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The Cervical Cancer Prevention Initiative: Investing in Cervical Cancer Prevention 2015–2020. Year One update, November 2016.
[Seattle, Washington], PATH, 2016 Nov. 7 p.It has been a year since the groundbreaking meeting in London where the Cervical Cancer Prevention Initiative was launched. This short report documents progress building the Initiative over the past 12 months, and lists key global milestones in cervical cancer during that time.
New York, New York, UNICEF, 2016 Jun.  p.Every child has the right to health, education and protection, and every society has a stake in expanding children’s opportunities in life. Yet, around the world, millions of children are denied a fair chance for no reason other than the country, gender or circumstances into which they are born. The State of the World’s Children 2016 argues that progress for the most disadvantaged children is not only a moral, but also a strategic imperative. Stakeholders have a clear choice to make: invest in accelerated progress for the children being left behind, or face the consequences of a far more divided world by 2030. At the start of a new development agenda, the report concludes with a set of recommendations to help chart the course towards a more equitable world.
Geneva, Switzerland, WHO, 2014.  p.This publication, Comprehensive cervical cancer control: a guide to essential practice (C4GEP), gives a broad vision of what a comprehensive approach to cervical cancer prevention and control means. In particular, it outlines the complementary strategies for comprehensive cervical cancer prevention and control, and highlights the need for collaboration across programmes, organizations and partners. This new guide updates the 2006 edition and includes the recent promising developments in technologies and strategies that can address the gaps between the needs for and availability of services for cervical cancer prevention and control.
MMWR. Morbidity and Mortality Weekly Report. 2015 Feb 20; New Delhi, India, WHO, Regional Office for South-East Asia, 2015. 64(6):137-140.  p.The overall objective of the strategic framework for comprehensive control of cancer cervix in South-East Asia is to guide and assist Member States to develop or strengthen national strategies to improve cervical cancer control activities; to reduce the burden of morbidity, disability and death from cervical cancer; and, to promote women’s health. The specific objectives of the framework are to help countries to prepare country-specific protocols to: 1. Introduce or scale up delivery of HPV vaccine to girls aged 9 to 13 years through a coordinated multisectoral approach involving national immunization, cancer control, reproductive and adolescent health programmes. 2. Implement or scale up organized cervical cancer screening programmes utilizing evidence-based, cost-effective interventions through effective service delivery strategies across the different levels of health care. 3. Strengthen health systems to ensure equitable access to cervical cancer screening services for all eligible women, with particular attention to socioeconomically disadvantaged population groups. 4. Augment management facilities for invasive cancer cervix and introduce palliative care services into the health system as part of a comprehensive cancer control programme. 5. Encourage / create convergence with related health programmes to ensure a coordinated and operationally feasible approach for cervical cancer control within the health system. 6. Initiate / augment a structured and coordinated advocacy and educational campaign so that the benefits of cervical cancer control are universally available and accessible. The framework discusses the determinants of a successful and organized screening programme, and feasible options that the countries can adopt. It recommends that cervical cancer screening services should be organized as a functional continuity across different levels of health-care delivery, from community to first-level health centres and to referral hospitals, so as to ensure high coverage of the target population and linkage between screening and treatment. Augmentation of cancer treatment services and improving palliative care are also crucial components of cervical cancer control that are discussed in the framework. (Excerpts)
Releve Epidemiologique Hebdomadaire. 2013 Jul 12; 88(28):285-96.This epidemiologic record discusses recent data about yellow fever outbreaks and cases in Africa and South America between 2011 and 2012. During this period, major outbreaks were reported in Sudan and Uganda while significant clusters of cases were reported in Cameroon, Chad and Cote d’Ivoire, necessitating an extended vaccination response. In addition, some isolated cases occurred in districts reporting high yellow fever vaccination coverage (Burkina Faso, Central African Republic, Togo), for which no vaccination response was undertaken. In South America, the World Health Organization American Region reported 32 cases (2011-2012), including 9 deaths, in Brazil, Ecuador, Plurinational State of Bolivia and Peru. As of 2012, most countries in the Caribbean and Latin America with enzootic areas had introduced the yellow fever vaccine into their national routine immunization schedules. The 2008 outbreaks in the Southern Cone expanded the area considered at risk to include northern Argentina and Paraguay. Building upon the yellow fever investment case strategy, which has reduced the frequency and size of disruptive outbreaks, the Yellow Fever Strategic Framework 2012-2020 prioritizes endemic countries according to their epidemic risk. This framework will enable WHO and partners to identify the populations’ high priority needs through a systematic approach so that limited resources can be allocated most effective to reduce the burden of yellow fever in Africa. Following a request from the countries, a form of yellow fever experts met in Panama to discuss how countries can make scientific evidence-based risk assessments and suggested that endemic countries should strive to enhance yellow fever surveillance systems.
Routine vaccination coverage in low- and middle-income countries: further arguments for accelerating support to child vaccination services.
Global Health Action. 2013; 6:20343.BACKGROUND AND OBJECTIVE: The Expanded Programme on Immunization was introduced by the World Health Organization (WHO) in all countries during the 1970s. Currently, this effective public health intervention is still not accessible to all. This study evaluates the change in routine vaccination coverage over time based on survey data and compares it to estimations by the WHO and United Nations Children's Fund (UNICEF). DESIGN: Data of vaccination coverage of children less than 5 years of age was extracted from Demographic and Health Surveys (DHS) conducted in 71 low- and middle-income countries during 1986-2009. Overall trends for vaccination coverage of tuberculosis, diphtheria, tetanus, pertussis, polio and measles were analysed and compared to WHO and UNICEF estimates. RESULTS: From 1986 to 2009, the annual average increase in vaccination coverage of the studied diseases ranged between 1.53 and 1.96% units according to DHS data. Vaccination coverage of diphtheria, tetanus, pertussis, polio and measles was all under 80% in 2009. Non-significant differences in coverage were found between DHS data and WHO and UNICEF estimates. CONCLUSIONS: The coverage of routine vaccinations in low- and middle-income countries may be lower than that previously reported. Hence, it is important to maintain and increase current vaccination levels.
Geneva, Switzerland, WHO, 2013.  p. (WHO Guidance Note)This WHO Guidance Note advocates for a comprehensive approach to prevention and control of cervical cancer and is aimed at senior policymakers and program managers. It describes the need to deliver effective interventions across the female lifespan. These interventions include community education; social mobilization; HPV vaccination; and cancer screening, treatment, and palliative care. The document outlines complementary strategies for comprehensive prevention and control, and it highlights collaboration across national health programs (particularly immunization, reproductive health, cancer control and adolescent health), organizations, and partners.
Successful polio eradication in Uttar Pradesh, India: the pivotal contribution of the Social Mobilization Network, an NGO / UNICEF collaboration.
Global Health: Science and Practice. 2013 Mar; 1(1):68-83.In Uttar Pradesh, India, in response to low routine immunization coverage and ongoing poliovirus circulation, a network of U.S.-based CORE Group member and local nongovernmental organizations partnered with UNICEF, creating the Social Mobilization Network (SMNet). The SMNet’s goal was to improve access and reduce family and community resistance to vaccination. The partners trained thousands of mobilizers from high-risk communities to visit households, promote government-run child immunization services, track children’s immunization history and encourage vaccination of children missing scheduled vaccinations, and mobilize local opinion leaders. Creative behavior change activities and materials promoted vaccination awareness and safety, household hygiene, sanitation, home diarrheal-disease control, and breastfeeding. Program decision-makers at all levels used household-level data that were aggregated at community and district levels, and senior staff provided rapid feedback and regular capacity-building supervision to field staff. Use of routine project data and targeted research findings offered insights into and informed innovative approaches to overcoming community concerns impacting immunization coverage. While the SMNet worked in the highest-risk, poorly served communities, data suggest that the immunization coverage in SMNet communities was often higher than overall coverage in the district. The partners’ organizational and resource differences and complementary technical strengths posed both opportunities and challenges; overcoming them enhanced the partnership’s success and contributions.
Report on country experience: A multi-sectoral response to combat polio outbreak in Namibia. Draft background paper.
[Unpublished] 2011. Draft background paper commissioned by the World Health Organization for the World Conference on Social Determinants of Health, Rio de Janeiro, Brazil, 19-21 October 2011.  p. (WCSDH/BCKGRT/19/2011; Draft Background Paper 19)Namibia witnessed an outbreak of Wild Polio Type 1 virus in 2006. A total of 323 suspected cases of Acute Flaccid Paralysis were reported, of which 19 were confirmed as Wild Polio Virus Type 1. The outbreak affected mostly the older population and thirty-two of the suspected cases died. The country mounted an immediate response that enabled the whole population to be vaccinated against polio virus. The outbreak of the epidemic witnessed an unprecedented response with the country coming together in the spirit of one Nation facing a common enemy. The reported deaths in some communities engendered fear among the populace and motivated the people to seek early treatment and prevention from further spread of the outbreak. The key to the successful response to the outbreak included: Political commitment; Resource mobilization and availability; Support of international community; Good community mobilization and cooperation from the communities; Commitment and dedication from the Health Care Providers and the volunteers; Team work and delegation; Good communication and support from the media. (Excerpt)
Measles outbreaks and progress towards meeting measles pre-elimination goals: WHO African Region, 2009-2010. Flambees de rougeole et progres accomplis en vue d'atteindre les objectifs de preelimination de la rougeole: Region africaine de l'OMS, 2009-2010.
Releve Epidemiologique Hebdomadaire. 2011 Apr 1; 86(14):129-36.This report summarizes the progress made during 2009-2010 towards meeting the pre-elimination goals after a historically low incidence of measles cases was reported in 2008. In addition, it provides information on measles outbreaks occurring during the same period which highlights the urgent need for renewed political will from governments and their partners to ensure that national multiyear vaccination plans, budgetary line-items and financial commitments exist for routine immunization services and measles-control activities. To assist countries in resonding to measles outbreaks, WHO guidelines were published in 2009.
Pandemic influenza A H1N1: Vaccination campaigns protect the most vulnerable populations in Togo. Photo and caption.
Arlington, Virginia, JSI, DELIVER, 2010 Dec.  p.During two countrywide vaccination campaigns, Togo's MOH immunized 10 percent of its most at-risk populations. Togo is one of 40 countries conducting a national H1N1 immunization campaign in collaboration with WHO and the USAID | DELIVER PROJECT.
New York, New York, UNICEF, 2009.  p.This report sets out a 7-point strategy for comprehensive diarrhoea control that includes a treatment package to reduce child deaths, and a prevention package to reduce the number of diarrhoea cases for years to come. The report looks at treatment options such as low-osmolarity ORS and zinc tablets, as well as prevention measures such as the promotion of breastfeeding, vitamin A supplementation, immunization against rotavirus -- a leading cause of diarrhoea -- and proven methods of improving water, sanitation and hygiene practices. Diarrhoea's status as the second leading killer of children under five is an alarming reminder of the exceptional vulnerability of children in developing countries. Saving the lives of millions of children at risk of death from diarrhoea is possible with a comprehensive strategy that ensures all children in need receive critical prevention and treatment measures. (Excerpt)
Lancet Infectious Diseases. 2008 Jan; 8(1):13.According to new data, the global number of measles deaths fell by 68% from 757 000 to 242 000 between 2000 and 2006. This decrease was a result of a spectacular 91% reduction in Africa, where countries rallied behind concerted immunisation campaigns to achieve a rare success story for a continent blighted by public-health failures. In Africa, deaths were cut from 396 000 to 36 000 by implementing the measles reduction strategy, which includes vaccinating all children before their first birthday and providing a second opportunity for measles vaccination through mass vaccination campaigns. "The clear message from this achievement is that the strategy works", said Julie Gerberding, director of the US Centers for Disease Control and Prevention, which was one of the founding partners of the Measles Initiative, together with WHO, UNICEF, the American Red Cross, and the United Nations Foundation. She said the focus would now move to India, where an estimated 10.5 million children are not immunised. Some178 000 people died of measles in south Asia last year - mostly in India and Pakistan - only 26% down from 2000. (excerpt)
Indian Pediatrics. 2007 Oct 17; 44(10):792-793.Asia accounts for approximately 90% of all rabies fatalities. WHO surveys reveal that half of deaths occur in children and only one third of them receive post exposure treatment (PET) majority being males. Many of these exposures are never reported as a child may be alone with the dog/may not impart significance to few abrasions/may be scared of some painful injections following dog bite and not report it to his caretakers deliberately. Children are more vulnerable to get dog bites as they tend to play with/tease them frequently and can be easily overpowered by dogs. Incubation period also tends to be shorter due to their lesser body surface area and frequent bites on head and neck because of small physique. (excerpt)
Bulletin of the History of Medicine. 2007 Summer; 81(2):407-430.Between 1947 and 1951 the Scandinavian-led International Tuberculosis Campaign tested more than 37 million children and adolescents for tuberculosis, and vaccinated more than 16 million with BCG vaccine. The campaign was an early example of an international health program, and it was generally seen as the largest medical campaign to date. It was born, however, as a Danish effort to create goodwill in war-ravaged Europe, and was extended outside Europe only because UNICEF in 1948 unexpectedly donated US $2 million specifically for BCG vaccination in areas outside Europe. As the campaign transformed from postwar relief to an international health program it was forced to make adaptations to different demographic, social, and cultural contexts. This created a tension between a scientific ideal of uniformity, on the one hand, and pragmatic flexibility on the other. Looking at the campaign in India, which was the most important non-European country in the campaign, this article analyzes three issues in more detail: the development of a simplified vaccination technique; the employment of lay-vaccinators; and whether the campaign in India was conceived as a short-term demonstration or a more extensive mass-vaccination effort. (author's)
Lancet. 2007 Aug; 370(9585):386-387.The important study by Lisa McNally and colleagues challenges the validity of the WHO recommendations for empirical antibiotic treatment of HIV-infected children with pneumonia. It is, however, important to recognise the limited options for improving these recommendations, given the complexity of the causes of pneumonia among children for whom treatment fails. In particular, changes of antibiotic regimen alone would be unlikely to improve treatment failure in children infected with respiratory viruses (33%). Some of the pneumonias caused by both pneumococci and respiratory viruses might, however, be preventable by vaccination with pneumococcal conjugate vaccines. Additionally, the identification of Pneumocystis jirovecii as the most significant pathogen in infants with treatment failure, despite empirical treatment as recommended by WHO, confirms the limited success of treating HIV-infected children with severe P jirovecii pneumonia. The higher prevalence (15%) of Mycobacterium tuberculosis in this study than in three other studies (8% each), might be related to a greater sensitivity of methods used for sample collection and an increasing burden of tuberculosis. Nevertheless, the observation that M tuberculosis was identified in 21.8% of children with treatment failure perhaps merits most attention. Of particular noteworthiness is that all the studies focused on children with an acute illness, challenging the numerous clinical algorithms used for making a clinical diagnosis of pulmonary tuberculosis and the notion that this disorder rarely presents acutely. The management of childhood pulmonary tuberculosis deserves greater priority and is the one issue that can and should be addressed more urgently. We believe tuberculosis should be included in both diagnostic and therapeutic algorithms for acute childhood pneumonia in areas with high HIV and tuberculosis prevalence. (full text)
Lancet Infectious Diseases. 2007 Jun; 7(6):379.UNICEF has said that a campaign to vaccinate millions of Iraqi children against measles, mumps, and rubella (MMR) ended successfully, although difficulties were encountered in the most insecure areas of the country. The campaign aimed to vaccinate Iraq's 3.9 million children aged from 1 to 5 years old with the MMR vaccine. Claire Hajaj, head of communication at UNICEF Iraq, told TLID that the exercise went well, even in Anbar and Diyala governorates, which are strongholds of the Sunni insurgency. The first 5 days of the exercise saw 1 million children vaccinated and a 50% coverage was achieved at the halfway stage, according to UNICEF. There were no reports of vaccination teams being confronted with specific threats because of their participation in the campaign, Hajaj said. However, two teams were caught up in an explosion in Baghdad. There was no information to suggest the teams were deliberately targeted. A few areas were reportedly unreachable because of insecurity. (excerpt)
Lancet. 2007 Apr 14; 369(9569):1238-1239.More than 10 million children are dying every year, mainly in developing countries, from causes that could be mostly prevented by available cost-effective interventions. Governments worldwide have committed themselves to improve this reality by adopting the Millennium Declaration, in which one of the ten Millennium Development Goals (MDGs) calls for a two-thirds reduction in the number of deaths for children younger than 5 years from the 1990 baseline. From a group of 20 proven interventions that could reduce child mortality by more than 60% (if their coverage could be improved from estimates made in 2000 to 99% of those who need them), three include vaccines: Haemophilus influenzae type B vaccine, measles vaccine, and tetanus toxoid. However, these effective interventions, including vaccines, were not delivered in a way that could reach children who need them most,4 and when delivered, they usually tend to serve the rich and privileged first, leaving the poor to the end. (excerpt)
Jornal de Pediatria. 2006; 82 Suppl(3):S1-S3.In the last few decades, immunization -- one of the greatest breakthroughs in health sciences -- has increasingly gained significant ground all over the world. Advances in general sciences, microbiology, pharmacology and immunology have, together with results of epidemiology and sociology studies, demonstrated the remarkable impact of vaccines on society and the importance of vaccination in health promotion and disease prevention. In the beginning of the 17th century, smallpox was one of the most devastating communicable diseases in the world; it affected most individuals before they reached adulthood, and had high mortality rates. Lady Mary Montagu, wife of the British ambassador in Istanbul at the time, observed that the disease could be avoided by using a technique adopted by Muslims, who inoculated dried pus from smallpox pustules obtained from an infected patient into the skin of healthy individuals. This procedure, known as "variolation," probably originated in China; later, it was taken to Western Europe. Although it led to several cases of death due to smallpox, it was used in England and in the United States until the beginning of investigations by British physician Edward Jenner, whose research results were published in the study Variolae Vaccinae in 1798. Dr. Jenner studied peasants who developed a benign condition known as "vaccinia" due to their contact with cowpox, and his investigation resulted in the development of the first immunization techniques. (excerpt)
Bulletin of the World Health Organization. 1955; 12:101-122.A new assessment activity in relation to the WHO/UNICEF BCG vaccination programme is described in this report: according to a detailed plan special field teams collect data on tuberculin sensitivity to determine how efficiently children are being selected for vaccination and to appraise the allergy produced by the mass vaccinations. Results of nine months' work in India have important implications for the practical BCG work. Testing of unvaccinated groups of schoolchildren shows that the pattern of tuberculin sensitivity differs in different parts of India. Specific tuberculin sensitivity is found in all areas, as evidenced by strong reactions to the 5 TU test. Many children had a low-grade non-specific sensitivity, evidenced by small reactions to 5 TU and large reactions to 100 TU. This non-specific tuberculin sensitivity was less frequent at high altitudes, and most common in low-lying humid areas: in all areas it was more prevalent than specific sensitivity. In some areas non-specific tuberculin sensitivity is so strong that it cannot be effectively distinguished from specific sensitivity: consequently, many children not infected with tuberculosis are undoubtedly being excluded from vaccination. Sample retesting of children vaccinated in the mass campaign revealed variable levels of allergy, in many instances much lower than had been expected. These results cannot be explained by a native incapacity of the Indian children to develop strong allergy--nor presumably by the vaccine used. Impairment of the vaccine by exposure to light could be no more than a contributory factor. The marked variability of the campaign results suggests that some factor connected with the handling or application of the vaccine (or possibly of the turberculin) is involved. (excerpt)
MMWR. Morbidity and Mortality Weekly Report. 2006 May; 12(55):18.Immunization is among the most successful and cost-effective public health interventions. Immunization programs have led to eradication of smallpox, elimination of measles and poliomyelitis in regions of the world, and substantial reductions in the morbidity and mortality attributed to diphtheria, tetanus, and pertussis. The World Health Organization (WHO) estimates that 2 million child deaths were prevented by vaccinations in 2003. Nonetheless, more deaths can be prevented through optimal use of currently existing vaccines. This report summarizes estimates of deaths attributed to vaccine preventable diseases (VPDs) and vaccination coverage by WHO region and outlines the Global Immunization Vision and Strategy developed by WHO and the United Nations Children's Fund (UNICEF) and partners for implementation during 2006-2015. (excerpt)
Seminars in Pediatric Infectious Diseases. 2004 Jul; 15(3):130-136.Since Edward Jenner's discovery of the smallpox vaccine 200 years ago, vaccines have been one of the most lifesaving health interventions for humankind and, conversely, one of the most underused health interventions in developing countries. The implementation of childhood vaccines in the United States and other industrialized countries led to a rapid and large decrease in morbidity and mortality from common childhood diseases. The smallpox eradication program, led by the World Health Organization (WHO) from 1967 to 1977, ended deaths from smallpox, a disease that once killed millions of children and adults each year. Beginning in the early 1980s, the development of routine immunization programs by WHO and UNICEF for children in developing countries led to a sustained program of administration of lifesaving vaccinations as part of primary healthcare systems. Since the launch of these routine immunization programs in most countries, more than 20 million deaths have been prevented from vaccine-preventable diseases (Fig 1). Ongoing initiatives to eradicate polio, reduce measles mortality rates, eliminate measles from discrete regions of the world, and introduce additional vaccines have been remarkably successful. However, more than 1.4 million children died from vaccine-preventable diseases in 2002, 610,000 from measles alone, suggesting that great challenges still exist to fully utilize the potential of lifesaving vaccines (WHO, unpublished data). This article reviews the status of current immunization initiatives, summarizes lessons learned, and makes recommendations for a healthier world through the use of vaccines. (excerpt)
All rights for all children. UNICEF in Central and Eastern Europe and the Commonwealth of Independent States.
Geneva, Switzerland, UNICEF, Regional Office for Central and Eastern Europe and the Commonwealth of Independent States, 2005. 48 p.All children have the right to survive, to be educated, to be healthy, to have a name and nationality. All children have the right to participate in decisions that affect them. And all children have the right to be protected from harm. UNICEF, the United Nations Children's Fund, speaks out for the rights of all children in Central and Eastern Europe and the Commonwealth of Independent States. The region faces unique challenges. No other region has been through so dramatic a transformation in so short a time and the scale of the changes has had a serious impact on children. Rising poverty and unemployment and falling social spending have excluded vast numbers of children from the economic progress that has been made in recent years. Millions of families are under pressure: the systems that once guided their lives have vanished and they must find their way in a new and unfamiliar landscape, confronting new dangers such as HIV/AIDS and the trafficking of drugs and human beings. (excerpt)
UN Chronicle. 1987 Aug; 24: p..Reducing by half the rates of infant and child deaths by the year 2000 was among the targets set for the United Nations Children's Fund (UNICEF) by its 41-member Executive Board at its 1987 session. The Board, in endorsing the programme objectives of its 1986-1990 medium-term plan, asked the Fund to give continued priority in both rural and urban areas to the "Child Survival and Development Revolution"--an initiative undertaken by UNICEF in 1983--through such measures as child immunization, oral rehydration therapy and diarrhoeal management, promotion of breast-feeding, improved nutrition and health education, and birth-spacing. The Fund should "work towards the retention of the child and its needs on the political agenda'. Special attention should be given to actions directed against the "causal roots of child and infant mortality'. Basic services should be stressed and child survival and development activities should be integrated into primary health care systems. (excerpt)
Science. 2005 Jan 21; 307:345.At least one early-warning system in Indonesia is in place and working. On the morning of 8 January, World Health Organization (WHO) officials in Banda Aceh received a call from a relief worker reporting a case of measles—one of the biggest potential killers of children during humanitarian disasters. The team confirmed it within hours; by afternoon, health officials and aid workers were able to vaccinate more than 1000 people in the sick child’s village. The danger is far from over: WHO estimates that only a quarter of the children in the Aceh area have received a measles vaccination. But the quick and effective response to this case—and another a few days later—is one example of the kind of science-based approaches that relief organizations are bringing to the region devastated by the tsunami, says Ronald Waldman of Columbia University, who helped coordinate WHO’s team in Banda Aceh. (excerpt)