BCG vaccination following latent TB treatment: Possible implications for different settings

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International Journal of Infectious Diseases
March 2019 Volume 80, Supplement, S1-S84
https://www.ijidonline.com/issue/S1201-9712(19)X0005-3

BCG vaccination following latent TB treatment: Possible implications for different settings

  1. Goscé, J. Bitencourt, R.K. Gupta, S. Arruda, L.C. Rodrigues, I. Abubakar

S17–S19
Published online: February 25, 2019

Building a European database to gather multi-country evidence on active and latent TB screening for migrants

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International Journal of Infectious Diseases
March 2019 Volume 80, Supplement, S1-S84
https://www.ijidonline.com/issue/S1201-9712(19)X0005-3

Building a European database to gather multi-country evidence on active and latent TB screening for migrants
Joanna Nederby Öhd, Knut Lönnroth, Ibrahim Abubakar, Robert W. Aldridge, Connie Erkens, Jerker Jonsson, Valentina Marchese, Alberto Matteelli, Dee Menezes, Dominik Zenner, Maria-Pia Hergens
S45–S49
Published online: March 1, 2019

A Model for Public Access to Trustworthy and Comprehensive Reporting of Research

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JAMA
April 16, 2019, Vol 321, No. 15, Pages 1429-1542
http://jama.jamanetwork.com/issue.aspx

Viewpoint
A Model for Public Access to Trustworthy and Comprehensive Reporting of Research
Marina Broitman, PhD; Harold C. Sox, MD; Jean Slutsky, PA, MSPH
free access
JAMA. 2019;321(15):1453-1454. doi:10.1001/jama.2019.2807
This Viewpoint describes the peer review processes of the Patient-Centered Outcomes Research Institute, the yield since 2010 of publicly posted final reports of funded comparative effectiveness studies, and speculates that the benefits of the legislatively mandated process may someday outweigh its many current procedural challenges.

Assessing researchers with a focus on research integrity

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The Lancet
Apr 20, 2019  Volume 393Number 10181p1569-1668, e38
https://www.thelancet.com/journals/lancet/issue/current

Editorial
Assessing researchers with a focus on research integrity
The Lancet
Despite decades of progress in global health, many low and middle income countries are not reaching their health Sustainable Development Goals, creating a sense of urgency to prioritise health in resource-strained environments. The use of artificial intelligence (AI) is becoming increasingly attractive to the health-care industry. The accompanying enthusiasm remains awkwardly placed somewhere between aspiration and reality.

The Artificial Intelligence in Global Health report, published on April 1, 2019, was funded by the USAID’s Center for Innovation and Impact and the Rockefeller Foundation, in close coordination with the Bill & Melinda Gates Foundation. The report looks at 27 cases of AI use in health care and distils them into four key groupings—population health, patient and front-line health worker virtual assistants, and physician clinical decision support. It hypothesises how AI solutions could improve access, quality, and efficacy of global health systems while accounting for their technological maturity and feasibility. The identified challenges, the most highly volatile being privacy, ethics, and data ownership, are in line with recent debates on regulation and policy for AI technology implementation in health care. To mitigate these challenges, stakeholders would need to be held accountable and be transparent whether supporting innovation, interoperability, or capacity building. The report sets the framework for a proactive and strategic approach to accelerate the development of cost-effective use of AI in global health by investing in case-specific, systematic, and technology-related key areas.

This report outlines an aspirational yet pragmatic framework for better coordination for AI investment between donors, governments, and the private sector, while harnessing a futuristic vision—the digitisation of global health. Because the cost-effectiveness of these AI solutions has yet to be validated, the call for investments feels somewhat premature. Traditionally, the global health community is a late adopter of new technologies. Hence, it is imperative that they have an integral and active role in the dialogue early on. As this report rightfully stipulates, technology will get there, but will the world follow?

A Belmont Report for Health Data

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New England Journal of Medicine
April 18, 2019   Vol. 380 No. 16
http://www.nejm.org/toc/nejm/medical-journal

Perspective
A Belmont Report for Health Data
Efthimios Parasidis, J.D., M.B.E., Elizabeth Pike, J.D., LL.M., and Deven McGraw, J.D., M.P.H., LL.M.
Just as indignities common in human-subjects research led to the articulation of ethical principles in the Belmont Report 40 years ago, contemporary concerns about data use call for stakeholders to promulgate ethical guidance for health data.

Combating infectious disease epidemics through China’s Belt and Road Initiative

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PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 20 Apr 2019)

Policy Platform
Combating infectious disease epidemics through China’s Belt and Road Initiative
Jin Chen, Robert Bergquist, Xiao-Nong Zhou, Jing-Bo Xue, Men-Bao Qian
| published 18 Apr 2019 PLOS Neglected Tropical Diseases
https://doi.org/10.1371/journal.pntd.0007107
…Conclusion and implication
A major part of the BRI focuses on support and communication to build a new mechanism for global health, prioritising the prevention and control of infectious diseases, preventing outbreaks becoming epidemics, and providing UHC, thus overcoming the vicious circle of poverty and ill health. China will strengthen cooperation with particular regard to the control of TB, echinococcosis, and dengue within the 69 countries and deliver enhanced communication and research leading to the elimination of LF, malaria, and schistosomiasis. Based on opportunities the BRI provides and the cooperative experience gained, the framework shown in Fig 3 should become available and applicable to the response to these challenges by sharing information, joint control, and technical know-how.

UHC and response to the challenges posed by infectious disease epidemics are vital for the new era, with health considerations at the core of the BRI. Despite the serious threats of the infectious disease epidemics, the emphasis on health through the BRI puts us in an excellent position to achieve the health-related aspects of the SDGs by implementing the Health Silk Road concept of improved life through health-related communication. Based on technical experience in this field, mature collaborating mechanisms, and the provision of financial support, the strategies in the context of the BRI reinforce the various countries’ extensive engagement in combating infectious disease epidemics.

The case-area targeted rapid response strategy to control cholera in Haiti: a four-year implementation study

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PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 20 Apr 2019)

The case-area targeted rapid response strategy to control cholera in Haiti: a four-year implementation study
Stanislas Rebaudet, Gregory Bulit, Jean Gaudart, Edwige Michel, Pierre Gazin, Claudia Evers, Samuel Beaulieu, Aaron Aruna Abedi, Lindsay Osei, Robert Barrais, Katilla Pierre, Sandra Moore, Jacques Boncy, Paul Adrien, Florence Duperval Guillaume, Edouard Beigbeder, Renaud Piarroux
Research Article | published 16 Apr 2019 PLOS Neglected Tropical Diseases
https://doi.org/10.1371/journal.pntd.0007263

Low population Japanese encephalitis virus (JEV) seroprevalence in Udayapur district, Nepal, three years after a JE vaccination programme: A case for further catch up campaigns?

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PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 20 Apr 2019)

Low population Japanese encephalitis virus (JEV) seroprevalence in Udayapur district, Nepal, three years after a JE vaccination programme: A case for further catch up campaigns?
Lance Turtle, Hannah E. Brindle, William Schluter, Brian Faragher, Ajit Rayamajhi, Rajendra Bohara, Santosh Gurung, Geeta Shakya, Sutee Yoksan, Sameer Dixit, Rajesh Rajbhandari, Bimal Paudel, Shailaja Adhikari, Tom Solomon, Mike J. Griffiths
Research Article | published 15 Apr 2019 PLOS Neglected Tropical Diseases
https://doi.org/10.1371/journal.pntd.0007269

Medical prescribing and antibiotic resistance: A game-theoretic analysis of a potentially catastrophic social dilemma

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PLoS One
http://www.plosone.org/
[Accessed 20 Apr 2019]

Research Article
Medical prescribing and antibiotic resistance: A game-theoretic analysis of a potentially catastrophic social dilemma
Andrew M. Colman, Eva M. Krockow, Edmund Chattoe-Brown, Carolyn Tarrant
Research Article | published 19 Apr 2019 PLOS ONE
https://doi.org/10.1371/journal.pone.0215480
 

Waning immunity

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Science         
19 April 2019  Vol 364, Issue 6437
http://www.sciencemag.org/current.dtl

Feature
Waning immunity
By Jon Cohen
Science19 Apr 2019 : 224-227 Full Access
Vaccine protection can fade in months or last a lifetime.Understanding why could lead to more durable immune responses.
Summary
The power of vaccines depends on their ability to train the immune system to recognize microbes and then, if an infection with one of them occurs, to mount a vigorous attack. But the immunity triggered by vaccines wanes over time, and researchers have a wobbly handle on the durability of the protection offered for several diseases. New studies suggest vaccine-induced immune responses against influenza, mumps, pertussis, and yellow fever may all disappear at a faster rate than appreciated, calling into question the timing of booster shots recommended by health officials. For adults who have received all six of their diphtheria and tetanus shots as children, their protection might be so robust that they do not need the booster that’s routinely used in the United States every 10 years. A central problem is that immunologists have not systematically investigated the mechanisms behind vaccine durability. A remarkably durable vaccine against human papillomavirus that contains what’s known as a viruslike particle offers some clues of ways forward, as it spurs the immune system to make antibodies from long-lived plasma cells, which to date have been in the shadows of their superstar cousins known as memory B cells. There is also a push to better connect data from vaccine “breakthrough” infections during outbreaks and the immune response analyses being done in laboratories that study immunization.

Parents’ healthcare-seeking behavior for their children among the climate-related displaced population of rural Bangladesh

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Social Science & Medicine
Volume 226  Pages 1-274 (April 2019)
https://www.sciencedirect.com/journal/social-science-and-medicine/vol/226/suppl/C

Research article  Abstract only
Parents’ healthcare-seeking behavior for their children among the climate-related displaced population of rural Bangladesh
Md Rabiul Haque, Nick Parr, Salut Muhidin
Pages 9-20

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

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From Google Scholar & other sources: Selected Journal Articles, Newsletters, Dissertations, Theses, Commentary
Open Forum Infectious Diseases
Volume 6, Issue 4, April 2019,
Mandatory Flu Vaccine for Healthcare Workers: Not Worthwhile
MB Edmond
Abstract
In 2010, the Society for Healthcare Epidemiology published a recommendation that annual influenza vaccination of healthcare workers be made a condition of employment despite no high-level evidence to support this recommendation. A better strategy for reducing the transmission of respiratory viruses in the healthcare setting would be to encourage vaccination and reduce presenteeism, which is very common among healthcare workers with influenza-like illness. In a hospital with a baseline vaccination compliance of 70%, reducing presenteeism by 2% has the equivalent impact of mandating vaccination in terms of the number of healthcare workers with influenza-like illness at work. Expectations for compliance with interventions to improve the quality of care should be correlated tightly to the underlying evidence to support the intervention, reserving mandates for interventions with very high quality supporting evidence.

 

Annual Review of Virology
Review in Advance first posted online on April 15, 2019
The MMR Vaccine and Autism
F DeStefano, TT Shimabukuro
Abstract
Autism is a developmental disability that can cause significant social, communication, and behavioral challenges. A report published in 1998, but subsequently retracted by the journal, suggested that measles, mumps, and rubella (MMR) vaccine causes autism. However, autism is a neurodevelopmental condition that has a strong genetic component with genesis before one year of age, when MMR vaccine is typically administered. Several epidemiologic studies have not found an association between MMR vaccination and autism, including a study that found that MMR vaccine was not associated with an increased risk of autism even among high-risk children whose older siblings had autism. Despite strong evidence of its safety, some parents are still hesitant to accept MMR vaccination of their children. Decreasing acceptance of MMR vaccination has led to outbreaks or resurgence of measles. Health-care providers have a vital role in maintaining confidence in vaccination and preventing suffering, disability, and death from measles and other vaccine-preventable diseases.

Paediatrics & Child Health
Volume 24, Issue 2, May 2019
Vaccine-preventable diseases: Uncommon disease primer for the front-line provider
S Desai, N MacDonald
Abstract
This practice point provides quick information for front-line health care providers on vaccine-preventable diseases which, given the success of immunization programs in Canada, are now uncommon or rarely seen. These infections can still occur in children and youth from Canada and elsewhere, and their clinical identification has important public health implications. Knowledge of signs and symptoms, immunizing travellers and newcomers to Canada, awareness of outbreaks in-community and elsewhere, and early consultation with an expert in infectious diseases and public health authorities in suspected cases, are key preventive care measures.

 

Journal of Computational Social Science
First Online: 09 April 2019
Personal stories matter: topic evolution and popularity among pro-and anti-vaccine online articles
Z Xu
Abstract
People tend to read health articles that have gone viral online. A large portion of online popular vaccine articles are against vaccines, which lead to increased exemption rates and recent outbreaks of vaccine-preventable diseases. Since anti-vaccine articles’ themes and persuasive strategies change fast, their effects on viewers’ behaviors may change over time. This study examined how pro- and anti-vaccine topics and public interests have changed from 2007 to 2017. Computational methods (e.g., topic modeling) were used to analyze 923 online vaccine articles and over 4 million shares, reactions, and comments that they have received on social media. Pro-vaccine messages (PVMs) that used personal stories received the most heated discussion online and pure scientific knowledge received the least attention. PVMs that present vaccine disagreements and limitations were not popular. These findings indicate the importance of narratives and directly attacking opposing arguments in health message design. Anti-vaccine messages (AVMs) that discussed flu shots and government conspiracy received the most attention. Since April 2015, even though more PVMs appeared online, AVMs, especially those about vaccine damage, were increasingly more popular than PVMs. Some social events and disease outbreaks might contribute to the popularity of AVMs. Newly emerged anti-vaccine topics (e.g., false rumors of CDC conspiracy) should be noted. This study shows that certain topics can be more popular online and can potentially reach a larger population. It also reveals the evolution of vaccine-related topics and public’s interest. Findings can help to design effective interventions and develop programs to track and combat misinformation

BMJ Global Health
Apr 2019, 4 (2)
Practice
Private sector engagement and contributions to immunisation service delivery and coverage in Sudan
Nada Ahmed1, Denise DeRoeck2, Nahad Sadr-Azodi3
Abstract
For more than two decades, the private sector in the Sudan (henceforth, Sudan), including non-governmental organisations and for-profit providers, has played a key role in delivering immunisation services, especially in the conflict-affected Darfur region and the most populated Khartoum state. The agreements that the providers enter into with state governments necessitate that they are licenced; follow the national immunisation policy and reporting and supervision requirements; use the vaccines supplied by government; and offer vaccinations free-of-charge. These private providers are well integrated into the states’ immunisation programmes as they take part in the Ministry of Health immunisation trainings and district review meetings and they are incorporated into annual district immunisation microplans. The purpose of this article is to describe the private sector contributions to equitable access to immunisation services and coverage, as well as key challenges, lessons learned and future considerations. Fifty-five per cent of private health facilities in Sudan (411 out of 752) provide immunisation services, with 75% (307 out of 411) based in Khartoum state and the Darfur region. In 2017, private providers administered around 16% of all third doses of pentavalent (diphtheria, pertussis, tetanus, hepatitis B and Haemophilus influenzae type b) vaccines to children. Private health providers of immunisation services have especially been critical in filling the gaps in government services in hard-to-reach or conflict-affected areas and among marginalised populations, and thus in reducing inequities in access. Through its experience in engaging the private sector, Sudan has learned the importance of regulating and licencing private facilities and incorporating them into the immunisation programme’s decision-making, planning, regular evaluation and supervision system to ensure their compliance with immunisation guidelines and the overall quality of services. In moving forward, strategic engagement with the private sector will become more prominent as Sudan transitions out of donors’ financial assistance with its projected income growth.

 
 
BMJ Global Health
Apr 2019, 4 (2)
Analysis
Immunisation financing and programme performance in the Middle East and North Africa, 2010 to 2017
Helen Saxenian1, Nahad Sadr-Azodi2, Miloud Kaddar3, Kamel Senouci4
Abstract
Immunisation is a cornerstone to primary health care and is an exceptionally good value. The 14 low-income and middle-income countries in the Middle East and North Africa region make up 88% of the region’s population and 92% of its births. Many of these countries have maintained high immunisation coverage even during periods of low or negative economic growth. However, coverage has sharply deteriorated in countries directly impacted by conflict and political unrest. Approximately 1.3 million children were not completely vaccinated in 2017, as measured by third dose of diphtheria–pertussis–tetanus vaccine. Most of the countries have been slow to adopt the newer, more expensive life-saving vaccines mainly because of financial constraints and the socioeconomic context. Apart from the three countries that have had long-standing assistance from Gavi, the Vaccine Alliance, most countries have not benefited appreciably from donor and partner activities in supporting their health sector and in achieving their national and subnational immunisation targets. Looking forward, development partners will have an important role in helping reconstruct health systems in conflict-affected countries. They can also help with generating evidence and strategic advocacy for high-priority and cost-effective services, including immunisation. Governments and ministries of health would ensure important benefits to their populations by investing further in their immunisation programmes. Where possible, the health system can create and expand fiscal space from efficiency gains in harmonising vaccine procurement mechanisms and service integration; broader revenue generation from economic growth; and reallocation of government budgets to health, and from within health, to immunization

Media/Policy Watch

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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 20 Apr 2019
[No new, unique, relevant content]
 
 
BBC
http://www.bbc.co.uk/
Accessed 20 Apr 2019
[No new, unique, relevant content]
 
 
The Economist
http://www.economist.com/
Accessed 20 Apr 2019
The needle and the damage avoided
New York’s measles outbreak puts vaccination rules on the spot
Many states have a “misinformed-parent exemption”
Print edition | United States
Apr 17th 2019 | BROOKLYN
 
 
Financial Times
http://www.ft.com/home/uk
Accessed 20 Apr 2019
[No new, unique, relevant content]
 
 
Forbes
http://www.forbes.com/
Accessed 20 Apr 2019
[No new, unique, relevant content]
 
 
Foreign Affairs
http://www.foreignaffairs.com/
Accessed 20 Apr 2019
[No new, unique, relevant content]
 
 
Foreign Policy
http://foreignpolicy.com/
Accessed 20 Apr 2019
Your Cell Phone Is Spreading Ebola
A deadly outbreak in Congo has become a global emergency because of a raging conflict over valuable minerals.
Voice | April 17, 2019,
Laurie Garrett
 
 
The Guardian
http://www.guardiannews.com/
Accessed 20 Apr 2019
Mounting concern over cholera health crisis in Yemen
More than 2,000 new cases reported every day, with 25% of those affected being children under five
17 Apr 2019   Yemen is facing a massive resurgence of cholera in what was already one of the world’s worst outbreaks, with more than 137,000 suspected cases and almost 300 deaths reported in the first three months of this year.
With well over 2,000 suspected cases being recorded every day – a doubling since the beginning of the year – aid agencies fear they could be facing a major new health crisis.
Amid mounting concern over the return of the epidemic – which first broke out in the war-devastated country in 2016 – aid agencies are reporting cases in 21 out of 23 governorates, with children under five making up a quarter of those affected…
 
 
New Yorker
http://www.newyorker.com/
Accessed 20 Apr 2019
[No new, unique, relevant content]
 
 
New York Times
http://www.nytimes.com/
Accessed 20 Apr 2019
Africa
Attackers Kill Doctor at Hospital in Congo’s Ebola Epicenter
Attackers stormed a hospital at the epicenter of Congo’s Ebola outbreak and killed “a dear colleague,” the head of the World Health Organization said Friday as he condemned the latest violence against health workers trying to contain the virus.
April 19
 
 
Travel
El Al Airline Warns of Measles After Flight Attendant Falls Into Coma
The woman was hospitalized after contracting the disease, and passengers on a flight from J.F.K. to Tel Aviv are told to watch for symptoms.
April 18
 
 
U.S.
Judge Upholds New York City’s Mandatory Measles Vaccination Order
A Brooklyn judge on Thursday ruled against a group of parents who challenged New York City’s recently imposed mandatory measles vaccination order, rejecting their arguments that the city’s public health authority exceeded its authority.
April 15
 
 
New York
Measles Outbreak: Yeshiva’s Preschool Program Is Closed by New York City Health Officials
The program is the first one to be closed as part of the city’s escalating effort to stem the country’s largest measles outbreak in decades.
April 15
 
 
SLATE
https://slate.com/
Accessed 20 Apr 2019
Forget About “Because Science”
Persuading people to vaccinate their children requires engaging with them about their values.
By Gregory E. Kaebnick and Michael Gusmano
April 15, 20197:30 AM
 
 
STAT
https://www.statnews.com/
Accessed 20 Apr 2019
First Opinion
Life-course vaccination can protect adults from infectious disease
By Lois Privor-Dumm
April 16, 2019
 
 
Wall Street Journal
http://online.wsj.com/home-page?_wsjregion=na,us&_homepage=/home/us
Accessed 20 Apr 2019
New York
New York City Issues Summonses to Parents of Three Unvaccinated Children
By Melanie Grayce West
April 18, 2019 9:50 pm ET
New York City’s health department said t it has issued three civil summonses to parents who failed to comply with a vaccine mandate and that the number of confirmed measles cases has jumped from 329 to 359.
 
 
Region
New York City Extends Order for Mandatory Measles Vaccinations
By Melanie Grayce West
April 17, 2019 4:53 pm ET
The order applies to children 6 months and older, with fines for noncompliance.
 
 
Washington Post
http://www.washingtonpost.com/
Accessed 20 Apr 2019
Apr 18, 2019
Washington state Senate passes vaccine bill in rebuke to anti-vaxxers
Lena H. Sun and Lenny Bernstein

 

Think Tanks et al

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Think Tanks et al

 

Brookings
http://www.brookings.edu/
Accessed 20 Apr 2019
[No new relevant content]

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

 

CSIS
https://www.csis.org/
Accessed 20 Apr 2019
[No new relevant content]

 

Council on Foreign Relations
http://www.cfr.org/
Accessed 20 Apr 2019
April 19, 2019
Democratic Republic of Congo
The Ebola Vaccine Is Highly Effective in Eastern Congo
An experimental vaccine developed by Merck & Co is proving to be 97.5 percent effective at preventing Ebola. The World Health Organization’s Strategic Advisory Group of Experts is now permitting the use of the vaccine based on its Expanded Access/Compassionate protocol for experimental vaccines. The vaccine is already protecting some ninety thousand people in the eastern Congo, where there has been a devastating outbreak of Ebola.
Blog Post by John Campbell Africa in Transition

 

Kaiser Family Foundation
https://www.kff.org/search/?post_type=press-release
Accessed 20 Apr 2019
[No new relevant content]

Vaccines and Global Health: The Week in Review :: 13 April 2019

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

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

– pdf version:  A pdf of the current issue is available here: Vaccines and Global Health_The Week in Review_13 Apr 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

Milestones :: Perspectives :: Research DRC – Ebola

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Milestones :: Perspectives :: Research

 

DRC – Ebola
 
36: Situation report on the Ebola outbreak in North Kivu
9 April 2019
Situation update

The recent escalation in the number of Ebola virus disease (EVD) cases continues in the North Kivu provinces of the Democratic Republic of the Congo. This past week saw 65 new confirmed cases reported in the last seven days, predominantly from the areas of Katwa, Mandima, Butembo, and Vuhovi…

::::::
 

IFRC – DR Congo: “Ebola is spreading faster, and many people are no longer seeking care”
Nairobi/Geneva, 11 April 2019 –The deadly Ebola outbreak in the Democratic Republic of the Congo is worsening as trust in the response effort falters, says the International Federation of Red Cross and Red Crescent Societies.

This warning follows confirmation of 18 new Ebola cases on Tuesday (9 April) – the highest single day figure in the now eight month-long outbreak. DR Congo’s Health Ministry also reported that 10 died people from Ebola on Tuesday, including eight who died in their communities having not sought treatment and support.

“This is a very distressing development,” said Emanuele Capobianco, IFRC’s Director of Health and Care. “The bottom line is that Ebola is now spreading faster, and many people are no longer seeking care. It is clear that some vulnerable communities do not trust Ebola responders.”

Redoubling efforts to engage with these communities is critical, according to Capobianco.

“Trust can be built by going community to community, working with local leaders and villagers, listening to their concerns with empathy, and incorporating their feedback and preferences into how we work,” he said.

In-depth community engagement is central to the Red Cross operation in North Kivu and Ituri provinces in eastern DR Congo, where more than 700 Red Cross volunteers from Ebola-affected communities are at work. They have reached more than 1 million people with locally adapted information and have collected more than 130,000 “pieces” of community feedback…

 

::::::

 

Statement on the meeting of the International Health Regulations (2005) Emergency Committee for Ebola virus disease in the Democratic Republic of the Congo on 12th April 2019

12 April 2019   Statement  Geneva
The meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) regarding Ebola virus disease (EVD) in the Democratic Republic of the Congo took place on Friday, 12th April, 2019, from 13:00 to 17:20 Geneva time (CET).

Key Findings:
It was the view of the Committee the ongoing Ebola outbreak in North Kivu and Ituri provinces of the Democratic Republic of the Congo does not constitute a Public Health Emergency of International Concern (PHEIC). However, the Committee wished to express their deep concern about the recent increase in transmission in specific areas, and therefore the potential risk of spread to neighbouring countries.

The Committee also wishes to commend the efforts of responders from the government of the Democratic Republic of Congo, the World Health Organization and partners to contain the outbreak in a complex and difficult setting.

Additionally, the Committee has provided the following public health advice: 
:: The committee advises to redouble efforts to detect cases as early as possible, identify and follow up all contacts, ensure the highest level of coverage vaccination of all contacts and contacts of contacts.

:: Sustained efforts must be made to prevent nosocomial transmission and to shorten time between onset of disease and access to high standards of care and therapeutics at Ebola treatment units.

:: Special emphasis should be placed on addressing the rise in case numbers in the remaining epicentres, notably Butembo, Katwa, Vuhovi, and Mandima.

:: The Committee advises WHO and all partners to identify, target, and scale up community dialogue and participation, engagement of traditional healers, and other community engagement tactics to strengthen and broaden community acceptance.

:: The Committee also noted the need to follow the recommendations of SAGE with regards to the vaccination strategy provided at its latest meeting.

:: The safety of responders should be prioritized, while avoiding the securitization of the response.

:: Because there is a very high risk of regional spread, neighbouring countries should continue to accelerate current preparedness and surveillance efforts, including vaccination of health care workers and front-line workers in surrounding countries.

:: Cross-border collaboration should continue to be strengthened, including timely sharing of data and alerts, cross-border community engagement and awareness raising. In addition, work should be done to better map population movements and understand social networks bridging national boundaries.

:: The Committee maintains its previous advice that it is particularly important that no international travel or trade restrictions should be applied. Exit screening, including at airports, ports, and land crossings, is of great importance; however, entry screening, particularly in distant airports, is not considered to be of any public health or cost-benefit value.

:: The committee strongly emphasized the critical need to strengthen currents efforts in both preparedness and response. This will require substantial, immediate and sustained additional financial support.

:: While there is no added benefit to declaring a PHEIC at this stage, there was concern about current levels of transmission requiring close attention to the evolving situation. The committee advised the WHO Director General to continue to monitor the situation closely and reconvene the Emergency Committee as needed.

Fast rollout of cholera vaccines for people in need in Mozambique

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Milestones :: Perspectives :: Research

OCV – Cyclone Idai

Fast rollout of cholera vaccines for people in need in Mozambique
10 April 2019, Maputo – The Ministry of Health in Mozambique has concluded a successful six-day emergency cholera vaccination campaign that reached more than 800 000 people in four districts affected by Cyclone Idai.

The campaign was supported by around 1200 community volunteers and partners including the World Health Organization (WHO), UNICEF, Médecins Sans Frontières (MSF), International Federation of the Red Cross and Red Crescent Societies (IFRC) and Save the Children.

“From start to finish, this campaign was one of the fastest ever, thanks to experienced people at the Ministry of Health, who knew there was a high risk of a cholera outbreak and made a rapid request for the vaccines as soon as the cyclone hit,” says Dr Djamila Cabral, Head of the WHO office in Mozambique. “The Ministry did an excellent job organizing the campaign and reaching so many people in such a short time. The oral cholera vaccine is one of the vital measures that can help save lives and stop the spread of this terrible disease during an outbreak.”

The oral cholera vaccines, donated by Gavi from the Global Cholera Vaccine Stockpile, arrived in Beira on Tuesday 2 April and, within 24 hours, began reaching people in need.

The vaccines were given to communities identified by the Government at highest risk – those without access to safe water and sanitation – in Beira, Dondo, Nhamatanda and Buzi districts.

Vaccine uptake has been very high and the campaign has been well received by the communities. Remaining vaccines will be used for other at-risk communities that were not reached by the initial campaign…

Humanitarian mechanism for vaccines used for first time in Europe to counter high prices

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Milestones :: Perspectives :: Research

Humanitarian mechanism for vaccines used for first time in Europe to counter high prices – MSF
:: A new humanitarian mechanism for vaccines has been used for the first time in Europe, allowing MSF to vaccinate refugee children in Greece at an affordable price.
:: Children were vaccinated with the pnemococcal conjugate vaccine, which is usually prohibitively expensive in Europe.
:: We urge for more vaccines to be included in the humanitarian mechanism, allowing children to be protected against more diseases.
Press Release 12 April 2019 Athens — Médecins Sans Frontières (MSF) has started vaccinating refugee children on the Greek islands of Chios, Samos and Lesvos using a programme set up to allow children in humanitarian emergencies to access the pneumococcal conjugate vaccine (PCV) at an affordable price.
This marks the first time the ‘Humanitarian Mechanism’ is used in a high-income country—the programme offers the vaccine at a special reduced price of about US$9 per child (for the three doses needed for full immunisation) for humanitarian use by civil society organisations and UN agencies. Pneumonia remains the single largest killer of children under five worldwide, and children living in precarious conditions—including those in refugee camps—are at particularly high risk.

Reverse global vaccine dissent

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Featured Journal Content

Science
12 April 2019 Vol 364, Issue 6436
http://www.sciencemag.org/current.dtl
EDITORIAL
Reverse global vaccine dissent
Heidi J. Larson1, William S. Schulz2
[See Milestones above for full text]
This year, the World Health Organization named vaccine hesitancy as one of the top 10 global health threats, alongside threats as grave as climate change, antimicrobial resistance, Ebola virus, and the next influenza pandemic. What happened? How did vaccine reluctance and refusal become such a major risk?

The concerns driving antivaccine sentiment today are diverse. For example, from 2003 to 2004, a vaccine boycott in Nigeria’s Kano State sparked the retransmission of polio across multiple countries as far as Indonesia. Rumors of vaccine contamination with antifertility agents contributed to distrust and reinforced the boycott, costing the Global Polio Eradication Initiative over U.S. $500 million to regain the progress that was lost. In Japan, vaccination against human papilloma virus plummeted to almost zero after young women complained of movement disorders and chronic pain, causing the government to suspend proactive recommendation of the vaccine nearly 6 years ago. Similar episodes occurred in Denmark, Ireland, and Colombia as YouTube videos of the girls’ symptoms spread anxiety, despite evidence of the vaccine’s safety.

The global surge in measles outbreaks has been exacerbated by vaccine refusers. In 2015, the measles strain that sparked the Disneyland outbreak came from visitors from the Philippines, infecting people who had refused vaccination. And in Indonesia, Muslim leaders issued a fatwa against a measles vaccine containing “haram” porcine compounds, while naturopathic “cupping” methods were promoted on Facebook as an alternative to vaccination. In 2018, a mix of political, religious, and alternative health antivaccine messages circulated on WhatsApp and Facebook in Southern India, disrupting a local measles-rubella vaccination campaign.

The phenomenon of vaccine dissent is not new. The pages of 18th-century London antivaccination pamphlets bristle with many of today’s memes, but these ideas now spread over unprecedented distances with remarkable speed, clustering in online neighborhoods of shared beliefs. This clustering can tear the protective fabric—the “herd (community) immunity”—that the majority of vaccine acceptors have woven. As the portion of the community that is vaccinated decreases, there is less protection for others who may be too young, unable, or choose not to be vaccinated. For some diseases, it only takes a small minority to disrupt the protective cover.

It is just over 20 years since British physician Andrew Wakefield sowed seeds of doubt about the safety of the MMR (measles, mumps, rubella) vaccine, suggesting a link between the vaccine and autism. Suspicions around the vaccine traveled globally, instilling anxiety among the most and least educated alike. The discredited Wakefield alone, though, cannot be blamed for today’s waves of vaccine discontent. He seeded a message on the eve of a technological revolution that disrupted business, politics, societies, and global health. The same year that Wakefield published his research, Google opened its doors. The launches of Facebook, YouTube, Twitter, and Instagram soon followed. These social media platforms have magnified individual sentiments that might have stayed local. Emotions are particularly contagious on social media, where personal narrative, images, and videos are shared easily.

Today’s tech companies are now being called to account for their role in spreading vaccine dissent. Last month, the American Medical Association urged the chief executives of key technology companies to “ensure that users have access to scientifically valid information on vaccinations.” But this is not merely an issue of correcting misinformation. There are social networks in which vaccine views and information are circulating in online communities, where vaccine choices become part of one’s overall identity.

To mitigate the globalization of vaccine dissent, while respecting legitimate sharing of concerns and genuine questions, a mix of relevant expertise is needed. Technology experts, social scientists, vaccine and public health experts, and ethicists must convene and take a hard look at the different roles each group has in addressing this challenge. It needs everyone’s attention.

Emergencies

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Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 10 April 2019
:: The report by the Director-General World Health Organization on the eradication of poliomyelitis is online, ahead of the 72nd World Health Assembly scheduled for May 2019. The report summarizes the remaining challenges to a polio-free world and presents the main elements of the new GPEI Polio Endgame Strategy 2019-2023.
:: An Independent Outbreak Response Assessment (OBRA) took place in Kinshasa, Democratic Republic of Congo on 5 April 2019. The OBRA was carried out to evaluate the quality of the response to the VDPV2 epidemic in the DRC and make the necessary recommendations to interrupt the transmission as soon as possible.
:: The Inaugural WHO Partners Forum convened in Stockholm, Sweden between 8-11 April 2019 with an aim to start a series of conversations with partners to help WHO meet the strategic goals as committed in the Thirteenth General Programme of Work (GPW13) for 2019-2023. The two-day meeting highlighted WHO’s impact on global health, encouraged support from WHO partners to enhance the quality and quantity of resources, and take stock of the innovations and lessons learned to strengthen partnerships and financing activities.  Read more here.

Summary of new viruses this week:
:: Pakistan – four WPV1-positive environmental samples

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 13 Apr 2019]

Bangladesh – Rohingya crisis
:: Bi‐weekly Situation Report 6 – 2 April 2019 pdf, 734kb

Cyclone Idai
:: Fast rollout of cholera vaccines for people in need in Mozambique 10 April 2019, Maputo
[See Milestones above for detail]

Democratic Republic of the Congo
:: Statement on the meeting of the International Health Regulations (2005) Emergency Committee for Ebola virus disease in the Democratic Republic of the Congo on 12th April 2019
12 April 2019 Statement Geneva
:: 36: Situation report on the Ebola outbreak in North Kivu 9 April 2019
:: DONs – Ebola virus disease – Democratic Republic of the Congo 11 April 2019
[See Ebola above for detail]

South Sudan
:: The Ministry of Health with support from WHO and partners investigates a cluster of unexplained deaths in Jie payam, Kapoeta East 8 April 2019

Myanmar – No new digest announcements identified
Nigeria – No new digest announcements identified
Somalia – No new digest announcements identified
Syrian Arab Republic – No new digest announcements identified
Yemen – No new digest announcements identified

::::::

WHO Grade 2 Emergencies [to 13 Apr 2019]

Brazil (in Portugese)
:: Brasil lança campanha de vacinação contra a influenza 10 de abril de 2019

Cameroon 
:: As internally displaced persons reach nearly 1 million in Ethiopia, WHO reinforces medical supplies 8 April 2019

Iraq
:: WHO sends shipment of kits and medical supplies to Missan governorate Baghdad 8 April 2019 – Responding to the needs of the Directorate of Health in Missan following the recent floods that hit the area, WHO, with the generous support of donors, sent a large consignment of emergency kits and medical supplies on 4 April to support the Directorate, 304 kilometres south east of Baghdad…

Libya
:: Amid Tripoli clashes, WHO rushes medical aid to the wounded in Libya Tripoli, 11 April – As clashes around Tripoli continued and the number of wounded rose to the hundreds, WHO reacted swiftly to provide field hospitals and ambulances with critically-needed life saving supplies.

occupied Palestinian territory 
:: Mobile clinic brings mammography services to remote communities in the West Bank
April 2019

Sudan
:: Sudan prepares to vaccinate over 11 million children against measles and polio 8 April 2019

Central African Republic – No new digest announcements identified
Ethiopia – No new digest announcements identified
MERS-CoV – No new digest announcements identified
Niger – No new digest announcements identified
Ukraine – No new digest announcements identified
Zimbabwe – No new digest announcements identified

::::::

WHO Grade 1 Emergencies [to 13 Apr 2019]
Afghanistan – No new digest announcements identified
Chad – No new digest announcements identified
Indonesia – Sulawesi earthquake 2018 – No new digest announcements identified
Kenya – No new digest announcements identified
Lao People’s Democratic Republic – No new digest announcements identified
Mali – No new digest announcements identified
Namibia – viral hepatitis – No new digest announcements identified
Peru – No new digest announcements identified
Philippines – Tyhpoon Mangkhut – No new digest announcements identified
Tanzania – No new digest announcements identified

::::::

WHO AFRO – Outbreaks and Emergencies Bulletin
Week 14: 01-07 April 2019
The WHO Health Emergencies Programme is currently monitoring 65 events in the region. This week’s edition covers key new and ongoing events, including:
:: Ebola virus disease outbreak in the Democratic Republic of the Congo
:: Cyclone Idai in Southern Africa (Mozambique, Zimbabwe and Malawi)
:: Humanitarian crisis in Cameroon
:: Humanitarian crisis in Ethiopia.

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.
CYCLONE IDAI
:: 12 April 2019  Mozambique: Cyclone Idai & Floods Situation Report No. 10
:: 12 April 2019  Zimbabwe: Floods Situation Report No. 2, As of 10 April 2019
:: 10 April 2019  Southern Africa: Cyclone Idai Snapshot (as of 9 April 2019)

WHO & Regional Offices [to 13 Apr 2019]

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WHO & Regional Offices [to 13 Apr 2019]
12 April 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 on 12th April 201
[See DR Congo – Ebola above for more detail]

9 April 2019 News release
Inaugural WHO Partners Forum launches new push for collaboration on global health
To meet the world’s most pressing health challenges, WHO, governments and global health leaders today called for improved partnerships and resourcing to support WHO’s mission to deliver care, services and protection for billions of people by 2023.
The inaugural two-day WHO Partners Forum opens Tuesday (9 April) in Stockholm and will be co-hosted with the Government of Sweden.
The meeting will result in a shared understanding of how to strengthen partnerships and improve effective financing of WHO, with an emphasis on predictability and flexibility.
…Other participants in the Inaugural WHO Partners Forum include leadership of the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Bill & Melinda Gates Foundation, International Federation of Red Cross and Red Crescent Societies and Gavi, the Vaccine Alliance.

::::::

Weekly Epidemiological Record, 5 April 2019, vol. 94, 14/15 (pp. 169–188)
:: Surveillance to track progress towards polio eradication worldwide, 2017–2018
:: Epidemic meningitis control in countries in the African meningitis belt, 2018

::::::

IVB Calls for consultants / proposals
11 April 2019
Estimating coverage of pipeline vaccine products and delivery technologies
Deadline for applications: 3 May 2019

11 April 2019
Consultant to assist with developing guidance materials, tools and strategies for the optimal use of new and under-utilized vaccinespdf, 401kb
Deadline for applications: 25 April 2019

::::::

WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: WHO and partners successfully vaccinate over 400,000 children against Measles in Borno State -Target 838,582 children more. 12 April 2019
:: Ghana announces the roll out of Malaria Vaccine Implementation Programme (MVIP)
11 April 2019
:: Mauritius launched its Seasonal Influenza Vaccination Programme for 2019 11 April 2019
:: Fast rollout of cholera vaccines for people in need in Mozambique 10 April 2019

WHO Region of the Americas PAHO
:: PHC 30-30-30, PAHO’s new Regional Compact on Primary Health Care for Universal Health(04/11/2019)

WHO South-East Asia Region SEARO
:: Quality primary care key to advancing universal health coverage: WHO SEAR/PR/1709
New Delhi, 5 April 2019: The World Health Organization today said quality healthcare services for people at the community level across all age groups, wherever they live and whenever they need them, without financial hardship, is fundamental to advancing universal health coverage for achieving health and well-being of evryone, everywhere…

WHO European Region EURO
:: Ukraine’s Affordable Medicines Programme shown to have significantly improved access to medicines12-04-2019
:: Member States urged to ramp up fight against noncommunicable diseases 12-04-2019
:: Small countries of the WHO European Region exchange ideas and experiences of equity, sustainable development 09-04-2019
:: WHO urges stronger action to reduce deaths from noncommunicable diseases in Europe by one third 09-04-2019

WHO Eastern Mediterranean Region EMRO
:: WHO Regional Director expresses solidarity with flood victims in Islamic Republic of Iran April 11, 2019
:: WHO sends medical aid to Libya amid clashes in Tripoli 11 April 2019
:: Polio vaccination campaign to vaccinate more than 6 million children in Iraq 11 April 2019
:: WHO airlifts medical supplies for flood response in Islamic Republic of Iran 10 April 2019

WHO Western Pacific Region
No new digest content identified.

Announcements

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Announcements

Paul G. Allen Frontiers Group [to 13 Apr 2019]
https://www.alleninstitute.org/news-press/
No new digest content identified.

BMGF – Gates Foundation [to 13 Apr 2019]
http://www.gatesfoundation.org/Media-Center/Press-Releases
No new digest content identified.

Bill & Melinda Gates Medical Research Institute [to 13 Apr 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 13 Apr 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 13 Apr 2019]
http://cepi.net/
No new digest content identified.

Clinton Health Access Initiative, Inc. (CHAI) [to 13 Apr 2019]
https://clintonhealthaccess.org/about/
No new digest content identified.

EDCTP [to 13 Apr 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
No new digest content identified.

Emory Vaccine Center [to 13 Apr 2019]
http://www.vaccines.emory.edu/
No new digest content identified.

European Medicines Agency [to 13 Apr 2019]
http://www.ema.europa.eu/ema/
News and press releases
No new digest content identified.

European Vaccine Initiative [to 13 Apr 2019]
http://www.euvaccine.eu/news-events
Latest news
New Project Manager vacancy at EVI
10 April 2019
EVI has an exciting new Project Manager position. Deadline for applications: 6th May 2019, 17:00 CET.

FDA [to 13 Apr 2019]
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
No new digest content identified.

Fondation Merieux [to 13 Apr 2019]
http://www.fondation-merieux.org/
No new digest content identified.

Gavi [to 13 Apr 2019]
https://www.gavi.org/https://www.gavi.org/https://www.gavi.org/
Latest News
No new digest content identified.

GHIT Fund [to 13 Apr 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 13 Apr 2019]
https://www.theglobalfund.org/en/news/
News
No new digest content identified.

Hilleman Laboratories [to 13 Apr 2019]
http://www.hillemanlabs.org/
No new digest content identified.

Human Vaccines Project [to 13 Apr 2019]
http://www.humanvaccinesproject.org/media/press-releases/
No new digest content identified.

IAVI [to 13 Apr 2019]
https://www.iavi.org/newsroom
No new digest content identified.

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

IFRC [to 13 Apr 2019]
http://media.ifrc.org/ifrc/news/press-releases/
Selected Press Releases, Announcements
Democratic Republic of the Congo
DR Congo: “Ebola is spreading faster, and many people are no longer seeking care”
Nairobi/Geneva, 11 April 2019 –The deadly Ebola outbreak in the Democratic Republic of the Congo is worsening as trust in the response effort falters, says the International Federation of Red Cross and Red Crescent Societies.
[See DR Congo – Ebola above for details]

IVAC [to 13 Apr 2019]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
No new digest content identified.

IVI [to 13 Apr 2019]
http://www.ivi.int/
IVI News & Announcements
[Undated]
Experts find evidence of underfunding in rheumatic heart disease research
IVI’s Director General, Dr. Jerome Kim was a member of the team of experts that looked at the underfunding of rheumatic heart disease (RHD) research.
RHD, a long-term consequence of Streptococcus pyogenes (Group A streptococcus, or GAS) infection, is estimated to affect at least 33 million people globally, causing approximately 300,000 deaths yearly. Despite this huge disease burden, RHD continues to receive relatively little attention from both researchers and the global health community. This translates into little funding, which limits the opportunities for innovations in disease control.
By comparing 16 major tropical diseases, using data from the Global Burden of Disease Study and funding from the G-FINDER database, the team established that RHD is the least-funded illness relative to its disease burden. The study was published in the Transactions of The Royal Society of Tropical Medicine and Hygiene on March 30, 2019 and can be accessed at: https://doi.org/10.1093/trstmh/trz014

JEE Alliance [to 13 Apr 2019]
https://www.jeealliance.org/
Selected News and Events
No new digest content identified.

MSF/Médecins Sans Frontières [to 13 Apr 2019]
http://www.msf.org/http://www.msf.org/http://www.msf.org/
Selected News; Project Updates, Reports [as presented on website]
Press Release 12 April 2019
Humanitarian mechanism for vaccines used for first time in Europe to counter high prices
[See Milestones above for detail]

Cyclone Idai & Southern Africa flooding
From emergency to recovery: Mozambique one month after Cycl…
Project Update 12 Apr 2019

Cyclone Idai & Southern Africa flooding
Chimanimani: A community in distress after Cyclone Idai
Project Update 10 Apr 2019

Child health
“Children with chronic diseases need our attention”
Interview 9 Apr 2019

NIH [to 13 Apr 2019]
http://www.nih.gov/news-events/news-releases
Monday, April 8, 2019
Scientists review influenza vaccine research progress and opportunities
What
In a new series of articles, experts in immunology, virology, epidemiology, and vaccine development detail efforts to improve seasonal influenza vaccines and ultimately develop a universal influenza vaccine. The 15 articles are part of a supplement in the April 15 issue of the Journal of Infectious Diseases. Researchers from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, and scientists supported by NIAID, are among the contributing authors. Barney S. Graham, M.D., Ph.D., deputy director of NIAID’s Vaccine Research Center (VRC), and Michelle C. Crank, M.D., head of the Translational Sciences Core in the VRC’s Viral Pathogenesis Laboratory, edited the supplement.
Articles
Articles in the supplement from NIAID experts include:
CI Paules and AS Fauci. Influenza vaccines: good, but we can do better. Journal of Infectious Diseases DOI: 10.1093/infdis/jiy633 (2019)
CM Saad-Roy et al. Dynamic perspectives on the search for a universal influenza vaccine. Journal of Infectious Diseases DOI: 10.1093/infdis/jiz044 (2019)
DM Morens and JK Taubenberger. Making universal influenza vaccines: lessons from the 1918 pandemic. Journal of Infectious Diseases DOI: 10.1093/infdis/jiy728 (2019)
MC Crank et al. Preparing for the next influenza pandemic: the development of a universal influenza vaccine. Journal of Infectious Diseases DOI: 10.1093/infdis/jiz043 (2019)
M Kanekiyo et al. New vaccine design and delivery technologies. Journal of Infectious Diseases DOI: 10.1093/infdis/jiy745 (2019)

April 9, 2019
NIH researchers make progress toward Epstein-Barr virus vaccine
What
A research team led by scientists from NIH’s National Institute of Allergy and Infectious Diseases (NIAID) has determined how several antibodies induced by Epstein-Barr virus (EBV), a herpesvirus that causes infectious mononucleosis and is associated with certain cancers, block infection of cells grown in the laboratory. They then used this information to develop novel vaccine candidates that, in animals, elicited potent anti-EBV antibody responses that blocked infection of cell types involved in EBV-associated cancers.
Currently, there is no licensed vaccine for EBV. The virus is associated with certain cancers (nasopharyngeal and gastric) of epithelial cells, which form the lining of the body’s surfaces, as well as Burkitt and Hodgkin lymphomas, which are cancers of the immune system’s B cells. Worldwide, about 200,000 cases of EBV-associated cancers occur annually, resulting in 140,000 deaths
Article
W Bu et al. Immunization with components of the viral fusion apparatus elicits antibodies that neutralize Epstein-Barr virus in B cells and epithelial cells. Immunity DOI: 10.1016/j.immuni.2019.03.010 (2019).

PATH [to 13 Apr 2019]
https://www.path.org/media-center/https://www.path.org/media-center/https://www.path.org/media-center/
April 10, 2019 by PATH
PATH applauds reintroduction of Global Health Security Act in U.S. Congress
Washington, D.C., April 10, 2019 — PATH applauds the bipartisan reintroduction of the Global Health Security Act in the U.S. Congress by Representatives Gerry Connolly (D-VA) and Steve Chabot (R-OH). The legislation aims to reaffirm U.S. government commitments to global health security that were made in the wake of the 2014-2016 West Africa Ebola crisis. As a leading funder and technical expert in the management of infectious disease outbreaks, the U.S. government plays a vital leadership role in today’s volatile world of more frequent and severe outbreaks…

April 8, 2019 by PATH
PATH CEO to step down at end of 2019; search underway for new CEO
Seattle, WA, March 8, 2019 – PATH announced today that President and CEO Steve Davis plans to step down at the end of 2019, after more than seven years leading the organization. Mr. Davis will continue to oversee PATH until a new CEO is in place, and will support the transition as a new leader comes on board. A global search will commence today to select his successor…

Sabin Vaccine Institute [to 13 Apr 2019]
http://www.sabin.org/updates/pressreleases
No new digest content identified.

UNAIDS [to 13 Apr 2019]
http://www.unaids.org/en
Selected Press Releases/Reports/Statements
12 April 2019
Malawi launches its health situation room

11 April 2019
Scaling up stigma-free services for women in Egypt

8 April 2019
Burkina Faso piloting PrEP

8 April 2019
HIV: a heavy burden on many cities

UNICEF  [to 13 Apr 2019]
https://www.unicef.org/media/press-releases
Selected Statements, Press Releases, Reports

Statement
Nearly half a million children in Tripoli at immediate risk
Statement by Abdel-Rahman Ghandour, UNICEF Special Representative in Libya
09/04/2019

Press release
175 million children are not enrolled in pre-primary education – UNICEF
UNICEF’s first-ever global report dedicated to early childhood education highlights a lack of investment in pre-primary by the majority of governments worldwide
08/04/2019

Press release
World Bank and UNICEF partner to promote education, skills and training for young people
World Bank to invest $1 billion to boost job prospects for young people in alignment with Generation Unlimited
09/04/2019

Press release
Climate change threatens lives and futures of over 19 million children in Bangladesh
UNICEF report calls for urgent action to keep children safe and mitigate impact on vital services

Vaccine Confidence Project [to 13 Apr 2019]
http://www.vaccineconfidence.org/
Editorial
Reverse global vaccine dissent
Larson HJ, Schulz WS. 2019 SCIENCE VOL 364 ISSUE 6436

Vaccine Education Center – Children’s Hospital of Philadelphia [to 13 Apr 2019]
http://www.chop.edu/centers-programs/vaccine-education-center
Published on Apr 10, 2019
Measles Outbreaks
In this video, Dr. Offit explains who may need measles vaccines during an outbreak. The accompanying article includes what you need to know about measles disease, the vaccine that helps to prevent it, and considerations for both vaccinated and unvaccinated individuals during an outbreak.

Wellcome Trust [to 13 Apr 2019]
https://wellcome.ac.uk/news
No new digest content identified.

The Wistar Institute [to 13 Apr 2019]
https://www.wistar.org/news/press-releases
No new digest content identified.

World Organisation for Animal Health (OIE) [to 13 Apr 2019]
http://www.oie.int/en/for-the-media/press-releases/2019/http://www.oie.int/en/for-the-media/press-releases/2019/http://www.oie.int/en/for-the-media/press-releases/2019/
No new digest content identified.

::::::

BIO [to 13 Apr 2019]
https://www.bio.org/insights/press-release
No new digest content identified.

DCVMN – Developing Country Vaccine Manufacturers Network [to 13 Apr 2019]
http://www.dcvmn.org/
No new digest content identified.

IFPMA [to 13 Apr 2019]
http://www.ifpma.org/resources/news-releases/
No new digest content identified.

PhRMA [to 13 Apr 2019]
http://www.phrma.org/press-room
No new digest content identified.

Industry Watch [to 13 Apr 2019]
:: Pfizer Announces Presentation of Data from a Phase 2 Study of its 20-Valent Pneumococcal Conjugate Vaccine Candidate Being Investigated for the Prevention of Invasive Disease and Pneumonia in Adults Aged 18 Years and Older
The U.S. FDA awarded Breakthrough Therapy Designation for this potential indication based on these Phase 2 data
The Biologics License Application is expected to be submitted to the U.S. FDA by the end of 2020, subject to the successful completion of Phase 3 studies
April 13, 2019

Journal Watch

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Journal Watch

   Vaccines and Global Health: The Week in Review continues its weekly scanning of key peer-reviewed journals to identify and cite articles, commentary and editorials, books reviews and other content supporting our focus on vaccine ethics and policy. Journal Watch is not intended to be exhaustive, but indicative of themes and issues the Center is actively tracking. We selectively provide full text of some editorial and comment articles that are specifically relevant to our work. Successful access to some of the links provided may require subscription or other access arrangement unique to the publisher.

If you would like to suggest other journal titles to include in this service, please contact David Curry at: david.r.curry@centerforvaccineethicsandpolicy.org

The Third Cognitive Revolution – The consequences and possibilities for biomedical research

Posted on by

EMBO Reports
Volume 20, Number 4 01 April 2019
http://embor.embopress.org/content/20/4?current-issue=y
Science & Society

Open Access
The Third Cognitive Revolution – The consequences and possibilities for biomedical research
The Third Cognitive Revolution poses particular challenges for biomedical research to adopt new knowledge. Interdisciplinary education at all levels would help to address these.
EMBO Reports (2019) 20: e47647
James B Hittner, Almira L Hoogesteijn, Jeanne M Fair, Marc HV van Regenmortel, Ariel L Rivas

Changing times for science and the public – Science journalists’ roles for the responsible communication of science

Posted on by

EMBO Reports
Volume 20, Number 4 01 April 2019
http://embor.embopress.org/content/20/4?current-issue=y
Science & Society

Changing times for science and the public – Science journalists’ roles for the responsible communication of science
The increasing number of corrections in the scientific record and the debate about reproducibility affect journalists’ reporting about science and thereby public opinion on scientists and research.
EMBO Reports (2019) 20: e47906
Suzana Liskauskas, Mariana D Ribeiro, Sonia MR Vasconcelos

Public health law coverage in support of the health-related sustainable development goals (SDGs) among 33 Western Pacific countries

Posted on by

Globalization and Health
http://www.globalizationandhealth.com/
[Accessed 24 Nov 2018]

Research
|   11 April 2019
Public health law coverage in support of the health-related sustainable development goals (SDGs) among 33 Western Pacific countries
A resilient health system is inevitable in attaining the health-related Sustainable Development Goals (SDGs). One way of strengthening health systems is improving the coverage of public health laws for better health governance. The aim of this study is to describe the public health law situation in the Western Pacific Region and analyse the association of public health law coverage with health-related SDGs statistics.
Authors: Yuri Lee and So Yoon Kim

Health Economics, Policy and Law SPECIAL ISSUE: Frontiers of Health Policy Research

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Health Economics, Policy and Law 
Volume 14 – Special Issue 2 – April 2019
https://www.cambridge.org/core/journals/health-economics-policy-and-law/latest-issue
SPECIAL ISSUE: Frontiers of Health Policy Research
If the enhancement of human freedom is both the main object and the primary means to development (Sen, 1999), then good individual and population health are both ends and means to development and freedom in all countries, regardless of their current ranking on the Human Development Index or other indexes on wealth, prosperity and well-being…
This special issue on the ‘frontiers in health policy research’ focuses attention on three distinct areas of inquiry. One set of papers analyses efforts to improve the quality of care and increase the value of care that health systems purchase. A second set of articles focuses on issues of health behaviour and social determinants of health. Finally, the third set of articles presents differing views on how to predict the adequacy of supply of medical professionals. The range of these articles illustrates, not only the exciting breadth of health policy research, but the degree to which scholars within this field are addressing issues of high importance to policy makers around the world. We think it is fair to claim that all of the articles address issues that are on the ‘frontier’ of health policy in the sense that they attempt to provide answers to questions that policy makers around the world are currently grappling with…

Humanitarian Exchange Magazine

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Humanitarian Exchange Magazine
Number 74, February 2019
https://odihpn.org/magazine/communication-community-engagement-humanitarian-response/https://odihpn.org/magazine/communication-community-engagement-humanitarian-response/https://odihpn.org/magazine/communication-community-engagement-humanitarian-response/
Communication and community engagement in humanitarian response
This edition of Humanitarian Exchange, co-edited with Charles-Antoine Hofmann from the UN Children’s Fund (UNICEF), focuses on communication and community engagement. Despite promising progress, coherent and coordinated information is still not provided systematically to affected communities, and humanitarian responses take insufficient account of the views and feedback of affected people. In 2017, UNICEF, the International Federation of Red Cross and Red Crescent Societies (IFRC), the UN Office for the Coordination of Humanitarian Affairs (OCHA) and other partners came together under the auspices of the Communicating with Disaster Affected Communities (CDAC) Network to establish the Communication and Community Engagement (CCE) initiative, which aims to organise a collective service for communications and community engagement. The articles in this edition take stock of efforts to implement this initiative.

Drawing on lessons from 23 Peer 2 Peer Support missions, Alice Chatelet and Meg Sattler look at what’s needed to integrate CCE into the humanitarian architecture. Viviane Lucia Fluck and Dustin Barter discuss the institutional and practical barriers to implementing community feedback mechanisms. Bronwyn Russel analyses the performance of the Nepal inter-agency common feedback project; Justus Olielo and Charles-Antoine Hofmann outline the challenges of establishing common services in Yemen; and Gil Francis Arevalo reports on community engagement in preparedness and response in the Philippines. Ian McClelland and Frances Hill discuss emerging findings from a strategic partnership in the Philippines between the Humanitarian Innovation Fund and the Asian Disaster Reduction and Response Network.

Charlotte Lancaster describes how call centres in Afghanistan and Iraq are enhancing two-way communication with crisis-affected people. Mia Marzotto from Translators without Borders reflects on the importance of language and translation in communication and community engagement, and Ombretta Baggio and colleagues report on efforts to bring community perspectives into decision-making during an Ebola outbreak in the Democratic Republic of Congo. Ayo Degett highlights emerging findings from a Danish Refugee Council project on participation in humanitarian settings, and Jeff Carmel and Nick van Praag report on the Listen Learn Act (LLA) project. Geneviève Cyvoct and Alexandra T. Warner write on an innovative common platform to track the views of affected people in Chad. The edition ends with an article by Stewart Davies on collective accountability in the response to the Central Sulawesi earthquake.

We need to monitor mortality to improve public health programs: here’s why and how to do it

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International Health
Volume 11, Issue 3, May 2019
http://inthealth.oxfordjournals.org/content/current

EDITORIAL
We need to monitor mortality to improve public health programs: here’s why and how to do it
Charles B Holmes; Izukanji Sikazwe; Elvin Geng
International Health, Volume 11, Issue 3, May 2019, Pages 159–162, https://doi.org/10.1093/inthealth/ihy039

The promise, problems and pitfalls of mass drug administration for malaria elimination: a qualitative study with scientists and policymakers

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International Health
Volume 11, Issue 3, May 2019
http://inthealth.oxfordjournals.org/content/current

ORIGINAL ARTICLES
The promise, problems and pitfalls of mass drug administration for malaria elimination: a qualitative study with scientists and policymakers
Nils Kaehler; Bipin Adhikari; Phaik Yeong Cheah; Nicholas P J Day; Daniel H Paris …
International Health, Volume 11, Issue 3, May 2019, Pages 166–176, https://doi.org/10.1093/inthealth/ihy079

Artificial intelligence in global health: a brave new world

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The Lancet
Apr 13, 2019  Volume 393Number 10180  p1477-1568, e37
https://www.thelancet.com/journals/lancet/issue/current

Editorial
Artificial intelligence in global health: a brave new world
The Lancet
Despite decades of progress in global health, many low and middle income countries are not reaching their health Sustainable Development Goals, creating a sense of urgency to prioritise health in resource-strained environments. The use of artificial intelligence (AI) is becoming increasingly attractive to the health-care industry. The accompanying enthusiasm remains awkwardly placed somewhere between aspiration and reality.

The Artificial Intelligence in Global Health report, published on April 1, 2019, was funded by the USAID’s Center for Innovation and Impact and the Rockefeller Foundation, in close coordination with the Bill & Melinda Gates Foundation. The report looks at 27 cases of AI use in health care and distils them into four key groupings—population health, patient and front-line health worker virtual assistants, and physician clinical decision support. It hypothesises how AI solutions could improve access, quality, and efficacy of global health systems while accounting for their technological maturity and feasibility. The identified challenges, the most highly volatile being privacy, ethics, and data ownership, are in line with recent debates on regulation and policy for AI technology implementation in health care. To mitigate these challenges, stakeholders would need to be held accountable and be transparent whether supporting innovation, interoperability, or capacity building. The report sets the framework for a proactive and strategic approach to accelerate the development of cost-effective use of AI in global health by investing in case-specific, systematic, and technology-related key areas.

This report outlines an aspirational yet pragmatic framework for better coordination for AI investment between donors, governments, and the private sector, while harnessing a futuristic vision—the digitisation of global health. Because the cost-effectiveness of these AI solutions has yet to be validated, the call for investments feels somewhat premature. Traditionally, the global health community is a late adopter of new technologies. Hence, it is imperative that they have an integral and active role in the dialogue early on. As this report rightfully stipulates, technology will get there, but will the world follow?

Efficacy and risk of harms of repeat ivermectin mass drug administrations for control of malaria (RIMDAMAL): a cluster-randomised trial

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The Lancet
Apr 13, 2019  Volume 393Number 10180  p1477-1568, e37
https://www.thelancet.com/journals/lancet/issue/current

Articles
Efficacy and risk of harms of repeat ivermectin mass drug administrations for control of malaria (RIMDAMAL): a cluster-randomised trial
Ivermectin is widely used in mass drug administrations for controlling neglected parasitic diseases, and can be lethal to malaria vectors that bite treated humans. Therefore, it could be a new tool to reduce plasmodium transmission. We tested the hypothesis that frequently repeated mass administrations of ivermectin to village residents would reduce clinical malaria episodes in children and would be well tolerated with minimal harms.
Brian D Foy,Haoues Alout, Jonathan A Seaman, Sangeeta Rao, Tereza Magalhaes, Martina Wade, Sunil Parikh, Dieudonné D Soma, André B Sagna, Florence Fournet, Hannah C Slater,
Roland Bougma, François Drabo, Abdoulaye Diabaté, A Gafar V Coulidiaty, Nöel Rouamba,
Roch K Dabiré,
Open Access

 

Shifting the Paradigm — Applying Universal Standards of Care to Ebola Virus Disease

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New England Journal of Medicine
April 11, 2019   Vol. 380 No. 15
http://www.nejm.org/toc/nejm/medical-journal

Perspective
Shifting the Paradigm — Applying Universal Standards of Care to Ebola Virus Disease
William A. Fischer, II, M.D., Ian Crozier, M.D., Daniel G. Bausch, M.D., Jean-Jacques Muyembe, M.D., Ph.D., Sabue Mulangu, M.D., Janet V. Diaz, M.D., Richard Kojan, M.D., David A. Wohl, M.D.,  and Shevin T. Jacob, M.D., M.P.H.
[Conclusion]
… It should no longer be acceptable to have two standards of care — one for patients in resource-constrained settings and another for those in countries where resources are more readily available. The ongoing response to EVD is teaching us that higher standards are no longer aspirational but are possible, and that during inevitable future outbreaks of EVD, no matter how remote the setting, we can provide people who are sick and suffering with the type of care that we would want to receive.

Broken drug markets in infectious diseases: Opportunities outside the private sector?

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PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 13 Apr 2019)

Viewpoints
Broken drug markets in infectious diseases: Opportunities outside the private sector?
Jonathan D. Alpern, Stephen J. Dunlop, William M. Stauffer
| published 11 Apr 2019 PLOS Neglected Tropical Diseases
https://doi.org/10.1371/journal.pntd.0007190
Author summary
A subset of anti-infective drugs are increasingly unavailable for patients in the United States due to pricing or withdrawal from the market. Timely market solutions are needed. We assert that solutions to ensure access to some essential anti-infective agents lie outside capital markets and that public-private partnerships may be the most viable solution.

 

 

 

Knowledge, attitudes and practices of hepatitis B prevention and immunization of pregnant women and mothers in northern Vietnam

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PLoS One
http://www.plosone.org/
[Accessed 13 Apr 2019]

Research Article
Knowledge, attitudes and practices of hepatitis B prevention and immunization of pregnant women and mothers in northern Vietnam
Thi T. Hang Pham, Thuy X. Le, Dong T. Nguyen, Chau M. Luu, Bac D. Truong, Phu D. Tran, Mehlika Toy, Samuel So
Research Article | published 10 Apr 2019 PLOS ONE
https://doi.org/10.1371/journal.pone.0208154

Willingness to pay for hepatitis B vaccination in Selangor, Malaysia: A cross-sectional household survey

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PLoS One
http://www.plosone.org/
[Accessed 13 Apr 2019]

Willingness to pay for hepatitis B vaccination in Selangor, Malaysia: A cross-sectional household survey
Yogambigai Rajamoorthy, Alias Radam, Niazlin Mohd Taib, Khalid Ab Rahim, Subramaniam Munusamy, Abram Luther Wagner, Mudatsir Mudatsir, Abdullatif Bazrbachi, Harapan Harapan
Research Article | published 09 Apr 2019 PLOS ONE
https://doi.org/10.1371/journal.pone.0215125

Community-based surveillance: A scoping review

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PLoS One
http://www.plosone.org/
[Accessed 13 Apr 2019]

Community-based surveillance: A scoping review
Involving community members in identifying and reporting health events for public health surveillance purposes, an approach commonly described as community-based surveillance (CBS), is increasingly gaining interest. We conducted a scoping review to list terms and definitions used to characterize CBS, to identify and summarize available guidance and recommendations, and to map information on past and existing in-country CBS systems.
José Guerra, Pratikshya Acharya, Céline Barnadas
Research Article | published 12 Apr 2019 PLOS ONE
https://doi.org/10.1371/journal.pone.0215278