The Novel #Coronavirus Originating in #Wuhan, #China – #Challenges for #GlobalHealth #Governance (JAMA, summary)

[Source: Journal of American Medical Association, full page: (LINK). Summary, edited.]

Viewpoint / January 30, 2020

The Novel Coronavirus Originating in Wuhan, ChinaChallenges for Global Health Governance

Alexandra L. Phelan, SJD, LLM1,2; Rebecca Katz, PhD, MPH1; Lawrence O. Gostin, JD2

Author Affiliations: 1 Center for Global Health Science and Security, Georgetown University, Washington, DC; 2 O’Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC

JAMA. Published online January 30, 2020. doi:10.1001/jama.2020.1097

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On December 31, 2019, China reported to the World Health Organization (WHO) cases of pneumonia in Wuhan, Hubei Province, China, caused by a novel coronavirus, currently designated 2019-nCoV. Mounting cases and deaths pose major public health and governance challenges. China’s imposition of an unprecedented cordon sanitaire (a guarded area preventing anyone from leaving) in Hubei Province has also sparked controversy concerning its implementation and effectiveness. Cases have now spread to at least 4 continents. As of January 28, there are more than 4500 confirmed cases (98% in China) and more than 100 deaths.1 In this Viewpoint, we describe the current status of 2019-nCoV, assess the response, and offer proposals for strategies to bring the outbreak under control.

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Corresponding Author: Lawrence O. Gostin, JD, O’Neill Institute for National and Global Health Law, Georgetown University Law Center, 600 New Jersey Ave NW, Washington, DC 20001 (gostin@law.georgetown.edu).

Published Online: January 30, 2020. doi:10.1001/jama.2020.1097

Conflict of Interest Disclosures: Mr Gostin is the director of the World Health Organization Collaborating Center on National and Global Health Law. No other disclosures were reported.

Keywords: 2019-NCoV; China; International cooperation.

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The 2019 #report of The Lancet #Countdown on #health and #climatechange: ensuring that the health of a #child born today is not defined by a changing climate (Lancet, summary)

[Source: The Lancet, full page: (LINK). Summary, edited.]

The 2019 report of The Lancet Countdown on health and climate change: ensuring that the health of a child born today is not defined by a changing climate

Nick Watts, MA, Markus Amann, PhD, Prof Nigel Arnell, PhD, Sonja Ayeb-Karlsson, PhD, Kristine Belesova, PhD, Prof Maxwell Boykoff, PhD et al.

Published: November 13, 2019 / DOI: https://doi.org/10.1016/S0140-6736(19)32596-6

 

Summary

The Lancet Countdown is an international, multidisciplinary collaboration, dedicated to monitoring the evolving health profile of climate change, and providing an independent assessment of the delivery of commitments made by governments worldwide under the Paris Agreement.

Keywords: Global Health; Climate change.

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#International #Funding for #Global Common #Goods for #Health: An Analysis Using the #Creditor Reporting System and G-FINDER Databases (Health Syst Reform, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Health Syst Reform. 2019 Nov 11:1-16. doi: 10.1080/23288604.2019.1663646. [Epub ahead of print]

International Funding for Global Common Goods for Health: An Analysis Using the Creditor Reporting System and G-FINDER Databases.

Schäferhoff M1, Chodavadia P2, Martinez S1, McDade KK2, Fewer S3, Silva S4, Jamison D3, Yamey G2.

Author information: 1 Open Consultants, Berlin, Germany. 2 Duke Global Health Institute, Duke University, Durham, NC, USA. 3 Institute for Global Health Sciences, University of California, San Francisco, CA, USA. 4 Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA.

 

Abstract

West Africa’s Ebola epidemic of 2014-2016 exposed, among other problems, the under-funding of transnational global health activities known as global common goods for health (CGH), global functions such as pandemic preparedness and research and development (R&D) for neglected diseases. To mobilize sustainable funding for global CGH, it is critical first to understand existing financing flowing to different types of global CGH. In this study, we estimate trends in international spending for global CGH in 2013, 2015, and 2017, encompassing the era before and after the Ebola epidemic. We use a measure of international funding that combines official development assistance (ODA) for health with additional international spending on R&D for diseases of poverty, a measure called ODA+. We classify ODA+ into funding for three global functions-provision of global public goods, management of cross-border externalities, and fostering of global health leadership and stewardship-and country-specific aid. International funding for global functions increased between 2013 and 2015 by $1.4 billion to a total of $7.3 billion in 2015. It then declined to $7.0 billion in 2017, accounting for 24% of all ODA+ in 2017. These findings provide empirical evidence of the reactive nature of international funders for global CGH. While international funders increased funding for global functions in response to the Ebola outbreak, they failed to sustain that funding. To meet future global health challenges proactively, international funders should allocate more funding for global functions.

KEYWORDS: global common goods for health; global health funding

PMID: 31710516 DOI: 10.1080/23288604.2019.1663646

Keywords: Global Health; International cooperation.

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Sustainable #development #levers are key in #global #response to #antimicrobial #resistance (Lancet, summary)

[Source: The Lancet, full page: (LINK). Summary, edited.]

Sustainable development levers are key in global response to antimicrobial resistance

Angelina Taylor, Jasper Littmann, Anna Holzscheiter, Maike Voss, Lothar Wieler, Tim Eckmanns

Published: October 30, 2019 / DOI: https://doi.org/10.1016/S0140-6736(19)32555-3

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Antimicrobial resistance (AMR) is a borderless challenge, with drug-resistant infections estimated to cause at least 700 000 deaths per year globally. 1  To address this, member states of WHO agreed to the Global Action Plan for AMR in 2015, followed by adoption of the UN political declaration on AMR in 2016. A global governance structure is in place—namely, the Tripartite, made up of WHO, the Food and Agriculture Organization of the UN (FAO), and the World Organisation of Animal Health (OIE)—all of which are strengthening their AMR mandates. 2  The UN Interagency Coordination Group on AMR (IACG), tasked by the UN Secretary-General, has been engaging with member states and other stakeholders and has made recommendations for globally combatting AMR. 3

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Keywords: Society; Poverty; Global Health; Antibiotics; Drugs Resistance.

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#Vaccine #impact on #antimicrobial #resistance to inform #Gavi, the Vaccine Alliance’s 2018 Vaccine Investment Strategy: report from an expert survey (F1000Res., abstract)

[Source: F1000 Research, full page: (LINK). Abstract, edited.]

Vaccine impact on antimicrobial resistance to inform Gavi, the Vaccine Alliance’s 2018 Vaccine Investment Strategy: report from an expert survey

[version 1; peer review: 2 approved]

Maya Malarski 1, Mateusz Hasso-Agopsowicz 2, Adam Soble 3, Wilson Mok 1, Sophie Mathewson 1, Johan Vekemans 2

Author details: 1 Policy, Vaccines & Sustainability, Gavi, the Vaccine Alliance, Le Grand-Saconnex, 1218, Switzerland; 2 Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, 1211, Switzerland; 3 Vaccine Supply & Demand, Vaccines & Sustainability, Gavi, the Vaccine Alliance, Le Grand-Saconnex, 1218, Switzerland

 

Abstract

Background:

While the rise of antimicrobial resistance (AMR) has been recognised as a major public health problem, the value of vaccines to control AMR is poorly defined. This expert survey was launched with the aim of informing the 2018 Vaccine Investment Strategy through which Gavi, the Vaccine Alliance prioritises future vaccine funding. This exercise focused on both vaccines currently supported by Gavi and under consideration for future funding.

Methods:

The relative importance of pre-defined criteria as drivers of overall value of vaccines as a tool/ intervention to control AMR was assessed by 18 experts: prevention of mortality and morbidity due to resistant pathogens, antibiotic use prevented, societal impact, ethical importance and sense of urgency. For each vaccine, experts attributed scores reflecting the estimated value for each criterion, and overall value relative to AMR was derived from the value assigned to each criterion and their relative importance for each vaccine.

Results:

Mortality, morbidity due to targeted resistant pathogens, and antibiotic use prevented were considered the most important determinants of overall value. Pneumococcal, typhoid and malaria vaccines were assigned highest value relative to antimicrobial resistance. Intermediate value was estimated for specific rotavirus, cholera, respiratory syncytial virus (RSV), influenza, dengue, measles, meningitis and Haemophilus influenza type b- (Hib-) containing pentavalent vaccines. Lowest value relative to AMR was estimated for Japanese encephalitis, hepatitis A, yellow fever, rabies and human papilloma virus vaccine.

Conclusions:

In the future, more evidence-based, data-driven, robust methodologies should be developed to guide coordinated, rational decision making on priority actions aimed at strengthening the use of vaccines against AMR.

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Keywords: Vaccines, antimicrobial resistance

Corresponding author: Johan Vekemans

Competing interests: No competing interests were disclosed.

Grant information: The author(s) declared that no grants were involved in supporting this work.

Copyright:  © 2019 World Health Organisation. This is an open access article distributed under the terms of the Creative Commons Attribution IGO License, which permits copying, adaptation and distribution in any medium or format for any purpose, provided the original work is properly cited, a link is provided to the license, and any changes made are indicated. Any such copying, adaptation and distribution must not in any way suggest that World Health Organisation endorses you or your use.

How to cite: Malarski M, Hasso-Agopsowicz M, Soble A et al. Vaccine impact on antimicrobial resistance to inform Gavi, the Vaccine Alliance’s 2018 Vaccine Investment Strategy: report from an expert survey [version 1; peer review: 2 approved]. F1000Research 2019, 8:1685 (https://doi.org/10.12688/f1000research.20100.1)

First published: 24 Sep 2019, 8:1685 (https://doi.org/10.12688/f1000research.20100.1)

Latest published: 24 Sep 2019, 8:1685 (https://doi.org/10.12688/f1000research.20100.1)

Keywords: Antibiotics; Drugs Resistance; Vaccines.

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#Pneumonia #research: time to fill in the gaps (Lancet Resp Med., summary)

[Source: The Lancet Respiratory Medicine, full page: (LINK). Abstract, edited.]

Pneumonia research: time to fill in the gaps

The Lancet Respiratory Medicine / Published: October 17, 2019 / DOI: https://doi.org/10.1016/S2213-2600(19)30400-X

 

Summary

Pneumonia remains a leading cause of death worldwide without substantial improvements in mortality since the introduction of antibiotics over 50 years ago. Approximately 1 million adults in the USA attend hospital for the treatment of pneumonia each year, and 50 000 die from the disease, with the majority being older than 65 years. Community-acquired pneumonia (CAP) is responsible for most of the health care burden of pneumonia and on Oct 1, 2019, the American Thoracic Society released new guidelines on the diagnosis and treatment of adults with CAP.

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Copyright © 2019 Elsevier Ltd. All rights reserved.

Keywords: Pneumonia.

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#Mapping 123 million #neonatal, #infant and #child #deaths between 2000 and 2017 (Nature, abstract)

[Source: Nature, full page: (LINK). Abstract, edited.]

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Roy Burstein, Nathaniel J. Henry,  […] Simon I. Hay

Nature, volume 574, pages353–358 (2019)

 

Abstract

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations.

Keywords: Society; Poverty; Pediatrics; Global Health.

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#Projection of #costs of #polio #eradication compared to permanent control (J Infect Dis., abstract)

[Source: Journal of Infectious Diseases, full page: (LINK). Abstract, edited.]

Projection of costs of polio eradication compared to permanent control

Marita Zimmermann, MPH, PhD, Brittany Hagedorn, MBA, Hil Lyons, MS, PhD

The Journal of Infectious Diseases, jiz488, https://doi.org/10.1093/infdis/jiz488

Published: 30 September 2019

 

Abstract

Despite increased efforts and spending toward polio eradication, it has yet to be eliminated worldwide. We aimed to project economic costs of polio eradication compared to permanent control. We used historical Financial Resource Requirements from the Global Polio Eradication Initiative, as well as vaccination and population data from publicly available sources to project costs for routine immunization, immunization campaigns, surveillance and lab, technical assistance, social mobilization, treatment, and overhead. We found that cumulative spending for a control strategy would exceed that for an eradication strategy in 2032 (range 2027-2051). Eradication of polio would likely be cost-saving compared to permanent control.

Polio, Eradication, Costs, Permanent Control, Budget

Issue Section: Brief Report

This content is only available as a PDF.

© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

Keywords: Poliomyelitis; Worldwide; Global Health.

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The #global burden of non-typhoidal #salmonella invasive disease: a systematic analysis for the Global Burden of Disease Study 2017 (Lancet Infect Dis., abstract)

[Source: The Lancet Infectious Diseases, full page: (LINK). Abstract, edited.]

The global burden of non-typhoidal salmonella invasive disease: a systematic analysis for the Global Burden of Disease Study 2017

GBD 2017 Non-Typhoidal Salmonella Invasive Disease Collaborators †

Open Access / Published: September 24, 2019 / DOI: https://doi.org/10.1016/S1473-3099(19)30418-9

 

Summary

Background

Non-typhoidal salmonella invasive disease is a major cause of global morbidity and mortality. Malnourished children, those with recent malaria or sickle-cell anaemia, and adults with HIV infection are at particularly high risk of disease. We sought to estimate the burden of disease attributable to non-typhoidal salmonella invasive disease for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017.

Methods

We did a systematic review of scientific databases and grey literature, and estimated non-typhoidal salmonella invasive disease incidence and mortality for the years 1990 to 2017, by age, sex, and geographical location using DisMod-MR, a Bayesian meta-regression tool. We estimated case fatality by age, HIV status, and sociodemographic development. We also calculated the HIV-attributable fraction and estimated health gap metrics, including disability-adjusted life-years (DALYs).

Findings

We estimated that 535 000 (95% uncertainty interval 409 000–705 000) cases of non-typhoidal salmonella invasive disease occurred in 2017, with the highest incidence in sub-Saharan Africa (34·5 [26·6–45·0] cases per 100 000 person-years) and in children younger than 5 years (34·3 [23·2–54·7] cases per 100 000 person-years). 77 500 (46 400–123 000) deaths were estimated in 2017, of which 18 400 (12 000–27 700) were attributable to HIV. The remaining 59 100 (33 300–98 100) deaths not attributable to HIV accounted for 4·26 million (2·38–7·38) DALYs in 2017. Mean all-age case fatality was 14·5% (9·2–21·1), with higher estimates among children younger than 5 years (13·5% [8·4–19·8]) and elderly people (51·2% [30·2–72·9] among those aged ≥70 years), people with HIV infection (41·8% [30·0–54·0]), and in areas of low sociodemographic development (eg, 15·8% [10·0–22·9] in sub-Saharan Africa).

Interpretation

We present the first global estimates of non-typhoidal salmonella invasive disease that have been produced as part of GBD 2017. Given the high disease burden, particularly in children, elderly people, and people with HIV infection, investigating the sources and transmission pathways of non-typhoidal salmonella invasive disease is crucial to implement effective preventive and control measures.

Funding

Bill & Melinda Gates Foundation.

Keywords: Salmonellosis; Global Health.

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#Global #Risk and #Elimination of #YellowFever #Epidemics (J Infect Dis., abstract)

[Source: Journal of Infectious Diseases, full page: (LINK). Abstract, edited.]

Global Risk and Elimination of Yellow Fever Epidemics

Martial L Ndeffo-Mbah, Abhishek Pandey

The Journal of Infectious Diseases, jiz375, https://doi.org/10.1093/infdis/jiz375

Published: 23 September 2019

 

Abstract

Background

Yellow fever (YF) is a vector-borne viral hemorrhagic disease endemic in Africa and Latin America. In 2016, the World Health Organization (WHO) developed the Eliminate YF Epidemics strategy aiming at eliminating YF epidemics by 2026.

Methods

We developed a spatiotemporal model of YF, accounting for the impact of temperature, vector distribution, and socioeconomic factors on disease transmission. We validated our model against previous estimates of YF basic reproductive number (⁠R0R0⁠). We used the model to estimate global risk of YF outbreaks and vaccination efforts needed to achieve elimination of YF epidemics.

Results

We showed that the global risk of YF outbreaks is highly heterogeneous. High-risk transmission areas (⁠R0R0 > 6) are mainly found in West Africa and the Equatorial region of Latin America. We showed that vaccination coverage needed to eliminate YF epidemics in an endemic country varies substantially between districts. In many endemic countries, a 90% vaccination coverage is needed to achieve elimination. However, in some high-risk districts in Africa, a 95% coverage may be required.

Conclusions

Global elimination of YF epidemics requires higher population-level immunity than the 80% coverage recommended by the WHO. Optimal YF vaccination strategy should be tailored to the risk profile of each endemic country.

yellow fever, basic reproductive number, threshold vaccination coverage, global epidemics elimination

Issue Section: Major Article

Keywords: Global Health; Yellow Fever; Vaccines; Mathematical models.

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