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MMWR. Morbidity and Mortality Weekly Report. 2018 May 4; 67(17):491-495.In 2005, the Regional Committee for the World Health Organization (WHO) Western Pacific Region (WPR)* established a goal for measles elimination(dagger) by 2012 (1). To achieve this goal, the 37 WPR countries and areas implemented the recommended strategies in the WPR Plan of Action for Measles Elimination (2) and the Field Guidelines for Measles Elimination (3). The strategies include 1) achieving and maintaining >/=95% coverage with 2 doses of measles-containing vaccine (MCV) through routine immunization services and supplementary immunization activities (SIAs), when required; 2) conducting high-quality case-based measles surveillance, including timely and accurate testing of specimens to confirm or discard suspected cases and detect measles virus for genotyping and molecular analysis; and 3) establishing and maintaining measles outbreak preparedness to ensure rapid response and appropriate case management. This report updates the previous report (4) and describes progress toward measles elimination in WPR during 2013-2017. During 2013-2016, estimated regional coverage with the first MCV dose (MCV1) decreased from 97% to 96%, and coverage with the routine second MCV dose (MCV2) increased from 91% to 93%. Eighteen (50%) countries achieved >/=95% MCV1 coverage in 2016. Seven (39%) of 18 nationwide SIAs during 2013-2017 reported achieving >/=95% administrative coverage. After a record low of 5.9 cases per million population in 2012, measles incidence increased during 2013-2016 to a high of 68.9 in 2014, because of outbreaks in the Philippines and Vietnam, as well as increased incidence in China, and then declined to 5.2 in 2017. To achieve measles elimination in WPR, additional measures are needed to strengthen immunization programs to achieve high population immunity, maintain high-quality surveillance for rapid case detection and confirmation, and ensure outbreak preparedness and prompt response to contain outbreaks.
Advocacy, communication, and partnerships: Mobilizing for effective, widespread cervical cancer prevention.
International Journal of Gynaecology and Obstetrics. 2017 Jul; 138 Suppl 1:57-62.Both human papillomavirus (HPV) vaccination and screening/treatment are relatively simple and inexpensive to implement at all resource levels, and cervical cancer screening has been acknowledged as a "best buy" by the WHO. However, coverage with these interventions is low where they are needed most. Failure to launch or expand cervical cancer prevention programs is by and large due to the absence of dedicated funding, along with a lack of recognition of the urgent need to update policies that can hinder access to services. Clear and sustained communication, robust advocacy, and strategic partnerships are needed to inspire national governments and international bodies to action, including identifying and allocating sustainable program resources. There is significant momentum for expanding coverage of HPV vaccination and screening/preventive treatment in low-resource settings as evidenced by new global partnerships espousing this goal, and the participation of groups that previously had not focused on this critical health issue. (c) 2017 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.
Progress towards measles elimination - African Region, 2013-2016. Progres realises en vue d'eliminer la rougeole - Region africaine, 2013-2016.
Releve Epidemiologique Hebdomadaire. 2017 May 05; 92(18):229-39.Add to my documents.
[Poliomyelitis--Challenges for the Last Mile of the Eradication Programme] Poliomyelitis--Herausforderungen in der Endphase des globalen Eradikationsprogramms.
Gesundheitswesen). 2016 Apr; 78(4):227-9.The World Health Organisation initiated the Global Polio Eradication Initiative in the year 1988. With the large-scale application of routine and mass vaccinations in children under the age of 5 years, polio disease has become restricted to only 3 endemic countries (Afghanistan, Pakistan and Nigeria) by today. However, since the beginning of the 21st century, increasing numbers of secondary polio epidemics have been observed which were triggered through migration, political turmoil and weak health systems. In addition, there emerged serious technical (e. g., back-mutations of oral vaccine virus to wild virus) and socio-political (refusal of vaccinations in Muslim populations of Nigeria and Pakistan) problems with the vaccination in the remaining endemic countries. It thus appears questionable if the current eradiation initiative will reach its goal in the foreseeable future. (c) Georg Thieme Verlag KG Stuttgart . New York.
Geneva, Switzerland, WHO, 2016. 64 p.This report is a companion to the World Health Organization’s 2016 guide for “Introducing HPV Vaccine Into National Immunization Programmes.” It summarizes experiences introducing HPV vaccine and provides guidance for introduction.
Geneva, Switzerland, WHO, EPI, 2016. 104 p.This document is intended for use by national immunization programme managers and immunization partners to inform the policy discussions and operational aspects for the introduction of HPV vaccine into national immunization programmes and to provide up-to-date references on the global policy, as well as the technical and strategic issues related to the introduction of HPV vaccine.
2016 Nov; New York, New York, UNICEF, 2016 Nov. 77 p.Pneumonia and diarrhoea are responsible for the unnecessary loss of 1.4 million children each year. This report highlights current pneumonia and diarrhoea related mortality, and illustrates the startling divide between the children being reached and the considerable number of those left behind. By developing key protective, preventative and treatment interventions, collectively we are now equipped with the knowledge and the tools required to preventing child deaths due to these leading childhood killers. The report also provides recommendations to further accelerate progress in effective interventions and bridge the greatest gaps in equity.
Multistakeholder partnerships with the Democratic People's Republic of Korea to improve childhood immunisation: a perspective from global health equity and political determinants of health equity.
Tropical Medicine and International Health. 2016 Aug; 21(8):965-972.Objective To examine the current partnerships to improve the childhood immunization programme in the Democratic Peoples’ Republic of Korea (DPRK) in the context of the political determinants of health equity. Methods A literature search was conducted to identify public health collaborations with the DPRK government. Based on the amount of publicly accessible data and a shared approach in health system strengthening among the partners in immunization programmes, the search focused on these partnerships. results The efforts by WHO, UNICEF, GAVI and IVI with the DPRK government improved the delivery of childhood vaccines (e.g. pentavalent vaccines, inactivated polio vaccine, two-dose measles vaccine and Japanese encephalitis vaccine) and strengthened the DPRK health system by equipping health centers, and training all levels of public health personnel for VPD surveillance and immunization service delivery. Conclusion The VPD-focused programmatic activities in the DPRK have improved the delivery of childhood immunization and have created dialogue and contact with the people of the DPRK. These efforts are likely to ameliorate the political isolation of the people of the DPRK and potentially improve global health equity.
[Geneva, Switzerland], WHO, 2015 Dec 17.  p.The Global Advisory Committee on Vaccine Safety (GACVS) of the World Health Organization recently reviewed updated data on HPV vaccine. The WHO recommends that HPV vaccines be introduced into national immunization programs provided that: prevention of cervical cancer and/or other HPV-related diseases constitutes a public health priority; vaccine introduction is programmatically feasible; sustainable financing can be secured; and the cost-effectiveness of vaccination strategies in the country or region is considered. Following a systematic investigation of safety concerns raised about HPV vaccines, to date, the GACVS has not found any safety issues that would alter recommendations for the use of the vaccine.
Lancet. 2016 Mar 19; 387:1147.WHO convened a multidisciplinary consultation last week to identify the tools and interventions needed to outsmart the Zika epidemic. Towards the end of the meeting, delegates representing the major regulatory agencies in the USA, Europe, and Brazil, committed to putting Zika-related products on a regulatory fast-track. They also agreed that instead of waiting, as they usually do, for manufacturers to approach them, they would take the initiative and approach companies working on promising products. Their gesture, in a sense, encapsulates the success of the meeting in bringing together so many minds from so many disciplines to focus, for 3 intensive days, on a single issue of vital importance. (Excerpts)
World Journal of Gastroenterology. 2014 Jul 21; 20(27):8998-9016.Hepatitis B (HB) virus (HBV) infection, which causes liver cirrhosis and hepatocellular carcinoma, is endemic worldwide. Hepatitis B vaccines became commercially available in the 1980s. The World Health Organization recommended the integration of the HB vaccine into the national immunisation programs in all countries. HBV prevention strategies are classified into three groups: (1) universal vaccination alone; (2) universal vaccination with screening of pregnant women plus HB immune globulin (HBIG) at birth; and (3) selective vaccination with screening of pregnant women plus HBIG at birth. Most low-income countries have adopted universal vaccine programs without screening of pregnant women. However, HB vaccines are not widely used in low-income countries. The Global Alliance for Vaccine and Immunization was launched in 2000, and by 2012, the global coverage of a three-dose HB vaccine had increased to 79%. The next challenges are to further increase the coverage rate, close the gap between recommendations and routine practices, approach high-risk individuals, screen and treat chronically infected individuals, and prevent breakthrough infections. To eradicate HBV infections, strenuous efforts are required to overcome socioeconomic barriers to the HB vaccine; this task is expected to take several decades to complete.
Releve Epidemiologique Hebdomadaire / Section D'hygiene Du Secretariat De La Societe Des Nations. 2014 Oct 31; 89(44):493-9.Add to my documents.
Releve Epidemiologique Hebdomadaire / Section D'hygiene Du Secretariat De La Societe Des Nations. 2014 Oct 31; 89(44):500-4.Add to my documents.
Morbidity and Mortality Weekly Report. 2014 Jul 25; 63(29):634-637.Since 2008, the World Health Organization (WHO) has coordinated the Global Rotavirus Surveillance Network, a network of sentinel surveillance hospitals and laboratories that report to ministries of health (MoHs) and WHO clinical features and rotavirus testing data for children aged <5 years hospitalized with acute gastroenteritis. In 2013, WHO conducted a strategic review to assess surveillance network performance, provide recommendations for strengthening the network, and assess the network’s utility as a platform for other vaccine-preventable disease surveillance. The strategic review team determined that during 2011 and 2012, a total of 79 sites in 37 countries met reporting and testing inclusion criteria for data analysis. Of the 37 countries with sites meeting inclusion criteria, 13 (35%) had introduced rotavirus vaccine nationwide. All 79 sites included in the analysis were meeting 2008 network objectives of documenting presence of disease and describing disease epidemiology, and all countries were using the rotavirus surveillance data for vaccine introduction decisions, disease burden estimates, and advocacy; countries were in the process of assessing the use of this surveillance platform for other vaccine-preventable diseases. However, the review also indicated that the network would benefit from enhanced management, standardized data formats, linkage of clinical data with laboratory data, and additional resources to support network functions. In November 2013, WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) endorsed the findings and recommendations made by the review team and noted potential opportunities for using the network as a platform for other vaccine-preventable disease surveillance. WHO will work to implement the recommendations to improve the network’s functions and to provide higher quality surveillance data for use in decisions related to vaccine introduction and vaccination program sustainability.
Principles and considerations for adding a vaccine to a national immunization programme: From decision to implementation and monitoring.
Geneva, Switzerland, WHO, EPI, 2014.  p.This essential resource document reviews the principles and issues to be considered when making decisions about, planning, and implementing the introduction of a vaccine into a national immunization programme. Importantly, the document highlights ways to use the opportunity provided by the vaccine introduction to strengthen immunization and health systems. The comprehensive guidance also describes the latest references and tools related to vaccine decision-making, economic analyses, cold chain, integrated disease control and health promotion, vaccine safety, communications, monitoring, and more, and provides key URL links to many of these resources.
Releve Epidemiologique Hebdomadaire. 2013 Apr 26; 88(17):173-80.Add to my documents.
Vaccine. 2013 Apr 18; 31(Suppl 2):B81-B96.Middle-income countries (MICs) as a group are not only characterized by a wide range of gross national income (GNI) per capita (US $1026 to $12,475), but also by diversity in size, geography, governance, and infrastructure. They include the largest and smallest countries of the world-including 16 landlocked developing countries, 27 small island developing states, and 17 least developed countries-and have a significant diversity in burden of vaccine-preventable diseases. Given the growth in the number of MICs and their considerable domestic income disparities, they are now home to the greatest proportion of the world’s poor, having more inhabitants below the poverty line than low-income countries (LICs). However, they have little or no access to external funding for the implementation of new vaccines, nor are they benefiting from an enabling global environment. The MICs are thus not sustainably introducing new life-saving vaccines at the same rate as donor-funded LICs or wealthier countries. The global community, through World Health Assembly resolutions and the inclusion of MIC issues in several recent studies and important documents-including the Global Vaccine Action Plan (GVAP) for the Decade of Vaccines-has acknowledged the sub-optimal situations in some MICs and is actively seeking to enhance the situation by expanding support to these countries. This report documents some of the activities already going on in a subset of MICs, including strengthening of national regulatory authorities and national immunization technical advisory groups, and development of comprehensive multi-year plans. However, some additional tools developed for LICs could prove useful to MICs and thus should be adapted for use by them. In addition, new approaches need to be developed to support MIC-specific needs. It is clear that no one solution will address the needs of this diverse group. We suggest tailored interventions in the four categories of evidence and capacity-building, policy and advocacy, financing, and procurement and supply chain. For MICs to have comparable rates of introduction as other wealthier countries and to contribute to the global fight against vaccine-preventable diseases, global partners must implement a coordinated and pragmatic intervention strategy in accord with their competitive advantage. This will require political will, joint planning, and additional modest funding.
[Geneva, Switzerland], WHO, 2013 Mar 22.  p. (A66/19)The Executive Board at its 132nd session in January 2013, considered and noted an earlier version of this report. The present document has been amended in response to Board members’ comments and updated to include details of recent developments. It also reports on the status of progress made towards achieving the goals of the Decade of Vaccines. Four sets of activities are essential to put the plan into practice and to turn the actions into results: (1) development of guidance for putting the plan into practice; (2) completion and implementation of a mechanism for evaluation and accountability in alignment with the accountability framework for the United Nations Secretary-General’s Strategy for Women’s and Children’s Health; (3) securing commitments from stakeholders; and (4) publicizing the opportunities, while acknowledging the challenges, offered by the Decade of Vaccines. This report summarizes the progress made in these areas. (Excerpt)
[Geneva, Switzerland], WHO, 2013 Mar 28.  p. (A66/18)The Executive Board at its 132nd session noted a previous version of this report. The Board provided additional guidance on addressing the short- and long-term risks to attaining the milestones of the new polio eradication and endgame strategic plan 2013-2018, particularly in the areas of: vaccination of travellers; fast-tracking access to affordable inactivated poliovirus vaccination options for all countries; strengthening routine immunization; and legacy planning, including that for the human resource infrastructure currently funded by the Global Polio Eradication Initiative. This guidance has been incorporated into the final plan, which is due to be shared with Member States in April 2013, in advance of the planned roll-out of the new plan at a Global Vaccine Summit scheduled to be held in Abu Dhabi (24 and 25 April 2013). In addition, data have been updated in this version of the report. In May 2014, the Secretariat will report to the Sixty-seventh World Health Assembly on progress in implementing and financing the strategic plan; outcomes of the consultative process on the legacy planning; and action required by the Health Assembly in advance of initiating the phased removal of the type 2 component of the oral poliovirus vaccine from all routine use globally. (Excerpt)
Promoting access to medical technologies and innovation. Intersections between public health, intellectual property and trade.
Geneva, Switzerland, World Health Organization [WHO], 2012.  p.Medical technologies -- medicines, vaccines and medical devices -- are essential for public health. Access to essential medicines and the lack of research to address neglected diseases have been a major concern for many years. More recently, the focus of health policy debate has broadened to consider how to promote innovation and how to ensure equitable access to all vital medical technologies. Today’s health policy-makers need a clear understanding both of the innovation processes that lead to new technologies and of the ways in which these technologies are disseminated in health systems. This study captures a broad range of experience and data in dealing with the interplay between intellectual property, trade rules and the dynamics of access to, and innovation in, medical technologies. The study is intended to inform ongoing technical cooperation activities undertaken by the three organizations (World Trade Organization, World Intellectual Property Organization and World Health Organization) and to support policy discussions. Based on many years of field experience in technical cooperation, the study has been prepared to serve the needs of policymakers who seek a comprehensive presentation of the full range of issues, as well as lawmakers, government officials, delegates to international organizations, non-governmental organizations and researchers.
Lancet. 2012 Jun 23; 379(9834):2328.Thiomersal, a mercury-based chemical, has been used in low doses as a preservative in multi-dose vaccines since the 1930s. But since the publicâ€™s growing concern about a possible link between thiomersal and autism, and the Center for Disease Controlâ€™s 1999 recommendation to manufacturers to remove thiomersal-containing vaccines, American companies have been removing the chemical from their vaccines and have been making single-dose vial for years. So far, these changes in vaccine production have only been reported in the US, but there is growing concern that if a global ban of thiomersal is recommended by the UN Environment Program (UNEP), it will have a deeply negative effect on the developing world. Multi-dose vials used in the developing world can hold up to ten doses of vaccines, increasing their ease of storage and transport in developing countries, and thiomersal-containing vaccines are an essential medicine. This article summarizes some concerns of a possible ban and its implications for global health.
Global health and the new bottom billion. What do shifts in global poverty and the Global Disease Burden mean for GAVI and the Global Fund?
Washington, D.C., Center for Global Development, 2011 Oct.  p. (Center for Global Development Working Paper No. 270)After a decade of rapid growth in average incomes, many countries have attained middle-income country (MIC) status. At the same time, the total number of poor people hasn’t fallen as much as one might expect and, as a result, most of the world’s poor now live in MICs. In fact, there are up to a billion poor people or a ‘new bottom billion’ living not in the world’s poorest countries but in MICs. Not only has the global distribution of poverty shifted to MICs, so has the global disease burden. This paper examines the implications of this ‘new bottom billion’ for global health efforts and recommends a tailored middle-income strategy for the Global Fund and GAVI. The paper describes trends in the global distribution of poverty, preventable infectious diseases, and health aid response to date; revisits the rationale for health aid through agencies like GAVI and the Global Fund; and proposes a new MIC strategy and components, concluding with recommendations.
MMWR. Morbidity and Mortality Weekly Report. 2011 Dec 2; 60:1611-4.Rotavirus disease is the leading cause of childhood morbidity and mortality related to diarrhea in Latin America and the Caribbean (LAC), where an estimated 8,000 deaths related to rotavirus diarrhea occur annually among children aged <5 years. After two safe and effective rotavirus vaccines became available, the World Health Organization (WHO) in 2007 recommended inclusion of rotavirus vaccine in the immunization programs of Europe and the Americas, and in 2009 expanded the recommendation to all infants aged <32 weeks worldwide. This report describes progress in the introduction of rotavirus vaccine in LAC, where it was first introduced in 2006 in Brazil, El Salvador, Mexico, Nicaragua, Panama, and Venezuela; by January 2011, it was included in the national immunization schedules of 14 countries in LAC. Estimated national rotavirus vaccine coverage (2 doses of the monovalent vaccine or 3 doses of the pentavalent vaccine) among children aged <1 year in 2010 ranged from 49% to 98% (median: 89%) in the 11 LAC countries with vaccine introduction before 2010. Of the 14 countries that had introduced rotavirus vaccine into their national immunization programs, 13 participate in a hospital-based rotavirus surveillance network. Data from some countries in this network and from other monitoring efforts in LAC countries have shown declines in hospitalizations and deaths related to severe diarrhea after rotavirus vaccine introduction. The rapid introduction of rotavirus vaccine in LAC demonstrates the benefits of the early commitment of national decision makers to introduce these vaccines in low-income and middle-income countries at the same time as in high-income countries.
Expert Review of Vaccines. 2011 Sep; 10(9):1271-80.The major public health consequences of malaria in pregnancy have long been acknowledged. However, further information is still required for development and implementation of a malaria vaccine specifically directed to prevent malaria in pregnant women and improve maternal, fetal and infant outcomes. The WHO Malaria Vaccine Advisory Committee (MALVAC) provides guidance to the WHO on strategic priorities and research needs for development of vaccines to prevent malaria. Here we summarize the discussions and conclusions of a MALVAC scientific forum meeting on considerations in the development of vaccines to prevent malaria in pregnant women. This report includes brief summaries of what is known, and major knowledge gaps in disease burden estimation, pathogenesis and immunity, and the challenges with current preventive strategies for malaria in pregnancy. We conclude with the formulation of a conceptual framework for research and development for vaccines to prevent malaria in pregnant women.
Bulletin of the World Health Organization. 2010 Mar; 88(3):232-4.Add to my documents.