Twenty‐two years’ experience registering trials in a low‐middle income country: The Peruvian Clinical Trial Registry

Journal of Evidence-Based Medicine
Volume 12, Issue 3 Pages: 185-231 August 2019
https://onlinelibrary.wiley.com/toc/17565391/current

 

ARTICLES
Twenty‐two years’ experience registering trials in a low‐middle income country: The Peruvian Clinical Trial Registry
The registration of clinical trials in Peru has improved quantitatively and qualitatively since it started, but its quantitative grow stopped in 2008. Since then, the number of registries has declined steadily. There is an influence of pharmaceutical companies in clinical trial registration.
Christoper A. Alarcon‐Ruiz, Joel Sack Roque‐Roque, Paula Heredia, Angie Roxana Gómez‐Briceno, Antonio M. Quispe
Pages: 187-193
First Published: 18 June 2019

What Is the Value of Different Zika Vaccination Strategies to Prevent and Mitigate Zika Outbreaks?

Journal of Infectious Diseases
Volume 220, Issue 6, 15 September 2019
https://academic.oup.com/jid/issue/220/6

 

VIRUSES
Editor’s Choice
What Is the Value of Different Zika Vaccination Strategies to Prevent and Mitigate Zika Outbreaks?
Sarah M Bartsch, Lindsey Asti, Sarah N Cox, David P Durham, Samuel Randall
The Journal of Infectious Diseases, Volume 220, Issue 6, 15 September 2019, Pages 920–931, https://doi.org/10.1093/infdis/jiy688
We simulated various vaccination strategies to mitigate Zika outbreaks in Honduras, Brazil, and Puerto Rico. While vaccinating everyone naturally averted the most cases, specifically targeting women of childbearing age or young adults was the most cost-effective and even provided cost savings.

Infant Pneumococcal Carriage During Influenza, RSV, and hMPV Respiratory Illness Within a Maternal Influenza Immunization Trial

Journal of Infectious Diseases
Volume 220, Issue 6, 15 September 2019
https://academic.oup.com/jid/issue/220/6

 

Infant Pneumococcal Carriage During Influenza, RSV, and hMPV Respiratory Illness Within a Maternal Influenza Immunization Trial
Alastair F Murray, Janet A Englund, Jane Kuypers, James M Tielsch, Joanne Katz
The Journal of Infectious Diseases, Volume 220, Issue 6, 15 September 2019, Pages 956–960, https://doi.org/10.1093/infdis/jiz212
Among influenza-positive infants, those born to mothers given influenza vaccine had lower pneumococcal carriage rates. Maternal influenza immunization may impact infant pneumococcal acquisition during influenza infection. Pneumococcal carriage did not impact lower respiratory disease rates in RSV, hMPV, or influenza.

Revisiting the Correlate of Reduced HIV Infection Risk in the Rv144 Vaccine Trial

Journal of Virology
September 2019; Volume 93,Issue 17
http://jvi.asm.org/content/current

 

Commentary
Revisiting the Correlate of Reduced HIV Infection Risk in the Rv144 Vaccine Trial
The RV144 vaccine trial is the only clinical study to have shown a modest but statistically significant decrease in HIV infection risk. RV144 and the subsequent studies identifying the level of V1V2-specific antibodies as a correlate of reduced infection risk are still controversial despite many papers supporting and expanding the initial study.

Population-level impact and herd effects following the introduction of human papillomavirus vaccination programmes: updated systematic review and meta-analysis

The Lancet
Aug 24, 2019 Volume 394Number 10199p611-708, e20-e27
https://www.thelancet.com/journals/lancet/issue/current

 

Articles
Population-level impact and herd effects following the introduction of human papillomavirus vaccination programmes: updated systematic review and meta-analysis
Mélanie Drolet, Élodie Bénard, Norma Pérez, Marc Brisson on behalf of the HPV Vaccination Impact Study Group
More than 10 years have elapsed since human papillomavirus (HPV) vaccination was implemented. We did a systematic review and meta-analysis of the population-level impact of vaccinating girls and women against human papillomavirus on HPV infections, anogenital wart diagnoses, and cervical intraepithelial neoplasia grade 2+ (CIN2+) to summarise the most recent evidence about the effectiveness of HPV vaccines in real-world settings and to quantify the impact of multiple age-cohort vaccination.

Opportunities, resources, and techniques for implementing genomics in clinical care

The Lancet
Aug 24, 2019 Volume 394Number 10199p611-708, e20-e27
https://www.thelancet.com/journals/lancet/issue/current

 

Series
Genomic Medicine
Opportunities, resources, and techniques for implementing genomics in clinical care
Teri A Manolio, Robb Rowley, Marc S Williams, Dan Roden, Geoffrey S Ginsburg, Carol Bult, Rex L Chisholm, Patricia A Deverka, Howard L McLeod, George A Mensah, Mary V Relling, Laura Lyman Rodriguez, Cecelia Tamburro, Eric D Green

Data without borders

Lancet Digital Health
Aug 2019 Volume 1Number 4e148-e192
https://www.thelancet.com/journals/landig/issue/current

 

Editorial
Data without borders
The Lancet Digital Health
[Excerpt]
…Many barriers to cross-sector data sharing have been identified by policy makers and others, including privacy concerns, restrictions on the export of patient data, and lack of access to advanced technology in limited-resource settings. Despite the challenges, there is growing evidence that cross-sector data sharing, if done carefully and transparently, will lead to improved health outcomes for populations. As such, although this could be a daunting task for governments, data sharing across sectors should be made a priority. Genuine, long-lasting government support is necessary, both in terms of political and financial commitment, if quick progress towards bridging population health and clinical medicine for better health care is to be achieved. A first step would be open communication between governments, academics, and private industries to develop unified platforms for sharing and analysis of diverse data.

Key concepts for making informed choices

Nature
Volume 572 Issue 7770, 22 August 2019
http://www.nature.com/nature/current_issue.html

 

Comment | 12 August 2019
Key concepts for making informed choices
Teach people to think critically about claims and comparisons using these concepts, urge Andrew D. Oxman and an alliance of 24 researchers — they will make better decisions.
Jeffrey K. Aronson, Eric Barends[…] & Luke Vale
Volume 572 Issue 7768, 8 August 2019

Seeking precision in public health

Nature Medicine
Volume 25 Issue 8, August 2019
https://www.nature.com/nm/volumes/25/issues/8

 

Editorial | 06 August 2019
Seeking precision in public health
‘Precision’ in a health context is usually thought to apply to the individual and seems conceptually at odds with efforts in public health directed toward improving population-level health metrics. But are these two aims truly irreconcilable?

Accounting for Capacity Constraints in Economic Evaluations of Precision Medicine: A Systematic Review

PharmacoEconomics
Volume 37, Issue 8, August 2019
https://link.springer.com/journal/40273/37/8

 

Systematic Review
Accounting for Capacity Constraints in Economic Evaluations of Precision Medicine: A Systematic Review
Precision (stratified or personalised) medicine is underpinned by the premise that it is feasible to identify known heterogeneity using a specific test or algorithm in patient populations and to use this information to guide patient care to improve health and well-being. This study aimed to understand if, and how, previous economic evaluations of precision medicine had taken account of the impact of capacity constraints.
Stuart J. Wright, William G. Newman, Katherine Payne

Vaccination coverage in the context of the emerging Yellow Fever threat in French Guiana

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 24 Aug 2019)

 

Research Article
Vaccination coverage in the context of the emerging Yellow Fever threat in French Guiana
Claude Flamand, Sarah Bailly, Camille Fritzell, Sandrine Fernandes Pellerin, Alhassane Toure, Naïssa Chateau, Mona Saout, Sébastien Linares, Fabien Dubois, Laurent Filleul, Mirdad Kazanji
| published 19 Aug 2019 PLOS Neglected Tropical Diseases
https://doi.org/10.1371/journal.pntd.0007661

Effects of maternal influenza vaccination on adverse birth outcomes: A systematic review and Bayesian meta-analysis

PLoS One
http://www.plosone.org/
[Accessed 24 Aug 2019]

 

Research Article
Effects of maternal influenza vaccination on adverse birth outcomes: A systematic review and Bayesian meta-analysis
Sohyun Jeong, Eun Jin Jang, Junwoo Jo, Sunmee Jang
Research Article | published 14 Aug 2019 PLOS ONE
https://doi.org/10.1371/journal.pone.0220910

Cost-effectiveness analysis of universal varicella vaccination in Turkey using a dynamic transmission model

PLoS One
http://www.plosone.org/
[Accessed 24 Aug 2019]

 

Research Article
Cost-effectiveness analysis of universal varicella vaccination in Turkey using a dynamic transmission model
Lara J. Wolfson, Vincent J. Daniels, Matthew Pillsbury, Zafer Kurugöl, Cuneyt Yardimci, Jeffrey Kyle, Ener Cagri Dinleyici
Research Article | published 13 Aug 2019 PLOS ONE
https://doi.org/10.1371/journal.pone.0220921

Pneumococcal vaccination rates in immunocompromised patients—A cohort study based on claims data from more than 200,000 patients in Germany

PLoS One
http://www.plosone.org/
[Accessed 24 Aug 2019]

 

Research Article
Pneumococcal vaccination rates in immunocompromised patients—A cohort study based on claims data from more than 200,000 patients in Germany
Niklas Schmedt, Julia Schiffner-Rohe, Ralf Sprenger, Jochen Walker, Christof von Eiff, Dennis Häckl
Research Article | published 08 Aug 2019 PLOS ONE
https://doi.org/10.1371/journal.pone.0220848

BCG vaccination and tuberculosis prevention: A forty years cohort study, Monastir, Tunisia

PLoS One
http://www.plosone.org/
[Accessed 24 Aug 2019]

 

Research Article
BCG vaccination and tuberculosis prevention: A forty years cohort study, Monastir, Tunisia
Cyrine Bennasrallah, Meriem Kacem, Wafa Dhouib, Imen Zemni, Manel Ben Fredj, Hela Abroug, Amira Djobbi, Assia Green, Samia Grira Said, Issam Maalel, Sarra Stambouli, Wafa Zhir, Hichem Bel Haj Youssef, Asma Sriha Belguith
Research Article | published 05 Aug 2019 PLOS ONE
https://doi.org/10.1371/journal.pone.0219991

In the eye of the storm: Infectious disease challenges for border countries receiving Venezuelan migrants

Travel Medicine and Infectious Diseases
Volume 30 Pages 1-148 (July–August 2019)
https://www.sciencedirect.com/journal/travel-medicine-and-infectious-disease/vol/30/suppl/C

 

Editorial No access
In the eye of the storm: Infectious disease challenges for border countries receiving Venezuelan migrants
Alfonso J. Rodríguez-Morales, José Antonio Suárez, Alejandro Risquez, Sergio Cimerman, … Alberto Paniz-Mondolfi
Pages 4-6

A Systematic Review of therapeutic agents for the treatment of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

Travel Medicine and Infectious Diseases
Volume 30 Pages 1-148 (July–August 2019)
https://www.sciencedirect.com/journal/travel-medicine-and-infectious-disease/vol/30/suppl/C

 

Research article Abstract only
A Systematic Review of therapeutic agents for the treatment of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV)
Hisham Momattin, Anfal Y. Al-Ali, Jaffar A. Al-Tawfiq
Pages 9-18

Yellow fever (YF) vaccination does not increase dengue severity: A retrospective study based on 11,448 dengue notifications in a YF and dengue endemic region

Travel Medicine and Infectious Diseases
Volume 30 Pages 1-148 (July–August 2019)
https://www.sciencedirect.com/journal/travel-medicine-and-infectious-disease/vol/30/suppl/C

 

Research article Abstract only
Yellow fever (YF) vaccination does not increase dengue severity: A retrospective study based on 11,448 dengue notifications in a YF and dengue endemic region
Marina Jolli Luppe, Alice Tobal Verro, Alana S. Barbosa, Maurício L. Nogueira, … Natal S. da Silva
Pages 25-31

Pre-vaccination screening strategies for the use of the CYD-TDV dengue vaccine: A meeting report

Vaccine
Volume 37, Issue 36 Pages 5137-5504 (23 August 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/36

 

Conference report
Pre-vaccination screening strategies for the use of the CYD-TDV dengue vaccine: A meeting report
A. Wilder-Smith, P. G. Smith, R. Luo, C. Kelly-Cirino, D. Curry, H. Larson, A. Durbine, M. Chu, P. Tharmaphornpilasg, L.C. Ng, A. M. C. Sartorii, E. J. A. Lunai, D. J. Gubler, G. Espanal, I.K. Yoon, S. Flasche
Abstract
The first licensed dengue vaccine, CYD-TDV (Dengvaxia) is efficacious in seropositive individuals, but increases the risk for severe dengue in seronegative persons about two years after administration of the first dose. For countries considering the introduction of Dengvaxia, WHO recommends a pre-vaccination screening strategy whereby only persons with evidence of a past dengue infection would be vaccinated. Policy-makers need to consider the risk-benefit of vaccination strategies based on such screening tests, the optimal age to introduce the vaccine, communication and implementation strategies. To address these questions, the Global Dengue and Aedes-transmitted diseases Consortium (GDAC) organized a 3-day workshop in January 2019 with country representatives from Asia and Latin America.
The meeting discussions highlighted many challenges in introducing Dengvaxia, in terms of screening test characteristics, costs of such tests combined with a 3-dose schedule, logistics, achieving high coverage rates, vaccine confidence and communication; more challenges than for any other vaccine introduction programme. A screening test would require a high specificity to minimize individual risk, and at the same time high sensitivity to maximize individual and population benefit. The underlying seroprevalence dependent positive predictive value is the best indicator for an acceptable safety profile of a pre-vaccination screening strategy. The working groups discussed many possible implementation strategies. Addressing the bottlenecks in school-based vaccine introduction for Dengvaxia will also benefit other vaccines such as HPV and booster doses for tetanus and pertussis. Levels of public trust are highly variable and context specific, and understanding of population perceptions and concerns is essential to tailor interventions, monitor and mitigate risks.

Evaluation of the impact of 13-valent pneumococcal conjugate vaccine immunization in children by surveillance of culture-confirmed pneumococcal disease: A prospective clinical microbiological study

Vaccine
Volume 37, Issue 36 Pages 5137-5504 (23 August 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/36

 

Research article Abstract only
Evaluation of the impact of 13-valent pneumococcal conjugate vaccine immunization in children by surveillance of culture-confirmed pneumococcal disease: A prospective clinical microbiological study
Chih-Ho Chen, Lin-Hui Su, Hsin-Chieh Li, Mei-Hua Hsu, … Cheng-Hsun Chiu
Pages 5147-5152

Optimising informed consent in school-based adolescent vaccination programmes in England: A multiple methods analysis

Vaccine
Volume 37, Issue 36 Pages 5137-5504 (23 August 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/36

 

Research article Open access
Optimising informed consent in school-based adolescent vaccination programmes in England: A multiple methods analysis
Tracey Chantler, Louise Letley, Pauline Paterson, Joanne Yarwood, … Sandra Mounier-Jack
Pages 5218-5224

Impact of vaccination delay on deaths averted by pneumococcal conjugate vaccine: Modeled effects in 8 country scenarios

Vaccine
Volume 37, Issue 36 Pages 5137-5504 (23 August 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/36

Research article Open access
Impact of vaccination delay on deaths averted by pneumococcal conjugate vaccine: Modeled effects in 8 country scenarios
Emily D. Carter, Yvonne Tam, Neff Walker
Pages 5242-5249

A path model of psychosocial constructs predicting future Zika vaccine uptake intent

Vaccine
Volume 37, Issue 36 Pages 5137-5504 (23 August 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/36

 

Research article Abstract only
A path model of psychosocial constructs predicting future Zika vaccine uptake intent
Jeanine P.D. Guidry, Kellie E. Carlyle, Paul B. Perrin, Jessica G. LaRose, … Marcus Messner
Pages 5233-5241

 

Long-term immunogenicity of measles, mumps and rubella-containing vaccines in healthy young children: A 10-year follow-up

Vaccine
Volume 37, Issue 36 Pages 5137-5504 (23 August 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/36

 

Research article Open access
Long-term immunogenicity of measles, mumps and rubella-containing vaccines in healthy young children: A 10-year follow-up
Stephane Carryn, Muriel Feyssaguet, Michael Povey, Emmanuel Di Paolo
Pages 5323-5331

Procurement of Category 2 Vaccines in China

Vaccines — Open Access Journal
http://www.mdpi.com/journal/vaccines
(Accessed 24 Aug 2019)

 

Open Access Article
Procurement of Category 2 Vaccines in China
by Jian-Lin Zhuang, Abram L. Wagner, Megan Laffoon, Yi-Han Lu and Qing-Wu Jiang
Vaccines 2019, 7(3), 97; https://doi.org/10.3390/vaccines7030097 (registering DOI) – 23 August 2019
Abstract
Internationally, vaccine pricing is relatively opaque, although many low- or lower-middle-income countries belong to international consortiums that jointly procure vaccines. China procures vaccines domestically, and vaccines that require payment from the public (“category 2 vaccines”), have undergone several regulatory changes over the past 15 years. This study aims to describe the vaccine procurement method changes in China since 2005 and to analyze how the procurement method impacted vaccine price. This review of vaccine procurement reforms found that a shift to provincial-level Group Purchasing Organizations after 2016 was accompanied by an increase in most prices. There was more variability in vaccine prices across provinces for vaccines with only one supplier, and these vaccines have a higher price than what is found in United Nations Children’s Fund (UNICEF)-supported countries. China’s current procurement system for non-mandatory vaccines leaves these vaccines costing several-fold more than in other countries, and in particular those supported by Gavi, the Vaccine Alliance. Exploring a variety of methods to reduce vaccine purchase prices will not only directly benefit the general population, but also the government, as they aim to implement more programs to benefit public health in a cost-effective manner.

Moving from Empirical to Rational Vaccine Design in the ‘Omics’ Era

Vaccines — Open Access Journal
http://www.mdpi.com/journal/vaccines
(Accessed 24 Aug 2019)

 

Open Access Review
Moving from Empirical to Rational Vaccine Design in the ‘Omics’ Era
by Mansi Sharma, Florian Krammer, Adolfo García-Sastre and Shashank Tripathi
Vaccines 2019, 7(3), 89; https://doi.org/10.3390/vaccines7030089 – 14 August 2019
Abstract
An ideal vaccine provides long lasting protection against a pathogen by eliciting a well-rounded immune response which engages both innate and adaptive immunity. However, we have a limited understanding of how components of innate immunity, antibody and cell-mediated adaptive immunity interact and function together at a systems level. With advances in high-throughput ‘Omics’ methodologies it has become possible to capture global changes in the host, at a cellular and molecular level, that are induced by vaccination and infection. Analysis of these datasets has shown the promise of discovering mechanisms behind vaccine mediated protection, immunological memory, adverse effects as well as development of more efficient antigens and adjuvants. In this review, we will discuss how systems vaccinology takes advantage of new technology platforms and big data analysis, to enable the rational development of better vaccines.

An Ethical Analysis of Coverage With Evidence Development

Value in Health
August 2019 Volume 22, Issue 8, p845-974
https://www.valueinhealthjournal.com/issue/S1098-3015(19)X0008-X

 

HEALTH POLICY ANALYSIS
An Ethical Analysis of Coverage With Evidence Development
Drew Carter, Tracy Merlin, David Hunter
p878–883
Published online: May 16, 2019
Abstract
Sometimes a government or other payer is called on to fund a new health technology even when the evidence leaves a lot of uncertainty. One option is for the payer to provisionally fund the technology and reduce uncertainty by developing evidence. This is called coverage with evidence development (CED). Only-in-research CED, when the payer funds the technology only for patients who participate in the evidence development, raises the sharpest ethical questions. Is the patient coerced or induced into participating? If so, under what circumstances, if any, is this ethically justified? Building on work by Miller and Pearson, we argue that patients have a right to funding for a technology only when the payer can be confident that the technology provides reasonable value for money. Technologies are candidates for CED precisely because serious questions remain about value for money, and therefore patients have no right to technologies under a CED arrangement. This is why CED induces rather than coerces. The separate question of whether the inducement is ethically justified remains. We argue that CED does pose risks to patients, and the worse these risks are, the harder it is to justify the inducement. Finally, we propose conditions under which the inducement could be ethically justified and means of avoiding inducement altogether. We draw on the Australian context, and so our conclusions apply most directly to comparable contexts, where the payer is a government that provides universal coverage with a regard for cost-effectiveness that is prominent and fairly clearly defined.

A Scoping Review of Investment Cases for Vaccines and Immunization Programs

Value in Health
August 2019 Volume 22, Issue 8, p845-974
https://www.valueinhealthjournal.com/issue/S1098-3015(19)X0008-X

 

SYSTEMATIC LITERATURE REVIEW
A Scoping Review of Investment Cases for Vaccines and Immunization Programs
So Yoon Sim, Mark Jit, Dagna Constenla, David H. Peters, Raymond C.W. Hutubessy
p942–952
Published online: June 10, 2019
Abstract
Background
Many investment cases have recently been published intending to show the value of new health investments, but without consistent methodological approaches.
Objectives
To conduct a scoping review of existing investment cases (using vaccines and immunization programs as an example), identify common characteristics that define these investment cases, and examine their role within the broader context of the vaccine development and introduction.
Methods
A systematic search was conducted from January 1980 to November 2017 to identify investment cases in the area of vaccines and immunization programs from gray literature and electronic bibliographic databases. Investment case outcomes, objectives, key variables, target audiences, and funding sources were extracted and analyzed according to their reporting frequency.
Results
We found 24 investment cases, and most of them aim to provide information for decisions (12 cases) or advocate for a specific agenda (9 cases). Outcomes presented fell into 4 broad categories—burden of disease, cost of investment, impact of investment, and other considerations for implementation. Number of deaths averted (70%), incremental cost-effectiveness ratios (67%), and reduction in health and socioeconomic inequalities (54%) were the most frequently reported outcome measures for impact of investment. Health system capacity (79%) and vaccine financing landscape (75%) were the most common considerations for implementation. A sizable proportion (41.4%) of investment cases did not reveal their funding sources.
Conclusions
This review describes information that is critical to decision making about resource mobilization and allocation concerning vaccines. Global efforts to harmonize investment cases more broadly will increase transparency and comparability.

Measles Elimination: Identifying Susceptible Sub-Populations to Tailor Immunization Strategies

Viruses
Volume 11, Issue 8 (August 2019)
https://www.mdpi.com/1999-4915/11/8

 

Open Access Communication
Measles Elimination: Identifying Susceptible Sub-Populations to Tailor Immunization Strategies
by Peter Kreidl, David Ammerer, Reinhard Würzner, Anita Luckner Hornischer, Dorothee von Laer and Wegene Borena
Viruses 2019, 11(8), 765; https://doi.org/10.3390/v11080765
Received: 31 July 2019 / Revised: 14 August 2019 / Accepted: 16 August 2019 / Published: 20 August 2019
Abstract
Measles elimination has been identified as a public health priority in Europe for a long time but has not yet been achieved. The World Health Organization (WHO) recommends identification of susceptible sub-populations to target supplementary immunization activities. We used three different sources of information: retrospective samples investigated for measles IgG between 1997 and 2016, vaccine coverage data from the existing electronic registry for birth cohorts 2015 to 1999, and surveillance data from 2009 until 20 July 2019. We calculated susceptibility by birth cohort using seroprevalence data, adjusting vaccine coverage data with reported effectiveness (93% for the first and 97% for the second dose, respectively), and compared it with measles incidence data, aggregated by birth cohorts and districts. Susceptibility levels for persons 10–41 years (birth cohorts 2007–1976) were 10.4% and thus far above the recommended values of WHO (5%). Older birth cohorts were sufficiently protected. Districts with the highest susceptibility estimates corresponded with districts with the highest incidence rates. Birth cohorts with susceptibility levels > 10% showed a 4.7 increased relative risk of having had more than one measles case. We conclude that retrospective serosurveys are a cheap and useful approach in identifying susceptible sub-populations, especially for older birth cohorts whose coverage data remain scarce.

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

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

Occupational Medicine
Published: 17 August 2019
Influenza and vaccination: beliefs and practices of local authority staff
D Mc Conalogue, N Verle, H Ellis, S Scott –
Abstract
Background
Influenza causes large outbreaks every year. Professionals outside healthcare, including social care staff and non-care giving roles, have a key role in protecting their clients and sustaining operational productivity through influenza vaccination. There has been little research on non-healthcare staff working with vulnerable people and those working in non-caregiving settings regarding influenza and influenza vaccination.
Aims
To understand the practices, experiences, perceptions and motivations of local authority staff regarding influenza and influenza vaccination.
Methods
Semi-structured focus groups were carried out with local authority staff in Gloucestershire. Transcripts were thematically analysed.
Results
Participants tended to perceive influenza as a serious illness, where a person had a specific risk factor or during pandemics. They did not feel vulnerable unless they had previous experience of infection or had an underlying health condition. Motivation to vaccinate was based on previous experience of influenza, where they had a close family member at risk or when working directly with vulnerable clients. Beliefs about negative side effects of the vaccine were the strongest reason for vaccine refusal. Ease of access to vaccination through on-site clinics is key to uptake. Management are perceived as key motivators or blockers to vaccine uptake.
Conclusions
Workers outside healthcare settings do not feel vulnerable to influenza and have low motivation to vaccinate, unless they have previous experience of infection or an underlying health condition. Vaccination programmes must proactively address workers’ beliefs and motivations to ensure their participation in flu vaccination programmes.

 

Omega
Available online 9 August 2019
Review
Vaccine distribution chains in low-and middle-income countries: A literature review
K De Boeck, C Decouttere, N Vandaele – Omega, 2019
Highlights
:: We present an overview of the main characteristics and challenges inherent to vaccine distribution chains in low- and middle-income countries.
:: An in-depth classification of the relevant OR/OM papers is provided.
:: A variety of problems reported in practice receives little attention or even remains unexplored in the current OR/OM literature.
:: A number of uncertainties and characteristics is not yet considered by the OR/OM community.
Abstract
Access to immunization varies greatly across the world. In order to increase vaccine coverage, the required vaccines need to be able to reach the targeted population. However, in low- and middle-income countries, this often turns out to be a challenging task. This article provides a literature review on vaccine distribution chains in low- and middle-income countries and consists of two main parts. The first part elaborates on the characteristics and challenges inherent to such distribution chains. In order to obtain a complete overview, both quantitative and qualitative papers are included. In the second part, relevant operations research and operations management literature is structured according to seven classification criteria: decision level, methodology, part of the vaccine distribution chain modelled, uncertainties and characteristics covered, performance measures, real-life applicability, and countries and vaccines covered. Throughout these classifications, a comparison is made between the issues reported in practice and those investigated in the operations research and operations management literature. Based on this analysis, we identify trends and conclude that several gaps exist, providing a promising avenue for future research.

 

Paripex – Indian Journal Of Research
Vol 8, No 2 (2019)
FACTORS INFLUENCING PARENTAL WILLINGNESS FOR THEIR BABY’S PARTICIPATION IN VACCINE CLINICAL TRIALS
N Hanumante, D Desale, MRB Deshmukh
Abstract
The study was planned to determine factors influencing parental decisions to permit their baby, to participate or not, in randomized vaccine clinical trials with the aim of improving recruitment in vaccine clinical trials.
This was prospective cross sectional non interventional study. Study population consisted of parents (n=125) of babies aged 6-8 weeks, A questionnaire was used which covered the basic demographic information and reasons for parents’ willingness for their baby to participate or not into clinical trials.
The demographic characteristics of participating babies which were in favour of clinical trial participation were i.e. female child & successive birth order.  Establishing trust with parents, counselling both parents, explaining study in detail as regards to risk/benefits, valuing their time, emerge to be the key factors for increasing participation of babies in vaccine clinical trial.

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 24 Aug 2019
[No new, unique, relevant content]

 

BBC
http://www.bbc.co.uk/
Accessed 24 Aug 2019
[No new, unique, relevant content]

 

The Economist
http://www.economist.com/
Accessed 24 Aug 2019
[No new, unique, relevant content]

 

Financial Times
http://www.ft.com/home/uk
Accessed 24 Aug 2019
Disease prevention
Nigeria to be last African nation declared polio-free
August 21, 2019

 

Forbes
http://www.forbes.com/
Accessed 24 Aug 2019
Aug 22, 2019
No Flu Vaccines For Detained Migrant Families? Why This Is Wrong
Assuming that flu viruses did not come up with this policy, here are the problems.
By Bruce Y. Lee Contributor

Aug 21, 2019
Missouri County Imposes Mandatory Hepatitis A Vaccines For Food Service Workers

Aug 19, 2019
New Survey Shows Many People Think Their Doctors Should Refuse To See Unvaccinated Children

 

Foreign Affairs
http://www.foreignaffairs.com/
Accessed 24 Aug 2019
[No new, unique, relevant content]

Foreign Policy
http://foreignpolicy.com/
Accessed 24 Aug 2019
[No new, unique, relevant content]

 

The Guardian
http://www.guardiannews.com/
Accessed 24 Aug 2019
WHO
Malaria will not be eradicated in near future’, warns WHO
Three-year review says new vaccines for eradicating disease are only 40% effective.

 

New Yorker
http://www.newyorker.com/
Accessed 24 Aug 2019
[No new, unique, relevant content]

 

New York Times
http://www.nytimes.com/
Accessed 24 Aug 2019
Opinion
Who Cares What Celebrities Think About Vaccines?
Very rarely do the misguided beliefs of famous people deserve headlines.
By Carolyn Kylstra
By The Associated Press, Aug. 23

Opinion
Ebola Could Be Eradicated — But Only if the World Works Together
New treatments for Ebola and drug-resistant tuberculosis offer hope, but they won’t be successful on their own.
By The Editorial Board
[See Perspectives above for full text]

 

Washington Post
http://www.washingtonpost.com/
Accessed 24 Aug 2019
Urgency for vaccine grows as virus ravages China’s pigs
Sam Mcneil and Candice Choi | AP · Foreign · Aug 21, 2019

Congo to use second vaccine to fight Ebola
Associated Press · Foreign · Aug 19, 2019

Think Tanks et al

Think Tanks et al

Brookings
http://www.brookings.edu/
Accessed 24 Aug 2019
Africa in focus
Health in Africa: 5 priorities for the G-7 Biarritz Summit
Yvonne Mburu
Monday, August 19, 2019

 

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

 

CSIS
https://www.csis.org/
Accessed 24 Aug 2019
Podcast Episode
The New Landscape for Gavi 5.0
August 20, 2019 | By Nellie Bristol, Katherine Bliss

 

Council on Foreign Relations
http://www.cfr.org/
Accessed 24 Aug 2019
August 20, 2019
Democratic Republic of Congo
Disinformation and Disease: Social Media and the Ebola Epidemic in the Democratic Republic of the Congo
Blog Post by David P. Fidler

 

Kaiser Family Foundation
https://www.kff.org/search/?post_type=press-release
Accessed 24 Aug 2019
[No new relevant content]

Vaccines and Global Health: The Week in Review :: 03 Aug 2019

.– Request anEmail 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_3 Aug 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

Publication of Vaccines and Global Health: The Week in Review will resume in full with the edition of 24 August 2019, following annual leave by the editor/publisher.

Dengue Vaccine :: Philippines weighs re-use of controversial dengue vaccine

Milestones :: Perspectives :: Research

 

Dengue Vaccine

Philippines weighs re-use of controversial dengue vaccine
August 2, 2019
MANILA (Reuters) – The Philippines is considering re-introducing a dengue vaccine whose use it halted because of links to the deaths of several children, as authorities battle to contain a dengue outbreak that has killed more than 450 people this year.

Concerns over dengue immunization for nearly 734,000 children aged nine or older sparked two congressional inquiries, a criminal investigation and a sharp fall in the number of parents seeking routine vaccinations for their children.

If the government decided to revive the use of Dengvaxia, developed by French drugmaker Sanofi, it would be administered with “utmost caution”, presidential spokesman Salvador Panelo said.

“If Dengvaxia is proven effective to those who already had dengue in the past, then its application to these individuals will surely cause the decline of the overall number of cases,” he told reporters.

The Philippines stopped using Dengvaxia in late 2017 and ordered Sanofi to stop selling, distributing and marketing it after Sanofi warned the vaccine could worsen the disease in some cases.

In March, the Department of Justice said it had found probable cause to indict Sanofi officials, and former and current Philippine health officials, over 10 deaths it said were linked to the use of Dengvaxia, which Sanofi has repeatedly said is safe and effective.

Panelo said the government would follow a protocol set by the World Health Organization for all individuals to be screened before receiving the vaccine, to determine if they have ever been exposed to the infection.

Any decision to start administering the vaccine again would not affect cases against individuals involved in the controversy, he added.

This year, the Philippines has reported more than 100,000 cases of dengue, a mosquito-borne tropical disease that kills about 20,000 people annually and infects hundreds of millions…

International Coalition of Medicines Regulatory Authorities (ICMRA) Antimicrobial Resistance Press Release (July 2019)

Milestones :: Perspectives :: Research

International Coalition of Medicines Regulatory Authorities (ICMRA)
Antimicrobial Resistance Press Release (July 2019)
31 July 2019
… ICMRA4 recognizes that AMR is a complex, multi-faceted problem, and is calling for a coordinated, One Health5 response across all sectors, including public health, animal health, and the environment. Its member medicines regulators from around the globe have united with the WHO to strongly encourage policy makers, industry, academia, healthcare professionals, non-governmental organizations, media organizations, and the public to come
together to:

:: continue advances in antimicrobial surveillance, infection prevention and control, and stewardship;
:: prioritize the development of innovative new medicines and other therapeutic products that will help combat AMR, including diagnostics and alternatives to antimicrobials;
:: ensure equitable access to antimicrobials across the globe; and
:: minimize the release of substances with antimicrobial properties into the environment.

There are unique challenges facing the development, commercialization and viability of products that tackle AMR, and there is a need for modern regulatory systems that can adapt to these needs. Medicines regulators therefore commit to work together to streamline regulatory requirements, without compromising the quality, efficacy and safety review of these products. We also commit to develop processes that facilitate the review of emerging
technologies, such as phage therapy6 and point-of-care diagnostics. We invite research and development stakeholders to seek advice at any time from medicines regulators for help navigating regulatory systems and to identify emerging challenges specific to the issue of AMR.

While global medicines regulators are fully prepared to continue to take action to address this public health threat, they are encouraging other partners to do their part to address this One Health issue:

:: ICMRA calls on leaders of industry to increase their collective investment in research and development. There is a dire need for new antimicrobials that will work when all other options fail, for alternatives to antimicrobials so that their use can be minimized, and for diagnostic products that facilitate prudent and appropriate use. Infection prevention and control is the foundation of modern healthcare and innovation to combat AMR must coincide with advancements in other areas to ensure a stable global health system.

:: ICMRA calls on all health care practitioners, in both human and animal health, to prioritize the appropriate use of antimicrobials and incorporate responsible antimicrobial prescribing principles into clinical practice. The WHO has developed the AWaRe tool to help guide decision-making on which antibiotic to use when7.

:: ICMRA calls on global health leaders to come together with industry to determine the most effective way to address the economic issues surrounding new product development to incentivize innovation and implement required changes.

:: ICMRA also calls for continued research in all aspects of AMR, including continual monitoring of the effectiveness of existing antimicrobial agents and conducting active surveillance of emerging antimicrobial resistance.

:: ICMRA calls on media organizations around the globe to keep AMR at the forefront of the news cycle and to help increase public awareness of this issue. AMR is one of the largest global threats to public health and the public needs to be aware of what is at stake and what individuals can do to combat this health threat.

We all have a role to play in combatting AMR. A coordinated effort from all partners is essential to ensuring our success in addressing this threat to our health, economies and security. Lives around the world depend on it.

Emergencies

Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 31 July 2019
:: July 2019 Polio News is available online for all the latest news, polio in numbers and the funding updates.

Summary of new viruses this week:
:: Afghanistan — one wild poliovirus type 1 (WPV1) case;
:: Pakistan— two WPV1-positive cases and eight WPV1-positive environmental samples;
:: Nigeria —one circulating vaccine-derived poliovirus type 2 (cVDPV2) case and one cVDPV2-positive environmental sample;
:: Democratic Republic of the Congo (DRC) — one cVDPV2 sample isolated from a contact case and one cVDPV2 community isolate;
:: Central African Republic — one cVDPV2-positive environmental sample and 13 cVDPV2 samples isolated from community;
:: Myanmar — one cVDPV type 1 case and five cVDPV1 samples isolated from a contact case.

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

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

Inter-Agency Statement on Ebola outbreak in the Democratic Republic of the Congo, one year on
Joint statement from WHO Director-General Dr Tedros Adhanom Ghebreyesus, UN Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator Mark Lowcock, UNICEF Executive Director Henrietta Fore, and World Food Programme Executive Director David Beasley
NEW YORK/GENEVA/KINSHASA/DAKAR/ROME, 31 July 2019 – “Tomorrow, 1 August, marks one year since the Government of the Democratic Republic of the Congo (DRC) declared an outbreak of the Ebola virus disease in North Kivu province of the DRC. Two weeks ago, it was declared a public health emergency of international concern.

“Just yesterday, a new case of the disease was confirmed in Goma, with the patient later dying – the second case to be confirmed this month in the city of around 1 million people. This latest case in such a dense population center underscores the very real risk of further disease transmission, perhaps beyond the country’s borders, and the very urgent need for a strengthened global response and increased donor investment.

“In the last year, there have been more than 2,600 confirmed cases, including more than 1,800 deaths in parts of Ituri and North Kivu provinces. Almost one in three ‘cases’ is a child. Every single ‘case’ is someone who has gone through an unimaginable ordeal. More than 770 have survived.

“The disease is relentless and devastating.

“Ebola passes from mother to child, husband to wife, patient to caregiver, from the dead body of a victim to the mourning relative. The disease turns the most mundane aspects of everyday life upside down — hurting local businesses, preventing children from going to school and hampering vital and routine health services. It is primarily a health crisis, but one that also critically impacts how people care for their family, view their neighbours and interact with their community.

“The challenges to stopping further transmission are indeed considerable. But none are insurmountable. And none can be an excuse for not getting the job done. The United Nations and partners are continuing to ramp up the response in support of the Government and to further bolster joint action. The UN is working to ensure an enabling environment for the public health response that its health agency supports, including appropriate security, logistics, political and community engagement, and action to address the concerns of affected communities. We commend the recent Government decision to take measures to ensure its efforts are further joined up.

“We also salute the heroic efforts of the mostly Congolese healthcare workers on the front line, the people of affected communities and partners. Despite their ceaseless work, the disease continues to spread. This outbreak is occurring in an active conflict zone which makes an effective response far more complicated because of insecurity, including armed attacks on health workers and facilities, and population displacement. In some of the affected areas, violence is preventing us from reaching communities and working with them to stop further transmission.

“We call on all parties to the violence to ensure that responders can do their work safely and that those seeking care can access it without fear of attacks.

“We are proud of the work that we and our partners have done so far, collaborating with communities in support of the Government-led response to protect those at risk and care for those affected:
:: Over 170,000 people vaccinated;
:: 1,300 people treated with investigational therapies across 14 treatment and transit centres;
:: 77 million screenings of national and international travelers;
:: 20,000 contacts visited daily to ensure they do not also become sick;
:: 3,000 samples tested in 8 laboratories every week;
:: More than 10,000 handwashing sites installed in critical locations;
:: More than 2,000 community engagement workers operating in affected – areas listening to concerns, gaining trust, and mobilizing local action;
:: Over 440,000 patients and contacts provided with food assistance, crucial to limiting movement among people who could spread the disease; and
:: Daily meals provided to 25,000 schoolchildren in Ebola-affected areas to help build trust within communities.

“Now we must build on those achievements, but to do so we urgently need far more support from the international community. The Government needs more support than ever before. The public health response to an Ebola outbreak requires an exceptional level of investment; 100 per cent of cases must be treated and 100 per cent of contacts must be traced and managed. We need air transport to get responders and critical equipment to some of the most remote areas and warehousing to safely store precious health supplies including vaccines. We will continue to accelerate our response, and we ask partners old and new to do the same.

“At this critical juncture, we reaffirm our collective commitment to the people of the DRC; we mourn for those we have lost; and we call for solidarity to end this outbreak.”

::::::

Rwanda’s border with DRC remains open
Kigali, August 1 2019 — The Ministry of Health confirms that Rwanda’s border with the Democratic Republic of Congo is open, following traffic slow-down this morning as measures were put in place to reinforce screening procedures and public safety at entry points.
To date, Rwanda remains Ebola free. The Ministry has advised against unnecessary travels to Goma-Eastern Congo, following increasing number of cases confirmed in DRC, and requested that individuals who have recently travelled to an Ebola affected area to report to the nearest screening station and to report any suspected Ebola cases via the Ministry of health toll-free lines 114, police number 112 or to community health workers or the nearest health centre…

::::::

Geneva Palais briefing note on the impact of the Ebola outbreak on children in the Democratic Republic of the Congo
Press release
This is a summary of remarks by Jerome Pfaffman, UNICEF Senior Health Specialist – to whom quoted text may be attributed – at today’s press briefing at the Palais des Nations in Geneva
30/07/2019
…This Ebola response is far more complex because it is in an active conflict zone. People living in North Kivu and Ituri are facing a public health emergency and a humanitarian crisis at the same time.
Both provinces, for example, are also facing a major measles outbreak. In Ituri, about half of the health facilities have been damaged or destroyed during fighting over the past two years. There is mass displacement. We have just completed a first vaccination campaign in the provincial capital, Bunia, where we vaccinated more than 40,000 children against measles. But we need to vaccinate far more children, against the full array of diseases, in order to protect them from all the public health risks they are exposed to.
This is why the new strategic response plan includes both an intensification of the public health response, and a whole program to address acute humanitarian and social needs.
UNICEF will need to triple its budget to respond to this complex crisis. This includes about 70 million dollars for epidemic control activities, 30 million to build community capacities in at-risk areas, and another 70 million to deliver essential services.
Colleagues and communities are fighting the outbreak tirelessly but we desperately need the international community to back us up…

::::::

Press release
UNICEF ramps up Ebola prevention efforts as South Sudan assessed as ‘high-risk’ country
UN children’s agency reaches 3 million with Ebola prevention messages
29/07/2019
…UNICEF South Sudan is focusing on and engaging populations that are most at risk in the states bordering DRC and Uganda. The UN children’s agency and its partners have trained 450 front-line mobilizers who are knocking on doors, organizing community meetings and engaging religious and local leaders to disseminate life-saving messages.
“Our teams and partners on the ground working in the communities confirm that an increasing number of people are now aware of Ebola, and the protection measures they can take to avoid infection,” said Ayoya, “The early detection and containment of the three Ebola cases in Uganda in June came as a result of increased public awareness and shows the true value of the prevention work and of working with communities. As long as Ebola remains on our doorstep, we cannot rest and must continue our efforts.”…

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

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 3 Aug 2019]

Democratic Republic of the Congo
[See DRC Ebola+ above for detail]

Cyclone Idai – No new digest announcements identified
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

::::::

WHO Grade 2 Emergencies [to 3 Aug 2019]

Libya
:: Libya: Five medical staff dead in latest attack on health facilities in Tripoli
Tripoli, 28 July 2019 – The World Health Organization strongly condemns yesterday’s attack on Az Zawiyah Field Hospital in the south of Tripoli. Five health workers were killed and eight were injured in the attack. The hospital was damaged and forced to suspend its services.

MERS-CoV
:: MERS-CoV global summary and assessment of risk – August 2018
pdf, 570kb

Myanmar
:: Bi‐weekly Situation Report 15 – 1 August 2019

Afghanistan – 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
Malawi floods – No new digest announcements identified
Measles in Europe – No new digest announcements identified
Niger – No new digest announcements identified
occupied Palestinian territory – No new digest announcements identified
Sao Tome and Principe Necrotizing Cellulitis (2017)
Sudan – No new digest announcements identified
Ukraine – No new digest announcements identified
Zimbabwe – No new digest announcements identified

::::::

WHO Grade 1 Emergencies [to 3 Aug 2019]

Angola – No new digest announcements identified
Chad – No new digest announcements identified
Djibouti – No new digest announcements identified
Indonesia – Sulawesi earthquake 2018 – No new digest announcements identified
Kenya – No new digest announcements identified
Mali – No new digest announcements identified
Namibia – viral hepatitis – No new digest announcements identified
Tanzania – No new digest announcements identified

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

UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises. 
Syrian Arab Republic – No new digest announcements identified
Yemen – No new digest announcements identified

::::::

UN OCHA – Corporate Emergencies
When the USG/ERC declares a Corporate Emergency Response, all OCHA offices, branches and sections provide their full support to response activities both at HQ and in the field.
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

 

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

WHO & Regional Offices [to 3 Aug 2019]

WHO & Regional Offices [to 3 Aug 2019]
31 July 2019
At 1-year mark, we mourn the lives lost, and call for solidarity
Joint statement by heads of agencies on the Ebola outbreak in the Democratic Republic of the Congo
Statement New York, Geneva, Kinshasa, Rome
[See Ebola above for detail]

 

::::::

Weekly Epidemiological Record, 26 July 2019, vol. 94, 30/31 (pp. 329–344)
:: Progress towards poliomyelitis eradication in Nigeria, January 2018 – May 2019
:: Performance of acute flaccid paralysis (AFP) surveillance and incidence of poliomyelitis, 2019

 

::::::

WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: Rwanda’s border with DRC remains open 02 August 2019
:: World Hepatitis Day:  Nigerians implored to be screened and vaccinated   01 August 2019
:: WHO marks one year since the beginning of the Ebola outbreak in the Democratic Republic of the Congo  31 July 2019
:: Ethiopia joins global efforts to end cholera by 2030 29 July 2019
:: EBOLA, Cascade training in IPC, Case Management, Hand Hygiene, Chlorine Preparation and Mental Health conducted in Rwanda 29 July 2019
:: WHO and the Africa Centres for Disease Control and Prevention call on countries in the region to work together on the Ebola response 29 July 2019

WHO Region of the Americas PAHO
:: Improving health service monitoring of high-risk populations seeks to prevent new HIV infections (08/01/2019)
:: Maternity Protection Laws must be implemented throughout the Americas to protect breastfeeding mothers in the workplace (08/01/2019)

WHO South-East Asia Region SEARO
:: Bangladesh, Bhutan, Nepal and Thailand achieve Hepatitis B control: WHO
SEAR/PR/1714 New Delhi, July 26, 2019: Bangladesh, Bhutan, Nepal and Thailand have become the first countries in WHO South-East Asia Region to achieve Hepatitis B control, with prevalence of the deadly disease dropping to less than one per cent among five-year-old children, the World Health Organization announced today.

WHO European Region EURO
:: Nationwide campaign aims to educate women in Ukraine on the harm of alcohol consumption during pregnancy 02-08-2019

WHO Eastern Mediterranean Region EMRO
:: WHO Regional Director’s statement on Pakistan
Cairo, Egypt, 1 August 2019 — I have just returned from my third, and most fruitful and memorable visit to Pakistan as WHO Regional Director for the Eastern Mediterranean. The 4 days I spent in the country this week were truly effective and productive. I had the chance to visit different areas in the country, including Larkana, where the current HIV…

WHO Western Pacific Region
No new digest content identified.