially those in communities, remain the most trusted advisor and influencer of vaccination decisions, and they must be supported to provide trusted, credible information on vaccines.

In 2019, WHO will ramp up work to eliminate cervical cancer worldwide by increasing coverage of the HPV vaccine, among other interventions. 2019 may also be the year when transmission of wild poliovirus is stopped in Afghanistan and Pakistan. Last year, less than 30 cases were reported in both countries. WHO and partners are committed to supporting these countries to vaccinate every last child to eradicate this crippling disease for good.

Dengue

Dengue, a mosquito-borne disease that causes flu-like symptoms and can be lethal and kill up to 20% of those with severe dengue, has been a growing threat for decades.

A high number of cases occur in the rainy seasons of countries such as Bangladesh and India. Now, its season in these countries is lengthening significantly (in 2018, Bangladesh saw the highest number of deaths in almost two decades), and the disease is spreading to less tropical and more temperate countries such as Nepal, that have not traditionally seen the disease.

An estimated 40% of the world is at risk of dengue fever, and there are around 390 million infections a year. WHO’s Dengue control strategy aims to reduce deaths by 50% by 2020.

HIV

The progress made against HIV has been enormous in terms of getting people tested, providing them with antiretrovirals (22 million are on treatment), and providing access to preventive measures such as a pre-exposure prophylaxis (PrEP, which is when people at risk of HIV take antiretrovirals to prevent infection).

However, the epidemic continues to rage with nearly a million people every year dying of HIV/AIDS. Since the beginning of the epidemic, more than 70 million people have acquired the infection, and about 35 million people have died. Today, around 37 million worldwide live with HIV. Reaching people like sex workers, people in prison, men who have sex with men, or transgender people is hugely challenging. Often these groups are excluded from health services. A group increasingly affected by HIV are young girls and women (aged 15–24), who are particularly at high risk and account for 1 in 4 HIV infections in sub-Saharan Africa despite being only 10% of the population.

This year, WHO will work with countries to support the introduction of self-testing so that more people living with HIV know their status and can receive treatment (or preventive measures in the case of a negative test result). One activity will be to act on new guidance announced In December 2018, by WHO and the International Labour Organization to support companies and organizations to offer HIV self-tests in the workplace.

Milestones :: Perspectives

WHO statement on reports of alleged misconduct

17 January 2019

Statement

WHO is aware of a news story published today about allegations of misconduct in the organization.

The allegations are being investigated according to WHO’s established procedures, having been referred to WHO’s Office of Internal Oversight Services by the Director-General, Dr Tedros Adhanom Ghebreyesus.

The anonymous allegations, which had been circulating internally, were also addressed openly by Dr Tedros in global meetings with staff in which he stressed that WHO has zero tolerance for misconduct or discrimination of any kind.

Since Dr Tedros took office as Director-General in July 2017, he has championed openness, transparency and diversity. WHO’s senior management team is now one of the most diverse and gender-balanced of any United Nations agency. All regions of the world are represented and almost two-thirds are women. WHO is working consistently to increase geographical diversity and improve gender balance at all levels as part of its ongoing transformation process.

WHO has established mechanisms by which anyone inside or outside the organization can report concerns about any form of suspected misconduct by WHO personnel. WHO has recently strengthened the capacity of its internal oversight mechanisms and has proven processes for reporting and dealing with allegations of misconduct.

These include an independently-run integrity hotline which anyone can use to report concerns confidentially and anonymously. We regularly report the outcome of substantiated allegations arising from independent investigations to Member States in our reports to Governing Bodies. All these reports are posted on our public website.

WHO listens to all feedback so we can learn and improve and provide the best possible advice and assistance to countries.

Milestones :: Perspectives

AP Exclusive: UN health chief orders probe into misconduct

By MARIA CHENG

Associates Press  January 17, 2019

LONDON (AP) — The head of the World Health Organization has ordered an internal investigation into allegations the U.N. health agency is rife with racism, sexism and corruption, after a series of anonymous emails with the explosive charges were sent to top managers last year.

Three emails addressed to WHO directors — and obtained by the Associated Press — complained about “systematic racial discrimination” against African staffers and alleged other instances of wrongdoing, including claims that some of the money intended to fight Ebola in Congo was misspent.

Last month, WHO Director-General Tedros Adhanom Ghebreyesus told staffers he had instructed the head of WHO’s office of internal oversight to look into the charges raised by the emails. He confirmed that directive to the AP on Thursday.

A WHO statement issued after the AP story was published said the agency was “aware” of such allegations and has “zero tolerance for misconduct or discrimination of any kind.” The statement said Tedros has “championed openness, transparency and diversity” since he became WHO’s chief.

However, critics doubt that WHO can effectively investigate itself and have called for the probe to be made public.

The first email, which was sent last April, claimed there was “systematic racial discrimination against Africans at WHO” and that African staffers were being “abused, sworn at (and) shown contempt to” by their Geneva-based colleagues.

Two further emails addressed to WHO directors complained that senior officials were “attempting to stifle” investigations into such problems and also alleged other instances of wrongdoing, including allegedly misspent Ebola funds.

The last email, sent in December, labeled the behavior of a senior doctor helping to lead the response against Ebola as “unacceptable, unprofessional and racist,” citing a November incident at a meeting where the doctor reportedly “humiliated, disgraced and belittled” a subordinate from the Middle East.

Tedros — a former health minister of Ethiopia and WHO’s first African director-general — said investigators looking into the charges “have all my support” and that he would provide more resources if necessary.

“To those that are giving us feedback, thank you,” he told a meeting of WHO’s country representatives in Nairobi last month. “We will do everything to correct (it) if there are problems.”

Milestones :: Perspectives

144th Session of the WHO Executive Board

24 January – 1 February 2019 Coordinated Universal Time

Geneva, Switzerland

Selected Agenda Content

EB144/1 – Provisional agenda
EB144/1 (annotated) – Provisional agenda (annotated)

EB144/8 – Public health preparedness and response
Report of the Independent Oversight and Advisory Committee for the WHO Health Emergencies Programme

EB144/9 – Polio Eradication
EB144/10 – Polio Transition

EB144/11 Rev.1 – Implementation of the 2030 Agenda for Sustainable Development

EB144/12 – Universal health coverage
Primary health care towards universal health coverage
EB144/13 – Universal health coverage
Community health workers delivering primary health care: opportunities and challenges
EB144/14 – Universal health coverage
Preparation for the high-level meeting of the United Nations General Assembly on universal health coverage

EB144/17 – Medicines, vaccines and health products
Access to medicines and vaccines
EB144/18 – Medicines, vaccines and health products
Cancer medicines
EB144/19 – Follow-up to the high-level meetings of the United Nations General Assembly on health-related issues
Antimicrobial resistance

EB144/21 – Follow-up to the high-level meetings of the United Nations General Assembly on health-related issues
Ending tuberculosis

EB144/23 – Pandemic Influenza Preparedness Framework for the sharing of influenza viruses and access to vaccines and other benefits
Implementation of decision WHA71(11) (2018)

EB144/24 – Member State mechanism on substandard and falsified medical products

EB144/27 – Promoting the health of refugees and migrants
Draft global action plan, 2019–2023

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