News Pouch: 27 June 2019
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Pandemic Threats and Health Emergencies
News Pouch: 27 June 2019
- Spotlight: Ebola outbreak situation
Updates and News on main Outbreaks
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WHO External Situation Report 47: 25 June 2019
Indicators over the past few weeks demonstrated early signs of transmission easing in intensity in some major hotspots such as Butembo and Katwa. However, concerns remain over the concurrent increase in the number of new cases occurring in areas that previously had lower rates of transmission, such as the Komanda, Lubero, and Rwampara health zones.
As of 23 June 2019, a total of 2247 EVD cases, including 2153 confirmed and 94 probable cases, were reported. A total of 1510 deaths were reported (overall case fatality ratio 67%), including 1416 deaths among confirmed cases. Of the 2247 confirmed and probable cases with known age and sex, 57% (1273) were female, and 29% (654) were children aged less than 18 years. Cases continue to rise among health workers, with the cumulative number infected increasing to 126 (6% of total cases).
click here to download the complete situation report (PDF).
Opinion: 'Ebola Is Fake': How Do You Fight a Disease People Don’t Believe In?
How do you convince people to follow stringent rules to reduce contamination and report suspected cases when some do not believe in the disease in the first place?
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Ebola hot spots shift as pattern of spread fluctuates
In the past 10 days, officials have recorded nearly 100 new cases, and the outbreak has reached 2,265 infections.
As Ebola outbreak rages, plan to test second vaccine sparks debate
DRC Ebola deaths top 1,500; more cases in Ituri province capital
The politics of PHEIC
The Ebola response in Congo is running short of money
And there are fears that a national crisis could turn into a regional catastrophe
Will 1 Of These 4 Experimental Treatments Cure Ebola?
Fauci notes that to have statistically significant results investigators need to administer the treatments to at least 500 people — evenly divided between the four options. So far about 340 people have been treated through the trial. (In addition, about 600 people have been given the treatments as part of a "compassionate use" provision but are not being studied through the trial.) "So I would imagine before this outbreak is under control it is likely we would have enough individuals in the clinical trial to be able to get an answer as to which [of the medications] actually work," says Fauci.
Machine-learning Prognostic Models from the 2014–16 Ebola Outbreak: Data-harmonization Challenges, Validation Strategies, and mHealth Applications
Five years after Ebola outbreak, still more grounds to cover
Meet the Ebola workers battling a virus in a war zone
Nature's Amy Maxmen reports from the front line of the crisis in the Democratic Republic of the Congo.
He survived Ebola. Now he fights it.
Physician Maurice Kakule Kutsunga caught Ebola and lived. Of the more than 2,200 people infected in the ongoing outbreak in the Democratic Republic of the Congo, Kutsunga is one of just 620 or so to survive. Now he works, alongside other survivors, to dispel misinformation that health facilities are “just another thing brought from the outside to kill” in a region scarred by years of conflict. The survivors also care for the sick, especially the youngest patients, who must be separated from their loved ones at a painful and terrifying time. “Now, most of the patients, especially the children, have a survivor caregiver,” says physician Marta Lado.
Nature | 5 min read
Ebola Virus Disease - CERF and Country-Based Pooled Fund support in 2018-2019 (As of 19 June 2019)
Country-Based Pooled Funds are funded by voluntary contributions from Governments and private donors. Between January 2018 and June 2019, donors contributed $105.8 million to the DRC Humanitarian Fund. Total allocations to Ebola response and readiness is $27.3 million only.
Kenya responded fast to Ebola scare, but cross-border risk remains high
US Officials Have Former NBA Star Dikembe Mutombo Record Ebola Messages
U.S. officials are working with basketball Hall of Famer Dikembe Mutombo to help fight the recent Ebola outbreak in the Democratic Republic of the Congo (DRC).
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Emerging Infectious Diseases (EID) Journal current issue
Pandemic influenza preparedness in WHO Member States-REPORT OF A MEMBER STATES SURVEY
In late 2018, the WHO Global Influenza Programme consulted its Member States through a survey to better understand the current level of pandemic preparedness among Member States and to identify the capacity areas in which WHO and its partners should focus their technical assistance in the coming years. This report summarizes the findings of this Member States survey.
Study indicates better immune response with change to inhaled flu vaccine
Researchers find an increase in vaccine virus shedding and seroconversion.
The H5N8 HPAI Global Situation Update from FAO/EMPRES – Animal Health
- Namibia reported H5N8 HPAI in jackass penguins;
- South Africa reported H5N8 HPAI in domestic ostriches;
- Updated maps on H5N8 and H5Nx HPAI events worldwide;
- 4 relevant publications;
ASF Asia Update for 20 June from FAO/EMPRES - Animal Health.
* Lao People's Democratic Republic reported ASF outbreak for the first time.
* In Viet Nam, ASF was reported in two more provinces for the first time.
* Viet Nam to support households, small and medium-sized enterprises keeping grandparent pigs / whose pigs are destroyed.
Becoming malaria free by 2020- China is hosting the third E-2020 global forum of malaria-eliminating countries from 18-20 June, with a focus on eliminating malaria among populations at risk.
Mosquito Control Awareness Week 2019
Mosquito-borne diseases are a One Health challenge, and epidemics from viruses spread by mosquitoes are happening more often. Mosquito-borne diseases can affect people, animals, and the environment, and one mosquito-borne disease – West Nile virus – is a priority zoonotic disease for the United States requiring a multisectoral, One Health approach to effectively address.
CDC has mosquito control resources:
- Mosquito Digital Press Kit for Media
- Mosquito Control Information
- West Nile Virus in the United States: Guidelines for Surveillance, Prevention, and Control
- CDC Feature: Prevent Mosquito Bites
Trying to Eradicate Malaria Around the World
The female Anopheles mosquito is the vector of malaria parasites (there are now more than 100 species). When diagnosed early, malaria is considered treatable for most patients, depending on the particular parasite.
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Saudi Arabia reports new MERS case in Ar Rass
Over the weekend health officials in Saudi Arabia reported another MERS-CoV case in Ar Rass, a city in Al Qassim province in the central part of the country. The patient is a 42-year-old man with recent camel contact. The Ministry of Health (MOH) classified the patient's illness as primary, meaning he likely didn't contract MERS-CoV (Middle East respiratory syndrome coronavirus) from another patient. Saudi Arabia has now reported 153 cases for the year.
Jun 22 Saudi MOH epidemiologic week 25 report
HIV outbreak in Pakistan draws attention to major failures in healthcare system
In April, hundreds of children in Pakistan were infected with HIV through the use of unsterile syringes and intravenous drips. Pakistani authorities initially said that the outbreak was traceable to the practice of a single doctor, who was arrested and taken into custody, but public health experts believe his practice to be only a part of the cause. The outbreak has shone a spotlight on what are thought to be widespread unsafe medical practices in the country. The Global Fund is the only provider of ARVs in Pakistan, and the surge in new infections has urgently increased the need for pediatric antiretrovirals.
Health Officials: West Virginia HIV Cluster Continues To Grow
West Virginia health officials say the number of HIV cases in Cabell County has risen to 53. The Herald-Dispatch reports the total increased by four cases in the past four weeks and nine cases in the past nine weeks.
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Global Fund's new Data Explorer aims to tell a story through data
The Global Fund has replaced the 'Grant Portfolio' section of its website with the Data Explorer, an interactive platform for examining Global Fund financing and for viewing the results of those investments. The new portal offers opportunities to refine and visualize data that were not previously available. Its developers say it should eventually expand to include more information on donor investments in the Global Fund and the ultimate impact of the Global Fund grants.
Chronicling the Turning Tide in the Global HIV/AIDS Response.
Thirty-eight years ago, this month, the US CDC published the first reported cases of what would later become known as AIDS. In the years that followed, millions of AIDS-related deaths devastated communities both in the United States and around the world as the disease reached epidemic proportions.
(State Department; 06/20/2019)
UNAIDS executive shortlist
• Salim Abdool Karim, director of the Centre for the AIDS Program of Research in South Africa or CAPRISA.
• Sani Aliyu, director general of the Nigerian National Agency for the Control of AIDS or NACA.
• Chris Beyrer, professor at Johns Hopkins Bloomberg School of Public Health.
• Winnie Byanyima, executive director of Oxfam International.
• Bernard Haufiku, former minister of health and social services of Namibia.
CDC notes 33 more US measles cases, raising total to 1,077
In its latest measles update today, the Centers for Disease Control and Prevention recorded 33 more measles cases in the previous week, raising 2019's total to 1,077 cases—the most cases in the United States since 1992 and since measles was declared eliminated in 2000.
Officials have confirmed 275 measles cases in nearby Rockland County, New York, as of Jun 19. That outbreak also began last September, and like other major outbreaks across the country, has been connected to an unvaccinated foreign traveler.
Jun 24 CDC update
Jun 17 NYC Health update
Jun 19 Rockland County update
Cholera vaccination drive begins in high-risk districts in Somalia
Facility-Associated Release of Polioviruses into Communities—Risks for the Posteradication Era
Angola, Ethiopia, Pakistan report new polio cases
Two countries in Africa and Pakistan have recorded new polio cases in the past week, according to an update today from the Global Polio Eradication Initiative (GPEI).
Jun 20 GPEI update
Prioritizing Zoonotic Diseases for Multisectoral, One Health Collaboration in the United States
The U.S. Centers for Disease Control and Prevention (CDC), the U.S. Department of Agriculture, and the U.S. Department of the Interior organized a One Health Zoonotic Disease Prioritization workshop to further joint efforts to address zoonotic disease challenges in the United States.
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An Online Decision Tree for Vaccine Efficacy Trial Design During Infectious Disease Epidemics: The Intervax-Tool
Licensed vaccines are urgently needed for emerging infectious diseases, but the nature of these epidemics causes challenges for the design of phase III trials to evaluate vaccine efficacy.
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WHO's Snakebite Envenoming Strategy for prevention and control
Biodiversity and Ecosystem
Fostering human health through ocean sustainability in the 21st century
Feeding cows seaweed could reduce their methane emissions
A diet that contains small amounts of seaweed will reduce methane emissions from belching cows—by 80%.
Prepare river ecosystems for an uncertain future
Ongoing human development and climate change mean that river managers can’t look to the old tools that aim to restore ecosystems to their original state, argue nine biologists in Nature. They describe how waterways can be managed adaptively to maintain water supplies and avoid devastating population crashes in riparian environments.
Nature | 8 min read
How mangroves protect people from tropical storms
PNAS Paper: https://www.pnas.org/content/116/25/12232
Food Safety and Security
Emerging human infectious diseases and the links to global food production
Synthesis of the literature suggests that, since 1940, agricultural drivers were associated with >25% of all — and >50% of zoonotic — infectious diseases that emerged in humans, proportions that will likely increase as agriculture expands and intensifies.
Sensitivity of grain yields to historical climate variability in India
"'Fate Of Food' Asks: What's For Dinner In A Hotter, Drier, More Crowded World?":
NPR's Terry Gross interviews environmental journalist Amanda Little to discuss her new book The Fate of Food and explore the trends and challenges of the sustainable food revolution.
A planetary health diet: kind to your body, animals and the planet
It has long been clear that certain foods and dietary choices are not good for human health, but there is now increasing evidence that they can also be bad for the health of the planet.
Not enough is being done to achieve the goal of ending global hunger and malnutrition by 2030, Graça Machel, Nelson Mandela's widow, has warned.
[Thin Lei Win, Reuters]
China agriculture minister to head UN agency
Qu Dongyu — a biologist, farmer’s son and China’s vice-minister of agriculture and rural affairs — will be the next head of the Food and Agriculture Organization of the United Nations. Qu has said that his priorities will include improving agriculture in tropical countries — where poverty and hunger are rampant — and helping arid countries to address the agricultural challenges that come with drought and water shortages.
Nature | 2 min read
New Multi-Partner Trust Fund launched to combat Antimicrobial Resistance globally
FAO, OIE and WHO intensify One Health approach
Use of the WHO Access, Watch, and Reserve classification to define patterns of hospital antibiotic use (AWaRe): an analysis of paediatric survey data from 56 countries
Racial/Ethnic Disparities in Antimicrobial Drug Use, United States, 2014–2015
Poll: US public aware of antibiotic resistance but sketchy on details
Nearly half of respondent (45%) haven't taken antibiotics as prescribed.
Patients with Feared Superbug Shed Large Amounts of It from Their Skin, Study Says New research on a frightening new superbug confirms what scientists have both suspected and feared: Some hospitalized patients who carry the fungus shed large amounts of it from their skin, contaminating the environment in which they are being treated and leaving enough of it to infect others later on.
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Nanopore Metagenomics Enables Rapid Clinical Diagnosis of Bacterial Lower Respiratory Infection
The gold standard for clinical diagnosis of bacterial lower respiratory infections is culture, which has poor sensitivity and is too slow to guide early, targeted antimicrobial therapy. Metagenomic sequencing could identify LRI pathogens much faster than culture, but methods are needed to remove the large amount of human DNA present in these samples for this approach to be feasible.
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Combination of Drugs May Combat Deadly Drug-Resistant Fungus
As health officials in New Jersey, Illinois and New York State scramble to contain the spread of a highly infectious and deadly fungus, microbiologists at Beth Israel Deaconess Medical Center have shown that a combination of anti-fungal and anti-bacterial medications may be an effective weapon against the recently discovered multidrug resistant, Candida auris.
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Poll: Most Americans See Antibiotic Resistance as a Public Health Problem, but Nearly Half Have Not Taken Antibiotics as Prescribed
While most Americans believe that antibiotic resistance poses a public health problem, new KFF polling finds nearly half (45%) say they personally have not taken antibiotics as prescribed – one factor contributing to the rise of “superbugs” that are resistant to existing treatment.
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- Ambulatory care stewardship
- Point-of-care testing
- Highly resistant gonorrhea in Taiwan
- New pneumonia antibiotic
- UK AMR funding
- Core stewardship and antibiotic use
- Antibiotic overuse in dengue
WHO AFRO - Outbreaks and Emergencies Bulletin – Week 25: 17 - 23 June 2019
The WHO Health Emergencies Programme is currently monitoring 77 events in the region. This week’s edition covers key new and ongoing events, including:
- Cholera in Nigeria
- Ebola virus disease in Democratic Republic of the Congo
- Humanitarian crisis in Ethiopia
- Humanitarian crisis in South Sudan.
Europe to experience 'intense heat' in multi-day heat wave
Spain will feel the first wave of "intense" heat over the weekend, before the high temperatures spread into France, Germany, Belgium, the Czech Republic, Switzerland and Italy. The heat wave could last until the start of July, Accuweather predicted.
WMO verifies 3rd and 4th hottest temperature recorded on Earth
The World Meteorological Organization (WMO) has officially evaluated temperature record extremes of 54.0 °C at two locations, one in Mitribah, Kuwait, on 21 July 2016 and a second in Turbat, Pakistan, on 28 May 2017.
Australia: Temperature rises will make Brisbane a 'difficult place to live' within 30 years, report finds
100 days after Cyclone Idai: Six reasons why Mozambique is still in crisis
The impact of Mozambique's cyclones on its HIV population
In the months after the cyclone, there’s been about a 25% increase in the number of advanced-stage HIV cases at the Munhava health center in Beira, according to Quezia Monteiro, an MSF medical activity manager, who runs an advanced HIV program at the center. In the aftermath of the storm, all MSF health workers were thrown into the emergency response, including responding to a cholera outbreak. Because of this, for about two weeks MSF’s HIV programming was halted. There is also concern that when the storms hit communities, HIV and opportunistic infection medication was lost as homes were destroyed and people were displaced.
Biometrics disagreement leads to food aid suspension in Yemen
An impasse over use of biometric data led the World Food Programme to partially suspend its delivery of food aid in warn-torn Yemen last week, raising questions about the use of such technology in humanitarian contexts.
The U.S. wants "sexual and reproductive health" struck from text on emergency humanitarian response and to include instead "options to avoid abortion."
[Ben Parker, The New Humanitarian]
Bio-Hazard Disaster Risk Governance through Multi-Agency Cooperation
Timing of vaccinations are key to controlling disease outbreaks
Researchers at the University of Waterloo have found that the most effective way to prevent disease outbreaks is for the majority of the population in a particular region to be vaccinated at the same time. Their study, which builds on an existing mathematical model of epidemics, affirms that the timing of vaccination is critical in controlling outbreaks.
How hurricanes cause disease outbreaks
Hospitals Aren’t Ready for a Mass Casualty Wildfire
Of all the wildfires that ravaged California in 2018, the Camp Fire was the deadliest. It tore through the mountain town of Paradise and killed at least 85 people, destroying the local Feather River Hospital along the way—so just as emergency services were trying to evacuate and tend to the injured, they also had to transport admitted patients.
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Data Highlight State-by-State Benefits of Federal Natural Disaster Mitigation Grants - Returns on investment vary across jurisdictions and hazard type
Pew determined that among the contiguous 48 states, the savings from mitigation investments ranged from $6.81 to $1 spent in Kansas to $3.26 to $1 in California.
Global pact to stop air pollution
"Five National Academies Call for Global Compact on Air Pollution and Health":
On June 19, the science academies of Brazil, Germany, South Africa, and the USA and the US National Academy of Medicine called on the UN to take global action on air pollution.
Think globally, act locally on air pollution
Soot from cooking stoves in Asia, agricultural emissions in Europe, desert dust in the Middle East: the leading causes of deadly air pollution can vary widely, with wildly different impacts on health. To protect millions more lives, scientists need to help governments determine the most hazardous constituents of air pollution in their countries and mitigate those first, argue environmental engineer Xiangdong Li and colleagues.
Nature | 7min read
Climate change threatens not only basic human rights to food, water, and shelter but also democracy and rule of law, according to U.N. special rapporteur.
[Damian Carrington, The Guardian]
Medical Groups Warn Climate Change Is a ‘Health Emergency’
As Democratic presidential hopefuls prepare for their first 2020 primary debate this week, 74 medical and public health groups aligned on Monday to push for a series of consensus commitments to combat climate change, bluntly defined by the organizations as “a health emergency.”
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World faces ‘climate apartheid’ risk, 120 more million in poverty: UN expert
Even in the best-case scenario of a 1.5°C temperature increase by 2100, extreme temperatures in many regions will leave disadvantaged populations food insecure, with less incomes and worsening health. Moreover, many will have to choose between starvation and migration, he said. “Perversely, while people in poverty are responsible for just a fraction of global emissions, they will bear the brunt of climate change, and have the least capacity to protect themselves,” Mr. Alston flagged. “We risk a ‘climate apartheid’ scenario where the wealthy pay to escape overheating, hunger and conflict while the rest of the world is left to suffer.”
Climate change wipes out hydro power
Extreme weather caused by climate change is undermining the reliability of hydroelectric dams. Drought left millions of people in hydro-dependent Zambia in the dark last month. Meanwhile, wildly fluctuating rainfall in California means that water managers must walk a tightrope between keeping reservoirs from overflowing and maintaining levels in preparation for the next drought.
Bloomberg | 4 min read
The impact of human health co-benefits on evaluations of global climate policy
aerosol impacts have not been fully incorporated into cost-benefit modeling that estimates how much the world should optimally mitigate. Here we find that when both co-benefits and co-harms are taken fully into account, optimal climate policy results in immediate net benefits globally, overturning previous findings from cost-benefit models that omit these effects. The global health benefits from climate policy could reach trillions of dollars annually, but will importantly depend on the air quality policies that nations adopt independently of climate change. Depending on how society values better health, economically optimal levels of mitigation may be consistent with a target of 2 °C or lower.
Long-term impact of current trends in the economic, social and environmental areas on the realization of the Sustainable Development Goals
EU climate deal falls at summit, four countries wield the axe
The European Council failed to agree on Thursday (20 June) on a landmark climate strategy for 2050 that would have seen member states slash greenhouse gas emissions significantly by 2050, as the Czech Republic, Estonia, Hungary and Poland baulked at the mention of a specific date, despite the efforts of France and Germany to convince them.
"A 500-million-year survey of Earth's climate reveals dire warning for humanity":
The new fossil exhibit at the Smithsonian Institution's National Museum of Natural History in Washington D.C. displays how the Earth's climate has shifted over the years and explores how today's humans are transforming the climate.
Missed synergies in climate plans
Small developing countries have reason to tackle many challenges at once with their limited resources. Do they?
Get the findings
Struggle for water intensifies as taps run dry in India
Air pollution and irrigation mask extremes of India's 2019 heatwave
Investors with $34 trillion demand urgent climate change action
In too deep: Analysis for institutional investors of critical water security issues facing the metals and mining sector
"Complex Systems, Climate Change, Urban Health and the Human Scale: An Evolutionary Complex Systems Perspective on Urban Health":
Gatzweiler et al. argue that the health challenges observed in cities, as well as the unsustainability of cities, result from the asymmetry of social, technological and ecological complexity.
"Americans Want Their City to Prepare for Summer’s Severe Weather":
The American Climate Perspectives Survey 2019 reports that 76% of Americans want their cities and towns to take action in preparing for the impacts of climate change.
Are cities planting the right trees—not just for the present, but for the future?
Trees planted in cities today are meant to be around decades from now, when the climate may be very different. But urban foresters’ go-to species may not be suited to the climate of the future.
Engineered wood could cool down buildings without using energy
A novel modified wood that reflects sundays and radiates heat into space could keep homes cooler and slash the energy use of air-conditioners.
U.S. customs and border chief has resigned amid furore over the dire conditions of holding facilities for refugee and migrant children in Texas.
U.N. chief António Guterres has urged member countries to maintain their support for the U.N. Palestinian aid agency in a pledging conference held Tuesday.
Some 250 migrant children held in an overcrowded border station in Texas have been moved to more suitable facilities following public uproar.
There Is a Stench’: No Soap and Overcrowding in Detention Centers for Migrant Children
A chaotic scene of sickness and filth is unfolding in an overcrowded border station in Clint, Tex., where hundreds of young people who have recently crossed the border are being held, according to lawyers who visited the facility this week. Some of the children have been there for nearly a month.
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World Refugee Day 2019: Building a stronger international response to the challenge of forced displacement
“With the number of refugees on the rise, the system is under stress. Countries and communities that host refugees find themselves having to absorb large numbers of newcomers, often in lagging regions where poverty is already high. And the cost of sustaining refugees while they are in exile is enormous.”
Tackling the health challenges of international migrant workers
Occupational health outcomes among international migrant workers: a systematic review and meta-analysis
International migrant workers are at considerable risk of work-related ill health and injury, and their health needs are critically overlooked in research and policy. Governments, policy makers, and businesses must enforce and improve occupational health and safety measures, which should be accompanied by accessible, affordable, and appropriate health care and insurance coverage to meet the care needs of this important working population.
Restrictive migration policies in low-income and middle-income countries
How climate change exacerbates the refugee crisis – and what can be done about it
WHO and UNICEF Estimate Progress in Water, Sanitation and Hygiene
WHO and UNICEF emphasize that the numbers of people lacking WASH access are still high: around 2.2 billion people worldwide do not have access to safe drinking water, 4.2 billion lack safe sanitation services, and three billion lack basic handwashing facilities. Quality of services also varies among different locations, and in 39 countries, most of them in sub-Saharan Africa, open defecation has increased.
WASH in health care facilities- Practical steps to achieve universal access to quality care
How Developing Countries Can Achieve Universal Health Coverage
Virtually every country worldwide has committed to achieving universal health coverage by 2030, as part of the United Nations Sustainable Development Goals. But some countries are progressing much faster than others in delivering equitable access not only to health services, but also to affordable medicines and vaccines. Among those leading the pack is Vietnam.
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Global Immunization and Gavi: Five Priorities for the Next Five Years
Child vaccination remains among the most cost-effective uses of public and aid monies. In a highly contested funding environment where priorities must be set for the allocation of scarce concessional resources, investment in expanding the availability and coverage of cost-effective vaccination must come at the top of the list.
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An Evolution in Thinking to Support the Post 2020 Global Vaccine
Immunization is one of the most successful and cost-effective health interventions known. This success however, is dependent on effectively optimising access to and sustainably delivering and utilising vaccines. The Global Vaccine Action Plan, endorsed by all 194 member states of the World Health Organisation in May 2012, is a framework to support the equitable access to vaccines through immunization programs. Excellent progress has been made on some but not all GVAP goals and strategic objectives.
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