Vaccines — Open Access Journal
http://www.mdpi.com/journal/vaccines
(Accessed 22 Sep 2018)

Open Access   Perspective
Immunizing the Immune: Can We Overcome Influenza’s Most Formidable Challenge?
by Ali H. Ellebedy
Vaccines 2018, 6(4), 68; https://doi.org/10.3390/vaccines6040068 (registering DOI) – 22 September 2018
Abstract
The first human influenza virus was isolated more than 85 years ago, and several vaccine candidates were developed and tested soon after. Yet, controlling infections mediated by this respiratory pathogen continues to present a formidable challenge. Development of an effective influenza vaccine has been undermined by the dynamic nature of influenza viruses: these viruses have the unique capacity to escape pre-existing immunity. In this perspective, I highlight pre-existing immunity as a different, but related, hurdle that may actually lessen the effectiveness of influenza vaccine-induced immune responses. Specifically, I discuss the impact of pre-existing immunity on the generation of de novo B cell responses to influenza vaccination. As the influenza virus changes its major antigenic determinants, it creates new ones in the process. Our immune system adapts by targeting the new determinants. However, pre-existing antibodies and memory B cells interfere with the generation of de novo responses against these newly formed epitopes, rendering vaccines less effective. Overcoming such interference is essential for the development of more effective influenza vaccines.

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

PLOS Biology
18 September 2018 |
Science in the fight to uphold the rights of children
By Peter Hotez, Arthur L. Caplan
Abstract

The United States is the only major nation to not yet have ratified the United Nations Convention on the Rights of the Child (UNCRC). Recently, there has been an erosion of the rights of children across America, Europe, and elsewhere, but through science, we may have an opportunity to counter some of this alarming trend. In the area of vaccines, the scientific community can raise its voice on the dangers that nonmedical exemptions and delays pose to children at risk for measles, influenza, and other childhood illnesses. Poverty places infants and children at high risk for illness and homelessness. Gun violence and gun-related accidents are killing on average four American children daily, and climate change is promoting global pediatric malnutrition. Increasing international, federal, and state support to seek innovative solutions to these and related issues is a moral imperative.

Media/Policy Watch

This watch section is intended to alert readers to substantive news, analysis and opinion from the general media and selected think tanks and similar organizations on vaccines, immunization, global public health and related themes. Media Watch is not intended to be exhaustive, but indicative of themes and issues CVEP is actively tracking. This section will grow from an initial base of newspapers, magazines and blog sources, and is segregated from Journal Watch above which scans the peer-reviewed journal ecology.

We acknowledge the Western/Northern bias in this initial selection of titles and invite suggestions for expanded coverage. We are conservative in our outlook in adding news sources which largely report on primary content we are already covering above. Many electronic media sources have tiered, fee-based subscription models for access. We will provide full-text where content is published without restriction, but most publications require registration and some subscription level.
 
 
The Atlantic
http://www.theatlantic.com/magazine/
Accessed 22 Sep 2018
[No new, unique, relevant content]
 
BBC
http://www.bbc.co.uk/
Accessed 22 Sep 2018
[No new, unique, relevant content]
 
The Economist
http://www.economist.com/
Accessed 22 Sep 2018
[No new, unique, relevant content]
 
Financial Times
http://www.ft.com/home/uk
Accessed 22 Sep 2018
[No new, unique, relevant content]
 
Forbes
http://www.forbes.com/
Accessed 22 Sep 2018
[No new, unique, relevant content]

Foreign Affairs
http://www.foreignaffairs.com/
Accessed 22 Sep 2018
[No new, unique, relevant content]

Foreign Policy
http://foreignpolicy.com/
Accessed 22 Sep 2018
[No new, unique, relevant content]

The Guardian
http://www.guardiannews.com/
Accessed 22 Sep 2018
[No new, unique, relevant content]
 
New Yorker
http://www.newyorker.com/
Accessed 22 Sep 2018
[No new, unique, relevant content]
 
New York Times
http://www.nytimes.com/
Accessed 22 Sep 2018
Europe
Italy Extends Time for Vaccine Proof for Young School Kids
Italian parents have more time before having to produce proof to schools that their children have received 10 mandatory vaccinations.
22 Sep 2018

Africa
Congo Reports Ebola Death Close to Busy Ugandan Border
A Congolese woman who refused an Ebola vaccination and then disappeared has died of the virus near the heavily traveled border with Uganda, which is preparing to begin vaccinations as needed.
22 Sep 2018

China to Improve Financial Supervision, Reform Vaccine Production
China will strengthen the coordination of supervision over “systematically important” financial institutions, state television said on Thursday, citing a central government meeting at which President Xi Jinping presided. The meeting, held by the central committee on deepening reforms, also decided China would reform and improve vaccine production and management, after recent vaccine scandals. (complete article)
20 September 2018

Zimbabwe Seeks $35 Million to Fight Cholera Outbreak
Zimbabwe is appealing to individual citizens and local companies for $35 million to help fight a cholera outbreak that has killed 31 and infected more than 5,000, the finance minister said. … The government has raised $29 million, half from private companies and foreign aid agencies, out of a target of $64.1 million needed for vaccinations, drugs, clean water and better water and sewer pipes, said Finance Minister Mthuli Ncube.
19 September 2018

Wall Street Journal
http://online.wsj.com/home-page?_wsjregion=na,us&_homepage=/home/us
Accessed 22 Sep 2018
[No new, unique, relevant content]

Washington Post
http://www.washingtonpost.com/
Accessed 22 Sep 2018
[No new, unique, relevant content]

Think Tanks et al
 
Brookings
http://www.brookings.edu/
Accessed 22 Sep 2018
[No new relevant content]

Center for Global Development  
http://www.cgdev.org/page/press-center
Accessed 22 Sep 2018
September 21, 2018
Call a Spade a Spade: Venezuela is a Public Health Emergency
Health outcomes in Venezuela are approaching emergency-like levels as services, medicines, and food become increasingly inaccessible. Venezuela’s under-5 mortality rate in 2016 already rivaled Syria’s, a Grade 3 emergency according to the World Health Organization (WHO). Since then, Caritas has estimated that 11.4 percent of children under 5 in Venezuela suffer from moderate or severe acute malnutrition.
Roxanne Oroxom and Amanda Glassman

CSIS
https://www.csis.org/
Accessed 22 Sep 2018
[No new relevant content]

Council on Foreign Relations
http://www.cfr.org/
Accessed 22 Sep 2018
[No new relevant content]

Milestones :: Perspectives

Global Preparedness Monitoring Board convenes for the first time in Geneva
10 September 2018 | Statement
WHO and the World Bank Group today convened the first meeting of the Global Preparedness Monitoring Board (GPMB), a new body set up to monitor the world’s readiness to respond to outbreaks and other health emergencies.

The GPMB is chaired by Dr Gro Harlem Brundtland, former Prime Minister of Norway and former WHO Director-General and Mr Elhadj As Sy, Secretary General of the International Federation of Red Cross and Red Crescent Societies, and includes some of the most notable leaders in global health.

The GPMB has been established to monitor progress, identify gaps and advocate for sustained, effective work to ensure global preparedness. At its first meeting at WHO’s headquarters in Geneva, the GPMB today discussed key issues in global preparedness and agreed its terms of reference and governance structure. The board aims to publish its first report on the global state of preparedness in September 2019.

“Despite all the progress we have made, the world remains vulnerable,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “The Global Preparedness Monitoring Board brings together deep experience and expertise to help keep the world safe.”

“There’s no substitute for preparedness, and investing in it should be a top priority for the entire global community,” said Dr Jim Yong Kim, President of the World Bank Group. “It is important that countries are beginning to take pandemic preparedness much more seriously.”
The GPMB has its origins in the 2014 Ebola outbreak in West Africa, which devastated thousands of families, damaged economies and shook the world.

Since then, WHO has undergone major transformation, with the establishment of its health emergencies programme. In the Organization’s new strategic 5-year plan, one of the three “triple billion” targets for 2023 is to see 1 billion people better protected from health emergencies.

The World Bank has also established the Pandemic Emergency Financing Facility and made its first cash disbursement to the Ebola outbreak in Democratic Republic of the Congo in May this year.  As part of its IDA 18 commitment, the World Bank is supporting the development of pandemic preparedness plans in 25 low- and lower-middle income countries. It is also investing in preparedness in several countries in the East Asia and Pacific region, and in strengthening regional disease surveillance and monitoring capacity across East and West Africa.

Most importantly, countries and communities have embraced the need for preparedness, with WHO’s Member States recommitting to establishing the capacities required under the International Health Regulations and dozens requesting Joint External Evaluations.

Milestones :: Perspectives

Ebola – Democratic Republic of the Congo

WHO – 06: Situation report on the Ebola outbreak in North Kivu 11 September 2018
[Excerpts]
Situation update
…Recent trends (Figure 1) suggest that control measures are working; however, these trends must be interpreted with caution. The outbreak remains active in Beni, Mabalako and Mandima health zones, and additional risks remain following the movement of several cases from these areas to Butembo and Masereka in recent weeks.
Since our last situation report on 4 September 2018 (External situation report 5), an additional 10 new confirmed or probable EVD cases have been reported from Butembo (2), Beni (5) Mabalako (1), Mandima (1), and Masereka (1) and nine new deaths. Currently there are nine suspected cases under investigation (Table 1).
As of 9 September 2018, a total of 132 confirmed and probable EVD cases, including 91 deaths and 36 cases who have recovered, have been reported. Among the 132 cases, 101 are confirmed and 31 are probable. Of the 91 deaths, 60 occurred in confirmed cases…

Case management
ETCs [Ebola Treatment Centers] continue to provide therapeutics under the monitored emergency use of unregistered and experimental interventions (MEURI) protocol in collaboration with the MoH and the Institut National de Recherche Biomédicale (INRB). WHO is providing technical clinical expertise onsite and is assisting with the creation of a data safety management board.
As of 6 September 2018, 29 patients have received investigational Ebola therapeutics, including: mAb114 (14 patients), Remdesivir (9 patients) and ZMapp (6 patients). Of the 20 patients, 14 have been discharged and nine have died. All the deaths were among patients with advanced organ failure on admission.
Médicines sans Frontièrs (MSF) Swiss and the Ministry of Health are building a 10 bed ETC in Butembo, which is expected to be operational by the end of this week…

Implementation of ring vaccination protocol
The SDB Commission plan for hard-to-reach areas started training on civil protection teams on 9 September 2018 with, the support of the Red Cross.
As of 10 September 2018, 48 vaccination rings have been defined, in addition to 13 rings of healthcare and other frontline workers. These rings notably include the contacts (and their contacts) of the confirmed cases from the last three weeks. To date, 8229 people consented and were vaccinated, including 2526 healthcare and front line workers, and 1968 children.    There is one area in Ndindi, where the implementation of vaccination is hampered by community resistance.
The ring vaccination teams are currently active in three health areas in North Kivu and one in Ituri.

Ebola virus disease – Democratic Republic of the Congo
Disease Outbreak News (DONs) – 14 September 2018

Milestones :: Perspectives

UNICEF to scale up Ebola response following new cases in major commercial center of Butembo in the Democratic Republic of Congo

KINSHASA/DAKAR/NEW YORK/GENEVA, 14 September 2018 – UNICEF is opening a new Ebola-response front in the Democratic Republic of Congo to provide support to thousands of people, including children, at risk in the city of Butembo, following the Government’s recent confirmation of two new Ebola cases.

“Butembo is an important commercial city and has nearly one million inhabitants. So there is a real risk the virus could spread quickly in such a large population centre,” said Dr Gianfranco Rotigliano, UNICEF Representative in the DRC during his visit to Butembo. “The number of confirmed Ebola cases in Butembo remains limited, but we have to ensure that everything is being done now to ensure that the outbreak is controlled at this early stage.”

UNICEF is expanding its Ebola response and deploying to Butembo a team of 11 specialists in community communication, education, psycho-social assistance, and water, sanitation and hygiene to help contain the disease and avoid any further spread of the epidemic. Prioritizing neighbourhoods in Butembo with confirmed Ebola cases and people who have been in contact with infected people, UNICEF together with its partners has already:
:: Trained 35 psycho-social workers to assist families and children affected by the disease;
:: Broadcast sensitization programmes on nine community radios and sensitized 36 journalists on prevention measures;
:: Informed 255 local community leaders in targeted neighbourhoods in Butembo about the Ebola virus, prevention measures and the alert number to contact for early and specialised health care for people with Ebola-like symptoms;
:: Sensitized about 7,000 people through religious leaders.

While expanding its response to the city of Butembo, UNICEF continues to work with its partners in Mangina and Beni. Since the beginning of the outbreak, UNICEF has collaborated with community, youth and religious leaders to reach more than 3.3 million people with Ebola prevention and advocacy messages. UNICEF is working with local communities and Ebola survivors to ensure that the strategies put in place are effective and sustainable, and to defuse local resistance against the Ebola response, especially in the Ndindi neighbourhood of Beni.

UNICEF multidisciplinary teams include anthropologists, who ensure that the response is sensitive to cultural believes and practices, particularly around caring for sick and diseased individuals, and addressing populations’ concerns about secure and dignified burials. In Ndindi, local committees are working hand-in-hand with UNICEF to identify and implement sensitization activities. Local committees have contributed to the setting up of sensitization trucks with megaphones driving through the neighbourhood. UNICEF has provided 120 local leaders with mobile phones to strengthen early detection and referral to relevant health services of people suspected to be infected.

Milestones :: Perspectives

WHO statement on the health situation in Yemen
Dr Ahmed Al Mandhari, WHO Regional Director for the Eastern Mediterranean
7 September 2018 – The scale of human suffering and health needs in Yemen today is unprecedented. An entire country and its health infrastructure has been brought to its knees. People who have survived more than three and a half years of war now find themselves facing additional threats of hunger and disease.

Malnourished mothers are unable to breastfeed their equally malnourished babies. Parents have lost their children as entire families are afflicted by cholera and repeatedly infected with other diseases. People thrown into extreme poverty due to the war are unable to buy food for their families, with some families living only on bread for sustenance. As the Yemeni Riyal continues to plummet, poor families who could afford very little, will be left with nothing.

While medical care is free in public health facilities, many Yemenis can barely afford the cost of public transport to get to these facilities, and families are forced to sell all their belongings to buy medicines. Health care workers have not received their salaries in two years.

The need for our lifesaving work in Yemen has never been greater.

Despite serious challenges impeding our response, our commitment to saving lives in Yemen continues. We are providing hospitals with fuel, safe water, medicines and ambulances to keep them functioning. We are supporting centres for the treatment of cholera and other diseases, as well as supporting therapeutic feeding centres for severely malnourished children suffering from medical complications. And we are making sure health staff continue to report to work by providing rapid response teams, mobile medical teams in hard-to-reach areas, and public health and surgical teams in priority hospitals with incentives.

This year alone, we have been able to reach an estimated 8.7 million people with health aid. But there are many more we are unable to reach due to the insecurity, or who are unable to find the right medicines or specialized care. People in Yemen are dying today not just because of the bullets and bombs, but because they are unable to receive the medical care they need to stay alive.

We cannot allow ourselves to be sensitized into accepting this situation as the norm. Humanitarian laws protecting civilians, hospitals, health staff and patients must be respected by all parties. Unrestricted passage of medicines and medical supplies into all parts of the country must be granted. The people of Yemen need immediate and unrestricted access to lifesaving health care, and they need it now more than ever before
 
 

Milestones :: Perspectives

China’s drug regulator clears 45 vaccine makers in sweeping, scandal-triggered inspections

by Angus Liu |
Fierce Pharma Sep 10, 2018 10:35am
When Changchun Changsheng Life Sciences’ manufacturing malpractice sparked a nationwide outcry over vaccine safety in July, the Chinese drug authority dispatched teams to inspect all other vaccine companies. Now, the results are in.
China’s recently rebranded National Medical Products Administration (NMPA) said (Chinese) on Friday it had inspected all of the other 45 vaccine makers between July 23 and Aug. 9 and found no quality or safety problems.
Among the 45 manufacturers, 38 were complying with GMP practices and other regulations, while the other seven have ceased production for more than three years and have no products currently on the market, said the agency…
 

Emergencies

 
POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 4 September 2018 [GPEI]
The Johns Hopkins University is leading a project to document lessons learned from GPEI, and translating those lessons to improve delivery of other lifesaving health programmes and strengthening health systems globally. Read more and learn how you can contribute: GPEI Lessons Learned Project.

Summary of new viruses this week:
Afghanistan – One new case of wild poliovirus (WPV1).
Pakistan – One new case of wild poliovirus (WPV1).
Afghanistan and Pakistan continue to detect WPV1 through environmental sampling, indicating sustained transmission
Papua New Guinea – three new cases of circulating vaccine-derived poliovirus type 1 (cVDPV1).
Somalia – two new cases of circulating vaccine-derived poliovirus type 2 (cVDPV2).

::::::

GPEI Lessons Learned Project
The Johns Hopkins University is leading a project to document lessons learned from GPEI, and translating those lessons to improve delivery of other lifesaving health programmes and strengthening health systems globally.

As an initial step in the project, a global survey is underway to map tacit knowledge of GPEI actors about implementation challenges (and the contexts in which those arose).

The specific objectives of the survey are:
:: Map tacit knowledge (ideas, approaches and experiences that were not documented, but relevant for both intended and unintended results) about GPEI under various context typologies
:: Identify key facilitators for GPEI programme implementation
:: Identify key implementation challenges, the level where they originated from (global, national, subnational), and how they were resolved.

The target audience for the global survey includes:
:: Individuals who have been directly involved in implementing activities under the GPEI between 1988 to date. Implementing activities refer to all cycles of implementation, including GPEI-related funding, policy, programming, and research cycles. The population includes individuals who have spent 12 or more continuous months working on activities under the GPEI between 1988 to date.

If you meet the specifications of the target audience, your participation is requested in this online survey, which takes approximately 15-30 minutes.

How to participate in the survey
Access to the survey can be granted by reaching out to the project team at poliolessonslearned@gmail.com with your name and organization.

::::::
::::::
 
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 15 Sep 2018]
Bangladesh – Rohingya crisis
:: Using local materials to build health facilities  12 September 2018
:: Weekly Situation Report 42 – 6 September 2018pdf, 220kb
 KEY HIGHLIGHTS

• The next round of oral cholera campaign (OCV) will begin on 6 October 2018, targeting 327 364 people.
• Acute Respiratory Infection (ARI) and suspected malaria cases are showing an increasing trend.
• A total of nine Mobile Medical Teams were deployed in week 35. Primary health care and dental care services were provided to 3 375 people across 13 camps.

SITUATION OVERVIEW

• According to the Needs and Population Monitoring (NPM) exercise, there are an estimated 919 000 Rohingya refugees in Cox’s Bazar as of 22 July 2018. Of these, 706 364 are new arrivals since 25 August 2017.
• More heavy rain from the current monsoon season and the second season of cyclones and monsoons toward the end of the year will increase the risk of water-borne diseases such as cholera and hepatitis A and vector-borne diseases such as malaria, dengue and chikungunya.

Democratic Republic of the Congo
:: 06: Situation report on the Ebola outbreak in North Kivu 11 September 2018
:: Disease Outbreak News (DONs) – Ebola virus disease – Democratic Republic of the Congo
14 September 2018
[See Milestones above for more detail]

Yemen
:: WHO statement on the health situation in Yemen  7 September 2018
Dr Ahmed Al Mandhari, WHO Regional Director for the Eastern Mediterranean
[See Milestones above for more detail]

Iraq – No new announcements identified
Nigeria – No new announcements identified
Somalia – No new announcements identified
South Sudan – No new announcements identified
Syrian Arab Republic – No new announcements identified

::::::
 
WHO Grade 2 Emergencies  [to 15 Sep 2018]
Cameroon  – See below
Central African Republic  – See below
Hurricane Irma and Maria in the Caribbean – No new announcements identified
occupied Palestinian territory – No new announcements identified
Libya – No new announcements identified
Myanmar – No new announcements identified
South Africa Listeriosis (2017) – See below
Sudan – No new announcements identified
Ukraine – No new announcements identified
Sao Tome and Principe Necrotizing Cellulitis (2017) – No new announcements identified

Outbreaks and Emergencies Bulletin, Week 36: 1 – 7 September 2018
The WHO Health Emergencies Programme is currently monitoring 55 events in the region. This week’s edition covers key ongoing events, including:
:: Declaration of the end of the listeriosis outbreak in South Africa
:: Ebola virus disease in the Democratic Republic of the Congo
:: Cholera in Niger
:: Cholera in Cameroon
:: Hepatitis E in Namibia
:: Humanitarian crisis in Central African Republic.

::::::
 
WHO Grade 1 Emergencies  [to 15 Sep 2018]
Afghanistan
Angola (in Portuguese)
Chad
Ethiopia
Kenya
Lao People’s Democratic Republic
Mali
Papua New Guinea
Peru
Tanzania
Tropical Cyclone Gira
Zambia
 
::::::
 
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 
:: Yemen Humanitarian Update Covering 27 August – 6 September 2018 | Issue 26
Published on 06 Sep 2018
KEY ISSUES:
:: As the depreciation of the Yemeni Rial continues, a further 3.5 million people may become food insecure and an additional 2 million may face a heightened risk of famine.
:: The conflict in Yemen continues to exact a heavy toll on civilians. In August, 241 civilian impact incidents were reported.
:: Humanitarian partners continue to work to prevent a third outbreak of cholera; some 133,000 suspected cholera cases have been confirmed since January…

Syrian Arab Republic   – No new 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 announcements identified.
Somalia   – No new 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 15 Sep 2018]
http://www.who.int/ebola/en/
Disease outbreak news
:: 06: Situation report on the Ebola outbreak in North Kivu 11 September 2018
:: Disease Outbreak News (DONs) – Ebola virus disease – Democratic Republic of the Congo
14 September 2018
[See Milestones above for more detail]

MERS-CoV [to 15 Sep 2018]
http://who.int/emergencies/mers-cov/en/
DONs
Middle East respiratory syndrome coronavirus (MERS-CoV) infection – Republic of Korea
12 September 2018
 
Yellow Fever  [to 15 Sep 2018]
http://www.who.int/csr/disease/yellowfev/en/
– No new announcements identified.

Zika virus  [to 15 Sep 2018]
http://www.who.int/csr/disease/zika/en/
– No new announcements identified.

WHO & Regional Offices [to 15 Sep 2018]

UN General Assembly High-Level Meeting on the fight against tuberculosis
New York, 26 September 2018
The theme: “United to end tuberculosis: an urgent global response to a global epidemic
Heads of State will gather in New York on 26 September this year at the United Nations General Assembly first-ever high-level meeting on tuberculosis (TB) to accelerate efforts in ending TB and reach all affected people with prevention and care.
 
Global hunger continues to rise, new UN report says
821 million people now hungry and over 150 million children stunted, putting hunger eradication goal at risk
11 September 2018   Rome
UN Food and Agriculture Organization (FAO), the International Fund for Agricultural Development (IFAD), the UN Children’s Fund (UNICEF), the World Food Programme (WFP) and WHO
 
::::::
 
GIN July and August 2018 pdf, 2.07Mb 7 September 2018

::::::
 
Weekly Epidemiological Record, 14 September 2018, vol. 93, 37 (pp. 477–488)
:: Widespread transmission of circulating vaccine-derived poliovirus identified by environmental surveillance and immunization response, Horn of Africa, 2017–2018
:: Isolation and identification of human influenza viruses in cell culture: summary analysis of the WHO external quality assessment programme for National Influenza Centres in the WHO regions of the Americas, Africa and Eastern Mediterranean, 2017

::::::
 
WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
Selected Featured News
:: With WHO’s support, South Sudan strengthens HIV treatment cascade to improve interventions and achieve the national 90-90-90 targets  15 September 2018
:: How an encounter with Ebola in the Democratic Republic of the Congo inspired change
14 September 2018
:: WHO is scaling up response to a fast-moving cholera outbreak in Zimbabwe’s capital
13 September 2018
:: Nigeria not lowering guards against Polio, two years after last detection of cases in the Northeast. 13 September 2018

WHO Region of the Americas PAHO
No new digest content identified.
 
WHO South-East Asia Region SEARO
No new digest content identified.
 
WHO European Region EURO
No new digest content identified.

WHO Eastern Mediterranean Region EMRO
:: European Union support strengthens trauma care services in Gaza  13 September 2018
:: Addressing escalating burden of NCDs in Afghanistan  12 September 2018

WHO Western Pacific Region
:: Case of imported MERS reported in Republic of Korea  9 September 2018

CDC/ACIP [to 15 Sep 2018]
http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html

MMWR News Synopsis for September 13, 2018

Sentinel Surveillance for Congenital Rubella Syndrome — India, 2016–2017

India is committed to the elimination of measles and control of rubella and congenital rubella syndrome by 2020. Rubella infection during early pregnancy can result in serious consequences such as miscarriage, stillbirth, or a constellation of severe birth defects known as congenital rubella syndrome (CRS). The Government of India is committed to eliminate measles and control rubella and CRS by 2020. The Indian Council of Medical Research (ICMR) and the Indian Ministry of Health and Family Welfare (MoHFW) initiated laboratory-supported surveillance for CRS in five sentinel sites in November 2016. During the first eight months, surveillance identified more than 200 suspected CRS patients. About a third of the patients had laboratory-confirmed CRS. The experience gained during the first phase of surveillance will be useful in expanding the surveillance network; data generated will help monitor progress toward CRS control in India.

Africa CDC   [to 15 Sep 2018]
https://au.int/en/africacdc

No new digest content identified.

China CDC 
http://www.chinacdc.cn/en/

No new digest content identified.

Announcements
 
AERAS  [to 15 Sep 2018]
http://www.aeras.org/pressreleases
No new digest content identified.
 
 
BMGF – Gates Foundation  [to 15 Sep 2018]
http://www.gatesfoundation.org/Media-Center/Press-Releases
No new digest content identified.

Bill & Melinda Gates Medical Research Institute    [to 15 Sep 2018]
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 15 Sep 2018]
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 15 Sep 2018]
http://cepi.net/
No new digest content identified.

EDCTP    [to 15 Sep 2018]
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
14 September 2018
EDCTP Annual Report 2017 – Maintaining momentum
EDCTP published its Annual Report 2017: Maintaining momentum. Since 2014 until the end of 2017, we have awarded 124 grants with an estimated total value of €255.9 million. This includes funding for 32 multicentre clinical trials, accounting for €195.24 million…

Emory Vaccine Center    [to 15 Sep 2018]
http://www.vaccines.emory.edu/
No new digest content identified.

European Medicines Agency  [to 15 Sep 2018]
http://www.ema.europa.eu/ema/
14/09/2018
Committee for Medicinal Products for Veterinary Use (CVMP) meeting of 11-13 September 2018
CVMP invites comments on a reflection paper dealing with resistance development of certain antimicrobials and its impact on human and animal health …

13/09/2018
Committee for Orphan Medicinal Products (COMP) elects new chair
Violeta Stoyanova-Beninska to begin three-year mandate at October meeting …

 
European Vaccine Initiative  [to 15 Sep 2018]
http://www.euvaccine.eu/news-events
No new digest content identified.
 
 
FDA [to 15 Sep 2018]
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
September 12, 2018
Statement from FDA Commissioner Scott Gottlieb, M.D., and Center for Devices and Radiological Health Director Jeff Shuren, M.D., J.D., on agency efforts to work with tech industry to spur innovation in digital health
 
 
Fondation Merieux  [to 15 Sep 2018]
http://www.fondation-merieux.org/
Mérieux Foundation event
Global challenges in vaccine acceptance science and programs
September 24 – 26, 2018 – Les Pensieres Center for Global Health, Veyrier du Lac (France)
 
 
Gavi [to 15 Sep 2018]
http://www.gavi.org/library/news/press-releases/
No new digest content identified.

 
GHIT Fund   [to 15 Sep 2018]
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 15 Sep 2018]
http://www.theglobalfund.org/en/news/?topic=&type=NEWS;&country=
News
Global Fund Partnership has Saved 27 Million Lives
12 September 2018
PARIS – The Global Fund to Fight AIDS, Tuberculosis and Malaria released a report today demonstrating that 27 million lives have been saved by the Global Fund partnership. The report shows tremendous progress that has been achieved by efforts to end the epidemics, while highlighting new threats.
The Results Report 2018 includes key annual results achieved in countries where the Global Fund invests:
:: 17.5 million people received antiretroviral therapy for HIV.
:: 5 million people tested and treated for TB.
:: 197 million mosquito nets distributed to prevent malaria.
Full Report: English | Français

Hilleman Laboratories   [to 15 Sep 2018]
http://www.hillemanlabs.org/
Date: 11/09/2018
Hilleman Labs announces publication of original research on Heat Stable Rotavirus Vaccines
Hilleman Laboratories today announced the publication of original research as well as expert commentary on development of Heat Stable Rotavirus Vaccine (HSRV).
 
 
Human Vaccines Project   [to 15 Sep 2018]
http://www.humanvaccinesproject.org/media/press-releases/
No new digest content identified.
 
 
IAVI  [to 15 Sep 2018]
https://www.iavi.org/
No new digest content identified.

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

IVAC  [to 15 Sep 2018]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
September 2018
IVAC’s VoICE tool now has over 200 data summaries and arguments to support the broad value of vaccines
VoICE, the Value of Immunization Compendium of Evidence, an online tool, aims to equip global advocates and partners with new arguments and evidence to demonstrate and support the continued investments in immunization programs, and why it is essential. This searchable online resource details the many far-reaching impacts of immunization and vaccine-preventable disease and on equity, […]
 
 
IVI   [to 15 Sep 2018]
http://www.ivi.int/
11 Sep 2018
IVI accelerates development of MERS vaccine
– Institute jointly conducts phase 1/2a clinical trial of GeneOne Life Science’s GLS-5300 DNA MERS vaccine
– IVI in search of additional promising candidate vaccines among developers worldwide, with support from Samsung Life Public Welfare Foundation
The International Vaccine Institute (IVI) said on September 11 that a phase 1/2a clinical trial of Korea-based GeneOne Life Science’s MERS vaccine is currently under way; as the organization is accelerating the development of vaccines against MERS in collaboration with Korean and foreign vaccine developers.
The clinical trial is being conducted in Korea by GeneOne with support from and in collaboration with IVI, and the first subject was recently dosed with the vaccine. IVI is funding the entire clinical trial with a donation from the Samsung Life Public Welfare Foundation to support the development of a MERS vaccine.
Dr. Jerome Kim, Director General of IVI said, “IVI will continue close collaboration with GeneOne and other partners to complete the clinical trial at the earliest date possible with the intent of making a MERS vaccine available in order to contribute to curbing a future MERS epidemic (in Korea and worldwide).”…
 
 
JEE Alliance  [to 15 Sep 2018]
https://www.jeealliance.org/
No new digest content identified.
 
 
MSF/Médecins Sans Frontières  [to 15 Sep 2018]
http://www.msf.org/
Selected Press Releases/Statements
Hepatitis C
MSF response to ruling in Gilead sofosbuvir patent hearing at European Patent Office
Munich, 13 September 2018 — Médecins Sans Frontières (MSF) is gravely disappointed with the European Patent Office’s decision today to uphold US pharmaceutical corporation Gilead Sciences’ patent related to the key hepatitis C drug sofosbuvir. In a bid to contest Gilead’s unmerited patent on this drug in order to make the medicine more affordable in Europe, a legal challenge was filed in March 2017 by patient and treatment provider organisations from 17 European countries, including Médecins Sans Frontières (MSF); Médecins du Monde (MdM); the European Public Health Alliance (EU-wide); Salud Por Derecho (Spain); AIDES (France); Praksis (Greece); and Access to Medicines Ireland..

DRC 2018 Ebola outbreaks
With a new Ebola outbreak, we knew we had to act fast
13 Sep 2018

 
NIH  [to 15 Sep 2018]
http://www.nih.gov/news-events/news-releases
September 10, 2018
Early stage clinical trial of antimalarial drug begins
— In 2016, an estimated 216 million new malaria cases and 445,000 deaths occurred.
… in the new study, led by principal investigator Michael Cohen-Wolkowiez, M.D., Ph.D., professor of pediatrics at the Duke Clinical Research Institute, is testing an investigational drug called DM1157, invented at Portland State University and developed by DesignMedix, both based in Portland, Oregon. The novel treatment is a modified form of chloroquine, an established antimalarial drug that kills malaria parasites once they have infected human red blood cells…

PATH  [to 15 Sep 2018]
https://www.path.org/media-center/
No new digest content identified.

Sabin Vaccine Institute  [to 15 Sep 2018]
http://www.sabin.org/updates/pressreleases
No new digest content identified.
 
 
UNAIDS [to 15 Sep 2018]
http://www.unaids.org/en
News
13 September 2018
UNAIDS again commended as the only UN body to meet or exceed all requirements of the UN Action Plan on Gender Equality

12 September 2018
New model drug law launched in western Africa
Unjust laws can prevent people from accessing the services they need to prevent or treat HIV, and people who use drugs need help and care, not punishment—these are two of the messages from the new Model Drug Law for West Africa. Launched on11 September in Dakar, Senegal, the model drug law aims to guide policy-makers in the region on how to better frame their drug laws…

12 September 2018
Russian Federation commits to reach 75% antiretroviral therapy coverage in 2019

10 September 2018
Leaders from China and Africa come together to build stronger and healthier communities
Leaders from African countries and China met in Beijing, China, during the 2018 Beijing Summit of the Forum on China–Africa Cooperation (FOCAC) on 3 and 4 September to accelerate the social and economic development of Africa…
Leaders agreed the Beijing Declaration and the Beijing Action Plan, which will serve as a blueprint for further cooperation between China and Africa in the next three years. The outcome documents, which list ending AIDS and halting and reversing HIV (together with tuberculosis and malaria) as part of the China–Africa health cooperation…

UNICEF  [to 15 Sep 2018]
https://www.unicef.org/media/press-releases
Selected Press Releases/Reports/Statements
Press release
UNICEF to scale up Ebola response following new cases in major commercial center of Butembo in the Democratic Republic of Congo
14/09/2018
[See Milestones above for more detail]

Press release
Geneva Palais briefing note on education under attack in Yemen
14/09/2018

Press release
Global hunger continues to rise, new UN report says
821 million people now hungry and over 150 million children stunted, putting hunger eradication goal at risk
10/09/2018

Vaccine Confidence Project  [to 15 Sep 2018]
http://www.vaccineconfidence.org/
No new digest content identified.
 

Vaccine Education Center – Children’s Hospital of Philadelphia  [to 15 Sep 2018]
http://www.chop.edu/centers-programs/vaccine-education-center
No new digest content identified.
 
 
Wellcome Trust  [to 15 Sep 2018]
https://wellcome.ac.uk/news
No new digest content identified.
 
 
The Wistar Institute   [to 15 Sep 2018]
https://www.wistar.org/news/press-releases
No new digest content identified.

World Organisation for Animal Health (OIE)   [to 15 Sep 2018]
http://www.oie.int/en/for-the-media/press-releases/2018/
No new digest content identified.

::::::
 
BIO    [to 15 Sep 2018]
https://www.bio.org/insights/press-release
No new digest content identified.

DCVMN – Developing Country Vaccine Manufacturers Network  [to 15 Sep 2018]
http://www.dcvmn.org/
No new digest content identified.
 
IFPMA   [to 15 Sep 2018]
http://www.ifpma.org/resources/news-releases/
No new digest content identified.

PhRMA    [to 15 Sep 2018]
http://www.phrma.org/press-room
No new digest content identified.

Reports/Research/Analysis/Commentary/Conferences/Meetings/Book Watch/Tenders

Vaccines and Global Health: The Week in Review has expanded its coverage of new reports, books, research and analysis published independent of the journal channel covered in Journal Watch below. Our interests span immunization and vaccines, as well as global public health, health governance, and associated themes. If you would like to suggest content to be included in this service, please contact David Curry at: david.r.curry@centerforvaccineethicsandpolicy.org

No new digest content identified.

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

American Journal of Tropical Medicine and Hygiene
Volume 99, Issue 1, 2018
http://www.ajtmh.org/content/journals/14761645/99/1

Perspective Piece
Malaria Elimination: Time to Target All Species
Andrew A. Lover, J. Kevin Baird, Roly Gosling and Ric N. Price
https://doi.org/10.4269/ajtmh.17-0869
Abstract
Important strides have been made within the past decade toward malaria elimination in many regions, and with this progress, the feasibility of eradication is once again under discussion. If the ambitious goal of eradication is to be achieved by 2040, all species of Plasmodium infecting humans will need to be targeted with evidence-based and concerted interventions. In this perspective, the potential barriers to achieving global malaria elimination are discussed with respect to the related diversities in host, parasite, and vector populations. We argue that control strategies need to be reorientated from a sequential attack on each species, dominated by Plasmodium falciparum to one that targets all species in parallel. A set of research themes is proposed to mitigate the potential setbacks on the pathway to a malaria-free world.

BMC Medical Ethics
http://www.biomedcentral.com/bmcmedethics/content
(Accessed 15 Sep 2018)
Research article

|   15 September 2018
What information and the extent of information research participants need in informed consent forms: a multi-country survey
The use of lengthy, detailed, and complex informed consent forms (ICFs) is of paramount concern in biomedical research as it may not truly promote the rights and interests of research participants. The extent of information in ICFs has been the subject of debates for decades; however, no clear guidance is given. Thus, the objective of this study was to determine the perspectives of research participants about the type and extent of information they need when they are invited to participate in biomedical research.
Authors: Juntra Karbwang, Nut Koonrungsesomboon, Cristina E. Torres, Edlyn B. Jimenez, Gurpreet Kaur, Roli Mathur, Eti N. Sholikhah, Chandanie Wanigatunge, Chih-Shung Wong, Kwanchanok Yimtae, Murnilina Abdul Malek, Liyana Ahamad Fouzi, Aisyah Ali, Beng Z. Chan, Madawa Chandratilake, Shoen C. Chiew…

BMC Medicine
http://www.biomedcentral.com/bmcmed/content
(Accessed 15 Sep 2018)

Correspondence
Updated cost-effectiveness and risk-benefit analysis of two infant rotavirus vaccination strategies in a high-income, low-endemic setting
Since 2013, a biennial rotavirus pattern has emerged in the Netherlands with alternating high and low endemic years and a nearly 50% reduction in rotavirus hospitalization rates overall, while infant rotavirus…
Authors: P. Bruijning-Verhagen, J. A. P. van Dongen, J. D. M. Verberk, R. Pijnacker, R. D. van Gaalen, D. Klinkenberg, H. E. de Melker and M.-J. J. Mangen
Citation: BMC Medicine 2018 16:168
Published on: 10 September 2018

BMC Research Notes
http://www.biomedcentral.com/bmcresnotes/content
(Accessed 15 Sep 2018)

Research note
Acceptability of the dengue vaccination among parents in urban poor communities of Quezon City, Philippines before and after vaccine suspension
Authors: Ezra M. Valido, Ida Safitri Laksanawati and Adi Utarini
Citation: BMC Research Notes 2018 11:661
Published on: 10 September 2018
Abstract
Objective
The study aims to illustrate the acceptability of the dengue vaccine before and after the dengue vaccination suspension in urban poor communities in Quezon City, Philippines.
Results
There were 12 interviews conducted in November 2017 and 5 focus group discussions in January 2018, a month after vaccine program suspension with 41 participants. All participants were selected through purposive criterion sampling. Thematic analysis showed acceptability of the dengue vaccine was associated with parental experience with vaccination and dengue, trust in public health institutions and communication received by parents. Post-dengue vaccination suspension triangulation indicated that the parents regretted the experience, trust to public institutions was eroded and the communication strategy was deemed inadequate. This led to low vaccine acceptability post-vaccine suspension.

BMC Research Notes
http://www.biomedcentral.com/bmcresnotes/content
(Accessed 15 Sep 2018)

Research note
Socio-demographic determinants of childhood immunization incompletion in Koforidua, Ghana
Immunization saves more than 3 million lives worldwide each year, and it saves millions from suffering illness and lifelong disability. The study sought to assess the socio-demographic factors that influence c…
Authors: Reindolf Anokye, Enoch Acheampong, Amy Budu-Ainooson, Anthony Kwaku Edusei, Paul Okyere, Joslin Dogbe and Alberta Nadutey
Citation: BMC Research Notes 2018 11:656
Published on: 10 September 2018

Disasters
Volume 42, Issue S2  Pages: S159-S327  October 2018
https://onlinelibrary.wiley.com/toc/14677717/current
Disasters in Conflict Areas

Papers
Disasters in conflict areas: finding the politics
Ayesha Siddiqi
Pages: S161-S172
First Published: 16 August 2018
Abstract
Despite some 50 years of research, relatively little is known about how disasters in conflict areas are created and discursively framed, and how information on them is publicly consumed. The emphasis in disaster studies has remained on establishing causal linkages, demonstrating the way in which natural hazard‐related disasters result in deepening conflict, or ushering in peace. Furthermore, it has been accepted that disaster risk reduction is the state’s responsibility. The strengths and limitations of these approaches are examined prior to a political reimagining of disasters in conflict areas. The absence of ‘politics’ from the wider debate on disasters in conflict areas is not just a benign oversight, but is in fact the politics of disasters in conflict areas. A politics that does not engage with the processes and outcomes of pursuing dominant agendas, such as neoliberal orthodoxy and state imperial control, in areas and communities vulnerable to natural hazards and political conflict needs to be recognised and challenged.

Health Research Policy and Systems
http://www.health-policy-systems.com/content
[Accessed 15 Sep 2018]

Review
|   10 September 2018
Introducing responsible innovation in health: a policy-oriented framework
Authors: Hudson Pacifico Silva, Pascale Lehoux, Fiona Alice Miller and Jean-Louis Denis

The Milbank Quarterly
A Multidisciplinary Journal of Population Health and Health Policy
Volume 96, Issue 3  Pages: 409-605  September 2018
https://onlinelibrary.wiley.com/toc/14680009/current

Original Scholarship
Impact of Pharmacists on Access to Vaccine Providers: A Geospatial Analysis
PARTH D. SHAH, JUSTIN G. TROGDON, SHELLEY D. GOLDEN, CAROL E. GOLIN, MACARY WECK MARCINIAK, NOEL T. BREWER
Pages: 568-592
First Published: 11 September 2018
Policy Points:
:: Policymakers in the United States should consider expanding pharmacy practice laws to allow pharmacists to vaccinate adolescents as a way to improve geographic access to adolescent vaccines, particularly for human papillomavirus (HPV) vaccine, which has low uptake.
:: Our state‐level analysis showed that pharmacists are more geographically dispersed than primary care physicians in the US state of Texas.
:: Including pharmacists among available adolescent vaccine providers would improve the geographic distribution of vaccine providers, especially in areas with an inadequate number of primary care physicians.

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 15 Sep 2018)
Perspective

Towards national systems for continuous surveillance of antimicrobial resistance: Lessons from tuberculosis
Amitabh B. Suthar, Patrick K. Moonan, Heather L. Alexander
| published 14 Sep 2018 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1002658

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 15 Sep 2018)

Research Article
Contact tracing performance during the Ebola epidemic in Liberia, 2014-2015
Krista C. Swanson, Chiara Altare, Chea Sanford Wesseh, Tolbert Nyenswah, Tashrik Ahmed, Nir Eyal, Esther L. Hamblion, Justin Lessler, David H. Peters, Mathias Altmann
| published 12 Sep 2018 PLOS Neglected Tropical Diseases
https://doi.org/10.1371/journal.pntd.0006762
 

Science         
14 September 2018   Vol 361, Issue 6407
http://www.sciencemag.org/current.dtl

In Depth
Steep drop in Zika cases undermines vaccine trial
By Jon Cohen
Science14 Sep 2018 : 1055-1056 Restricted Access
Controversial strategy of intentionally infecting volunteers to test vaccine candidates is now back on the agenda.
Summary
When Zika raced through the Americas in 2016, it caused widespread alarm because the usually mild infection led to brain damage in babies. An intense effort began to develop a Zika vaccine, and in March 2017, the U.S. National Institute of Allergy and Infectious Diseases launched a $110 million trial of its most promising candidate. The trial, now taking place in nine countries in North and South America, has hit a wall: There are too few cases of Zika in the region—largely because vast swaths of populations were infected and now are immune—to assess whether the vaccine works. As a result, researchers are now planning to vaccinate people and then intentionally infect them with the Zika virus. This human challenge model, used for decades with other diseases, was dismissed as too risky by an ethics committee just last year, mainly because infected people can sexually transmit the virus to people who are not in the study. But given the drop in transmission, a better understanding about the duration of sexual transmission, and decreasing interest from industry in Zika vaccine R&D, the human challenge model now looks like the best way to move the field forward.

Vaccine
Volume 36, Issue 39  Pages 5803-5934 (18 September 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/39

Mandatory infant & childhood immunization: Rationales, issues and knowledge gaps
Noni E. MacDonald, Shawn Harmon, Eve Dube, Audrey Steenbeek, … Robb Butler
Pages 5811-5818

Vaccine
Volume 36, Issue 39  Pages 5803-5934 (18 September 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/39

Review article  Abstract only
Vaccination of 50+ adults to promote healthy ageing in Europe: The way forward
Susanna Esposito, Nicola Principi, Giovanni Rezza, Paolo Bonanni, … Gregory Poland
Pages 5819-5824

Vaccine
Volume 36, Issue 39  Pages 5803-5934 (18 September 2018)
https://www.sciencedirect.com/journal/vaccine/vol/36/issue/39

Research article  Abstract only
The impact on vaccination coverage following introduction of a routine pneumococcal vaccination programme for the elderly in Japan
Aiko Shono, Shu-ling Hoshi, Masahide Kondo
Pages 5886-5890

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

Annual Review of Microbiology
Vol. 72:423-446 (Volume publication date September 2018)
https://doi.org/10.1146/annurev-micro-090817-062414
Ebola: Lessons on Vaccine Development
H Feldmann, F Feldmann, A Marzi
Abstract
The West African Ebola virus (EBOV) epidemic has fast-tracked countermeasures for this rare, emerging zoonotic pathogen. Until 2013–2014, most EBOV vaccine candidates were stalled between the preclinical and clinical milestones on the path to licensure, because of funding problems, lack of interest from pharmaceutical companies, and competing priorities in public health. The unprecedented and devastating epidemic propelled vaccine candidates toward clinical trials that were initiated near the end of the active response to the outbreak. Those trials did not have a major impact on the epidemic but provided invaluable data on vaccine safety, immunogenicity, and, to a limited degree, even efficacy in humans. There are plenty of lessons to learn from these trials, some of which are addressed in this review. Better preparation is essential to executing an effective response to EBOV in the future; yet, the first indications of waning interest are already noticeable.

Annual Review of Microbiology
Vol. 72:273-292 (Volume publication date September 2018)
https://doi.org/10.1146/annurev-micro-090817-062427
The Promise of a Malaria Vaccine—Are We Closer?
MB Laurens
Abstract
Malaria vaccine development has rapidly advanced in the past decade. The very first phase 3 clinical trial of the RTS,S vaccine was completed with over 15,000 African infants and children, and pilot implementation studies are underway. Next-generation candidate vaccines using novel antigens, platforms, or approaches targeting different and/or multiple stages of the Plasmodium life cycle are being tested. Many candidates, in various stages of development, promise enhanced efficacy of long duration and broad protection against genetically diverse malaria strains, with a few studies under way in target populations in endemic areas. Malaria vaccines together with other interventions promise interruption and eventual elimination of malaria in endemic areas.

Expert Review of Vaccines
Accepted author version posted online: 06 Sep 2018
Review
Effectiveness and impact of the 10-valent pneumococcal conjugate vaccine, PHiD-CV: review of clinical trials and post-marketing experience
T Mrkvan, SI Pelton, J Ruiz-Guiñazú, AA Palmu… – 2018
ABSTRACT
Introduction: Pneumococcal diseases (including septicemia, meningitis, pneumonia, and upper respiratory infections) constitute a major public health problem. The World Health Organization recommends pneumococcal conjugate vaccine immunization of young children worldwide.
Areas covered: We reviewed evidence on the effects of the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV), which is used in childhood immunization programs in over 45 countries or regions. The effectiveness of PHiD-CV against invasive pneumococcal disease (IPD), pneumonia, and acute otitis media was assessed. We also present its effect on pneumococcal nasopharyngeal carriage (NPC) and indirect effects (herd protection) among unvaccinated individuals.
Expert commentary: Results from randomized, double-blind trials and post-marketing studies in various countries provide evidence of the protective efficacy, effectiveness, and impact of PHiD-CV against pneumococcal diseases. Data from different geographic locations also show reductions in NPC of vaccine pneumococcal serotypes, laying the foundation for indirect protection against pneumococcal disease. In countries where PHiD-CV is included in childhood immunization programs, there are signs of herd protection for vaccine serotypes among unvaccinated individuals. Although increases in non-vaccine serotype IPD and NPC rates were observed, there was an overall reduction of pneumococcal disease.

Media/Policy Watch

This watch section is intended to alert readers to substantive news, analysis and opinion from the general media and selected think tanks and similar organizations on vaccines, immunization, global public health and related themes. Media Watch is not intended to be exhaustive, but indicative of themes and issues CVEP is actively tracking. This section will grow from an initial base of newspapers, magazines and blog sources, and is segregated from Journal Watch above which scans the peer-reviewed journal ecology.

We acknowledge the Western/Northern bias in this initial selection of titles and invite suggestions for expanded coverage. We are conservative in our outlook in adding news sources which largely report on primary content we are already covering above. Many electronic media sources have tiered, fee-based subscription models for access. We will provide full-text where content is published without restriction, but most publications require registration and some subscription level.
 
 
The Atlantic
http://www.theatlantic.com/magazine/
Accessed 15 Sep 2018
[No new, unique, relevant content]
 
BBC
http://www.bbc.co.uk/
Accessed 15 Sep 2018
[No new, unique, relevant content]
 
The Economist
http://www.economist.com/
Accessed 15 Sep 2018
[No new, unique, relevant content]
 
Financial Times
http://www.ft.com/home/uk
Accessed 15 Sep 2018
[No new, unique, relevant content]
 
Forbes
http://www.forbes.com/
Accessed 15 Sep 2018
[No new, unique, relevant content]

Foreign Affairs
http://www.foreignaffairs.com/
Accessed 15 Sep 2018
[No new, unique, relevant content]

Foreign Policy
http://foreignpolicy.com/
Accessed 15 Sep 2018
[No new, unique, relevant content]

The Guardian
http://www.guardiannews.com/
Accessed 15 Sep 2018
[No new, unique, relevant content]
 
New Yorker
http://www.newyorker.com/
Accessed 15 Sep 2018
[No new, unique, relevant content]
 
New York Times
http://www.nytimes.com/
Accessed 15 Sep 2018
Asia Pacific
China Says Battling Swine Fever Is ‘Complex and Challenging’
Battling the spread of African swine fever in China is “very complex and challenging”, the country’s agriculture ministry said after chairing a meeting of over a dozen major government bodies.

Wall Street Journal
http://online.wsj.com/home-page?_wsjregion=na,us&_homepage=/home/us
Accessed 15 Sep 2018
[No new, unique, relevant content]

Washington Post
http://www.washingtonpost.com/
Accessed 15 Sep 2018
Sep 12, 2018
A prototype of how to fight the next pandemic: A vaccine without the shot
Developing a vaccine for the next pandemic flu is the first problem. Getting it to people without increasing the spread of the virus is the next.
Carolyn Y. Johnson ·

Think Tanks et al

 
Brookings
http://www.brookings.edu/
Accessed 15 Sep 2018
[No new relevant content]

Center for Global Development  
http://www.cgdev.org/page/press-center
Accessed 15 Sep 2018
[No new relevant content]

CSIS
https://www.csis.org/
Accessed 15 Sep 2018
Podcast Episode
Navigating the Ebola Outbreak in the Democratic Republic of the Congo
September 13, 2018 | By J. Stephen Morrison

Council on Foreign Relations
http://www.cfr.org/
Accessed 15 Sep 2018
September 13, 2018
China
Outbreak of African Swine Flu in China Is One of Many
With 700 million pigs, China has about half of the world’s swine population, which makes up their primary source of protein. African Swine Flu is almost 100 percent fatal to pigs, is highly infectious, and there is no vaccination against it.
Blog Post by John Campbell Africa in Transition

Milestones :: Perspectives
 
Ebola – Democratic Republic of the Congo

WHO –
Ebola virus disease – Democratic Republic of the Congo
Disease outbreak news   ::  7 September 2018
[Excerpt]
…WHO risk assessment
This outbreak of EVD is affecting north-eastern provinces of the Democratic Republic of the Congo, which border Uganda, Rwanda and South Sudan. Potential risk factors for transmission of EVD at the national and regional levels include the transportation links between the affected areas, the rest of the country, and neighbouring countries; the internal displacement of populations; and the displacement of Congolese refugees to neighbouring countries. The country is concurrently experiencing other epidemics (e.g. cholera, vaccine-derived poliomyelitis), and a long-term humanitarian crisis. Additionally, the security situation in North Kivu and Ituri may hinder the implementation of response activities. Based on this context, the public health risk was assessed to be high at the national and regional levels, and low globally.
As the risk of national and regional spread remains high, it is important for neighbouring provinces and countries to enhance surveillance and preparedness activities. WHO will continue to work with neighbouring countries and partners to ensure health authorities are alerted and are operationally ready to respond…

05: Situation report on the Ebola outbreak in North Kivu 
4 September 2018
The 1 September 2018 marks one month since the declaration of the Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces, Democratic Republic of the Congo. The Ministry of Health, WHO and partners have made progress in response to the outbreak during this time. Recent trends (Figure 1) suggest that control measures are working; however, these trends must be interpreted with caution.
Since our last situation report on 28 August 2018 (External situation report 4), an additional 11 new EVD cases (8 confirmed and 3 probable) and seven new deaths have been reported. Nine other suspected cases are currently under investigation to confirm or exclude EVD…

::::::
 
In eastern DRC, nearly 2.5 million people reached in effort to contain Ebola outbreak – UNICEF
KINSHASA/DAKAR/NEW YORK/GENEVA, 5 September 2018 – UNICEF and its partners have now reached 2,454,000 people with Ebola prevention messages since the start of the latest outbreak in the eastern part of the Democratic Republic of the Congo (DRC). Ebola awareness and prevention efforts have been rolled out in seven health zones, in close collaboration with the local communities, including 1,715 local community workers.

“An increasing number of communities are now aware of Ebola and how to prevent its transmission,” said Dr Gianfranco Rotigliano, UNICEF Representative in the DRC. “The active involvement of concerned communities is key to stopping the spread of the disease. We are working closely with them to promote handwashing and good hygiene practices, to accept dignified and safe funerals and to identify and assist people that might be infected with the virus.”

At-risk populations are being reached through community engagement, interpersonal communication, public animations, radio, door-to-door activities, church meetings and adolescent groups. Prevention messages are shared in French, Lingala, Swahili and Nande so that everyone can learn how to protect oneself against the virus and contain its spread.

Eight Ebola survivors have joined the communication teams, sharing their experiences with local communities and stressing the importance of early detection and treatment of people with Ebola-like symptoms.

UNICEF continues to put children at the heart of its response to the outbreak. In support of local authorities, since the beginning of the response, UNICEF and its partners have:
:: Briefed and engaged in communication activities 2,560 influential leaders and representatives of different social and professional networks;
:: Sensitized more than 4,500 people eligible for the Ebola vaccination about the benefits of the vaccine;
:: Provided safe drinking water to more than 500,000 people in the affected areas;
:: Assisted 91 unaccompanied children and orphans as well as 101 families  affected by the disease;
:: Trained more than 150 psychosocial workers to support affected families and their children;
:: Trained and deployed 7 nutrition specialists to ensure nutritional assistance to the patients in the Ebola Treatment Centres in Mangina and Beni;
:: Installed 972 hand washing units and distributed 324 laser thermometers in 162 targeted schools in Mangina and Beni.

In the context of the start of the school year, UNICEF is continuing its prevention efforts in schools, while pursuing its efforts in communication, WASH and psycho-social assistance to families that have been affected by the virus.

Milestones :: Perspectives

Statement on the Lake Chad Region – Berlin Humanitarian Conference
by Dr Rick Brennan, WHO Director of Emergency Operations
Berlin, Germany   3 September 2018
Distinguished delegates,
As others have observed today, the narrative and dialogue around the Lake Chad Basin crisis has matured significantly since we met in Oslo last year.

We need to make the humanitarian-development peace nexus concrete. There is a general recognition that robust and principled humanitarian action is necessary – but not sufficient – to meet the needs of the people in the region. There is also an acknowledgment that root causes must be met, resilience of communities and institutions built, and the humanitarian-development-peace nexus operationalized.

Our challenge remains to shift from agreeing on these concepts and principles, to ensuring their concrete implementation – and to identify the solutions that Mark Lowcock constantly urges us to develop.

There are unique opportunities for effective implementation of the New Way or Working within the Lake Chad Basin sub-region, especially within the health sector. In fact, there is probably no better opportunity in the world today than the Lake Chad Basin region to demonstrate that it is possible to effectively implement the New Way of Working. And it is the view of WHO and our health sector partners, that health presents unique opportunities in this regard.

Humanitarian health response has been effective to date and must be sustained. Humanitarian health action has already documented some remarkable achievements over the past two years in Northeast Nigeria. Through progressively expanding access to essential health services – and working in collaboration with other life-saving sectors – we have documented a sharp drop in mortality in Northeast Nigeria. Mortality rates, which were dramatically elevated above emergency thresholds early in the response, are now within normal limits, at least among those populations to whom we have access. Last year, a collaborative malaria control effort with the Ministry of Health, UNICEF and other partners averted at least 6500 childhood deaths due to malaria. We have also jointly responded effectively to major outbreaks of measles, cholera, meningitis and polio. You may recall that polio established its foothold back in Africa due to the crisis in Northeast Nigeria.

Resilience in the health sector must be built at individual and systems levels. While we all aim to maintain a strong humanitarian response for the short-to medium- term, we see several important opportunities to build the resilience of both individuals and the health system. Firstly, there are few factors that make individuals more resilient physically and mentally than good health and strong nutritional status. Continued strengthening of the coverage and quality of essential health services will help to ensure that individuals are both resistant to disease and recover more rapidly when they do become ill.

Similarly, we need to make the health system itself resilient. Perhaps the best example of this is through building its capacities to prevent, detect and respond to outbreaks of infectious diseases. The Lake Chad region is remarkably prone to outbreaks of disease that have crossed borders, such as meningitis, cholera and hepatitis E. Building capacities for disease surveillance, laboratory diagnosis, and rapid response is vital to the resilience of any health system – and this is nowhere more evident than in the Lake Chad region.

Good governance is essential for sustainable health system development. We also need to be concrete about how we lay the foundations of longer-term health system recovery and development. This can be a complex process, as we have learned in other contexts. But I would like to highlight a sine qua non for sustainable development within the health sector – and that is good governance and leadership. All of the support from international partners will come to naught in the longer term unless authorities at all levels take strong ownership of the health system, ensure transparent management processes and provide an inclusive voice for communities. Involvement of civil society and the private sector has been demonstrated to contribute to health system recovery in several examples and we need to accelerate this process in the context of Lake Chad.

The health sector can contribute to peacebuilding. Finally, the health sector can play its own modest role in advancing peace and reconciliation. Public health campaigns can be opportunities for humanitarian pauses and can be a leading wedge for opening up humanitarian access. Polio vaccinations have helped to open access for other health services in Northeast Nigeria, for example. Re-establishing health services can be a confidence and trust-building process. This is especially true when they are extended to populations who have historically been neglected by central authorities and when they are designed to address longer-term inequities.

In summary, ladies and gentlemen, we must collectively move from agreeing on what needs to be done, to taking concrete steps to implement the humanitarian-development-peace nexus across all sectors. Conceptual frameworks and good intentions and are not enough – we must implement, and we must do so with the full engagement of communities and national partners.

Milestones :: Perspectives
World Organisation for Animal Health (OIE)   [to 8 Sep 2018]
http://www.oie.int/en/for-the-media/press-releases/2018/

7 September 2018
Countries reaffirm political will to globally eradicate Peste des petits ruminants
The aim is to stamp out a virus, which kills millions of sheep and goats each year, and thus protect the livelihoods of hundreds of millions of poor rural families.

Brussels, 7 September 2018 – Over 45 countries today renewed their commitment to globally eradicate by 2030, Peste des petits ruminants (PPR), a highly contagious and devastating disease responsible for the death of millions of sheep and goats each year. At the same time, countries urged resource partners and the development community to contribute in bridging the PPR Global Eradication Programme’s US$340 million funding gap.

The decision to reaffirm this international political engagement and encourage resource partners to join the fight against the disease came at the global conference: Partnering and investing for a PPR-free world, organised by the World Organisation for Animal Health (OIE) and the Food and Agriculture Organization of the United Nations, and hosted by the European Commission in Brussels…

…The PPR Global Control and Eradication Strategy was initially adopted at a 2015 conference in Abidjan jointly organized by FAO and the OIE. Through a 2017-2021 PPR Global Eradication Programme, countries formulated  National Strategic Plans, which detail the steps for assessing, controlling, and eradicating the PPR virus, maintaining PPR virus freedom, as well as the financial resources required and committed by national authorities to implement these plans…

PPR Global Control and Eradication Strategy
FAP, OiE   2015: 8 pages
Foreword
Peste des petits ruminants (PPR) can severely affect small ruminants in almost 70 countries in Africa, the Middle East and parts of Asia. It is a highly contagious disease that causes USD 1.5 to 2 billion in losses each year in regions that are home to over 80% of the world’s sheep and goats and to more than 330 million of the world’s poorest people, many of whom depend on them for their livelihoods. The disease threatens food security and the livelihoods of smallholders and prevents animal husbandry sectors from achieving their economic potential. Reducing the number of PPR-endemic countries is therefore a shared interest and should be considered a Global Public Good.

PPR, as one of the most damaging of all animal diseases, is among the priority diseases indicated in the FAO-OIE Global Framework for the Progressive Control of Transboundary Animal Diseases (GF-TADs) 5 Year Action Plan. In response to recommendations of GF-TADs, a resolution by the World Assembly of Delegates of the OIE and recommendations of the Committee on Agriculture (COAG) and the Council of FAO, the GF-TADs Working group has developed the PPR Global Control and Eradication Strategy (hereinafter the ‘Global Strategy’), which is being presented at the FAO and OIE International Conference for the Control and Eradication of peste des petits ruminants to be held in Abidjan (Côte d’Ivoire), from 31 March to 2 April 2015.

The Global Strategy described in this document is not a ‘stand-alone’ activity designed for PPR control and eradication only. It will allow progress to be made in other fields, with the  strengthening of Veterinary Services as a cornerstone of the strategy which will provide the necessary enabling environment to control other animal diseases through a cost-effective combination of activities against several major diseases of small ruminants…

[Excerpt]
4.4. Vaccines
One of the key conditions for the success of the global rinderpest eradication programme was the use a rinderpest vaccine that was highly efficacious in protecting animals against all rinderpest virus strains. A similar tool also exists for the prevention and control of PPR. Indeed efficient live attenuated PPR vaccines are available that can induce lifelong protective immunity in vaccinated animals (see Annex 3.2).

Currently more than 20 manufacturers produce PPR vaccine. Therefore, it will be of the utmost importance for the products of all these manufacturers, before their use in the field, to be certified as meeting OIE vaccine quality standards (24) to ensure their efficacy. In that regard, the certification body should be an independent institution such as the African Union Pan-African Veterinary Vaccine Centre (AU-PANVAC), which ensures the quality control of various veterinary vaccines, including PPR vaccine, in Africa. PANVAC is an OIE and FAO Collaborating/ Reference Centre for quality control of veterinary vaccines.

Current PPR virus (PPRV) attenuated vaccines are thermolabile and to avoid their thermal inactivation they require uninterrupted maintenance of the cold chain until their application to the animal. The currently commercially available vaccines are in freeze-dried form and they are stable for at least two years at 2°C to 8°C and for several years at –20°C. Once the vaccine is reconstituted, it needs to be utilised as soon as possible, but not later than 30 minutes after dilution. Most of the PPR-endemic regions have a hot climate and they usually have poor infrastructure to maintain the cold chain needed to preserve vaccine potency and efficacy. To address this constraint, many research laboratories have succeeded in improving the freeze-drying conditions in the presence of cryoprotectants to obtain a thermostable PPR vaccine product. It is expected that the continued transfer of these newer technologies to vaccine
manufacturers will improve the quality of the final products delivered in the field.

Consideration should be given to the constitution of regional vaccine banks to ensure vaccine availability in case of emergencies. The OIE has established vaccine banks using the concept of virtual rolling stocks (32): the supplier (vaccine production companies selected through calls for tender based on international standards) produces the vaccines when needed or a limited physical stock of vaccines remains with the supplier and is renewed on a rolling basis under terms and conditions contractually defined with the OIE. This concept enables the rapid supply of an emergency stock of vaccines to infected countries in order to vaccinate animal populations at risk and to progressively achieve eradication wherever possible. The concept can also serve the purpose of delivering quality vaccine for the annual control programmes, in a non-emergency situation…

Emergencies
 
POLIO
Public Health Emergency of International Concern (PHEIC)
Polio this week as of 4 September 2018 [GPEI]
Summary of new viruses this week:
Papua New Guinea – three new cases of circulating vaccine-derived poliovirus type 1 (cVDPV1). No new cases of wild poliovirus.
Afghanistan and Pakistan continue to detect WPV1 through environmental sampling, indicating sustained transmission.

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

WHO Grade 3 Emergencies  [to 8 Sep 2018]
Nigeria 
:: WHO statement from the High-level conference on the Lake Chad Region  3 September 2018
[See Milestones above for full text]

The Syrian Arab Republic
:: Generous donation of medical equipment from Japan boosts public health services in Syria
3 September 2018

Iraq  – No new announcements identified
South Sudan  – No new announcements identified
Yemen  – No new announcements identified
 
::::::
 
WHO Grade 2 Emergencies  [to 8 Sep 2018]
Cameroon  – No new announcements identified
Central African Republic  – No new announcements identified.
Democratic Republic of the Congo – No new announcements identified
Ethiopia  – No new announcements identified.
Libya – No new announcements identified.
Myanmar  – No new announcements identified
Niger  – No new announcements identified.
Ukraine – No new announcements identified

::::::
::::::
 
UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises. 
Syrian Arab Republic   – No new announcements identified.
Yemen  – No new 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.
Somalia   
:: Humanitarian Bulletin Somalia, 1 August – 5 September 2018
HIGHLIGHTS

• Food security improving, but nutrition levels remain critical.
• Rise in forced evictions raises concern
• Children < 5 targeted in nationwide polio campaign…

Ethiopia  – No new 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 8 Sep 2018]
http://www.who.int/ebola/en/
Disease outbreak news
:: Ebola virus disease – Democratic Republic of the Congo  7 September 2018
:: 05: Situation report on the Ebola outbreak in North Kivu  4 September 2018
 [See Milestones above for more detail]

MERS-CoV [to 8 Sep 2018]
http://who.int/emergencies/mers-cov/en/
– No new announcements identified.
 
Yellow Fever  [to 8 Sep 2018]
http://www.who.int/csr/disease/yellowfev/en/
– No new announcements identified.

Zika virus  [to 8 Sep 2018]
http://www.who.int/csr/disease/zika/en/
– No new announcements identified.

WHO & Regional Offices [to 8 Sep 2018]

Launch of new global estimates on levels of physical activity in adults
5 September 2018 | News Release

Protecting women in Solomon Islands from cervical cancer
4 September 2018 – Feature story

WHO airlifts over 500 tons of essential medicines and medical supplies to Yemen
3 September 2018 | News Release

::::::
 
Weekly Epidemiological Record, 7 September 2018, vol. 93, 36 (pp. 457–476)
:: Dengue vaccine: WHO position paper – September 2018
[Excerpt]
…WHO position
The live attenuated dengue vaccine CYD-TDV has been shown in clinical trials to be efficacious and safe in persons who have had a dengue virus infection in the past (seropositive individuals), but carries an increased risk of severe dengue in those who experience their first
natural dengue infection after vaccination (seronegative individuals). Countries should consider introduction of the dengue vaccine CYD-TDV only if the minimization of risk among seronegative individuals can be assured.62

For countries considering vaccination as part of their dengue control programme, pre-vaccination screening is the recommended strategy. 63 With this strategy, only persons with evidence of a past dengue infection would be vaccinated (based on an antibody test, or on a documented laboratory confirmed dengue infection in the past). If pre-vaccination screening is not feasible, vaccination without individual screening could be considered in areas with recent documentation of seroprevalence rates of at least 80% by age 9 years.

Screening tests would need to be highly specific to avoid vaccinating truly seronegative persons and to have high sensitivity to ensure that a high proportion of seropositive persons are vaccinated. Conventional serological testing for dengue virus IgG (e.g. dengue IgG ELISA)
is available in most dengue endemic countries, and could be used to identify persons who have had a past dengue infection. However, such laboratory-based assays do not provide results at the point of care. Point-of-care tests, i.e. RDTs, would facilitate the implementation of the pre-vaccination screening strategy, but to date none have been validated or licensed specifically for the detection of past dengue infection. Use of currently available IgG-containing RDTs – despite their lower sensitivity for detection of past dengue infection compared with conventional dengue IgG ELISA – could be considered in high transmission settings until better RDTs for determining serostatus become available.

No screening test is likely to be 100% specific due to potential cross-reactivity with other flaviviruses. In settings with high dengue seroprevalence, a test with lower specificity might be acceptable as the proportion of seronegative individuals incorrectly vaccinated would be low. A pre-vaccination screening strategy may also be considered in low-to-moderate transmission settings. In settings with low seroprevalence a test with high specificity is needed. Given the limitations regarding specificity, some seronegative individuals may be vaccinated because of a false positive test result. Furthermore, as vaccine-induced protection against dengue in seropositive individuals is high but not complete, breakthrough disease will occur in some seropositive vaccinees. These limitations will need to be communicated to populations offered vaccination.

Decisions about implementing a pre-vaccination screening strategy with the currently available tests will require careful assessment at the country level, including consideration of the sensitivity and specificity of available tests and of local priorities, dengue epidemiology, country-specific dengue hospitalization rates, and affordability of both CYD-TDV and screening tests.

Decisions about implementing a seroprevalence criterion-based vaccination strategy without individual screening in areas with documented seroprevalence rates of at least 80% at age 9 years will require population serosurveys at high resolution, i.e. at district and sub-district level. Careful assessment is required with regard to the feasibility and cost of population seroprevalence studies. Communication needs to ensure appropriate and full disclosure of the risks of vaccination of persons with unknown serostatus.

Vaccination should be considered as part of an integrated dengue prevention and control strategy. There is an ongoing need to adhere to other disease preventive measures such as well-executed and sustained vector control. Individuals, whether vaccinated or not, should
seek prompt medical care in if dengue-like symptoms occur. Vaccinated patients should  continue to be offered the best evidence-based clinical care for all patients with dengue…

62 Evidence to recommendation Table 1: Consideration of Dengue Vaccine. Geneva:
World Health Organization; 2018 – http://www.who.int/immunization/policy/position_
papers/E2R_1_dengue_2018.pdf
63 Evidence to recommendation Table 2: Seroprevalence and screening and vaccination
strategy. Geneva: World Health Organization; 2018 – http://www.who.int/immunization/
policy/position_papers/E2R_2_dengue_2018.pdf
 
::::::
 
WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
Selected Featured News
:: South Sudan intensifies Ebola preparedness in response to the outbreak in Democratic Republic of Congo  07 September 2018
:: WHO scales up response as Borno declares another outbreak of cholera  06 September 2018
:: Uganda targets over 1,600,000 persons for Cholera vaccination campaign  05 September 2018

WHO Region of the Americas PAHO
No new digest content identified.
 
WHO South-East Asia Region SEARO
:: Countries in WHO South-East Asia to intensify efforts to control dengue, eliminate malaria
:: Strengthen emergency medical teams for better response to disasters: WHO
:: Dr Poonam Khetrapal Singh unanimously nominated for second term as Regional Director WHO South-East Asia
:: Countries in WHO South-East Asia Region resolve to make essential medical products accessible, affordable to all
 
WHO European Region EURO
:: WHO launches a cutting-edge package to scale up risk communication capacity in the European Region in 5 steps 06-09-2018
:: Confirmed case of MERS-CoV in United Kingdom 03-09-2018

WHO Eastern Mediterranean Region EMRO
:: Generous donation from Japan boosts public health services in Syria  3 September 2018
:: WHO airlifts over 500 tons of essential medicines and medical supplies to Yemen  3 September 2018
:: Palestinian casualties of Gaza demonstrations  3 September 2018
: 14 million children in Afghanistan to be immunized against measles   1 September 2018

WHO Western Pacific Region
:: WHO continues to support flood response activities in Attapeu Province  3 September 2018
 

CDC/ACIP [to 8 Sep 2018]
http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html

Latest News
CDC guidance to travelers as influenza season nears
Friday, September 7, 2018

MMWR News Synopsis for September 6, 2018

Assessment of State, Local, and Territorial Zika Planning and Preparedness Activities — United States, June 2016–July 2017
The ability of health departments to prepare for and respond to emerging public health challenges is pivotal to protect the health of all Americans.  The 2015-2016 Zika virus epidemic demonstrated how health departments, with the assistance of CDC, were able to quickly adapt and enhance planning to respond to a new threat. During the 2015-2016 Zika virus epidemic, CDC awarded $25 million in supplemental funding to 41 states, eight territories and four metropolitan areas to support preparedness and response efforts.  This report is the first to present a snapshot of preparedness activities performed by grant recipients and demonstrates improving readiness in the event Zika virus were to emerge in the future.  Health departments need to be ready to adapt to emerging public health challenges. The ability of state, local and territorial governments to adapt quickly in response to the arrival of Zika virus was because of the 16 years of preparedness coordination between CDC and health departments across the country.

Progress Toward Poliovirus Containment Implementation — Worldwide, 2017–2018
Poliovirus containment requires global participation and is essential to ensure polio is not reintroduced into the population after polio eradication. As the world progresses toward polio disease eradication, polioviruses in laboratories and other facilities must be securely contained to prevent release back into the human population. The global poliovirus containment initiative, essential to maintaining a polio-free world, is underway in every country and currently focuses on the poliovirus serotype that has been declared eradicated (type 2). Facilities with type 2 poliovirus must undergo a rigorous certification process including audits from a national authority. In addition, facilities around the world must inspect specimen inventories to ensure that samples were not collected at a time and place when poliovirus was in circulation in the community. While there are many challenges in implementing this complex international program, important poliovirus containment achievements have been made in the last year.

Africa CDC   [to 8 Sep 2018]
https://au.int/en/africacdc
September 03, 2018

African Union conducts pre deployment training workshop for health workers destined to fight Ebola in North Kivu and Ituri provinces in DRC

China CDC 
http://www.chinacdc.cn/en/

Website not responding at inquiry

Announcements

 
AERAS  [to 8 Sep 2018]
http://www.aeras.org/pressreleases
No new digest content identified.
 
 
BMGF – Gates Foundation  [to 8 Sep 2018]
http://www.gatesfoundation.org/Media-Center/Press-Releases
No new digest content identified.

Bill & Melinda Gates Medical Research Institute    [to 8 Sep 2018]
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 8 Sep 2018]
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 8 Sep 2018]
http://cepi.net/
No new digest content identified.

EDCTP    [to 8 Sep 2018]
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
3 September 2018
EDCTP launches €2.25 M emergency funding initiative in response to Ebola outbreak in the Democratic Republic of Congo
Today, the European & Developing Countries Clinical Trials Partnership (EDCTP) launched an emergency funding initiative ‘Mobilisation of research funds in case of Public Health Emergencies’ to support research activities in response to the  Ebola Virus Disease (EVD) outbreak in the Democratic Republic of Congo. Applications for research funding must be submitted by 10 September 2018.

Emory Vaccine Center    [to 8 Sep 2018]
http://www.vaccines.emory.edu/
No new digest content identified.

European Medicines Agency  [to 8 Sep 2018]
http://www.ema.europa.eu/ema/
07/09/2018
Meeting highlights from the Pharmacovigilance Risk Assessment Committee (PRAC) 3-6 September 2018
PRAC elects new vice-chair [Dr Martin Huber from Germany]
At its monthly meeting, the European Medicines Agency’s (EMA) Pharmacovigilance Risk Assessment Committee (PRAC) did not start or conclude a new referral.

 
European Vaccine Initiative  [to 8 Sep 2018]
http://www.euvaccine.eu/news-events
No new digest content identified.
 
 
FDA [to 8 Sep 2018]
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/default.htm
September 05, 2018
Statement from FDA Commissioner Scott Gottlieb, M.D., on the agency’s global efforts to help assure product quality and transparency at foreign drug manufacturing facilities
… We’ve established a framework to help assure that drug products all meet the same high-quality standards, regardless of where they’re manufactured; and whether they’re brand name or generic products, or prescription or over-the-counter drugs. Today, we’re announcing several steps that improve on that effort.
Helping assure the quality and safety of globally produced products requires a variety of efforts at different times throughout the lifecycle of a drug’s manufacturing and finishing. Our inspections and surveillance of manufacturing facilities are an integral part of this oversight. We need to make sure that our inspections are prioritized based on potential risks to patients, and that we’re using our resources efficiently.
Today, to add greater transparency around our site selection model, we’re publishing our internal policy for how manufacturing facilities are prioritized and scheduled for surveillance inspections. Our policy explains how a facility’s compliance history, recall trends, time since last inspection, inherent risk of the drug being manufactured, processing complexity and other factors are all weighed and considered…
 
 
Fondation Merieux  [to 8 Sep 2018]
http://www.fondation-merieux.org/
Mérieux Foundation event
Global challenges in vaccine acceptance science and programs
September 24 – 26, 2018 – Les Pensieres Center for Global Health, Veyrier du Lac (France)
 
 
Gavi [to 8 Sep 2018]
http://www.gavi.org/library/news/press-releases/
No new digest content identified.

 
GHIT Fund   [to 8 Sep 2018]
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 8 Sep 2018]
http://www.theglobalfund.org/en/news/?topic=&type=NEWS;&country=
News
India Supports Global Fund Efforts to Mobilize Funds
05 September 2018
India announced today it would host the Global Fund’s Preparatory Meeting of the Sixth Replenishment in New Delhi in February 2019, an important milestone to mobilize funds aimed at accelerating the end of AIDS, TB and malaria as epidemics.
 
Hilleman Laboratories   [to 8 Sep 2018]
http://www.hillemanlabs.org/
Date: 09/01/2018
Hilleman Laboratories partners with innovative Future Vaccine Manufacturing Hub
Hilleman Laboratories, an equal joint-venture partnership between MSD and Wellcome Trust, is honored to be one of the key partners of the new Future Vaccine Manufacturing Hub led by Imperial College London. The hub has been established to increase immunisation coverage across the globe and improve the response to disease outbreaks through the rapid and cost-effective deployment of vaccines. £10 million of funding has been granted by the UK Department for Health, and will be managed by the Engineering and Physical Sciences Research Council (EPSRC).
The all-new Future Vaccine Manufacturing Hub aims to address two major challenges facing creation of future vaccine manufacturing systems:
:: How to design vaccine production systems that can produce tens of thousands of new doses within weeks of a new threat being identified
:: How to improve current manufacturing processes and change the way vaccines are manufactured, stabilized and stored so that existing and new diseases can be prevented effectively, at reduced costs…
 
 
Human Vaccines Project   [to 8 Sep 2018]
http://www.humanvaccinesproject.org/media/press-releases/
No new digest content identified.
 
 
IAVI  [to 8 Sep 2018]
https://www.iavi.org/
No new digest content identified.

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

IVAC  [to 8 Sep 2018]
https://www.jhsph.edu/research/centers-and-institutes/ivac/index.html
No new digest content identified.
 
 
IVI   [to 8 Sep 2018]
http://www.ivi.int/
Undated
IVI’s 18th Vaccinology Course gathers 120 international participants from 19 countries in Seoul September 3-7
:: Annual Course to update on the recent development in vaccinology, including basics of immunology, epidemiology, vaccine design and development
:: Featured experts include: Stanley Plotkin (University of Pennsylvania), Dr. Barney Graham (US NIH), Dr. Randy Schoepp (USAMRID), Dr. Andy Pollard (University of Oxford), and Dr. Eric Mintz (US CDC)
:: Donor-supported fellowship invites 12 developing country participants to help increase country capacities in vaccines, immunization
:: Week-long course supported by GlaxoSmithKlein, EuBiologics, Sky 72 Golf Club, Seoul Metropolitan City, and Community Chest of Korea – Incheon
 
 
JEE Alliance  [to 8 Sep 2018]
https://www.jeealliance.org/
No new digest content identified.
 
 
MSF/Médecins Sans Frontières  [to 8 Sep 2018]
http://www.msf.org/
Selected Press Releases/Statements
DRC 2018 Ebola outbreaks
North Kivu: MSF treats 65 Ebola patients in first month
Project Update 7 Sep 2018
Médecins Sans Frontières (MSF) has treated 65 patients confirmed to be diagnosed with Ebola in the first month of intervention in the latest Ebola outbreak, in North Kivu, Democratic Republic of Congo (DRC). This number is more than 80 percent  of the total number of confirmed patients hospitalised in Ebola Treatment Centres so far during this epidemic. Of the patients confirmed Ebola positive in Mangina Ebola Treatment Centre, 29 have recovered and returned to their families. Three patients remain under treatment…

Central African Republic
“The tip of the iceberg”: Stream of patients offer glimpse into scale of sexual violence
Project Update 7 Sep 2018

Libya
Evacuation of refugees and migrants out of Libya is urgently needed
Press Release 7 Sep 2018

Mexico
Abductions and violence, the price to pay to cross Mexico
Project Update 3 Sep 2018

 
NIH  [to 8 Sep 2018]
http://www.nih.gov/news-events/news-releases
September 5, 2018
Clinical trial testing topical cream plus influenza vaccine in progress
— Cream regimen could boost immunity.
A Phase 1 clinical trial examining whether a topical cream can enhance the immune response conferred by a “pre-pandemic” influenza vaccine is underway at Baylor College of Medicine in Houston. Investigators are evaluating whether imiquimod cream, which is commonly used to treat genital warts and certain skin cancers, can boost the body’s immune response to an H5N1 influenza vaccine. The trial is enrolling 50 healthy adults ages 18-50 years. Baylor is one of the Vaccine and Treatment Evaluation Units (VTEUs) — a network of clinical research sites that can rapidly enroll large volunteer cohorts to evaluate experimental vaccines against infectious diseases. The VTEUs are funded and managed by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health…

PATH  [to 8 Sep 2018]
https://www.path.org/media-center/
No new digest content identified.

Sabin Vaccine Institute  [to 8 Sep 2018]
http://www.sabin.org/updates/pressreleases
No new digest content identified.
 
 
UNAIDS [to 8 Sep 2018]
http://www.unaids.org/en
5 September 2018
First ladies from Africa and China working towards a future free from AIDS
Read

UNICEF  [to 8 Sep 2018]
https://www.unicef.org/media/press-releases
Selected Press Releases/Reports/Statements
Statement
Statement by UNICEF Executive Director Henrietta Fore on the eve of Yemen peace talks
“The children of Yemen need to heal. They need justice. They need lasting peace, now.”
05/09/2018

Press release
In eastern DRC, nearly 2.5 million people reached in effort to contain Ebola outbreak – UNICEF
05/09/2018
[See Week in Review above for more detail]

Vaccine Confidence Project  [to 8 Sep 2018]
http://www.vaccineconfidence.org/
No new digest content identified.
 

Vaccine Education Center – Children’s Hospital of Philadelphia  [to 8 Sep 2018]
http://www.chop.edu/centers-programs/vaccine-education-center
No new digest content identified.
 
 
Wellcome Trust  [to 8 Sep 2018]
https://wellcome.ac.uk/news
Explainer / Published: 4 September 2018
Wellcome Flagships will focus on five health innovation challenges
Flagships are a new way of working for Wellcome. Director of Innovation Stephen Caddick explains what flagships are, how they’ll work and what we want to achieve.
One of the main ideas in our strategy, Innovation for Impact [PDF 200KB], is to identify a small number of health innovation challenges where we think a concerted effort could result in major, tangible improvements to people’s health.
Of course, this is easy to say and pretty hard to do. The key approach we’re using is based on building a series of linked activities, which we call Flagships.
We intend to commit up to £300m of our budget to five Flagships over the next six years. And we hope to work with partners who will share our commitment and help us to realise the ambition of each Flagship…
 
 
The Wistar Institute   [to 8 Sep 2018]
https://www.wistar.org/news/press-releases
Press Release
Sep. 6, 2018
Synthetic DNA Vaccine Effective Against Influenza A Virus Subtype That Is Responsible for More Severe Influenza Seasons
Compared with conventional vaccines, synthetic DNA vaccines can be manufactured faster and may avoid the need for annual vaccine reformulations.

Press Release
Sep. 5, 2018
Enhancing the Efficacy of Immune Checkpoint Inhibitor Therapy Using a Novel Treatment Combination
PHILADELPHIA — (Sept. 5, 2018) — A combination of a novel inhibitor of the protein CK2 (Casein kinase 2) and an immune checkpoint inhibitor has dramatically greater antitumor activity than either inhibitor alone, according to research from The Wistar Institute that was published online in Cancer Research.
Press Release
Sep. 4, 2018
Synthetic DNA Technology Provides a Novel Strategy for Effective Delivery of a Complex Anti-HIV Agent
PHILADELPHIA — (Sept. 4, 2018) — Scientists at The Wistar Institute have applied their synthetic DNA technology to engineer a novel eCD4-Ig anti-HIV agent and to enhance its potency in vivo, providing a new simple strategy for constructing complex therapeutics for infectious agents as well as for diverse implications in therapeutic delivery. This critical development was published online in the journal EBio Medicine.

World Organisation for Animal Health (OIE)   [to 8 Sep 2018]
http://www.oie.int/en/for-the-media/press-releases/2018/
7 September 2018
Countries reaffirm political will to globally eradicate Peste des petits ruminants
The aim is to stamp out a virus, which kills millions of sheep and goats each year, and thus protect the livelihoods of hundreds of millions of poor rural families.
[See Milestones above for detail]

::::::
 
BIO    [to 8 Sep 2018]
https://www.bio.org/insights/press-release
No new digest content identified.

DCVMN – Developing Country Vaccine Manufacturers Network  [to 8 Sep 2018]
http://www.dcvmn.org/
No new digest content identified.
 
IFPMA   [to 8 Sep 2018]
http://www.ifpma.org/resources/news-releases/
Policy Positions – Publications
:: IFPMA AMR Policy Position: Reimbursement and Health Technology Assessment Reform
:: IFPMA AMR Policy Position: Supporting sustainable investments in antimicrobial R&D
:: IFPMA AMR Policy Position: The need for AMR R&D pull incentives

PhRMA    [to 8 Sep 2018]
http://www.phrma.org/press-room
September 5, 2018
Nearly 1 in 5 Hospitals Marks Up Medicine Prices at Least 700 Percent
Nearly one in five hospitals marks up medicine prices 700 percent or more, according to a new analysis from the Moran Company that was commissioned by PhRMA.

Industry Watch [to 8 Sep 2018]
:: NIH Selects CEL-SCI’s LEAPS Rheumatoid Arthritis Vaccine for Commercialization Accelerator Program
September 05, 2018   VIENNA, Va.– CEL-SCI Corporation (NYSE American: CVM) announced today that the National Institutes of Health (NIH) selected CEL-SCI and its LEAPS* rheumatoid arthritis vaccine candidate as a Small Business Innovation Research/Small Business Technology Transfer (SBIR/STTR) Commercialization Accelerator Program Phase II awardee for 2018-2019. LEAPS has been specifically selected by the NIH for the Commercialization Transition Track, which provides technical assistance to awardee companies to move NIH-funded technologies towards commercialization and market readiness…

Reports/Research/Analysis/Commentary/Conferences/Meetings/Book Watch/Tenders

Vaccines and Global Health: The Week in Review has expanded its coverage of new reports, books, research and analysis published independent of the journal channel covered in Journal Watch below. Our interests span immunization and vaccines, as well as global public health, health governance, and associated themes. If you would like to suggest content to be included in this service, please contact David Curry at: david.r.curry@centerforvaccineethicsandpolicy.org

No new digest content identified.

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

American Journal of Infection Control
September 2018 Volume 46, Issue 9, p961-1082
http://www.ajicjournal.org/current

State of the Science Review
Social media and outbreaks of emerging infectious diseases: A systematic review of literature
Lu Tang, Bijie Bie, Sung-Eun Park, Degui Zhi
Published online: April 5, 2018
Highlights
:: A systematic review of published articles on social media and emerging infectious disease.
:: Three major approaches are identified: assessment of public opinion, organization’s social media use, and evaluation of information accuracy.
:: More theorization and methodologic rigor is needed.

American Journal of Infection Control
September 2018 Volume 46, Issue 9, p961-1082
http://www.ajicjournal.org/current

Major Articles
Unusual presentation of Middle East respiratory syndrome coronavirus leading to a large outbreak in Riyadh during 2017
Hala Amer, Abdulrahman S. Alqahtani, Hind Alzoman, Nawfal Aljerian, Ziad A. Memish
p1022–1025
Published online: April 13, 2018
 

American Journal of Public Health
September 2018   108(53)
http://ajph.aphapublications.org/toc/ajph/current

AJPH EDITORIALS – SUMMARY
Public Health Emergencies: Unpacking Medical Countermeasures Management for Preparedness and Response
Tanya Telfair LeBlanc PhD, MS, Christine Kosmos RN, MS, SBN, and Rachel Nonkin Avchen PhD, MS
Accepted: August 13, 2018
Published Online: September 07, 2018