News Pouch: 2 September 2019

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Pandemic Threats and Health Emergencies

News Pouch: 2 September 2019

Welcome to this issue of the newsletter where we highlight key latest news and literature relevant to health emergencies preparedness and response research and policy, tagged by thematic area.

We appreciate receiving your reports, articles and studies to share widely within our network. Please contact Chadia Wannous via email at

Wishing you useful reading!

  • Spotlight: Ebola Outbreak Situation
  • Updates and News on Outbreaks
    • Priority Infectious Diseases
      • Influenza
      •  VBD, and more
  • One Health
    • Biodiversity and ecosystem
    • Food Security and Safety
    • AMR
    • Health in Emergencies and Disasters
    • Health and Climate Change
    • Urban Health
    • Migration Health
    • Global Health
    • Contact us

    Ebola Outbreak Situation

    WHO External Situation Report 56 / 2019

    MSF crisis update 28 August
    Alarming number of Ebola deaths in DRC a ‘rallying cry’ to scale up treatment

    South Kivu reports 5th Ebola case; MSF calls for expanded vaccination
    In another new development, two experts said more research on Ebola in breastmilk is urgently needed to guide recommendations.
    More »
    Aug 28 MSF press release

    Ebola virus disease and breastfeeding: time for attention
    Aug 27 Lancet letter

    World Bank and WHO Statement on Partnership & Deployment of Financing to WHO for Ebola Response in DRC

    How women in DRC are carrying the weight of the Ebola crisis

    Hospital Ebola spread confirmed in South Kivu, DRC

    Funding designed to fail in Ebola
    The World Bank’s funding scheme for disease outbreaks drained potential resources from the Democratic Republic of the Congo, says former World Bank economist Olga Jonas. “I have ploughed through the confusing 386-page bond prospectus,” says Jonas. “It was a good deal for investors, not for global health.”
    Nature | 5 min read

    Disinformation and Disease: Social Media and the Ebola Epidemic in the Democratic Republic of the Congo
    The proliferation of disinformation online amidst the DRC’s outbreak of the Ebola virus is a serious threat to global health. Efforts to curb bad information and conspiracy theories on social media about the disease and other health issues have been no more successful in health than in other contexts.
    It takes a village to deliver the first vaccines by drone in DRC
    I started working in the Democratic Republic of Congo (DRC) four years ago when VillageReach was approached with an opportunity–to improve the availability of vaccines and essential medicines in rural Equateur province.

    Priority Diseases

    African ministers adopt regional strategy to manage health emergencies
    Strengthening disease management. At a WHO meeting in Congo-Brazzaville this week, African health ministers adopted a new regional disease outbreak strategy, with an emphasis on cross-border cooperation.

    Emerging Infectious Diseases Journal- Volume 25, Number 10—October 2019

    Burundi and Sudan, which share a border with Ebola-hit DRC, are among the list of countries scoring low on epidemic preparedness, according to an independent analysis.

    Microbes at war

    FDA approves novel antibiotic for community-acquired pneumonia

    Lefamulin approval was supported by two phase 3 trials involving moxifloxacin.
    More »

    NIAID awards $2.2 million for broadly protective flu patch vaccine candidate
    The NIAID funding will help launch the phase 1 trail of MIMIX.
    Aug 19 Vaxess press release
    WHO: Influenza Vaccine Response During The Start Of A Pandemic
    We have often talked about the importance of NPIs (Nonpharmaceutical Interventions) like flu hygiene, school closures, and social distancing in the opening months of any pandemic because the creation, mass production, and distribution of an emergency vaccine is a difficult, uncertain, and time consuming endeavor.
    Identification of influenza urban transmission patterns by geographical, epidemiological and whole genome sequencing data: protocol for an observational study

    The H5N8 HPAI Global Situation Update from FAO/EMPRES – Animal Health 
    South Africa reported H5N8 HPAI in ostriches and Egyptian Geese;
    Updated maps on H5N8 and H5Nx HPAI events worldwide;
    1 relevant publication;
    Vector-Borne Diseases (VBD)
    Africa Ministers agree on an aggressive plan to control mosquitoes and other vectors causing diseases
    The region accounts for 90% of the global burden of malaria, for instance, and reports 130 000 cases and 500 deaths of yellow fever annually. In addition, 24 000 cases of visceral leishmaniasis (caused by sand fly bites), and, on average, 19 000 cases of cutaneous leishmaniasis are reported from the region annually. The increase in diseases is partly attributed to the impacts of climate change that have helped expand the environments favourable to the vectors. Compounding the situation, the previous package of approaches to prevention and elimination for vector-borne diseases did not prioritize vector-control interventions, largely due to human resource, technical and infrastructural capacity gaps in vector surveillance and research. To address these challenges, Health Ministers at RC69 yesterday discussed the increasing threat of vector-borne diseases and adopted the Framework for the Implementation of the Global Vector Control Response in the WHO African Region.
    Read More

    Is it still too soon to assign an end date for malaria?
    Even with the scale-up of current tools to fight malaria, Africa will still have about 11 million people infected with the disease by 2050, according to a report published Friday by the World Health Organization Strategic Advisory Group on Malaria Eradication.

    FDA gives fast-track designation to Zika vaccine
    Moderna, Inc., also of Cambridge, announced that the US Food and Drug Administration (FDA) has granted "Fast Track" designation for its investigational Zika vaccine, mRNA-1893, currently being evaluated in a phase 1 study in healthy adults.
    Aug 19 Moderna press release

    Can a new Lyme disease vaccine overcome a history of distrust and failure?
    Even though summer may be winding down, concerns about Lyme disease are not abating. Researchers are developing a vaccine and another preventive method called pre-exposure prophylaxis. There are several vaccines available for dogs, but bringing one to market for humans has been a difficult road, since the first and only Lyme vaccine was pulled from the market in 2002 due to low demand, potential side effects, and vaccine mistrust. So is the world ready for a new Lyme vaccine? Mistrust is still an issue, but demand may be higher now. Even though some 30,000 cases of Lyme are reported to the CDC every year, the agency estimates that the true number may be 10 times more.
    STAT’s Brittany Flaherty has more here
    ASF Asia Update for 29 August from FAO/EMPRES - Animal Health.
    * Lao PDR reported additional 76 ASF outbreaks; ASF has spread to 15 out of its 18 Provinces/city.
    * China reported an ASF outbreak in Yunnan Province.
    * Russian Federation reported 7 ASF outbreaks on backyard/village type farming near the border with Heilongjiang Province, China.            

    Transmissibility of MERS-CoV Infection in Closed Setting, Riyadh, Saudi Arabia, 2015

    A new Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Situation Update from FAO/EMPRES – Animal Health.

    • Seven new human cases have been reported in Saudi Arabia, including 1 fatality;
    • Updated map of MERS-CoV livestock field surveys;
    • Updated map of global distribution of human cases;
    • Updated epidemiological timeline (by exposure source);
    • Two new relevant publications;
    • Project updates by Egypt, Ethiopia, Kenya, and Jordan;

    Measles: Four European nations lose eradication status
    The disease is no longer considered eradicated in Albania, the Czech Republic, Greece and the UK.

    Forecasted Size of Measles Outbreaks Associated With Vaccination Exemptions for Schoolchildren

    A small dip in vaccination rates could lead to large measles outbreaks
    Just a 5% decrease in measles vaccination rates in Texas could spark up to a 4,000% jump in the size of an outbreak, according to a new modeling study.
    The Dr. Lawrence H. and Roberta Cohn Forums
    The Measles Outbreak: Why Vaccines Matter
    Presented jointly with PRI’s The World & WGBH
    Live webcast will stream on Thursday, September 12, 2019
    Noon-1pm ET. An on-demand video will be posted.
    Questions for the panelists:
    Polio eradication.
    Three years after the last case of wild poliovirus was detected in Africa, a WHO commission will evaluate whether the virus has actually been eradicated across the continent.

    Africa polio eradication on brink

    Global HIV Treatment — Turning Headwinds to Tailwinds

    How close are we to a ‘workable’ HIV vaccine?

    Animal activists are on the wrong side of the fight against AIDS

    Global burden of latent multidrug-resistant tuberculosis: trends and estimates based on mathematical modelling

    TB rates among U.S. children have declined by almost half, but disparities persist
    Rates of tuberculosis have declined by almost half in U.S. children, according to a new analysis.

    One Health  

    Zoonoses Articles in the September 2019 Emerging Infectious Diseases Journal
    Rinderpest, smallpox, and the imperative of destruction
    Biodiversity and Ecosystem
    The oft-cited headline that 1 million species are threatened with
    extinction has been criticized by some as being inflated. If anything, the estimate was conservative. So how did IPBES calculate this? Expert Andy Purvis explains in 13 short video clips:  
    ‘Extinction crisis’ pushes countries to agree stronger protection for global wildlife
    At-risk wildlife that is facing a “growing extinction crisis” received a boost on Wednesday, as countries wrapped up a marathon meeting in Geneva, by agreeing to increased protection measures and more sustainable trade in animals and plants across the globe.

    What Exactly Is Deforestation Doing to Our Planet?

    Negotiating legally-binding agreement to provide future generations with a ‘healthy, resilient and productive ocean’

    ‘Invisible’ crisis of water quality threatens human and environmental well-being: World Bank report

    More research into microplastics and a crackdown on plastic pollution urgently needed

    France's Macron to push for charter on biodiversity at G7 summit
    Food Safety and Security
    Progress in pest prevention offers hope for Africa’s food security
    The WHO has developed the draft target products profiles (TPPs)
    The global increase in antimicrobial resistance is limiting available treatment options for many bacterial infections, and the current clinical pipeline for new antibacterial agents is not sufficient to cover future public health needs. The WHO is therefore developing target products profiles (TPPs) for needed antibacterial agents, providing the public health perspective to funders and developers on the performance and operational characteristics desired of new needed therapeutic products.
    Innovate4 AMR
    For the second year, WHO is supporting the Innovate4AMR online student design challenge seeking innovative, creative solutions to address the issues of antimicrobial resistance (AMR). This competition is organized by ReAct, Johns Hopkins IDEA (Innovation+Design Enabling Access) Initiative and the International Federation of Medical Student Associations (IFMSA); in partnership with WHO; and supported by the South Centre.
    Applications close 16 September.

    To mark WAAW 2019 the WHO Headquarters is developing the first ever WHO augmented reality app on AMR and we want you to be a part of it!
    WHO Headquarters is currently looking for partners in to help launch this educational app on AMR during World Antibiotic Awareness Week 2019.
    Read the concept note (below) and help us spread global awareness and increase education on AMR.

    Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017

    Quick fix for care, productivity, hygiene and inequality: reframing the entrenched problem of antibiotic overuse

    Knowing antimicrobial resistance in practice: a multi-country qualitative study with human and animal healthcare professionals
    AMR awareness was high among human and animal healthcare professionals. This awareness of AMR did not translate into reduced prescribing and dispensing; rather, it linked to the ready use of next-line antibiotics. Contextual factors that influenced prescribing and dispensing included antibiotic accessibility and affordability; lack of local antibiotic sensitivity information; concerns over hygiene and sanitation; and interaction with medical representatives.

    Stewardship / Resistance Scan for Aug 27, 2019

    Antibiotic pollution initiative
    Carbapenem-resistant Klebsiella spread

    Stewardship / Resistance Scan for Aug 30, 2019

    • Infection-linked pancreatic scopes
    • Oral antibiotic for skin infections
    • Resistant enterococci in Germany

    More »

    FREE Online course:
    Effective Livestock Production with Low Use of Antibiotics.

    Educational video
    The Zoonotic and Emerging Diseases Group, based jointly at the University of Liverpool and the International Livestock Research Institute, released an educational video about AMR created primarily for an East African audience.


    PLOS Latest Research

    Late diagnosis of multidrug-resistant tuberculosis in a child at Dr George Mukhari Academic Hospital, Ga-Rankuwa, South Africa: A case report
    Could Dampening Expression of the Neisseria gonorrhoeae mtrCDE-Encoded Efflux Pump Be a Strategy To Preserve Currently or Resurrect Formerly Used Antibiotics To Treat Gonorrhea?
    Effects of two-dose ceftiofur treatment for metritis on the temporal dynamics of antimicrobial resistance among fecalEscherichia coli in Holstein-Friesian dairy cows
    Epidemic of carbapenem-resistant Klebsiella pneumoniae in Europe is driven by nosocomial spread
    Knowledge and use of antibiotics in Thailand: A 2017 national household survey
    Aggressive or moderate drug therapy for infectious diseases? Trade-offs between different treatment goals at the individual and population levels
    Mathematical model predicts anti-adhesion–antibiotic–debridement combination therapies can clear an antibiotic resistant infection
    Mice Fed an Obesogenic Western Diet, Administered Antibiotics, and Subjected to a Sterile Surgical Procedure Develop Lethal Septicemia with Multidrug-Resistant Pathobionts
    The international dimensions of antimicrobial resistance: Contextual factors shape distinct ethical challenges in South Africa, Sri Lanka and the United Kingdom
    Antibiotic resistance as a tragedy of the commons: An ethical argument for a tax on antibiotic use in humans
    How well do routine molecular diagnostics detect rifampicin heteroresistance in Mycobacterium tuberculosis?
    Fluoroquinolone heteroresistance in Mycobacterium tuberculosis: detection by genotypic and phenotypic assays in experimentally mixed populations | Scientific Reports
    β-Lactamases and β-Lactamase Inhibitors in the 21st Century
    DNA Topoisomerase Inhibitors: Trapping a DNA-Cleaving Machine in Motion
    Variable ability of rapid tests to detect Mycobacterium tuberculosis rpoB mutations conferring phenotypically occult rifampicin resistance
    Bogotá River anthropogenic contamination alters microbial communities and promotes spread of antibiotic resistance genes
    Using hospital network-based surveillance for antimicrobial resistance as a more robust alternative to self-reporting
    A selective membrane-targeting repurposed antibiotic with activity against persistent methicillin-resistant Staphylococcus aureus | PNAS
    Identification of Primary Antimicrobial Resistance Drivers in Agricultural Nontyphoidal Salmonella enterica Serovars by Using Machine Learning
    Hierarchical Hidden Markov models enable accurate and diverse detection of antimicrobial resistance sequences
    Resistance of Neisseria gonorrhoeae isolates to beta-lactam antibiotics (benzylpenicillin and ceftriaxone) in Russia, 2015–2017
    Trends and risk factors for antimicrobial-resistant Neisseria gonorrhoeae, Melbourne, Australia, 2007 – 2018
    Whole genome sequencing revealed new molecular characteristics in multidrug resistant staphylococci recovered from high frequency touched surfaces in London
    Improving the estimation of the global burden of antimicrobial resistant infections
    Antimicrobial use in an Indonesian community cohort 0-18 months of age

    Emergencies and Disasters

    Week 35: 26 August - 01 September 2019
    The WHO Health Emergencies Programme is currently monitoring 63 events in the region. This week's edition covers key new and ongoing events, including:
    • Ebola virus disease in Uganda
    • Rift Valley fever in Central African Republic
    • Ebola virus disease in Democratic Republic of the Congo
    • Humanitarian crisis in north-east Nigeria.

    Three challenges for the African Union’s new humanitarian agency
    A new institution to take charge of humanitarian policy and response in Africa will face three tough challenges at its birth in October: providing sufficient resources, defining a clear division of labour with existing organisations, and ensuring international aid agencies step back. The African Union wants African nations, multi-country alliances, or African NGOs to lead humanitarian coordination and response by 2025, with the new African Humanitarian Agency (AfHA) replacing the current leadership provided by UN agencies and other organisations.

    Bahamas: Shelter and clean water priorities in wake of “catastrophic” hurricane

    Hurricane Dorian - Bahamas Situation Report 1 – period covered: September 1 - 2, 2019
    Florida Governor Declares State of Emergency as Hurricane Dorian Gains Force Hurricane Dorian is "expected to become a major hurricane on Friday," according to the National Hurricane Center. Maximum sustained winds at 5 a.m. ET Thursday were 85 mph - a Category 1 hurricane - with higher gusts, according to the center's most recent update. Dorian was about 150 miles north northwest of Puerto Rico, moving about 13 mph toward the northwest.

    Floods in north India: A man-made disaster

    Relentless sequence of disasters in Asia-Pacific ‘sign of things to come’, cautions UN regional body

    One year after Genoa tragedy: Are Europe’s bridges any safer?
    Twenty-two life-saving aid programs in Yemen are in danger of shutting down in the next two months if donors do not deliver on their funding pledges.
    Association between earthquake experience and depression 37 years after the Tangshan earthquake: a cross-sectional study
    Biochemistry in a Conflict Zone  
    Yemeni biochemist Eqbal Dauqan conducted research while bombs dropped during the country’s 2015 civil war. In 2018, she won a tenure-track position at the University of Agder in Kristiansand, Norway. Alongside her research into natural antioxidants, she mentors junior scientists whose personal and political circumstances impede their professional development.

    Climate Change

    July was the hottest month ever recorded

    July was the hottest month ever recorded on Earth. And that’s just one of several worrying records broken last month, according to the US National Oceanic and Atmospheric Administration. July came hot on the heels of the warmest June on record. And the extra heat has helped to shrink Arctic sea-ice levels by nearly 20% — another record.
    Nature | 6 min read

    The air conditioning trap: how cold air is heating the world

    Human Health on an Ailing Planet — Historical Perspectives on Our Future
    Inasmuch as history ever teaches a straightforward lesson, the message of this particular history may be that more evidence alone will not compel action in a nonrational policy sphere. We believe that the current imperative for climate action requires physicians to mobilize politically as they have before, again becoming fierce advocates for major social and economic change. A truly ethical relationship with the planet that we inhabit so precariously, and with the generations who will follow, demands nothing less.

    Combating EPA Rollbacks — Health Care’s Response to a Retreat on Climate
    The EPA is now working to weaken fuel-efficiency standards for cars, relax rules on methane emissions, stop regulating mercury emissions, and implement other changes related to power plants that all lead to increased air pollution. Such efforts deprecate climate science and advance the interests of the fossil-fuel industries while exacerbating harm to human health.

    Ambient Particulate Air Pollution and Daily Mortality in 652 Cities
    Data show independent associations between short-term exposure to PM10 and PM2.5 and daily all-cause, cardiovascular, and respiratory mortality in more than 600 cities across the globe. These data reinforce the evidence of a link between mortality and PM concentration established in regional and local studies.

    Why the Amazon Rainforest Fires Could Be Disastrous for Climate Change
    Humans, More than Drought, Are Fueling the Amazon’s Flames
    From his office in Greenbelt, Maryland, Doug Morton can see the Amazon burning. He watches images from NASA satellites that circle the tropics four times a day, their cameras pointed at the trees below to produce images from visible light, infrared, and thermal data.

    Brazil's indigenous people swear to fight for Amazon 'to last drop of blood'

    Building resilience of health systems in Asian LDCs to climate change
    This project supports six Asian least developed countries (LDCs) – Bangladesh, Cambodia, Lao People’s Democratic Republic, Myanmar, Nepal, and Timor-Leste – to strengthen capacity of their health systems to adapt to the impacts of climate change. In particular, the project aims to strengthen institutional capacity to improve health sector planning and effective decision-making to ultimately develop climate resilient health systems.
    IPCC report on climate change and land

    The Climate Crisis — Health and Care Delivery

    Urban Health

    As South Asia's heat rises, living standards decline
    “Around 800 million South Asians—almost half of the region’s population—live in “hotspots” or geographical areas that will experience fewer crop yields, worse health outcomes, and declining productivity. As a result, hard-fought poverty reduction may be reversed.”

    Migration Health

    A new Trump administration rule would allow the U.S. to detain indefinitely families who cross the border illegally, abolishing a 20-day limit.
    The regulation, which must be approved by a federal judge, would also let the White House set standards for conditions at centers. It is expected to be immediately challenged in court. Above, migrant families at a bus station last year after being released by immigration authorities in McAllen, Tex.
    The overhaul issued today would reverse protections set under the Flores settlement in 1997. Here’s how they came to be.
    Can Physicians Work in US Immigration Detention Facilities While Upholding Their Hippocratic Oath?
    The modern successor to the Hippocratic oath, called the Declaration of Geneva, was updated and approved by the World Medical Association in 2017. The pledge states that “The health and well-being of my patient will be my first consideration” and “I will not use my medical knowledge to violate human rights and civil liberties, even under threat.” Can a physician work in US immigration detention facilities while upholding this pledge?

    Mumps outbreaks in migrant detention facilities detailed in new report
    A new report details the first outbreaks of mumps in U.S. migrant detention centers. Nearly 900 cases have been reported in facilities since September 2018. A Texas center had the first cases, followed by 56 other locations across 18 states — translating to nearly 1 in 5 of all Immigration and Customs Enforcement facilities. Most cases were in adult migrants, with a small fraction of facility staff affected. In response, ICE’s health services arm provided more than 25,000 doses of the measles, mumps, and rubella vaccine. As of last week, the outbreaks are ongoing in 15 facilities across seven states. In the U.S. overall, some 16,000 mumps cases have been reported since 2015, often in close quarters because the disease is highly contagious.
    Helping African Families Heal with IOM's Migrant Deaths and Disappearances 

    Read more
    Improving Health Access for Displaced Women and Girls in Iraq
    Read more

    Immigrant Health: Anchoring Public Health Practice in a Justice Framework

    Included, but Deportable: A New Public Health Approach to Policies That Criminalize and Integrate Immigrants

    Global Health

    Road to UHC.
    Governments will address universal health coverage during a high-level meeting at the U.N. in September. So far, the proposed agreement appears to fall flat of concrete financing commitments, civil society experts say.
    The Swiss government announced on Wednesday $102 million in contributions to UNAIDS and the Global Fund to fight against infectious diseases.

    Dry Toilets: An Approach to Provide Safe Sanitation and Sustainable Sewage Treatment?
    A case study in Haiti demonstrates how dry toilet systems could secure appropriate sanitation and hygiene for communities while advancing sustainable management and treatment of waste.


    Nearly $320 billion is spent a year on water and sanitation subsidies. How does it help?
    Subsidies can be powerful tools in delivering water and sanitation when they are designed to be smart, targeted, and effectively implemented. New World Bank research shows that governments across the world are pouring money into water and sanitation subsidies but all too often that funding doesn’t flow to those who need it most.
    Press Release | Infographic | Q & A | Podcast

    Vaccine alliance in US$7.4bn funding push

    No-deal Brexit threatens flu vaccine supply, doctors warn
    WHO launches global registry on human genome editing
    A WHO expert advisory committee has approved the first phase of a new global registry to track research on human genome editing. The 18-member committee also announced an online consultation on the governance of genome editing

    WHO joins coalition to promote open access to research articles

    The WHO is joining a coalition that works to ensure open access to research articles. The partnership, launched last September by several charities and country funding organizations, wants to make publicly and privately funded research easily available through open access journals or made immediately available on other platforms. But getting research journals on board — many of which put articles behind a paywall and rely on the associated fees for a means of income — will remain a challenge. With yesterday’s announcement, the WHO also became the first of the UN agencies to throw its hat into the fight for open access research. “By joining this coalition, we believe we can accelerate progress towards universal free access to health research,” WHO chief scientist Dr. Soumya Swaminathan said in a statement


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