BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles

(Accessed 23 Feb 2019)
Research article
Administrative cases: an effective alternative to lawsuits in assuring access to medicines?
Although public policy in Brazil supports access to essential medicines, the health system cannot meet all demand. Increasingly, the population has used legal demands to seek access to medicines, an approach that can undermine equitable access by creating policy inconsistencies (e.g., granting access to medicines outside the SUS formulary). In response, the Executive Branch has signed institutional agreements to create an administrative case for submitting requests for medicines directly to the Executive Branch. The objective of this study was to assess the degree to which the administrative cases for requests are in accordance with public policies and guidelines, e.g., if administrative cases results in fewer decisions to purchase outside the SUS formulary.

Authors: Virginia Oliveira Chagas, Mércia Pandolfo Provin and Rita Goreti Amaral

Citation: BMC Public Health 2019 19:212

Published on: 20 February 2019

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.

Genome Medicine
https://genomemedicine.biomedcentral.com/articles
[Accessed 24 Nov 2018]

Comment
Translating genomic medicine to the clinic: challenges and opportunities
Genomic medicine has considerable potential to provide novel diagnostic and therapeutic solutions for patients who have molecularly complex diseases and who are not responding to existing therapies…The huge medical, economic, and societal problems arising from the large number of patients who do not respond to therapy emphasize the need for novel diagnostic and therapeutic solutions for the management of patients. Genomic medicine has considerable potential, but also presents significant challenges that are likely to be addressed by joint international initiatives.
Authors: Huan Zhang, Lars Klareskog, Andreas Matussek, Stefan M. Pfister and Mikael Benson
Citation: Genome Medicine 2019 11:9
Published on: 22 February 2019

Globalization and Health
http://www.globalizationandhealth.com/
[Accessed 23 Feb 2019]

Review
In search of Pan-American indigenous health and harmony
The objective of this article is to describe the state of North, Central, South American and Caribbean (Pan-American) indigenous health. The second objective is to identify recommendations for optimal healthca…
Authors: Julie Babyar
Citation: Globalization and Health 2019 15:16
Published on: 20 February 2019

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.

Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 15, Issue 2, 2019
http://www.tandfonline.com/toc/khvi20/current

Article Commentary
Maternal vaccine knowledge in low- and middle-income countries—and why it matters
Anna Larson Williams, Rachel Mitrovich, Lawrence Mwananyanda & Chris Gill
Pages: 283-286
Published online: 10 Oct 2018

Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 15, Issue 2, 2019
http://www.tandfonline.com/toc/khvi20/current

Article
Measuring childhood vaccination acceptance of mother in Zhejiang province, East China
Yu Hu, Yaping Chen, Ying Wang & Hui Liang
Pages: 287-294
Published online: 05 Oct 2018

Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 15, Issue 2, 2019
http://www.tandfonline.com/toc/khvi20/current

Article
The impact of Measles-Rubella vaccination on the morbidity and mortality from Congenital Rubella Syndrome in 92 countries
Emilia Vynnycky, Timoleon Papadopoulos & Konstantinos Angelis
Pages: 309-316
Published online: 25 Oct 2018

Journal of Evidence-Based Medicine
Volume 12, Issue S1  Pages: 1-34  January 2019
https://onlinelibrary.wiley.com/toc/17565391/current

7th Meeting of the COMET Initiative (VII), Thursday 15th and Friday 16th November 2018, De Rode Hoed, Amsterdam
On the 15^th and 16^th November 2018, the Core Outcome Measures in Effectiveness Trials (COMET) Initiative held its seventh international meeting. After success at COMET VI, the COMET meeting returned to De Rode Hoed (The Red Hat) in Amsterdam for their second consecutive meeting. One‐hundred and fifteen participants gathered from around the world, coming from five continents and 18 countries.

The Lancet
Feb 23, 2019  Volume 393  Number 10173  p717-846, e30-e32
https://www.thelancet.com/journals/lancet/issue/current

Editorial
Fetal medicine: past, present, and future
The Lancet

Maternal and Child Health Journal
Volume 23, Issue 2, February 2019
https://link.springer.com/journal/10995/23/2

Original Paper
Disparities in Tdap Vaccination and Vaccine Information Needs Among Pregnant Women in the United States
Jennifer L. Kriss, Alison P. Albert…

Nature 
Volume 566 Issue 7744, 21 February 2019
http://www.nature.com/nature/current_issue.html

Editorial | 20 February 2019
A new model for disease research in Africa
Locally led studies on public health are good for the continent and the globe. Scientists, politicians and funders should support it.

PLoS One
http://www.plosone.org/
[Accessed 23 Feb 2019]

Research Article
Vaccination timeliness among newborns and infants in Ethiopia
Matthew L. Boulton, Bradley F. Carlson, Abram L. Wagner, Julia M. Porth, Berhanu Gebremeskel, Yemesrach Abeje
Research Article | published 19 Feb 2019 PLOS ONE
https://doi.org/10.1371/journal.pone.0212408

PLoS One
http://www.plosone.org/
[Accessed 23 Feb 2019]

Research Article
Effectiveness of pneumococcal conjugate vaccines against invasive pneumococcal disease among children under five years of age in Africa: A systematic review
James Samwel Ngocho, Best Magoma, Gaudencia Alois Olomi, Michael Johnson Mahande, Sia Emmanueli Msuya, Marien Isaäk de Jonge, Blandina Theophil Mmbaga
Research Article | published 19 Feb 2019 PLOS ONE
https://doi.org/10.1371/journal.pone.0212295

Public Health  
Volume 167  Pages 1-160, A1-A2 (February 2019)
http://www.publichealthjrnl.com/current

Review article  Abstract only
A systematic review of the prevalence of limited health literacy in Southeast Asian countries

1. Rajah, M.A.A. Hassali, M.K. Murugiah

Pages 8-15

Public Health  
Volume 167  Pages 1-160, A1-A2 (February 2019)
http://www.publichealthjrnl.com/current

Research article  Abstract only
Neighbourhood influence on the fourth dose of diphtheria-tetanus-pertussis vaccination
S.T. Hegde, A.L. Wagner, P.J. Clarke, R.C. Potter, … M.L. Boulton
Pages 41-49

Revista Panamericana de Salud Pública/Pan American Journal of Public Health (RPSP/PAJPH)
http://www.paho.org/journal/index.php?option=com_content&view=featured&Itemid=101

22 Feb 2019
Control and management strategies in multidrug-resistant tuberculosis: literature review
Review | Portuguese |

Revista Panamericana de Salud Pública/Pan American Journal of Public Health (RPSP/PAJPH)
http://www.paho.org/journal/index.php?option=com_content&view=featured&Itemid=101

22 Feb 2019
Co-management of tuberculosis and diabetes: an integrative review
Review | Portuguese |

Revista Panamericana de Salud Pública/Pan American Journal of Public Health (RPSP/PAJPH)
http://www.paho.org/journal/index.php?option=com_content&view=featured&Itemid=101

22 Feb 2019
Human papillomavirus vaccine receptivity: a systematic review
Review | Portuguese |

Revista Panamericana de Salud Pública/Pan American Journal of Public Health (RPSP/PAJPH)
http://www.paho.org/journal/index.php?option=com_content&view=featured&Itemid=101

22 Feb 2019
Legal framework for electronic medical records in the Region of the Americas: definition of domains to legislate and situation analysis
Original research | Spanish |

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
[See Milestones/Perspectives above for full text]

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

South African law may impede human health research
By Linda Nordling
Science22 Feb 2019 : 802 Restricted Access
Data protection measure may block reuse of data in biobanks.
Summary
South Africa’s varied population makes it a magnet for research on public health and human diversity. But a new privacy law called The Protection of Personal Information Act, scheduled to go into effect in 2020, could upend such research. The law aims to protect South Africans from abuse of their personal data and says that such information, including genetic data, must be collected for a specific purpose—and that data subjects need to be “aware of the purpose.” But giant sample and data repositories called biobanks are transforming health research around the world by allowing multiple researchers to ask new questions of the same data. At a meeting in Cape Town on 4–5 February, lawyers, ethicists, and researchers discussed how the new South African rule could limit such secondary use of data and hamstring international collaborations.

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

Policy Forum
Regulation of predictive analytics in medicine
By Ravi B. Parikh, Ziad Obermeyer, Amol S. Navathe
Science22 Feb 2019 : 810-812 Restricted Access
Algorithms must meet regulatory standards of clinical benefit
Summary
Artificial intelligence (AI) and increased computing power have long held the promise of improving prediction and prognostication in health care (1). Now, use of predictive analytics and AI in medicine, though with fits and starts, is transitioning from hype to reality: Several commercial algorithms have received regulatory approval for broad clinical use. But the barrier for entry of new advanced algorithms has been low. To unlock the potential of advanced analytics while protecting patient safety, regulatory and professional bodies should ensure that advanced algorithms meet accepted standards of clinical benefit, just as they do for clinical therapeutics and predictive biomarkers. External validation and prospective testing of advanced algorithms are clearly needed (2), but recent regulatory clearances raise concerns over the rigor of this process. Given these concerns, we propose five standards to guide regulation of devices based on predictive analytics and AI. Although well-established research standards, such as the TRIPOD Checklist, exist for developing and validating multivariable prediction models in medicine (3), our standards provide regulatory guidance for such algorithms prior to implementation in clinical settings.

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

Research Articles
Estimating cholera incidence with cross-sectional serology
By Andrew S. Azman, Justin Lessler, Francisco J. Luquero, Taufiqur Rahman Bhuiyan, Ashraful Islam Khan, Fahima Chowdhury, Alamgir Kabir, Marc Gurwith, Ana A. Weil, Jason B. Harris, Stephen B. Calderwood, Edward T. Ryan, Firdausi Qadri, Daniel T. Leung
Science Translational Medicine20 Feb 2019 Open Access CCBY
Cross-sectional Vibrio cholerae–related antibody measures can be used to estimate cholera incidence in a population.
Estimating the true prevalence of cholera
Successful development of anti-cholera measures requires accurate estimates of infection incidence. Reporting of cholera cases, however, typically relies on clinical assessment at the time of patient presentation and can be problematized by lack of access to health care and variable, nonspecific symptomatology. Combining a small number of serological markers with machine learning methods, Azman et al. were able to accurately detect individuals who had had cholera infections within the previous year. Simulated serosurveys showed that this simple antibody-based approach could potentially be used as an alternative method to estimate cholera incidence in a population.
Abstract
The development of new approaches to cholera control relies on an accurate understanding of cholera epidemiology. However, most information on cholera incidence lacks laboratory confirmation and instead relies on surveillance systems reporting medically attended acute watery diarrhea. If recent infections could be identified using serological markers, cross-sectional serosurveys would offer an alternative approach to measuring incidence. Here, we used 1569 serologic samples from a cohort of cholera cases and their uninfected contacts in Bangladesh to train machine learning models to identify recent Vibrio cholerae O1 infections. We found that an individual’s antibody profile contains information on the timing of V. cholerae O1 infections in the previous year. Our models using six serological markers accurately identified individuals in the Bangladesh cohort infected within the last year [cross-validated area under the curve (AUC), 93.4%; 95% confidence interval (CI), 92.1 to 94.7%], with a marginal performance decrease using models based on two markers (cross-validated AUC, 91.0%; 95% CI, 89.2 to 92.7%). We validated the performance of the two-marker model on data from a cohort of North American volunteers challenged with V. cholerae O1 (AUC range, 88.4 to 98.4%). In simulated serosurveys, our models accurately estimated annual incidence in both endemic and epidemic settings, even with sample sizes as small as 500 and annual incidence as low as two infections per 1000 individuals. Cross-sectional serosurveys may be a viable approach to estimating cholera incidence.

Vaccine
Volume 37, Issue 11  Pages 1377-1540 (7 March 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/11

Short communication  Open access
POLICI: A web application for visualising and extracting yellow fever vaccination coverage in Africa
Arran Hamlet, Kévin Jean, Sergio Yactayo, Justus Benzler, … Tini Garske
Pages 1384-1388

Vaccine
Volume 37, Issue 11  Pages 1377-1540 (7 March 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/11

Research article  Open access
Age-related immunogenicity and reactogenicity of live oral cholera vaccine CVD 103-HgR in a randomized, controlled clinical trial
James M. McCarty, Michael D. Lock, Sean Bennett, Kristin M. Hunt, … Marc Gurwith
Pages 1389-1397

Vaccine
Volume 37, Issue 11  Pages 1377-1540 (7 March 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/11

Research article  Abstract only
Community acceptance and willingness-to-pay for a hypothetical Zika vaccine: A cross-sectional study in Indonesia
Harapan Harapan, Mudatsir Mudatsir, Amanda Yufika, Yusuf Nawawi, … Allison Imrie
Pages 1398-1406

Vaccine
Volume 37, Issue 11  Pages 1377-1540 (7 March 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/11

Research article  Open access
Developing standardized competencies to strengthen immunization systems and workforce
Denise Traicoff, Alice Pope, Peter Bloland, Dharmesh Lal, … Hardeep Sandhu
Pages 1428-1435

Vaccine
Volume 37, Issue 11  Pages 1377-1540 (7 March 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/11

Research article  Abstract only
Factors affecting parental intention to vaccinate kindergarten children against influenza: A cross-sectional survey in China
Yanbing Zeng, Zhipeng Yuan, Jiahui Yin, Yaofeng Han, … Ya Fang
Pages 1449-1456

Vaccine
Volume 37, Issue 11  Pages 1377-1540 (7 March 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/11

Research article  Abstract only
The anti-vaccine movement in Poland: The socio-cultural conditions of the opposition to vaccination and threats to public health
Piotr Żuk, Paweł Żuk, Justyna Lisiewicz-Jakubaszko
Pages 1491-1494

Vaccine
Volume 37, Issue 11  Pages 1377-1540 (7 March 2019)
https://www.sciencedirect.com/journal/vaccine/vol/37/issue/11

Research article  Abstract only
Perceptions and acceptability of an experimental Ebola vaccine among health care workers, frontline staff, and the general public during the 2014–2015 Ebola outbreak in Sierra Leone
Mohamed F. Jalloh, Mohammad B. Jalloh, Alison Albert, Brent Wolff, … Helena Nordenstedt
Pages 1495-1502
 
 

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

Global Health Action
[01 Jan 2019, 12(1):1574544]
Article
Organization and implementation of an oral cholera vaccination campaign in an endemic urban setting in Dhaka, Bangladesh.
IA Khan, AI Khan, A Rahman, SA Siddique, MT Islam… –
Abstract
Bangladesh has historically been cholera endemic, with seasonal cholera outbreaks occurring each year. In collaboration with the government of Bangladesh, the Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) initiated operational research to test strategies to reach the high-risk urban population with an affordable oral cholera vaccine (OCV) “ShancholTM” and examine its effectiveness in reducing diarrhea due to cholera. Here we report a sub-analysis focusing on the organization, implementation and effectiveness of different oral cholera vaccine delivery strategies in the endemic urban setting in Bangladesh. We described how the vaccination program was planned, prepared and implemented using different strategies to deliver oral cholera vaccine to a high-risk urban population in Dhaka, Bangladesh based on administrative data and observations made during the program. The objective of this study is to evaluate the organization, implementation and effectiveness of different oral cholera vaccine delivery strategies in the endemic urban setting in Bangladesh. OCV administration by trained local volunteers through outreach sites and mop-up activities yielded high coverage of 82% and 72% of 172,754 targeted individuals for the first and second dose respectively, using national Expanded Program on Immunization (EPI) campaign mechanisms without disrupting routine immunization activities. The cost of delivery was low. Safety and cold chain requirements were adequately managed. The adopted strategies were technically and programmatically feasible. Current evidence on implementation strategies in different settings together with available OCV stockpiles should encourage at-risk countries to use OCV along with other preventive and control measures.
 
 

Family & Community Health
April/June 2019 – Volume 42 – Issue 2 – p 161–169
https://journals.lww.com/familyandcommunityhealth/pages/default.aspx
Original Articles
Toward a Model of HPV Vaccine Series Completion in Adolescent Hispanic Males: Identifying Mothers’ Salient Behavioral, Normative, and Control Beliefs
AM Roncancio, CC Carmack, KK Ward, SW Vernon…
Abstract
Human papillomavirus (HPV) vaccine series completion among adolescent Hispanic males (35%) is lower than the Healthy People 2020 80% goal. This directed qualitative content analysis identified mothers’ beliefs about their sons completing the series. We found that mothers (N = 19) (1) express positive feelings; (2) believe the vaccine has positive effects; (3) identify the father and doctors as supporters and friends as nonsupporters; (4) list health insurance, transportation, and clinic reminders as facilitators; and (5) mention affordability as a barrier to vaccine completion. Results provide guidance for interventions. Increasing HPV vaccination among boys will decrease the overall incidence of HPV in this population.
 
 

Journal of Adolescent Health
Available online 15 February 2019
Original article
Predictors of Human Papillomavirus Vaccine Completion Among Low-Income Latina/o Adolescents
MA Gerend, YP Stephens, MM Kazmer, EH Slate… – Journal of Adolescent …, 2019
The purpose of this longitudinal study was to identify individual and interpersonal factors associated with human papillomavirus (HPV) vaccine series completion in a sample of low-income Latina/o adolescent girls and boys.
American Journal of Preventive Medicine
Available online 15 February 2019
Review Article
Human Papillomavirus Vaccine Interventions in the US: A Systematic Review and Meta-analysis
AM Rodriguez, TQN Do, M Goodman, KM Schmeler… – American Journal of …, 2019
Despite current recommendations, human papillomavirus vaccine uptake remains low. A systematic review and meta-analysis assessed the effectiveness of interventions targeting human papillomavirus vaccine initiation and completion among children, adolescents, and young adults aged 9–26 years.
 
Deutsche Medizinische Wochenschrift (1946)
[13 Feb 2019, 144(4):244-253]
Journal Article
Gaps in Vaccine Coverage and Adverse Effects of Vaccines-An Overview
C Bogdan – Deutsche medizinische Wochenschrift (1946), 2019
Abstract
The success of vaccination programs is jeopardized by gaps in vaccine coverage of the target population. These are frequently due to a lack of awareness, but also result from misconceptions of adverse effects of vaccines. Subject of this article are the current vaccination rates of children, adolescents and adults as well as of medical personnel in Germany, the reporting and surveillance system for adverse effects of vaccines, the magnitude of registered permanent vaccine-induced damages and the possible immunological mechanisms underlying vaccine-triggered autoimmune diseases.
 

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 23 Feb 2019
More than 900 dead in Madagascar measles outbreak
February 21, 2019
JOHANNESBURG (AP) — The World Health Organization says that an epidemic of measles in Madagascar has caused more than 900 deaths.
According to WHO figures, there have been more than 68,000 cases of the disease in which 553 deaths were confirmed and another 373 suspected from measles since the outbreak began in September.
Those most at risk are infants from nine to 11 months old.
The epidemic is blamed on a low immunization rate for measles across the island nation over a period of many years, according to WHO spokesman Tarik Jasarevic. The vaccination rate is estimated to be less than 60 percent, according to figures from WHO and UNICEF figures, he said.
Madagascar has launched a nationwide campaign to try to bring the outbreak under control, through mass vaccination campaigns and surveillance.
 
 
The Atlantic
http://www.theatlantic.com/magazine/
Accessed 23 Feb 2019
[No new, unique, relevant content]
 
 
BBC
http://www.bbc.co.uk/
Accessed 23 Feb 2019
[No new, unique, relevant content]
 
 
The Economist
http://www.economist.com/
Accessed 23 Feb 2019
[No new, unique, relevant content]
 
 
Financial Times
http://www.ft.com/home/uk
Accessed 23 Feb 2019
[No new, unique, relevant content]
 
 
Forbes
http://www.forbes.com/
Accessed 23 Feb 2019
5 Cognitive Biases That Explain Why People Still Don’t Vaccinate
Parents who refuse to vaccinate their children often fall prey to several common cognitive biases, experts say.
By  Sarah Watts  Contributor
…The subject of vaccines involves complex medical science, so the mechanism of how they work and what’s in them can be hard for a layperson to understand. Additionally, because public safety is involved (particularly the safety of children, who are more vulnerable to disease), strong emotions abound. As a result, people are likely to fall prey to a number of cognitive biases when deciding whether or not to vaccinate. Here are just five examples.
1. Cognitive dissonance. “Cognitive dissonance occurs when an individual has conflicting thoughts or behavior. To ease the discomfort, the individual either needs to change the behavior or change the belief,” says Smith. For a parent who hears about the efficacy of vaccines but also worries they may harm their child, they may decide that vaccines don’t work in order to eliminate the dissonance. “Though these conclusions are incorrect, choosing to believe them makes parents feel better about their choices to not vaccinate,” says Smith.

2) Omission bias. “One interesting bias I’ve come upon is the omission bias,” says Dr. Nidhi Ghildayal, researcher and PhD in Public Health at the University of Minnesota. In regard to vaccines, the omission bias occurs when “parents believe that the act of vaccinating, which they may have heard has a small chance of [side effects], is worse than simply not committing any action, even if the potential consequences of this non-action pose a significantly higher risk.” In other words, not vaccinating can feel safer because it’s an inaction – even though the risks involved in that inaction are greater.

3) Confirmation bias. Parents who choose not to vaccinate may also rely on confirmation bias to justify their decision, says Smith. “Confirmation bias is the tendency to interpret or focus on information which supports our existing beliefs,” she says. Although everyone falls victim to confirmation bias some of the time, parents who choose not to vaccinate “frequently turn a blind eye to the copious research and evidence that shows the necessity of vaccines, and instead focus on any evidence that supports what they believe in order to feel better about their decision,” Smith says.

4) Availability heuristic. “The availability heuristic is another common cognitive bias in which individuals tend towards remembering or rehashing rare or distant instances in which vaccines have failed, as opposed to understanding and retaining all the instances in which vaccines have worked and prevented illness,” Ghildayal says. “Media and social circles are much more likely to bring up these rare occurrences, so an individual is much more likely to have those cases in the front of their mind.”

5) Illusory correlation. The illusory correlation is a belief that a relationship exists between two variables when in reality, it probably doesn’t. “Parents may choose to believe that children who show symptoms of autism have been influenced by vaccinations, since the symptoms and the vaccinations tend to occur around the same time,” says Smith, even though the connection between autism and vaccinations has been debunked. “A preconceived belief about the connection between vaccination and autism leads parents to use any incidence where autism and vaccination co-occur to confirm their bias and to support their choice to not vaccinate.”

 
 
Foreign Affairs
http://www.foreignaffairs.com/
Accessed 23 Feb 2019
[No new, unique, relevant content]
 
 
Foreign Policy
http://foreignpolicy.com/
Accessed 23 Feb 2019
[No new, unique, relevant content]
 
 
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
[See Milestones/Perspectives above for full text]
 
 
New Yorker
http://www.newyorker.com/
Accessed 23 Feb 2019
[No new, unique, relevant content]
 
 
New York Times
http://www.nytimes.com/
Accessed 23 Feb 2019
Health
Feb 23, 2019
Pinterest Restricts Vaccine Search Results to Curb Spread of Misinformation
Pinterest, a digital platform popular with parents, took an unusual step to crack down on the proliferation of anti-vaccination propaganda: It purposefully hobbled its search box.
Type “vaccine” into its search bar and nothing pops up. “Vaccination” or “anti-vax”? Also nothing.
Pinterest, which allows people to save pictures on virtual pinboards, is often used to find recipes for picky toddlers, baby shower décor or fashion trends, but it has also become a platform for anti-vaccination activists who spread misinformation on social media.
It is an especially effective way to reach parents: 80 percent of mothers and 38 percent of fathers in the United States are on Pinterest, according to 2017 data from comScore. The company has more than 250 million monthly active users and is expected to go public this year.
Other platforms like Facebook and YouTube have also been infiltrated with misinformation about vaccines, and are taking steps to combat it. One of YouTube’s policies is to demonetize anti-vaccine videos.
But only Pinterest, as first reported by The Wall Street Journal, has chosen to banish results associated with certain vaccine-related searches, regardless of whether the results might have been reputable.
“Right now, blocking results in search is a temporary solution to prevent people from encountering harmful misinformation,” said Jamie Favazza, a spokeswoman. The company said it was working with experts to develop a more tailored long-term approach.
The changes, which were not publicly announced, started in September and October.
 
 
Wall Street Journal
http://online.wsj.com/home-page?_wsjregion=na,us&_homepage=/home/us
Accessed 23 Feb 2019
[No new, unique, relevant content]
 
 
Washington Post
http://www.washingtonpost.com/
Accessed 23 Feb 2019
Some anti-vaccination parents cite religious exemptions. Measles outbreaks could change that.
Sarah Pulliam Bailey · Feb 21, 2019

Think Tanks et al

Brookings
http://www.brookings.edu/
Accessed 23 Feb 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 23 Feb 2019
[No new relevant content]

Council on Foreign Relations
http://www.cfr.org/
Accessed 23 Feb 2019
[No new relevant content]

Kaiser Family Foundation
https://www.kff.org/search/?post_type=press-release
Accessed 23 Feb 2019
[No new relevant content]

Milestones :: Perspectives

Thousands of children vaccinated in remote Rukban settlement amid severe lack of access to medical care
UNICEF, UN and Syrian Arab Red Crescent reach more than 40,000 people with life-saving supplies in largest-ever humanitarian convoy since the start of the Syria crisis

NEW YORK/DAMASCUS, 15 February 2019 – UNICEF-supported vaccinators were able to immunize thousands of children during a 9-day mission to the remote makeshift settlement in Rukban at the border with Jordan, home to more than 40,000 people – mostly women and children.

The joint UNICEF, UN and Syrian Arab Red Crescent mission to Rukban is the largest humanitarian delivery in Syria’s eight-year crisis. Thirty of the convoy’s 118 trucks were loaded with UNICEF’s life-saving supplies for children, including health and nutrition supplies for an estimated 20,000 children and mothers; hygiene kits for more than 40,000 people; recreational kits; and education supplies, including school books, stationery and school bags, for over 8,000 children…

Milestones :: Perspectives

World Organisation for Animal Health (OIE)   [to 16 Feb 2019]
http://www.oie.int/en/for-the-media/press-releases/2018/
14/02/19
New report shows global shift in use of antibiotics in animals

Figures released in a new report today by the World Organisation for Animal Health (OIE) show positive global progress on the regulation and monitoring of antimicrobial use in animals. The report aims to build the capacity of all countries to collect critical data on the use of antimicrobials in animals.  

Paris, 14 February 2019 – The OIE has developed a voluntary data collection system on the use of antimicrobial agents in animals to which any country can contribute. The report presents the overall findings of the third annual data collection, providing a global and regional analysis from 2015 to 2017. A record of 155 countries participated in it, demonstrating increased international understanding and prioritisation of this issue.

“The OIE database is an important initiative building national and global surveillance capacity on antimicrobial use in animals,” said Dr Monique Eloit, Director-General of the OIE. “Irrespective of the financial resources at their disposal, the OIE aims to support countries to ensure that antibiotics and other important veterinary medicines are used prudently and responsibly. One of the OIE’s key recommendations is for countries to immediately phase out the use of critical antimicrobials for growth promotion.”

Indeed, the report shows that the reported use of antimicrobials for growth promotion has declined from 60 to 45 countries since the last round of data collection. However, key antimicrobials, classified by the WHO as ‘Highest Priority Critically Important Antimicrobials’, including colistin, continue to be used routinely in several regions for this purpose. This practice puts at risk many of the medicines that we take for granted today, for both animals and humans.

The development of a robust regulatory framework is a key component to protect and ensure responsible and prudent use of antimicrobial agents in animal health and production. It is also a powerful instrument to phasing out their use as growth promoters, while recognising that voluntary approaches can be effective in certain countries. The report shows positive progress, while 72 countries do not have a regulatory framework on the use of growth promotors, it is a decrease from the first database report in which 110 countries lacked such a framework. This decline suggests critical progress in the implementation of regulations on the use of antimicrobial agents.

“Many countries have already taken key actions, such as setting up surveillance systems and regulating the use of antimicrobials in human and animal health, but we still have a long way to go,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “Working together is the only way to avoid the huge human, social, economic and environmental costs of antimicrobial resistance.”…

Milestones :: Perspectives

DRC

DRC 2018 Ebola outbreaks
Potential new Ebola drugs being trialled in MSF treatment centres
Statement 12 Feb 2019
Four potential new treatments for Ebola are being used in a randomised controlled trial (RCT) at the Ebola Treatment Centres operated by Médecins Sans Frontières (MSF) in Katwa and Butembo, in North Kivu province, Democratic Republic of Congo (DRC).

The trial, being run in collaboration with the Ministry of Health, originally began in November 2018 in another treatment centre in the region, and MSF facilities are now able to contribute to providing valuable information on these developmental drugs.

The treatments that will be used in the RCT are drugs remdesivir, mAb114, REGN-EB3 and ZMapp. They have been offered to patients since the beginning of the current Ebola outbreak under Monitored Emergency Use of Unregistered and Investigational Interventions (MEURI) protocols.

The switch from MEURI protocols to a clinical trial is a critical step, as a clinical trial can generate the scientific data needed to draw conclusions on how effective these treatments are. The main objective of the trial is to identify the most effective of the four products to treat Ebola patients.

The trial is overseen by a steering committee convened by the World Health Organization and led by the National Institute of Biomedical Research of DRC (INRB) and the US National Institute of Health (NIH) in collaboration with other national and international organisations.
Butembo and Katwa are currently the hotspots of the Ebola epidemic that was declared in DRC on 1 August 2018.

The Butembo treatment centre can admit 96 people, while the one in Katwa, which opened last month, has a 62-bed capacity. Since they opened, MSF has admitted more than 2,100 patients to these two centres, of which 250 were confirmed cases, with 110 people recovering.

Featured Journal Content

The Lancet
Feb 16, 2019  Volume 393  Number 10172p611-716, e29
https://www.thelancet.com/journals/lancet/issue/current

Comment
Ebola in the Democratic Republic of the Congo: time to sound a global alert?
Lawrence Gostin, Alexandra Phelan, Alex Godwin Coutinho, Mark Eccleston-Turner, Ngozi Erondu, Oyebanji Filani, Tom Inglesby, Rebecca Katz, Allan Maleche, Jennifer B Nuzzo, Oyewale Tomori, Matthew Kavanagh
[Excerpt]
…We call upon the WHO Director-General to reconvene the EC to review the grounds for a PHEIC declaration. He should invite states, the UN, and NGOs to attend and submit evidence. 10  The United Nations Organization Stabilization Mission in the Democratic Republic of the Congo (MONUSCO), UNHCR, the UN Refugee Agency, and civil society could provide critical information. The EC should recommend proactive measures on health, diplomacy, security, and community engagement. Concrete recommendations could specify the level and kind of resources needed and composition of security and diplomatic assets.

A PHEIC is a clarion call to galvanise high-level political, financial, and technical support. A PHEIC would provide a clear signal from the world’s global health body that UN leadership is urgent. A PHEIC also empowers the WHO Director-General to make temporary, non-binding recommendations that have normative force.10

The IHR do not specify any surge in authority or financing when declaring a PHEIC. In the past, states did not heed WHO warnings that travel and trade restrictions are harmful. During the west African Ebola epidemic, 58 states restricted travel from affected areas, and during the 2009 influenza A H1N1 pandemic, states imposed trade and travel restrictions.12,13,14]

Trade or travel barriers in the DRC would have devastating impacts. WHO, with UN support, should take active steps to prevent unlawful and harmful restrictions. In 2009, WHO and the World Trade Organization (WTO) criticised governments that took non-evidence-based actions; going forward, WHO and WTO could publicly name non-compliant countries. Governments should also agree to dispute resolution, including binding IHR arbitration.10

If a PHEIC escalated conflict by raising the profile of the international response, it would be deeply concerning. Recent elections in DRC were clouded by concerns about vote-rigging, unsettling lines of power and legitimacy. Armed groups have used violence to generate chaos. A PHEIC could increase incentives to target Ebola responders to gain leverage. As in South Sudan, armed groups could manipulate aid for non-humanitarian purposes.15 Like any complex multilateral negotiation, cultural competence and smart diplomacy are required. Outsiders are unlikely to be privy to all on-the-ground realities and risks.

The IHR were designed to respond to a health emergency like the DRC Ebola epidemic. We urge the WHO Director-General to reconvene the EC and re-assess the declaration of a PHEIC. The UN and governments should increase support for WHO and partners. If the IHR fails, or worse, increases political instability, it will require urgent reform.

State non-compliance should not obscure the value of the IHR in establishing norms of rapid identification, notification, and response. The IHR require states to develop health-system capacities, assessed by WHO’s Joint External Evaluation. IHR reform should focus on technical and financial assistance for national health capacities. A PHEIC should trigger surge capacity in relation to authority and finances, with effective mechanisms to gain state compliance.

WHO has shown leadership and operational endurance, working tirelessly to combat the DRC Ebola epidemic. But WHO and partners cannot succeed alone. We live at a political moment when international solutions to collective threats are increasingly hard to achieve. But WHO and the UN system will be called upon with ever-greater frequency in the future to manage complex humanitarian crises. We must plan for a future in which political violence and instability become the new abnormal.

[References at title link above]

Emergencies
 
 
POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 13 February 2019
:: The 2019 Annual Letter by Bill & Melinda Gates makes a case for investment in global health. Progress by Global Polio Eradication Initiative is a good reminder of how investment in global health funds benefits people around the world. Read the letter here.
:: In Indonesia, a circulating vaccine-derived poliovirus type 1 (cVDPV1) outbreak is confirmed.
 
 
Summary of new viruses this week:
:: Pakistan – once case of wild poliovirus type 1 (WPV1) and four wild polioviruses type 1 (WPV1) positive environmental samples;
:: Nigeria – two circulating vaccine derived poliovirus type 2 (VDPV2) positive environmental samples;
:: Indonesia– one case of circulating vaccine derived poliovirus type 1 (cVDPV1).
 
 

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 16 Feb 2019]
Democratic Republic of the Congo
:: Ebola virus disease – Democratic Republic of the Congo   14 February 2019
… Main challenges this past week primarily pertain to community mistrust, particularly in Katwa, and the difficulty in encouraging community members to be more proactive in reporting suspected cases, presenting early to ETCs for treatment, and participating in community-based prevention and response efforts. However, in the face of these protracted challenges, response strategies have demonstrated to be effective in curtailing the spread of EVD. Fostering greater community trust by strengthening engagement with its members remains a top priority for response teams.
 
On 13 February, the Ministry of Health (MoH) launched the Strategic Response Plan 3 (SRP 3). The plan lays out the response strategy, objectives and budget requirements for the MoH, WHO, and all implementing partners for the next six months (February through July 2019). SRP 3 takes into account recommendations from operational reviews, and builds on a series of new strategic directions that capitalize on lessons learned under the scope of SRP 2. Activities laid out aim to stop the transmission of EVD in North Kivu and Ituri provinces, and prevent its spread to other provinces and neighbouring countries.
 
WHO remains confident that this outbreak can be successfully brought to an end through strategies outlined in SRP 3. To achieve the goals set out by the plan, MoH, WHO, and partners are appealing for US$ 148 million. WHO and partners count on the continued support of the international community to provide the required funding in order to stop this outbreak…
 
Nigeria
:: WHO supports five countries to fight lassa fever outbreaks   8 February 2019
 
Bangladesh – Rohingya crisis – No new digest announcements identified  
Myanmar – No new digest announcements identified  
Somalia – No new digest announcements identified
South Sudan – No new digest announcements identified  
Syrian Arab Republic – No new digest announcements identified  
Yemen – No new digest announcements identified
 
::::::
 
WHO Grade 2 Emergencies  [to 16 Feb 2019]
Libya
:: US$ 43.5 million needed to provide life-saving health aid in Libya in 2019
Cairo, 11 February 2019 – The World Health Organization and health partners are appealing for US$ 43.5 million to provide life-saving interventions for 388 000 people inside Libya affected by ongoing conflict…
 
Iraq
:: WHO intercountry cooperation yields rich health dividends
13 February 2019 – Intercountry collaboration between Iraq and Jordan allowed WHO and health authorities in Iraq to rapidly and successfully respond to an increase in cases of acute respiratory infections…
 
MERS-CoV
:: MERS therapeutics and vaccines workshop 30 November 2018
13 Feb 2019
Meeting report pdf, 606kb
Final Agendapdf, 290kb
List of participantspdf, 348kb
 
 
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
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 16 Feb 2019]
Afghanistan
Chad
Indonesia – Sulawesi earthquake 2018
Kenya
Lao People’s Democratic Republic
Mali
Namibia – viral hepatitis
Peru
Philippines – Tyhpoon Mangkhut
Tanzania
 
::::::
 
WHO AFRO Outbreaks – Week 06: 04 – 10 February 2019
The WHO Health Emergencies Programme is currently monitoring 60 events in the region. This week’s edition covers key new and ongoing events, including:
:: Ebola virus disease in the Democratic Republic of the Congo
:: Lassa fever in Nigeria
:: Ebola virus disease in the Democratic Republic of the Congo
:: Measles in Madagascar
:: Humanitarian crisis in Central African Republic
 
 
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. 
Yemen – No new digest announcements identified
Syrian Arab Republic   – 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  – No new digest announcements identified
Somalia  – No new digest announcements identified

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

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

EBOLA/EVD  [to 16 Feb 2019]
http://www.who.int/ebola/en/
:: Ebola virus disease – Democratic Republic of the Congo   14 February 2019
 
 
MERS-CoV [to 16 Feb 2019]
http://who.int/emergencies/mers-cov/en/
:: MERS therapeutics and vaccines workshop 30 November 2018  13 Feb 2019
Meeting report pdf, 606kb
Final Agendapdf, 290kb
List of participantspdf, 348kb
 
 
Yellow Fever  [to 16 Feb 2019]
http://www.who.int/csr/disease/yellowfev/en/
– No new digest announcements identified.
 
 
Zika virus  [to 16 Feb 2019]
http://www.who.int/csr/disease/zika/en/
– No new digest announcements identified.

WHO & Regional Offices [to 16 Feb 2019]
 
12 February 2019
News Release
New WHO-ITU standard aims to prevent hearing loss among 1.1 billion young people
 
12 February 2019
News Release
International push to improve food safety
 
11 February 2019 | News release
US$ 43.5 million needed to provide life-saving health aid in Libya in 2019
 
::::::
  
Weekly Epidemiological Record, 15 February 2019, vol. 94, 07 (pp. 81–84)
:: 7th Meeting of the WHO Expert Working Group of the Global Influenza Surveillance and Response System for Surveillance of Antiviral Susceptibility
:: Executive summary of the 10th meeting of the WHO Working Group for the Molecular :: Detection and Subtyping of Influenza Viruses and the use of next-generation sequencing in the Global Influenza Surveillance and Response System
 
 
WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: Cabo Verde is ready to host 2nd African Health Forum and share good practices on progress towards Universal Health Coverage  14 February 2019
:: Uganda Health Workers Respond Swiftly to a Suspected Ebola Death  12 February 2019
:: Ethiopia Launches Measles Vaccine Second Dose (MCV2) Introduction: Over 3.3 million children will receive the vaccine annually  11 February 2019
:: Nigeria’s call to action – Time to Eliminate Cervical Cancer in Nigeria  10 February 2019
 
 
WHO Region of the Americas PAHO
:: Latest PAHO “Basic Indicators” shed light on health situation in the Americas (02/13/2019)

Vaccination
Vaccination coverage in 2017 varies for different vaccines: 94% percent of the target population of children in the Americas received the tuberculosis (BCG) vaccine; 90% received the vaccine for the first dose of measles, mumps, and rubella (MMR1); 88% received three doses of diphtheria, tetanus and pertussis (DTP3) vaccine; 85% received three doses of polio vaccine; and 73% received the last dose of rotavirus vaccine.
 
WHO South-East Asia Region SEARO
– No new digest announcements identified.
 
WHO European Region EURO
:: Towards a digital health roadmap for the WHO European Region 14-02-2019
 
 
WHO Eastern Mediterranean Region EMRO
:: Effective collaboration mitigates risk of potential outbreak
13 February 2019 – Intercountry collaboration between Iraq and Jordan allowed WHO and health authorities in Iraq to rapidly and successfully respond to an increase in cases of acute respiratory infections.
The last week of November 2018 witnessed an alarming rise in the incidence of acute respiratory infections in Suleimaniya governorate in the Kurdistan Region of Iraq. By 31 December, more than 35 suspected cases of influenza were admitted to Shaheed Hemin Hospital for Internal Medicine in the governorate…
:: US$ 43.5 million needed to provide life-saving health aid in Libya  11 February 2019
 
 
WHO Western Pacific Region
– No new digest announcements identified.

CDC/ACIP [to 16 Feb 2019]
http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html

MMWR News Synopsis for February 15, 2019
Update: Influenza Activity — United States, September 30, 2018–February 2, 2019
Influenza activity in the United States remained elevated through February 2, 2019, and is expected to continue for several more weeks. Influenza vaccination is the best way to reduce the risk of influenza and its potentially serious consequences, including hospitalizations in adults and deaths in children. Influenza antiviral medications are an important adjunct to vaccination in the treatment and prevention of influenza. Since December 2018, influenza activity increased overall and remained elevated through early February. Nationwide, influenza A(H1N1)pdm09 viruses have predominated, but in the southeastern United States influenza A(H3N2) viruses have predominated. As of February 2, 2019, this has been a low-severity influenza season, with a lower percentage of outpatient visits for influenza-like illness (ILI), lower rates of hospitalization, and fewer deaths attributed to pneumonia and influenza compared with recent seasons. Nevertheless, this season has resulted in many illnesses, hospitalizations and deaths, which are being reported in-season for the first time. The majority of the influenza viruses characterized antigenically and genetically are similar to the cell-grown reference viruses representing the 2018–19 Northern Hemisphere influenza vaccine viruses.

Interim Estimates of 2018–19 Seasonal Influenza Vaccine Effectiveness — United States, February 2019
While flu vaccines vary in how well they work, vaccination can provide important protection against influenza. People age 6 months and older who have not yet been vaccinated this season should be vaccinated. People who are at high risk of serious flu complications and develop flu symptoms, and people who are very sick with flu should be treated early with antiviral medications. CDC recommends yearly influenza vaccination for children at least 6 months old and adults. Early estimates indicate that influenza vaccines have reduced the risk of medically attended influenza-related illness by almost half (47%) in vaccinated people so far this season. Vaccination reduced the rate of illness caused by the predominant influenza H1N1 virus by about 46 percent among patients of all ages, and by about 62 percent among children 6 months through 17 years of age. Vaccination provided similar protection to that seen in previous H1N1 seasons in children and in adults younger than age 50. For these estimates, 3,254 children and adults with acute respiratory illness were enrolled from November 23, 2018 to February 2, 2019 at five study sites with outpatient medical facilities in the United States.

Recommendations of the Advisory Committee on Immunization Practices for Use of Hepatitis A Vaccine for Persons Experiencing Homelessness
The Advisory Committee on Immunization Practices now recommends routine hepatitis A (HepA) vaccination for all people ages 1 year and older who experience homelessness. In October 2018, the Advisory Committee on Immunization Practices (ACIP) unanimously approved updating the recommendations for HepA vaccine to include all people ages 1 year and older experiencing homelessness. The new recommendation is based on evidence showing the substantial public health and cost benefit of routine HepA vaccination for people who are homeless. Additionally, recent outbreaks of hepatitis A virus transmission have demonstrated the vulnerability of this population to this infection. Between 2016 and 2018, more than 7,000 cases of hepatitis A infection were reported in 12 states. The majority of these infections were among people reporting homelessness and/or injection or non-injection drug use. HepA vaccination for people who are homeless will protect these vulnerable individuals and reduce the risk of person-to-person outbreaks among this population.

Africa CDC   [to 16 Feb 2019]

https://au.int/en/africacdc

No new digest content 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 [16 Feb 2019]

Announcements
 
 
Paul G. Allen Frontiers Group    [to 16 Feb 2019]
https://www.alleninstitute.org/news-press/
No new digest content identified.
 
 
BMGF – Gates Foundation  [to 16 Feb 2019]
http://www.gatesfoundation.org/Media-Center/Press-Releases
No new digest content identified.
 
 
Bill & Melinda Gates Medical Research Institute    [to 16 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 16 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 16 Feb 2019]
http://cepi.net/
No new digest content identified.
 
 
EDCTP    [to 16 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
No new digest content identified.
 
 
Emory Vaccine Center    [to 16 Feb 2019]
http://www.vaccines.emory.edu/
No new digest content identified.
 
 
European Medicines Agency  [to 16 Feb 2019]
http://www.ema.europa.eu/ema/
News and press releases
Role of big data for evaluation and supervision of medicines in the EU
15/02/2019
Recommendations for a path towards understanding the acceptability of evidence derived from ‘Big data’ in support of the evaluation and supervision of medicines by regulators were published today as part of a summary report of the Heads of Medicines Agencies (HMA) – EMA Joint Big Data task force . The recommendations and associated actions set out what needs to be addressed, but the mechanisms by which this may be achieved requires further focused work over the coming year. Stakeholders are invited to submit feedback and observations on the recommendations to inform the upcoming work of the group.

Massive amounts of data are generated on a daily basis through wearable devices, electronic health records, social media, clinical trials or spontaneous adverse reaction reports. There is no doubt that insights derived from this data will increasingly be used by regulators to assess the benefit-risk of medicines across their whole lifecycle. However, in order to benefit from and make prudent use of the data collected, regulators need a deeper understanding of the data landscape.

The HMA – EMA Joint Big Data task force is composed of experienced medicines regulators from 14 national competent authorities and EMA. In preparing the report, it assessed the generation of ‘big data’, their relevant sources and main formats, the methods for processing and analysing big data and the current state of expertise across the European medicines regulatory network.

A crucial step was defining ‘big data’ itself, a widely-used term that is lacking a commonly-accepted definition. The definition adopted by the task force reads as follows: “extremely large datasets which may be complex, multi-dimensional, unstructured and heterogeneous, which are accumulating rapidly and which may be analysed computationally to reveal patterns, trends and associations. In general, big data sets require advanced or specialised methods to provide an answer within reliable constraints.”

Six subgroups of data sources relevant to regulatory decision-making were considered by the taskforce: genomics, bioanalytical ‘omics (proteomics, etc.), clinical trials, observational data, spontaneous adverse drug reactions data and social media and mobile health data.

Stakeholders and members of the public are invited to submit their comments on the core recommendations in the summary report (not to exceed 1,000 words) to bigdatasec@dkma.dk

until 15 April 2019. In particular, views on prioritisation of future actions would be welcomed.

The feedback received will be taken into account in the next phase of the work of the task force. A newly-refined mandate for the group is in place for the next year to define next steps and prioritisation of actions.
 
 
European Vaccine Initiative  [to 16 Feb 2019]
http://www.euvaccine.eu/news-events
Latest news
No new digest content identified.
 
 
FDA [to 16 Feb 2019]
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
No new digest content identified.
 
 
Fondation Merieux  [to 16 Feb 2019]
http://www.fondation-merieux.org/
No new digest content identified.
 
 
Gavi [to 16 Feb 2019]
https://www.gavi.org/
13 February 2019
UK to host Gavi replenishment in 2020
Geneva, 13 February 2019 – The UK government today announced that it will host Gavi’s replenishment pledging conference in mid-2020.
The event will follow the successful Gavi pledging conference in Berlin in January 2015, which raised US $7.5 billion for the 2016-2020 period. Next year’s event will raise funds to support Gavi’s programmes from 2021-2025, and will aim to bring together contributions from donors.    These resources will be complemented by developing countries co-financing and the vaccine industry’s contributions. The investment case, which will set out the amount required, will be published later this year…

12 February 2019
Ethiopia introduces measles vaccine second dose with support from Gavi
Addis Ababa, 12 February 2019 – Ethiopia has introduced measles vaccine second dose (MCV2) vaccination into the routine immunization programme, with technical and financial support from Gavi, the Vaccine Alliance and the World Health Organisation. Around 3.3 million children throughout the country will receive measles vaccine second dose annually…
 
 
GHIT Fund   [to 16 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
No new digest content identified.
 
 
Global Fund  [to 16 Feb 2019]
https://www.theglobalfund.org/en/news/
News
No new digest content identified.
 
 
Hilleman Laboratories   [to 16 Feb 2019]
http://www.hillemanlabs.org/
No new digest content identified.
 
 
Human Vaccines Project   [to 16 Feb 2019]
http://www.humanvaccinesproject.org/media/press-releases/
February 13, 2019
Decoding the Human Immune System
For the first time ever, researchers are comprehensively sequencing the human immune system, which is billions of times larger than the human genome. In a new study published in Nature from the Human Vaccines Project, scientists have sequenced a key part of this vast and mysterious system — the genes encoding the circulating B cell receptor repertoire.
Sequencing these receptors in both adults and infants, the scientists found surprising overlaps that could provide potential new antibody targets for vaccines and therapeutics that work across populations. As part of a large multi-year initiative, this work seeks to define the genetic underpinnings of people’s ability to respond and adapt to an immense range of disease.
Led by scientists at Vanderbilt University Medical Center and the San Diego Supercomputer Center, this advancement is possible due to the merging of biological research with high-powered frontier supercomputing. While the Human Genome Project sequenced the human genome and led to the development of novel genomics tools, it did not tackle the size and complexity of the human immune system…
 
 
IAVI  [to 16 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 16 Feb 2019]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
No new digest content identified.
 
 
IVI   [to 16 Feb 2019]
http://www.ivi.int/
IVI News & Announcements
IVI and Yonsei University College of Medicine’s IIID to collaborate in vaccine R&D
On February 12 IVI exchanged a memorandum of understanding with the Institute of Immunology and Immunological Diseases (IIID), part of Yonsei University’s College of Medicine [Korea]. With this agreement, the two organizations are establishing a collaborative relationship in research and development of vaccines in order to help achieve the common goal of accelerating safe, effective, and affordable vaccines for people in developing countries and global health….
 
 
JEE Alliance  [to 16 Feb 2019]
https://www.jeealliance.org/
Selected News and Events
No new digest content identified.
 
 
MSF/Médecins Sans Frontières  [to 16 Feb 2019]
http://www.msf.org/
Selected News; Project Updates, Reports [as presented on website]
Cameroon
Nothing to drink and nowhere to sleep for thousands who’ve fl…
Press Release 14 Feb 2019

Democratic Republic of Congo
Even during a widespread measles epidemic, we can sa…
Interview 14 Feb 2019

Yemen
MSF opens new emergency room in Ad Dahi hospital
Project Update 14 Feb 2019

DRC 2018 Ebola outbreaks
Potential new Ebola drugs being trialled in MSF treatment centres
Statement 12 Feb 2019
[See Emergencies above for detail]

El Salvador
Breaking the invisible barriers that divide neighbourhoods con…
Project Update 11 Feb 2019

Colombia
Buenaventura: “MSF fills a huge vacuum in helping victims of vio…
Interview 11 Feb 2019
 
 
NIH  [to 16 Feb 2019]
http://www.nih.gov/news-events/news-releases
February 14, 2019
NIH names Dr. Noni H. Byrnes director of the Center for Scientific Review
— National Institutes of Health Director Francis S. Collins M.D., Ph.D., announced today the selection of Noni H. Byrnes, Ph.D., as director of the NIH Center for Scientific Review (CSR), effective Feb. 17, 2019.
 
Patients to share personal journeys at NIH Rare Disease Day events
February 11, 2019 — Connect with patients about navigating life with a rare disease.
 
 
PATH  [to 16 Feb 2019]
https://www.path.org/media-center/
No new digest content identified.
 
 
Sabin Vaccine Institute  [to 16 Feb 2019]
http://www.sabin.org/updates/pressreleases
Monday, February 11, 2019
The Bill & Melinda Gates Foundation and the Sabin Vaccine Institute Partner to Improve Vaccine Access by Strengthening Immunization Programs

WASHINGTON, DC – With the mutual goal of improving access to life-saving vaccines, the Bill & Melinda Gates Foundation recommitted its support to the Sabin Vaccine Institute (Sabin) to relaunch a global network for immunization managers. The success of immunization programs to reach populations with vaccines depends on excellent program management. Sabin will use the three-year, U.S. $3.5 million grant to provide national and sub-national immunization managers with training, education and networking opportunities, with an emphasis on strengthening management and leadership skills.

This initiative builds on the IAIM Network (International Association of Immunization Managers), established five years ago with support from the Bill & Melinda Gates Foundation to help immunization managers connect, share best practices and learn from trusted peers. The IAIM Network has become the world’s largest network for immunization managers, with more than 400 managers from over 120 countries engaging in virtual or in-person activities.

“We know that improving management capabilities and skills has a direct effect on program performance,” said Dr. Bruce Gellin, president of Global Immunization at Sabin. “This network will empower immunization managers to get answers, grow in their role and raise their collective voice.”…
 
 
UNAIDS [to 16 Feb 2019]
http://www.unaids.org/en
Selected Press Releases/Reports/Statements
15 February 2019
Healthy populations for healthy economies in Africa

15 February 2019
Ethiopia demonstrates that communities deliver

14 February 2019
OAFLA to broaden its scope of work

14 February 2019
Taking action against HIV medicine stock-outs in the Bolivarian Republic of Venezuela

12 February 2019
AIDS care in the Californian desert

12 February 2019
UNAIDS is awarded the Science and Medicine Award at the 25th Annual Steve Chase Awards
 
 
UNICEF  [to 16 Feb 2019]
https://www.unicef.org/media/press-releases
Selected Press Releases/Reports/Statements
Press release
Thousands of children vaccinated in remote Rukban settlement amid severe lack of access to medical care
UNICEF, UN and Syrian Arab Red Crescent reach more than 40,000 people with life-saving supplies in largest-ever humanitarian convoy since the start of the Syria crisis
15/02/2019

Press release
UNHCR and UNICEF urge action in Europe to end childhood statelessness
14/02/2019

Press release
More than 3,000 children released from armed groups in South Sudan since conflict began, but thousands more continue to be used
12/02/2019

News note
Fast Facts: 10 facts illustrating why we must #EndChildMarriage
11/02/2019

Press release
Dubai Cares and UNICEF announce the Dubai Declaration on Early Childhood Development at the World Government Summit
Declaration is a follow-up to the official MENA launch of the Lancet Series Advancing Early Childhood Development
10/02/2019

Press release
13.5 million children now uprooted in Africa – including those displaced by conflict, poverty and climate change
On eve of African Union Summit, UNICEF urges African States to lead in the protection and empowerment of uprooted children
 
 
Vaccine Confidence Project  [to 16 Feb 2019]
http://www.vaccineconfidence.org/
No new digest content identified.
 
 
Vaccine Education Center – Children’s Hospital of Philadelphia  [to 16 Feb 2019]
http://www.chop.edu/centers-programs/vaccine-education-center
No new digest content identified.
 
 
Wellcome Trust  [to 16 Feb 2019]
https://wellcome.ac.uk/news
Opinion | 15 February 2019
This is a pivotal moment for clinical trial regulations
by Beth Thompson
Globally, clinical research is governed by guidelines established almost three decades ago. And Brexit is a looming issue for trials that take place in the UK. Wellcome’s Policy team is working to address both problems.
 
 
The Wistar Institute   [to 16 Feb 2019]
https://www.wistar.org/news/press-releases
Press Release    Feb. 15, 2019
Wistar’s David B. Weiner, Ph.D., Awarded Prestigious Scientific Achievement Award from Life Sciences Pennsylvania
PHILADELPHIA — (Feb. 15, 2019) — David B. Weiner, Ph.D., executive vice president, director of the Vaccine & Immunotherapy Center, and the W.W. Smith Charitable Trust Professor in Cancer Research at The Wistar Institute, has been named the recipient of this year’s Scientific Achievement Award from Life Sciences Pennsylvania. The organization, with its more than 800-member companies, has a single mission to make Pennsylvania a hub of innovation by creating a business and public policy environment that fosters life sciences growth and success.

“Our Scientific Achievement Award recognizes a scientist in the Pennsylvania life sciences community who has demonstrated outstanding achievement by advancing scientific knowledge, innovation, and/or patient care,” said Christopher P. Molineaux, president & CEO of Life Sciences PA. “We can’t think of a better honoree this year than David – considered a founder of the field of synthetic DNA vaccines with more than 30 years of research contributions and scientific influence.”…
 
 
World Organisation for Animal Health (OIE)   [to 16 Feb 2019]
http://www.oie.int/en/for-the-media/press-releases/2018/
14/02/19
New report shows global shift in use of antibiotics in animals
[See Milestones above for detail]
 
::::::
 
BIO    [to 16 Feb 2019]
https://www.bio.org/insights/press-release
Feb 15 2019
BIO Statement on CMS Proposed Decision Memo for the CAR-T National Coverage Determination
Washington, DC (February 15, 2019) – Today, Biotechnology Innovation Organization (BIO) Executive Vice President for Health Policy, Dan Durham, issued the following statement r  regarding the CMS proposed decision memo for the CAR-T National Coverage Determination:
“We are further analyzing CMS’ released proposed decision memo for the National Coverage Determination for CAR T-cell therapy and look forward to providing the Agency with detailed comments in the coming weeks. It is critical that CMS coverage policies balance timely access to FDA-approved therapies across all potential appropriate settings of care, particularly when making determinations around innovations that represent significant advances in the delivery of treatment, such as CAR T. Further, such policy requirements should not be overly burdensome for providers, should be well aligned with FDA REMS requirements, and should provide enough flexibility as the class of medicines evolves.”
 
 
DCVMN – Developing Country Vaccine Manufacturers Network  [to 16 Feb 2019]
http://www.dcvmn.org/
No new digest content identified.
 
 
IFPMA   [to 16 Feb 2019]
http://www.ifpma.org/resources/news-releases/
No new digest content identified.
 
 
PhRMA    [to 16 Feb 2019]
http://www.phrma.org/press-room
No new digest content identified.
 
 
Industry Watch  [to 16 Feb 2019]
:: Moderna Announces Positive Interim Phase 1 Data for First Combination Vaccine Against the Respiratory Viruses hMPV and PIV3 February 12, 2019
   Interim data show vaccination with mRNA-1653 boosted serum neutralization titers against hMPV and PIV3 at all dose levels tested and was generally well tolerated
   Company plans to advance mRNA-1653 into a Phase 1b study in seropositive pediatric subjects

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 Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 16 Feb 2019)

Research article
Comparison of influenza disease burden in older populations of Hong Kong and Brisbane: the impact of influenza and pneumococcal vaccination
Influenza and pneumococcal vaccine uptake in the older population aged 65 years or over of Hong Kong dramatically increased since the 2003 SARS outbreak. This study is aimed to evaluate the impact of increased…
Authors: Lin Yang, King Pan Chan, Chit Ming Wong, Susan Shui Seng Chiu, Ricardo J. Soares Magalhaes, Thuan Quoc Thach, Joseph Syrial Malik Peiris, Archie C. A. Clements and Wenbiao Hu
Citation: BMC Infectious Diseases 2019 19:162
Published on: 14 February 2019

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 16 Feb 2019)

Research article
Epidemiological characteristics and trends of a Nationwide measles outbreak in Mongolia, 2015–2016
Mongolia was one of the four countries that received a measles-elimination certificate from the World Health Organization Regional Office for the Western Pacific in 2014. Following the outbreaks in many countr…
Authors: Oyunchimeg Orsoo, Yu Mon Saw, Enkhbold Sereenen, Buyanjargal Yadamsuren, Ariunsanaa Byambaa, Tetsuyoshi Kariya, Eiko Yamamoto and Nobuyuki Hamajima
Citation: BMC Public Health 2019 19:201
Published on: 15 February 2019

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 16 Feb 2019)

Research article
Pertussis vaccination status and vaccine acceptance among medical students: multicenter study in Germany and Hungary
Medical students are at risk of contracting and transmitting infectious diseases such as pertussis. Complete vaccination status is important to protect own, patient and public health. Knowing own vaccination s…
Authors: Mandy Böhme, Karen Voigt, Erika Balogh, Antje Bergmann, Ferenc Horváth, Joachim Kugler, Jörg Schelling, Jeannine Schübel and Henna Riemenschneider
Citation: BMC Public Health 2019 19:182
Published on: 12 February 2019