Lessons learned from engaging communities for Ebola vaccine trials in Sierra Leone: reciprocity, relatability, relationships and respect (the four R’s)

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 14 Dec 2019)

 

Lessons learned from engaging communities for Ebola vaccine trials in Sierra Leone: reciprocity, relatability, relationships and respect (the four R’s)
Building trust and engaging the community are important for biomedical trials. This was core to the set up and delivery of the EBOVAC-Salone and PREVAC Ebola vaccine trials in Sierra Leone during and following…
Authors: Sara Dada, Gillian McKay, Ana Mateus and Shelley Lees
Citation: BMC Public Health 2019 19:1665
Content type: Research article
Published on: 11 December 2019

Factors associated with the uptake of newly introduced childhood vaccinations in Ethiopia: the cases of rotavirus and pneumococcal conjugate vaccines

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 14 Dec 2019)

 

Factors associated with the uptake of newly introduced childhood vaccinations in Ethiopia: the cases of rotavirus and pneumococcal conjugate vaccines
Childhood immunization programmes have made substantial contributions to lowering the burden of disease among children in developing countries, however a large proportion of children still remain unimmunized. …
Authors: Abrham Wondimu, Qi Cao, Jan C. Wilschut and Maarten J. Postma
Citation: BMC Public Health 2019 19:1656
Content type: Research article
Published on: 10 December 2019

Public views regarding the responsibility of patients, clinicians, and institutions to participate in research in the United States

Clinical Trials
Volume 16 Issue 6, December 2019
https://journals.sagepub.com/toc/ctja/16/6

 

Ethics
Public views regarding the responsibility of patients, clinicians, and institutions to participate in research in the United States
Kevin P Weinfurt, Li Lin, Jeremy Sugarman
First Published July 1, 2019; pp. 574–579
Abstract
Background
The need for more and better evidence to inform clinical decision making among all stakeholders has fueled calls for creating learning healthcare systems. The successful realization of a learning healthcare system seems to assume that various parties have a responsibility to participate in learning activities, including research. The objective of this study was to determine whether members of the general public perceive an ethical responsibility to participate in pragmatic clinical research that would be inherent to a learning health system.
Methods
A total of 2994 English-speaking adults completed a nationally representative online survey.
Results
About two-thirds of respondents were relatively neutral regarding a responsibility for themselves and others to participate in research; the remainder felt that they and others did not have a responsibility to participate in research.
Conclusions
Efforts to justify and develop a robust learning health system in an ethically acceptable fashion need to take these findings into account.

Opportunities for Artificial Intelligence in Advancing Precision Medicine

Current Genetic Medicine Reports
Volume 7, Issue 4, December 2019
https://link.springer.com/journal/40142/7/4

 

Epigenetics and Epigenomics (C Bell, Section Editor)
Topical Collection
Opportunities for Artificial Intelligence in Advancing Precision Medicine
Fabian V. Filipp
We critically evaluate the future potential of machine learning (ML), deep learning (DL), and artificial intelligence (AI) in precision medicine. The goal of this work is to show progress in ML in digital health, to exemplify future needs and trends, and to identify any essential prerequisites of AI and ML for precision health.

Perceived challenges in the informed consent process: Mismatches between enrollers and researchers at a South African clinical research site

Developing World Bioethics
Volume 19, Issue 4 Pages: 187-247 December 2019
https://onlinelibrary.wiley.com/toc/14718847/current

 

ORIGINAL ARTICLES
Perceived challenges in the informed consent process: Mismatches between enrollers and researchers at a South African clinical research site
Megan Scott, Jennifer Watermeyer, Samantha Nolle, Claire Penn
Pages: 206-214
First Published: 29 January 2019

Fairness in drug prices: do economists think differently from the public?

Health Economics, Policy and Law 
Volume 15 – Issue 1 – January 2020
https://www.cambridge.org/core/journals/health-economics-policy-and-law/latest-issue

 

Articles
Fairness in drug prices: do economists think differently from the public?
Antonio J. Trujillo, Taruja Karmarkar, Caleb Alexander, William Padula, Jeremy Greene, Gerard Anderson
Published online by Cambridge University Press: 04 December 2018, pp. 18-29

The State of Health Policy and Systems Research: Reflections From the 2018 5th Global Symposium

Health Policy and Planning
Volume 34, Issue Supplement_3, December 2019
https://academic.oup.com/heapol/issue/34/Supplement_3

 

Access to Medicines through Health Systems in Low- and Middle-Income Countries
Editorial
The State of Health Policy and Systems Research: Reflections From the 2018 5th Global Symposium
Kara Hanson, Kumanan Rasanathan, Asha George
Health Policy Plan, Volume 34, Issue Supplement_2, November 2019, Pages ii1–ii3, https://doi.org/10.1093/heapol/czz113

Methodological gaps and opportunities for studying multisectoral collaboration for health in low- and middle-income countries

Health Policy and Planning
Volume 34, Issue Supplement_3, December 2019
https://academic.oup.com/heapol/issue/34/Supplement_3

 

Supplement Articles
Methodological gaps and opportunities for studying multisectoral collaboration for health in low- and middle-income countries
Douglas Glandon, Shinjini Mondal, Ida Okeyo, Shehla Zaidi, Mishal S Khan
Health Policy Plan, Volume 34, Issue Supplement_2, November 2019, Pages ii7–ii17, https://doi.org/10.1093/heapol/czz116

Use of evidence and negotiation in the review of national standard treatment guidelines and essential medicines list: experience from Ghana

Health Policy and Planning
Volume 34, Issue Supplement_3, December 2019
https://academic.oup.com/heapol/issue/34/Supplement_3

 

Use of evidence and negotiation in the review of national standard treatment guidelines and essential medicines list: experience from Ghana
Augustina Koduah, Brian A Asare, Edith Gavor, Martha Gyansa-Lutterodt, Edith Andrews Annan
Health Policy Plan, Volume 34, Issue Supplement_2, November 2019, Pages ii104–ii120, https://doi.org/10.1093/heapol/czz107

Vaccination timeliness and delay in low- and middle-income countries: a systematic review of the literature, 2007-2017

Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 15, Issue 12, 2019
http://www.tandfonline.com/toc/khvi20/current

 

Article
Vaccination timeliness and delay in low- and middle-income countries: a systematic review of the literature, 2007-2017
Nina B. Masters, Abram L. Wagner & Matthew L. Boulton
Pages: 2790-2805
Published online: 12 Jun 2019

Challenges facing vaccinators in the 21st century: results from a focus group qualitative study

Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 15, Issue 12, 2019
http://www.tandfonline.com/toc/khvi20/current

 

Article
Challenges facing vaccinators in the 21st century: results from a focus group qualitative study
Frédérique Wiot, Jane Shirley, Anna Prugnola, Alberta Di Pasquale & Roy Philip
Pages: 2806-2815
Published online: 09 Jul 2019

Post-vaccination campaign coverage evaluation of oral cholera vaccine, oral polio vaccine and measles–rubella vaccine among Forcibly Displaced Myanmar Nationals in Bangladesh

Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 15, Issue 12, 2019
http://www.tandfonline.com/toc/khvi20/current

 

Article
Post-vaccination campaign coverage evaluation of oral cholera vaccine, oral polio vaccine and measles–rubella vaccine among Forcibly Displaced Myanmar Nationals in Bangladesh
Ashraful Islam Khan, Md. Taufiqul Islam, Shah Alam Siddique, Shakil Ahmed, Nurnabi Sheikh, Ashraf Uddin Siddik, Muhammad Shariful Islam & Firdausi Qadri
Pages: 2882-2886
Published online: 23 Aug 2019

The factors associated with maternal consent to human papillomavirus vaccination among adolescents in Israel

Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 15, Issue 12, 2019
http://www.tandfonline.com/toc/khvi20/current

 

Article
The factors associated with maternal consent to human papillomavirus vaccination among adolescents in Israel
Rana Shibli & Shmuel Rishpon
Pages: 3009-3015
Published online: 24 Jul 2019

Reduction patterns of Japanese encephalitis incidence following vaccine introduction into long-term expanded program on immunization in Yunnan Province, China

Infectious Diseases of Poverty
http://www.idpjournal.com/content
[Accessed 14 Dec 2019]

Reduction patterns of Japanese encephalitis incidence following vaccine introduction into long-term expanded program on immunization in Yunnan Province, China
Authors: Xiao-Ting Hu, Qiong-Fen Li, Chao Ma, Zhi-Xian Zhao, Li-Fang He, Ting-Ting Tang, Wen Yu and Philip Owiti

 

Content type: Research Article
10 December 2019

 

New Drugs, New Ideas: Payment Policy Innovations for High‐Cost Pharmaceuticals

The Milbank Quarterly
A Multidisciplinary Journal of Population Health and Health Policy

 

Volume 97, Issue 4 Pages: 881-1242 December 2019
https://onlinelibrary.wiley.com/toc/14680009/current
Opinions
New Drugs, New Ideas: Payment Policy Innovations for High‐Cost Pharmaceuticals
BRIAN J. MILLER, GAIL WILENSKY
Pages: 922-925
First Published: 30 September 2019

Childhood Vaccination Mandates: Scope, Sanctions, Severity, Selectivity, and Salience

The Milbank Quarterly
A Multidisciplinary Journal of Population Health and Health Policy

 

Original Scholarship
Childhood Vaccination Mandates: Scope, Sanctions, Severity, Selectivity, and Salience
KATIE ATTWELL, MARK C. NAVIN
Pages: 978-1014
First Published: 16 September 2019
Policy Points
:: We offer the first systematic conceptual framework for analyzing the operation of mandatory vaccination policies.
:: Our multicomponent framework facilitates synthesis judgments on single issues of pressing concern to policymakers, in particular, how mandatory vaccination policies motivate people to vaccinate.
:: We consider the impact of each component of our framework on persons who remain unvaccinated for different reasons, including complacency, social disadvantage, and more or less committed forms of refusal.

A Randomized, Controlled Trial of Ebola Virus Disease Therapeutics

New England Journal of Medicine
December 12, 2019 Vol. 381 No. 24
http://www.nejm.org/toc/nejm/medical-journal

 

Original Articles
A Randomized, Controlled Trial of Ebola Virus Disease Therapeutics
Both MAb114 and REGN-EB3 were superior to ZMapp in reducing mortality from EVD. Scientifically and ethically sound clinical research can be conducted during disease outbreaks and can help inform the outbreak response.
Sabue Mulangu, M.D., et al and the PALM Writing Group for the PALM Consortium Study Team

Measles Antibody Levels in Young Infants

Pediatrics
December 01, 2019; Volume 144, Issue 6
https://pediatrics.aappublications.org/content/144/6?current-issue=y

 

Articles
Measles Antibody Levels in Young Infants
Michelle Science, Rachel Savage, Alberto Severini, Elizabeth McLachlan, Stephanie L. Hughes, Callum Arnold, Susan Richardson, Natasha Crowcroft, Shelley Deeks, Scott Halperin, Kevin Brown, Todd Hatchette, Jonathan Gubbay, Tony Mazzulli, Shelly Bolotin
Pediatrics, Dec 2019, 144 (6) e20190630

Near Real-Time Surveillance to Assess the Safety of the 9-Valent Human Papillomavirus Vaccine

Pediatrics
December 01, 2019; Volume 144, Issue 6
https://pediatrics.aappublications.org/content/144/6?current-issue=y

 

Near Real-Time Surveillance to Assess the Safety of the 9-Valent Human Papillomavirus Vaccine
James G. Donahue, Burney A. Kieke, Edwin M. Lewis, Eric S. Weintraub, Kayla E. Hanson, David L. McClure, Elizabeth R. Vickers, Julianne Gee, Matthew F. Daley, Frank DeStefano, Rulin C. Hechter, Lisa A. Jackson, Nicola P. Klein, Allison L. Naleway, Jennifer C. Nelson, Edward A. Belongia
Pediatrics, Dec 2019, 144 (6) e20191808

The Rights of Children for Optimal Development and Nurturing Care

Pediatrics
December 01, 2019; Volume 144, Issue 6
https://pediatrics.aappublications.org/content/144/6?current-issue=y

 

Special Articles
The Rights of Children for Optimal Development and Nurturing Care
Julie Uchitel, Errol Alden, Zulfiqar A. Bhutta, Jeffrey Goldhagen, Aditee Pradhan Narayan, Shanti Raman, Nick Spencer, Donald Wertlieb, Jane Wettach, Sue Woolfenden, Mohamad A. Mikati
Pediatrics, Dec 2019, 144 (6) e20190487

The projected impact of geographic targeting of oral cholera vaccination in sub-Saharan Africa: A modeling study

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 14 Dec 2019)

 

Research Article
The projected impact of geographic targeting of oral cholera vaccination in sub-Saharan Africa: A modeling study
Elizabeth C. Lee, Andrew S. Azman, Joshua Kaminsky, Sean M. Moore, Heather S. McKay, Justin Lessler
| published 11 Dec 2019 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1003003

Public Health and the Virtues of Responsibility, Compassion and Humility

Public Health Ethics
Volume 12, Issue 3, November 2019
http://phe.oxfordjournals.org/content/current

 

Original Articles
Public Health and the Virtues of Responsibility, Compassion and Humility
Jessica Nihlén Fahlquist
Public Health Ethics, Volume 12, Issue 3, November 2019, Pages 213–224, https://doi.org/10.1093/phe/phz007
Abstract
In contrast to medical care, which is focused on the individual patient, public health is focused on collective health. This article argues that, in order to better protect the individual, discussions of public health would benefit from incorporating the insights of virtue ethics. There are three reasons to for this. First, the collective focus may cause neglect of the effects of public health policy on the interests and rights of individuals and minorities. Second, whereas the one-on-one encounters in medical care facilitate a compassionate and caring attitude, public health involves a distance between professionals and the public. Therefore, public health professionals must use imagination and care to evaluate the effects of policies on individuals. Third, the relationship between public health professionals and the people who are affected by the policies they design is characterized by power asymmetry, demanding a high level of responsibility from those who wield them.
Against this background, it is argued that public health professionals should develop the virtues of responsibility, compassion and humility. The examples provided, i.e. breastfeeding information and vaccination policy, illustrate the importance of these virtues, which needed for normative as well as instrumental reasons, i.e. as a way to restore trust.

Authority and the Future of Consent in Population-Level Biomedical Research

Public Health Ethics
Volume 12, Issue 3, November 2019
http://phe.oxfordjournals.org/content/current

 

Authority and the Future of Consent in Population-Level Biomedical Research
Mark Sheehan, Rachel Thompson, Jon Fistein, Jim Davies, Michael Dunn
Public Health Ethics, Volume 12, Issue 3, November 2019, Pages 225–236, https://doi.org/10.1093/phe/phz015
Abstract
Population-level biomedical research has become crucial to the health system’s ability to improve the health of the population. This form of research raises a number of well-documented ethical concerns, perhaps the most significant of which is the inability of the researcher to obtain fully informed specific consent from participants. Two proposed technical solutions to this problem of consent in large-scale biomedical research that have become increasingly popular are meta-consent and dynamic consent. We critically examine the ethical and practical credentials of these proposals and find them lacking. We suggest that the consent problem is not solved by adopting a technology driven approach grounded in a notion of ‘specific’ consent but by taking seriously the role of research governance in combination with broader conceptions of consent. In our view, these approaches misconstrue the rightful location of authority in the way in which population-level biomedical research activities are structured and organized. We conclude by showing how and why the authority for determining the nature and shape of choice making about participation ought not to lie with individual participants, but rather with the researchers and the research governance process, and that this necessarily leads to the endorsement of a fully articulated broad consent approach.

Protect global collaboration

Science
13 December 2019 Vol 366, Issue 6471
http://www.sciencemag.org/current.dtl

 

Editorial
Protect global collaboration
By Alan I. Leshner
Science13 Dec 2019 : 1291
Summary
Organized intellectual espionage is a concept that may not seem relevant to most American scientists because such instances are extremely rare, like most cases of scientific misconduct. But this type of theft from research institutions in the United States, although infrequent and isolated, is very real and very serious. It compromises the scientific values that uphold the openness of academic institutions in the United States as well as the nation’s security. Over the past decade, U.S. academic, security, and intelligence communities have identified an increasing number of instances of such misconduct by foreign nations, primarily China but also Russia and Iran. As policies to aggressively deter these occurrences are under vigorous discussion, the scientific community needs to step up and participate in designing the legal path forward, no matter how unpalatable that might seem. Otherwise, scientists will simply be left accepting the cards dealt to them regarding openness and collaboration, which could be even more distasteful.

International mass gatherings and travel-associated illness: A GeoSentinel cross-sectional, observational study

Travel Medicine and Infectious Diseases
Volume 32 November–December 2019

 

Research article Abstract only
International mass gatherings and travel-associated illness: A GeoSentinel cross-sectional, observational study
Philippe Gautret, Kristina M. Angelo, Hilmir Asgeirsson, Alexandre Duvignaud, … Rainer Weber
Article 101504

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.

 

The Atlantic
http://www.theatlantic.com/magazine/
Accessed 14 Dec 2019
[No new, unique, relevant content]

 

BBC
http://www.bbc.co.uk/
Accessed 14 Dec 2019
[No new, unique, relevant content]

 

The Economist
http://www.economist.com/
Accessed 14 Dec 2019
[No new, unique, relevant content]

 

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

 

Forbes
http://www.forbes.com/
Accessed 14 Dec 2019
Dec 12, 2019
How Prepared Are We For The Next Pandemic? Not Very, Experts Show
Global leaders in public health, industry, and government faced hard questions in a pandemic preparedness exercise called Event 201.

Dec 10, 2019
Physician Paul Farmer Reflects On Health Solutions Brought To Medical Deserts And The Places Still In Dire Need
At the eighth annual Forbes Healthcare Summit, medical anthropologist Paul Farmer talked about the impact of Partners In Health, the organization he cofounded in 1987.
By Katherine Love Forbes Staff

 

Foreign Affairs
http://www.foreignaffairs.com/
Accessed 14 Dec 2019
Economic Development   January/February 2020
Comment
How Poverty Ends
In the absence of a magic potion for development, the best way for a country to profoundly transform millions of lives is not to try in vain to boost growth. It is to…
Abhijit V. Banerjee and Esther Duflo

 

Foreign Policy
http://foreignpolicy.com/
Accessed 14 Dec 2019
[No new, unique, relevant content]

 

The Guardian
http://www.guardiannews.com/
Accessed 14 Dec 2019
Global health
Spike in Ebola cases alarms health officials in DRC
Peter Beaumont
Fri 13 Dec 2019
Health officials are investigating an alarming spike in Ebola cases in the Democratic Republic of the Congo, with many blamed on a single individual who appears to have contracted the disease for a second time this year.

 

New Yorker
http://www.newyorker.com/
Accessed 14 Dec 2019
[No new, unique, relevant content]

 

New York Times
http://www.nytimes.com/
Accessed 14 Dec 2019
Asia Pacific
Samoa Extends Measles State of Emergency, NZ to Fund Pacific Vaccination Campaign
The South Pacific island nation of Samoa on Saturday extended a state of emergency due to a measles outbreak which has killed 72 people, mostly infants, as New Zealand announced NZ$1 million ($640,700) to help combat measles in the Pacific.
By Reuters

Opinion
Terminally Ill at 25 and Fighting Fake News on Vaccines
In 2015, an anti-vaccination campaign in Ireland caused a sudden fall in the uptake of the HPV vaccine. Then Laura Brennan got involved.
Dec. 11 By David Robert Grimes

Health
A Research Nonprofit Shutters TB Vaccine Effort and Lays Off Scientists
A financially troubled Seattle research institute cut back programs, leaving researchers to find new homes for work on infectious diseases like tuberculosis and leprosy.
Dec. 13 By Katie Thomas

U.S.
Doctors End Protest to Demand Flu Vaccines for Migrants
A group of doctors on Wednesday ended a three-day protest against the U.S. government’s refusal to allow the flu vaccine be administered to migrants, following the arrests of six demonstrators outside a Border Patrol regional headquarters in San Diego.
Dec. 11 By The Associated Press

U.S.
Arkansas Judge Denies Students’ Appeal to Vaccination Policy
A judge has denied two University of Arkansas students’ request to block a public health decree that has barred them from attending classes during a mumps outbreak because they don’t have the proper vaccinations.
Dec. 11 By The Associated Press

Asia Pacific
Malaysia Vaccinating for Polio After First Case in 27 Years
Malaysia began a vaccination campaign in a rural town on Borneo island after a 3-month-old boy was confirmed to have polio in the country’s first case of the highly infectious virus in 27 years.
Dec. 8 By The Associated Press

 

Washington Post
https://www.washingtonpost.com/
Accessed 14 Dec 2019
Doctors protested Border Patrol to offer flu vaccines to detained migrants. They left in handcuffs
Katie Shepherd · Morning Mix · Dec 12, 2019

Think Tanks et al

Think Tanks et al

Brookings
http://www.brookings.edu/
Accessed 14 Dec 2019
[No new relevant content]

 

Center for Global Development
http://www.cgdev.org/page/press-center
Accessed 14 Dec 2019
Mind the Gaps: Takeaways from Emerging Research and Policy Implications for Aid Transition in Health and Development
Publication 12/10/19
As countries grow economically, governments face rapidly growing demands for quality, affordable, accessible, and equitable healthcare and other social services. At the same time, many middle-income countries face the prospect of transitioning away from donor aid, adding pressure to already-constrained public budgets to fill gaps as donor support ramps down.

 

CSIS
https://www.csis.org/
Accessed 14 Dec 2019
[No new relevant content]

 

Council on Foreign Relations
http://www.cfr.org/
Accessed 14 Dec 2019
[No new relevant content]

 

Kaiser Family Foundation
https://www.kff.org/search/?post_type=pre ss-release
[No new relevant content]

Vaccines and Global Health: The Week in Review :: 7 December 2019

.– 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_7 Dec 2019

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

– Twitter:  Readers can also follow developments on twitter: @vaxethicspolicy.
.
– 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.

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

More than 9.4 million children vaccinated against typhoid fever in Sindh

Milestones :: Perspectives :: Research

 

Typhoid – Pakistan

More than 9.4 million children vaccinated against typhoid fever in Sindh
4 December 2019 – A historical milestone has been successfully achieved in Pakistan with the vaccination in Sindh Province of more than 9.4 million children aged from 9 months to 15 years against typhoid fever, with a coverage rate of 95%. Pakistan is the first country in the world to introduce the World Health Organization (WHO)-recommended typhoid conjugate vaccine (TCV) into its routine immunization programme. This measure will contribute to the control of the extensively drug-resistant (XDR) typhoid fever outbreak in the province, where more than 11,000 cases have been reported since November 2016.

More than 8,000 skilled vaccinators and health workers, along with 20,000 social mobilisers and more than 2000 supervisors and monitors, including international monitors, participated in the campaign from 18 to 30 November 2019.

The dedication of frontline workers and strong commitment from the Federal and Sindh governments underpinned the success of the campaign and the introduction of TCV into the routine immunization schedule. There was effective coordination between different ministries and departments, in particular with the education department to ensure the vaccination of students at more than 18,000 government and private schools and madrasas. The Pakistan Pediatric Association and universities also played a crucial role in mobilizing the community to vaccinate their children…

More than 140,000 die from measles as cases surge worldwide :: Measles – Global situation :: Measles vaccination drive launched, North Kivu targets 2.2 million children :: The Backward March of Civilization

Milestones :: Perspectives :: Research

 

Measles

More than 140,000 die from measles as cases surge worldwide
Infants and young children most at risk of fatal complications, health agencies warn
5 December 2019
Joint News Release
Worldwide more than 140,000 people died from measles in 2018, according to new estimates from the World Health Organization (WHO) and the United States Centers for Diseases Control and Prevention (CDC). These deaths occurred as measles cases surged globally, amidst devastating outbreaks in all regions.

Most deaths were among children under 5 years of age. Babies and very young children are at greatest risk from measles infections, with potential complications including pneumonia and encephalitis (a swelling of the brain), as well as lifelong disability – permanent brain damage, blindness or hearing loss.

Recently published evidence shows that contracting the measles virus can have further long-term health impacts, with the virus damaging the immune system’s memory for months or even years following infection. This ‘immune amnesia’ leaves survivors vulnerable to other potentially deadly diseases, like influenza or severe diarrhoea, by harming the body’s immune defenses.
“The fact that any child dies from a vaccine-preventable disease like measles is frankly an outrage and a collective failure to protect the world’s most vulnerable children,” said Dr Tedros Adhanom Ghebreysus, Director-General of the World Health Organization. “To save lives, we must ensure everyone can benefit from vaccines – which means investing in immunization and quality health care as a right for all.”

Measles is preventable through vaccination. However, vaccination rates globally have stagnated for almost a decade. WHO and UNICEF estimate that 86% of children globally received the first dose of measles vaccine through their country’s routine vaccination services in 2018, and fewer than 70% received the second recommended dose.
Worldwide, coverage with measles vaccine is not adequate to prevent outbreaks. WHO recommends that 95% vaccination coverage with two doses of measles vaccine is needed in each country and all communities to protect populations from the disease…

[in last week’s edition]
Measles – Global situation
Disease outbreak news = WHO
27 November 2019

 

::::::

Measles vaccination drive launched, North Kivu targets 2.2 million children
Kinshasa, 5 December 2019 – Around 2.2 million children are to be vaccinated against measles in North Kivu, the Democratic Republic of the Congo (DRC), where efforts are underway to curb the world’s second-worst Ebola outbreak amid persistent insecurity.

The DRC is also currently experiencing the world’s largest and most severe measles epidemic, affecting all its 26 provinces. Since the start of 2019, more than 250 000 suspected cases and over 5000 deaths mostly among children under 5 years, have been recorded.

This drive closes the second phase of a preventive vaccination campaign and will be followed by a third and final phase planned in 10 remaining provinces: Bas Uélé, Equateur, Haut Katanga, Haut Lomami, Haut Uélé, Kasai Oriental, Lualaba, Maniema, Mongala and Tshuapa.

This mass follow-up campaign will ultimately reach 18.9 million children across the country by the end of the year, particularly targeting those who may have been missed by routine immunization.

“While the Ebola outbreak in the DRC has won the world’s attention and progress is being made in saving lives, we must not forget the other urgent health needs the country faces,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “This new vaccination campaign aims to protect children in North Kivu, as well as other parts of the country from a disease that is easily preventable with a vaccine.”…

 

::::::

Opinion

 

Wall Street Journal
Review & Outlook
The Backward March of Civilization
A measles outbreak in Samoa kills 60 due to lack of vaccinations.
By The Editorial Board
Dec. 6, 2019
Our age likes to believe in the inevitability of human progress, but for an example of the opposite consider the Pacific island nation of Samoa. A measles outbreak there has already killed more than 60 people, and authorities declared a two-day curfew on Thursday and Friday.

Businesses were obliged to close and vehicles had to stay off the roads from 7 a.m. to 5 p.m. Mike Cherney of The Journal reports that residents were told to fly red banners from their homes if anyone inside needed vaccinations in the country of roughly 200,000 people. Officials were going door-to-door to vaccinate people. Most of the dead were children under 4 years old, and more than 4,300 have been hit with the disease.

The outbreak is especially tragic because measles can be contained with vaccinations. But misinformation from vaccine opponents has spread around the world in recent years, including in supposedly civilized America.

An outbreak hit New York last year among Orthodox Jewish neighborhoods where parents often block vaccinations. New York State banned nonmedical exemptions for school vaccinations as a result. Some 1,200 measles cases have been recorded across the U.S. so far this year, the most since 1992.

Countries like Samoa are more vulnerable because they have less developed health systems and sometimes less efficient governments. Only 31% of Samoans were vaccinated against measles as of 2018.

The outbreak—and death toll—ought to chasten celebrities and others in the U.S. who have spread fears about vaccines, which are remarkably safe and prevent more deaths by far than they cause. It’s also a reminder that the march of civilization isn’t always for the better. Especially in the age of social media and lack of social trust, bad information can drive out good. Avoidable deaths like those in Samoa can be the tragic result.

Infectious disease crisis in the Philippines

Milestones :: Perspectives :: Research

 

Lancet Infectious Diseases
Dec 2019 Volume 19 Number 12 p1265-1380, e404-e451
http://www.thelancet.com/journals/laninf/issue/current
Editorial
Infectious disease crisis in the Philippines
The Lancet Infectious Diseases
The Philippines was among the first countries in the world to introduce the Haemophilus influenzae type b vaccine, and one of the earliest countries in the Western Pacific region to introduce the rotavirus vaccine and the pneumococcal conjugate vaccine. The country achieved the Millennium Development Goal of reducing child mortality by two-thirds in 25 years thanks to Government-declared immunisation months during which millions of children were vaccinated annually. However, vaccine-preventable diseases are again rampant in the Philippines, potentially reversing the positive results of decades of successful immunisation campaigns.

This year the country has reported outbreaks of dengue, diphtheria, measles, and polio. In August, the Department of Health declared a national dengue epidemic. As of Nov 5, 371 717 dengue cases, including 1407 deaths, have been reported in 2019, which is 106% cases more than in 2018. Children aged 5–9 years have been the most affected age group for dengue incidence (23%) and deaths (38%). For diphtheria, the Department of Health has reported 197 cases with 47 deaths through Oct 5, an increase in cases of 47% compared with the same period in 2018. In 2019, health officials have also reported more than 42 200 measles cases up to early October. In addition, measles complications were responsible for 560 deaths. More than eight out of ten people affected by the measles outbreak were children aged 4 years and younger. For polio, four cases caused by infection with vaccine-derived poliovirus have been reported in the country, which had been polio-free for 19 years; these polio cases were due to low population immunity. The Department of Health has now launched campaigns to bolster polio immunisation, planning to inoculate large numbers of children younger than 5 years in several parts of the country.

These outbreaks of vaccine-preventable diseases in the Philippines indicate that vaccination rates are currently insufficient to provide protection. Whereas a reduction in immunisation has been observed in many countries around the world, mistrust in vaccines in the Philippines has been heavily fuelled by the discussion around the use of Dengvaxia, the only dengue vaccine available on the market, and its subsequent ban. Dengue, a viral disease trasmitted by Aedes spp mosquitoes, is endemic in the Philippines. Poverty, geographical remoteness, rapid urbanisation, malnutrition, and poor hygiene and sanitation are all contributing factors in the spread of dengue (and how to address these factors will be a topic in an upcoming Lancet Commission on Aedes-borne viral diseases), and a dengue vaccine is considered an essential tool to control the spread of the disease.

In April, 2016, the Philippines was the first country, alongside Brazil, to introduce a national immunisation campaign for dengue using Dengvaxia. However, as reported in our Editorial in February, 2018, in late 2017, health authorities in the Philippines decided to stop the immunisation campaign after 14 children died out of more than 800 000 inoculated with Dengvaxia in 2016–17. Although no death was directly linked to the vaccine, concerns were further raised by a study funded by Sanofi Pasteur, the producer of the vaccine, that indicated that dengue-seronegative children vaccinated with Dengvaxia had higher chances of subsequent hospitalisation for dengue than seropositive children. This outcome depends on the fact that dengue virus occurs in four serotypes, and immunity against any one serotype does not generate lasting immunity against the other three serotypes. What happens instead is that a new infection with a different serotype might lead to more severe disease manifestations. In individuals not previously exposed to dengue virus, the vaccine simulates a primary infection. On the basis of the new Sanofi data, WHO then recommended the use of Dengvaxia only in children older than 9 years in endemic areas where seropositivity is expected to be high. However, the suspension of Dengvaxia vaccination in the Philippines ultimately resulted in a drop of confidence for parents and caregivers in the safety of immunisation in general.

Although new vaccine candidates are currently under study for dengue, the main issue for the Philippines now is to rebuild the trust of the population in the safety of vaccines for diphtheria, measles, and polio. The current crisis faced by the Philippines should be a warning for other countries where immunisation rates are dropping to invest in public health and information campaigns to promote the use of vaccines. It is unacceptable that a child can die of a disease that is preventable by a readily available vaccine.

World malaria report 2019

Milestones :: Perspectives :: Research

 

Malaria

World malaria report 2019
WHO Report
4 December 2019 :: 232 pages ISBN: 978-92-4-156572-1
PDF: https://apps.who.int/iris/rest/bitstreams/1262394/retrieve
Overview
The World malaria report 2019 provides a comprehensive update on global and regional malaria data and trends. The report tracks investments in malaria programmes and research as well as progress across all intervention areas: prevention, diagnosis, treatment, elimination and surveillance. It also includes dedicated chapters on the consequences of malaria on maternal, infant and child health, the “High Burden to High Impact” approach as well as biological threats to the fight against malaria.
The 2019 report is based on information received from more than 80 countries and areas with ongoing malaria transmission. This information is supplemented by data from national household surveys and databases held by other organizations.

More pregnant women and children protected from malaria, but accelerated efforts and funding needed to reinvigorate global response, WHO report shows
4 December 2019
News release Geneva, Switzerland
The number of pregnant women and children in sub-Saharan Africa sleeping under insecticide-treated bed nets and benefiting from preventive medicine for malaria has increased significantly in recent years, according to the World Health Organization’s World malaria report 2019.

However, accelerated efforts are needed to reduce infections and deaths in the hardest-hit countries, as progress stalls. Last year, malaria afflicted 228 million people and killed an estimated 405 000, mostly in sub-Saharan Africa.

Pregnancy reduces a woman’s immunity to malaria, making her more susceptible to infection and at greater risk of illness, severe anaemia and death. Maternal malaria also interferes with the growth of the fetus, increasing the risk of premature delivery and low birth weight – a leading cause of child mortality.

“Pregnant women and children are the most vulnerable to malaria, and we cannot make progress without focusing on these two groups,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “We’re seeing encouraging signs, but the burden of suffering and death caused by malaria is unacceptable, because it is largely preventable. The lack of improvement in the number of cases and deaths from malaria is deeply troubling.”

In 2018, an estimated 11 million pregnant women were infected with malaria in areas of moderate and high disease transmission in sub-Saharan Africa.  As a result, nearly 900 000 children were born with a low birthweight.

Despite the encouraging signs seen in the use of preventive tools in pregnant women and children, there was no improvement in the global rate of malaria infections in the period 2014 to 2018.

Inadequate funding remains a major barrier to future progress. In 2018, total funding for malaria control and elimination reached an estimated US$ 2.7 billion, falling far short of the US$ 5 billion funding target of the global strategy…

Reform of the International Coordinating Group for Vaccine Provision: a new framework for coordination, accountability and transparency

Milestones :: Perspectives :: Research

 

Governance

Reform of the International Coordinating Group for Vaccine Provision: a new framework for coordination, accountability and transparency
Weekly Epidemiological Record, 6 December 2019, vol. 94, 49 (pp. 581–600)
Introduction
The International Coordinating Group (ICG) for Vaccine Provision is a mechanism for allocation of vaccines from global stockpiles to respond to emergency requests in major infectious disease outbreaks and humanitarian emergencies.1, 2 There are currently 3 functionally separate ICG decision-making groups, for meningitis, yellow fever (YF) and cholera vaccine allocation, which comprise representatives from its 4 founding partners, the International Federation of Red Cross and Red Cres-cent Societies, Médecins Sans Frontières, the United Nations Children’s Fund (UNICEF) and WHO. The ICG’s guiding principles are to ensure equitable and timely access to essential vaccines while maintaining independent decision-making.1 It has evolved in the face of an ever-changing policy environment and new challenges in infectious disease control.
This paper outlines the timeline of the changes to the ICG mechanism to date, which gives the context for a discussion of current reforms, including changes to its governance structure and measures to ensure account-ability to stakeholders. The implications of these changes for future development of the ICG are then discussed…

…Discussion
The new oversight mechanism preserves the ICG’s flexibility and decision-making independence, while facilitating a new level of coordination between the ICG, its partners and wider disease control initiatives, including the newly established “Defeating Meningitis by 2030” strategy.31, 32 The Accountability Framework, in conjunction with the GOC oversight mechanism, has the potential to enhance stakeholder trust, drive improvements in the effectiveness of the ICG process and respond to new challenges.

In addition to market-shaping and coordination among partners, another area for improvement is the timeliness of vaccine delivery to affected countries. The requirement for licensing and customs authorization for vaccine shipments by national authorities remains a major cause of delays in vaccine deployment. While ICG decision-making groups have a strong record of meeting their time performance targets for circulating requests and reaching decisions on approval or rejection,33 vaccines arrived in affected countries within 7 days for only 18% of approved requests during 2016–2018. Inability to achieve this target is considered to be outside the control of ICG decision-making groups,22, 31 as recognized in the Accountability Framework, which defines the areas of responsibility in vaccine delivery for UNICEF SD, manufacturers and national governments.

Following efforts to fast-track vaccine development in the wake of the 2014–2015 Ebola virus epidemic in West Africa and the recent outbreak in DRC,34 several promising vaccine candidates have been identified.35 The first commercially available Ebola virus vaccine has been licensed and prequalified in November 2019.36 Given the probable need for a coordinated mechanism to ensure effective, equitable allocation of limited vaccine in the event of another large-scale outbreak, proposals for establishment of an ICG-like stockpile mechanism for Ebola virus disease are under discussion. The mechanism would have to be adapted to Ebola virus disease response,18, 36 with a holistic approach including potential prophylactic vaccine use alongside emergency response.

The ICG has pursued its mandate for over 20 years, responded in time to crises, controlled outbreaks, ensured equitable access to vaccines and essential medicines and protected millions of lives.31 Between 2006 and 2018, the ICG decision-making groups handled 291 emergency vaccine requests and approved the release of over 125 million doses of stockpiled meningitis, YF and cholera vaccines.13, 22 In 2018 alone, the 3 ICG groups received 25 requests, of which 21 were approved for over 16.5 million vaccine doses. Its role has been extended to cover new infectious diseases with epidemic potential and its mechanism refined as it has adapted to the persistent challenges inherent in managing vaccine stockpiles, their global allocation and the changing needs and demands of a range of partners and stake-holders. The reform of the ICG not only gives new focus to its work and reaffirms its continuing role in the global response to pandemic-prone diseases but also lays the foundation for further expansion and improvements towards achieving its core objectives.

Ensuring access to affordable, timely vaccines in emergencies

Featured Journal Content

 

Bulletin of the World Health Organization
Volume 97, Number 12, December 2019, 789-856
https://www.who.int/bulletin/volumes/97/12/en/
PERSPECTIVES
Ensuring access to affordable, timely vaccines in emergencies
— Kate Elder, Barbara Saitta, Tanja Ducomble, Miriam Alia, Ryan Close, Suzanne Scheele, Elise Erickson, Rosalind Scourse, Patricia Kahn & Greg Elder
http://dx.doi.org/10.2471/BLT.18.228585
Vaccination is an effective intervention to reduce disease, disability, death and health inequities worldwide. Over the last two decades, vaccines have become more accessible in low-income countries; however, significant gaps remain, particularly in humanitarian emergencies, where populations face increased risks of many diseases. In 2013, the World Health Organization (WHO) published Vaccination in acute humanitarian emergencies: a framework for decision-making, to provide guidance on which vaccines to prioritize during emergencies.1 However, substantial obstacles, especially high prices for new vaccines, hinder implementation of this framework and of critical vaccination activities in emergency settings.
In response to these challenges, global health stakeholders held a series of consultations in 2016 and proposed a WHO-based mechanism, the Humanitarian Mechanism, for the rapid procurement of affordable vaccines during emergencies, to be used by nongovernmental organizations (NGOs), civil society organizations, United Nations (UN) agencies and governments.
Here we present the background of the creation of the mechanism from the perspective of Médecins Sans Frontières (MSF), including a description of our past challenges in accessing affordable pneumococcal conjugate vaccine (PCV; Box 1), a critical vaccine during many emergencies. We then describe how the mechanism has so far facilitated access to more affordable PCV and outline steps that could increase its potential for saving lives…
The Humanitarian Mechanism
In May 2017, the Humanitarian Mechanism was jointly launched by WHO, the United Nations Children’s Fund (UNICEF), Save the Children and MSF.8 The mechanism aims to address the high prices of new vaccines and to facilitate rapid access to vaccines for children in emergencies who missed doses or who live in countries where a given vaccine is not yet in the national immunization calendar, but where there is a high risk of exposure. Under the mechanism’s terms of reference, manufacturers commit to supplying a particular vaccine (currently only PCV10 and PCV13) at a set price. UNICEF, through its supply division, and other organizations with their own supply chain capacity, negotiate contracts bilaterally with manufacturers, specifying ordering and delivery terms as well as protocols. When an emergency need for a vaccine is identified, the implementing organization makes a request to WHO, specifying the context, number of doses needed and other relevant details; within two days WHO verifies the emergency context and appropriateness of the request. Upon verification, the order can be placed and the vaccine supplied.8 WHO manages the administrative aspects of the mechanism; once contracts between the implementing organization and manufacturer are in place, the administrative aspects, and the verification process require minimal overhead cost…

Next steps
Building on these initial successes, we see three critical elements of the mechanism, which if fully implemented, could greatly enhance its impact. First, the mechanism needs to be better known among global health actors, including UN agencies and NGOs, who should be encouraged to use it under appropriate circumstances. Second, while the mechanism’s terms of reference includes use by governments responding to emergencies,8 conditions attached to the PCV pledges discussed here (the only pledges to the mechanism so far) exclude governmental use. Manufacturers should allow governments to access the mechanism during emergencies to procure critical vaccines needed to protect their populations. Many middle-income countries already grapple with high vaccine prices for routine immunization programmes and may find the cost of extending vaccination to influxes of displaced people during emergencies prohibitive. While Gavi adopted a fragility, emergencies and refugees policy in June 2017 to allow more flexible use of Gavi-supported vaccine doses in specific contexts, strict criteria exist for how and where this flexibility can be applied, and it can only cover Gavi-eligible countries.12
Finally, the types of vaccines pledged to the mechanism by manufacturers should be expanded: the only commitments to date are for pneumococcal conjugate vaccines. Current and future manufacturers should commit other vaccines with affordability and accessibility challenges to the mechanism, so they can be procured rapidly at the lowest global price

Conclusion
The mechanism is a significant step forward in delivering life-saving vaccines to populations caught in emergencies and conflict. The mechanism’s mandate is strengthened by multiple organizations recognizing the gap between existing technical guidelines and constraints on their implementation, that is, the lack of rapidly available, affordable vaccines. While the mechanism does not address the broader systemic failures of the vaccine market, it was created to specifically address the failure of the global vaccine market to meet relatively small, urgent vaccine procurement needs efficiently and affordably. Further steps are needed for the mechanism to reach its full potential; however, it already provides a critical platform during humanitarian crises for expanding the number of people who can receive life-saving vaccines.

Emergencies

Emergencies

 

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

Ebola Outbreak in DRC 70: 03 December 2019
Situation Update
In the week of 25 November to 1 December 2019, 10 new confirmed EVD cases were reported from two health zones in two affected provinces in the Democratic Republic of the Congo. The confirmed cases in this week came from Mabalako (50%, n=5) and Mandima (50%, n=5) Health Zones.
In the past week, violence, widespread civil unrest, and targeted attacks have severely disrupted the Ebola response and restricted access to affected communities in multiple locations.
On the night of 27 November 2019, an attack on the Ebola response camp in Biakato Mines resulted in the death of three responders and the injury of seven others. Response personnel in Biakato were relocated to Goma, and the majority of response activities in the area have been suspended. On the same night, a separate attack on the Ebola coordination office in Mangina resulted in one death. Most response personnel in Mangina have also been relocated. As of 2 December 2019, North Kivu Province has declared ‘ville morte’ and many response activities have been suspended across the province.
As seen previously during this outbreak, such disruptions limit contact tracing, surveillance, and vaccination efforts, and they may result in increased transmission…

 

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WHO Director-General praises bravery of health workers during visit to eastern Democratic Republic of Congo following fatal attacks on Ebola responders
1 December 2019 News release

 

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Democratic Republic of Congo
As security situation deteriorates, MSF withdraws staff from Biakato
Statement 6 Dec 2019
On 4 December 2019, Medecins Sans Frontières (MSF) took the painful decision to temporarily withdraw our staff from the Biakato region of Ituri province, Democratic Republic of Congo. After months of working extremely closely with the community to address the health needs in the region, MSF is saddened to have made this decision….

 

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Gavi Board approves new Ebola vaccine programme
New Delhi, 5 December 2019 – A global emergency stockpile of Ebola vaccines will be available to countries for outbreak response and prevention following the approval of a new Ebola vaccine programme by the Board of Gavi, the Vaccine Alliance, which met this week in New Delhi, India.

Gavi will open a new funding window, with estimated investment of US$ 178 million between now and 2025 for the new Ebola vaccine programme. Gavi-supported low- and middle-income countries will be able to access the stockpile free of charge and will receive support for the operational costs of vaccination campaigns. Wealthier countries will be able to access vaccines but will be expected to self-finance.

As well as creating the emergency stockpile, Gavi will also support targeted preventative vaccination outside of an outbreak in high-risk populations, such as health workers, in countries at risk. The target populations and scope of countries will be based on future recommendations by the WHO’s Strategic Advisory Group of Experts on Immunisation (SAGE).

“Today, I think about Ebola victim Dr Ameyo Adadevoh, a true vaccine hero who died stopping the Ebola virus from spreading in Nigeria and we should all be excited by the Alliance decision,” said Dr Ngozi Okonjo-Iweala, Chair of the Gavi Board. “This is a historic milestone in humanity’s fight against this horrific disease. Just five years ago we faced an Ebola outbreak in West Africa with no vaccine and no way to treat the disease. Today, thanks to the heroic efforts of countless patients, health workers, scientists, manufacturers, donors, partners as well as the leadership of African countries, we now have one vaccine approved for use and more on their way, as well as rapid diagnostics and several promising treatments. With these tools at our disposal, the battle against Ebola can be won, and I’m proud of the role Gavi has played in this.”
The W
HO’s SAGE Working Group on Ebola Vaccines and Vaccination has provided guidance that the global emergency stockpile should be maintained at 500,000 licensed doses of vaccines. The price of Ebola vaccines funded by Gavi will be defined as part of a tender process managed by UNICEF, as Gavi’s partner and procurement agency.

There are currently eight candidate Zaire Ebolavirus vaccines at different phases of development. This includes Merck’s vaccine currently being used under compassionate use as part of the response to the ongoing DRC outbreak, which has recently received conditional marketing approval from the European Commission and prequalification from the WHO. More than 250,000 people have received it since the outbreak started in August last year. Moreover, close to a thousand people have received a second candidate vaccine manufactured by Johnson & Johnson as part of a study in North Kivu, DRC.

“The Ebola vaccine has shown extraordinary efficacy in tackling the outbreak in the DRC,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. “This achievement demonstrates the Alliance at its best. Now that funding has been approved, we will get to work with manufacturers and our Alliance partners to build the stockpile. It will be critical for Gavi to secure enough funding for the 2021-2025 period to maintain this Ebola vaccine programme in order to protect people, health systems and economies that may be threatened by this devastating disease in the future.”

A coordinating mechanism to decide how and when the vaccine stockpile will be deployed will be established with partner organisations.

 

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POLIO
Public Health Emergency of International Concern (PHEIC)

Polio this week as of 04 December 2019
:: To provide an insight on the status of polio eradication efforts as at September 2019, the WHO Director-General’s report on polio eradication to the upcoming Executive Board (EB) meeting has been published here. Available in six languages, the report summarizes the programmatic, epidemiological and financial challenges to securing a lasting polio-free world.

Summary of new viruses this week (AFP cases and ES positives):
:: Afghanistan — one WPV1 case and one WPV1 positive environmental sample;
:: Pakistan — 25 WPV1 positive environmental samples;
:: Angola — 16 cVDPV2 cases and four cVDPV2 positive environmental samples.

 

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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 7 Dec 2019]

Democratic Republic of the Congo
:: Ebola Outbreak in DRC 70: 03 December 2019

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
Syrian Arab Republic – No new digest announcements identified
Yemen – No new digest announcements identified

 

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WHO Grade 2 Emergencies [to 7 Dec 2019]

Angola
:: WHO supports Angola’s Government efforts to end polio outbreak 02 December 2019

Afghanistan – 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
Myanmar – No new digest announcements identified
Niger – No new digest announcements identified
occupied Palestinian territory – No new digest announcements identified
Sudan – No new digest announcements identified
Ukraine – No new digest announcements identified
Zimbabwe – No new digest announcements identified

 

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WHO Grade 1 Emergencies [to 7 Dec 2019]

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 – No new digest announcements identified
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
:: 06 December 2019 Southern Africa: Humanitarian Key Messages, December 2019

EBOLA OUTBREAK IN THE DRC – No new digest announcements identified

 

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WHO & Regional Offices [to 7 Dec 2019]

WHO & Regional Offices [to 7 Dec 2019]
28 November 2019
News release
4 December 2019
News release
More pregnant women and children protected from malaria, but accelerated efforts and funding needed to reinvigorate global response, WHO report shows

3 December 2019
News release
Pollution Pods at COP25 show climate change and air pollution are two sides of the same coin

3 December 2019
News release
Climate risks to health are growing but prioritized funding lacking to safeguard human health from climate change

1 December 2019
News release
WHO Director-General praises bravery of health workers during visit to eastern Democratic Republic of Congo following fatal attacks on Ebola responders

 

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Weekly Epidemiological Record, 6 December 2019, vol. 94, 49 (pp. 581–600)
:: Progress towards regional measles elimination – worldwide, 2000–2018

 

:: Reform of the International Coordinating Group for Vaccine Provision: a new framework for coordination, accountability and transparency
Introduction
The International Coordinating Group (ICG) for Vaccine Provision is a mechanism for allocation of vaccines from global stockpiles to respond to emergency requests in major infectious disease outbreaks and humanitarian emergencies.1, 2 There are currently 3 functionally sepa-rate ICG decision-making groups, for meningitis, yellow fever (YF) and cholera vaccine allocation, which comprise representatives from its 4 founding partners, the International Federation of Red Cross and Red Cres-cent Societies, Médecins Sans Frontières, the United Nations Children’s Fund (UNICEF) and WHO. The ICG’s guiding principles are to ensure equitable and timely access to essential vaccines while maintaining indepen-dent decision-making.1 It has evolved in the face of an ever-changing policy environment and new challenges in infectious disease control.
This paper outlines the timeline of the changes to the ICG mechanism to date, which gives the context for a discussion of current reforms, including changes to its governance structure and measures to ensure account-ability to stakeholders. The implications of these changes for future development of the ICG are then discussed.

 

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WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: WHO unveils plan to tackle rising HIV drug resistance in Africa 06 December 2019
:: Measles vaccination drive launched, North Kivu targets 2.2 million children 05 December 2019
:: Seventeen African Countries Conducting Exercise to Test Readiness of Public Health E…
04 December 2019

WHO Region of the Americas PAHO
:: Climate risks to health are growing but prioritized funding lacking to safeguard human health from climate change (12/05/2019)

WHO South-East Asia Region SEARO
:: 4 December 2019 News release
Malaria on the decline in WHO South-East Asia Region; efforts must continue as risks persist: WHO

WHO European Region EURO
No new digest content identified.

WHO Eastern Mediterranean Region EMRO
:: More than 9.4 million children vaccinated against typhoid fever in Sindh 4 December 2019
:: WHO supports Sudan to enhance cholera diagnosis at its laboratories 2 December 2019

WHO Western Pacific Region
No new digest content identified.

CDC/ACIP [to 7 Dec 2019]

CDC/ACIP [to 7 Dec 2019]
http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html
Tuesday, December 3, 2019
Transcript of CDC Telebriefing – Vital Signs HIV

Tuesday, December 3, 2019
HIV Testing, Treatment, Prevention Not Reaching Enough Americans

MMWR News Synopsis for Friday, December 6, 2019
Progress Toward Regional Measles Elimination — Worldwide, 2000–2018
Despite global improvements during 2000-2018, including a 66% decrease in reported measles incidence and an estimated 23.2 million lives saved because of measles vaccination, reported measles incidence has increased in five of the six World Health Organization (WHO) regions since 2016, and estimated global measles mortality has increased since 2017. During 2000–2018, increased coverage with measles vaccines, supplemental immunization activities, and other elimination efforts contributed to a 66% decrease in reported measles incidence, a 73% reduction in estimated measles mortality, and a reduction in the number of circulating wild measles genotypes worldwide. Measles vaccination prevented an estimated 23.2 million deaths during this period. Despite this progress, global measles control milestones have not been achieved, reported measles incidence has increased in five of the six World Health Organization regions since 2016, and estimated global measles deaths have increased since 2017. Large measles outbreaks in countries with weak immunization systems accounted for most reported measles cases. Outbreaks should serve as opportunities to investigate underlying causes for under-vaccination and to design and implement specific routine immunization strengthening activities to prevent future outbreaks.

Progress Toward Measles Elimination — China, January 2013–June 2019
China made considerable progress towards measles elimination during January 2013-June 2019. Measles cases, incidence, and outbreaks were all at historic low levels in 2017 and 2018, and they have continued to decrease through June 2019. China’s measles incidence per million population decreased from 20.4 in 2013 to 2.8 in 2018. Measles cases, incidence, and outbreaks were all at historic low levels in 2017 and 2018. Reported measles-related deaths decreased from 32 in 2015 to one in 2018, and to zero through June, 2019. Measles elimination in China can be achieved through strengthening the immunization program’s existing strategies: Ensuring sufficient vaccine supply, continuing to improve laboratory-supported surveillance and outbreak investigation and response, strengthening school entry vaccination checks, and vaccinating students without documentation of two doses of measles-rubella vaccine.