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

No new digest content identified.

Journal of Experimental Social Psychology
Volume 88, May 2020, 103947
Case Report
Donald Trump and vaccination: The effect of political identity, conspiracist ideation and presidential tweets on vaccine hesitancy
MJ Hornsey, M Finlayson, G Chatwood, CT Begeny…
Highlights
:: Trump voters are more concerned about vaccines than other Americans.
:: This effect emerges via Trump voters’ greater willingness to believe conspiracies.
:: Reading Trump’s antivaxx tweets increases vaccination concern among Trump voters.
:: Trump’s antivaxx tweets did not polarize liberal voters into being more provaxx.
Abstract
Donald Trump is the first U.S. President to be on the record as having anti-vaccination attitudes. Given his enormous reach and influence, it is worthwhile examining the extent to which allegiance to Trump is associated with the public’s perceptions of vaccine safety and efficacy. In both Study 1 (N = 518) and Study 2 (N = 316), Trump voters were significantly more concerned about vaccines than other Americans. This tendency was reduced to non-significance after controlling for conspiracist ideation (i.e., general willingness to believe conspiracy theories) and, to a lesser degree, political conservatism. In Study 2, participants were later exposed to real Trump tweets that either focused on his anti-vaccination views, or focused on golf (the control condition). Compared to when the same respondents were sampled a week earlier, there was a significant increase in vaccine concern, but only among Trump voters who were exposed to the anti-vaccination tweets. The effects were exclusively negative: there was no evidence that anti-vaccination Trump tweets polarized liberal voters into becoming more pro-vaccination. In line with the social identity model of leadership, Study 2 indicates that some leaders do not simply represent the attitudes and opinions of the group, but can also change group members’ opinions.

Cancer Control
Volume 27: 1-16 2020
Original Research Paper
Mining HPV Vaccine Knowledge Structures of Young Adults From Reddit Using Distributional Semantics and Pathfinder Networks
M Amith, T Cohen, R Cunningham, LS Savas, N Smith… –
Abstract
The human papillomavirus (HPV) vaccine protects adolescents and young adults from 9 high-risk HPV virus types that cause 90% of cervical and anal cancers and 70% of oropharyngeal cancers. This study extends our previous research analyzing online content concerning the HPV vaccination in social media platforms used by young adults, in which we used Pathfinder network scaling and methods of distributional semantics to characterize differences in knowledge organization reflected in consumer- and expert-generated online content. The current study extends this approach to evaluate HPV vaccine perceptions among young adults who populate Reddit, a major social media platform. We derived Pathfinder networks from estimates of semantic relatedness obtained by learning word embeddings from Reddit posts and compared these to networks derived from human expert estimation of the relationship between key concepts. Results revealed that users of Reddit, predominantly comprising young adults in the vaccine catch up age-group 18 through 26 years of age, perceived the HPV vaccine domain from a virus-framed perspective that could impact their lifestyle choices and that their awareness of the HPV vaccine for cancer prevention is also lacking. Further differences in knowledge structures were elucidated, with implications for future health communication initiatives.

Annals of Oncology
Articles in Press
Reduced seroprevalence against vaccine preventable diseases (VPDs) in adult patients with cancer: necessity of routine vaccination as part of the therapeutic concept
A Guzek, AS Berghoff, J Jasinska, E Garner-Spitzer… –
Abstract
Cancer patients are immunocompromised and thus have an increased risk for infections, such as vaccine-preventable diseases (VPDs).1,2 Studies in children with cancer showed impaired antibody (Ab) titers to various VPDs, yet data in adults are scarce.3,4 Hence, we evaluated the seroprevalence of Abs against the most common VPDs, namely measles, mumps, rubella, varicella/zoster (VZV), hepatitis A and B, diphtheria, tetanus, pertussis, and tick-borne encephalitis (TBE) in 478 adult patients with solid malignancies or hematological malignancies (HM) and in 117 age- and sex-matched healthy controls (supplementary Methods, supplementary Table S1, and supplementary Figure S1, available at Annals of Oncology online).

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 11 Jan 2020
Science
The Virus Buried in a 100-Year-Old Lung
Scientists have managed to sequence the genome of a measles virus that infected a 2-year-old girl who died in 1912.
Sarah Zhang January 9, 2020

BBC
http://www.bbc.co.uk/
Accessed 11 Jan 2020
[No new, unique, relevant content]

The Economist
http://www.economist.com/
Accessed 11 Jan 2020
Sick days
A rare outbreak of polio reflects the Philippines’ poor health care
Distributing vaccines to 7,000 islands is not easy
Jan 9th 2020
MANILA
FOR NINETEEN years the Philippines was free from polio. But in September the announcement came that two children living in provinces 900 miles apart had been paralysed by a vaccine-derived strain of the disease. The strain was also found in sewage and in a waterway. Foreign and domestic health authorities have since jumped into action. The next in a series of immunisation drives starts on January 20th on the southern island of Mindanao…

Financial Times
http://www.ft.com/home/uk
[No new, unique, relevant content]

Forbes
http://www.forbes.com/
Accessed 11 Jan 2020
Jan 10, 2020,
Vaccination Rates Rise In California After Personal Belief Exemptions Curbed
Clary Estes Contributor

Foreign Affairs
http://www.foreignaffairs.com/
Accessed 11 Jan 2020
[No new, unique, relevant content]

Foreign Policy
http://foreignpolicy.com/
Accessed 11 Jan 2020
[No new, unique, relevant content]

The Guardian
http://www.guardiannews.com/
Accessed 11 Jan 2020
[No new, unique, relevant content]

New Yorker
http://www.newyorker.com/
Accessed 11 Jan 2020
[No new, unique, relevant content]

New York Times
http://www.nytimes.com/
Accessed 11 Jan 2020
Opinion
You Are Unvaccinated and Got Sick. These Are Your Odds.
Comparing the dangerous effects of three diseases with the minimal side effects of their corresponding vaccines.
By Peter J. Hotez and Bill Marsh Jan. 9

U.S.
After a Measles Scare, Seattle Cracks Down on Vaccine Compliance
At a time when states and school districts are trying to increase vaccination rates, an aggressive strategy in Seattle appears to be paying off.
By Mike Baker

Washington Post
https://www.washingtonpost.com/
Accessed 11 Jan 2020
[No new, unique, relevant content]

Think Tanks et al

Brookings
http://www.brookings.edu/
Accessed 11 Jan 2020
[No new relevant content]

Center for Global Development
http://www.cgdev.org/page/press-center
Accessed 11 Jan 2020
[No new relevant content]

CSIS
https://www.csis.org/
Accessed 11 Jan 2020
[No new relevant content]

Council on Foreign Relations
http://www.cfr.org/
Accessed 11 Jan 2020
[No new relevant content]

Kaiser Family Foundation
https://www.kff.org/search/?post_type=press-release
Accessed 11 Jan 2020
[No new relevant content]

Milestones :: Perspectives :: Research

Lancet Infectious Diseases
Volume 20, ISSUE 1, P1, January 01, 2020
http://www.thelancet.com/journals/laninf/issue/current
Personal View
The public health crisis of underimmunisation: a global plan of action
Lawrence O Gostin, James G Hodge Jr, Barry R Bloom, Ayman El-Mohandes, Jonathan Fielding,
Peter Hotez, Ann Kurth, Heidi J Larson, Walter A Orenstein, Kenneth Rabin, Scott C Ratzan, Daniel Salmon
[Excerpts]
Summary
Vaccination is one of public health’s greatest achievements, responsible for saving billions of lives. Yet, 20% of children worldwide are not fully protected, leading to 1·5 million child deaths annually from vaccine-preventable diseases. Millions more people have severe disabling illnesses, cancers, and disabilities stemming from underimmunisation. Reasons for falling vaccination rates globally include low public trust in vaccines, constraints on affordability or access, and insufficient governmental vaccine investments. Consequently, an emerging crisis in vaccine hesitancy ranges from hyperlocal to national and worldwide. Outbreaks often originate in small, insular communities with low immunisation rates. Local outbreaks can spread rapidly, however, transcending borders. Following an assessment of underlying determinants of low vaccination rates, we offer an action based on scientific evidence, ethics, and human rights that spans multiple governments, organisations, disciplines, and sectors.

Introduction
Vaccination is among public health’s greatest achievements, saving billions of lives. Global scourges such as smallpox have been eradicated, with polio nearing eradication. Childhood diseases (such as measles, mumps, and pertussis) have substantially diminished through modern vaccination practices. Yet, one in five children worldwide are not fully protected, resulting in 1·5 million child deaths annually from diseases that are preventable by vaccination, including diarrhoea and pneumonia, equating to one death every 20 s.¹ Millions more people have severe disabling illnesses, cancers, and disabilities from infections caused by underimmunisation. Ten highly populous countries with suboptimal immunisation systems account for over 70% of the world’s unvaccinated children.¹

Despite vast benefits, immunisation levels are falling among specific populations in countries at all wealth levels. Reasons vary, ranging from low public trust in vaccines to constraints on affordability or access. The WHO rates vaccine hesitancy—reluctance or refusal to vaccinate despite vaccine availability—as among the top ten global health threats for 2019.² Overall, both WHO and UNICEF report in 2019 that global immunisation rates for common childhood vaccines have flat-lined at 86% over the past decade.², ³ Country rates vary widely, from 25% in Equatorial Guinea to 96% in Norway.³ Vaccinations in many countries are falling below levels needed for so-called herd immunity, or community protection, resulting in outbreaks. The global incidence of measles increased by 30% over the previous year in 2017 alone, with major diphtheria outbreaks in multiple regions.⁴

The vaccination crisis ranges from hyperlocal to national and worldwide. Outbreaks often originate in small, insular communities with low vaccination rates. Yet, local outbreaks can spread rapidly, transcending borders. Mass migration and international travel propel infectious diseases across the globe. Anti-vaccine messaging targets local communities, but is also disseminated widely on internet platforms and social media. Multiple forces driving the resurgence of childhood diseases also threaten immunisation campaigns, such as for polio and malaria.

The remarkable promise of immunisation has stubbornly stalled, with losses measured in deaths and human suffering.⁵ In 2018, 20 million children missed out on lifesaving measles, diphtheria, and tetanus vaccines.³ Underlying this public health crisis is a striking paradox—vaccines are victims of their own success. Immunisations are remarkably effective, closely monitored, and very safe. Consequently, many clinicians and parents have not seen the consequences of vaccine-preventable diseases and underestimate their harms. Governments also fail to adequately invest in vaccines, from research to cold storage and delivery.

There are no simple solutions to this problem, but innovative policies and programmes working in concert would substantially increase vaccination rates. We offer an action plan based on scientific evidence, ethics, and human rights. Crucially, an effective response must be multidisciplinary and multisectoral, spanning governments, international organisations, the private sector, and civil society. Our plan begins with an examination of underlying determinants of low vaccination rates…

Generating sustainable solutions
Underimmunisation is a global crisis requiring sustainable solutions. We offer a three-pronged strategy: innovative financing for vaccine affordability, accessibility, and availability; evidence-based health communication campaigns at local, national, and global levels; and law reform that has public acceptance and is fairly implemented.

:: Vaccine affordability, accessibility, and availability
Projected global funding shortfalls of $7·2 billion (between 2016 and 2020) undermine immunisation goals.³⁶
WHO’s 2013 Global Vaccine Action Plan estimated $60 billion needed for 94 LMICs from 2011 to 2020,³⁷ nearly half of which is unsecured through government or philanthropic sources. WHO also seeks an additional $10 billion for its own operations by 2023, including $667 million to “strengthen routine vaccination and health systems” and $1·6 billion for polio eradication.³⁸
Most costs focus on immunisation services, including management, training, social mobilisation, and surveillance. Rapid deployment of vaccines in response to emerging threats is also essential to save lives and reduce costs.

WHO’s Action Plan partners focus on the entire vaccine pipeline—from research, price, storage, and delivery to robust health systems. Dedicated funding for national immunisation programmes is an essential driver for national and global initiatives. Gavi, for example, generates long-term resources through the international finance facility for immunisation and advanced market commitments to support pneumococcal vaccines. A global campaign to raise financing to scale should be a major priority, especially for low-income countries that are unable to pay for or administer vaccines across their populations. Solidarity for universal vaccine availability is warranted because deficiencies in any country threaten populations worldwide. Each government must assure robust national immunisation systems, but the international community also shares responsibility to fill gaps in capacity through enhanced coordination, forecasting, and manufacturer incentives. Global partnerships like the Coalition for Epidemic Preparedness Innovations (CEPI) align public and private actors to fund, develop, and equitably distribute vaccines.

:: Trustworthy information environment
Resources alone, of course, cannot ensure high immunisation rates if the public distrusts the quality, safety, or effectiveness of vaccines. Gaining trust has become difficult with the rise of nationalist populism, which often questions science and casts doubt on expert opinions. The public cannot rely on the media to provide unbiased or accurate messages. Although some parents remain vehemently opposed to vaccinations, most are open to non-judgmental messages and want the best for their children. Altering the informational environment to afford greater salience to accurate, science-based messages could assuage parental concerns. WHO, governments, and partners (eg, philanthropists, industry, and civil society) should sustainably fund evidence-based engagement and health communication strategies that are proactive, timely, and credible, and tailored to specific audiences. WHO is generating a hub for vaccination acceptance and demand to provide reliable information and tools. Governments should similarly develop national and regional campaigns, including an emphasis on behavioural changes. Key components of effective communication campaigns include objective messaging in traditional and social media designed to assuage fears and promote accurate health information and immunisation outcomes. Campaigns should recruit well trusted spokespeople such as leaders in sport, entertainment, and religion. Health engagement is often the most effective at the community level through local leaders, teachers, and religious figures.

Governments should also adopt transparent, lawful, and measured regulations to correct or remove disinformation from the internet and social media. In the same way that states limit malicious hate speech and violent images, they can sensibly regulate patently false or misleading vaccine information. Social media enterprises should be held accountable for rooting out irresponsible vaccine rumours pervading their platforms. For example, searches for vaccine-related terms on Pinterest are automatically diverted to trustworthy vaccine sources like WHO and CDC.³⁹ Furthermore, internet search engines should prioritise reliable scientific sources over anti-vaccine websites.

Traditional and social media play a special role in open and free societies, and their independence is highly valued. Encouraging self-regulation and ethical corporate responsibility could avoid formal regulation. Governments at the 2019 G20 Summit, for example, asked social media companies to remove violent, terrorism-related messages and images. Facebook agreed to assess its policies governing anti-vaccination information and advertising on its site. YouTube has begun taking down misleading videos and images. Moreover, Amazon is removing anti-vaccination videos, books, and documentaries.

:: National or regional law reform
Governments can use legal tools successfully to increase vaccination rates. Efficacious vaccination laws can lead to higher immunisation coverage.³⁰ Vaccination mandates passed in France and Italy are associated with increased vaccine rates.⁴⁰ A meta-analysis of European laws, however, did not find a strong link between vaccination laws and coverage.²⁴ These disparate findings might suggest that legal approaches tailored to local cultures work best.

Vaccination laws must exempt people for legitimate medical reasons, such as infants and immunosuppressed individuals. Yet, overzealous reliance on non-medical exemptions can result in preventable outbreaks.²⁷ Multiple US studies conclude that school vaccination laws with fewer exemptions lowered the incidence of childhood diseases. Governments should consider repealing or restricting permissive religious and philosophical exceptions. Such reforms are consistent with freedoms of religion and conscience because they do not target particular religious or other communities, but are applied fairly and equally throughout society. Parents are responsible for not placing their own, and other, children at risk of serious infections. Well tailored laws can also help reduce the number of people objecting to vaccinations due to misinformation.

Conclusion
The global crises of underimmunisation risks hard-won gains in preventing infectious diseases. Resurging childhood diseases and fragile global vaccination campaigns necessitate concerted action. Our action plan focuses on the prime causes of underimmunisation: vaccine availability, public distrust, and lax immunisation laws. Immunisation is a potent public health tool. Finding the political will and holding governments accountable are essential. Countless lives can be saved if the international community sustainably funds vaccination systems, assures reliable information, and safeguards the common good through meaningful law reform.

Emergencies

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

Ebola Outbreak in DRC 73: 24 December 2019
Situation Update
In the week of 16 to 22 December 2019, 14 new confirmed Ebola virus disease (EVD) cases were reported from four health areas within two health zones in North Kivu province in the Democratic Republic of the Congo. The new confirmed cases in the past week are from Mabalako Health Zone (12/14; 86%) and Butembo Health Zone (2/14; 14%)…

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DRC Ebola outbreaks
Military presence leads MSF to stop activities in Ebola-affected Biakato
Press Release 24 Dec 2019
Following security incidents in Biakato, Democratic Republic of Congo, an increase in security – including armed military forces – have been deployed around and within health structures. The presence of arms and weapons in hospitals and clinics has resulted in Médecins Sans Frontières (MSF) taking the difficult decision to stop medical activities – including those related to Ebola – in Biakato.
“We are no longer able to work in accordance with our principles of neutrality and impartiality,” said Ewenn Chenard, Emergency Coordinator for MSF. “We regret this decision, but the presence of armed forces around and within the health structures of Biakato goes against our principles.”
MSF has been working with the people of Biakato, located in DRC’s northeastern Ituri province, since 2016, supporting the Ministry of Health. Initially, our activities were dedicated to assisting victims of sexual violence…

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POLIO
Public Health Emergency of International Concern (PHEIC)

Statement of the Twenty-Third IHR Emergency Committee Regarding the International Spread of Poliovirus
20 December 2019
[Excerpts; Editor’s text bolding]
The twenty-third meeting of the Emergency Committee under the International Health Regulations (2005) (IHR) regarding the international spread of poliovirus was convened by the Director General on 11 December 2019 at WHO headquarters with members, advisers and invited Member States attending via teleconference, supported by the WHO secretariat.

The Emergency Committee reviewed the data on wild poliovirus (WPV1) and circulating vaccine derived polioviruses (cVDPV).  The Secretariat presented a report of progress for affected IHR States Parties subject to Temporary Recommendations.  The following IHR States Parties provided an update on the current situation and the implementation of the WHO Temporary Recommendations since the Committee last met on 16 September 2019: Afghanistan, Angola, Benin, Central African Republic (CAR), Chad, Cote d’Ivoire, Democratic Republic of Congo (DR Congo), Ethiopia, Ghana, Nigeria, Pakistan, Philippines, Togo and Zambia…

Wild poliovirus
The Committee remains gravely concerned by the significant increase in WPV1 cases globally to 113 as at 11 December 2019, compared to 28 for the same period in 2018, with no significant success yet in reversing this trend. 

In Pakistan transmission continues to be widespread, as indicated by both AFP (acute flaccid paralysis) surveillance and environmental sampling. Khyber Pakhtunkhwa province continues to be of particular concern.  The issues noted previously by the committee, including refusal by individuals and communities to accept vaccination, and problems with politicization of the national polio program are still being addressed.  Added pressure is now on the program due to confirmation of detection of cVDPV2 in several provinces (see below).
In Afghanistan, the security situation remains very challenging.  Inaccessible and missed children particularly in the Southern Region represent a large cohort of susceptible children in this part of Afghanistan.  The risk of a major upsurge of cases is growing, with other parts of the country that have been free of WPV1 for some time now at risk of outbreaks. This would again increase the risk of international spread.  Major efforts must be made to improve access if eradication efforts are going to progress.

The committee noted that based on sequencing of viruses, there were recent instances of international spread of viruses from Pakistan to Afghanistan and also from Afghanistan to Pakistan.  The recent increased frequency of WPV1 international spread between the two countries suggests that rising transmission in Pakistan and Afghanistan correlates with increasing risk of WPV1 exportation beyond the single epidemiological block formed by the two countries…

Vaccine derived poliovirus
The multiple cVDPV outbreaks in four WHO regions (African, Eastern Mediterranean, South-east Asian and Western Pacific Regions) are very concerning, with seven new countries reporting outbreaks since the last meeting (Chad, Cote d’Ivoire, Malaysia, Pakistan, Philippines, Togo and Zambia).  Since the last meeting, cVDPV2 has spread through West Africa and the Lake Chad area, reaching Cote d’Ivoire, Togo and Chad, and cVDPV1 has spread from the Philippines to Malaysia.

The rapid emergence of multiple cVDPV2 strains in several countries is unprecedented and very concerning, and not yet fully understood. 

The committee noted that the GPEI was developing a strategy to address cVDPV2 outbreaks but was extremely concerned that the monovalent OPV2 stockpile was becoming depleted.  The committee strongly supports the development and proposed Emergency Use Listing of the novel OPV2 vaccine which should become available mid-2020, and which it is hoped will result in no or very little seeding of further outbreaks.

Conclusion
The Committee unanimously agreed that the risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC) and recommended the extension of Temporary Recommendations for a further three months.  The committee recognizes the concerns regarding the lengthy duration of the polio PHEIC, but concludes that the current situation is extraordinary, with clear ongoing risk of international spread and ongoing need for coordinated international response…

Additional considerations  
Preparedness – The committee urged all countries, particularly those in Africa, be on high alert for the possibility of cVDPV2 importation and respond to such importations as a national public health emergency.  This means countries should ensure polio surveillance can rapidly detect cVDPV2, and plans are in place to respond rapidly with well planned and executed mOPV2 campaigns, and with strict procedures to ensure unused vials are returned and managed so that inappropriate or accidental use is avoided.

International Coordination – Unprecedented levels of international spread of cVDPV require urgent coordinated control measures at regional and sub-regional levels.  The committee strongly encourages countries to do more in support of cross border actions, such as sharing of surveillance and other data, synchronizing campaigns and where possible ensure vaccination of international travelers.

Emergency Response – The committee noted the endorsement of SAGE for the accelerated clinical development of novel OPV2 and its assessment under the WHO Emergency Use and Listing (EUL) procedure, which can be used in a public health emergency of international concern (PHEIC), and added its support to ensure the supply of monovalent OPV2.

Financing – The number of outbreaks is proving to be costly to manage, and the committee urged affected countries to prioritize polio control as a public health emergency and ensure adequate domestic funding is available for an effective response.  The committee urged affected countries to mobilize domestic funding to complement the GPEI resources which are being stretched by the large number of outbreaks being fought globally.

Communication – Vaccine hesitancy is a significant factor in the spread of these outbreaks particularly certain countries including Pakistan and Angola.  The committee urged countries to invest time and resources into pro-actively circumventing and countering myths and misinformation regarding vaccination is general, and rumors that arise during the course of campaigns in particular.  Campaign communications need to address issues around avoiding spreading excreted Sabin-like viruses through good hygiene.

Based on the current situation regarding WPV1 and cVDPV, and the reports provided by affected countries, the Director-General accepted the Committee’s assessment and on 19 December 2019 determined that the situation relating to poliovirus continues to constitute a PHEIC, with respect to WPV1 and cVDPV.  The Director-General endorsed the Committee’s recommendations for countries meeting the definition for ‘States infected with WPV1, cVDPV1 or cVDPV3 with potential risk for international spread’, ‘States infected with cVDPV2 with potential risk for international spread’ and for ‘States no longer infected by WPV1 or cVDPV, but which remain vulnerable to re-infection by WPV or cVDPV’ and extended the Temporary Recommendations under the IHR to reduce the risk of the international spread of poliovirus, effective 19 December 2019.

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Three African countries halt polio outbreaks
Kenya, Mozambique and Niger have curbed polio outbreaks that erupted in different episodes over the past 24 months, allowing them to regain their polio-free status, World Health Organization (WHO) announced
Brazzaville, 19 December 2019 – Kenya, Mozambique and Niger have curbed polio outbreaks that erupted in different episodes over the past 24 months, allowing them to regain their polio-free status, World Health Organization (WHO) announced.
Transmission of vaccine-derived poliovirus was detected in the three countries in 2018, affecting 12 children. No other cases have since been detected.
“Ending outbreaks in the three countries is proof that the implementation of response activities and ensuring that three rounds of high-quality immunization campaigns are conducted can stop the remaining outbreaks in the region,” said Dr Modjirom Ndoutabe, Coordinator of the WHO-led polio outbreaks Rapid Response Team for the African Region.
“We are strongly encouraged by this achievement and determined in our efforts to see polio eradicated from the continent. It is a demonstration of the commitment by Governments, WHO and our partners to ensure that future generations live free of this debilitating virus,” added Dr Ndoutabe…

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Editor’s Note:
WHO has posted a refreshed emergencies page which presents an updated listing of Grade 3,2,1 emergencies as below.

WHO Grade 3 Emergencies [to 4 Jan 2020]

Democratic Republic of the Congo
:: Ebola Outbreak in DRC 73: 24 December 2019

Syrian Arab Republic
:: WHO deeply concerned about deteriorating health conditions in northwest Syria
25 December 2019, Geneva-Cairo-Copenhagen –  The World Health Organization today expressed its deepening concern about the situation in northwest Syria and the impact hostilities are having on the health of a population that has endured sustained hardships, in what is now harsh weather conditions.
“The recent military escalation in this area has resulted in loss of lives, injuries and exacerbated suffering of civilians, displacing more than 130,000, including women, children and elderly,” said Dr Richard Brennan, Director of Health Emergencies for WHO’s Eastern Mediterranean Region. “Some have been displaced three times during the nine years of the Syrian conflict,” he added.
Among the 12 million people in need of health services in Syria, over 2.7 million are in the northwest and half 0.5 million live in the areas south of Idleb, where disruption of fragile health services continues…

Mozambique floods – No new digest announcements identified
Nigeria – No new digest announcements identified
Somalia – No new digest announcements identified
South Sudan – No new digest announcements identified
Yemen – No new digest announcements identified

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WHO Grade 2 Emergencies [to 4 Jan 2020]
Myanmar
:: Bi‐weekly Situation Report 25 – 19 December 2019
HIGHLIGHTS
:: Tuberculosis(TB) performance for the third quarter for Cox’s Bazar District was reviewed at a meeting held with a view to strengthening TB programme activities in the district.
:: Oral Cholera Vaccine (OCV)campaign in Rohingya camps has ended on 14 December. However, the campaign for the host community will continue for the period of 8 to 31 December 2019.
:: A total of 127 Community Health Worker(CHW) supervisors have received a two-day training on risk factors of Non-Communicable Diseases (NCD) and behavioral interventionsin Cox’s Bazar.
:: The government of Bangladesh through National Expanded Program on Immunization(EPI), is going to conduct a month-long Measles Outbreak Response Immunization (ORI) activity from 12 January to 12 February 2020 in the Rohingya camps.
SITUATION OVERVIEW
As per Inter-Sector Coordination Group (ISCG)report of September 2019, there are 914,998 Rohingya refugees in Cox’s Bazar. This includes 34,172 refugees from Myanmar who registered before 31st August 2017. All refugees, including new arrivals, face compounding vulnerabilities, including in health. WHO has been responding to this crisis since September 2017. A summary of response actions from epidemiological weeks 49 and 50 of 2019 is presented below…

Niger
:: L’OMS offre un important lot de médicaments et matériels médicaux au Gouvernement du…
27 décembre 2019
Le Niger fait régulièrement face à des urgences de plus en plus complexes avec un impact négatif sur la santé des populations. Parmi ces urgences « les maladies à potentiel épidémique », telles que le choléra, la méningite, entre autres, mais aussi « les conséquences sanitaires liées à l’activisme de groupes armées non étatiques (GANE) » le long du périmètre des quatre frontières Mali-Burkina Faso-Nigéria-Niger impliquant dix (10) districts sanitaires (DS) dans la région de Tillabéry, 2 dans celle de Tahoua, cinq (5) dans celle de Diffa et 2 dans celle de Maradi, engendrant de grands mouvements de populations.

Afghanistan – No new digest announcements identified
Angola – No new digest announcements identified
Burkina Faso [in French] – No new digest announcements identified
Burundi – No new digest announcements identified
Cameroon – No new digest announcements identified
Central African Republic – No new digest announcements identified
Ethiopia – No new digest announcements identified
HIV in Pakistan – No new digest announcements identified
Iran floods 2019 – No new digest announcements identified
Iraq – No new digest announcements identified
Libya – No new digest announcements identified
Malawi floods – No new digest announcements identified
Measles in Europe – No new digest announcements identified
MERS-CoV – No new digest announcements identified
occupied Palestinian territory – No new digest announcements identified
Sudan – No new digest announcements identified
Ukraine – No new digest announcements identified
Zimbabwe – No new digest announcements identified

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WHO Grade 1 Emergencies [to 4 Jan 2020]

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

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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: Recent Developments in Northwestern Syria Situation Report No. 4 – As of 2 January 2020

Yemen – No new digest announcements identified

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UN OCHA – Corporate Emergencies
When the USG/ERC declares a Corporate Emergency Response, all OCHA offices, branches and sections provide their full support to response activities both at HQ and in the field.
Editor’s Note:
Ebola in the DRC has bene added as a OCHA “Corporate Emergency” this week:
CYCLONE IDAI and Kenneth – No new digest announcements identified
EBOLA OUTBREAK IN THE DRC – No new digest announcements identified

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WHO & Regional Offices [to 4 Jan 2020]

WHO Director-General Dr Tedros, video message for new year 2020
2 January 2020
In his new year’s message for 2020, WHO Director-General Dr Tedros Adhanom Ghebreyesus pays tribute to the tireless work of health workers around the world. Dr Tedros highlights the critical contribution these people make to all our lives and flags the urgent need for an additional 18 million more.

Year of the Nurse and the Midwife 2020 
Nurses and midwives play a vital role in providing health services. These are the people who devote their lives to caring for mothers and children; giving lifesaving immunizations and health advice; looking after older people and generally meeting everyday essential health needs. They are often, the first and only point of care in their communities. The world needs 9 million more nurses and midwives if it is to achieve universal health coverage by 2030.
That’s why the World Health Assembly has designated 2020 the International Year of the Nurse and the Midwife…

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WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: Three African countries halt polio outbreaks 20 December 2019

WHO Region of the Americas PAHO
No new digest content identified.

WHO South-East Asia Region SEARO
:: 26 December 2019 News release
15 years of Indian Ocean tsunami – WHO South-East Asia Region continues to prioritize preparedness to respond to public health emergencies

WHO European Region EURO
:: WHO project wins the Global Aesthetic Achievement of the Year award 03-01-2020

WHO Eastern Mediterranean Region EMRO
:: Regional Summit of National Ethics and Bioethics Committees 24 December 2019
:: WHO doctor awarded for helping the mothers and babies of Gaza 22 December 2019

WHO Western Pacific Region
No new digest content identified.

CDC/ACIP [to 4 Jan 2020]
http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html
No new digest content identified.

Africa CDC [to 4 Jan 2020]
http://www.africacdc.org/
News
No new digest content identified.

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

National Health Commission of the People’s Republic of China
http://en.nhc.gov.cn/
Updated: 2019-12-19
Law protecting medical staff implemented
2019-12-30
China’s top legislature and health commission condemned the fatal stabbing of a doctor at a Beijing hospital by a patient’s relative when the country’s law on promotion of basic medical and healthcare was adopted on Dec 28…
In a bid to deter illegal acts targeting medical staff and institutions, the law stipulates that the personal safety and dignity of medical workers must not be infringed upon and that their legitimate rights are protected by law…

Infectious disease situation stable in China: official
2019-12-27
A Chinese health official said on Dec 26 China’s current infectious disease situation is generally stable despite that the country is in the peak of the flu season.
According to the latest surveillance statistics, some provincial-level regions have already entered the flu season, with influenza virus A subtype H3N2 and B virus lineage Victoria were detected as the main viruses, Wang Bin, an official with the National Health Commission, said at a press conference.
Li Zhongjie, an official with the Chinese Center for Disease Control and Prevention, said that vaccination is the most effective and economical way to prevent infectious diseases.
In addition, Li stressed the importance of developing good personal hygiene habits to reduce the risk of exposure to viruses.

China’s flu vaccine supply can meet demand
2019-12-27

Announcements

Paul G. Allen Frontiers Group [to 4 Jan 2020]
https://alleninstitute.org/what-we-do/frontiers-group/news-press/
No new digest content identified.

BMGF – Gates Foundation [to 4 Jan 2020]
http://www.gatesfoundation.org/Media-Center/Press-Releases
No new digest content identified.

Bill & Melinda Gates Medical Research Institute [to 4 Jan 2020]
https://www.gatesmri.org/
The Bill & Melinda Gates Medical Research Institute is a non-profit biotech organization. Our mission is to develop products to fight malaria, tuberculosis, and diarrheal diseases—three major causes of mortality, poverty, and inequality in developing countries. The world has unprecedented scientific tools at its disposal; now is the time to use them to save the lives of the world’s poorest people
No new digest content identified.

CARB-X [to 4 Jan 2020]
https://carb-x.org/
CARB-X is a non-profit public-private partnership dedicated to accelerating antibacterial research to tackle the global rising threat of drug-resistant bacteria.
No new digest content identified.

CEPI – Coalition for Epidemic Preparedness Innovations [to 4 Jan 2020]
http://cepi.net/
Latest news
No new digest content identified.

Clinton Health Access Initiative, Inc. (CHAI) [to 4 Jan 2020]
https://clintonhealthaccess.org/
News & Press Releases
No new digest content identified.

EDCTP [to 4 Jan 2020]
http://www.edctp.org/
The European & Developing Countries Clinical Trials Partnership (EDCTP) aims to accelerate the development of new or improved drugs, vaccines, microbicides and diagnostics against HIV/AIDS, tuberculosis and malaria as well as other poverty-related and neglected infectious diseases in sub-Saharan Africa, with a focus on phase II and III clinical trials
Latest news
No new digest content identified.

Emory Vaccine Center [to 4 Jan 2020]
http://www.vaccines.emory.edu/
No new digest content identified.

European Medicines Agency [to 4 Jan 2020]
http://www.ema.europa.eu/ema/
News & Press Releases
No new digest content identified.

European Vaccine Initiative [to 4 Jan 2020]
http://www.euvaccine.eu/news-events
No new digest content identified.

FDA [to 4 Jan 2020]
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
Press Announcements
No new digest content identified.

Fondation Merieux [to 4 Jan 2020]
http://www.fondation-merieux.org/
News, Events
20 – 22 Jan 2020
Mérieux Foundation co-organized event
Dengue pre-vaccination screening strategies workshop
Les Pensières Center for Global Health, Veyrier-du-Lac (France)

Gavi [to 4 Jan 2020]
https://www.gavi.org/
No new digest content identified.
GHIT Fund [to 4 Jan 2020]
https://www.ghitfund.org/newsroom/press
GHIT was set up in 2012 with the aim of developing new tools to tackle infectious diseases that No new digest content identified.

Global Fund [to 4 Jan 2020]
https://www.theglobalfund.org/en/news/
News & Stories
No new digest content identified.

Hilleman Laboratories [to 4 Jan 2020]
http://www.hillemanlabs.org/
No new digest content identified.

Human Vaccines Project [to 4 Jan 2020]
http://www.humanvaccinesproject.org/media/press-releases/
Press Releases
No new digest content identified.

IAVI [to 4 Jan 2020]
https://www.iavi.org/newsroom
No new digest content identified.

International Coalition of Medicines Regulatory Authorities [ICMRA]
http://www.icmra.info/drupal/en/news
Selected Statements, Press Releases, Research
No new digest content identified.

International Generic and Biosimilar Medicines Association [IGBA]
https://www.igbamedicines.org/
No new digest content identified.

IFFIm
http://www.iffim.org/library/news/press-releases/
No new digest content identified.

IFRC [to 4 Jan 2020]
http://media.ifrc.org/ifrc/news/press-releases/
Selected Press Releases, Announcements
No new digest content identified.

IVAC [to 4 Jan 2020]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
Updates
No new digest content identified.

IVI [to 4 Jan 2020]
http://www.ivi.int/
Selected IVI News & Announcements
No new digest content identified.

JEE Alliance [to 4 Jan 2020]
https://www.jeealliance.org/
Selected News and Events
No new digest content identified.

MSF/Médecins Sans Frontières [to 4 Jan 2020]
http://www.msf.org/
Latest [Selected Announcements]
Syria
“There are no safe places for people in Idlib”
Interview 27 Dec 2019

DRC Ebola outbreaks
Crisis update – December 2019
Crisis Update 27 Dec 2019

DRC Ebola outbreaks
Military presence leads MSF to stop activities in Ebola-affected Biakato
Press Release 24 Dec 2019
Following security incidents in Biakato, Democratic Republic of Congo, an increase in security – including armed military forces – have been deployed around and within health structures. The presence of arms and weapons in hospitals and clinics has resulted in Médecins Sans Frontières (MSF) taking the difficult decision to stop medical activities – including those related to Ebola – in Biakato.
“We are no longer able to work in accordance with our principles of neutrality and impartiality,” said Ewenn Chenard, Emergency Coordinator for MSF. “We regret this decision, but the presence of armed forces around and within the health structures of Biakato goes against our principles.”
MSF has been working with the people of Biakato, located in DRC’s northeastern Ituri province, since 2016, supporting the Ministry of Health. Initially, our activities were dedicated to assisting victims of sexual violence…

National Vaccine Program Office – U.S. HHS [to 4 Jan 2020]
https://www.hhs.gov/vaccines/about/index.html
NVAC 2020 Meetings
February 13-14, 2020 NVAC Meeting
June 9-10, 2020 NVAC Meeting
September 23-24, 2020 Meeting (Virtual)

NIH [to 4 Jan 2020]
http://www.nih.gov/news-events/news-releases
Selected News Releases
Changed route of immunization dramatically improves efficacy of TB vaccine
January 2, 2020 — NIH scientists report results from animal study.
… Now, researchers from the National Institutes of Health’s National Institute of Allergy and Infectious Diseases (NIAID) and their colleagues have shown that simply changing the dose and route of administration from intradermal (ID) to intravenous (IV) greatly increases the vaccine’s ability to protect rhesus macaques from infection following exposure to Mycobacterium tuberculosis (Mtb), the bacterium that causes TB. The findings provide a new understanding of the mechanisms of BCG-elicited protection against tuberculosis infection and disease. In addition, the findings support investigation of IV BCG administration in clinical trials to determine whether this route improves its effectiveness in teens and adults.
Study investigators at the NIAID Vaccine Research Center were led by Robert A. Seder, M.D., and Mario Roederer, Ph.D. Their collaborators included JoAnne L. Flynn, Ph.D., of University of Pittsburgh School of Medicine…

PATH [to 4 Jan 2020]
https://www.path.org/media-center/
Selected Announcements
No new digest content identified.

Sabin Vaccine Institute [to 4 Jan 2020]
http://www.sabin.org/updates/pressreleases
Statements and Press Releases
No new digest content identified.

UNAIDS [to 4 Jan 2020]
http://www.unaids.org/en
Selected Press Releases/Reports/Statements
26 December 2019
Treating HIV-positive children with speed and skill

UNICEF [to 4 Jan 2020]
https://www.unicef.org/media/press-releases
Selected Statements, Press Releases, Reports
Statement
UNICEF’s New Year appeal for Syria: Cease fighting in the northwest and end the nine-year war
Statement by UNICEF Executive Director Henrietta Fore
02/01/2020

Press release
New Year’s babies: Over 392,000 children will be born worldwide on New Year’s Day
In 2020, UNICEF is calling for world leaders and nations to invest in health workers with the know-how and equipment to save every newborn
01/01/2020

Press release
2019 concludes a ‘deadly decade’ for children in conflict, with more than 170,000 grave violations verified since 2010
Three-fold rise in verified attacks on children since 2010, an average of 45 violations a day
29/12/2019

Statement
Children bear the brunt of intensifying violence in northwest Syria
Statement from Ted Chaiban, UNICEF Regional Director for the Middle East and North Africa
24/12/2019

Vaccination Acceptance Research Network (VARN) [to 4 Jan 2020]
https://vaccineacceptance.org/news.html#header1-2r
No new digest content identified.

Vaccine Confidence Project [to 4 Jan 2020]
http://www.vaccineconfidence.org/
No new digest content identified.

Vaccine Education Center – Children’s Hospital of Philadelphia [to 4 Jan 2020]
http://www.chop.edu/centers-programs/vaccine-education-center
No new digest content identified.

Wellcome Trust [to 4 Jan 2020]
https://wellcome.ac.uk/news
News | 28 December 2019
MBE for Nicola Perrin in Queen’s New Year Honours
Nicola Perrin, former Head of Policy at Wellcome and latterly Head of Understanding Patient Data, has been awarded an MBE for her work on championing the responsible use of patient data.

The Wistar Institute [to 4 Jan 2020]
https://www.wistar.org/news/press-releases
No new digest content identified.

World Organisation for Animal Health (OIE) [to 4 Jan 2020]
https://www.oie.int/en/for-the-media/press-releases/2019/
No new digest content identified.

::::::

ARM [Alliance for Regenerative Medicine] [to 4 Jan 2020]
https://alliancerm.org/press-releases/
No new digest content identified.

BIO [to 4 Jan 2020]
https://www.bio.org/press-releases
Press Releases
No new digest content identified.

DCVMN – Developing Country Vaccine Manufacturers Network [to 4 Jan 2020]
http://www.dcvmn.org/
News
No new digest content identified.

IFPMA [to 4 Jan 2020]
http://www.ifpma.org/resources/news-releases/
Selected Press Releases, Statements, Publications
No new digest content identified.

PhRMA [to 4 Jan 2020]
http://www.phrma.org/
Selected Press Releases, Statements
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 focu-s on vaccine ethics and policy. Journal Watch is not intended to be exhaustive, but indicative of themes and issues the Center is actively tracking. We selectively provide full text of some editorial and comment articles that are specifically relevant to our work. Successful access to some of the links provided may require subscription or other access arrangement unique to the publisher.
If you would like to suggest other journal titles to include in this service, please contact David Curry at: david.r.curry@centerforvaccineethicsandpolicy.org

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 4 Jan 2020)

The influence of a community intervention on influenza vaccination knowledge and behavior among diabetic patients
This study was conducted to evaluate the impact of a comprehensive community intervention on cognition and inoculation behaviors of diabetic patients immunized with influenza vaccine.
Authors: Lili Tao, Ming Lu, Xiaoning Wang, Xiaoyan Han, Shuming Li and Haiyan Wang
Citation: BMC Public Health 2019 19:1747
Content type: Research article
Published on: 27 December 2019

Bulletin of the World Health Organization
Volume 98, Number 1, January 2020, 1-76
https://www.who.int/bulletin/volumes/98/1/en/

EDITORIALS
Improving quality of care in fragile, conflict-affected and vulnerable settings
— Shamsuzzoha Babar Syed, Sheila Leatherman, Matthew Neilson, Andre Griekspoor, Dirk Horemans, Mondher Letaief & Edward Kelley
http://dx.doi.org/10.2471/BLT.19.246280

Bulletin of the World Health Organization
Volume 98, Number 1, January 2020, 1-76
https://www.who.int/bulletin/volumes/98/1/en/

RESEARCH
Health-care investments for the urban populations, Bangladesh and India
— Daphne CN Wu, Eduardo P Banzon, Hellen Gelband, Brian Chin, Varsha Malhotra, Sonalini Khetrapal, David Watkins, Sungsup Ra, Dean T Jamison & Prabhat Jha
http://dx.doi.org/10.2471/BLT.19.234252

Bulletin of the World Health Organization
Volume 98, Number 1, January 2020, 1-76
https://www.who.int/bulletin/volumes/98/1/en/

Development assistance for community health workers in 114 low- and middle-income countries, 2007–2017
— Chunling Lu, Daniel Palazuelos, Yiqun Luan, Sonia Ehrlich Sachs, Carole Diane Mitnick, Joseph Rhatigan & Henry B Perry
http://dx.doi.org/10.2471/BLT.19.235499

Disaster Medicine and Public Health Preparedness
Volume 13 – Issue 5-6 – December 2019
https://www.cambridge.org/core/journals/disaster-medicine-and-public-health-preparedness/

Commentary
Clarification of the Concept of Risk Communication and its Role in Public Health Crisis Management in China
Wuqi Qiu, Cordia Chu
Published online by Cambridge University Press: 10 June 2019, pp. 834-836
Abstract
Risk communication plays a very important role in the prevention of public health crisis events and has been considered by the World Health Organization (WHO) to be 1 of the main functions of an emergency public health crisis. However, it is a relatively new research field in China, so many people have mistaken understandings of risk communication. This article will describe the concept and importance of risk communication and briefly introduce the role of risk communication in public health crisis management. It also provides information for the prevention of public health crisis events in the future.

Disaster Medicine and Public Health Preparedness
Volume 13 – Issue 5-6 – December 2019
https://www.cambridge.org/core/journals/disaster-medicine-and-public-health-preparedness/

Original Research
Disaster Medicine: A Comprehensive Review of the Literature From 2016
Ritu R. Sarin, John L. Hick, Alicia A. Livinski, Jennifer Nieratko, Meghan Treber, Audrey Mazurek, Shayne Brannman, Paul Biddinger, Jonathan Burstein, Gregory Ciottone, Scott Goldberg, Andrew Milsten, Ira Nemeth, Eric Goralnick
Published online by Cambridge University Press: 19 June 2019, pp. 946-957
Abstract
Objective:
The Society of Academic Emergency Medicine Disaster Medicine Interest Group, the Office of the Assistant Secretary for Preparedness and Response – Technical Resources, Assistance Center, and Information Exchange (ASPR TRACIE) team, and the National Institutes of Health Library searched disaster medicine peer-reviewed and gray literature to identify, review, and disseminate the most important new research in this field for academics and practitioners.
Methods:
MEDLINE/PubMed and Scopus databases were searched with key words. Additional gray literature and focused hand search were performed. A Level I review of titles and abstracts with inclusion criteria of disaster medicine, health care system, and disaster type concepts was performed. Eight reviewers performed Level II full-text review and formal scoring for overall quality, impact, clarity, and importance, with scoring ranging from 0 to 20. Reviewers summarized and critiqued articles scoring 16.5 and above.
Results:
Articles totaling 1176 were identified, and 347 were screened in a Level II review. Of these, 193 (56%) were Original Research, 117 (34%) Case Report or other, and 37 (11%) were Review/Meta-Analysis. The average final score after a Level II review was 11.34. Eighteen articles scored 16.5 or higher. Of the 18 articles, 9 (50%) were Case Report or other, 7 (39%) were Original Research, and 2 (11%) were Review/Meta-Analysis.
Conclusions:
This first review highlighted the breadth of disaster medicine, including emerging infectious disease outbreaks, terror attacks, and natural disasters. We hope this review becomes an annual source of actionable, pertinent literature for the emerging field of disaster medicine.

Genome Medicine
https://genomemedicine.biomedcentral.com/articles
[Accessed 4 Jan 2020]

Comment
Open Access
Published: 31 December 2019
Digital twins to personalize medicine
Bergthor Björnsson, et al on behalf of the Swedish Digital Twin Consortium
Genome Medicine volume 12, Article number: 4 (2019
Abstract
Personalized medicine requires the integration and processing of vast amounts of data. Here, we propose a solution to this challenge that is based on constructing Digital Twins. These are high-resolution models of individual patients that are computationally treated with thousands of drugs to find the drug that is optimal for the patient.
Background
Despite great strides in biomedical advances during the past century, a large number of patients do not respond to drug treatment. According to a report from the US Food and Drug Administration (FDA), medication is deemed ineffective for 38–75% of patients with common diseases [¹]. This results in patient suffering and increased healthcare costs. These problems reflect the complexity of common diseases, which may involve altered interactions between thousands of genes that differ between patients with the same diagnosis. There is a wide gap between this complexity and modern health care, in which diagnostics often relies on a small number of biomarkers of limited sensitivity or specificity. Digital and genomic medicine may bridge this gap by monitoring, processing, and integrating vast amounts of data from wearable digital devices, omics, imaging, and electronic medical records [²]. However, the integration and clinical exploitation of such complex data are unresolved challenges.
Application of the digital twin concept to personalize medicine
Digital twins are a concept from engineering which has been applied to complex systems such as airplanes or even cities [³]. The aims are to model those systems computationally, in order to develop and test them more quickly and economically than is possible in the real-life setting. Ideally, the digital twin concept can be translated to patients in order to improve diagnostics and treatment. This is the general aim of the DigiTwin consortium, which includes academic, clinical and industrial partners from 32 countries (https://www.digitwins.org). Practical and scalable solutions for specific problems will also require national initiatives. As an example, the Swedish Digital Twin Consortium (SDTC) aims to develop a strategy for personalized medicine (https://www.sdtc.se). The SDTC strategy, which is the focus of this Comment, is based on: (i) constructing unlimited copies of network models of all molecular, phenotypic, and environmental factors relevant to disease mechanisms in individual patients (i.e., digital twins); (ii) computationally treating those digital twins with thousands of drugs in order to identify the best performing drug; and (iii) treating the patient with this drug …

Global Health: Science and Practice (GHSP)
Vol. 7, No. 4 December 23, 2019
http://www.ghspjournal.org/content/current

ORIGINAL ARTICLES
Using Data to Keep Vaccines Cold in Kenya: Remote Temperature Monitoring with Data Review Teams for Vaccine Management
Mercy Lutukai, Elizabeth A. Bunde, Benjamin Hatch, Zoya Mohamed, Shahrzad Yavari, Ernest Some, Amos Chweya, Caroline Kania, Jesse C. Ross, Carmit Keddem and Yasmin Chandani
Global Health: Science and Practice December 2019, 7(4):585-597; https://doi.org/10.9745/GHSP-D-19-00157
Using technology to make data visible to stakeholders and giving those stakeholders a framework for analyzing that data for decision making improves cold chain management of vaccines in Kenya.

Global Health: Science and Practice (GHSP)
Vol. 7, No. 4 December 23, 2019
http://www.ghspjournal.org/content/current

ORIGINAL ARTICLES
Using Data to Keep Vaccines Cold in Kenya: Remote Temperature Monitoring with Data Review Teams for Vaccine Management
Mercy Lutukai, Elizabeth A. Bunde, Benjamin Hatch, Zoya Mohamed, Shahrzad Yavari, Ernest Some, Amos Chweya, Caroline Kania, Jesse C. Ross, Carmit Keddem and Yasmin Chandani
Global Health: Science and Practice December 2019, 7(4):585-597; https://doi.org/10.9745/GHSP-D-19-00157
Using technology to make data visible to stakeholders and giving those stakeholders a framework for analyzing that data for decision making improves cold chain management of vaccines in Kenya.

Global Public Health
Volume 15, 2020 Issue 1
http://www.tandfonline.com/toc/rgph20/current

Article
Towards a new definition of health security: A three-part rationale for the twenty-first century
Annamarie B. Sehovic
Pages: 1-12
Published online: 25 Jun 2019

Global Public Health
Volume 15, 2020 Issue 1
http://www.tandfonline.com/toc/rgph20/current

Article
Conceptions within misconceptions: Pluralisms in an Ebola vaccine trial in West Africa
Arsenii Alenichev, Koen Peeters Grietens & René Gerrets
Pages: 13-21
Published online: 25 Jun 2019
ABSTRACT
Ensuring that biomedical information about research procedures is adequately understood by participants and their communities is key for conducting ethical research. This article explores participants’ understanding of trial procedures for an experimental vaccine against Ebola virus disease (EVD) in a West African context. We found that some trial participants believed there was a chance of contracting Ebola and other sicknesses from the vaccine, and others believed both the vaccine and the placebo control would be able to prevent other illnesses than EVD. While these beliefs might be understood as misconceptions about the vaccine trial, this paper shows that such a conclusion is problematic because it excludes local explanatory health models and logics of causality. The paper invites bioethicists to work with anthropologists to take seriously different models of health knowledge in global health research. Investigating and addressing such differences could be the key to understanding human subjects’ motives for participation, and to creating space for studies of empirical ethics.

Globalization and Health
http://www.globalizationandhealth.com/
[Accessed 4 Jan 2020]

Review
Open Access
Published: 30 December 2019
Impacts of intellectual property provisions in trade treaties on access to medicine in low and middle income countries: a systematic review
Authors: Md. Deen Islam, Warren A. Kaplan, Danielle Trachtenberg, Rachel Thrasher, Kevin P. Gallagher and Veronika J. Wirtz
Citation: Globalization and Health 2019 15:88
Content type: Review
Published on: 30 December 2019
Abstract
Background
We present a systematic review describing ex-ante and ex-post evaluations of the impacts of intellectual property provisions in trade treaties on access to medicine in low and middle income countries. These evaluations focused on multilateral and bilateral trade agreements. We ascertained which IP provisions impacting access to medicines were the focus of these evaluations. We provide a further research agenda related to investigating the effect of trade agreement’s intellectual property provisions on access to medicines…
Conclusion
Both ex ante and ex post methods have advantages and limitations and, on balance, both types report, for the most part, an increase in price and a decrease in consumer welfare with imposition of intellectual property protection in trade agreements. The main differences between these studies are in the magnitude of the changes. There is a gap in our empirical understanding of the mechanisms through which such changes affect access to medicines and which outcomes relevant to access are most affected by which type of changes in intellectual property policy and law.

International Journal of Community Medicine and Public Health
Vol 7, No 1 (2020) January 2020
https://www.ijcmph.com/index.php/ijcmph/issue/view/58

Original Research Articles
Assessment of vaccine management in cold chain points of Jashpur and Sarguja districts of Chhattisgarh
Nitin H. Kamble, Daneshwar Singh, Harshal G. Mendhe, Kiran Makade

International Journal of Community Medicine and Public Health
Vol 7, No 1 (2020) January 2020
https://www.ijcmph.com/index.php/ijcmph/issue/view/58

Barriers for measles rubella vaccination campaign in rural area of Jammu: a qualitative study
Sonika Sangra, Neha Choudhary, Wahida Kouser

International Journal of Epidemiology
Volume 48, Issue 6, December 2019
https://academic.oup.com/ije/issue/48/6

Opinion
Integrating a One Health approach into epidemiology to improve public policy
Laura H Kahn
Int J Epidemiol, Volume 48, Issue 6, December 2019, Pages 1737–1739, https://doi.org/10.1093/ije/dyz178

Journal of Travel Medicine
Volume 26, Issue 8, 2019
https://academic.oup.com/jtm/issue/26/8

Editorial
Dengue pre-vaccination serology screening for the use of Dengvaxia®
Elizabeth Hunsperger, PhD, Rosanna Peeling, PhD, Duane J Gubler, DSc, Eng Eong Ooi, BMBS, PhD
J Travel Med, Volume 26, Issue 8, 2019, taz092, https://doi.org/10.1093/jtm/taz092
Can pre-vaccination screening for prior dengue infection using commercially available rapid diagnostic tests guide Dengvaxia administration?
Extract
Dengue is a global problem with an estimated 100 million symptomatic cases worldwide every year.1 Endemic throughout the tropics, this disease is expanding into the subtropics in the geographic footprint of its mosquito vectors, principally Aedes aegypti. This acute disease that presents with syndromes ranging from undifferentiated febrile illness to circulatory shock from vasculopathy, hemorrhage and organ dysfunction is caused by four closely related but antigenically distinct dengue viruses (DENV1–4). Epidemiological observations have found that certain strains of DENV are associated with increased epidemic potential and severe disease2 Moreover, elevated risk…

Journal of Travel Medicine
Volume 26, Issue 8, 2019
https://academic.oup.com/jtm/issue/26/8

Cholera in travellers: a systematic review
Bradley A Connor, MD, Richard Dawood, MD, Mark S Riddle, MD, Davidson H Hamer, MD
J Travel Med, Volume 26, Issue 8, 2019, taz085, https://doi.org/10.1093/jtm/taz085

The Lancet
Volume 395, ISSUE 10217, P1, January 04, 2020
https://www.thelancet.com/journals/lancet/issue/current

Editorial
2020: a critical year for women, gender equity, and health
The Lancet

The Lancet
Volume 395, ISSUE 10217, P1, January 04, 2020
https://www.thelancet.com/journals/lancet/issue/current

Comment
Surviving or thriving in the Eastern Mediterranean region: the quest for universal health coverage during conflict
Awad Mataria, Rana Hajjeh, Ahmed Al-Mandhari

Lancet Global Health
Volume 8, ISSUE 1, Pe1, January 01, 2020
http://www.thelancet.com/journals/langlo/issue/current

Comment
Advancing research ethics systems in Latin America and the Caribbean: a path for other LMICs?
Marcie Neil, Carla Saenz

Lancet Global Health
Volume 8, ISSUE 1, Pe1, January 01, 2020
http://www.thelancet.com/journals/langlo/issue/current

World RePORT: a database for mapping biomedical research funding
Taghreed Adam, Hannah Akuffo, James G Carter, Zach Charat, Michael J Cheetham, Aldo Crisafulli, Cindy M Danielson, Jennifer Gunning, Brian Haugen, Dominika Jajkowicz, Simon Kay,
Peter H Kilmarx, Julia Mólto López, Ole F Olesen, Inmaculada Peñas-Jiménez, Kedest Tesfagiorgis, Stacy K Wallick, Roger I Glass

Lancet Global Health
Volume 8, ISSUE 1, Pe1, January 01, 2020
http://www.thelancet.com/journals/langlo/issue/current

Articles
A comprehensive assessment of universal health coverage in 111 countries: a retrospective observational study
Adam Wagstaff, Sven Neelsen

Lancet Global Health
Volume 8, ISSUE 1, Pe1, January 01, 2020
http://www.thelancet.com/journals/langlo/issue/current

Implementation of non-communicable disease policies: a geopolitical analysis of 151 countries
Luke N Allen, Brian D Nicholson, Beatrice Y T Yeung, Francisco Goiana-da-Silva

Lancet Global Health
Volume 8, ISSUE 1, Pe1, January 01, 2020
http://www.thelancet.com/journals/langlo/issue/current

Estimates of the global population of children who are HIV-exposed and uninfected, 2000–18: a modelling study
Amy L Slogrove, Kathleen M Powis, Leigh F Johnson, John Stover, Mary Mahy

Lancet Infectious Diseases
Volume 20, ISSUE 1, P1, January 01, 2020
http://www.thelancet.com/journals/laninf/issue/current

Editorial
Dare we dream of the end of malaria?
The Lancet Infectious Diseases

Lancet Infectious Diseases
Volume 20, ISSUE 1, P1, January 01, 2020
http://www.thelancet.com/journals/laninf/issue/current

Alternative hepatitis B vaccine strategies in healthy non-responders to a first standard vaccination scheme
Paul Loubet, Odile Launay

Lancet Infectious Diseases
Volume 20, ISSUE 1, P1, January 01, 2020
http://www.thelancet.com/journals/laninf/issue/current

Viral emergence and immune interplay in flavivirus vaccines
Carlo Fischer, Edmilson F de Oliveira-Filho, Jan Felix Drexler

Lancet Infectious Diseases
Volume 20, ISSUE 1, P1, January 01, 2020
http://www.thelancet.com/journals/laninf/issue/current

Preparedness for emerging epidemic threats: a Lancet Infectious Diseases Commission
Vernon J Lee, Ximena Aguilera, David Heymann, Annelies Wilder-Smith for The Lancet Infectious Diseases Commission
At any time, an emerging, lethal, and highly transmissible pathogen might pose a risk of being spread globally because of the interconnectedness of the global population. ¹, ² Emerging epidemic threats are occurring with increasing scale, duration, and effect, often disrupting travel and trade, and damaging both national and regional economies. ³, ⁴ Even geographically limited outbreaks such as the Ebola virus disease in Africa might have a global effect.

Lancet Infectious Diseases
Volume 20, ISSUE 1, P1, January 01, 2020
http://www.thelancet.com/journals/laninf/issue/current

Articles
Immunogenicity of chimeric haemagglutinin-based, universal influenza virus vaccine candidates: interim results of a randomised, placebo-controlled, phase 1 clinical trial
David I Bernstein, et al.

Lancet Infectious Diseases
Volume 20, ISSUE 1, P1, January 01, 2020
http://www.thelancet.com/journals/laninf/issue/current

Personal View
The public health crisis of underimmunisation: a global plan of action
Lawrence O Gostin, James G Hodge Jr, Barry R Bloom, Ayman El-Mohandes, Jonathan Fielding,
Peter Hotez, Ann Kurth, Heidi J Larson, Walter A Orenstein, Kenneth Rabin, Scott C Ratzan, Daniel Salmon
Summary
Vaccination is one of public health’s greatest achievements, responsible for saving billions of lives. Yet, 20% of children worldwide are not fully protected, leading to 1·5 million child deaths annually from vaccine-preventable diseases. Millions more people have severe disabling illnesses, cancers, and disabilities stemming from underimmunisation. Reasons for falling vaccination rates globally include low public trust in vaccines, constraints on affordability or access, and insufficient governmental vaccine investments. Consequently, an emerging crisis in vaccine hesitancy ranges from hyperlocal to national and worldwide. Outbreaks often originate in small, insular communities with low immunisation rates. Local outbreaks can spread rapidly, however, transcending borders. Following an assessment of underlying determinants of low vaccination rates, we offer an action based on scientific evidence, ethics, and human rights that spans multiple governments, organisations, disciplines, and sectors.

Lancet Infectious Diseases
Volume 20, ISSUE 1, P1, January 01, 2020
http://www.thelancet.com/journals/laninf/issue/current

WHO international standard for anti-rubella: learning from its application
Sarah L Kempster, et aL

Nature
Volume 577 Issue 7788, 2 January 2020
http://www.nature.com/nature/current_issue.html

Editorial | 01 January 2020
Get the Sustainable Development Goals back on track
At the current rate, most of the goals will not be met. Here’s how the 2030 agenda can be put back on the right path.

Nature
Volume 577 Issue 7788, 2 January 2020
http://www.nature.com/nature/current_issue.html

Article | 01 January 2020 | Open Access
Prevention of tuberculosis in macaques after intravenous BCG immunization
The delivery route and dose of the BCG vaccine profoundly alters the protective outcome after Mycobacterium tuberculosis challenge in non-human primates.
Patricia A. Darrah, Joseph J. Zeppa[…] & Robert A. Seder

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 4 Jan 2020)

Personalized public health: An implementation research agenda for the HIV response and beyond
Elvin H. Geng, Charles B. Holmes, Mosa Moshabela, Izukanji Sikazwe, Maya L. Petersen
Editorial | published 31 Dec 2019 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1003020
[Excerpt]
The third factor
We have arrived at a moment in the global HIV response where implementation research is ready to take center stage. Treatment has been scaled-up globally over the past ten years and, as a result, HIV-related mortality and incidence have fallen by more than 50% since a peak in the early 2000s [¹]. Despite progress, however, antiretroviral therapy (ART) must still reach perhaps another 15 million persons living with HIV in the coming years. Progress in prevention also remains well below targets. The formula needed for success—past, present and future—consists of three main factors: first, the efficacy of available interventions to treat and prevent HIV; second, adequacy of financing; and third, the effectiveness, efficiency and quality of implementation. As to the first factor, well-tolerated, potent and affordable medications for HIV treatment and prevention already exist: tomorrow’s novel products will likely offer only incremental benefits, and do so through affecting barriers to implementation (e.g., injectable cabotegravir). Regarding the second, donor funding for the global HIV response has leveled out over the past decade and domestic allocations in low- and middle-income countries have not reached needed levels: a large surge in funding is unlikely [²]. Perhaps more than ever before, success in the global HIV response depends on the third factor in the equation: the effectiveness, efficiency, and quality of implementation.

PLoS One
http://www.plosone.org/
[Accessed 4 Jan 2020]

Asylum seekers’ perspectives on vaccination and screening policies after their arrival in Greece and The Netherlands
Christina Louka, Elizabeth Chandler, Adelita V. Ranchor, Hans Broer, Spyros Pournaras, Sofanne J. Ravensbergen, Ymkje Stienstra

Research Article | published 26 Dec 2019 PLOS ONE
https://doi.org/10.1371/journal.pone.0226948
Abstract
Introduction
Europe has been dealing with an increasing number of refugees during the past 5 years. The timing of screening and vaccination of refugees is debated by many professionals, however refugees’ perspectives on health issues are infrequently taken into account. In this study, we aimed to investigate asylum seekers’ perspectives on infectious diseases screening and vaccination policies.
Materials and methods
Interviews were conducted in Greece and the Netherlands. Asylum seekers and recently arrived refugees were approached and informed with the help of interpreters; consent forms were acquired. The survey focused on demographic data, vaccination status, screening policies and prevention of infectious diseases.
Results
A total of 61 (43 male, 70.5%) refugees (30 Afghanis, 16 Syrian, 7 Erithrean) were interviewed. Mean age was 35.2 years (SD 13.5) and 50% had received primary or secondary education, while 24.6% received none. Median time after arrival in Greece and the Netherlands was 24 months (IQR 8.5–28). 44 out of 61 (72.1) participants were willing to be vaccinated after arrival in Europe, 26 preferred vaccination and screening to be performed at the point of entry. The need for screening and vaccination was perceived higher amongst participants in Greece (100% vs 43.3%) due to living conditions leading to increased risk of outbreaks.
Conclusion
Participants were willing to communicate their perspectives and concerns. Screening and vaccination programs could be more effective when implemented shortly after arrival and by involving asylum seekers and refugees when developing screening and vaccination interventions.

Preventive Medicine
Volume 130 January 2020
https://www.sciencedirect.com/journal/preventive-medicine/vol/130/suppl/C

Research article Full text access
Cost-effectiveness of a comprehensive immunization program serving high-risk, uninsured adults
Kimberly J. Wilson, H. Shelton Brown, Ujas Patel, Debbie Tucker, Kurt Becker
Article 105860

Preventive Medicine
Volume 130 January 2020
https://www.sciencedirect.com/journal/preventive-medicine/vol/130/suppl/C

Research article Full text access
Exacerbating disparities?: Cervical cancer screening and HPV vaccination
Michelle I. Silver, Sarah Kobrin
Article 105902

Proceedings of the Royal Society B
18 December 2019 Volume 286 Issue 1917
https://royalsocietypublishing.org/toc/rspb/current

Editorial
Gene drive: progress and prospects
N. Wedell, T. A. R. Price and A. K. Lindholm
Published:18 December 2019Article ID:20192709
https://doi.org/10.1098/rspb.2019.2709
Abstract
Gene drive is a naturally occurring phenomenon in which selfish genetic elements manipulate gametogenesis and reproduction to increase their own transmission to the next generation. Currently, there is great excitement about the potential of harnessing such systems to control major pest and vector populations. If synthetic gene drive systems can be constructed and applied to key species, they may be able to rapidly spread either modifying or eliminating the targeted populations. This approach has been lauded as a revolutionary and efficient mechanism to control insect-borne diseases and crop pests. Driving endosymbionts have already been deployed to combat the transmission of dengue and Zika virus in mosquitoes. However, there are a variety of barriers to successfully implementing gene drive techniques in wild populations. There is a risk that targeted organisms will rapidly evolve an ability to suppress the synthetic drive system, rendering it ineffective. There are also potential risks of synthetic gene drivers invading non-target species or populations. This Special Feature covers the current state of affairs regarding both natural and synthetic gene drive systems with the aim to identify knowledge gaps. By understanding how natural drive systems spread through populations, we may be able to better predict the outcomes of synthetic drive release.