A welcome framework for research in Africa

Nature 
Volume 556 Issue 7701, 19 April 2018
http://www.nature.com/nature/current_issue.html

Editorial | 18 April 2018
A welcome framework for research in Africa
A new set of ethics principles should help researchers and funders do justice to the interests of those involved with Africa’s genomics research.
Helicopter science. Sample safaris. Parachute research. These are all pejorative terms used to describe the practice of collecting biological samples, artefacts or data from developing countries and analysing them elsewhere, with little input from — or credit given to — local scientists. Such practices are almost universally denounced by research funders and institutions in the global north. Yet the language still crops up, especially in disciplines such as genomics, for which the technology required to decode DNA at high volumes remains concentrated in wealthy countries.

In human genomics, there has been a push to ensure that research on samples collected in developing countries — particularly in Africa — is anchored in local science and community engagement. One example of this is the Human Heredity and Health in Africa (H3Africa) initiative, which is funded by the US National Institutes of Health and the London-based Wellcome Trust. Since 2012, it has funded genomics projects whose principal investigators are African, with several of the projects being managed locally from Kenya’s capital, Nairobi.

As we report this week, the H3Africa group has now published a guide for the ethical handling of genomic research and biobanking in Africa. It sets out to empower African researchers and communities, and to educate them on their rights in asking for greater control over how samples are collected, stored and used. It also contains rules of engagement for non-African institutions that are partnering with, or funding research in, Africa. It’s a useful guide, and draws on existing ethics policy documents. Many of its recommendations — such as avoiding tokenistic participation by African researchers, and ensuring that research results are fed back to the communities that donated the samples — have been regarded as good practice in the field for some time. But, in reality, such practices are all too often still lacking.

The fact that the document is derived from in-depth conversations with African researchers and ethics review boards gives it added legitimacy. Perceptions can vary about whether partnerships are equitable or not, and it is not uncommon for northern partners to hold up projects as exemplary in terms of their equitability, with African participants in the same projects complaining of limited input. This framework should help, by allowing negotiating partners to sing from the same hymn sheet.

Because it is voluntary, the framework’s impact will depend on its use by its target audiences. African research-ethics committees that preside over applications to carry out genetic research can use it to ensure that their decisions have the interests of Africans at heart. African researchers can draw on it to negotiate more-advantageous terms in partnerships. Research funders can encourage applicants to consider the framework when submitting proposals. African governments can use it to inform their rules guiding genomics research. And, perhaps most importantly, African communities can look to the framework for information about what to expect, or even demand, from their participation in research.

Ultimately, the foremost priority of researchers, funders, regulators and ethicists should be to respect the rights and interests of the populations studied. In the scramble for African genomes, such rights can easily be overlooked — especially in countries with weak governance, where research-ethics rules are outdated or where patient-rights groups are lacking. There is therefore a need for greater involvement by African governments and civil society, to ensure that genomic research is in the public’s interest, not just in the interests of the participating scientists — regardless of where they come from.

How poverty affects diet to shape the microbiota and chronic disease

Nature Reviews Immunology
April 2018 Vol 18 No 4
https://www.nature.com/nri/journal/v18/n4/index.html

Perspectives
Opinion
How poverty affects diet to shape the microbiota and chronic disease
Christy A. Harrison & Douglas Taren
p279 | doi:10.1038/nri.2017.121
In this Opinion article, the authors consider how poverty and diet can shape the microbiota and immune health. They highlight how this contributes to the greater levels of chronic disease that are experienced by low-income individuals in high-income societies.
Abstract
Here, we discuss the link between nutrition, non-communicable chronic diseases and socio-economic standing, with a special focus on the microbiota. We provide a theoretical framework and several lines of evidence from both animal and human studies that support the idea that income inequality is an underlying factor for the maladaptive changes seen in the microbiota in certain populations. We propose that this contributes to the health disparities that are seen between lower-income and higher-income populations in high-income countries.

Monoclonal Antibodies for Emerging Infectious Diseases — Borrowing from History

New England Journal of Medicine
April 19, 2018  Vol. 378 No. 16
http://www.nejm.org/toc/nejm/medical-journal

Perspective   Free Preview
Monoclonal Antibodies for Emerging Infectious Diseases — Borrowing from History
H.D. Marston, C.I. Paules, and A.S. Fauci
Recent conceptual and technological advances in mAb development could have an enormous impact on the field of infectious diseases, particularly in the context of emerging infectious disease (EID) outbreaks, in which the process of vaccine development for new pathogens may be difficult and prolonged. The rapid development and strategic deployment of effective, highly specific preventive and therapeutic interventions have the potential to alter the course of an epidemic…

Evaluation of Intussusception after Monovalent Rotavirus Vaccination in Africa

New England Journal of Medicine
April 19, 2018  Vol. 378 No. 16
http://www.nejm.org/toc/nejm/medical-journal

Original Articles
Evaluation of Intussusception after Monovalent Rotavirus Vaccination in Africa
J.E. Tate and Others
Abstract
Background
Postlicensure evaluations have identified an association between rotavirus vaccination and intussusception in several high- and middle-income countries. We assessed the association between monovalent human rotavirus vaccine and intussusception in lower-income sub-Saharan African countries.
Methods
Using active surveillance, we enrolled patients from seven countries (Ethiopia, Ghana, Kenya, Malawi, Tanzania, Zambia, and Zimbabwe) who had intussusception that met international (Brighton Collaboration level 1) criteria. Rotavirus vaccination status was confirmed by review of the vaccine card or clinic records. The risk of intussusception within 1 to 7 days and 8 to 21 days after vaccination among infants 28 to 245 days of age was assessed by means of the self-controlled case-series method.
Results
Data on 717 infants who had intussusception and confirmed vaccination status were analyzed. One case occurred in the 1 to 7 days after dose 1, and 6 cases occurred in the 8 to 21 days after dose 1. Five cases and 16 cases occurred in the 1 to 7 days and 8 to 21 days, respectively, after dose 2. The risk of intussusception in the 1 to 7 days after dose 1 was not higher than the background risk of intussusception (relative incidence [i.e., the incidence during the risk window vs. all other times], 0.25; 95% confidence interval [CI], <0.001 to 1.16); findings were similar for the 1 to 7 days after dose 2 (relative incidence, 0.76; 95% CI, 0.16 to 1.87). In addition, the risk of intussusception in the 8 to 21 days or 1 to 21 days after either dose was not found to be higher than the background risk.
Conclusions
The risk of intussusception after administration of monovalent human rotavirus vaccine was not higher than the background risk of intussusception in seven lower-income sub-Saharan African countries. (Funded by the GAVI Alliance through the CDC Foundation.)

Preprints in medical research: Progress and principles

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 21 April 2018)

Editorial |
Preprints in medical research: Progress and principles
Larry Peiperl, on behalf of the PLOS Medicine Editors
published 16 Apr 2018 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1002563
[Initial text]
Sharing of preprints—scientific manuscripts that are posted in a publicly accessible, online repository before peer review for journal publication—can accelerate access to information in infectious disease outbreaks, according to an article published earlier this month by Michael Johansson and colleagues in PLOS Medicine. In an analysis of published articles and those posted on preprint servers, the authors found that preprint posting increased during the 2015–17 outbreak of Zika in the Americas relative to the 2014–15 Ebola outbreak in West Africa, and that preprints, while still used for only a small proportion of papers, provided much earlier access to scientific findings [1].
For medical journal editors who agreed in late 2015 and early 2016 that authors should not be penalized for sharing results in public health emergencies [24], these results signal gratifying progress over practices in 2003, when the severe acute respiratory syndrome (SARS) epidemic was shown to have ended before 93% of journal articles on the epidemiology of SARS were published [5]…

Could violent conflict derail the London Declaration on NTDs?

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 21 April 2018)

Viewpoints
Could violent conflict derail the London Declaration on NTDs?
Rebecca Y. Du, Jeffrey D. Stanaway, Peter J. Hotez
| published 19 Apr 2018 PLOS Neglected Tropical Diseases
https://doi.org/10.1371/journal.pntd.0006136
[Excerpt]
…The impact of violent conflict on achieving the 2012 London Declaration
The following diseases are the 10 NTDs targeted by the 2012 London Declaration: dracunculiasis (Guinea worm disease), lymphatic filariasis, leprosy, human African trypanosomiasis (sleeping sickness), trachoma, schistosomiasis, soil-transmitted helminth (STH) infections, chagas disease, visceral leishmaniasis, and onchocerciasis (river blindness) [4]. Every one of these diseases, with the exception of STHs, is highly endemic in one or more countries with high potential for or ongoing violent conflict, as defined by the GPI. STHs also are most likely impacted by conflict; however, the two STHs modeled separately by the GBD 2013 (hookworm and trichuriasis) did not show high endemicity in countries with conflict; therefore, we did not include them in our discussion. We do hypothesize that the same mechanisms that increase risk for NTDs during conflict apply to STHs as well.
We cannot quantify the impact of conflict on each NTD; however, conflict has most likely influenced disease prevalence or disease control and elimination efforts for each of these NTDs in one way or another. It is already reported that ongoing efforts to control onchocerciasis in CAR [18] and sleeping sickness in South Sudan and Uganda [1921] are being disrupted by violent conflict. In the following section, we discuss the major mechanisms through which violent conflict may increase NTD risk…

Supply-side interventions to improve health: Findings from the Salud Mesoamérica Initiative

PLoS One
http://www.plosone.org/
[Accessed 21 April 2018]

Research Article
Supply-side interventions to improve health: Findings from the Salud Mesoamérica Initiative
Ali H. Mokdad, Erin B. Palmisano, Paola Zúñiga-Brenes, Diego Ríos-Zertuche, Casey K. Johanns, Alexandra Schaefer, Sima S. Desai, Annie Haakenstad, Marielle C. Gagnier, Claire R. McNellan, Danny V. Colombara, Sonia López Romero, Leolin Castillo, Benito Salvatierra, Bernardo Hernandez, Miguel Betancourt-Cravioto, Ricardo Mujica-Rosales, Ferdinando Regalia, Roberto Tapia-Conyer, Emma Iriarte
Research Article | published 16 Apr 2018 PLOS ONE
https://doi.org/10.1371/journal.pone.0195292
Abstract
Background
Results-based aid (RBA) is increasingly used to incentivize action in health. In Mesoamerica, the region consisting of southern Mexico and Central America, the RBA project known as the Salud Mesoamérica Initiative (SMI) was designed to target disparities in maternal and child health, focusing on the poorest 20% of the population across the region.
Methods and findings
Data were first collected in 365 intervention health facilities to establish a baseline of indicators. For the first follow-up measure, 18 to 24 months later, 368 facilities were evaluated in these same areas. At both stages, we measured a near-identical set of supply-side performance indicators in line with country-specific priorities in maternal and child health. All countries showed progress in performance indicators, although with different levels. El Salvador, Honduras, Nicaragua, and Panama reached their 18-month targets, while the State of Chiapas in Mexico, Guatemala, and Belize did not. A second follow-up measurement in Chiapas and Guatemala showed continued progress, as they achieved previously missed targets nine to 12 months later, after implementing a performance improvement plan.
Conclusions
Our findings show an initial success in the supply-side indicators of SMI. Our data suggest that the RBA approach can be a motivator to improve availability of drugs and services in poor areas. Moreover, our innovative monitoring and evaluation framework will allow health officials with limited resources to identify and target areas of greatest need.

Systematic review of economic evaluations of the 23-valent pneumococcal polysaccharide vaccine (PPV23) in individuals 60 years of age or older

Vaccine
Volume 36, Issue 19  Pages 2501-2742 (3 May 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/19

Review
Systematic review of economic evaluations of the 23-valent pneumococcal polysaccharide vaccine (PPV23) in individuals 60 years of age or older
Review article
Pages 2510-2522
Alvaro Mitsunori Nishikawa, Ana Marli Christovam Sartori, Giulia Marcelino Mainardi, Angela Carvalho Freitas, … Patrícia Coelho de Soárez

The public health value of vaccination for seniors in Europe

Vaccine
Volume 36, Issue 19  Pages 2501-2742 (3 May 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/19

The public health value of vaccination for seniors in Europe
Review article
Pages 2523-2528
Susanna Esposito, Elisabetta Franco, Gaetan Gavazzi, Angel Gil de Miguel, … Jose Antonio López Trigo
Abstract
Longer life expectancy and decreasing fertility rates mean that the proportion of older people is continually increasing worldwide, and particularly in Europe. Ageing is associated with an increase in the risk and severity of infectious diseases. These diseases are also more difficult to diagnose and manage in seniors who often have at least one comorbid condition (60% of seniors have two or more conditions). Infectious diseases increase the risk of hospitalization, loss of autonomy and death in seniors. Effective vaccines are available in Europe for infectious diseases such as influenza, pneumococcal diseases, herpes zoster, diphtheria, tetanus and pertussis. Their effectiveness has been demonstrated in terms of reducing the rates of hospitalization, disability, dependency and death. The prevention of diseases in seniors also results in savings in healthcare and societal costs each year in Europe. Despite the availability of vaccines, vaccine-preventable diseases affect millions of European citizens annually, with the greatest burden of disease occurring in seniors, and the medical and economic benefits associated with are not being achieved. Vaccination coverage rates must be improved to achieve the full benefits of vaccination of seniors in Europe.

Systematic review of cost-effectiveness studies of human papillomavirus (HPV) vaccination: 9-Valent vaccine, gender-neutral and multiple age cohort vaccination

Vaccine
Volume 36, Issue 19  Pages 2501-2742 (3 May 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/19

Systematic review of cost-effectiveness studies of human papillomavirus (HPV) vaccination: 9-Valent vaccine, gender-neutral and multiple age cohort vaccination
Review article
Pages 2529-2544
Siok Shen Ng, Raymond Hutubessy, Nathorn Chaiyakunapruk

Human papillomavirus vaccine acceptability and decision-making among adolescent boys and parents: A meta-ethnography of qualitative studies

Vaccine
Volume 36, Issue 19  Pages 2501-2742 (3 May 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/19

Human papillomavirus vaccine acceptability and decision-making among adolescent boys and parents: A meta-ethnography of qualitative studies
Review article
Pages 2545-2558
Ashley Lacombe-Duncan, Peter A. Newman, Philip Baiden
Abstract
Objective
Genital warts and human papillomavirus (HPV)-associated cancers in men can be substantially reduced through HPV vaccination; yet, globally, HPV vaccine uptake among boys remains low. This meta-ethnography synthesizes qualitative studies to understand, in-depth, HPV vaccine acceptability and decision-making among adolescent boys and/or their parents.
Methods
A systematic search identified qualitative studies examining HPV vaccines from the perspectives of boys and/or boys’ parents. The Consolidated Criteria for Reporting Qualitative Research (COREQ) 32-item checklist was used to assess quality of reporting. Using meta-ethnographic techniques, we conducted a structured and iterative process of data analysis, coded original studies, and then developed descriptive and analytic themes to synthesize the findings.
Results
Review of 15 eligible studies (n = 3362 parents, n = 39 boys) revealed multilevel factors that influence HPV vaccine acceptability and decision-making among adolescent boys and their parents: (1) individual, e.g., low HPV vaccine knowledge/awareness, (2) interpersonal, e.g., key relationships between parents, sons, and healthcare providers (HCP), (3) community/societal, e.g., parental duty to protect, and (4) systemic, e.g., HPV vaccine messaging. Parents generally accepted adolescent boys’ sexuality and the need for vaccination, motivated by wanting to protect their sons from HPV and HPV-associated cancers, and valued HCP-initiated discussion and recommendation. Acceptability was mitigated by low awareness/knowledge of HPV vaccines and low perceived benefits for boys, lack of HCP-initiated discussion, out-of-pocket costs, multiple doses, stigma, and mixed messages about HPV.
Conclusions
Multilevel factors influence HPV vaccine acceptability and decision-making among parents and their adolescent sons. Providing clear and unambiguous messages about HPV vaccines—for whom (boys and girls), for what (genital warts and cancers in men), and when (before sexual debut)—through increased HCP-initiated discussion and targeted public health campaigns may support HPV vaccine uptake among boys. Future research should consistently disaggregate findings by sex of child and parent, and explore effective messaging tailored for boys and parents.

Associations between parents’ satisfaction with provider communication and HPV vaccination behaviors

Vaccine
Volume 36, Issue 19  Pages 2501-2742 (3 May 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/1

Associations between parents’ satisfaction with provider communication and HPV vaccination behaviors
Original research article
Pages 2637-2642
Melanie L. Kornides, Holly B. Fontenot, Annie-Laurie McRee, Catherine A. Panozzo, Melissa B. Gilkey

Parental acceptability of HPV vaccination for boys and girls aged 9–13 years in China – A population-based study

Vaccine
Volume 36, Issue 19  Pages 2501-2742 (3 May 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/19

Parental acceptability of HPV vaccination for boys and girls aged 9–13 years in China – A population-based study
Original research article
Pages 2657-2665
Zixin Wang, Jingjing Wang, Yuan Fang, Danielle L. Gross, … Joseph T.F. Lau

Media/Policy Watch

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.
 
 
Financial Times
http://www.ft.com/home/uk
Accessed 21 April 2018
Malaria vaccine pilot steers past final delays
16 April 2017.
 
Wall Street Journal
http://online.wsj.com/home-page?_wsjregion=na,us&_homepage=/home/us
Accessed 21 April 2018
New CDC Chief Resigned From Four Entities to Comply With Ethics Rules
By Betsy McKay
April 17, 2018 11:09 am ET
Robert Redfield, the new director of the Centers for Disease Control and Prevention, resigned positions at four entities, sold stock and forfeited options in two companies and is signing his share of future patent licensing fees and royalties over to his university to comply with ethics rules.

Washington Post
http://www.washingtonpost.com/
Accessed 21 April 2018
Nigeria’s Boko Haram extremists hamper polio eradication
16 April 2018
…The complicated fight against polio is yet another way the Nigeria-based extremist group Boko Haram has disrupted life in the northeast, leaving children vulnerable to an entirely preventable disease.
“When such children come to the camps or host communities they become a threat to other children,” said Almai Some, the field coordinator in Borno state for the vaccination campaign run by Rotary.
Some of the families arriving are from areas where polio vaccinators have not been able to visit for as long as six years.
Boko Haram’s insurgency began in Maiduguri, Borno state’s capital, but its reach has expanded beyond Nigeria’s borders to neighboring Niger, Chad and Cameroon. Its violence has proved to be a major setback to the international campaign against polio.
Nigeria is one of just three countries where polio is endemic and has not been eliminated, along with Pakistan and Afghanistan. The final phase to wipe out polio is “proving to be extraordinarily difficult” because “the poliovirus is surviving despite all the good work and in the face of everything that is being thrown at it,” said a WHO-appointed monitoring group at the end of last year…

Vaccines and Global Health: The Week in Review 14 April 2018

Vaccines and Global Health: The Week in Review is a weekly digest  summarizing news, events, announcements, peer-reviewed articles and research in the global vaccine ethics and policy space. Content is aggregated from key governmental, NGO, international organization and industry sources, key peer-reviewed journals, and other media channels. This summary proceeds from the broad base of themes and issues monitored by the Center for Vaccine Ethics & Policy in its work: it is not intended to be exhaustive in its coverage. You are viewing the blog version of our weekly digest, typically comprised of between 30 and 40 posts below all dated with the current issue date

.– Request an Email Summary: Vaccines and Global Health : The Week in Review is published as a single email summary, scheduled for release each Saturday evening before midnight (EDT in the U.S.). If you would like to receive the email version, please send your request to david.r.curry@centerforvaccineethicsandpolicy.org.

 pdf version A pdf of the current issue is available here: Vaccines and Global Health_The Week in Review_14 April 2018

– blog edition: comprised of the approx. 35+ entries posted below.

– Twitter:  Readers can also follow developments on twitter: @vaxethicspolicy.
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– Links:  We endeavor to test each link as we incorporate it into any post, but recognize that some links may become “stale” as publications and websites reorganize content over time. We apologize in advance for any links that may not be operative. We believe the contextual information in a given post should allow retrieval, but please contact us as above for assistance if necessary.

Support this knowledge-sharing service: Your financial support helps us cover our costs and to address a current shortfall in our annual operating budget. Click here to donate and thank you in advance for your contribution.

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

Nearly one billion people in Africa to be protected against yellow fever by 2026

Milestones :: Perspectives
 
Nearly one billion people in Africa to be protected against yellow fever by 2026
Joint press release
ABUJA, 10 April 2018 — Nearly one billion people will be vaccinated against yellow fever in 27 high-risk African countries by 2026 with support from the World Health Organization (WHO), Gavi – the Vaccine Alliance, UNICEF and more than 50 health partners.

The commitment is part of the Eliminate Yellow fever Epidemics (EYE) in Africa strategy, which was launched by Dr Tedros Adhanom Ghebreyesus, WHO Director-General, Professor Isaac Folorunso Adewole, Nigeria’s Minister of Health and partners at a regional meeting in Abuja, Nigeria on Tuesday (10 April).

“The world is facing an increased risk of Yellow fever outbreaks and Africa is particularly vulnerable,” said Dr Tedros. “With one injection we can protect a person for life against this dangerous pathogen. This unprecedented commitment by countries will ensure that by 2026 Africa is free of Yellow fever epidemics.”

During the three-day EYE strategy regional launch meeting representatives from key African countries, WHO, UNICEF, Gavi, and other partners are developing a roadmap on how to roll-out the EYE strategy at national level. This implementation effort follows the endorsement of the strategy by African Ministers of Health at the 67th WHO regional committee in September 2017.

“This comprehensive, global strategy offers an unprecedented opportunity to end the devastating Yellow fever epidemics that periodically impact Africa,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. “Ensuring that the most vulnerable communities have access to the vaccine through routine systems plays a central role in making this happen. Vaccine manufacturers and Gavi partners have worked hard to improve the global vaccine supply situation in recent years to make sure there is enough vaccine to respond to outbreaks, allow preventive campaigns and that routine immunization functions at full capacity.”

The three objectives of the strategy include protecting at-risk populations through preventive mass vaccination campaigns and routine immunization programmes, preventing international spread, and containing outbreaks rapidly. Developing strong surveillance with robust laboratory networks is key to these efforts.

UNICEF will make vaccines available, advocate for greater political commitment and provide support in vaccinating children through routine immunization as well as during outbreaks of the disease.

“Today, the threat of yellow fever looms larger than ever before, especially for thousands of children across Africa,” said Stefan Peterson, UNICEF’s Chief of Health. “Given that almost half of the people to be vaccinated are children under 15 years of age, this campaign is critical to saving children’s lives, and would go a long way toward stamping out this disease.”

Brazil is currently battling its worst outbreak of Yellow fever in decades with more than 1,000 confirmed cases. The ease and speed of population movements, rapid urbanization and a resurgence of mosquitoes due to global warming have significantly increased the risk of urban outbreaks with international spread.

Experience in West Africa demonstrates that the EYE strategy can work. When Yellow fever re-emerged as a public health issue in the early 2000s, countries in the region controlled the epidemics through preventive mass campaigns combined with routine immunization. No yellow fever epidemics have been recorded since in countries which successfully implemented this approach.

.
Note to Editors
The EYE strategy partners include GAVI the Vaccine Alliance, Endemic and New Technologies Franchise Sanofi Pasteur, Sealy Center for Vaccine Development at the University of Texas, GE Foundation, United Nations Children’s Fund (UNICEF), United States Agency for International Development (USAID), Agence de Médecine Préventive (AMP), School of Veterinary Medicine University of Surrey, Bio Manguinhos/Fiocruz, Department for International Development (DFID), Institut Pasteur Dakar, ExxonMobil, Save the Children, ArcelorMittal, Wellcome Trust, Imperial College London, Centers for Disease Control and Prevention (CDC), United Nations High Commissioner for Refugees (UNHCR), Sanofi Pasteur, Department of Tropical Medicine University of Hawaii, Medair, Chumakov Federal Scientific Center for Research & Development of Immune-and-Biological Products Russian Academy  of Medical Sciences, China National Biotech Group, Skoll Global Threats Fund, Bill & Melinda Gates Foundation, International Federation of Red Cross and Red Crescent Societies (IFRC), National Institutes of Health (NIH), BioProtection Systems/NewLikn Genetics Corp., Robert Koch-Institut, Regional Immunization Technical Advisory Group (RITAG), PATH – Center for Vaccine Innovation and Access, Department of Entomology University of California, World Meteorological Organization (WMO), Vaccinology and Immunology Unit University Hospitals Geneva, Nigerian Academy of Science, Médecins Sans Frontières (MSF), Instituto Evandro Chagas (IEC), International Organization for Migration (IOM) and European Centre for Disease Prevention and Control (ECDC).

Inovio Awarded up to $56 Million from CEPI to Advance DNA Vaccines Against Lassa Fever and MERS

Milestones :: Perspectives

Inovio Awarded up to $56 Million from CEPI to Advance DNA Vaccines Against Lassa Fever and MERS
Major investment by Coalition for Epidemic Preparedness Innovations (CEPI) to advance vaccine development and manufacturing on two of CEPI’s highest priority infectious diseases
PLYMOUTH MEETING, Pa. (USA) and OSLO, Norway – April 11, 2018 – Inovio Pharmaceuticals, Inc. (NASDAQ: INO) and CEPI – the Coalition for Epidemic Preparedness Innovations — today announced a partnership under which Inovio will develop vaccine candidates against Lassa fever and Middle East Respiratory Syndrome (MERS).

CEPI will fund up to $56,000,000 to support Inovio’s pre-clinical and clinical advancement through Phase 2 of INO-4500, its Lassa fever vaccine, and INO-4700, its MERS vaccine. The shared goal of Inovio and CEPI is for the Lassa and MERS vaccines to be available as soon as possible for emergency use.

This is the second company agreement CEPI has signed since its launch in 2017. These partnerships represent an innovative approach to funding vaccine development, unlocking research and development potential so that vaccines are ready for efficacy studies during an outbreak. The agreement will enable funding for Inovio’s development efforts over a five-year period. The partnership agreement also includes options, not counted in the total above, to establish investigational stockpiles of both vaccines….

Richard Hatchett, CEO of CEPI said: “Epidemics don’t respect borders; they destroy lives and devastate economies and we need to move swiftly to prepare for them. “Partnering with Inovio is a considerable move forward for CEPI’s vaccine portfolio and developing a global insurance policy against these diseases.”

CEPI’s funding will support development up to the end of Phase 2, providing clinical safety and immunological data, and the establishment of investigational stockpiles that will be ready for clinical efficacy trial testing during outbreaks.

CEPI’s portfolio of investments will provide additional benefits to the wider vaccine community through the development of assays, reference standards and associated knowledge that may accelerate the development of other vaccines and medical counter measures against Lassa fever and MERS…

Inovio will develop these DNA vaccines employing its ASPIRE™ (Antigen SPecific Immune REsponses) platform. This platform delivers optimized synthetic antigenic genes into cells, where they are translated into protein antigens that activate an individual’s immune system to generate robust targeted T cell and antibody responses. Inovio’s immunotherapies function exclusively in vivo, and have generated an antigen-specific immune response against targeted diseases in all clinical trials to date…

Inovio is advancing MERS and Lassa vaccines with the support of its collaborators: The Wistar Institute, Laval University, the NIH’s Rocky Mountain Laboratories, U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), VGXI/GeneOne Life Science and the International Vaccine Institute.

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Emergencies

Emergencies

 
POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 3 April 2018 [GPEI]
:: New on www.polioeradication.org: Bill Gates and Aliko Dangote support polio eradication efforts in Nigeria. We talk with Professor Rose Leke, Chair of the African Regional Certification Commission, and with Dr Ondrej Mach, who explains why we are developing new polio vaccines for the post-eradication era.
:: The report following the February meeting of the Global Commission for Certification of Poliomyelitis Eradication (GCC) is now published and available here. The GCC came together to review the criteria that will need to be met to achieve global certification of eradication.
:: In Kenya, advance notification of a circulating vaccine-derived poliovirus type 2 (cVPDV2) detected from an environmental sample is being investigated (to be officially reflected in next week’s global data). A cVDPV2 was isolated from an environmental sample collected on 21 March 2018 from Nairobi, linked to the cVDPV2 confirmed from Mogadishu, Somalia. No cases of paralysis associated with this virus have been detected, however a risk assessment is ongoing as is planning for a potential regional response.

Summary of newly-reported viruses this week:
Afghanistan: Two new wild poliovirus type 1 (WPV1)  positive environmental samples have been reported in Kandahar province.
Pakistan: One new wild poliovirus type 1 (WPV1)  positive environmental sample has been reported in Sindh province
 
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Global Commission for the Certification of the Eradication of Poliomyelitis – Report from the Seventeenth Meeting
Geneva, Switzerland, 26 – 27 February 2018 :: 23 pages
The Global Commission for the Certification of Poliomyelitis Eradication (GCCPE/GCC) met in February 2018. It noted that although no WPV paralytic cases had been reported in Pakistan since November 2017 and fewer cases were being reported from Afghanistan for comparable periods in earlier years, considerable numbers of positive environmental samples were being reported from both countries implying that there was still significant ongoing transmission. This circulation of WPVs has implications for the commencement and conclusion of the process of certification of interruption of transmission.

The GCC has previously asked for development of a risk assessment tool that can be used by National Certification Committees and Regional Certification Commissions allowing the GCC to compare risks and their mitigation between countries and across Regions. The GCC noted the progress being made with this tool and hopes that it will be introduced shortly in all Regions.

The GCC considered the possibility that there may still be cVDPV outbreaks in the approach to certification and agreed conditions for the process of certification in such circumstances. The GCC also reviewed the surveillance standards that it will require countries to fulfil according to the systems in place (AFP, environmental and enterovirus surveillance or combinations of these). The GCC’s Terms of Reference were reviewed since it had been many years since this was last done. The GCC has previously recommended that countries should undertake outbreak simulation exercises and proposed that the GCC should undertake a certification exercise. This could be done using the example of certification of WPV3 eradication. Finally, the GCC asked for a time line for its activities to be presented regularly and updated as circumstances on the interruption of transmission and containment change.

The GCC will meet next in approximately six months.
Prof. David M. Salisbury CB
FRCP, FRCPCH, FFPH, FMedSci.
Chair, GCC

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WHO Grade 3 Emergencies  [to 14 April 2018]

WHO concerned about suspected chemical attacks in Syria
11 April 2018 – WHO is deeply alarmed by reports of the suspected use of toxic chemicals in Douma city, East Ghouta.

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WHO Grade 2 Emergencies  [to 14 April 2018]

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::::::
 
UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises. 
Syrian Arab Republic
:: Syrian Arab Republic: Response to the East Ghouta Crisis in Rural Damascus Situation Report No. 3 (3 April – 11 April 2018) 11 Apr 2018
:: Turkey | Syria: Situation in North-western Syria – Situation Report No.2 (as of 10 April 2018)
 
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UN OCHA – Corporate Emergencies
When the USG/ERC declares a Corporate Emergency Response, all OCHA offices, branches and sections provide their full support to response activities both at HQ and in the field.
Ethiopia 
:: Ethiopia Humanitarian Bulletin Issue 50 | 26 March – 08 April 2018

Rohinga Refugee Crisis 
:: ISCG Situation Report: Rohingya Refugee Crisis, Cox’s Bazar | 12 April 2018
 
 
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Editor’s Note:
We will cluster these recent emergencies as below and continue to monitor the WHO webpages for updates and key developments.

 
Yellow Fever  [to 14 April 2018]
http://www.who.int/csr/disease/yellowfev/en/
:: Nearly one billion people in Africa to be protected against yellow fever by 2026  10 April 2018
[See Milestones/Perspectives above for more detail]

WHO & Regional Offices [to 14 April 2018]

WHO & Regional Offices [to 14 April 2018]
Latest News
Guidance to promote breastfeeding in health facilities
11 April 2018 – Breastfeeding all babies for the first 2 years would save the lives of more than 820,000 children under age 5 annually.

Highlights
Denmark hosts the WHO Global Dialogue on Partnerships for Sustainable Financing of Noncommunicable Disease Prevention and Control
April 2018 – Noncommunicable diseases are responsible for 40 million deaths globally every year. Tackling NCDs is a global priority, but despite this, investment is still lacking and action is needed to reach the United Nations Sustainable Development Goal target 3.4 of reducing premature deaths from NCDs by one third by 2030. In response, Denmark is co-hosting the WHO Global Dialogue in Copenhagen from 9 to 11 April 2018
::::::
 
Weekly Epidemiological Record, 13 April 2018, vol. 93, 15 (pp. 185–200)
:: Surveillance to track progress towards polio eradication worldwide, 2016–2017
:: Performance of acute flaccid paralysis (AFP) surveillance and incidence of poliomyelitis, 2018
:: Monthly report on dracunculiasis cases, January-February 2018

::::::
 
SAGE call for nominations
Deadline for applications: 31 May 2018
WHO is soliciting proposals for nominations of experts to serve on its Strategic Advisory Group of Experts (SAGE) on immunization.
SAGE is the principal advisory group to WHO for vaccines and immunization. SAGE reports to the Director-General of WHO and advises on global policies and strategies, ranging from vaccine R&D and vaccination recommendations to delivery of immunization, its linkages with other health interventions and integration into health systems. Its remit is not restricted to childhood immunization but extends to all vaccine-preventable diseases for all age groups.
Please see this link for further information: http://www.who.int/immunization/sage/en/

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WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
Selected Featured News
:: Tanzania rolls out vaccination against cervical cancer  12 April 2018
:: Nearly one billion people in Africa to be protected against yellow fever by 2026  10 April 2018

WHO European Region EURO
:: Multidisciplinary primary care teams in Spain provide person-centred care 11-04-2018
:: Surveillance teams risk all to track disease outbreaks in northern Syria 11-04-2018
:: Northern Syria: access to primary health care gives hope to malnourished child 10-04-2018
:: Bringing health services closer to people in Kyrgyzstan 05-04-2018

WHO Eastern Mediterranean Region EMRO
:: WHO concerned about suspected chemical attacks in Syria  11 April 2018

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CDC/ACIP [to 14 April 2018]
http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html

MMWR News Synopsis for April 12, 2018
Surveillance Systems to Track Progress Toward Polio Eradication — Worldwide, 2016–2017
While 2017 saw the fewest number of polio cases ever recorded globally, continued improvements to national surveillance systems are necessary to ensure timely detection of cases and accurate certification of polio-free status. As the world moves closer to eliminating polio, it is more important than ever to have strong surveillance systems in place. Only 22 wild poliovirus (WPV) cases were reported in 2017, the fewest ever reported globally. Despite this improvement, the number of vaccine-derived poliovirus (cVPDVs) cases increased to 96 in 2017, due to outbreaks in Syria and in Democratic Republic of the Congo. While surveillance performance is improving at the country level, gaps remain within countries largely because of conflict and inaccessibility in some regions. Rapid improvements in surveillance systems are needed. As long as polioviruses continue to circulate in any country, all countries remain at risk.

Announcements

Announcements

Bill & Melinda Gates Medical Research Institute    [to 14 April 2018]
https://www.linkedin.com/company/bill-melinda-gates-medical-research-institute/
   The Bill & Melinda Gates Medical Research Institute is a non-profit research organization dedicated to combating diseases that impact the world’s poorest. We strive to combat inequities in health by accelerating progress in translational science to ensure life-saving products are available and accessible to everyone. We consider ourselves pioneers dedicated to uncovering radical solutions that will close the gap between cutting-edge scientific innovation and its application to challenges in global health.
No new digest content identified.

 
CEPI – Coalition for Epidemic Preparedness Innovations  [to 14 April 2018]
http://cepi.net/
Posted on 11TH APR 2018 by Rachel Grant
Inovio Awarded up to $56 Million from CEPI to Advance DNA Vaccines Against Lassa Fever and MERS
Major investment by Coalition for Epidemic Preparedness Innovations (CEPI) to advance vaccine development and manufacturing on two of CEPI’s highest priority infectious diseases
[See Milestones/Perspectives above for more detail]

IVAC  [to 14 April 2018]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
IVAC Blog
IVAC Welcomes Dr. Naor Bar-Zeev
Posted 4/10/18
The International Vaccine Access Center (IVAC) is pleased to announce that Naor Bar-Zeev, MBBS(Hons), MPH, MBiostat, PhD, has joined the IVAC team as an Associate Professor in the Department of International Health at the Johns Hopkins Bloomberg School of Public Health.

 
MSF/Médecins Sans Frontières  [to 14 April 2018]
http://www.doctorswithoutborders.org/news-stories/press/press-releases
April 13, 2018
Central African Republic: MSF Treats Wounded Amid Violence in Bangui
MSF has treated 80 wounded patients amid violence in Bangui over the past week. In the early morning of April 8, United Nations and Central African Republic security forces launched a joint operation in the PK5 neighborhood in Bangui, which involved heavy fighting and resulted in dozens of people injured.

Press release
Syria: Displaced People From Eastern Ghouta Need Treatment
April 13, 2018
Roughly 60,000 people have been displaced from eastern Ghouta, near Damascus, to northwestern Syria in the past month. A significant number of these men, women, and children are injured or sick and in need of medical care. Doctors Without Borders/Médecins Sans Frontières (MSF) supports the main hospital in charge of triaging and treating these patients at a location known as the “zero point,” where people arrive on buses.

 
NIH  [to 14 April 2018]
http://www.nih.gov/news-events/news-releases
April 9, 2018
NIH scientists develop macaque model to study Crimean-Congo hemorrhagic fever
— CCHF is a viral disease spread by ticks in the Middle East, Asia, Africa and parts of Europe.
 
 
PATH  [to 14 April 2018]
http://www.path.org/news/index.php
Press release | April 12, 2018
New study results from Uganda strengthen the case for contraceptive self-injection
Study finds that self-administration enables women to use injectable contraception longer

Announcement | April 10, 2018
PATH names Anthony Okoth as Country Director for Kenya office

UNICEF  [to 14 April 2018]
https://www.unicef.org/media/
Selected Press Releases
11 April, 2018
WHO and UNICEF issue new guidance to promote breastfeeding in health facilities globally
GENEVA – The World Health Organization (WHO) and UNICEF today issued new ten-step guidance to increase support for breastfeeding in health facilities that provide maternity and newborn services. Breastfeeding all babies for the first two years would save the lives of more than 820,000 children under age 5 annually.

Nearly one billion people in Africa to be protected against yellow fever by 2026
ABUJA, 10 April 2018 — Nearly one billion people will be vaccinated against yellow fever in 27 high-risk African countries by 2026 with support from the World Health Organization (WHO), Gavi – the Vaccine Alliance, UNICEF and more than 50 health partners.
[See Milestones/Perspectives above for more detail]

High risk of disease outbreaks in earthquake-hit Papua New Guinea – UNICEF and WHO
PORT MORESBY, 9 April 2018 – UNICEF and the World Health Organization (WHO) have cautioned about the high potential of waterborne and vaccine-preventable disease outbreaks in earthquake-affected areas of Papua New Guinea.
 

Wellcome Trust  [to 14 April 2018]
https://wellcome.ac.uk/news
Published: 12 April 2018
How to make sense of the brain’s billions of neurons
A unique global collaboration is attempting to transform the way we study the brain. If it succeeds, it could start to address longstanding unanswered questions about how brain disorders alter our neural circuits.

Genetic changes linked to adult kidney cancer can occur in childhood
News / Published: 12 April 2018
Researchers at the Wellcome Sanger Institute have discovered that key genetic changes which may lead to kidney cancer can occur as early as childhood or adolescence. This can be up to 50 years before the disease is diagnosed

How we’ve defined what success looks like for Wellcome’s work
Explainer / Published: 10 April 2018
Chonnettia Jones, our Director of Insight and Analysis, explains how developing a success framework is leading to new ways of thinking and working across Wellcome

 
The Wistar Institute   [to 14 April 2018]
https://www.wistar.org/news/press-releases
Press Release   Apr. 12 2018
Novel Combination Therapy Effective for NRAS Mutant and Therapy Resistant Melanoma
Co-targeting BET and MEK holds promise as a salvage therapy for melanoma resistant to targeted therapy and immunotherapy.

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DCVMN – Developing Country Vaccine Manufacturers Network  [to 14 April 2018]
http://www.dcvmn.org/
14 April 2018
Regional workshop: Optimization of vaccines’ manufacturing, containers and testing for global supply
7 May 2018 to 10 May 2018
Hyderabad / India
 
 
Industry Watch    [to 14 April 2018]
:: Boehringer Ingelheim to invest €65 million in avian vaccines
Boehringer Ingelheim is set to invest almost €65 million in a high-tech building at its Lyon Porte-des-Alpes site in Saint-Priest, France (Rhône), to meet the growing demand worldwide for avian vaccines
The Group has thus confirmed its commitment to making France, and Lyon in particular, one of its major growth drivers in the animal health market
April 11, 2018

Journal Watch

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

Population sensitivity of acute flaccid paralysis and environmental surveillance for serotype 1 poliovirus in Pakistan: an observational study

 

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 14 April 2018)

Research article
Population sensitivity of acute flaccid paralysis and environmental surveillance for serotype 1 poliovirus in Pakistan: an observational study
To support poliomyelitis eradication in Pakistan, environmental surveillance (ES) of wastewater has been expanded alongside surveillance for acute flaccid paralysis (AFP). ES is a relatively new method of surv…
Authors: Kathleen M. O’Reilly, Robert Verity, Elias Durry, Humayun Asghar, Salmaan Sharif, Sohail Z. Zaidi, M. Zubair M. Wadood, Ousmane M. Diop, Hiro Okayasu, Rana M. Safdar and Nicholas C. Grassly
Citation: BMC Infectious Diseases 2018 18:176
Published on: 13 April 2018

Characteristics of human encounters and social mixing patterns relevant to infectious diseases spread by close contact: a survey in Southwest Uganda

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 14 April 2018)

Research article
Characteristics of human encounters and social mixing patterns relevant to infectious diseases spread by close contact: a survey in Southwest Uganda
Quantification of human interactions relevant to infectious disease transmission through social contact is central to predict disease dynamics, yet data from low-resource settings remain scarce.
Authors: O. le Polain de Waroux, S. Cohuet, D. Ndazima, A. J. Kucharski, A. Juan-Giner, S. Flasche, E. Tumwesigye, R. Arinaitwe, J. Mwanga-Amumpaire, Y. Boum II, F. Nackers, F. Checchi, R. F. Grais and W. J. Edmunds
Citation: BMC Infectious Diseases 2018 18:172
Published on: 11 April 2018

Planning for globally coordinated cessation of bivalent oral poliovirus vaccine: risks of non-synchronous cessation and unauthorized oral poliovirus vaccine use

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 14 April 2018)

Research article
Planning for globally coordinated cessation of bivalent oral poliovirus vaccine: risks of non-synchronous cessation and unauthorized oral poliovirus vaccine use
Oral polio vaccine (OPV) containing attenuated serotype 2 polioviruses was globally withdrawn in 2016, and bivalent OPV (bOPV) containing attenuated serotype 1 and 3 polioviruses needs to be withdrawn after th…
Authors: Radboud J. Duintjer Tebbens, Lee M. Hampton and Kimberly M. Thompson
Citation: BMC Infectious Diseases 2018 18:165
Published on: 10 April 2018
 

Improving access to medicines via the Health Impact Fund in India: a stakeholder analysis

Global Health Action
Volume 11, 2018 – Issue 1
https://www.tandfonline.com/toc/zgha20/11/1?nav=tocList

Article
Improving access to medicines via the Health Impact Fund in India: a stakeholder analysis
Patrick McMullan, Vamadevan S. Ajay, Ravi Srinivas, Sandeep Bhalla, Dorairaj Prabhakaran & Amitava Banerjee
Article: 1434935
Published online: 02 Mar 2018

Implementation of genomics research in Africa: challenges and recommendations

Global Health Action
Volume 11, 2018 – Issue 1
https://www.tandfonline.com/toc/zgha20/11/1?nav=tocList
Capacity Building

Implementation of genomics research in Africa: challenges and recommendations

Sally N. Adebamowo, Veronica Francis, Ernest Tambo, Seybou H. Diallo, Guida Landouré, Victoria Nembaware, Eileen Dareng, Babu Muhamed, Michael Odutola, Teniola Akeredolu, Barbara Nerima, Petronilla J. Ozumba, Slee Mbhele, Anita Ghanash, Ablo P. Wachinou & Nicholas Ngomi of the H3Africa Study Coordinators Working Group as members of the H3A Consortium
Article: 1419033
Published online: 16 Jan 2018
ABSTRACT
Background: There is exponential growth in the interest and implementation of genomics research in Africa. This growth has been facilitated by the Human Hereditary and Health in Africa (H3Africa) initiative, which aims to promote a contemporary research approach to the study of genomics and environmental determinants of common diseases in African populations.
Objective: The purpose of this article is to describe important challenges affecting genomics research implementation in Africa.
Methods: The observations, challenges and recommendations presented in this article were obtained through discussions by African scientists at teleconferences and face-to-face meetings, seminars at consortium conferences and in-depth individual discussions.
Results: Challenges affecting genomics research implementation in Africa, which are related to limited resources include ill-equipped facilities, poor accessibility to research centers, lack of expertise and an enabling environment for research activities in local hospitals. Challenges related to the research study include delayed funding, extensive procedures and interventions requiring multiple visits, delays setting up research teams and insufficient staff training, language barriers and an underappreciation of cultural norms. While many African countries are struggling to initiate genomics projects, others have set up genomics research facilities that meet international standards.
Conclusions: The lessons learned in implementing successful genomics projects in Africa are recommended as strategies to overcome these challenges. These recommendations may guide the development and application of new research programs in low-resource settings.

What can we learn from interventions that aim to increase policy-makers’ capacity to use research? A realist scoping review

Health Research Policy and Systems
http://www.health-policy-systems.com/content
[Accessed 14 April 2018]

Review
|   10 April 2018
What can we learn from interventions that aim to increase policy-makers’ capacity to use research? A realist scoping review
Health policy-making can benefit from more effective use of research. In many policy settings there is scope to increase capacity for using research individually and organisationally, but little is known about what strategies work best in which circumstances. This review addresses the question: What causal mechanisms can best explain the observed outcomes of interventions that aim to increase policy-makers’ capacity to use research in their work?
Authors: Abby Haynes, Samantha J. Rowbotham, Sally Redman, Sue Brennan, Anna Williamson and Gabriel Moore

Humanitarian response in urban areas

Humanitarian Exchange Magazine
Number 71  March 2018
https://odihpn.org/magazine/humanitarian-response-urban-areas/

Humanitarian response in urban areas
Humanitarian crises are increasingly affecting urban areas either directly, through civil conflict, hazards such as flooding or earthquakes, urban violence or outbreaks of disease, or indirectly, through hosting people fleeing these threats. The humanitarian sector has been slow to understand how the challenges and opportunities of working in urban spaces necessitate changes in how they operate. For agencies used to working in rural contexts, the dynamism of the city, with its reliance on markets, complex systems and intricate logistics, can be a daunting challenge. Huge, diverse and mobile populations complicate needs assessments, and close coordination with other, often unfamiliar, actors is necessary.

Socioeconomic factors associated with full childhood vaccination in Bangladesh, 2014

 International Journal of Infectious Diseases
April 2018 Volume 69, In Progress  Open Access
http://www.ijidonline.com/issue/S1201-9712(18)X0003-4

Original Reports
Socioeconomic factors associated with full childhood vaccination in Bangladesh, 2014
Matthew L. Boulton, Bradley F. Carlson, Laura E. Power, Abram L. Wagner
p35–40
Published online: February 5, 2018
Highlights
:: Full vaccination of children is high in Bangladesh, although it varies by vaccine type.
:: Full vaccination coverage was lowest among non-locals in all regions.
:: The mothers’ access to care and autonomy in healthcare decision-making are associated with higher vaccination coverage in their children.
:: Increasing childhood vaccination coverage will be key to meeting national goals for disease elimination and to improve child health in Bangladesh.

Novel Vaccine Technologies: Essential Components of an Adequate Response to Emerging Viral Diseases

JAMA
April 10, 2018, Vol 319, No. 14, Pages 1415-1520
http://jama.jamanetwork.com/issue.aspx

Viewpoint
Novel Vaccine Technologies: Essential Components of an Adequate Response to Emerging Viral Diseases
Barney S. Graham, MD, PhD; John R. Mascola, MD; Anthony S. Fauci, MD
JAMA. 2018;319(14):1431-1432. doi:10.1001/jama.2018.0345
In this Viewpoint, Anthony Fauci and colleagues review modern technological advances that facilitate acceleration of vaccine development in response to new and emerging viral disease threats, and argue for investment in surveillance in developing countries to expedite pathogen identification and jump-start the vaccine development process.

Action research in the healthcare field: a scoping review

JBI Database of Systematic Review and Implementation Reports
April 2018 – Volume 16 – Issue 4
http://journals.lww.com/jbisrir/Pages/currenttoc.aspx
Systematic Reviews

Action research in the healthcare field: a scoping review
Action research is an approach that involves collaboration to develop a process through knowledge building and social change. Several viewpoints of action research have been introduced as the different traditions of developed action research. To develop a coherent process, researchers have to posit their worldviews and theoretical framework and align these with the research aims and procedures, and local transformation needs. This diversity leads to a variety of action research practices in healthcare. Particularly, in this review, we raised the need for examining participants’ experiences and changes related to the action research process.
Cordeiro, Luciana; Soares, Cassia Baldini
JBI Database of Systematic Reviews and Implementation Reports. 16(4):1003-1047, April 2018.

A call to action: improving women’s, children’s, and adolescents’ health in the Muslim world

The Lancet
Apr 14, 2018 Volume 391 Number 10129 p1455-1548
http://www.thelancet.com/journals/lancet/issue/current

Comment
A call to action: improving women’s, children’s, and adolescents’ health in the Muslim world
Amina J Mohammed
We have witnessed considerable progress in reducing maternal and child mortality in recent decades, but fragility and inequity continue to leave our most vulnerable communities behind. The study presented by Nadia Askeer and colleagues1 in The Lancet sheds welcome light on why, despite improvements, progress in reproductive, maternal, newborn, child, and adolescent health (RMNCAH) has been generally slower in some Muslim majority countries (MMCs). This study has a special meaning to me, not only as Deputy Secretary-General of the United Nations; but as a Muslim woman, a mother, and a grandmother.

In its universality, the 2030 Agenda for Sustainable Development urges us to go the last mile to deliver a sustainable, prosperous, and inclusive future for all—leaving no one behind. Building on the traditional development paradigm, the Sustainable Development Goals (SDGs) promise a world in which people not only survive but thrive.

The health and wellbeing of women and children are key. At a historic 1·2 billion,2 today’s adolescents also demand our focus so we can unlock a demographic dividend that can yield benefits for generations to come. With the proportionally youngest population of all major religious groups,3 this holds particular relevance for MMCs.

As Akseer and colleagues note, greater investment in national public health systems in MMCs is needed to reduce out-of-pocket health-care spending and improve RMNCAH outcomes, particularly for reproductive and maternal health and childhood vaccination. As we work to achieve universal health coverage, this investment must be central to our efforts to strengthen entire health systems so that we can ensure access to quality, affordable, and respectful services for all. Increased efforts at the community level will also be important, including through the strengthening of local institutions, skilled, gender-responsive community health workers, the engagement of men and boys, and the buy-in of religious communities. We must also strengthen our communications and advocacy efforts to improve practices and promote healthy behaviours such as birth spacing, exclusive breastfeeding, and care for lactating mothers, particularly in Islamic countries. Coupled with greater intergenerational engagement, we can create the environment needed to improve health outcomes for years to come.

In an evolving and complex development landscape, we must move beyond the traditional silos that have hampered our efforts to address the contextual barriers that keep so many back, particularly women and girls. Simply put, we cannot achieve the RMNCAH targets of SDG 3—globally or within the Islamic context—without also investing in social sectors. These investments must work to improve the overall status of women, which continues to halt progress globally against RMNCAH targets and the SDGs.

The current study articulates this well, with better RMNCAH outcomes observed in countries such as Bangladesh and Egypt, where targeted investments beyond the health sector have been made to improve girls’ access to education and women’s empowerment. Health does not exist in a vacuum. Success will require bold partnerships, building linkages and leveraging unique functions within and across sectors to deliver on an integrated agenda. Strengthened engagement of women in decision-making processes, particularly at the local level, will be paramount to help ensure approaches that prioritise both the health and wellbeing of our women and girls.

Greater investments in RMNCAH are also some of our greatest tools in the face of rising levels of conflict and humanitarian crisis, which disproportionately affect MMCs. We must prioritise the potential of women and adolescents as agents of peace through greater investments across health, education, and economic sectors.

The Every Woman Every Child (EWEC) Global Strategy for Women’s, Children’s and Adolescents’ Health (2016-2030)4 provides a roadmap for country-specific implementation of the SDGs, accounting for the very barriers raised in the current study. I was pleased to play a part in the development and launching of this robust strategy during the SDG Summit in 2015. The Organisation of Islamic Cooperation (OIC) previously committed to implementing the first EWEC global strategy (2010–15), and since its launch in 2015, nearly 20 OIC member states have committed to implement the updated EWEC global strategy. I encourage OIC leaders and member states to recommit to implementing the EWEC global strategy as a key driver of the 2025 Programme of Action,5 the United Nations Commission on Population and Development, and the broader SDGs.

With just 12 years to deliver on the promises enshrined within the 2030 agenda, the time for action is now. I call on my fellow leaders, including those in predominantly Muslim countries, to consider the findings of this study and work together—with ambitious resolve, across borders and sectors—to fully implement the 2030 agenda. Investing in women’s, children’s, and adolescents’ health is a smart place to start.

Status and drivers of maternal, newborn, child and adolescent health in the Islamic world: a comparative analysis

The Lancet
Apr 14, 2018 Volume 391 Number 10129 p1455-1548
http://www.thelancet.com/journals/lancet/issue/current

Articles
Status and drivers of maternal, newborn, child and adolescent health in the Islamic world: a comparative analysis
Nadia Akseer, Mahdis Kamali, Nour Bakhache, Maaz Mirza, Seema Mehta, Sara Al-Gashm, Zulfiqar A Bhutta
1493

Countdown to 2030: tracking progress towards universal coverage for reproductive, maternal, newborn, and child health

The Lancet
Apr 14, 2018 Volume 391 Number 10129 p1455-1548
http://www.thelancet.com/journals/lancet/issue/current

Review
Countdown to 2030: tracking progress towards universal coverage for reproductive, maternal, newborn, and child health
Countdown to 2030 Collaboration
Summary
Building upon the successes of Countdown to 2015, Countdown to 2030 aims to support the mon   itoring and measurement of women’s, children’s, and adolescents’ health in the 81 countries that account for 95% of maternal and 90% of all child deaths worldwide. To achieve the Sustainable Development Goals by 2030, the rate of decline in prevalence of maternal and child mortality, stillbirths, and stunting among children younger than 5 years of age needs to accelerate considerably compared with progress since 2000. Such accelerations are only possible with a rapid scale-up of effective interventions to all population groups within countries (particularly in countries with the highest mortality and in those affected by conflict), supported by improvements in underlying socioeconomic conditions, including women’s empowerment. Three main conclusions emerge from our analysis of intervention coverage, equity, and drivers of reproductive, maternal, newborn, and child health (RMNCH) in the 81 Countdown countries.

First, even though strong progress was made in the coverage of many essential RMNCH interventions during the past decade, many countries are still a long way from universal coverage for most essential interventions. Furthermore, a growing body of evidence suggests that available services in many countries are of poor quality, limiting the potential effect on RMNCH outcomes.

Second, within-country inequalities in intervention coverage are reducing in most countries (and are now almost non-existent in a few countries), but the pace is too slow.

Third, health-sector (eg, weak country health systems) and non-health-sector drivers (eg, conflict settings) are major impediments to delivering high-quality services to all populations. Although more data for RMNCH interventions are available now, major data gaps still preclude the use of evidence to drive decision making and accountability.

Countdown to 2030 is investing in improvements in measurement in several areas, such as quality of care and effective coverage, nutrition programmes, adolescent health, early childhood development, and evidence for conflict settings, and is prioritising its regional networks to enhance local analytic capacity and evidence for RMNCH.

Current understanding of the human microbiome

Nature Medicine
April 2018, Volume 24 No 4 pp375-526
https://www.nature.com/nm/journal/v24/n3/index.html

Review
Current understanding of the human microbiome – pp392 – 400
Jack A Gilbert, Martin J Blaser, J Gregory Caporaso, Janet K Jansson, Susan V Lynch & Rob Knight
doi:10.1038/nm.4517
Abstract
Our understanding of the link between the human microbiome and disease, including obesity, inflammatory bowel disease, arthritis and autism, is rapidly expanding. Improvements in the throughput and accuracy of DNA sequencing of the genomes of microbial communities that are associated with human samples, complemented by analysis of transcriptomes, proteomes, metabolomes and immunomes and by mechanistic experiments in model systems, have vastly improved our ability to understand the structure and function of the microbiome in both diseased and healthy states. However, many challenges remain. In this review, we focus on studies in humans to describe these challenges and propose strategies that leverage existing knowledge to move rapidly from correlation to causation and ultimately to translation into therapies.

The Blind Men and the Elephant — Aligning Efforts in Global Health

New England Journal of Medicine
April 12, 2018  Vol. 378 No. 15
http://www.nejm.org/toc/nejm/medical-journal

Perspective   Free Preview
The Blind Men and the Elephant — Aligning Efforts in Global Health
Ranu S. Dhillon, M.D., and Abraar Karan, M.D., M.P.H.
Should we pursue global health initiatives to ensure health security, promote development, or achieve health equity as a human right? Perhaps we can delineate actionable issues incorporating key priorities from each perspective and integrate diverse activities.

Dynamics of cholera epidemics from Benin to Mauritania

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 14 April 2018)

Research Article
Dynamics of cholera epidemics from Benin to Mauritania
Sandra Moore, Anthony Zunuo Dongdem, David Opare, Paul Cottavoz, Maria Fookes, Adodo Yao Sadji, Emmanuel Dzotsi, Michael Dogbe, Fakhri Jeddi, Bawimodom Bidjada, Martine Piarroux, Ouyi Tante Valentin, Clément Kakaï Glèlè, Stanislas Rebaudet, Amy Gassama Sow, Guillaume Constantin de Magny, Lamine Koivogui, Jessica Dunoyer, Francois Bellet, Eric Garnotel, Nicholas Thomson, Renaud Piarroux
Research Article | published 09 Apr 2018 PLOS Neglected Tropical Diseases
https://doi.org/10.1371/journal.pntd.0006379
Author summary
We analyzed cholera epidemics from Benin to Mauritania, during 2009 to 2015, and performed a series of field visits as well as molecular epidemiology analyses of V. cholerae isolates from most recent epidemics throughout West Africa. We found that at least 54% of cases concerned populations living in the three urban areas of Accra, Freetown, and Conakry. Accra, Ghana represented the main cholera hotspot in the entire study region. Our findings indicate that the water network system in Accra may play a role in the rapid diffusion of cholera throughout the city. As observed in Accra, Conakry, and Freetown, once cholera cases arrive in overpopulated urban settings with poor sanitation, increased rainfall facilitated the contamination of unprotected water sources with human waste from cholera patients, thus promoting a rapid increase in cholera incidence. To more efficiently and effectively combat cholera in West Africa, these findings may serve as a guide to better target cholera prevention and control interventions.

Special Immunization Service: A 14-year experience in Italy

PLoS One
http://www.plosone.org/
[Accessed 14 April 2018]

Research Article
Special Immunization Service: A 14-year experience in Italy
Concerns regarding vaccine safety are increasing along with lack of compliance to vaccination schedules. This study aimed to assess vaccination-related risks and the impact of a Special Immunization Service (SIS) at the Pediatric Emergency Department (PED) of Padua on vaccination compliance among participants.
Daniele Donà, Susanna Masiero, Sara Brisotto, Lorena Gottardello, Rebecca Lundin, Eleonora Borgia, Federica Visentin, Liviana Da Dalt
Research Article | published 12 Apr 2018 PLOS ONE
https://doi.org/10.1371/journal.pone.0195881

Attitudes towards and knowledge about Human Papillomavirus (HPV) and the HPV vaccination in parents of teenage boys in the UK

PLoS One
http://www.plosone.org/
[Accessed 14 April 2018]

Attitudes towards and knowledge about Human Papillomavirus (HPV) and the HPV vaccination in parents of teenage boys in the UK
Susan Mary Sherman, Emma Nailer
Research Article | published 11 Apr 2018 PLOS ONE
https://doi.org/10.1371/journal.pone.0195801

Bystander risk, social value, and ethics of human research

 Science         
13 April 2018   Vol 360, Issue 6385 13 April 2018
http://www.sciencemag.org/current.dtl

Policy Forum
Bystander risk, social value, and ethics of human research
By S. K. Shah, J. Kimmelman, A. D. Lyerly, H. F. Lynch, F. G. Miller, R. Palacios, C. A. Pardo, C. Zorrilla
Science13 Apr 2018 : 158-159 Restricted Access
Contentious risks demand a new approach
Summary
Two critical, recurring questions can arise in many areas of research with human subjects but are poorly addressed in much existing research regulation and ethics oversight: How should research risks to “bystanders” be addressed? And how should research be evaluated when risks are substantial but not offset by direct benefit to participants, and the benefit to society (“social value”) is context-dependent? We encountered these issues while serving on a multidisciplinary, independent expert panel charged with addressing whether human challenge trials (HCTs) in which healthy volunteers would be deliberately infected with Zika virus could be ethically justified (1). Based on our experience on that panel, which concluded that there was insufficient value to justify a Zika HCT at the time of our report, we propose a new review mechanism to preemptively address issues of bystander risk and contingent social value.

Impact of rotavirus vaccination on rotavirus hospitalisation rates among a resource‐limited rural population in Mbita, Western Kenya

Tropical Medicine & International Health
Volume 23, Issue 4  Pages: i-iv, 341-445, E1  April 2018
https://onlinelibrary.wiley.com/toc/13653156/current

Original Research Papers
Impact of rotavirus vaccination on rotavirus hospitalisation rates among a resource‐limited rural population in Mbita, Western Kenya
Ernest Apondi Wandera, Shah Mohammad, Martin Bundi, James Nyangao, Amina Galata
Cyrus Kathiiko, Erick Odoyo, Sora Guyo, Gabriel Miring’u, Satoshi Komoto, Yoshio Ichinose
Pages: 425-432
First Published: 12 February 2018

Pertussis in Africa: Findings and recommendations of the Global Pertussis Initiative (GPI)

Vaccine
Volume 36, Issue 18   Pages 2385-2500 (25 April 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/17

Review
Pertussis in Africa: Findings and recommendations of the Global Pertussis Initiative (GPI)
Review article
Pages 2385-2393
Rudzani Muloiwa, Nicole Wolter, Ezekiel Mupere, Tina Tan, … Gregory Hussey
Abstract
Pertussis remains a major cause of morbidity and mortality, particularly in infants and young children, and despite the availability of vaccines and pertinent national and international guidelines. The disease burden is more severe in low- and middle-income countries (LMICs), especially in the African continent. Pertussis is more prevalent among young infants in Africa. Poor or no pertussis surveillance, lack of disease awareness, diagnostic limitations, and competing health priorities are considered key contributory factors for this high pertussis burden in Africa. Most African countries use whole-cell pertussis (wP) vaccines, but coverage with three primary doses of diphtheria–tetanus–pertussis vaccines falls short of the World Health Organization’s recommended goal of >90%. The Global Pertussis Initiative (GPI) works toward developing recommendations through systematic evaluation and prioritization of strategies to prevent pertussis-related infant and child deaths, as well as reducing global disease burden to acceptable national, regional, and local levels. For countries using wP vaccines, the GPI recommends continuing to use wP to improve primary and toddler booster vaccination coverage. Vaccination during pregnancy is the next priority when acellular pertussis (aP) vaccines and other resources are available that directly protect newborns too young to be vaccinated, followed by, in order of priority, booster doses in older children, adolescents, healthcare workers and finally, all adults. Improved surveillance should be a high priority for African LMICs assessing true disease burden and vaccine effectiveness to inform policy. More research is warranted to evaluate the safety and efficacy of wP and aP vaccines and strategies, and to determine their optimal use.

Poor knowledge of vaccination recommendations and negative attitudes towards vaccinations are independently associated with poor vaccination uptake among adults – Findings of a population-based panel study in Lower Saxony, Germany

Vaccine
Volume 36, Issue 18   Pages 2385-2500 (25 April 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/17

Poor knowledge of vaccination recommendations and negative attitudes towards vaccinations are independently associated with poor vaccination uptake among adults – Findings of a population-based panel study in Lower Saxony, Germany
Original research article
Pages 2417-2426
Manas K. Akmatov, Nicole Rübsamen, Igor V. Deyneko, André Karch, Rafael T. Mikolajczyk

Predictors and Barriers to Full Vaccination among Children in Ethiopia

Vaccines — Open Access Journal
http://www.mdpi.com/journal/vaccines
(Accessed 14 April 2018)

Open Access   Article
Predictors and Barriers to Full Vaccination among Children in Ethiopia
by Yemesrach A. Tefera, Abram L. Wagner, Eyoel B. Mekonen, Bradley F. Carlson and Matthew L. Boulton
Vaccines 2018, 6(2), 22; doi:10.3390/vaccines6020022 – 10 April 2018
Abstract
Predictors of immunization status outside of large cities in Ethiopia are not well known, and Muslims have lower vaccination coverage. The aim of this study is to assess factors associated with full immunization among children 12–23 months in Worabe, Ethiopia, a Muslim-majority community. A cross-sectional study is conducted in summer 2016. Multivariable logistic regression was used to assess the significance of predictors of full immunization. Among 484 children, 61% are fully vaccinated. Children whose mothers had fewer antenatal care (ANC) visits have decreased odds of full vaccination (zero visits: odds ratio (OR) = 0.09; one visit: OR = 0.15; two visits: OR = 0.46; three visits: OR = 0.89). The most common reasons that the mother gave for not vaccinating the child are fear of side reactions (36%), being too busy (31%), or hearing rumors about vaccines (28%). Local interventions incorporating interventions with religious authorities could raise awareness in the community of the importance of childhood immunizations and ANC visits.

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

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

Influenza and Other Respiratory Viruses
First published: 6 April 2018
https://doi.org/10.1111/irv.12558

Original Article
The potential economic value of influenza vaccination for healthcare workers in the Netherlands
MJ Meijboom, J Riphagen-Dalhuisen, E Hak
Abstract
Despite the clinical evidence, influenza vaccination coverage of healthcare workers remains low. To assess the health economic value of implementing an influenza immunization program among healthcare workers (HCW) in University Medical Centers (UMCs) in the Netherlands, a cost-benefit model was developed using a societal perspective.The model was based on a trial performed among all UMCs in the Netherlands that included both hospital staff as well as patients admitted to the pediatrics and internal medicine departments. The model structure and parameters estimates was based on the trial and complemented with literature research, and the impact of uncertainty explored with sensitivity analyses.In a base-case scenario without vaccine coverage, influenza related annual costs were estimated at € 410,815 for an average UMC with 8,000 HCWs and an average occupancy during the influenza period of 6,000 hospitalized patients. Of these costs, 82% attributed to the HCWs and 18% were patient related. With a vaccination coverage of 15.47%, the societal program’s savings were € 2,861 which corresponds to a saving of € 270.53 per extended hospitalization. Univariate sensitivity analyses show that the results are most sensitive to changes in the model parameters vaccine effectiveness in reducing influenza-like-illness (ILI) and the vaccination-related costs.In addition to the decreased burden of patient morbidity among hospitalized patients, the effects of the hospital immunization program slightly outweigh the economic investments. These outcomes may support healthcare policy makers’ recommendations about the influenza vaccination program for healthcare workers.