Bulletin of the World Health Organization
Volume 97, Number 3, March 2019, 169-244
https://www.who.int/bulletin/volumes/97/3/en/

Connectivity of rapid-testing diagnostics and surveillance of infectious diseases
– Damien Ming, Timothy Rawson, Sorawat Sangkaew, Jesus Rodriguez-Manzano, Pantelis Georgiou & Alison Holmes
http://dx.doi.org/10.2471/BLT.18.219691
The World Health Organization (WHO) developed the ASSURED criteria to describe the ideal characteristics for point-of-care testing in low-resource settings: affordable, sensitive, specific, user-friendly, rapid and robust, equipment-free and deliverable.1 These standards describe. Over the last decade, widespread adoption of point-of-care testing has led to significant changes in clinical decision-making processes. The development of compact molecular diagnostics, such as the GeneXpert® platform, have enabled short turnaround times and allowed profiling of antimicrobial resistance. Although modern assays have increased operational requirements, many devices are robust and can be operated within communities with minimal training. These new generation of rapid tests have bypassed barriers to care and enabled treatment to take place independently from central facilities. Here we describe the importance of connectivity, the automatic capture and sharing of patient healthcare data from testing, in the adoption and roll-out of rapid testing…

Conflict and Health
http://www.conflictandhealth.com/
[Accessed 2 Mar 2019]

Research
|   26 February 2019
Cost-effectiveness of birth-dose hepatitis B vaccination among refugee populations in the African region: a series of case studies
Authors: Joseph Michael Reardon, Siobhán M. O’Connor, Joseph D. Njau, Eugene K. Lam, Catherine A. Staton and Susan T. Cookson

Contemporary Clinical Trials
Volume 78  Pages 1-146 (March 2019)
https://www.sciencedirect.com/journal/contemporary-clinical-trials/vol/78/suppl/C

Review article   Abstract only
Synthesis of researcher reported strategies to recruit adults of ethnic minorities to clinical trials in the United Kingdom: A systematic review
Yumna Masood, Peter Bower, Muhammad Wali Waheed, Gill Brown, Waquas Waheed
Pages 1-10

Ethics & Human Research
Volume 41, Issue 1  January-February 2019
https://onlinelibrary.wiley.com/journal/25782363

New Challenges and Unresolved Issues
The inaugural issue of Ethics & Human Research (E&HR) marks an exciting milestone in The Hastings Centers’ 40‐year history of publishing a journal that focuses on the ethical, regulatory, and policy issues related to research with humans. Like its predecessor, IRB: Ethics & Human Research, E&HR will publish conceptual and empirical analyses on a wide range of topics related to the human research enterprise.

The journal’s name change conveys to the global community of authors and readers that E&HR is not solely about issues related to institutional review boards (IRBs) in the United States. The title shift provides an opportunity to identify new ethical, policy, and regulatory challenges that rapid developments in science, medicine, and regulatory frameworks bring to the conduct and oversight of human subjects research in the United States and elsewhere. Along with publishing work that investigates new challenges, E&HR aims not only to draw attention to unresolved issues but also to broaden the scope of issues for investigation and analysis in the field of human research ethics. The pieces in this inaugural issue identify several new challenges and hint at some of the unresolved issues and broader topics that merit further attention.

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
Number 74,  February 2019
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.

International Journal of Infectious Diseases
February 2019 Volume 79, Supplement 1, p1-150   Open Access
https://www.ijidonline.com/issue/S1201-9712(18)X0014-9

International Meeting on Emerging Diseases and Surveillance (IMED) 2018 Abstracts; November 9-12, 2018; Vienna, Austria

Ebola in animals – our knowledge to date: assessing human exposure risks

1. von Dobschuetz, X.C.R. Roche, C. Pittiglio, L. Plee, S. Shadomy, E. Palamara, M. Bruni, L. Myers, E. Bonbon, C. Ingabire, C. Bebay, C. Biaou, L. Wiersma, A. Saidouni, P. Kone, M. Ndenge Hello, V. Bonkela Isa Nkoy, S. Morzaria, J. Pinto, E. Raizman, A. El Idrissi, G. Lamielle, J. Lubroth

Published in issue: February 2019

International Journal of Infectious Diseases
February 2019 Volume 79, Supplement 1, p1-150   Open Access
https://www.ijidonline.com/issue/S1201-9712(18)X0014-9
International Meeting on Emerging Diseases and Surveillance (IMED) 2018 Abstracts; November 9-12, 2018; Vienna, Austria

Global flu view: a platform to connect crowdsourced disease surveillance around the world
A.W. Crawley, D. Paolotti, C. Dalton, J. Brownstein, M. Smolinski
Published in issue: February 2019

International Journal of Infectious Diseases
February 2019 Volume 79, Supplement 1, p1-150   Open Access
https://www.ijidonline.com/issue/S1201-9712(18)X0014-9
International Meeting on Emerging Diseases and Surveillance (IMED) 2018 Abstracts; November 9-12, 2018; Vienna, Austria

Novel platform (wEB) to study flu virus evolution and predict vaccine efficacy

1. Paessler, V. Veljkovic

Published in issue: February 2019

International Journal of Infectious Diseases
February 2019 Volume 79, Supplement 1, p1-150   Open Access
https://www.ijidonline.com/issue/S1201-9712(18)X0014-9
International Meeting on Emerging Diseases and Surveillance (IMED) 2018 Abstracts; November 9-12, 2018; Vienna, Austria

The potential for international dissemination of emerging viral pathogens
J.M. Read, D. Cummings
Published in issue: February 2019

Journal of Adolescent Health
Volume 64, Issue 2, Supplement, S1-S140
https://www.jahonline.org/issue/S1054-139X(18)X0002-0

PSYCHOLOGICAL WELL-BEING: INTERNATIONAL TRANSCULTURAL PERSPECTIVES
06 March 2019 – 09 March 2019
Abstracts

48. HPV Vaccination Quality Improvement Effort At An Urban University: A Novel Setting To Increase Vaccination Uptake

Katheryn N.H. Schloss, Katharine J. Head, Stephen F. Wintermeyer, Philip Huynh, Cynthia L. Robbins
S26–S27
Published in issue: February 2019
 

Journal of Epidemiology & Community Health
March 2019 – Volume 73 – 3
https://jech.bmj.com/content/73/3

Social programmes and health
Government social assistance programmes are failing to protect the health of low-income populations: evidence from the USA and Canada (2003–2014) (15 November, 2018) Free
Faraz Vahid Shahidi, Odmaa Sod-Erdene, Chantel Ramraj, Vincent Hildebrand, Arjumand Siddiqi

Journal of Pediatrics
March 2019 Volume 206, p1-310
http://www.jpeds.com/current

Original Articles
Association of Provider Recommendation and Human Papillomavirus Vaccination Initiation among Male Adolescents Aged 13-17 Years—United States
Peng-Jun Lu, David Yankey, Benjamin Fredua, Alissa C. O’Halloran, Charnetta Williams, Lauri E. Markowitz, Laurie D. Elam-Evans
p33–41.e1
Published online: November 15, 2018

The Lancet
Mar 02, 2019  Volume 393Number 10174   p847-958
https://www.thelancet.com/journals/lancet/issue/current

Articles
Safety, tolerability, pharmacokinetics, and immunogenicity of the therapeutic monoclonal antibody mAb114 targeting Ebola virus glycoprotein (VRC 608): an open-label phase 1 study
Martin R Gaudinski, Emily E Coates, Laura Novik, Alicia Widge, Katherine V Houser, Eugeania Burch, LaSonji A Holman, Ingelise J Gordon, Grace L Chen, Cristina Carter, Martha Nason,
Sandra Sitar, Galina Yamshchikov, Nina Berkowitz, Charla Andrews, Sandra Vazquez, Carolyn Laurencot, John Misasi, Frank Arnold, Kevin Carlton, Heather Lawlor, Jason Gall, Robert T Bailer, Adrian McDermott, Edmund Capparelli, Richard A Koup, John R Mascola, Barney S Graham, Nancy J Sullivan, Julie E Ledgerwood on behalf of the VRC 608 Study team

Summary
Background
mAb114 is a single monoclonal antibody that targets the receptor-binding domain of Ebola virus glycoprotein, which prevents mortality in rhesus macaques treated after lethal challenge with Zaire ebolavirus. Here we present expedited data from VRC 608, a phase 1 study to evaluate mAb114 safety, tolerability, pharmacokinetics, and immunogenicity.
Methods
In this phase 1, dose-escalation study (VRC 608), conducted at the US National Institutes of Health (NIH) Clinical Center (Bethesda, MD, USA), healthy adults aged 18–60 years were sequentially enrolled into three mAb114 dose groups of 5 mg/kg, 25 mg/kg, and 50 mg/kg. The drug was given to participants intravenously over 30 min, and participants were followed for 24 weeks. Participants were only enrolled into increased dosing groups after interim safety assessments. Our primary endpoints were safety and tolerability, with pharmacokinetic and anti-drug antibody assessments as secondary endpoints. We assessed safety and tolerability in all participants who received study drug by monitoring clinical laboratory data and self-report and direct clinician assessment of prespecified infusion-site symptoms 3 days after infusion and systemic symptoms 7 days after infusion. Unsolicited adverse events were recorded for 28 days. Pharmacokinetic and anti-drug antibody assessments were completed in participants with at least 56 days of data. This trial is registered with ClinicalTrials.gov, number NCT03478891, and is active but no longer recruiting.
Findings
Between May 16, and Sept 27, 2018, 19 eligible individuals were enrolled. One (5%) participant was not infused because intravenous access was not adequate. Of 18 (95%) remaining participants, three (17%) were assigned to the 5 mg/kg group, five (28%) to the 25 mg/kg group, and ten (55%) to the 50 mg/kg group, each of whom received a single infusion of mAb114 at their assigned dose. All infusions were well tolerated and completed over 30–37 min with no infusion reactions or rate adjustments. All participants who received the study drug completed the safety assessment of local and systemic reactogenicity. No participants reported infusion-site symptoms. Systemic symptoms were all mild and present only in four (22%) of 18 participants across all dosing groups. No unsolicited adverse events occurred related to mAb114 and one serious adverse event occurred that was unrelated to mAb114. mAb114 has linear pharmacokinetics and a half-life of 24·2 days (standard error of measurement 0·2) with no evidence of anti-drug antibody development.
Interpretation
mAb114 was well tolerated, showed linear pharmacokinetics, and was easily and rapidly infused, making it an attractive and deployable option for treatment in outbreak settings.
Funding
Vaccine Research Center, US National Institute of Allergy and Infectious Diseases, and NIH.

The Lancet
Mar 02, 2019  Volume 393Number 10174   p847-958
https://www.thelancet.com/journals/lancet/issue/current

Seminar
Ebola virus disease
Denis Malvy, Anita K McElroy, Hilde de Clerck, Stephan Günther, Johan van Griensven
Summary
Ebolaviruses are pathogenic agents associated with a severe, potentially fatal, systemic disease in man and great apes. Four species of ebolaviruses have been identified in west or equatorial Africa. Once the more virulent forms enter the human population, transmission occurs primarily through contact with infected body fluids and can result in major epidemics in under-resourced settings. These viruses cause a disease characterised by systemic viral replication, immune suppression, abnormal inflammatory responses, major fluid and electrolyte losses, and high mortality. Despite recent progress on vaccines, and with no licensed prophylaxis or treatment available, case management is essentially supportive with management of severe multiple organ failure resulting from immune-mediated cell damage. The 2013–16 outbreak was classified by WHO as a Public Health Emergency of International Concern, which drew attention to the challenges of diseases caused by infections with ebolaviruses and questioned scientific, clinical, and societal preparation to handle future epidemics.

Lancet Global Health
Mar 2019  Volume 7Number 3e281-e384
http://www.thelancet.com/journals/langlo/issue/current

Articles
Classification of global measles cases in 2013–17 as due to policy or vaccination failure: a retrospective review of global surveillance data
Minal K Patel, Walter A Orenstein
Summary
Background
Despite improvements in reported coverage of measles-containing vaccine (MCV) and progress towards elimination of measles, 172 939 measles cases were reported worldwide in 2017. Questions have been raised about whether measles cases are due to failure of immunisation programmes or vaccine policy failure, which might require changes to vaccination schedules or number of doses.
Methods
This retrospective review of global surveillance data analysed case-based data for cases of measles occurring during 2013–17 submitted to WHO by its member states. Cases were classified as programmatically preventable (ie, did not receive the age-appropriate number of doses for that country) or programmatically non-preventable (ie, appropriately vaccinated as per national programme) on the basis of age at onset, year of birth, vaccination status, and eligibility for MCV doses in the country reporting the case. We grouped reasons why cases were non-preventable into four categories as follows: (1) received at least two doses of MCV; (2) too young for first dose; (3) received one dose but was too young to receive the second; or (4) was only eligible for one dose according to the national schedule. We analysed numbers and proportions of preventable and non-preventable cases of measles by region and year, reasons for non-preventable cases by year, preventable cases by age group, and preventable and non-preventable cases, including reasons for non-preventable cases, by measles elimination status of countries.
Findings
Between Jan 1, 2013, and Dec 31, 2017, 634 139 measles cases were reported; 7850 (1%) cases were excluded because they did not provide age at onset, so 626 289 were included in our analysis. 191 333 (31%) of these cases had unknown vaccination status. 275 754 (63%) of the 434 956 cases with available vaccination data were categorised as programmatically preventable, 213 461 (77%) of whom were aged 1 year to less than 15 years. 156 384 (36%) cases were categorised as non-preventable, of whom 38 677 (25%) were two-dose vaccine recipients, 74 438 (48%) were too young to receive their first MCV dose, 11 914 (8%) received their first dose and were too young to receive their second dose, and 31 355 (20%), mostly in the Africa region, were non-preventable because they were only eligible for one dose on the basis of the national immunisation programme.
Interpretation
Most measles cases during 2013–17 were programmatically preventable, highlighting the need for improving the effectiveness of immunisation programmes that already exist. Individual countries should do similar analyses to establish the changes needed in their country to decrease numbers of measles cases.

Funding
None.

Lancet Global Health
Mar 2019  Volume 7Number 3e281-e384
http://www.thelancet.com/journals/langlo/issue/current

Comment
Measles vaccination: no time to rest
Alessia Melegaro

Lancet Global Health
Mar 2019  Volume 7Number 3e281-e384
http://www.thelancet.com/journals/langlo/issue/current

Trends in infant mortality in Venezuela between 1985 and 2016: a systematic analysis of demographic data
Jenny García, Gerardo Correa, Brenda Rousset
Summary
Background
Between the 1950s and 2000, Venezuela showed one of the most substantial improvements in infant mortality rates in Latin America. However, the recent economic crisis alongside an increase in infectious and parasitic diseases might be reversing previous patterns. Because no official updated mortality statistics have been published since 2013, the effect of these recent events has been difficult to assess accurately. We therefore aimed to estimate infant mortality rate trends and report the effect of the crisis.
Methods
We estimated infant mortality rates using direct methods (ie, death counts from Venezuelan Ministry of Health via yearbooks and notifiable diseases bulletins, and birth records published by the UN Economic Commission for Latin America and the Caribbean and the Venezuelan National Institute of Statistics) and indirect methods (using census data and a Living Conditions Survey ENCOVI 2016). We shaped yearly estimations using a semiparametric regression model, specifically a P-Spline model with a cubic thin plate base. The primary objective was to estimate infant mortality rate trends from 1985 to 2016.
Findings
Around 2009, the long-term decline in infant mortality rate stopped, and a new pattern of increase was observed. The infant mortality rate reached 21·1 deaths per 1000 livebirths (90% CI −17·8 to 24·3) in 2016, almost 1·4 times the rate of 2008 (15·0, −14·0 to 16·1). This increase represents a huge setback on previous achievements in reducing infant mortality.
Interpretation
Our conservative estimation indicates that Venezuela is in the throes of a humanitarian crisis. The increase in infant mortality rate in 2016 compared with 2008 takes the country back to the level observed at the end of the 1990s, wiping out 18 years of expected progress, and leaves the Venezuelan Government far from achieving the target of nine deaths per 1000 livebirths stated in the UN Millennium Development Goals.

Funding
None.

Lancet Global Health
Mar 2019  Volume 7Number 3e281-e384
http://www.thelancet.com/journals/langlo/issue/current

Effect of 10-valent pneumococcal conjugate vaccine on the incidence of radiologically-confirmed pneumonia and clinically-defined pneumonia in Kenyan children: an interrupted time-series analysis
Micah Silaba, Michael Ooko, Christian Bottomley, Joyce Sande, Rachel Benamore, Kate Park,
James Ignas, Kathryn Maitland, Neema Mturi, Anne Makumi, Mark Otiende, Stanley Kagwanja,
Sylvester Safari, Victor Ochola, Tahreni Bwanaali, Evasius Bauni, Fergus Gleeson, Maria Deloria Knoll, Ifedayo Adetifa, Kevin Marsh, Thomas N Williams, Tatu Kamau, Shahnaaz Sharif, Orin S Levine, Laura L Hammitt, J Anthony G Scott

Lancet Infectious Diseases
Mar 2019  Volume 19Number 3p217-338, e63-e108
http://www.thelancet.com/journals/laninf/issue/current

Series
Tuberculosis transmission in HIV-endemic settings
Advances in the understanding of Mycobacterium tuberculosis transmission in HIV-endemic settings
Julian S Peters, Jason R Andrews, Mark Hatherill, Sabine Hermans, Leonardo Martinez,Erwin Schurr, Yuri van der Heijden, Robin Wood, Roxana Rustomjee, Bavesh D Kana

Lancet Infectious Diseases
Mar 2019  Volume 19Number 3p217-338, e63-e108
http://www.thelancet.com/journals/laninf/issue/current

Tuberculosis transmission in HIV-endemic settings
Transmission of drug-resistant tuberculosis in HIV-endemic settings
Palwasha Y Khan, Tom A Yates, Muhammad Osman, Robin M Warren, Yuri van der Heijden, Nesri Padayatchi, Edward A Nardell, David Moore, Barun Mathema,  Neel Gandhi, Vegard Eldholm,Keertan Dheda, Anneke C Hesseling, Valerie Mizrahi, Roxana Rustomjee, Alexander Pym

Lancet Infectious Diseases
Mar 2019  Volume 19Number 3p217-338, e63-e108
http://www.thelancet.com/journals/laninf/issue/current

Tuberculosis transmission in HIV-endemic settings
Spatially targeted screening to reduce tuberculosis transmission in high-incidence settings
Patrick G T Cudahy, Jason R Andrews, Alyssa Bilinski, David W Dowdy, Barun Mathema,
Nicolas A Menzies, Joshua A Salomon, Sourya Shrestha, Ted Cohen

Lancet Infectious Diseases
Mar 2019  Volume 19Number 3p217-338, e63-e108
http://www.thelancet.com/journals/laninf/issue/current

Review
Tuberculosis susceptibility and protection in children
Robindra Basu Roy, Elizabeth Whittaker, James A Seddon, Beate Kampmann

Lancet Respiratory Medicine
Mar 2019  Volume 7Number 3p187-282, e10-e12
http://www.thelancet.com/journals/lanres/issue/current

Comment
The way forward for tuberculosis vaccines
Richard G White, Willem A Hanekom, Johan Vekemans, Rebecca C Harris
Tuberculosis is now the largest single-pathogen cause of adult mortality globally; more than 10 million incident cases of the disease occur worldwide every year. In 2018, global tuberculosis prevention, diagnosis, and treatment efforts were estimated to cost US$10·4 billion. With such a high global burden, and a current average annual decline in incidence of only 1·8%, new efficacious vaccines are urgently needed to accelerate progress towards the WHO End TB and elimination goals.

Nature 
Volume 566 Issue 7745, 28 February 2019
http://www.nature.com/nature/current_issue.html

World View | 26 February 2019
Why were scientists silent over gene-edited babies?
To be successful as researchers, we must be able to think through the impacts of our work on society and speak up when necessary, says Natalie Kofler.

Nature Genetics
Volume 51 Issue 3, March 2019
https://www.nature.com/ng/

Editorial | 28 February 2019
Brave new dialogue
The development of CRISPR–Cas technology and its applications in biomedical research have generated much excitement. If fully realized, this technology has the potential to help treat or prevent severe diseases. However, these tools also carry considerable risk if improperly used. The scientific community must promote constructive dialogue among its members and within society at large to ensure that research on genome editing is conducted responsibly.

Pediatrics
March 2019, VOLUME 143 / ISSUE 3
https://pediatrics.aappublications.org/content/143/3?current-issue=y
From the American Academy of Pediatrics

Open Access
Recommended Childhood and Adolescent Immunization Schedules: United States, 2019
COMMITTEE ON INFECTIOUS DISEASES
Pediatrics Mar 2019, 143 (3) e20190065; DOI: 10.1542/peds.2019-0065

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 2 Mar 2019)

Research Article
A multi-country study of the economic burden of dengue fever based on patient-specific field surveys in Burkina Faso, Kenya, and Cambodia
Jung-Seok Lee , Vittal Mogasale , Jacqueline K. Lim , Sowath Ly , Kang Sung Lee , Sopheak Sorn , Esther Andia , Mabel Carabali , Suk Namkung , Sl-Ki Lim , Valéry Ridde , Sammy M. Njenga , Seydou Yaro , In-Kyu Yoon
Abstract
Background
Dengue fever is a rapidly growing public health problem in many parts of the tropics and sub-tropics in the world. While there are existing studies on the economic burden of dengue fever in some of dengue-endemic countries, cost components are often not standardized, making cross-country comparisons challenging. Furthermore, no such studies have been available in Africa.
Methods/Principal findings
A patient-specific survey questionnaire was developed and applied in Burkina Faso, Kenya, and Cambodia in a standardized format. Multiple interviews were carried out in order to capture the entire cost incurred during the period of dengue illness. Both private (patient’s out-of-pocket) and public (non-private) expenditure were accessed to understand how the economic burden of dengue is distributed between private and non-private payers.
A substantial number of dengue-confirmed patients were identified in all three countries: 414 in Burkina Faso, 149 in Kenya, and 254 in Cambodia. The average cost of illness for dengue fever was $26 (95% CI $23-$29) and $134 (95% CI $119-$152) per inpatient in Burkina Faso and Cambodia, respectively. In the case of outpatients, the average economic burden per episode was $13 (95% CI $23-$29) in Burkina Faso and $23 (95% CI $19-$28) in Kenya. Compared to Cambodia, public contributions were trivial in Burkina Faso and Kenya, reflecting that a majority of medical costs had to be directly borne by patients in the two countries.
Conclusions/Significance
The cost of illness for dengue fever is significant in the three countries. In particular, the current study sheds light on the potential economic burden of the disease in Burkina Faso and Kenya where existing evidence is sparse in the context of dengue fever, and underscores the need to achieve Universal Health Coverage. Given the availability of the current (CYD-TDV) and second-generation dengue vaccines in the near future, our study outcomes can be used to guide decision makers in setting health policy priorities.

Author summary
Dengue fever is a major public health concern in many parts of South-East Asia and South America. In addition to countries where dengue has been highly prevalent for many years, there is a growing concern on the undocumented burden of dengue in Africa. Following the successful execution of the first-round economic burden study in Vietnam, Thailand, and Colombia by the Dengue Vaccine Initiative, the second-round economic burden study was implemented in Burkina Faso, Kenya and Cambodia using the same standardized methodology. In particular, the second-round study targeted GAVI eligible countries for future vaccine introductions and included two African countries where the burden of dengue was relatively unknown. Our study outcomes show that the economic burden of dengue fever is significant in all three countries. The dengue vaccination era began in 2016 with the first dengue vaccine (CYD-TDV) although its public use should be carefully determined due to the safety concerns related to the vaccine. Considering that there are other second-generation dengue vaccines in development, the current study outcomes provide an important step to estimate the economic benefits of vaccination in the three countries.

Qualitative Health Research
Volume 29 Issue 4, March 2019
http://qhr.sagepub.com/content/current

Research Articles
“I Knew I Could Make a Difference”: Motivations and Barriers to Engagement in Fighting the West African Ebola Outbreak Among U.S.-Based Health Professionals
Alexandra Greenberg, Georgia J. Michlig, Elizabeth Larson, Ilona Varallyay, Karen Chang, Blessing Enobun, Ellen Schenk, Benjamin Whong, Pamela J. Surkan, Caitlin E. Kennedy, Steven A. Harvey
First Published April 21, 2018; pp. 522–532

Science Translational Medicine
20 February 2019  Vol 11, Issue 480
http://stm.sciencemag.org/

Genome Editing 
Both sides of the CRISPR coin
By Steven M. Jay
Science Translational Medicine27 Feb 2019 Full Access
Examination of the long-term effects of genome editing reveals potential and perils.

Tropical Medicine & International Health
Volume 24, Issue 3  Pages: i-iv, 259-378 March 2019
https://onlinelibrary.wiley.com/toc/13653156/current

Reviews
Open Access
The willingness to participate in biomedical research involving human beings in low‐ and middle‐income countries: a systematic review
Joyce L. Browne, Connie O. Rees, Johannes J. M. van Delden, Irene Agyepong, Diederick E. Grobbee, Ama Edwin, Kerstin Klipstein‐Grobusch, Rieke van der Graaf
Pages: 264-279
First Published: 18 December 2018
Abstract
Objectives
To systematically review reasons for the willingness to participate in biomedical human subjects research in low‐ and middle‐income countries (LMICs).
Methods
Five databases were systematically searched for articles published between 2000 and 2017 containing the domain of ‘human subjects research’ in ‘LMICs’ and determinant ‘reasons for (non)participation’. Reasons mentioned were extracted, ranked and results narratively described.
Results
Ninety‐four articles were included, 44 qualitative and 50 mixed‐methods studies. Altruism, personal health benefits, access to health care, monetary benefit, knowledge, social support and trust were the most important reasons for participation. Primary reasons for non‐participation were safety concerns, inconvenience, stigmatisation, lack of social support, confidentiality concerns, physical pain, efficacy concerns and distrust. Stigmatisation was a major concern in relation to HIV research. Reasons were similar across different regions, gender, non‐patient or patient participants and real or hypothetical study designs.
Conclusions
Addressing factors that affect (non‐)participation in the planning process and during the conduct of research may enhance voluntary consent to participation and reduce barriers for potential participants.

Vaccines — Open Access Journal
http://www.mdpi.com/journal/vaccines
(Accessed 2 Mar 2019)

Open Access Article
Analysis of State-Specific Differences in Childhood Vaccination Coverage in Rural India
by Nijika Shrivastwa, Abram L. Wagner and Matthew L. Boulton
Vaccines 2019, 7(1), 24; https://doi.org/10.3390/vaccines7010024 – 24 February 2019
Abstract
There is little research on state-level differences in child health outcomes in India. The aim of this study was to identify state-level characteristics that relate to childhood immunizations. Most state-level characteristics came from the 2011 Indian Census. Individual-level data and other state-level characteristics were obtained from the 2007–2008 District Level Household and Facility Survey. Predictors of full vaccination were assessed with logistic regression models. Among 86,882 children 12–36 months, 53.2% were fully vaccinated. Children living in bigger households (≥7 members), born in non-institutional settings, and female had lower odds of complete vaccination. Individuals living in states in the mid-range of poverty had lower odds of full vaccination compared to those in lower or higher poverty states (3rd vs. 1st quintile: odds ratio [OR]: 0.36, 95% confidence interval [CI]: 0.30, 0.42). Greater average population per primary health center was associated with decreased odds of full vaccination (5th vs. 1st quintile: OR: 0.37, 95% CI: 0.30, 0.47). Vaccination coverage in India can be explained by a complex interplay of individual- and state-level factors. Solutions to increasing vaccination must be multisectoral and acknowledge the cultural and socio-economic diversity that influences an individual child’s vaccination coverage along with within-state disparities

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

Frontiers in Public Health
https://www.frontiersin.org/journals/public-health#
Accepted on 25 February 2019
Articles
Vaccine production in Africa: a feasible business model for capacity building and sustainable new vaccine introduction
G Makenga, S Bonoli, E Montomoli, T Carrier…
Abstract
Africa has the highest incidence of mortality caused by infectious diseases, and remarkably does not have the capacity to manufacture vaccines that are essential to reduce mortality, improving life expectancy, and promoting economic growth. GAVI has significantly helped introduction of new vaccines in Africa but its sustainability is questionable, and new vaccines introduction post-graduation is rare. Conversely, Africa with its high population and economy growth is an increasing potential market for vaccines. This study aimed to investigate how investment for vaccine production in Africa could be triggered and in which way it could be affordable to most African governments or investors.

The investigation was based on a literature review and supplemented by online questionnaires directed to global vaccine stakeholders, African governments and regulatory authorities, and also in-depth interviews with experts in manufacturing capacity implementation and regulatory capacity building in Africa to complement the study. We developed business plan scenarios including facility costs calculations and a possible investment plan based on expert opinions and publicly available information from pertinent sources.

We saw that, governments in Africa, show interest in vaccine production establishments but only with external support for investment. The common regulatory functionality gap was the quality control laboratories to test vaccine lots before regulatory release. The global vaccine stakeholders showed less preference in investment for vaccine production establishment in Africa. The diverse political ambitions among African governments make it difficult to predict and access the market, a prerequisite for competitive production. A feasible solution could be a small production facility that would use technologies with high yield at low costs of goods to cover the regional needs. A respective antigen production facility is estimated to cost USD 25 Million, an affordable dimension for investors or interested African governments.

Attractiveness for the African market is deemed to be high when targeting diseases almost exclusively for Africa (e.g. malaria or invasive non-typhoidal salmonella). With a smart five-years tangible implementation plan, marketing agreements within existing regional collaborations and with a strong political will, an African government alone or together with an investor could convince global vaccine stakeholders and investors to support

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 Associated Press
https://apnews.com/
Accessed 2 Mar 2019
Amid measles outbreak, Ore. eyes vaccine requirements
By SARAH ZIMMERMAN   3/1/2019yesterday
 
 
The Atlantic
http://www.theatlantic.com/magazine/
Accessed 2 Mar 2019
Health
The Small, Small World of Facebook’s Anti-vaxxers
Squelching vaccine misinformation might be easier than the platform makes it seem.
Alexis C. Madrigal   Feb 27, 2019
…While there is no dearth of posts related to vaccines, the top 50 Facebook pages ranked by the number of public posts they made about vaccines generated nearly half (46 percent) of the top 10,000 posts for or against vaccinations, as well as 38 percent of the total likes on those posts, from January 2016 to February of this year. The distribution is heavy on the top, particularly for the anti-vax position. Just seven anti-vax pages generated nearly 20 percent of the top 10,000 vaccination posts in this time period: Natural News, Dr. Tenpenny on Vaccines and Current Events, Stop Mandatory Vaccination, March Against Monsanto, J. B. Handley, Erin at Health Nut News, and Revolution for Choice…
 
 
BBC
http://www.bbc.co.uk/
Accessed 2 Mar 2019
Published Date
1 Mar 2019
Vaccination deniers gaining traction, NHS boss warns
The head of NHS England has warned that “vaccination deniers” are gaining traction on social media as part of a “fake news” movement.
Simon Stevens said parents were seeing “fake messages” online about vaccines, which was making it harder to “win the public argument” on vaccination.
NHS England is considering what action can be taken to stop such messages spreading, Mr Stevens said…
 
 
The Economist
http://www.economist.com/
Accessed 2 Mar 2019
[No new, unique, relevant content]
 
 
Financial Times
http://www.ft.com/home/uk
Accessed 2 Mar 2019
[No new, unique, relevant content]
 
 
Forbes
http://www.forbes.com/
Accessed 2 Mar 2019
Feb 25, 2019
Is YouTube Right to Demonetize Anti-Vax Channels?
YouTube’s censorship of anti-vaccine videos is counterproductive. Here’s why.
By Mason Sands  Contributor
Feb 25, 2019
65 Measles Cases In Washington, Yet Arizona May Expand Vaccine Exemptions
With at least 65 cases in Washington measles outbreak, the state of Washington legislature considering reducing vaccine exemptions, and over 900 people dying from a Madagascar measles outbreak, what is the Arizona state legislature doing?
By Bruce Y. Lee Contributor
 
 
Foreign Affairs
http://www.foreignaffairs.com/
Accessed 2 Mar 2019
[No new, unique, relevant content]
 
 
Foreign Policy
http://foreignpolicy.com/
Accessed 2 Mar 2019
[No new, unique, relevant content]
 
 
The Guardian
http://www.guardiannews.com/
Accessed 2 Mar 2019
Vaccines and immunisation
Japan battles worst measles outbreak in a decade | World news …
Japan’s health ministry urged people to get vaccinated immediately and hospitals and other medical facilities to take preventive measures.
 
 
New Yorker
http://www.newyorker.com/
Accessed 2 Mar 2019
Our Columnists
Why Measles Is a Quintessential Political Issue of Our Time
Measles is contagious and potentially deadly—but also preventable through vaccination. The immunization debate around it is one that turns on the conflict between facts and lies.
By Masha Gessen
2 March 2019
 
 
New York Times
http://www.nytimes.com/
Accessed 2 Mar 2019
March 1, 2019
U.S.
Measles Outbreak in Pacific Northwest About Half of US Cases
The focus on measles in the Pacific Northwest intensified Friday as public health officials in Oregon announced a new case of the highly contagious disease unrelated to an ongoing outbreak in Washington state that’s sickened 68 people so far.

March 1, 2019
Europe
Sanofi ‘Strongly Disagrees’ With Philippines Prosecutors Over Its Dengue Vaccine
Sanofi on Friday said it “strongly” disagreed with the findings made against the company and six of its employees in the Philippines over its controversial dengue vaccine.

March 1, 2019
Europe
Philippines to Charge Officials of Sanofi, Government Over Dengue Vaccine
The Philippine Department of Justice on Friday said it had found probable cause to indict officials from French drugmaker Sanofi and former and current Philippine health officials over 10 deaths it said were linked to use of a dengue vaccine.
 
 
Wall Street Journal
http://online.wsj.com/home-page?_wsjregion=na,us&_homepage=/home/us
Accessed 2 Mar 2019
Schools
Measles Cases in Brooklyn’s Orthodox Jewish Communities Rise
By Leslie Brody, Melanie Grayce West
Feb. 28, 2019 6:42 pm ET
The measles outbreak in Brooklyn’s Orthodox Jewish community continues to grow, New York City health officials said, even after the city ordered schools to bar unvaccinated students in some ZIP Codes from attending.
 
 
Washington Post
http://www.washingtonpost.com/
Accessed 2 Mar 2019
‘Something is in those vaccines’: Lawmaker says mandatory measles shots are ‘Communist’
Timothy Bella · Mar 1, 2019
Amid a surging measles outbreak in the United States that has grown to about 160 cases in 10 states, Arizona’s legislature recently passed bills allowing for a religious exemption for required vaccination shots — a move that public health advocates warn could lead to fewer immunizations. Republican Gov. Doug Ducey, who describes himself as “pro-vaccination” and “anti-measles,” suggested Wednesday he would strike down those proposals.
But one state lawmaker begged to differ with the governor. Republican State Rep. Kelly Townsend, a five-term state representative who is no stranger to making controversial and befuddling statements on social media, took to Facebook on Thursday to bemoan that Arizona was “prepared to give up our liberty, the very sovereignty of our body, because of measles.”
Why? Because doing so would be “Communist.”
“I read yesterday that the idea is being floated that if not enough people get vaccinated, then we are going to force them to,” Townsend wrote on Thursday morning. “The idea that we force someone to give up their liberty for the sake of the collective is not based on American values but rather, Communist.”…

Think Tanks et al
 
Brookings
http://www.brookings.edu/
Accessed 2 Mar 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 2 Mar 2019
[No new relevant content]

Council on Foreign Relations
http://www.cfr.org/
Accessed 2 Mar 2019
[No new relevant content]

Kaiser Family Foundation
https://www.kff.org/search/?post_type=press-release
Accessed 2 Mar 2019
[No new relevant content]

Milestones :: Perspectives

Yemen
 
Nationwide measles and rubella immunization campaign reaches 11.6 million children in Yemen

21 February 2019 – In collaboration with local health authorities, WHO and UNICEF have concluded a nationwide measles and rubella vaccination campaign in Yemen reaching more than 11.6 million (90%) children aged 6 months–16 years across the country.

WHO, with the support of Saudi Arabia, United Arab Emirates, Kuwait and Gavi, the Vaccine Alliance, contributed to the campaign through the provision of vaccines, fuel, training, deployment of health workers and supervisors, as well as raising awareness among communities about ways to protect themselves against these diseases.

Dhamar, Mareb and Sana’a governorates have reported over 100% coverage due to a large number of internally displaced persons coming from other governorates. The campaign continued for an additional 3 days in districts where low coverage was reported.

Despite the challenging conditions, WHO teams and health workers were able to reach high-risk areas, IDP camps and marginalized communities with awareness-raising activities and vaccination.

Milestones :: Perspectives
Vaccine “Hesitancy”
 

The Guardian
http://www.guardiannews.com/
Accessed 23 Feb 2019
Vaccines and immunisation

Opinion
The Guardian view on vaccination: a duty of public health
Editorial
The anti-vaxx movement arises from mistrust but threatens the physical health of society
Sun 17 Feb 2019
The latest World Health Organization report on measles epidemics shows that cases jumped by 50% last year. In one of the poorest and least connected countries in the world, Madagascar, nearly a thousand children are reported to have died after a measles outbreak in the countryside. The real figure is likely to be much higher, because of difficulties of reporting. An emergency programme of vaccination seems to have contained that epidemic for the moment but it is a reminder of how devastating the disease can be against unprepared populations. In the rich world, meanwhile, previously prepared populations are having their defences dismantled from the inside.

The discovery of ad campaigns against vaccination on Facebook that are carefully targeted at pregnant women is unusually worrying. It shows how the widespread availability of sophisticated advertising techniques is going to give considerable power to people who previously had no way of getting their message across to large numbers. In the most recent US campaigns against vaccination, 147 different advertisements have been used and some viewed more than 5m times. There is an arms race under way, whether we like it or not.

Facebook and YouTube/Google must take some responsibility for the consequences of their profit-seeking algorithms. Neither company should be profiting from an activity so detrimental to public health as anti-vaccination propaganda. Both ban tobacco advertising but permit propagandising against vaccination, even from people with a commercial interest in quack remedies. Yet the withholding of children from vaccination might be considered even more anti-social than tobacco smoking. The teenager who smokes puts their own body at risk more than that of anyone else, whereas the parent who refuses a child vaccination is unlikely to harm their own health at all: only that of their offspring. If this were just a decision to allow their own children to run a small risk, it might be defended. But it is not. Because of the way that herd immunity works, such parents are threatening other people’s children too, some of whom cannot for medical reasons be vaccinated.

In some western countries threatened by campaigns against vaccination there are rules in place to stop unvaccinated children from attending school. This protects communities and sends a powerful signal to the wider world, but it is a drastic step. It risks punishing children twice for their parents’ faults.

If parents trusted the state, the medical profession, or the gatekeepers of the media, this problem would not arise. The roots of the protests against vaccination lie for a large part in the inarticulate but powerful sense that modern life is dehumanising, and that powerful forces are conspiring to turn us into obedient robots and to squeeze out our humanity. When power is no longer trusted, it does not matter that it telling the truth. Yet the distrust of anti-vaxxer parents is a threat to everyone’s children and not just their own.

One step is obviously a campaign of public education by figures who are trusted by the target audience in the way that their friends on social media are. If public health campaigns were run with half the ruthless ingenuity displayed by betting companies, we might be better off. But not everything can be left to governments and large companies. Parents who care about their own children’s health must be prepared to take the argument to the playgrounds and on to social media as well.

Milestones :: Perspectives

Science         
22 February 2019  Vol 363, Issue 6429
http://www.sciencemag.org/current.dtl

Editorial
The law and vaccine resistance
By Dorit Rubinstein Reiss
Science22 Feb 2019 : 795
Last week, the Centers for Disease Control and Prevention announced that more than 100 cases of measles, spanning 10 states, had been reported in the United States since the beginning of the year. This news came on the heels of the World Health Organization’s estimate of over 200,000 cases of measles in 2018. These numbers signal the reemergence of a preventable, deadly disease, attributed in significant part to vaccine hesitancy. Communities and nations must seriously consider leveraging the law to protect against the spread of this highly contagious disease.

In the United States, measles was deemed “eliminated” in 2000 because of vaccination success. Since then, its reemergence has been associated with a resistance to vaccination. This also reflects the fact that unvaccinated U.S. residents visit countries that have seen large measles outbreaks (such as Ukraine, the Philippines, and Israel), become infected, and bring the disease back home.

Outbreaks in the United States are still fewer than in, say, Europe because of unique U.S. policies and laws that maintain high vaccination coverage. All 50 states and the District of Columbia have laws requiring vaccinations for school and daycare attendance. School mandates have proven very effective: The stronger they are, the higher the vaccination rate, and the lower the risk of outbreaks. The Vaccines for Children Program is a broad federal initiative that funds vaccines for children whose families cannot otherwise afford them. There is, however, more that the United States can do. There are “hotspots” where vaccination rates are low, and these are where outbreaks appear. Recent measles outbreaks—including those in Washington state and New York—occurred when an unvaccinated individual, after visiting an area where measles is endemic, returned to a U.S. community with low vaccination rates and infected others (primarily unvaccinated children).

What can be done? States have extensive leeway to protect public health, and courts have consistently upheld strong school immunization mandates. Thus, states could tighten nonmedical exemptions (for example, by requiring consultation with a doctor) or remove these exemptions completely from school mandates. Valid medical exemptions are important, but it is less clear whether nonmedical exemptions are appropriate. Some scholars are concerned that eliminating nonmedical exemptions may generate resentment among parents and interfere with parental autonomy. Others—including professional medical associations—disagree, because mandates protect children, and a parent’s freedom to send an unvaccinated child to school places classmates at risk of dangerous diseases. There is a strong argument for removing nonmedical exemptions, and at the least, they should be hard to get, to further incentivize parents to vaccinate. In many states, however, getting an exemption is as easy as checking a box. States and localities could also require schools to provide their immunization rates to parents at the start of the school year.

Beyond school mandates, states can consider other legal tools that have not yet been used. States could implement workplace mandates for those working with vulnerable populations, such as health care workers, teachers in schools, and providers of daycare. States could impose tort liability (civil law damages for harm) when unexcused refusal to vaccinate leads to individuals becoming infected unnecessarily or worse, to a large outbreak. States could permit teenagers to consent to vaccinations without parental approval. And states could mandate vaccinations to enroll in institutions of higher education.

Vaccine hesitancy is a problem with many components. In handling it, societies should improve public understanding of vaccinations but also not hesitate to use the law to prevent deadly diseases from spreading.

Milestones :: Perspectives

 DRC – Ebola

29: Situation report on the Ebola outbreak in North Kivu  19 February 2019

Situation Update

The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces, Democratic Republic of the Congo, continues to prove challenging to contain as ongoing security incidents and pockets of community mistrust hamper response efforts. Following our last report on 12 February 2019, 24 new EVD cases have been reported, including 20 confirmed and four probable cases. The four probable cases were all deaths that occurred in November and December 2018 in Komanda Health Zone, with a clinical history consistent with EVD but without the opportunity to be tested…
…Case management

On 24 November 2018, MoH announced the launch of a randomized control trial (RCT) for Ebola therapeutics. The RCT is now enrolling and treating patients at ETC sites in Katwa, Beni and Butembo. This is ongoing, with all confirmed cases in ETCs receiving therapy under the compassionate use protocol, together with supportive care. To date, 66 patients have been enrolled in the RCT and 334 patients have received therapy under the compassion use protocol.

An Ebola transit (TC) centre was opened in Katwa in the last week.

…Implementation of ring vaccination protocol

As of 17 February 2019, a cumulative total of 80,989 people have been vaccinated since the start of the outbreak.

Vaccination of HCWs and FLsWS are underway in bordering areas of Uganda and South Sudan. Advanced preparations are ongoing in Rwanda.

::::::

STRATEGIC RESPONSE PLAN FOR THE EBOLA VIRUS DISEASE OUTBREAK IN THE PROVINCES OF NORTH KIVU AND ITURI

February – July 2019

13 February 2019

[Excerpts’ full plan at title link qbove]]

Introduction

The tenth epidemic of Ebola virus disease (EVD) in the Democratic Republic of the Congo, affecting the provinces of North Kivu and Ituri, was declared by the Ministry of Health on 1 August 2018. The initial strategic response plan (SRP-1) covering the period up to in October 2018 and then the second strategic response plan (SRP-2) for the period from October 2018 to January 2019 facilitated deployment of the important resources of the Congolese Government and its partners.

Despite the complexity of this epidemic (dense and mobile population, insecurity, community resistance and risk of spread at the national and regional levels), the implementation of the interventions made it possible to significantly reduce the spread of the outbreak in the initial epicentres of Mangina / Mandima and Beni and stopped transmission in some secondary focal points like Tchomia, Masereka and Mutwanga.

Nevertheless, since the beginning of December a significant increase in the incidence of new cases has been observed particularly along the corridor towards the large urban center of Butembo (health zones of Butembo and Katwa) and beyond in the zone of Kayna health center located about 150 km from Goma. In addition, active outbreaks have emerged to the north, particularly in the health zones of Komanda and Oicha.

The third strategic response plan (SRP-3), which covers February through end July 2019, considers the salient points and recommendations made during the operational review of the implementation of the SRP-2 and other guidance based on lessons learned and risk analysis.

…6.9 Vaccination of at-risk groups

Despite the context and challenges, as of January 27, 2019, in North Kivu and Ituri Provinces 695 rings (3 February) were defined in the community and 2 targeted geographical areas. A total of 73,298 contacts and contacts of contacts were listed. Of those vaccinated, 18,895 are contacts, 22,441 are health and front-line staff and 16,855 are children aged 1 to 18 years.

As the number of cases reported from unknown contacts remains high, efforts have been made to improve the identification of contacts and contact of contacts, particularly in all locations where the symptomatic case visited a high-risk health facility before being isolated or dying.

It is important to emphasize that the investigational vaccine will continue to be used according to WHO recommendations in compliance with Good Clinical Practice (GCP) and that sustained attention be paid to the quality of the processes, procedures and management of clinical trials data in accordance with international standards.

However, there is a shortage of national staff trained in GCP, low involvement of HZMTs and the community in the organization of vaccination and an increase in the number of ineligible people (pregnant women, breastfeeding women and infants).

Other measures to establish and continue to prevent the spread of transmission include:

:: Further improve the listing of the “satellites” of the rings (i.e. outside the place of residence of the case, these are all places that the symptomatic person visited before being isolated or dying) to identify and offer vaccination to all people at risk.

:: Organize vaccination teams performing “sweeping” operations to review how rings were defined for cases with onset of symptoms in the last 7 days and to verify if contacts at the place of residence and in the satellites have been fully enumerated and vaccinated.

::  Organize teams that primarily vaccinate all health personnel and front-line staff in priority-identified facilities because they have seen or treated a case of EVD within the previous 21 days.

::  Modify the protocol for the use of the rVSV vaccine to include vaccination of pregnant women after the 1st trimester of pregnancy and vaccination of infants including new-borns, as recommended by the National Ethics Committee. Arrangements will be made for the follow-up of pregnant women who were vaccinated through the end of their pregnancies.

::  The supply of infrared thermometers and handwashing facilities, drinking water, soap and capacity building on hygiene behaviour in schools.

:: The construction of isolation rooms for suspected cases at school.

::  Providing specific documentation and protocol for the prevention, guidance and management of suspected cases at school to provide key messages on family-based Ebola prevention.

:: Strengthen the technical capacity of national PCB teams to be able to deploy an experimental vaccine for this epidemic and in the future and consider appropriate study options for the evaluation of other vaccines against GCPs…

Emergencies
 
 
POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 20 February 2019
:: On 19 February, the 20th IHR Emergency Committee including members, advisers, and invited Member States convened to discuss the status of international spread of poliovirus. The Committee unanimously agreed that the risk of polio spread continues to be a Public Health Emergency of International Concern (PHEIC) and proposed an extension of Temporary Recommendations for an additional three months. The recommendations come amid outbreak notification of cVDPV1 and cVDPV2 in Indonesia and Mozambique respectively. The official WHO Statement and the Temporary Recommendations will be issued shortly. [Full statement not yet posted]

:: The GPEI has developed the Global Polio Surveillance Action Plan 2018-2020, incorporating newer strategies and innovations to help endemic, outbreak and high-risk countries measure and enhance sensitivity of their surveillance systems. Read more here.

:: WHO is seeking input on draft guidance for managing human exposure to live polioviruses in facilities such as labs and vaccine plants. The document is open for public comment and WHO is particularly seeking feedback from national authorities for containment and others working in public health.
 
 
Summary of new viruses this week:
:: Afghanistan — one case of wild poliovirus type 1 (WPV1) and four WPV1-positive environmental samples;

:: Pakistan – two cases of WPV1 and 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 23 Feb 2019]
Democratic Republic of the Congo
:: :: 29: Situation report on the Ebola outbreak in North Kivu  19 February 2019
:: DONS – Ebola virus disease – Democratic Republic of the Congo   21 February 2019

Bangladesh – Rohingya crisis
:: Bi‐weekly Situation Report 3 – 14 February 2019
…Immunization
Vaccination at Registration Post: Three vaccination posts have been established in camp 7, camp 17 and 26 with the support of UNHCR to provide immunization service to newborn eligible for birth registration under family head count. The activity started in Teknaf in Sep 2018 and in Ukhia (camp 7 and 17) in Feb 2019. Immunization activities are offered for 5 days a week.
Health worker immunization: Two vaccinations post are providing immunization to health care workers on weekly basis to humanitarian workers in camps. To-date 1,753 Td doses have been administered to health workers.
VPD Surveillance: 3 AFP cases have been investigated in 2019 with result still pending. Out of 88 suspected measles cases in 2019, 53 patients (42%) have been investigated through Case Report Form.

South Sudan
::  WHO provides lifesaving health care services to displaced populations and host communities in 22 locations in South Sudan  18 February 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 23 Feb 2019]
Brazil (in Portugese) – 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
Hurricane Irma and Maria in the Caribbean – No new digest announcements identified
Iraq – No new digest announcements identified
Libya – No new digest announcements identified
MERS-CoV – 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) – No new digest announcements identified
Sudan – No new digest announcements identified
Ukraine – No new digest announcements identified
Zimbabwe – No new digest announcements identified

::::::

WHO Grade 1 Emergencies  [to 23 Feb 2019]
Afghanistan
Chad
Indonesia – Sulawesi earthquake 2018
Kenya
Lao People’s Democratic Republic
Mali
Namibia – viral hepatitis
Peru
Philippines – Tyhpoon Mangkhut
Tanzania

 
::::::
::::::

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   
:: Humanitarian Update Syrian Arab Republic – Issue 01 | 19 February 2019

  FIGURES
. People in need of humanitarian assistance 13M
. People in acute need of humanitarian assistance 5.2M
. Internally displaced people (as of August) 6.2M
. Returnees (January – December 2018) 1.4 M
. People in need in UN-declared hardto-reach areas 1.1M
HRP 2018 FUNDING
. 3.36 billion requested (US$)
. 64.9% funded

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.
Ethiopia 
:: Ethiopia Humanitarian Bulletin Issue #3 | 04-17 February 2019

HIGHLIGHTS
. Over 45,000 IDPs in need of urgent humanitarian assistance in Central Gondar.
. The level of humanitarian needs in 2019 expected to remain similar to 2018.
. UNHCR notes spontaneous movement of South Sudanese refugees in Ethiopia.

Somalia  – No new digest announcements identified

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

Editor’s Note:</strong
We will cluster these recent emergencies as below and continue to monitor the WHO webpages for updates and key developments.

EBOLA/EVD  [to 23 Feb 2019]
http://www.who.int/ebola/en/
:: 29: Situation report on the Ebola outbreak in North Kivu  19 February 2019
:: DONS – Ebola virus disease – Democratic Republic of the Congo   21 February 2019
 
 
MERS-CoV [to 23 Feb 2019]
http://who.int/emergencies/mers-cov/en/
– No new digest announcements identified.
 
 
Yellow Fever  [to 23 Feb 2019]
http://www.who.int/csr/disease/yellowfev/en/
– No new digest announcements identified.
 
 
Zika virus  [to 23 Feb 2019]
http://www.who.int/csr/disease/zika/en/
– No new digest announcements identified.

WHO & Regional Offices [to 23 Feb 2019]

21 February 2019
Nationwide measles and rubella immunization campaign reaches 11.6 million children in Yemen

20 February 2019
News Release
Countries are spending more on health, but people are still paying too much out of their own pockets

::::::

 
Weekly Epidemiological Record, 22 February 2019, vol. 94, 08 (pp. 85–104)
:: Pneumococcal conjugate vaccines in infants and children under 5 years of age: WHO position paper – February 2019

::::::

WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: Kenya now eliminates maternal and neonatal tetanus  22 February 2019
:: Zambian Government commits to ending cholera by 2025   22 February 2019
:: Community informants yield results in surveillance for suspected polio in hard-to-reach areas
22 February 2019
:: WHO and Uganda Red Cross society sign agreement to strengthen Ebola screening at Points of Entry between Uganda and DRC  21 February 2019
:: New Minister of Health recommits government to end Hepatitis E Outbreak  20 February 2019
 
 
WHO Region of the Americas PAHO
– No new digest announcements identified.
 
 
WHO South-East Asia Region SEARO
– No new digest announcements identified.
 
 
WHO European Region EURO
:: Summits give citizens a voice in creating sustainable health policy 22-02-2019
 
 
WHO Eastern Mediterranean Region EMRO
:: Improving access to health care in Yemen  19 February 2019
 
 
WHO Western Pacific Region
– No new digest announcements identified.

CDC/ACIP [to 23 Feb 2019]

http://www.cdc.gov/media/index.html

https://www.cdc.gov/vaccines/acip/index.html

– No new digest announcements identified.

Africa CDC   [to 23 Feb 2019]

https://au.int/en/africacdc

– No new digest announcements identified.

China CDC 

http://www.chinacdc.cn/en/

New website launched…no “news” or “announcements” page identified. Link to National Health Commission of the People’s Republic of China not responding at inquiry [23 Feb 2019]

Announcements

 
Paul G. Allen Frontiers Group    [to 23 Feb 2019]
https://www.alleninstitute.org/news-press/
News
2 million-cell experiment traces how a mammal grows, cell by single cell
February 20, 2019
Largest single-cell database of its kind sheds light on early mouse development, lays groundwork for understanding developmental diseases
 
 
BMGF – Gates Foundation  [to 23 Feb 2019]
http://www.gatesfoundation.org/Media-Center/Press-Releases
No new digest content identified.
 
 
Bill & Melinda Gates Medical Research Institute    [to 23 Feb 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 23 Feb 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 23 Feb 2019]
http://cepi.net/
11 Feb 2019
CEPI partners with IVI to accelerate development of vaccines against emerging global health threats
Oslo, Norway; Seoul, Republic of Korea 11 February 2019—The Coalition for Epidemic Preparedness Innovations (CEPI) and the Republic of Korea-based International Vaccine Institute (IVI), an international organisation devoted to vaccines for global health, today announced a collaboration to accelerate the development of vaccines against emerging infectious diseases.
Under the terms of the CEPI–IVI Master Implementing Partner Services Agreement, IVI will provide technical services for CEPI-funded projects, executing specific activities as needs arise on behalf of CEPI in the course of advancing new vaccines against emerging pathogens. To this end, IVI will receive funding and support from CEPI to implement the necessary technical services per service orders for vaccine development by engaging local scientists in Korea, and by mobilising IVI’s expertise and capabilities, which include: laboratory and vaccine process research and development, epidemiological studies, and clinical trial and regulatory support…
 
 
EDCTP    [to 23 Feb 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
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Emory Vaccine Center    [to 23 Feb 2019]
http://www.vaccines.emory.edu/
No new digest content identified.
 
 European Medicines Agency  [to 23 Feb 2019]
http://www.ema.europa.eu/ema/
News and press releases
No new digest content identified.
 
 
 
European Vaccine Initiative  [to 23 Feb 2019]
http://www.euvaccine.eu/news-events
Latest news
5th Call for TRANSVAC Vaccine Development Services
18 February 2019
TRANSVAC2  project offers high-quality technical services to support the development of prophylactic and therapeutic vaccines…
 
 
FDA [to 23 Feb 2019]
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
February 22, 2019 –
Statement from FDA Commissioner Scott Gottlieb, M.D., and Director of FDA’s Center for Drug Evaluation and Research Janet Woodcock, M.D., on the FDA’s continuing efforts to maintain its strong oversight of generic drug quality issues domestically and abroad
 
 
Fondation Merieux  [to 23 Feb 2019]
http://www.fondation-merieux.org/
No new digest content identified.
 
 
Gavi [to 23 Feb 2019]
https://www.gavi.org/
22 February 2019
Typhoid vaccination campaign to tackle outbreak in Zimbabwe
Geneva, 22 February 2019 – A major typhoid vaccination campaign begins today in Harare to tackle a drug-resistant outbreak of the disease.
The campaign aims to vaccinate 325,000 people in nine suburbs of Zimbabwe’s capital. It will be the first campaign in Africa to use a new typhoid conjugate vaccine (TCV) which, unlike other typhoid vaccines, can be administered to young children and has long-lasting immunity.
This is the second wave of a major typhoid outbreak in Harare which first began in October 2017. This second wave began in September 2018 and has so far resulted in 1,810 cases and two deaths.
Around one in five cases in Harare are estimated to be resistant to the antibiotic ciprofloxacin – the first line of defence against the disease – with an alarming 73% resistance reported in certain areas. With drug resistant genes circulating, there is a risk that resistance could grow.
“While typhoid vaccines have existed for over a century, previously they could only offer short term protection and couldn’t be used to protect those most vulnerable to this severe disease: young children,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. “These new conjugate vaccines will be a game-changer, not only in the battle against typhoid but also in the global effort to tackle drug resistance. The fact that they are now ready to be used to contain this devastating outbreak in Zimbabwe is fantastic news.”…
 
 
GHIT Fund   [to 23 Feb 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
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Global Fund  [to 23 Feb 2019]
https://www.theglobalfund.org/en/news/
News
No new digest content identified.
 
 
Hilleman Laboratories   [to 23 Feb 2019]
http://www.hillemanlabs.org/
No new digest content identified.
 
 
Human Vaccines Project   [to 23 Feb 2019]
http://www.humanvaccinesproject.org/media/press-releases/
No new digest content identified.
 
 
IAVI  [to 23 Feb 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.
 
 
IVAC  [to 23 Feb 2019]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
No new digest content identified.
 
 
IVI   [to 23 Feb 2019]
http://www.ivi.int/
IVI News & Announcements
Typhoid conjugate vaccine from Indonesia found to be safe, immunogenic in phase 1 clinical trial
SEOUL, Korea, JAKARTA, Indonesia, February 22, 2019 — Scientists from Bio Farma, the University of Indonesia, and the International Vaccine Institute (IVI), recently published the results of a phase I clinical trial study of a novel typhoid conjugate vaccine involving Indonesian adults and children, showing that the vaccine was safe and generated potentially protective immune responses…
Researchers at IVI and Indonesian partners aimed to define the safety and immunogenicity of a new S. typhi Vi-DT conjugate vaccine. The latest study, published recently in the journal PLoS ONE, suggests that the new vaccine is safe and immunogenic in adults and children over 2 years of age, with a single dose inducing strong immune responses regardless of age.
“This study is an important step towards the development of Vi-DT typhoid vaccine that can safeguard the world’s most vulnerable -especially young children, against typhoid fever,” said Dr. Sushant Sahastrabuddhe, Director of the Typhoid Program at IVI…
 
 
JEE Alliance  [to 23 Feb 2019]
https://www.jeealliance.org/
Selected News and Events
Mali – A Multi-sectoral and Multi-stakeholder Cooperation Success Story
8.2.2019
Article
Disease outbreaks continue to occur in Mali and the ongoing security crisis highlights the importance of a comprehensive national framework for health security. Recognizing the need for cooperation…
 
 
MSF/Médecins Sans Frontières  [to 23 Feb 2019]
http://www.msf.org/
Selected News; Project Updates, Reports [as presented on website]
Nauru
Nauru | Concerns over reopening Christmas Island detention centre
MSF Australia. 21 Feb 2019
 
 
Central African Republic
Unprotected: Report on violence and lack of protection for civili…
Report 19 Feb 2019
 
 
NIH  [to 23 Feb 2019]
http://www.nih.gov/news-events/news-releases
February 19, 2019
New protocol could ease diagnosis of bacterial infections in infants
— Findings promise to reduce need for spinal tap, antibiotics, and hospitalizations.
 
 
PATH  [to 23 Feb 2019]
https://www.path.org/media-center/
No new digest content identified.
 
 
Sabin Vaccine Institute  [to 23 Feb 2019]
http://www.sabin.org/updates/pressreleases
No new digest content identified.
 
 
UNAIDS [to 23 Feb 2019]
http://www.unaids.org/en
Selected Press Releases/Reports/Statements
22 February 2019
Faith-based organizations: essential partners in the AIDS response for migrants

20 February 2019
Tanzanian and South African experts exchange expertise

19 February 2019
HIV testing campaign brings the community together in Bangui

18 February 2019
We need action on human rights
 
 
UNICEF  [to 23 Feb 2019]
https://www.unicef.org/media/press-releases
Selected Press Releases/Reports/Statements
Press release
Increasing number of people face severe food shortages in South Sudan
Joint UNFAO, UNICEF, WFP Press Release
22/02/2019

Statement
Redeployment agreement from Hudaydah welcome – calls to bring positive change for children
Statement by Geert Cappelaere, UNICEF Regional Director for the Middle East and North Africa
20/02/2019

Statement
Central African Republic peace agreement brings hope to millions of children
Statement attributable to UNICEF Executive Director Henrietta Fore
18/02/2019

Statement
UNICEF Executive Director Henrietta Fore’s remarks at Munich Security Conference: Town Hall Event: “Update on Ebola in the DRC & Beyond”
Munich, Germany, 16 February 2019 –
“Once again, we’re facing an outbreak of Ebola — the 10th in the DRC.
“And once again, we face familiar challenges — and more. An unforgiving disease that requires 100 per cent of cases to be controlled and isolated. A high-density, mobile population.    A lingering mistrust of aid. More children and women among those infected and dying of the disease. And a new, unexpected threat: security concerns and direct attacks that impede access.
“In some ways, we’re in a better place than 2014. Building on what we’ve learned from previous outbreaks, we’re now working as a tightly co-ordinated team, using a common Strategic Response Plan.
“Since the beginning of the epidemic, UNICEF and our partners have deployed more than 650 staff members to the effort. All under the excellent leadership of the Ministry of Health, which is well-trained and experienced from previous outbreaks.
“Together, we’re providing drinking water to more than 1.3 million people. We’re providing sanitation and hygiene kits — and emergency nutritional care for Ebola patients. We’re directly assisting 950 affected families. We’re supporting orphans and unaccompanied children. And we’ve reached more than 10 million people with information on preventing this disease and reducing transmission — including in schools.
“We’re also deploying innovative approaches — isolation cubes for treatment, new vaccines, experimental therapeutics, and big-data analysis to track the spread of the outbreak.
“Our protection teams are doing intense-contact follow-up work, to ensure well-being within communities and to prevent spread to non-affected areas.
“We’re putting a renewed emphasis on risk communication and community engagement, to improve trust in — and uptake of — vital health and prevention services.
“And the UN peacekeeping force is providing a welcome security umbrella for all that we’re doing.
“Thanks to this work, we’ve controlled the outbreak in Equateur, and in many spots in North Kivu, including Beni. We’ve also succeeded in preventing the outbreak from spreading to other regions and countries.
“But the outbreak remains active. There is a serious risk of it reaching major urban centres, like Goma.
“Our staff members — across all of our organizations — are stretched thin. They’re facing continued community resistance — and new security threats.
“In this uncertain environment, we will be strained to control new outbreaks in DRC — or even respond to other health emergencies like cholera or polio that might emerge in neighbouring countries.
“We must find ways to stay one step ahead of Ebola.
“And we can do it. The excellent work of Uganda and Rwanda to prepare has made all the difference in preventing an outbreak.
“Which is why — in addition to our immediate response — UNICEF is working with our partners with a new urgency to strengthen health systems and local response capabilities over the long-term.
“This includes bolstering immunization stocks and capacity.
“It includes scaling-up surveillance and isolation capabilities, especially in urban areas — so important in controlling the Lagos outbreak in 2014.
“And it includes investing in stronger communication efforts with communities, and new prevention and control efforts in health facilities and schools. This includes a new team of anthropologists and communication for development specialists to improve our research and assessment efforts.
“In the meantime, we must make the most of a key window of opportunity, before the Strategic Response Plan ends in July 2019. We must continue raising the alarm on this emergency to summon more funds, recruit more staff, and be strategic about where — and when — we deploy current staff.
“Throughout, we must work closely with the new government to reduce security threats, strengthen health systems for the future, and gain access to every child and community affected.
“Ebola is unforgiving — but it’s not unbeatable.
“Let’s draw inspiration — and learn lessons — from our successes so far, and act now, before the outbreak spreads to Goma or crosses the border.
Thank you.”
 
 
Vaccine Confidence Project  [to 23 Feb 2019]
http://www.vaccineconfidence.org/
No new digest content identified.
 
 
Vaccine Education Center – Children’s Hospital of Philadelphia  [to 23 Feb 2019]
http://www.chop.edu/centers-programs/vaccine-education-center
No new digest content identified.
 
 
Wellcome Trust  [to 23 Feb 2019]
https://wellcome.ac.uk/news
Opinion | 19 February 2019
Open access and Plan S: how Wellcome is tackling four key concerns
by Robert Kiley, David Carr
There has been lots of reaction to the changes we’re making to Wellcome’s open access policy to ensure that no research is behind a paywall. This is how we are working to address them.
 
 
The Wistar Institute   [to 23 Feb 2019]
https://www.wistar.org/news/press-releases
Press Release    Feb. 21, 2019
The Wistar Institute and Anixa Biosciences Extend Collaborative Research Agreement
Philadelphia and San Jose, Calif. – (Feb. 21, 2019) – The Wistar Institute has extended its collaboration with Anixa Biosciences, Inc. (NASDAQ: ANIX), a biotechnology company focused on using the body’s immune system to fight cancer. The project is focused on understanding the role of myeloid-derived suppressor cells (MDSCs) and how they can be used in diagnostic and therapeutic applications…
 
 
World Organisation for Animal Health (OIE)   [to 23 Feb 2019]
http://www.oie.int/en/for-the-media/press-releases/2019/
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BIO    [to 23 Feb 2019]
https://www.bio.org/insights/press-release
No new digest content identified.
 
 
DCVMN – Developing Country Vaccine Manufacturers Network  [to 23 Feb 2019]
http://www.dcvmn.org/
No new digest content identified.
 
 
IFPMA   [to 23 Feb 2019]
http://www.ifpma.org/resources/news-releases/
No new digest content identified.
 
 
PhRMA    [to 23 Feb 2019]
http://www.phrma.org/press-room
No new digest content identified.
 
 
Industry Watch  [to 23 Feb 2019]

:: Bharat Biotech Acquires Chiron Behring Vaccines
Hyderabad, India, February 15 th 2019:

Bharat Biotech announces the forthcoming acquisition of Chiron Beh-ring Vaccines Pvt Ltd, located in Ankleshwar, Gujarat from GlaxoSmithKline Asia. Bharat Biotech will acquire 100% equity stake in Chiron Behring Vaccines in an all cash transaction, subject to a number of closing condi-tions which Bharat Biotech and GSK intend to complete in the coming weeks.

Chiron Behring Vaccines was formed as a result of the purchase of the vaccines business of Hoechst AG by Chiron Corporation USA. It is one of the largest manufacturers of high quality rabies vaccines in the world. Chiron Behring Vaccines is a WHO Pre-qualified manufacturer of rabies vaccines, eligible for supplies to UN agencies and has product registrations in more than 20 countries. The rabies vaccine manufactured at An-kleshwar is a result of decades of research & product development..

Bharat Biotech has a wide portfolio of vaccines, with market access to more than 70 countries. The addition of this rabies vaccine will establish Bharat Biotech as a global leader in rabies vaccines manufacturing. Bharat Biotech plans to enhance upon the manufacturing capabilities at Chiron Behring Vaccines and expand mar-ket access through product registrations in additional high demand countries.

Announcing the deal, Dr. Krishna Ella, Chairman and Managing Director of Bharat Biotech, said:

“This acquisition is strategic in helping us enhance our opportunities to achieve greater scale in tackling pub-lic health problems. Bharat Biotech will strengthen its product portfolio and substantially increase product availability in response to the growing demand for this vaccine. With the significant disease burden of rabies in India and other countries, I appreciate GSK’s vision in this transition to Bharat Biotech, to continue to meet the needs of the patients…

Philippines revokes Sanofi’s product license for dengue vaccine
February 19, 2019,  MANILA (Reuters) – The Philippines has permanently halted the sale, distribution and marketing of Sanofi’s dengue vaccine in the country after the French drug maker failed to meet the directives of regulators.

Food and Drug Administration (FDA) Director General Nela Charade Puno said on Tuesday registration certificates for Dengvaxia products have been revoked because of Sanofi’s “brazen defiance” of the agency’s directives.

The FDA said Sanofi failed to comply with post marketing authorization requirements as of December last year.

Sanofi said it disagreed with the FDA’s findings.

“Sanofi Pasteur respectfully disagrees with the conclusions stated in the order and considers that the Philippines FDA has taken this decision despite our diligence, including the submission of documents from completed post-approval commitments and regular updates on the status of post-marketing studies,” the company said in a statement.

Sanofi, which filed a motion for reconsideration, said the agency had not questioned the safety and efficacy of Dengvaxia…

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

BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content

(Accessed 23 Feb 2019)
Research article
Advancing towards contemporary practice: a systematic review of organisational performance measures for non-acute health charities
The study concluded that (1) demonstration of organisational performance is relevant to non-acute health charities; (2) organisational performance measurement is feasible in this sector; (3) an evidence-based organisational performance measurement framework for the sector has not yet been developed nor has an existing organisational performance measurement framework been adapted for the sector, although the Balanced Scorecard is likely to be an effective option and (4) five leading measures – Quality of Service; Finance; Stakeholders (Customers and Clients); People and Culture; and Governance and Business Management; could be used to determine organisational performance in these sectors. Finally, ‘Mission and Purpose’ could be explored as a potential measure. Further research to understand why there is such limited published organisational performance evidence for the sector could be useful. Case studies of organisational measurement strategies of successful non-acute healthcare charities and research into important factors for organisational performance implementation in the sector may contribute to greater uptake and knowledge dissemination.
Authors: Richard Colbran, Robyn Ramsden, Karen Stagnitti and John W. Toumbourou
Citation: BMC Health Services Research 2019 19:132
Published on: 22 February 2019
 
 

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 23 Feb 2019)

Research article
Effects of the rotavirus vaccine program across age groups in the United States: analysis of national claims data, 2001–2016
The direct effectiveness of infant rotavirus vaccination implemented in 2006 in the United States has been evaluated extensively, however, understanding of population-level vaccine effectiveness (VE) is still …
Authors: Julia M. Baker, Rebecca M. Dahl, Justin Cubilo, Umesh D. Parashar and Benjamin A. Lopman
Citation: BMC Infectious Diseases 2019 19:186
Published on: 22 February 2019
 
 

BMC Medicine
http://www.biomedcentral.com/bmcmed/content
(Accessed 23 Feb 2019)

Research article
HBV vaccination and PMTCT as elimination tools in the presence of HIV: insights from a clinical cohort and dynamic model
Sustainable Development Goals set a challenge for the elimination of hepatitis B virus (HBV) infection as a public health concern by the year 2030. Deployment of a robust prophylactic vaccine and enhanced inte…
Authors: Anna L. McNaughton, José Lourenço, Louise Hattingh, Emily Adland, Samantha Daniels, Anriette Van Zyl, Connie S. Akiror, Susan Wareing, Katie Jeffery, M. Azim Ansari, Paul Klenerman, Philip J. R. Goulder, Sunetra Gupta, Pieter Jooste and Philippa C. Matthews
Citation: BMC Medicine 2019 17:43
Published on: 21 February 2019