Emergencies

Emergencies

Ebola – DRC+
Public Health Emergency of International Concern (PHEIC)

No new Situation Update posted.

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Global consortium working with DRC Government to introduce second Ebola vaccine
31 Oct 2019 CEPI
A global consortium is supporting the Government of the Democratic Republic of the Congo (DRC) to introduce a second investigational Ebola vaccine as part of ongoing efforts to contain the outbreak in eastern DRC.

The large-scale clinical trial, sponsored by the London School of Hygiene & Tropical Medicine (LSHTM), is designed to help prevent the spread of the epidemic, the second worst in history, beyond the currently affected areas in eastern DRC, and if possible gather crucial information about the effectiveness of the vaccine to be better prepared to fight Ebola in the future.

The consortium is led by the DRC Ministry of Health (MOH) and Institut National de Recherche Biomédicale (INRB) and includes LSHTM, the Coalition for Epidemic Preparedness Innovations (CEPI); Médecins Sans Frontières (MSF) and Epicentre; with the Wellcome Trust contributing critical strategic guidance. Janssen Vaccines & Prevention B.V. is donating the experimental vaccine regimen for the study undertaken by the consortium.

The two-dose Ebola vaccine regimen (Ad26.ZEBOV, MVA-BN-Filo) is manufactured by the Janssen Pharmaceutical Companies of Johnson & Johnson. It was developed in collaboration with global partners, including Bavarian Nordic A/S, the U.S. Biomedical Advanced Research and Development Authority (BARDA), part of the Office of the Assistant Secretary for Preparedness and Response at the U.S. Department of Health and Human Services (HHS), the Innovative Medicines Initiative (IMI) funded through the European Union Horizon 2020 Programme, and the U.S. National Institutes of Health (NIH) at HHS.

The introduction of this second vaccine was recommended by the World Health Organization’s Strategic Advisory Group of Experts on Immunization in May 2019 to complement ongoing use of another investigational vaccine, rVSV-ZEBOV, made by Merck Pharmaceuticals. The Merck vaccine is being used in a ring vaccination strategy targeting contacts of those with Ebola virus disease and other health and frontline workers at high risk.

More than 6,500 people have taken part in multiple previous and ongoing clinical trials of the Janssen Ebola vaccine regimen. The available data indicate that the vaccine is well tolerated and induces robust immune responses to the Zaire strain of Ebola virus – the cause of the DRC outbreak. At present, there are no human data on efficacy in preventing Ebola virus infection.
In 2019 researchers in Uganda began a two-year clinical trial of the vaccine among healthcare and frontline workers. The vaccine is also undergoing evaluation along with the Merck vaccine as part of a large Phase 2 randomized, placebo-controlled trial in West Africa called PREVAC that began in 2017.

Ad26.ZEBOV, MVA-BN-Filo will be offered to adults and children aged one year or older under a clinical trial protocol that aims to evaluate the effectiveness and safety of the vaccine in an outbreak setting. The regimen includes two doses (one of Ad26.ZEBOV and the second of MVA-BN-Filo), spaced two months apart.

Janssen will donate up to 500,000 doses of the vaccine regimen for those in communities near the outbreak who are considered at risk, as determined by the DRC MOH, INRB and consortium partners, taking into account the latest epidemiological data on disease spread, as well as logistical and security concerns.

Dr Eteni Longondo, Minister of Public Health, DRC, said: “As part of our Ebola response efforts, the Government of DRC plans to introduce a second experimental Ebola vaccine within a clinical trial protocol. It’s vital that we intensify our efforts. That’s why we’re working with international partners to provide our response teams with another tool to fight and ultimately stop the spread of this terrible disease.”

The study will be implemented by the INRB and MOH, supported by MSF, Epicentre, and LSHTM under the leadership of the Principal Investigator Dr Jean-Jacques Muyembe, INRB Director General and head of the DRC multisector Ebola response committee.

Dr Muyembe said: “The current Ebola outbreak is concentrated in North Kivu and Ituri provinces, areas which have had to deal with insecurity and violent conflict. This environment has complicated response efforts and led to distrust of health care workers, which has become a major problem. Therefore, effective community engagement will be absolutely critical to the successful introduction of a second Ebola vaccine. Deploying any vaccine in these circumstances is enormously challenging and must be done alongside a range of other public health measures and interventions, such as contact tracing. But building trust and confidence within affected communities must be our priority.”…
country….

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POLIO
Public Health Emergency of International Concern (PHEIC)

Polio this week as of 30 October 2019
:: With less than a month left to the GPEI pledging event in Abu Dhabi, G20 Health Ministers gathered in Okayama, Japan, on 19 – 20 October 2019 to address major global health issues where they maintained their commitment to eradicating polio. Read more on the ministers’ declaration.
:: Following the certification of eradication of WPV3, WHO Director General Dr Adhanom Ghebreyesus expressed his gratitude to all who made the achievement possible and called on all stakeholders to continue with the fight to eradicate WPV1. Read the DG’s thank-you letter.
:: The effects of polio hit hard. The disease not only causes pain and suffering to the victim and the family, but also forces relatives to quit their income-generating activities, to provide care to the afflicted child. Read about little Junaisa – the first polio patient in the Philippines since 2001.
:: Get up-to-date on the different aspects of GPEI’s status of work in 2018 through the newly released 2018 annual report.

 

Summary of new viruses this week:
:: Afghanistan— one WPV1 case;
:: Pakistan— one WPV1 case and 12 WPV1-positive environmental samples;
:: Central African Republic— three cVDPV2 cases and one cVDPV2 positive environmental sample. Angola— 11 cVDPV2 cases;
:: Philippines— one cVDPV2 case, one cVDPV1 and two cVDPV2 positive environmental samples.

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Okayama Declaration of the G20 Health Ministers
October 19-20, 2019

12. We reaffirm our commitment to eradicate polio, and we note the leadership role of WHO.
We are concerned with the rising number of vaccine-derived polio outbreaks. We call for
a strong cross-border cooperation and strict implementation of vaccine requirements for
travelers as specified in the International Health Regulations (IHR, 2005). We support the
efforts of the Global Polio Eradication Initiative (GPEI), Gavi, the Vaccine Alliance (Gavi),
WHO, UNICEF, and other stakeholders in strengthening routine and supplemental
immunization. We also support their efforts to ensure transition of relevant polio assets
into the national programs and we encourage countries to provide adequate domestic
resources to strengthen national health systems. We look forward to the replenishment of
GPEI next month.

13. We recognize that immunization is one of the most cost-effective health investments with
proven strategies that make it accessible to all segments of the population with an
emphasis on women and girls, the most hard-to-reach as well as the vulnerable and
marginalized populations. We express our concern about vaccine hesitancy as mentioned
in the WHO’s Ten threats to global health in 2019. We are committed to strengthen health
systems and accessibility of safe, effective, quality, and affordable vaccines for sustainable
immunization to achieve high vaccination coverage as well as confidence in vaccines. We
look forward to the third replenishment of Gavi next year in the United Kingdom…

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Editor’s Note:
WHO has posted a refreshed emergencies page which presents an updated listing of Grade 3,2,1 emergencies as below.

WHO Grade 3 Emergencies [to 2 Nov 2019]

Democratic Republic of the Congo
:: 835 000 people to receive second dose of the cholera vaccine in North Kivu, Democratic Republic of the Congo Goma, 30 October 2019

Mozambique floods – No new digest announcements identified
Nigeria – No new digest announcements identified
Somalia – No new digest announcements identified
South Sudan – No new digest announcements identified
Syrian Arab Republic – No new digest announcements identified
Yemen – No new digest announcements identified

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WHO Grade 2 Emergencies [to 2 Nov 2019]

Myanmar
:: Bi‐weekly Situation Report 21 – 24 October 2019 pdf, 639kb

Niger
:: Evaluation externe de la riposte (OBRA) à l’épidémie de poliomyélite 31 octobre 2019

Afghanistan – No new digest announcements identified
Angola – No new digest announcements identified
Burkina Faso [in French] – No new digest announcements identified
Burundi – No new digest announcements identified
Cameroon – No new digest announcements identified
Central African Republic – No new digest announcements identified
Ethiopia – No new digest announcements identified
HIV in Pakistan – No new digest announcements identified
Iran floods 2019 – No new digest announcements identified
Iraq – No new digest announcements identified
Libya – No new digest announcements identified
Malawi floods – No new digest announcements identified
Measles in Europe – No new digest announcements identified
MERS-CoV – No new digest announcements identified
occupied Palestinian territory – No new digest announcements identified
Sudan – No new digest announcements identified
Ukraine – No new digest announcements identified
Zimbabwe – No new digest announcements identified

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WHO Grade 1 Emergencies [to 2 Nov 2019]

Chad – No new digest announcements identified
Djibouti – No new digest announcements identified
Kenya – No new digest announcements identified
Mali – No new digest announcements identified
Namibia – viral hepatitis – No new digest announcements identified
Tanzania – No new digest announcements identified

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UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises. 
Syrian Arab Republic
:: Syria ǀ Flash Update #10, Humanitarian impact of the military operation in north-eastern Syria, 26 – 28 October 2019 [EN/AR]

Yemen – No new digest announcements identified

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UN OCHA – Corporate Emergencies
When the USG/ERC declares a Corporate Emergency Response, all OCHA offices, branches and sections provide their full support to response activities both at HQ and in the field.
Editor’s Note:
Ebola in the DRC has bene added as a OCHA “Corporate Emergency” this week:
CYCLONE IDAI and Kenneth
:: 01 Nov 2019 Kenya: Heavy rains impact more than 100,000 people

EBOLA OUTBREAK IN THE DRC – No new digest announcements identified

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