Nature
Volume 571 Issue 7766, 25 July 2019
http://www.nature.com/nature/current_issue.html
Comment | 22 July 2019
Mandate vaccination with care
Governments that are considering compulsory immunizations must avoid stoking anti-vaccine sentiment, argue Saad B. Omer, Cornelia Betsch and Julie Leask.
Saad B. Omer, Cornelia Betsch & Julie Leask
New England Journal of Medicine
July 25, 2019 Vol. 381 No. 4
http://www.nejm.org/toc/nejm/medical-journal
Clinical Practice
Measles
Peter M. Strebel, M.B., Ch.B., M.P.H., and Walter A. Orenstein, M.D.
This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors’ clinical recommendations.
New England Journal of Medicine
July 25, 2019 Vol. 381 No. 4
http://www.nejm.org/toc/nejm/medical-journal
Special Report
The Ongoing Ebola Epidemic in the Democratic Republic of Congo, 2018–2019
Oly Ilunga Kalenga, M.D., Ph.D., Matshidiso Moeti, M.D., Annie Sparrow, M.B., B.S., M.D., M.P.H., Vinh-Kim Nguyen, M.D., Ph.D., Daniel Lucey, M.D., M.P.H., and Tedros A. Ghebreyesus, Ph.D.
Abstract
The international response to the evolving Ebola epidemic in eastern Democratic Republic of Congo (DRC) has had interim successes while facing ongoing difficulties. The outbreak has occurred in an area of intractable conflict among multiple armed groups at a time of contentious national elections. Despite porous international borders and considerable population movement, however, transmission has been confined to North Kivu and Ituri provinces. Factors potentially contributing to this containment include conduct of about 55 million screenings, surveillance of contacts (12,591 under surveillance currently), testing of 280 samples per day, provision of safe and dignified burials for most deaths, vaccination of high-risk people (112,485 vaccinated as of May 7, 2019), and medical treatment including four investigational therapies. Major challenges remain. Since late February 2019, a sharp rise in cases and increased transmission have been observed. These coincide with organized attacks by armed groups targeting response teams, deteriorating security, and the population’s increasing distrust of the response effort. The risk of local and regional spread remains high given the high proportion of deaths occurring outside treatment facilities, relatively low proportions of new patients who were known contacts, ongoing nosocomial transmission, and persistent delays in detection and reporting. Stopping this epidemic will require the alignment of the principal political and armed groups in eastern DRC in support of the response.
PLoS One
http://www.plosone.org/
[Accessed 27 Jul 2019]
Research Article
Low immunization coverage in Wonago district, southern Ethiopia: A community-based cross-sectional study
Samrawit Hailu, Ayalew Astatkie, Kjell Arne Johansson, Bernt Lindtjørn
| published 24 Jul 2019 PLOS ONE
https://doi.org/10.1371/journal.pone.0220144
Public Health Ethics
Volume 12, Issue 2, July 2019
http://phe.oxfordjournals.org/content/current
Original Articles
Government Policy Experiments and Informed Consent
Douglas MacKay, Averi Chakrabarti
Public Health Ethics, Volume 12, Issue 2, July 2019, Pages 188–201, https://doi.org/10.1093/phe/phy015
Abstract
Governments are increasingly making use of field experiments to evaluate policy interventions in the spheres of education, public health and welfare. However, the research ethics literature is largely focused on the clinical context, leaving investigators, institutional review boards and government agencies with few resources to draw on to address the ethical questions they face regarding such experiments. In this article, we aim to help address this problem, investigating the conditions under which informed consent is required for ethical policy research conducted or authorized by government. We argue that investigators need not secure participants’ informed consent when conducting government policy experiments if: (i) the government institution conducting or authorizing the experiment possesses a right to rule over the spheres of policy targeted by the research; and (ii) data collection does not involve the violation of participants’ autonomy rights.
Science Translational Medicine
24 July 2019 Vol 11, Issue 502
https://stm.sciencemag.org/
Review
The 1918 influenza pandemic: 100 years of questions answered and unanswered
By Jeffery K. Taubenberger, John C. Kash, David M. Morens
Science Translational Medicine24 Jul 2019 Restricted Access
This Review summarizes key findings about the “Spanish” influenza pandemic and addresses implications for current pandemic response and control, including vaccination optimization.
Vaccine
Volume 37, Issue 33, Pages 4659-4766 (2 August 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/33
Rabies Vaccines and Therapeutics
Edited by A.R. Fooks, Ab Osterhaus
Research article Open access
The path towards effective antivirals against rabies
Dirk Jochmans, Johan Neyts
Pages 4660-4662
From Google Scholar & other sources: Selected Journal Articles, Newsletters, Dissertations, Theses, Commentary
No new digest content identified.
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 27 Jul 2019
[No new, unique, relevant content]
BBC
http://www.bbc.co.uk/
Accessed 27 Jul 2019
[No new, unique, relevant content]
The Economist
http://www.economist.com/
Accessed 27 Jul 2019
[No new, unique, relevant content]
Financial Times
http://www.ft.com/home/uk
Accessed 27 Jul 2019
Accessed 27 Jul 2019
[No new, unique, relevant content]
Forbes
http://www.forbes.com/
Accessed 27 Jul 2019
Early Results On Alzheimer’s Vaccine Trial In People With Down Syndrome Promising, Researchers Say
“This is the first vaccine targeting Abeta that has been tested in the Down syndrome population,” said Prof. Andrea Pfeifer, CEO of AC Immune, adding that she believes studying the Down syndrome population is critical for developing successful treatments for everyone with Alzheimer’s.
By Robin Seaton Jefferson Contributor
Jul 22, 2019
Vaccine Proponents Receive Death Threats. Again.
Vaccine controversy remains a hotbed of debate and strong opinions. Advocates publicly voicing support of widespread vaccination continue to be recipients of not only criticism, but also of death threats.
By Nina Shapiro Contributor
Foreign Affairs
http://www.foreignaffairs.com/
Accessed 27 Jul 2019
[No new, unique, relevant content]
Foreign Policy
http://foreignpolicy.com/
Accessed 27 Jul 2019
[No new, unique, relevant content]
The Guardian
http://www.guardiannews.com/
Accessed 27 Jul 2019
Vaccines and immunisation
Anti-extremism software to be used to tackle vaccine disinformation
Redirection tool that confronts anti-vax theories under development by UK’s Moonshot
Ben Quinn
Sun 21 Jul 2019 17.55 BST Last modified on Mon 22 Jul 2019 11.00 BST
New Yorker
http://www.newyorker.com/
Accessed 27 Jul 2019
[No new, unique, relevant content]
New York Times
http://www.nytimes.com/
Accessed 27 Jul 2019
Health
Congo Draws Up a New Battle Plan Against Ebola Amid Power Struggle
Following the resignation of the country’s health minister, the president will take over the response and deploy a new vaccine.
By Donald G. McNeil Jr. and Denise Grady Jul 26
Asia Pacific
Deployment of Second Ebola Vaccine Would Not Be Quick Fix, Experts Warn
The resignation of Congo’s health minister in the midst of the country’s worst Ebola outbreak could clear the way for a second experimental vaccine to be deployed. But the new shot would likely take months to win the trust of frightened locals and show results, health officials say.
By Reuters July 25
Africa
Ebola Vaccine Hampered by Deep Distrust in Eastern Congo
Until his last breath, Salomon Nduhi Kambale insisted he had been poisoned by someone and that was the reason he was vomiting blood. The 30-year-old man wouldn’t give community health teams his phone number, and when they found it, he hung up on them.
By The Associated Press July 24
Africa
Congo’s Health Minister Resigns Over Ebola Approach
Dr. Oly Ilunga, who had overseen the nearly year-old response to the Ebola crisis, resigned after the government reassigned that responsibility.
By Reuters July 22
Washington Post
http://www.washingtonpost.com/
Accessed 27 Jul 2019
Jul 21, 2019
Nurses are teaching doctors how to treat anti-vaccine fears and myths
Lena H. Sun ·
Think Tanks et al
Brookings
http://www.brookings.edu/
Accessed 27 Jul 2019
TechTank
4 steps to stop the spread of disinformation online
Lisa Kaplan
Tuesday, July 23, 2019
Center for Global Development
http://www.cgdev.org/page/press-center
[No new relevant content]
CSIS
https://www.csis.org/
Accessed 27 Jul 2019
[No new relevant content]
Council on Foreign Relations
http://www.cfr.org/
Accessed 27 Jul 2019
July 25, 2019
Global Governance
Apathy Continues to Plague Global Health
In a world awash in troubles, nothing less than catastrophe will spur policymakers to forceful action on global health. Unfortunately, concerted action could come too late to prevent local crises fro…
Kaiser Family Foundation
https://www.kff.org/search/?post_type=press-release
Accessed 27 Jul 2019
[No new relevant content]
.– 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_20 Jul 2019
– blog edition: comprised of the approx. 35+ entries posted below.
– Twitter: Readers can also follow developments on twitter: @vaxethicspolicy.
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.
David R. Curry, MS
Executive Director
Center for Vaccine Ethics and Policy
Milestones :: Perspectives :: Research
20 million children missed out on lifesaving measles, diphtheria and tetanus vaccines in 2018
New estimates find dangerous stagnation of global vaccination rates, due to conflict, inequality and complacency
NEW YORK/GENEVA, 15 July 2019 – 20 million children worldwide – more than 1 in 10 – missed out on lifesaving vaccines such as measles, diphtheria and tetanus in 2018, according to new data from WHO and UNICEF.
Globally, since 2010, vaccination coverage with three doses of diphtheria, tetanus and pertussis (DTP3) and one dose of the measles vaccine has stalled at around 86 per cent. While high, this is not sufficient. 95 per cent coverage is needed – globally, across countries, and communities – to protect against outbreaks of vaccine-preventable diseases.
“Vaccines are one of our most important tools for preventing outbreaks and keeping the world safe,” said Director-General of the World Health Organization Dr Tedros Adhanom Ghebreyesus. “While most children today are being vaccinated, far too many are left behind. Unacceptably, it’s often those who are most at risk– the poorest, the most marginalized, those touched by conflict or forced from their homes – who are persistently missed,” he said.
Most unvaccinated children live in the poorest countries and are disproportionately in fragile or conflict-affected states. Almost half are in just 16 countries – Afghanistan, the Central African Republic, Chad, Democratic Republic of the Congo (DRC), Ethiopia, Haiti, Iraq, Mali, Niger, Nigeria, Pakistan, Somalia, South Sudan, Sudan, Syria and Yemen.
If these children do get sick, they are at risk of the severest health consequences, and least likely to access lifesaving treatment and care.
Measles outbreaks reveal entrenched gaps in coverage, often over many years.
Stark disparities in vaccine access persist across and within countries of all income levels. This has resulted in devastating measles outbreaks in many parts of the world – including countries that have high overall vaccination rates.
In 2018, almost 350,000 measles cases were reported globally, more than doubling from 2017.
“Measles is a real-time indicator of where we have more work to do to fight preventable diseases,” said UNICEF Executive Director Henrietta Fore. “Because measles is so contagious, an outbreak points to communities that are missing out on vaccines due to access, costs or, in some places, complacency. We have to exhaust every effort to immunize every child,” she added.
Ukraine leads a varied list of countries with the highest reported incidence rate of measles in 2018. While the country has now managed to vaccinate over 90 per cent of its infants, coverage had been low for several years, leaving a large number of older children and adults at risk.
Several other countries with high incidence and high coverage have significant groups of people who have missed the measles vaccine in the past. This shows how low coverage over time or discrete communities of unvaccinated people can spark deadly outbreaks.
Human papillomavirus (HPV) vaccine coverage data available for the first time
For the first time, there is also data on the coverage of human papillomavirus (HPV) vaccine, which protects girls against cervical cancer later in life. As of 2018, 90 countries – home to 1 in 3 girls worldwide – had introduced the HPV vaccine into their national programmes. Just 13 of these are lower-income countries. This leaves those most at risk of the devastating impacts of cervical cancer still least likely to have access to the vaccine.
Together with partners like Gavi, the Vaccine Alliance, WHO and UNICEF are supporting countries to strengthen their immunization systems and outbreak response, including by vaccinating all children with routine immunization, conducting emergency campaigns, and training and equipping health workers as an essential part of quality primary healthcare.
###
About the data
Since 2000, WHO and UNICEF jointly produce national immunization coverage estimates for Member States on an annual basis. In addition to producing the immunization coverage estimates for 2018, the WHO and UNICEF estimation process revises the entire historical series of immunization data with the latest available information. The 2018 revision covers 39 years of coverage estimates, from 1980 to 2018. DTP3 coverage is used as an indicator to assess the proportion of children vaccinated and is calculated for children under one year of age. The estimated number of vaccinated children are calculated using population data provided by the 2019 World Population Prospects (WPP) from the UN.
Milestones :: Perspectives :: Research
Mass campaign to vaccinate over 3 million children against polio kicks off in Venezuela
14/07/2019
CARACAS / PANAMA CITY, 14 July, 2019 – A mass polio vaccination campaign for more than 3.1 million children under the age of five in Venezuela started today, led by the Ministry of Health, with support from UNICEF and the Pan American Health Organization (PAHO).
“It is essential that every child in Venezuela is immunized against polio, because there is no cure for this devastating disease,” said UNICEF Venezuela Interim Representative Hervé de Lys. “The vaccination campaign starting today will be instrumental in keeping Venezuela polio-free tomorrow.”
More than 7,000 immunization points will be set up across the country to vaccinate all children under five years. In advance of the campaign, UNICEF procured and delivered more than 3.8 million doses of oral polio vaccine (OPV) and 124,479 doses of inactivated polio vaccine (IPV). The children’s agency also helped to produce radio and TV spots to disseminate lifesaving messages on immunization.
“Protecting children against this preventable disease is a moral imperative,” said María Cristina Perceval, UNICEF Regional Director for Latin America and the Caribbean. “The wellbeing of Venezuela’s children is above politics. UNICEF calls on all sides, parents, caregivers, and teachers to ensure all children get vaccinated.”
In 1994, the Americas was certificated as a region with no acute flaccid paralysis cases caused by polio, but the wild poliovirus remains a potential threat if vaccination is neglected or discontinued.
In addition to the polio vaccines procured for the campaign, UNICEF has provided almost 6.7 million doses of diphtheria vaccine, and 176,000 doses of the measles, mumps and rubella (MMR) vaccine, in collaboration with partners across Venezuela so far in 2019.
According to UN estimates, about 3.2 million children need assistance inside the country. UNICEF requires US$32 million to provide children with access to health and immunization, water, education, nutrition and protection services. So far, just US$17.8 million has been received. Funding needs are likely to increase significantly in the coming weeks and months as UNICEF continues to scale up its response to the humanitarian needs in collaboration with Government and civil society partners.
Milestones :: Perspectives :: Research
Mass campaign to vaccinate over 3 million children against polio kicks off in Venezuela
14/07/2019
CARACAS / PANAMA CITY, 14 July, 2019 – A mass polio vaccination campaign for more than 3.1 million children under the age of five in Venezuela started today, led by the Ministry of Health, with support from UNICEF and the Pan American Health Organization (PAHO).
“It is essential that every child in Venezuela is immunized against polio, because there is no cure for this devastating disease,” said UNICEF Venezuela Interim Representative Hervé de Lys. “The vaccination campaign starting today will be instrumental in keeping Venezuela polio-free tomorrow.”
More than 7,000 immunization points will be set up across the country to vaccinate all children under five years. In advance of the campaign, UNICEF procured and delivered more than 3.8 million doses of oral polio vaccine (OPV) and 124,479 doses of inactivated polio vaccine (IPV). The children’s agency also helped to produce radio and TV spots to disseminate lifesaving messages on immunization.
“Protecting children against this preventable disease is a moral imperative,” said María Cristina Perceval, UNICEF Regional Director for Latin America and the Caribbean. “The wellbeing of Venezuela’s children is above politics. UNICEF calls on all sides, parents, caregivers, and teachers to ensure all children get vaccinated.”
In 1994, the Americas was certificated as a region with no acute flaccid paralysis cases caused by polio, but the wild poliovirus remains a potential threat if vaccination is neglected or discontinued.
In addition to the polio vaccines procured for the campaign, UNICEF has provided almost 6.7 million doses of diphtheria vaccine, and 176,000 doses of the measles, mumps and rubella (MMR) vaccine, in collaboration with partners across Venezuela so far in 2019.
According to UN estimates, about 3.2 million children need assistance inside the country. UNICEF requires US$32 million to provide children with access to health and immunization, water, education, nutrition and protection services. So far, just US$17.8 million has been received. Funding needs are likely to increase significantly in the coming weeks and months as UNICEF continues to scale up its response to the humanitarian needs in collaboration with Government and civil society partners.
DRC – Ebola/Cholera/Polio/Measles
Editor’s Note:
The complex challenges faced in DRC across a range of health and security fronts continue. We include extensive coverage of the decision to declare the Ebola outbreak as a PHEIC below.
Summary of new polio viruses this week:
:: Democratic Republic of Congo (DRC)
Five cases of circulating vaccine-derived poliovirus type 2 (cVDPV2) have been reported this week in the Democratic Republic of the Congo (DR Congo): three from Malemba-Nkulu district, Haut Lomami province; one each from Tshumbe and Wembo-Nyama districts, Sankuru province. The onset of paralysis was on 10 February, 30 May, 26 May, 23 May, 3 June 2019 respectively. There are 11 reported cases of cVDPV2 in 2019. The total number of cVDPV2 cases reported in 2018 is 20. DRC is currently affected by seven separate cVDPV2 outbreaks; one each originated in Haut Katanga, Mongala, Sankuru and two in Haut Lomami and Kasai provinces.
::::::
Ebola outbreak in the Democratic Republic of the Congo declared a Public Health Emergency of International Concern
17 July 2019 News release Geneva
WHO Director-General Dr. Tedros Adhanom Ghebreyesus today declared the Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) a Public Health Emergency of International Concern (PHEIC).
“It is time for the world to take notice and redouble our efforts. We need to work together in solidarity with the DRC to end this outbreak and build a better health system,” said Dr. Tedros. “Extraordinary work has been done for almost a year under the most difficult circumstances. We all owe it to these responders — coming from not just WHO but also government, partners and communities — to shoulder more of the burden.”…
“It is important that the world follows these recommendations. It is also crucial that states do not use the PHEIC as an excuse to impose trade or travel restrictions, which would have a negative impact on the response and on the lives and livelihoods of people in the region,” said Professor Robert Steffen, chair of the Emergency Committee…
“This is about mothers, fathers and children – too often entire families are stricken. At the heart of this are communities and individual tragedies,” said Dr. Tedros. “The PHEIC should not be used to stigmatize or penalize the very people who are most in need of our help.”
Statement on the meeting of the International Health Regulations (2005) Emergency Committee for Ebola virus disease in the Democratic Republic of the Congo on 17 July 2019
[Excerpts]
The meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) regarding Ebola virus disease in the Democratic Republic of the Congo (DRC) took place on Wednesday, 17 July 2019, from 12:00 to 16:30 Geneva time (CEST).
Proceedings of the meeting
…The current situation in the Democratic Republic of the Congo was reviewed. There are increased numbers of cases in Butembo and Mabalako; the epicentre has moved from Mabalako to Beni; and there is one imported case in Goma. Factors affecting the outbreak include population movement in highly densely populated areas; weak infection and prevention control practices in many health facilities; complex political environment; continued reluctance in the community; and the ongoing unstable security situation, which led to the recent murders of two community health workers. More than 70 entry points are being monitored and 75 million screenings have been conducted, with 22 cases detected in this manner. Beni is the main hotspot; cases in other areas are decreasing. There are 2512 confirmed or probable cases, including 136 health workers affected, with 40 deaths among them.
Beni remains the epicentre of the outbreak, with 46% of the cases over the last 3 weeks. Mangina has 18% of the cases, and one new case in Goma came from Beni, with diagnosis confirmed within one hour of the patient’s arrival at a health facility. The patient, who was not known to be a contact, traveled to Goma with several other people in a bus. When the vehicle broke down, he went to a health facility via motorbike. He was transferred to an Ebola Treatment Centre, but later died. Response to the case in Goma took place within 72 hours. Contact tracing was performed, with 75 contacts vaccinated, as well as co-travellers, and family members are being monitored. Surveillance is being reinforced and readiness strengthened. 15,000 people cross the border from Goma to Rwanda every day, as Goma is an important centre of economic activities with Rwanda. Closing this border would strongly affect the population of Goma and have adverse implications for the response. There is a continuing need for increased awareness among the population on the outbreak situation and stronger engagement on health-seeking behaviours.
The UN Ebola Emergency Response Coordinator gave an update on the situation and efforts to maintain an enabling environment to support outbreak response. He emphasized the need for community engagement and access in all areas, increased multisectoral collaboration, and more financial and human resources. Insecurity is the greatest concern, especially after two community health workers were killed last week. Efforts to increase security are underway. There is a need to focus both on intervention gaps and the quality of interventions.
The WHO Secretariat provided details on the latest rapid risk assessment. The Secretariat highlighted the effectiveness of the response; there have been improvements in surveillance and the intensity of virus transmission has been reduced, but there has been a geographical extension. There has been no local transmission in these areas, but the continued seeding of virus into new areas represents a constant risk of further amplification. 3
Risk remains very high at national and regional levels but still low at global level. There is cause for concern linked to the recent case in Goma, as the city is a provincial capital with an airport with international flights.
The intensity of the epidemiological situation is fluctuating, with about 80 new cases reported weekly. There is continued shifting of hotspots and associated risks. There is continued seeding to new or previously cleared areas but thus far without sustained local transmission. The recent travel to and from Uganda of a local trader who later died of Ebola demonstrates that the risk remains high for bordering countries. The virus has extended geographically but transmission is not as intense. However, the situation in Beni remains difficult and worrisome, especially as the proportion of community deaths has been rising. Ongoing challenges include insecurity, community acceptance, delays in case detection and isolation, challenges in contact tracing, a highly mobile population, and multiple routes of transmission. Nosocomial transmission, burial practices, and the use of traditional healers continue to amplify transmission in affected communities. The level of preparedness in Goma and priority actions for Rwanda were presented, demonstrating significant improvements across a number of key preparedness pillars (surveillance, Ebola Treatment Centres, etc.). Gaps and challenges remain, specifically at the district level.
The ring vaccination strategy is proving efficient and successful. Issues related to vaccine supply were reviewed. Vaccine supply and availability data were presented and show that vaccine supplies are currently insufficient, thereby necessitating the introduction of an adjusted dose. The Secretariat welcomed the increased production planned by Merck, which will effectively double the supply of rVSV-EBOV in 2020. Further, the EVD Working Group of SAGE will monitor vaccine supplies and suggest any further dose adjustment that might be required to assure adequate doses until further production is available.
Context and Discussion
The Committee commended the response to date, under the leadership of the DRC Ministry of Health, and supported by WHO, UN agencies, NGOs and other partners. The response has contributed to limiting the spread and impact of this virus in a difficult context in many areas in DRC. The courage and commitment of all frontline workers were specifically praised by the Committee.
However, the Committee is concerned that a year into the outbreak, there are worrying signs of possible extension of the epidemic. Despite significant improvement in many places, there is concern about potential spread from Goma, even though there have been no new cases in that city. The Committee is also concerned by the reinfection and ongoing transmission in Beni, which has been previously associated with seeding of virus into multiple other locations. Further, the murder of two HCWs demonstrates continued risk for responders owing to the security situation.
In addition, despite previous recommendations for increased resources, the global community has not contributed sustainable and adequate technical assistance, human or financial resources for outbreak response.
Conclusions and Advice
It was the view of the Committee that a coordinated international response under the International Health Regulations (2005) is required. Thus, the conditions for a Public Health Emergency of International Concern (PHEIC) under the IHR (2005) have been met.
The Committee discussed the impact of a PHEIC declaration on the response, possible unintended consequences, and how these might be managed. The global community should anticipate possible negative consequences and proactively prevent them from occurring, taking into account experience with Ebola in West Africa in 2014.
The declaration of the PHEIC is not a reflection on the performance of the response team but rather a measure that recognizes the possible increased national and regional risks and the need for intensified and coordinated action to manage them.
The Committee provided the following advice to the Director-General for his issuance as formal Temporary Recommendations under the IHR (2005).
For affected countries:
For neighbouring countries:
For all States:
The Committee recognizes the shortage of supply of rVSV ZEBOV GP vaccine, despite the commendable efforts of the manufacturer of doubling the supply by 2020, and recommends that WHO works with member states and manufacturers to immediately take all measures to increases supplies, including consideration of working with Contract Manufacturing Organizations (CMOs) and transfer of technology.
The Committee emphasized the importance of continued support by WHO and other national and international partners towards the effective implementation and monitoring of these recommendations.
Based on this advice, the reports made by the affected State Party, and the currently available information, the Director-General accepted the Committee’s assessment and on 17 July 2019 declared the Ebola outbreak in the Democratic Republic of the Congo a Public Health Emergency of International Concern (PHEIC).
The Director-General endorsed the Committee’s advice and issued them as Temporary Recommendations under IHR (2005) to reduce the international spread of Ebola, effective 17 July 2019. The Director-General thanked the Committee Members and Advisors for their advice and requested their reassessment of this situation within three months.
::::::
Wednesday, July 17, 2019
As cases of Ebola continue to increase in the eastern region of The Democratic Republic of the Congo (DRC), and travel-associated cases have been reported in neighboring Uganda, CDC fully supports the decision by the International Health Regulations Emergency Committee of the World Health Organization (WHO) to declare the outbreak a “public health emergency of international concern” (PHEIC). A PHEIC is declared if an extraordinary event poses a public health threat to other nations through the spread of disease and requires a more robust coordinated international response…
“Ending the Ebola outbreak is one of the Trump Administration’s top global health priorities,” said HHS Secretary Alex Azar. “We appreciate the strong response of Dr. Tedros and WHO leadership to this outbreak, yet it is clear that much more remains to be done. The United States government has already played a vital role in supporting the response in the DRC and neighboring nations, and will continue this support until we have put an end to the outbreak.”…
“Make no mistake, the challenges to stopping the Ebola outbreak are growing steeper and the public health response will unquestionably be longer,” said CDC Director Robert R. Redfield, M.D. “CDC stands ready to support our U.S. government and international partners in limiting the spread of Ebola, improving the human condition, and bringing this outbreak to an end.”
As part of the Administration’s whole-of-government effort, CDC experts are working with the United States Agency for International Development (USAID) Disaster Assistance Response Team (DART) on the ground in the DRC and the American Embassy in Kinshasa to support the Congolese and international response. The United States government, including CDC, is working with DRC, Uganda, WHO, and other partners to support the current Ebola outbreak response by providing technical assistance and expertise in disease tracking, case investigation, contact tracing, case management, infection prevention and control, safe burials, community engagement and social mobilization, risk communication and health education, behavioral science, laboratory testing, border health, data management, vaccination campaigns, and logistics.
To rapidly identify cases and prevent further spread of Ebola, CDC is working with the U.S. Embassy in DRC to preposition CDC staff in Goma to rapidly respond to hotspots where the security situation is permissible. As of July 16, 2019, CDC staff have conducted 311 deployments to the DRC, neighboring countries, and WHO headquarters. CDC has 246 permanent staff in the three high-risk countries bordering the outbreak (South Sudan, Rwanda, Uganda), including 43 in DRC. DRC has more than 150 graduates of CDC’s Field Epidemiology and Laboratory Training Program who are playing a central role in this public health response.
CDC activated its Emergency Operations Center (EOC) on Thursday, June 13, 2019, to support the inter-agency response to the outbreak in eastern Democratic Republic of the Congo. CDC’s activation of the EOC allows the agency to provide increased operational support for the response to meet the outbreak’s evolving challenges.
There are no cases of Ebola in the United States. At this time, we believe the risk to the United States from the current Ebola outbreak in DRC remains low based on the travel volume and travel patterns from the outbreak area to the United States…
::::::
Disease Outbreak News (DONs}
Ebola virus disease – Democratic Republic of the Congo
18 July 2019
…The outbreak of Ebola virus disease (EVD) in North Kivu and Ituri provinces continued this past week with similar transmission intensity to recent weeks. While the stability of the transmission intensity of the outbreak is an indication of the strong response efforts to limit local transmission in affected health zones, the spread of EVD into new geographical areas and continued insecurity in the affected regions continue to complicate the control of the outbreak.
A salient example of this is the confirmed case of EVD that was reported in Goma, a city of approximately two million inhabitants close to the Rwandan border, on 14 July 2019. The case was a man who travelled to the city from Beni by bus, visiting a local health centre on arrival where the alert was raised. He transferred the same day to the Ebola Treatment Centre (ETC) in Goma, and died while being transferred to the ETC in Butembo. The case’s full travel history is known, and all contacts are being identified and followed-up. Vaccination of his contacts, and contacts of contacts, in Goma commenced on 15 July 2019. The confirmation of a case of EVD in the city of Goma had been long anticipated. Preparation activities, including the vaccination of health workers, intensive training in infection prevention and control, and heightened surveillance have been ongoing for more than six months. Neighbouring Rwanda is also conducting preparedness activities. Rumours of his contacts travelling to Bukavu, South Kivu, have been investigated and ruled out by response teams…
::::::
15 July 2019 News release Geneva
Almost a year after the outbreak of Ebola was declared in eastern Democratic Republic of the Congo (DRC) and with the number of new cases at worrying levels, the United Nations hosted a high-level meeting today in Geneva to take stock of the coordinated response and galvanize further support for the government-led effort to defeat the deadly disease…
Statement
GENEVA, 15 July 2019 – On behalf of everyone at UNICEF, thanks to OCHA and WHO for hosting this important discussion.
Yesterday’s confirmed case in Goma makes clear: we are at a pivotal juncture in the response.
As we discuss the situation and plan next steps, let’s remember to consider the “human” impact of the Ebola outbreak and the devastating toll it has on the lives of children…
Preventing infection among children must therefore be at the heart of the Ebola response.
Ebola also affects children in different ways than adults.
For first responders at the community level — including many of the groups and organizations represented here today — this means adapting our responses to the unique physical, psychological and social needs of children and young people.
For example, children who lose a parent due to Ebola or whose parents are infected by the disease are at risk of being stigmatized, isolated or abandoned, in addition to the heartbreak of losing a loved one. They are doubly affected by Ebola.
And so, together with the Government, WHO, OCHA, Medair, IFRC and many other national and international partners, UNICEF staff members are working around the clock to meet the immediate and longer-term needs of the children and families affected.
UNICEF and our implementing partners have 1,200 staff on the ground, along with nearly 2,000 social mobilizers and psychosocial workers contributing to key areas of the response. This includes infection prevention and control, psychosocial and nutrition support, pediatric care, and support for supplies and logistics.
Also, given our longstanding presence and experience within communities, UNICEF is leading on “community engagement.”
This is an essential component of any outbreak response. The trajectory of this Ebola outbreak hinges on deeply personal decisions taken by individual households and communities with no previous experience of this terrifying disease. To defeat Ebola, they require knowledge, skills and resources.
From the start of the outbreak in North Kivu, it was evident that we would face tremendous challenges in this work with communities. We had to walk a very fine line in order to remain neutral in a very politicized environment, particularly during the high-stakes electoral period. This seriously undermined our ability to engage communities, and there was more than one setback in the response.
We have learned hard lessons about the ways in which people’s perceptions about the disease can be manipulated; and how violence, or fear of violence, can derail the work to prevent and treat Ebola – even in communities that want to work with us.
Once the elections were behind us, we were able to again start working on building a critical mass of community engagement that is now showing results, although this work will always remain vulnerable to the conflict dynamics of the region.
We are working with longstanding national institutions including Initiative for a Cohesive Leadership, and Search for Common Ground, who are working behind doors, bringing together the social and political influencers, community leaders and members of armed groups, that can allow Ebola response teams to work in a safe and trusting environment.
We are scaling up our work with pre-existing, village-level Community Action Committees to identify the concerns and needs of the population, so that we can collectively adapt the response, and address humanitarian needs.
We have listened, and we have learned. We are responding with a lighter footprint. We have adjusted burial practices so that they are both culturally acceptable and medically safe. We are decontaminating sensitive sites at night, to protect affected households from stigma and discrimination. And we will keep listening and learning.
We have seen consistent reactions from the community that underline the need to improve the way the entire Ebola response is being implemented by all actors. They have made very clear that every aspect of the response, from preparedness through to medical treatment and beyond, must ensure a constructive approach to engaging with the community and doing no harm. There are efforts underway to improve how we coordinate with all actors involved in the response to achieve this, which is a key priority to deliver on going forward.
For UNICEF, this means getting communities to understand, accept and ultimately lead a response, that to them, must seem alien and overwhelming. We are there to support them.
To build this acceptance, awareness and action, we work with a broad range of influential political, community and religious leaders, Ebola survivors, and mass media, to bring crucial knowledge on symptoms, prevention and treatment to at-risk households and communities.
UNICEF-supported psychosocial workers are often the first people that a family newly affected by Ebola meets. The role they play in supporting families to make safe decisions related to treatment or burial, is crucial to preventing the spread of infection.
We know that each time that the outbreak moves to a new health zone, the work needs to be started anew. This is why community engagement is now part of preparedness activities in all at-risk areas in DRC and neighboring countries.
Through the new Strategic Response Plan, we’re also working to rehabilitate critical basic services and structures, while strengthening social safety nets and social cohesion. This longer-term, more comprehensive approach is essential in a context like northeast DRC, which was in crisis long before the Ebola outbreak.
Ebola cannot be defeated in isolation. We need to address the full range of long-standing needs among communities that have suffered through decades of conflict and other pressing needs. This approach will contribute towards rebuilding trust.
In Goma this weekend, we’ve seen again that good preparedness is indispensable. In DRC, emergency response efforts must be redoubled. High-risk countries must be equipped and ready to respond quickly to contain the disease as soon as it spills over. It is not a question of ‘if’ but a question of ‘when’. We must be vigilant.
Our work is not done until the last case is successfully treated, and transmission completely stopped.
For this, we need faster isolation of patients, additional vaccines, better infection prevention and control to prevent a rapid, “super-spreader” event from occurring.
This can only be achieved by a well-financed response — one that is grounded in strong community engagement, and well co-ordinated among all partners, without exception.
UNICEF hopes that today’s session is an important moment in gathering the needed support and resources around this critical issue.
Lives are hanging in the balance. And young people like Dieudonné are counting on us to deliver. We must not let them down.
::::::
Press release
This is a summary of what was said by Marixie Mercado, UNICEF spokesperson in Geneva – to whom quoted text may be attributed – at today’s press briefing at the Palais des Nations in Geneva.
GENEVA, 16 July 2019 – I returned from the Democratic Republic of the Congo (DRC) on Sunday. While I was there, I spent 10 days in North Kivu and Ituri, the two provinces affected by Ebola, and spent time in Goma, Beni, Butembo, and Bunia.
I’ll start with the reasons why the Ebola outbreak response needs to focus on children.
This outbreak is infecting more children than previous outbreaks. As of 7 July, there had been 750 infections among children. This represents 31% of total cases, compared with about 20% in previous outbreaks.
Young children – those below five years old, are especially hard hit. Of the 750 cases among children, 40 per cent were among under-fives. They, in turn, are infecting women. Among adults, women comprise 57 per cent of cases. According to the latest data I have, the case fatality ratio for under-fives is 77 per cent, compared with 67 per cent for all age groups.
Preventing infection among children must be at the heart of the overall Ebola response.
Young children are at higher risk than adults – which is why they need specialized attention. But Ebola also affects children very differently from adults, and the response needs to also factor in their very specific psychological and social needs.
Children infected with Ebola need child-specific medical care. Same drugs, but different dosages, but also need zinc to treat diarrhea, as well as treatment against intestinal parasites. Already malnourished children – which is far too common in the DRC – require treatment with food specifically formulated for children.
Children who are separated, often abruptly and brutally, from their parents due to Ebola, need dedicated care and attention while their parents undergo treatment.
Children who are orphaned due to Ebola need longer-term care and support. This includes mediation with extended families that refuse to take them in; health and nutrition support to make sure they stay healthy; and, for those who need it, school fees and other material aid to enable children to go back to school, which is so critical to their overall well-being.
Virtually all of them need help to counter the debilitating effects of the stigma and discrimination that taints children affected by Ebola, so that they are accepted, valued and loved by their families and communities.
Now I’ll move on to what we’ve done in response.
We have dedicated paediatricians working within the Ebola Treatment Centres to provide child-specific medical care. Every child under treatment has a dedicated caregiver who is also an Ebola survivor.
We provided the equipment and supplies to convert one of the treatment “cubes” at the Beni Ebola Treatment Center (ETC) into a delivery room for pregnant mothers, and are procuring similar material for the ETC in Katwa, which also handles similar cases from Butembo.
We have incorporated teams of nutritionists to work alongside the Ebola Treatment Centers to provide individualized, specialist nutritional care for children (and adults) who are suspected or confirmed to have Ebola. This is the first time an Ebola outbreak response has included this kind of care, and there is growing recognition among responders that it plays a vital role in the overall health status of patients.
We have provided every child known to us who has been separated from their parents or orphaned due to Ebola with dedicated care at specially set up childcare facilities located alongside the Ebola Treatment Centres. To soften the trauma of separation, the facilities are staffed with Ebola survivors, who are now immune to the disease, and able to hold children, and bring them to see their parents at the Ebola Treatment Centers.
We work with trusted community-based psychosocial workers to counsel children and families before, during, and after treatment, to explain the process and support them every step of the way.
Emergencies
POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 17 July 2019
:: In Central African Republic, a series of previously-detected/reported VDPV2s have now been officially classified as ‘circulating’. Since initial detection of the viruses in May, the country had already operationally considered these viruses to represent an outbreak and implemented emergency outbreak response and declared the event to be a national public health emergency.
:: A cVDPV2 originating in Jigawa, Nigeria, continues to spread. Genetically-linked virus has been confirmed from an environmental sample in Ghana.
:: In Myanmar, a cVDPV1 has been reported and response measures are being implemented. Neighbouring countries have been informed of the confirmed cVDPV1, and surveillance for polioviruses is being strengthened across the region. Myanmar had previously successfully stopped a cVDPV2 outbreak in 2015.
Summary of new viruses this week:
:: Afghanistan — one wild poliovirus type 1 (WPV1) case and one WPV1-positive environmental sample;
:: Pakistan— four WPV1 cases and three WPV1-positive environmental samples;
:: Nigeria —three circulating vaccine-derived poliovirus type 2 (cVDPV2) cases, two cVDPV2-positive environmental samples, and one cVDPV2 isolated from a healthy contact;
:: Democratic Republic of Congo (DRC) — five cVDPV2 cases;
:: Central African Republic (CAR) — three cVDPV2 cases, one case classified cVDPV2 based on a positive contact, and ten cVDPV2 community/close contacts ;
:: Angola — one cVDPV2 isolated from healthy child;
:: Ghana — one cVDPV2-positive environmental sample linked to Jigawa/Nigeria outbreak;
:: Myanmar — two cVDPV1 cases and two cVDPV1 positive contacts.
::::::
::::::
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 20 Jul 2019]
Democratic Republic of the Congo
:: Ebola outbreak in the Democratic Republic of the Congo declared a Public Health Emergency of International Concern 19 July 2019
:: High-level meeting on the Ebola outbreak in the Democratic Republic of the Congo affirms support for Government-led response and UN system-wide approach 15 July 2019
:: 50: Situation report on the Ebola outbreak in North Kivu 16 July 2019
:: Disease Outbreak News (DONs} Ebola virus disease – Democratic Republic of the Congo
18 July 2019
[See DRC Ebola+ above for detail]
Syrian Arab Republic
:: Elizabeth Hoff: Seven years of tireless work in war-torn Syria 15 July 2019
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
Yemen – No new digest announcements identified
::::::
WHO Grade 2 Emergencies [to 20 Jul 2019]
Measles in Europe
:: Vaccination against measles increases amid ongoing measles outbreaks in Europe 15-07-2019
MERS-CoV
:: Middle East respiratory syndrome coronavirus (MERS-CoV) – The Kingdom of Saudi Arabia
16 July 2019
From 1 through 31 May 2019, the National International Health Regulations (IHR) Focal Point of Saudi Arabia reported 14 additional cases of Middle East respiratory syndrome (MERS-CoV) infection, including five deaths…
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
Libya – No new digest announcements identified
Malawi floods – 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
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 20 Jul 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 20 Jul 2019]
14 June 2019 Statement
Statement on the meeting of the International Health Regulations (2005) Emergency Committee for Ebola virus disease in the Democratic Republic of the Congo
17 July 2019 News release
Ebola outbreak in the Democratic Republic of the Congo declared a Public Health Emergency of International Concern
15 July 2019 News release
High-level meeting on the Ebola outbreak in the Democratic Republic of the Congo affirms support for Government-led response and UN system-wide approach
15 July 2019 News release
World hunger is still not going down after three years and obesity is still growing – UN report
15 July 2019 News release
WHO/Europe studies find baby foods are high in sugar and inappropriately marketed for babies
15 July 2019 News release
20 million children miss out on lifesaving measles, diphtheria and tetanus vaccines in 2018
::::::
Calls for consultants / proposals
17 July 2019
Consultant on enteric vaccine development pdf, 292kb
Deadline for applications: 7 August 2019
::::::
Weekly Epidemiological Record, 19 July 2019, vol. 94, 29 (pp. 317–328)
:: WHO Alliance for the Global Elimination of Trachoma by 2020: progress report on elimination of trachoma, 2018
::::::
WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: WHO partners NCDC for effective containment of cholera outbreaks 19 July 2019
:: Renewed impetus to achieve universal access to immunization by 2030 19 July 2019
As the Global Vaccine Action Plan GVAP) 2011-2020 nears its conclusion in 2020, a regional consultation was held this week by the WHO Regional Office for Africa to shape a new immunization strategy for the next decade with the aim that everyone, everywhere, at every age, fully benefits from vaccines for good health and well-being.
:: Reminder to strengthen measures to prevent the spread of Ebola Virus to Rwanda 18 July 2019
:: WHO and UNICEF support the Ministry of Health to conduct a workshop for orientation of media personnel in emergency risk communication 18 July 2019
:: A high-level delegation led by South Sudan’s Undersecretary of Health visited Yei River State to intensify Ebola preparedness in the country 17 July 2019
:: WHO scales up activities in Burkina Faso in response to worsening humanitarian situation
15 July 2019
WHO Region of the Americas PAHO
– No new digest announcements identified
WHO South-East Asia Region SEARO
:: Maldives eliminates mother-to-child transmission of HIV, Syphilis
SEAR/PR/1713 New Delhi/ Male, July 15, 2019: Maldives has eliminated mother-to-child transmission of HIV and syphilis, joining first few countries in the world to ensure a generation free of these deadly diseases, World Health Organization said today…
WHO European Region EURO
:: Member States to reflect on 10 years of progress in public health and set health priorities for Europe at RC69 15-07-2019
:: Vaccination against measles increases amid ongoing measles outbreaks in Europe 15-07-2019
WHO Eastern Mediterranean Region EMRO
:: Elizabeth Hoff: Seven years of tireless work in war-torn Syria 14 July 2019
WHO Western Pacific Region
:: Risk of Ebola in the Western Pacific remains low 18 July 2019 News releases
CDC/ACIP [to 20 Jul 2019]
http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html
Wednesday, July 17, 2019
CDC supports WHO declaration of “Public Health Emergency of International Concern” for Ebola outbreak in eastern region of The Democratic Republic of the Congo
[See DRC – Ebola above for detail]
Africa CDC [to 20 Jul 2019]
http://www.africacdc.org/
No new digest content identified.
China CDC
http://www.chinacdc.cn/en/
No new digest content identified.
National Health Commission of the People’s Republic of China
http://en.nhc.gov.cn/
Selected Updates and Press Releases
2019-07-19 China Daily from National Health Commission website
China starts latest trial of long-lasting HIV vaccine
An HIV vaccine being developed by Chinese scientists will be given to 160 volunteers in a second-phase clinical trial, a medical scientist at the Chinese Center for Disease Control and Prevention said on July 15.
The candidate vaccine, DNA-rTV, relies on replication of the DNA of HIV to stimulate effective immunization, according to Shao Yiming, a chief HIV researcher at the center.
He said the vaccine, based on the one used to prevent smallpox, is the first such HIV vaccine to begin a second-phase clinical trial.
“With significant reduction of virulence, the vaccine will not cause infection in healthy receivers,” Shao said.
The vaccine under development does not contain the full human immunodeficiency virus. Rather, it contains DNA segments from HIV so it will not cause an infection…
Announcements
Paul G. Allen Frontiers Group [to 20 Jul 2019]
https://alleninstitute.org/what-we-do/frontiers-group/news-press/
News
These neurons are tied to one of multiple sclerosis’ most dramatic effects: Brain shrinkage
July 17, 2019
A new study identifies a type of brain cell that withers away in late stages of the disease
BMGF – Gates Foundation [to 20 Jul 2019]
http://www.gatesfoundation.org/Media-Center/Press-Releases
No new digest content identified.
Bill & Melinda Gates Medical Research Institute [to 20 Jul 2019]
https://www.gatesmri.org/
The Bill & Melinda Gates Medical Research Institute is a non-profit biotech organization. Our mission is to develop products to fight malaria, tuberculosis, and diarrheal diseases—three major causes of mortality, poverty, and inequality in developing countries. The world has unprecedented scientific tools at its disposal; now is the time to use them to save the lives of the world’s poorest people
No new digest content identified.
CARB-X [to 20 Jul 2019]
https://carb-x.org/
CARB-X is a non-profit public-private partnership dedicated to accelerating antibacterial research to tackle the global rising threat of drug-resistant bacteria.
No new digest content identified.
CEPI – Coalition for Epidemic Preparedness Innovations [to 20 Jul 2019]
http://cepi.net/
17 July 2019
CEPI awards funding agreement worth up to US$9.5 million to Colorado State University to develop a human vaccine against Rift Valley fever
Oslo, Norway, July 17, 2019—The Coalition for Epidemic Preparedness Innovations (CEPI) and Colorado State University (CSU) today announce a partnering agreement to advance the development of a vaccine candidate against Rift Valley fever (RVF) virus. With support from the European Union’s (EU’s) Horizon 2020 programme, CEPI will provide up to US$9.5 million for manufacturing and preclinical studies to assess a single-dose vaccine candidate (DDVax) against RVF. First identified in 1931 during an investigation into an outbreak among sheep on a farm in the Rift Valley of Kenya, this potentially fatal virus is found across Africa and is now emerging in the Middle East.
DDVax is a second generation RVF vaccine, which was designed after researchers identified and removed the key genes of the virus that allowed it to cause disease. Removal of these genes also stops the virus from replicating in mosquitoes—a known vector that spreads the disease in animals and in humans—therefore blocking this potential route of transmission. The vaccine stimulates the body’s immune system to generate neutralising antibodies against the RVF virus. It also likely generates a significant cellular immune response that can kill infected cells…
Clinton Health Access Initiative, Inc. (CHAI) [to 20 Jul 2019]
https://clintonhealthaccess.org/about/
Published July 15th, 2019
CHAI Financials: 2018
EDCTP [to 20 Jul 2019]
http://www.edctp.org/
The European & Developing Countries Clinical Trials Partnership (EDCTP) aims to accelerate the development of new or improved drugs, vaccines, microbicides and diagnostics against HIV/AIDS, tuberculosis and malaria as well as other poverty-related and neglected infectious diseases in sub-Saharan Africa, with a focus on phase II and III clinical trials
Latest news
19 July 2019
African High Commissioners and Ambassadors in Pretoria met EDCTP
African High Commissioners and Ambassadors from 18 countries accredited to South Africa met with EDCTP in Pretoria on 11 July 2019. The meeting was hosted by the Mozambique High Commission. The objective of the meeting was to inform the Ambassadors about the EDCTP activities in sub-Saharan Africa. EDCTP aims to increase the political and financial support of African countries for clinical research and the development of the associated research capacity in Africa, as part of the common pursuit of the Sustainable Development Goals.…
Emory Vaccine Center [to 20 Jul 2019]
http://www.vaccines.emory.edu/
No new digest content identified.
European Medicines Agency [to 20 Jul 2019]
http://www.ema.europa.eu/ema/
News and press releases
No new digest content identified.
European Vaccine Initiative [to 20 Jul 2019]
http://www.euvaccine.eu/news-events
No new digest content identified.
FDA [to 20 Jul 2019]
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
No new digest content identified.
Fondation Merieux [to 20 Jul 2019]
http://www.fondation-merieux.org/
No new digest content identified.
Gavi [to 20 Jul 2019]
https://www.gavi.org/
No new digest content identified.
GHIT Fund [to 20 Jul 2019]
https://www.ghitfund.org/newsroom/press
GHIT was set up in 2012 with the aim of developing new tools to tackle infectious diseases that devastate the world’s poorest people. Other funders include six Japanese pharmaceutical
No new digest content identified.
Global Fund [to 20 Jul 2019]
https://www.theglobalfund.org/en/news/
No new digest content identified.
Hilleman Laboratories [to 20 Jul 2019]
http://www.hillemanlabs.org/
No new digest content identified.
Human Vaccines Project [to 20 Jul 2019]
http://www.humanvaccinesproject.org/media/press-releases/
No new digest content identified.
IAVI [to 20 Jul 2019]
https://www.iavi.org/newsroom
No new digest content identified.
International Coalition of Medicines Regulatory Authorities (ICMRA)
http://www.icmra.info/drupal/en/news
No new digest content identified.
IFFIm
http://www.iffim.org/library/news/press-releases/
18 July 2019
IFFIm issues NOK600 million Vaccine Bonds [click link to review “restricted access library note]
Funding will support CEPI’s development of new vaccines to prevent deadly diseases.
London, 18 July 2019 – The International Finance Facility for Immunisation (IFFIm) today issued NOK600,000,000 Zero Coupon Notes to help finance research and development of new vaccines by the Coalition for Epidemic Preparedness Innovation (CEPI). CEPI is a public private initiative that accelerates development of vaccines against emerging infectious diseases and enables equitable access to these vaccines for affected populations during outbreaks.
The vaccine bonds will frontload a NOK600 million pledge from the Government of Norway to Gavi in support of CEPI .
Today’s issuance was lead managed by Skandinaviska Enskilda Banken (SEB) and the Toronto-Dominion Bank. The issuance, which will mature on 15 March 2025, has a reoffer price of 93.892, 2bps through mid-swaps in NOK…
IFRC [to 20 Jul 2019]
http://media.ifrc.org/ifrc/news/press-releases/
Selected Press Releases, Announcements
Asia Pacific, Bangladesh
Bangladesh: Severe flooding puts more than 4 million people at risk of food insecurity and disease
Dhaka/Kuala Lumpur/Geneva, 19 July 2019 – Days of severe rains have battered the northern and southeastern part of Bangladesh, putting more than 4 million people at risk of food insecurity and disease. Floods and landslides have damaged roads and vital …
19 July 2019
Asia Pacific, DPRK
DPR Korea: Malnutrition and disease on the rise as drought ruins early harvest
Beijing/Kuala Lumpur/Geneva, 18 July 2019 –-An early season drought in the Democratic People’s Republic of Korea (DPRK) has cut by half the expected production of a critical harvest, increasing pressure on highly vulnerable groups across the country. T …
18 July 2019
IVAC [to 20 Jul 2019]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
No new digest content identified.
IVI [to 20 Jul 2019]
http://www.ivi.int/
IVI News & Announcements
No new digest content identified.
JEE Alliance [to 20 Jul 2019]
https://www.jeealliance.org/
Selected News and Events
No new digest content identified.
MSF/Médecins Sans Frontières [to 20 Jul 2019]
http://www.msf.org/
Selected News; Project Updates, Reports
DRC Ebola outbreaks
Crisis update – July 2019
Colombia
The uncertain lives of Venezuelan migrants on the Colombian border
Project Update 17 Jul 2019
HIV/AIDS
Fight is not over as AIDS deaths remain high
Press Release 16 Jul 2019
Public health
Eight things we’ve learned from MSF operational research projects
Interview 16 Jul 2019
NIH [to 20 Jul 2019]
http://www.nih.gov/news-events/news-releases
July 15, 2019
NIH and partners to launch HIV vaccine efficacy trial in the Americas and Europe
— Study will enroll men who have sex with men and transgender people; complementary study in women is ongoing.
The National Institutes of Health and partners today announced plans to conduct a Phase 3 HIV vaccine efficacy trial at multiple clinical research sites in North America, South America and Europe. The trial, called HPX3002/HVTN 706 or Mosaico, will assess whether an investigational vaccine regimen designed to induce immune responses against a variety of global HIV strains can safely and effectively prevent HIV acquisition among men who have sex with men and transgender people. A complementary study in women called HPX2008/HVTN 705 or Imbokodo that launched in 2017 in five southern African countries is ongoing.
Mosaico is sponsored by Janssen Vaccines & Prevention, B.V., part of the Janssen Pharmaceutical Companies of Johnson & Johnson, with funding support from NIH’s National Institute of Allergy and Infectious Diseases (NIAID). The HIV Vaccine Trials Network (HVTN), headquartered at the Fred Hutchinson Cancer Research Center in Seattle, is facilitating the implementation of the study. Additional partners providing support include the U.S. Army Medical Research and Development Command (USAMRDC). The public-private partnership’s plans for Mosaico will be described in more detail at the 10th IAS Conference on HIV Science (IAS 2019) in Mexico City.
This Phase 3 efficacy study will enroll 3,800 HIV-negative men and transgender people aged 18 to 60 years who have sex with men and/or transgender people. It is anticipated to open for enrollment at clinical research sites in the United States later this year. In addition, clinical research sites in Argentina, Brazil, Italy, Mexico, Peru, Poland and Spain will participate in the study…
PATH [to 20 Jul 2019]
https://www.path.org/media-center/
July 16, 2019 by PATH
PATH welcomes Abayomi Sule, Rachel Sibande, and Lisa Anderson to its board of directors
July 16, 2019 by PATH
PATH’s board of directors are pleased to welcome Dr. Abayomi Sule, Dr. Rachel Sibande, and Lisa Pigott Anderson to the board. Dr. Sule brings extensive experience in healthcare management, consulting, and advising local and international organizations, as well as a passion for healthcare innovations and transparency. Dr. Sibande enhances the board’s knowledge in public health, food security, and disaster management through her leadership in leveraging data for international development projects. Ms. Anderson brings decades of executive leadership and volunteer experience with charitable foundations and NGOs and a demonstrated passion to improve maternal and women’s health in low-resource settings.
Sabin Vaccine Institute [to 20 Jul 2019]
http://www.sabin.org/updates/pressreleases
No new digest content identified.
UNAIDS [to 20 Jul 2019]
http://www.unaids.org/en
Selected Press Releases/Reports/Statements
15 July 2019
Pan-African Parliament calls for increased domestic resources for HIV and health in Africa
25 July 2019
Indonesia commits to piloting PrEP
UNICEF [to 20 Jul 2019]
https://www.unicef.org/media/press-releases
Selected Statements, Press Releases, Reports
Press release
‘Transformative shift’ in support for families of young children urgently needed worldwide – UNICEF
The United Nations Children’s Fund has released new recommendations on family-friendly policies including paid parental leave, breastfeeding support, childcare and child benefits
18/07/2019
News note
Unwanted, exploited and abused: Tens of thousands of children in Al-Hol camp and several parts of Syria in limbo amid dire humanitarian needs
UNICEF calls for improved humanitarian access and protection of children including re-integration into local communities and safe return to home countries
17/07/2019
16/07/2019
Press release
Geneva Palais briefing note on the impact of the Ebola outbreak on children in the Democratic Republic of the Congo
This is a summary of what was said by Marixie Mercado, UNICEF spokesperson in Geneva – to whom quoted text may be attributed – at today’s press briefing at the Palais des Nations in Geneva.
16/07/2019
[See Milestones above for detail]
Statement
Remarks from UNICEF Deputy Executive Director Omar Abdi at the High-Level Event on the Response and Preparedness for the Ebola Outbreak in the Democratic Republic of the Congo
15/07/2019
[See Milestones above for detail]
Press release
20 million children missed out on lifesaving measles, diphtheria and tetanus vaccines in 2018
New estimates find dangerous stagnation of global vaccination rates, due to conflict, inequality and complacency
15/07/2019
[See Milestones above for detail]
Press release
Mass campaign to vaccinate over 3 million children against polio kicks off in Venezuela
14/07/2019
[See Milestones above for detail]
Vaccination Acceptance Research Network (VARN) [to 20 Jul 2019]
https://vaccineacceptance.org/news.html#header1-2r
No new digest content identified.
Vaccine Confidence Project [to 20 Jul 2019]
http://www.vaccineconfidence.org/
Posted on 19 Jul, 2019
Peter Piot reaction to Ebola outbreak in DRC being declared a Public Health Emergency of International Concern 17 July 2019
Vaccine Education Center – Children’s Hospital of Philadelphia [to 20 Jul 2019]
http://www.chop.edu/centers-programs/vaccine-education-center
No new digest content identified.
Wellcome Trust [to 20 Jul 2019]
https://wellcome.ac.uk/news
News | 18 July 2019
New funding to boost global research capacity in humanities and social science
We’ve launched two new calls to fund international exchange programmes and research development activities for humanities and social science researchers around the world – the International Exchange Programmes and Research Development Awards.
The Wistar Institute [to 20 Jul 2019]
https://www.wistar.org/news/press-releases
No new digest content identified.
World Organisation for Animal Health (OIE) [to 20 Jul 2019]
http://www.oie.int/en/for-the-media/press-releases/2019/
No new digest content identified.
::::::
BIO [to 20 Jul 2019]
https://www.bio.org/insights/press-release
No new digest content identified.
DCVMN – Developing Country Vaccine Manufacturers Network [to 20 Jul 2019]
http://www.dcvmn.org/
No new digest content identified.
IFPMA [to 20 Jul 2019]
http://www.ifpma.org/resources/news-releases/
No new digest content identified.
PhRMA [to 20 Jul 2019]
http://www.phrma.org/press-room
No new digest content identified.
Industry Watch [to 20 Jul 2019]
:: Boehringer Ingelheim Acquires AMAL Therapeutics, Significantly Enriching Its Cancer Immunology Portfolio with Novel Cancer Vaccines Platform
:: Acquisition adds key platform supporting Boehringer Ingelheim’s focus on patients with difficult-to-treat gastrointestinal and lung cancers
:: AMAL’s first-in-class proprietary KISIMA® platform leverages peptide/protein-based vaccination technology
: AMAL will remain at the campus of the University of Geneva in Switzerland and operate as a subsidiary within Boehringer Ingelheim
July 15, 2019 INGELHEIM AM RHEIN, Germany & GENEVA– Boehringer Ingelheim today announced its acquisition of all shares of AMAL Therapeutics SA, a private Swiss biotechnology company focused on cancer immunotherapy and advancing first-in-class therapeutic cancer vaccines derived from its technology platform KISIMA. AMAL’s lead vaccine ATP128 is currently developed for stage IV colorectal cancer and is slated to begin first-in-human trials later this month. Boehringer Ingelheim plans to develop new therapies by combining assets from its cancer immunology portfolio with AMAL’s proprietary KISIMA immunization platform.
“Acquiring AMAL is part of Boehringer Ingelheim’s long-term strategy to enhance our existing position as an innovator of novel cancer therapies, including immuno-oncology treatments, which leverage cutting-edge scientific discoveries and their applications,” said Michel Pairet, member of Boehringer Ingelheim’s Board of Managing Directors with responsibility for the company’s Innovation Unit. “We want to pioneer new paradigms of biology-based care for cancer patients, and the technologies and expertise developed at AMAL are critical to our efforts.”
The total transaction could amount up to EUR 325 million, and is comprised of an upfront payment as well as contingent clinical, development and regulatory milestones plus up to EUR 100 million if certain commercial milestones are hit…
Journal Watch
Vaccines and Global Health: The Week in Review continues its weekly scanning of key peer-reviewed journals to identify and cite articles, commentary and editorials, books reviews and other content supporting our focu-s on vaccine ethics and policy. Journal Watch is not intended to be exhaustive, but indicative of themes and issues the Center is actively tracking. We selectively provide full text of some editorial and comment articles that are specifically relevant to our work. Successful access to some of the links provided may require subscription or other access arrangement unique to the publisher.
If you would like to suggest other journal titles to include in this service, please contact David Curry at: david.r.curry@centerforvaccineethicsandpolicy.org
Annals of Internal Medicine
16 July 2019 Vol: 171, Issue 2
http://annals.org/aim/issue
Ideas and Opinions
Assuring Gender Safety and Equity in Health Care: The Time for Action Is Now
Lynn E. Fiellin, MD; Darilyn V. Moyer, MD
Issues of sexual and gender harassment and gender inequity have infiltrated all fields and industries, and health care is no exception. Thirty percent to 50% of female physicians or physicians in training report sexual harassment (1, 2). Therefore, on 1 March 2019, TIME’S UP Healthcare (www.timesuphealthcare.org) was established to bring to the medical field the parent organization’s efforts to hasten action and solutions. Herein, we address concerns regarding gender safety and equity in health care and describe the TIME’S UP Healthcare organization, its goals and activities, and its new partnership with the American College of Physicians (ACP).
A 2018 report by the National Academies of Science, Engineering, and Medicine brought the crisis of sexual harassment in health care to the fore (1). The report covers research describing sexual harassment from the perspective of students, trainees, and faculty. Sexual harassment, a form of discrimination, is composed of gender harassment (the most common form), including verbal and nonverbal hostile behaviors based on one’s…
BMJ Global Health
July 2019 – Volume 4 – 4
https://gh.bmj.com/content/4/4
Editorial
The need for comprehensive and multidisciplinary training in substandard and falsified medicines for pharmacists (18 July, 2019)
Alessandra Ferrario, Ebiowei Samuel F Orubu, Moji Christianah Adeyeye, Muhammad H Zaman, Veronika J Wirtz
BMJ Global Health
July 2019 – Volume 4 – 4
https://gh.bmj.com/content/4/4
Analysis
Integrated Disease Surveillance and Response (IDSR) strategy: current status, challenges and perspectives for the future in Africa (3 July, 2019)
Ibrahima Socé Fall, Soatiana Rajatonirina, Ali Ahmed Yahaya, Yoti Zabulon, Peter Nsubuga, Miriam Nanyunja, Joseph Wamala, Charles Njuguna, Charles Okot Lukoya, Wondimagegnehu Alemu, Francis Chisaka Kasolo, Ambrose Otau Talisuna
BMJ Global Health
July 2019 – Volume 4 – 4
https://gh.bmj.com/content/4/4
Use of routinely collected electronic healthcare data for postlicensure vaccine safety signal detection: a systematic review (8 July, 2019)
Yonatan Moges Mesfin, Allen Cheng, Jock Lawrie, Jim Buttery
BMJ Global Health
July 2019 – Volume 4 – 4
https://gh.bmj.com/content/4/4
The global scale and implications of delivering multiple interventions through integrated child health events (8 July, 2019)
Mahoko Kamatsuchi, Adrian Gheorghe, Dina Balabanova
BMJ Global Health
July 2019 – Volume 4 – 4
https://gh.bmj.com/content/4/4
Practice
Interventions to improve water supply and quality, sanitation and handwashing facilities in healthcare facilities, and their effect on healthcare-associated infections in low-income and middle-income countries: a systematic review and supplementary scoping review (8 July, 2019)
Julie Watson, Lauren D’Mello-Guyett, Erin Flynn, Jane Falconer, Joanna Esteves-Mills, Alain Prual, Paul Hunter, Benedetta Allegranzi, Maggie Montgomery, Oliver Cumming
BMC Medicine
http://www.biomedcentral.com/bmcmed/content
(Accessed 20 Jul 2019)
Opinion
Building the case for actionable ethics in digital health research supported by artificial intelligence
The digital revolution is disrupting the ways in which health research is conducted, and subsequently, changing healthcare. Direct-to-consumer wellness products and mobile apps, pervasive sensor technologies a…
Authors: Camille Nebeker, John Torous and Rebecca J. Bartlett Ellis
Citation: BMC Medicine 2019 17:137
Published on: 17 July 2019
BMC Pregnancy and Childbirth
http://www.biomedcentral.com/bmcpregnancychildbirth/content
(Accessed 20 Jul 2019)
Research article
Uptake of maternal care and childhood immunization among ethnic minority and Han populations in Sichuan province: a study based on the 2003, 2008 and 2013 health service surveys
China has made remarkable progress in maternal and child health (MCH) over the last thirty years, but socio-economic inequalities persist. Ethnicity has become an important determinant of poor MCH outcomes, bu…
Authors: Juying Zhang, Yuchan Mou, Jiaqiang Liao, Huaying Xiong, Zhanqi Duan, Yuan Huang and Carine Ronsmans
Citation: BMC Pregnancy and Childbirth 2019 19:250
Published on: 16 July 2019
BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 20 Jul 2019)
Research article
Establishing a theoretical foundation for measuring global health security: a scoping review
Since the 2014–2016 West Africa Ebola epidemic, the concept of measuring health security capacity has become increasingly important within the broader context of health systems-strengthening, enhancing responses to public health emergencies, and reducing global catastrophic biological risks. Efforts to regularly and sustainably track the evolution of health security capabilities and capacities over time – while also accounting for political, social, and environmental risks – could help countries progress toward eliminating sources of health insecurity. We sought to aggregate evidence-based principles that capture a country’s baseline public health and healthcare capabilities, its health security system performance before and during infectious disease crises, and its broader social, political, security, and ecological risk environments…. We synthesized four foundational principles for measuring global health security: measurement requires assessment of existing capacities, as well as efforts to build core public health, healthcare, and biosecurity capabilities; assessments of national programs and efforts to mitigate a critical subset of priority threats could inform efforts to generate useful metrics for global health security; there are measurable enabling factors facilitating health security-strengthening efforts; and finally, measurement requires consideration of social, political, and ecological risk environments.
Authors: Sanjana J. Ravi, Diane Meyer, Elizabeth Cameron, Michelle Nalabandian, Beenish Pervaiz and Jennifer B. Nuzzo
Citation: BMC Public Health 2019 19:954
Published on: 17 July 2019
Clinical Therapeutics
July 2019 Volume 41, Issue 7, p1227-1400
http://www.clinicaltherapeutics.com/current
PREVENTION OF RHEUMATOID ARTHRITIS: Challenges and Opportunities to Change the Paradigm of Disease Management
Edited by Kevin Dale Deane, Tsang Tommy Cheung
Development in Practice
Volume 29, Issue 5, 2019
http://www.tandfonline.com/toc/cdip20/current
Transitions towards sustainable development: a view from the Gulf Cooperation Council (GCC) region
Health Research Policy and Systems
http://www.health-policy-systems.com/content
[Accessed 20 Jul 2019]
Research
| 19 July 2019
How can we improve priority-setting for investments in health research? A case study of tuberculosis
Authors: Mishal S. Khan, Afifah Rahman-Shepherd, Hannah Painter and Helen Fletcher
Health Research Policy and Systems
http://www.health-policy-systems.com/content
[Accessed 20 Jul 2019]
Research
| 18 July 2019
An inductive exploration of the implementation knowledge of research funders
Authors: Anders Brantnell, Enrico Baraldi and Theo van Achterberg
JAMA
July 16, 2019, Vol 322, No. 3, Pages 183-282
http://jama.jamanetwork.com/issue.aspx
Viewpoint
Preserving Civility in Vaccine Policy Discourse – A Way Forward
Gregory A. Poland, MD; Jon C. Tilburt, MD; Edgar K. Marcuse, MD
free access
JAMA. 2019;322(3):209-210. doi:10.1001/jama.2019.7445
This Viewpoint calls out the threat to vaccine policy posed by a very small number of antivaccine (“antivax”) advocates who disrupt attempts to engage vaccine-hesitant persons in public hearings about risks and benefits of vaccination and, acknowledging the concerns of a skeptical public, calls for a renewed commitment to civility in discussing public health policy.
Journal of Infectious Diseases
Volume 220, Issue 1, 1 July 2019
https://academic.oup.com/jid/issue/220/1
EDITORIAL COMMENTARY
Risk of Herpes Zoster in Cancer Patients and the Promise of New Vaccines
Kosuke Kawai, Barbara P Yawn
The Journal of Infectious Diseases, Volume 220, Issue 1, 1 July 2019, Pages 1–2, https://doi.org/10.1093/infdis/jiy626
Journal of Infectious Diseases
Volume 220, Issue 1, 1 July 2019
https://academic.oup.com/jid/issue/220/1
MAJOR ARTICLES AND BRIEF REPORTS
Safety and Immunogenicity of a 2-Dose Heterologous Vaccination Regimen With Ad26.ZEBOV and MVA-BN-Filo Ebola Vaccines: 12-Month Data From a Phase 1 Randomized Clinical Trial in Uganda and Tanzania
Zacchaeus Anywaine, Hilary Whitworth, Pontiano Kaleebu, George Praygod, Georgi Shukarev …
The Journal of Infectious Diseases, Volume 220, Issue 1, 1 July 2019, Pages 46–56, https://doi.org/10.1093/infdis/jiz070
This phase 1 study demonstrated that heterologous prime-boost vaccination with Ad26.ZEBOV and MVA-BN-Filo Ebola vaccines at intervals of 28 or 56 days was well tolerated and immunogenic in healthy African adult volunteers.
Journal of Infectious Diseases
Volume 220, Issue 1, 1 July 2019
https://academic.oup.com/jid/issue/220/1
Safety and Immunogenicity of a 2-Dose Heterologous Vaccine Regimen With Ad26.ZEBOV and MVA-BN-Filo Ebola Vaccines: 12-Month Data From a Phase 1 Randomized Clinical Trial in Nairobi, Kenya
Gaudensia Mutua, Omu Anzala, Kerstin Luhn, Cynthia Robinson, Viki Bockstal …
The Journal of Infectious Diseases, Volume 220, Issue 1, 1 July 2019, Pages 57–67, https://doi.org/10.1093/infdis/jiz071
This phase 1 study demonstrated that 2-dose vaccination with Ad26.ZEBOV and MVA-BN-Filo vaccines was well tolerated and induced durable immune responses to Ebola virus in healthy African volunteers for up to 360 days after the priming dose.
The Lancet
Jul 20, 2019 Volume 394 Number 10194 p187-272, e2
https://www.thelancet.com/journals/lancet/issue/current
Editorial
A wake up call for the Ebola outbreak response
The Lancet
The Lancet
Jul 20, 2019 Volume 394 Number 10194 p187-272, e2
https://www.thelancet.com/journals/lancet/issue/current
Comment
Offline: The ethical darkness of global health
Richard Horton
Nature
Volume 571 Issue 7765, 18 July 2019
http://www.nature.com/nature/current_issue.html
Editorial | 09 July 2019
Diversity and international collaboration should not become casualties of anti-espionage policies
US universities have a responsibility to defuse the climate of suspicion hanging over their Chinese and Chinese American communities.
Nature
Volume 571 Issue 7765, 18 July 2019
http://www.nature.com/nature/current_issue.html
World View | 17 July 2019
Sustainable development will falter without data
Unless governments establish competent monitoring systems, the world will not reach the UN Sustainable Development Goals, says Jessica Espey.
New England Journal of Medicine
July 18, 2019 Vol. 381 No. 3
http://www.nejm.org/toc/nejm/medical-journal
Editorials
HIV-1 Epidemic Control — Insights from Test-and-Treat Trials
S.S. Abdool Karim
New England Journal of Medicine
July 18, 2019 Vol. 381 No. 3
http://www.nejm.org/toc/nejm/medical-journal
Original Articles
Effect of Universal Testing and Treatment on HIV Incidence — HPTN 071 (PopART) R.J. Hayes and Others
207-218
New England Journal of Medicine
July 18, 2019 Vol. 381 No. 3
http://www.nejm.org/toc/nejm/medical-journal
HIV Testing and Treatment with the Use of a Community Health Approach in Rural Africa
New England Journal of Medicine
July 18, 2019 Vol. 381 No. 3
http://www.nejm.org/toc/nejm/medical-journal
Universal Testing, Expanded Treatment, and Incidence of HIV Infection in Botswana
New England Journal of Medicine
July 18, 2019 Vol. 381 No. 3
http://www.nejm.org/toc/nejm/medical-journal
Special Article
Health Care Spending, Utilization, and Quality 8 Years into Global Payment
New England Journal of Medicine
July 18, 2019 Vol. 381 No. 3
http://www.nejm.org/toc/nejm/medical-journal
Clinical Implications of Basic Research
Controlling CRISPR-Cas9 Gene Editing
Steven F. Dowdy, Ph.D.
Off-target DNA editing by the CRISPR-Cas9 ribonucleoprotein nuclease in the experimental treatment of genetic disease is a safety concern. A recent study provides proof of principle of an oligonucleotide-based “quencher” that blocks its activity.
PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 20 Jul 2019)
Research Article
The catalytic role of a research university and international partnerships in building research capacity in Peru: A bibliometric analysis
Christopher W. Belter, Patricia J. Garcia, Alicia A. Livinski, Fabiola Leon-Velarde, Kristen H. Weymouth, Roger I. Glass
| published 15 Jul 2019 PLOS Neglected Tropical Diseases
https://doi.org/10.1371/journal.pntd.0007483
vaccines and global health :: ethics and policy 