Pew Charitable Trusts [to 21 May 2016]
http://www.pewtrusts.org/en/about/news-room/press-releases

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May 11, 2016
Pew Releases Scientific Roadmap to Spur Antibiotic Discovery and Innovation
Press Release – Antibiotic Resistance Project
WASHINGTON—The Pew Charitable Trusts today released a strategy to end the 30-year drought in the discovery of new types of antibiotics, key to fighting some of the most serious microbial threats. The Scientific Roadmap for Antibiotic Discovery identifies priority research goals and specific steps to break through the most significant scientific barriers impeding antibiotic discovery and to pave the way for urgently needed new drugs.

“Drug-resistant bacteria are an ever-increasing threat, but the discovery of new antibiotics has slowed to a crawl,” said Allan Coukell, senior director for health programs at The Pew Charitable Trusts. “Every antibiotic in use today is based on a discovery made more than 30 years ago.”…

Rockefeller Foundation [to 21 May 2016]
http://www.rockefellerfoundation.org/newsroom

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May 12, 2016
The Rockefeller Foundation launches “100×25” campaign to reach 100 women CEOs of the Fortune 500 companies by 2025
New research report commissioned by The Rockefeller Foundation shows American men and women believe business leaders and companies have the greatest responsibility when it comes to creating gender equality in the workplace
NEW YORK—Today at the Forbes Women’s Summit, The Rockefeller Foundation announced a commitment to accelerate the number of women leaders in corporate America through the launch of “100×25,” an ongoing and multi-faceted campaign that will influence decision makers to achieve the goal of 100 women leading Fortune 500 companies by 2025. 100×25 is the first in a series of campaigns that will ask “what if” questions that will define the future of work and the global economy.

The Foundation also released a new research report conducted by grantee Global Strategy Group on the topic of gender parity in leadership positions in business. The underlying research found that men and women believe corporate America is falling short in terms of advancing gender equality in leadership positions and that business leaders are best positioned to create solutions to the problem.

Currently, only 21 women are at the helm of Fortune 500 companies and only one woman was hired as a CEO in 2015. This reality is at odds with Americans’ perceptions of progress toward gender parity in leadership positions in 2016. According to The Rockefeller Foundation’s new research report, 9 in 10 Americans think there are more women leading Fortune 500 companies than there actually are. And 40 percent of Americans think women should make up at least half of the top executives at Fortune 500 companies…

:: Journal Watch
The Sentinel will track key peer-reviewed journals which address a broad range of interests in human rights, humanitarian response, health and development. It is not intended to be exhaustive. We will add to those monitored below as we encounter relevant content and upon recommendation from readers. We selectively provide full text of abstracts and other content but note that successful access to some of the articles and other content may require subscription or other access arrangement unique to the publisher. Please suggest additional journals you feel warrant coverage.

BMC Health Services Research
http://www.biomedcentral.com/bmchealthservres/content
(Accessed 14 May 2016)

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Research article
Correlates of unequal access to preventive care in China: a multilevel analysis of national data from the 2011 China Health and Nutrition Survey
Chi Huang, Chao-Jie Liu, Xiong-Fei Pan, Xiang Liu and Ning-Xiu Li
BMC Health Services Research 2016 16:177
Published on: 12 May 2016

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Research article
Economic burden of multimorbidity among older adults: impact on healthcare and societal costs
Multimorbidity is not uncommon and the associated impact it places on healthcare utilisation and societal costs is of increased concern.
Louisa Picco, Evanthia Achilla, Edimansyah Abdin, Siow Ann Chong, Janhavi Ajit Vaingankar, Paul McCrone, Hong Choon Chua, Derrick Heng, Harish Magadi, Li Ling Ng, Martin Prince and Mythily Subramaniam
BMC Health Services Research 2016 16:173
Published on: 10 May 2016

BMC Medicine
http://www.biomedcentral.com/bmcmed/content
(Accessed 14 May 2016)

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Commentary
Ethical priority setting for universal health coverage: challenges in deciding upon fair distribution of health services
Ole F. Norheim
Published on: 11 May 2016
Abstract
Priority setting is inevitable on the path towards universal health coverage. All countries experience a gap between their population’s health needs and what is economically feasible for governments to provide. Can priority setting ever be fair and ethically acceptable? Fairness requires that unmet health needs be addressed, but in a fair order. Three criteria for priority setting are widely accepted among ethicists: cost-effectiveness, priority to the worse-off, and financial risk protection. Thus, a fair health system will expand coverage for cost-effective services and give extra priority to those benefiting the worse-off, whilst at the same time providing high financial risk protection. It is considered unacceptable to treat people differently according to their gender, race, ethnicity, religion, sexual orientation, social status, or place of residence. Inequalities in health outcomes associated with such personal characteristics are therefore unfair and should be minimized. This commentary also discusses a third group of contested criteria, including rare diseases, small health benefits, age, and personal responsibility for health, subsequently rejecting them. In conclusion, countries need to agree on criteria and establish transparent and fair priority setting processes.

BMC Pregnancy and Childbirth
http://www.biomedcentral.com/bmcpregnancychildbirth/content
(Accessed 14 May 2016)

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Research article
Signal functions for measuring the ability of health facilities to provide abortion services: an illustrative analysis using a health facility census in Zambia
Annually, around 44 million abortions are induced worldwide. Safe termination of pregnancy (TOP) services can reduce maternal mortality, but induced abortion is illegal or severely restricted in many countries…
Oona M. R. Campbell, Estela M. L. Aquino, Bellington Vwalika and Sabine Gabrysch
BMC Pregnancy and Childbirth 2016 16:105
Published on: 14 May 2016

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Research article
Previous induced abortion among young women seeking abortion-related care in Kenya: a cross-sectional analysis
Unsafe abortion is a leading cause of death among young women aged 10–24 years in sub-Saharan Africa. Although having multiple induced abortions may exacerbate the risk for poor health outcomes, there has been…
Caroline W. Kabiru, Boniface A. Ushie, Michael M. Mutua and Chimaraoke O. Izugbara
BMC Pregnancy and Childbirth 2016 16:104
Published on: 14 May 2016

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Research article
Antenatal consultation for parents whose child may require admission to neonatal intensive care: a focus group study for media design
For parents whose child may require admission to a neonatal intensive care unit (NICU), the antenatal consultation is often their first point of contact with the child’s medical team.
Patrick von Hauff, Karen Long, Barbara Taylor and Michael A. van Manen
BMC Pregnancy and Childbirth 2016 16:103
Published on: 14 May 2016

Current Opinion in Infectious Diseases
June 2016 – Volume 29 – Issue 3 pp: v-v,229-318
http://journals.lww.com/co-infectiousdiseases/pages/currenttoc.aspx
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PAEDIATRIC AND NEONATAL INFECTIONS
Edited by Paul T. Heath

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Interactions between intestinal pathogens, enteropathy and malnutrition in developing countries
Prendergast, Andrew J.; Kelly, Paul
Abstract
Purpose of review: This review focuses on recent data highlighting the interactions between intestinal pathogens, enteropathy and malnutrition in developing countries, which drive morbidity and mortality and hinder the long-term developmental potential of children.
Recent findings: Diarrhoea remains the second commonest cause of death in children below 5 years, and malnutrition underlies 45% of all child deaths. Even in the absence of diarrhoea, subclinical pathogen carriage and enteropathy are almost universal in developing countries. Here, we review recent studies addressing the causes and consequences of diarrhoea; emerging data on environmental influences that govern postnatal development of the gut and microbiota; current concepts of environmental enteric dysfunction; and recent intervention trials in the field. We highlight the interactions between these processes, whereby intestinal pathogens drive a cycle of gut damage, malabsorption, chronic inflammation and failed mucosal regeneration, leading to malnutrition and susceptibility to further enteric infections.
Summary: Efforts to improve child survival and long-term developmental potential need to address the overlapping and interacting effects of diarrhoea, enteropathy and malnutrition. Recent insights from human and animal studies suggest potential targets for intervention.
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HIV-1 at the placenta: immune correlates of protection and infection
Johnson, Erica L.; Chakraborty, Rana
Abstract
Purpose of review: Mother-to-child transmission (MTCT) of HIV-1 remains a significant global health concern despite implementation of maternal combination antiretroviral therapy for treatment as prevention to offset transmission. The risk of in-utero HIV-1 transmission in the absence of interventions is ∼7%. This low rate of transmission points to innate and adaptive mechanisms to restrict lentiviral infection within the placenta.
Recent findings: Placental macrophages (Hofbauer cells) are key mediators in in-utero transmission of HIV-1. Hofbauer cells constitutively express elevated concentrations of regulatory cytokines, which inhibit HIV-1 replication in vitro, and possess intrinsic antiviral properties. Hofbauer cells sequester HIV-1 in intracellular compartments that can be accessed by HIV-1-specific antibodies and may occur in vivo to offset MTCT. Intriguingly, studies have reported strong associations between maternal human cytomegalovirus (HCMV) viremia and MTCT of HIV-1. HCMV infection at the placenta promotes inflammation, chronic villitis, and trophoblast damage, providing potential HIV-1 access into CD4+CCR5+ target cells. The placenta exhibits a variety of mechanisms to limit HIV-1 replication, yet viral-induced activation with maternal HCMV may override this protection to facilitate in-utero transmission of HIV-1.
Summary: Understanding immune correlates of protection or transmission at the placenta during on-going HIV-1 exposure may contribute to understanding HIV pathogenesis and the development of effective immunotherapies.
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Group B Streptococcus: developing a correlate of protection for a vaccine against neonatal infections
Dangor, Ziyaad; Lala, Sanjay G.; Kwatra, Gaurav; More
Abstract
Purpose of review: Maternal vaccination to prevent invasive Group B Streptococcus (GBS) disease in infants is an important alternative strategy to intrapartum antibiotic prophylaxis. Licensure of GBS vaccines could be expedited using immunological correlates of protection.
Recent findings: Between 2014 and 2015, we identified two studies that demonstrated an inverse association between invasive GBS disease and maternal serotype III capsular antibody levels greater than 1 μg/ml and greater than 3 μg/ml, and higher maternal antibody levels were associated with protection against serotype Ia disease. Furthermore, serotype Ia and III antibody levels greater than 3 μg/ml were associated with a reduced risk of GBS colonization in pregnant women.
Experimental studies have investigated the use of GBS surface proteins as vaccine candidates. Although the immunogenic potential of pilus island and other surface proteins has been shown in animal-model studies, no association between maternal pilus island antibody levels and invasive GBS disease was demonstrated in infants. Additionally, several novel innate immune mediators that prevent GBS infection have been described in human and experimental studies.
Summary: Recent studies suggest that maternal capsular antibody thresholds may be used as immunological correlates of protection for vaccine licensure. Surface proteins, as candidate vaccines or conjugates to the polysaccharide-protein vaccine, may broaden protection against invasive GBS disease.

Globalization and Health
http://www.globalizationandhealth.com/
[Accessed 14 May 2016]
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Research
The use of technology enhanced learning in health research capacity development: lessons from a cross country research partnership
E. Byrne, L. Donaldson, L. Manda-Taylor, R. Brugha, A. Matthews, S. MacDonald, V. Mwapasa, M. Petersen and A. Walsh
Globalization and Health 2016 12:19
Published on: 10 May 2016
Abstract
Background
With the recognition of the need for research capacity strengthening for advancing health and development, this research capacity article explores the use of technology enhanced learning in the delivery of a collaborative postgraduate blended Master’s degree in Malawi. Two research questions are addressed: (i) Can technology enhanced learning be used to develop health research capacity?, and: (ii) How can learning content be designed that is transferrable across different contexts?
Methods
An explanatory sequential mixed methods design was adopted for the evaluation of technology enhanced learning in the Masters programme. A number of online surveys were administered, student participation in online activities monitored and an independent evaluation of the programme conducted.
Results
Remote collaboration and engagement are paramount in the design of a blended learning programme and support was needed for selecting the most appropriate technical tools. Internet access proved problematic despite developing the content around low bandwidth availability and training was required for students and teachers/trainers on the tools used. Varying degrees of engagement with the tools used was recorded, and the support of a learning technologist was needed to navigate through challenges faced.
Conclusion
Capacity can be built in health research through blended learning programmes. In relation to transferability, the support required institutionally for technology enhanced learning needs to be conceptualised differently from support for face-to-face teaching. Additionally, differences in pedagogical approaches and styles between institutions, as well as existing social norms and values around communication, need to be embedded in the content development if the material is to be used beyond the pilot resource-intensive phase of a project.
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Research
Analysis of the corporate political activity of major food industry actors in Fiji
Non-communicable diseases (NCDs) are the leading cause of mortality in Fiji, a middle-income country in the Pacific. Some food products processed sold and marketed by the food industry are major contributors t…
Melissa Mialon, Boyd Swinburn, Jillian Wate, Isimeli Tukana and Gary Sacks
Globalization and Health 2016 12:18
Published on: 10 May 2016
Abstract
Background
Non-communicable diseases (NCDs) are the leading cause of mortality in Fiji, a middle-income country in the Pacific. Some food products processed sold and marketed by the food industry are major contributors to the NCD epidemic, and the food industry is widely identified as having strong economic and political power. However, little research has been undertaken on the attempts by the food industry to influence public health-related policies and programs in its favour. The “corporate political activity” (CPA) of the food industry includes six strategies (information and messaging; financial incentives; constituency building; legal strategies; policy substitution; opposition fragmentation and destabilisation). For this study, we aimed to gain a detailed understanding of the CPA strategies and practices of major food industry actors in Fiji, interpreted through a public health lens.
Methods and results
We implemented a systematic approach to monitor the CPA of the food industry in Fiji for three months. It consisted of document analysis of relevant publicly available information. In parallel, we conducted semi-structured interviews with 10 stakeholders involved in diet- and/or public health-related issues in Fiji. Both components of the study were thematically analysed. We found evidence that the food industry adopted a diverse range of strategies in an attempt to influence public policy in Fiji, with all six CPA strategies identified. Participants identified that there is a substantial risk that the widespread CPA of the food industry could undermine efforts to address NCDs in Fiji.
Conclusions
Despite limited public disclosure of information, such as data related to food industry donations to political parties and lobbying, we were able to identify many CPA practices used by the food industry in Fiji. Greater transparency from the food industry and the government would help strengthen efforts to increase their accountability and support NCD prevention. In other low- and middle-income countries, it is likely that a systematic document analysis approach would also need to be supplemented with key informant interviews to gain insight into this important influence on NCD prevention.

Health Affairs
May 2016; Volume 35, Issue 5
http://content.healthaffairs.org/content/current
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Prescription Drugs, Global Health & More
From The Editor-in-Chief
Prescription Drugs, Global Health, And Population Health
Alan R. Weil
This month’s issue of Health Affairs covers a broad range of topics. We begin with prescription drugs, noting the recent report from IMS Health that drug spending increased by 8.5 percent in 2015.
Prescription Drugs
Unit prices for cancer drugs are higher in the United States than other developed countries. Sebastian Salas-Vega and Elias Mossialos compare the value in lives saved for cancer drug spending in nine countries, including the United States. Assigning a standard value for extended life-years, the authors calculate a $32.6 billion net positive return from cancer drug care in 2014 in the United States—a lower return per dollar spent than in all other countries analyzed. Japan achieved almost seven times the US rate of return.
Anomalies in the US drug market often yield price increases over time after a drug has been released. Caroline Bennette and colleagues set out to understand why. Analyzing data for twenty-four cancer drugs over six …
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Global Health
Improving Health Care Coverage, Equity, And Financial Protection Through A Hybrid System: Malaysia’s Experience
Ravindra P. Rannan-Eliya, Chamara Anuranga, Adilius Manual, Sondi Sararaks, Anis S. Jailani,
Abdul J. Hamid, Izzanie M. Razif, Ee H. Tan, and Ara Darzi
Author Affiliations
1Ravindra P. Rannan-Eliya (raviofficelk@gmail.com) is executive director of the Institute for Health Policy, in Colombo, Sri Lanka.
2Chamara Anuranga is a research associate at the Institute for Health Policy.
3Adilius Manual is a research officer at the Institute for Health Systems Research, National Institutes of Health (NIH), in Selangor, Malaysia.
4Sondi Sararaks is a senior medical officer at the Institute for Health Systems Research, NIH, Malaysia.
5Anis S. Jailani is a research officer at the Institute for Health Systems Research, NIH, Malaysia.
6Abdul J. Hamid is a research officer at the Institute for Health Systems Research, NIH, Malaysia.
7Izzanie M. Razif is a research officer in the National Health Financing Unit of the Ministry of Health, in Putrajaya, Malaysia.
8Ee H. Tan is senior principal assistant director of the Oral Health Division of the Ministry of Health, in Putrajaya.
9Ara Darzi is executive chair of the World Innovation Summit for Health, Qatar Foundation, and director of the Institute of Global Health Innovation, Imperial College London, in the United Kingdom.
Abstract
Malaysia has made substantial progress in providing access to health care for its citizens and has been more successful than many other countries that are better known as models of universal health coverage. Malaysia’s health care coverage and outcomes are now approaching levels achieved by member nations of the Organization for Economic Cooperation and Development. Malaysia’s results are achieved through a mix of public services (funded by general revenues) and parallel private services (predominantly financed by out-of-pocket spending). We examined the distributional aspects of health financing and delivery and assessed financial protection in Malaysia’s hybrid system. We found that this system has been effective for many decades in equalizing health care use and providing protection from financial risk, despite modest government spending. Our results also indicate that a high out-of-pocket share of total financing is not a consistent proxy for financial protection; greater attention is needed to the absolute level of out-of-pocket spending. Malaysia’s hybrid health system presents continuing unresolved policy challenges, but the country’s experience nonetheless provides lessons for other emerging economies that want to expand access to health care despite limited fiscal resources.

Health Policy and Planning
Volume 31 Issue 5 June 2016
http://heapol.oxfordjournals.org/content/current
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Original Articles
The composition of demand for newly launched vaccines: results from the pneumococcal and rotavirus vaccine introductions in Ethiopia and Malawi
B Adam Williams, Teklay Kidane, Geoffrey Chirwa, Neghist Tesfaye, Marta R Prescott, Soleine T Scotney, Moussa Valle, Sintayehu Abebe, Adija Tambuli, Bridget Malewezi, Tahir Mohammed, Emily Kobayashi, Emily Wootton, Renee Wong, Rahima Dosani, Hamsa Subramaniam, Jessica Joseph, Elif Yavuz, Aliza Apple, Yann Le Tallec, and Alice Kang’ethe
Health Policy Plan. (2016) 31 (5): 563-572 doi:10.1093/heapol/czv103
Abstract
Understanding post-launch demand for new vaccines can help countries maximize the benefits of immunization programmes. In particular, low- and middle-income countries (LMICs) should ensure adequate resource planning with regards to stock consumption and service delivery for new vaccines, whereas global suppliers must produce enough vaccines to meet demand. If a country underestimates the number of children seeking vaccination, a stock-out of commodities will create missed opportunities for saving lives. We describe the post-launch demand for the first dose of pneumococcal conjugate vaccine (PCV1) in Ethiopia and Malawi and the first dose of rotavirus vaccine (Rota1) in Malawi, with focus on the new birth cohort and the ‘backlog cohort’, comprised of older children who are still eligible for vaccination at the time of launch. PCV1 and Rota1 uptake were compared with the demand for the first dose of pentavalent vaccine (Penta1), a routine immunization that targets the same age group and immunization schedule. In the first year, the total demand for PCV1 was 37% greater than that of Penta1 in Ethiopia and 59% greater in Malawi. In the first 6 months, the demand of Rota1 was only 5.9% greater than Penta1 demand in Malawi. Over the first three post-introduction months, 70.7% of PCV1 demand in Ethiopia and 71.5% of demand in Malawi came from children in the backlog cohort, whereas only 28.0% of Rota1 demand in Malawi was from the backlog cohort. The composition of demand was impacted by time elapsed since vaccine introduction and age restrictions. Evidence suggests that countries’ plans should account for the impact of backlog demand, especially in the first 3 months post-introduction. LMICs should request for higher stock volumes when compared with routine needs, plan social mobilization activities to reach the backlog cohort and allocate human resources and cold chain capacity to accommodate high demand following vaccine introduction.
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Resource needs and gap analysis in achieving universal access to HIV/AIDS services: a data envelopment analysis of 45 countries
Wu Zeng, Donald S Shepard, Carlos Avila-Figueroa, and Haksoon Ahn
Abstract
Background—To manage the human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) epidemic, international donors have pledged unprecedented commitments for needed services. The Joint United Nations Programme on HIV/AIDS (UNAIDS) projected that low- and middle-income countries needed $25 billion to meet the 2010 HIV/AIDS goal of universal access to AIDS prevention and care, using the resource needs model (RNM).
Methods—Drawing from the results from its sister study, which used a data envelopment analysis (DEA) and a Tobit model to evaluate and adjust the technical efficiency of 61 countries in delivering HIV/AIDS services from 2002 to 2007, this study extended the DEA and developed an approach to estimate resource needs and decompose the performance gap into efficiency gap and resource gap. In the DEA, we considered national HIV/AIDS spending as the input and volume of voluntary counseling and testing (VCT), prevention of mother to child transmission (PMTCT) and antiretroviral treatment (ART) as the outputs. An input-oriented DEA model was constructed to project resource needs in achieving 2010 HIV/AIDS goal for 45 countries using the data in 2006, assuming that all study countries maximized efficiency.
Findings—The DEA approach demonstrated the potential to include efficiency of national HIV/AIDS programmes in resource needs estimation, using macro-level data. Under maximal efficiency, the annual projected resource needs for the 45 countries was $6.3 billion, ∼47% of their UNAIDS estimate of $13.5 billion. Given study countries’ spending of $3.9 billion, improving efficiency could narrow the gap from $9.6 to $2.4 billion. The results suggest that along with continued financial commitment to HIV/AIDS, improving the efficiency of HIV/AIDS programmes would accelerate the pace to reach 2010 HIV/AIDS goals. The DEA approach provides a supplement to the AIDS RNM to inform policy making.

Human Rights Quarterly
Volume 38, Number 2, May 2016
http://muse.jhu.edu/issue/33495
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Articles
The Rights of Man and the Rights of the Man-Made: Corporations and Human Rights
Turkuler Isiksel
ABSTRACT:
The Citizens United and Hobby Lobby decisions of the US Supreme Court stoked the longstanding controversy over the court’s doctrine that corporations are persons entitled to certain constitutional rights on the same basis as citizens. It is less widely noted that, in some fields of international economic law, firms are increasingly considered not just legal persons but bearers of human rights. This article critically examines the incipient arrogation of human rights discourse in the context of international investment arbitration, where the claims of firms are often articulated and adjudicated with language and standards borrowed from human rights law. This development, which the article describes as the dehumanization of human rights, is part of a larger process whereby international economic institutions accord legal recognition and certain protections to private economic actors. The article traces the important implications of business corporations being considered as bearers of human rights for determining the proper scope and purpose of international human rights norms, and for conceptualizing their relationship to constitutional democracy.
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Chronicity and Pseudo Inheritance of Social Exclusion: Differences According to the Poverty of the Family of Origin Among Trash Pickers in León, Nicaragua
José Juan Vázquez, Sonia Panadero
ABSTRACT:
People living in extreme poverty or social exclusion mainly come from poor families, and their social difficulties tend to become chronic. This situation appears to be especially pronounced in countries with lower levels of development. This article analyzes different aspects of people (n = 99) who make their living collecting trash from dumps in León, Nicaragua, one of the countries with the lowest levels of development in Latin America. This group is difficult to access, heavily stigmatized, lives in chronic and extreme poverty and their families were also poor. The results show that the pickers in León whose families were poorest had the highest illiteracy rates, were poorest in health, had experienced more stressful life events, and had poorer future expectations. Negative health and life circumstances, low levels of education, and fatalism may lead to the pickers’ situations of social exclusion becoming chronic.
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Nepali Widows’ Access to Legal Entitlements: A Human Rights Issue
Pamela G. Poon, Kiely Houston, Abina Shrestha, Rajin Rayamajhi, Lily Thapa, Pamela J. Surkan
Abstract
Despite legal reforms, Nepali widows face barriers in exercising their property rights. This article provides a qualitative perspective on Nepali widows’ understanding of their rights and their ability to pursue legal entitlements due to widowhood. In-depth interviews and focus groups were conducted with seventy-six Nepali widows, four paralegals, and three key informants. They demonstrate that widows have limited success in exercising their property rights and seeking government benefits primarily because of a dominant patriarchal society, familial traditions, and bureaucratic restrictions. Nepali widows’ continued denial of property constitutes a human rights violation that Nepal’s new government should seek to redress.
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Forced Marriage, Slavery, and Plural Legal Systems: An African Example
Jody Sarich, Michele Olivier, Kevin Bales
Abstract
Slavery, long abolished under international law, left a devastating imprint on Africa. However, enslavement of women through forced marriages remains a common phenomenon in many African states. These African states share the common feature of legal pluralism where traditional legal systems continue to be observed alongside national laws in which slavery is outlawed. Where traditional practices condone the marriage of underage girls who are legally unable to consent, the questioning of age-old accepted forms of marriage can generate strong reactions. This article traces the position of forced and child marriages in international law, and investigates how legality becomes a moveable target when legal systems exist in parallel. Despite international and African Union conventions on slavery and human rights declaring that marriages not based on the full and free consent of both parties are considered a violation of human rights and a form of slavery, these practices persist. These instruments are assessed to gauge the level of conformity (or variance) of African state practice where forced marriages commonly occur. Importantly, the reasons behind noncompliance and the impact of legal pluralism are explored in African states where forced marriages commonly occur.

Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 12, Issue 4, 2016
http://www.tandfonline.com/toc/khvi20/current
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Reviews
Vaccines in pregnancy: The dual benefit for pregnant women and infants
pages 848-856
H. Marshall, M. McMillan, R. M. Andrews, K. Macartney & K. Edwards
ABSTRACT
Maternal immunization has the potential to reduce the burden of infectious diseases in the pregnant woman and her infant. Many countries now recommend immunization against influenza at any stage of pregnancy and against pertussis in the third trimester. Despite evidence of the safety and effectiveness of these vaccines when administered during pregnancy, uptake generally remains low for influenza and moderate for pertussis vaccine. Enhancing confidence in both immunization providers and pregnant women by increasing the evidence-base for the safety and effectiveness of vaccines during pregnancy, improving communication and access by incorporating immunization into standard models of antenatal care are likely to improve uptake. Developing a framework for implementation of vaccines for pregnant women which is cognizant of local and national cultural, epidemiological, behavioral and societal factors will enable a smooth transition and high uptake for new vaccines currently in development for pregnant women.
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Reviews
Improving rates of maternal immunization: Challenges and opportunities
pages 857-865
Donna M. MacDougall & Scott A. Halperin
ABSTRACT
Objectives: An increasing number of vaccines are recommended or are being developed for use during pregnancy to protect women, fetuses, and/or newborns. For vaccines that are already recommended, vaccine uptake is variable and well below desired target. We reviewed the literature related to factors that affect a healthcare provider’s recommendation and a woman’s willingness to be vaccinated during pregnancy. Design: A scoping review of published literature from 2005 to 2015 was undertaken and all relevant articles were abstracted, summarized, and organized thematically. Results: Barriers and facilitators were identified that either decreased or increased the likelihood of a healthcare provider offering and a pregnant woman accepting vaccination during pregnancy. Concern about the safety of vaccines given during pregnancy was the most often cited barrier among both the public and healthcare providers. Other barriers included doubt about the effectiveness of the vaccine, lack of knowledge about the burden of disease, and not feeling oneself to be at risk of the infection. Major facilitators for maternal immunization included specific safety information about the vaccine in pregnant women, strong national recommendations, and healthcare providers who both recommended and provided the vaccine to their patients. Systems barriers such as inadequate facilities and staffing, vaccine purchase and storage, and reimbursement for vaccination were also cited. Evidence-based interventions were few, and included text messaging reminders, chart reminders, and standing orders. Conclusions: In order to have an effective vaccination program, improvements in the uptake of recommended vaccines during pregnancy are needed. A maternal immunization platform is required that normalizes vaccination practice among obstetrical care providers and is supported by basic and continuing education, communication strategy, and a broad range of research.
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Review
Current status of new tuberculosis vaccine in children
DOI:10.1080/21645515.2015.1120393
Yu Pangab#, Aihua Zhaoc#, Chad Cohend, Wanli Kanga, Jie Lue, Guozhi Wangc, Yanlin Zhaob & Suhua Zhenga*
pages 960-970
ABSTRACT
Pediatric tuberculosis contributes significantly to the burden of TB disease worldwide. In order to achieve the goal of eliminating TB by 2050, an effective TB vaccine is urgently needed to prevent TB transmission in children. BCG vaccination can protect children from the severe types of TB such as TB meningitis and miliary TB, while its efficacy against pediatric pulmonary TB ranged from no protection to very high protection. In recent decades, multiple new vaccine candidates have been developed, and shown encouraging safety and immunogenicity in the preclinical experiments. However, the limited data on protective efficacy in infants evaluated by clinical trials has been disappointing, an example being MVA85A. To date, no vaccine has been shown to be clinically safer and more effective than the presently licensed BCG vaccine. Hence, before a new vaccine is developed with more promising efficacy, we must reconsider how to better use the current BCG vaccine to maximize its effectiveness in children.

Infectious Diseases of Poverty
http://www.idpjournal.com/content
[Accessed 14 May 2016]

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Research Article
Prevalence of chronic infections and susceptibility to measles and varicella-zoster virus in Latin American immigrants
Yves Jackson, Lilian Santos, Isabelle Arm-Vernez, Anne Mauris, Hans Wolff, François Chappuis and Laurent Getaz
Published on: 11 May 2016
Abstract
Background
Large numbers of Latin American immigrants recently arrived in Western Europe. Curative and preventive programmes need to take account of their risk of suffering and transmitting imported chronic infections and of their susceptibility to cosmopolitan infections. We aimed to assess the prevalence and co-occurrence of imported chronic infections among Latin American immigrants, and their susceptibility to highly prevalent cosmopolitan infections.
Methods
Adult participants were recruited in the community and in a primary health centre in Geneva in 2008. Serological tests were performed on stored sera for HIV, HBV, syphilis, Strongyloides stercoralis, Trypanosoma cruzi, varicella and measles. We considered only chronic active infections in the analysis.
Results and discussion
The 1 012 participants, aged 37.2 (SD 11.3) years, were mostly female (82.5 %) and Bolivians (48 %). Overall, 209 (20.7 %) had at least one and 27 (2.7 %) two or more chronic infections. T. cruzi (12.8 %) and S. stercoralis (8.4 %) were the most prevalent chronic active infections compared to syphilis (0.4 %), HBV (0.4 %) and HIV (1.4 %). Concomitant infections affected 28.2 and 18.5 % of T. cruzi and S. stercoralis infected cases. Bolivian origin (aOR: 13.6; 95 % CI: 3.2–57.9) was associated with risk of multiple infections. Susceptibilities for VZV and measles were 0.7 and 1.4 %, respectively. Latin American immigrants are at risk of complications and possible reactivation of chronic parasitic infections but have overall low risks of chronic viral and syphilitic active infections.
Conclusions
Systematic screening for chronic active parasitic infections is therefore necessary especially among Bolivians. The high protection rate against measles and VZV doesn’t require specific preventive interventions.

International Health
Volume 8 Issue 3 May 2016
http://inthealth.oxfordjournals.org/content/current

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EDITORIAL
Africa in transition: the case of malaria
Kevin Marsh
Extract
Int. Health (2016) 8 (3): 155-156 doi:10.1093/inthealth/ihw022
In 2000, the Economist carried an infamous cover describing Africa as ‘the hopeless continent’. In 2013 this was replaced with one designating Africa ‘the hopeful continent’. The idea of ‘Africa rising’ is in the air and although this is a hotly debated area, no one doubts that Africa is in a period of dramatic transition. Most African economies are growing at around 5% per annum; the current GDP of Africa of around $2.4 trillion is expected to rise more than tenfold by 2050, when its population is predicted to be above 2 billion, with 60% living in urban areas. These changes will be paralleled by equally dramatic changes in health, a process which is already well underway. Much has been written about the dual challenges of persisting infectious diseases at the same time as an increasing burden of non-communicable diseases. Tackling these challenges will call for a major investment in research and here there are exciting transitions too. The launch by the African Academy of Sciences (ASS), in-partnership with NEPAD and a group of international partners, of the Alliance for Accelerating Excellence in Science in Africa (AESA) (http://aasciences.ac.ke/programmes/easa/alliance-for-accelerating-excellence-in-science-in-africa-aesa/) marks a genuine shift in the centre of gravity for health research in Africa. One particularly welcome manifestation of this …

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Commentaries
Collecting data on violence against children and young people: need for a universal standard
Karen M. Devriesa,*, Dipak Nakerb, Adrienne Monteath-van Dokc, Claire Milligand and Alice Shirleyd
Author Affiliations
aLondon School of Hygiene and Tropical Medicine, 15–17 Tavistock Place, WC1H 9SH, UK
bRaising Voices, 16 Tufnell Drive, Kamwokya P. O. Box 6770, Kampala, Uganda
cPlan International, Dukes Court, Block A, Duke Street, Woking, Surrey GU21 5BH, UK
dSave the Children, St John’s Lane, London, EC1 M 4AR, UK
*Corresponding author: E-mail: karen.devries@lshtm.ac.uk
Abstract
Preventing and responding to violence against children is an aim of the new Sustainable Development Goals. Numerous agencies are now collecting data from children about violence, including academics, non-governmental organisations, government agencies, consultants and others. Data are necessary to ensure appropriate prevention and response, but there is a real risk of harm to children if ethical standards are not adhered to. There are additional complexities in settings where child protection systems are not well developed. We propose specific suggestions for good practice, based on our past experience and policies, and call for all agencies to adhere to high ethical standards.
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Original Articles
Ethical challenges in research with orphans and vulnerable children: a qualitative study of researcher experiences
Int. Health (2016) 8 (3): 187-196 doi:10.1093/inthealth/ihw020
Maureen C. Kelley, Tracy Brazg, Benjamin S. Wilfond, Liliana J. Lengua, Beth E. Rivin, Susanne P. Martin-Herz, and Douglas S. Diekema
Corresponding author: Present address: The Ethox Centre, Nuffield Department of Population Health, University of Oxford, Old Road Campus – Roosevelt Drive, Oxford OX3 7LF; Tel: +44 186 561 7805; E-mail: maureen.kelley@ethox.ox.ac.uk
Abstract
Background Orphans and vulnerable children (OVCs) represent a significant population worldwide, enduring poor health and living conditions. Evidence-based interventions are needed. However, without parents, ethical concerns about including OVCs in research persist. The aim of our study was to better understand the ethical challenges facing researchers who work with OVCs.
Methods We conducted semi-structured interviews with 12 international pediatric researchers working with OVCs in seven countries. We used descriptive content analysis to characterize the ethical rationale for inclusion and associated challenges.
Results Researchers believed research was justified as a necessary means for informing evidence-based interventions to benefit OVCs directly or as a population. Ethical challenges included difficulty identifying OVCs given variation among children living without parents; difficulty identifying guardians among a range of caregivers; concerns about meaningfulness of guardian consent; difficulty assessing risk; and responding to children’s many needs.
Conclusions A range of caregivers bear responsibility to protect OVC’s interests in place of parents in research but are often not prepared to do so. This places greater burden on researchers to assess risks and respond to children’s needs. Findings suggest that we should improve support and rethink the roles of guardians, researchers and older children in research participation and protection.

International Journal of Infectious Diseases
May 2016 Volume 46, p1-126
http://www.ijidonline.com/current

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Original Reports
Taking forward the World TB Day 2016 theme ‘Unite to End Tuberculosis’ for the WHO Africa Region
Francine Ntoumi, Pontiano Kaleebu, Eusebio Macete, Sayoki Mfinanga, Jeremiah Chakaya, Dorothy Yeboah-Manu, Matthew Bates, Peter Mwaba, Markus Maeurer, Eskild Petersen, Alimuddin Zumla
p34–37
Published online: March 8 2016
Preview
Tuberculosis (TB) has remained a global emergency ever since it was declared as such by the World Health Organization (WHO) in 1993.1 The theme designated for this year’s World TB Day, March 24, 2016, is ‘Unite to End TB’.2 World TB Day is held to commemorate the day in 1882 when Professor Robert Koch announced his ground-breaking discovery of the cause of TB, the bacillus Mycobacterium tuberculosis.3 At the time of Koch’s announcement in Berlin, TB was widespread and rampaging through Europe and the Americas, causing the death of one out of every seven people.

JAMA
May 10, 2016, Vol 315, No. 18
http://jama.jamanetwork.com/issue.aspx

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Viewpoint
The Emerging Zika Virus Epidemic in the Americas: Research Priorities FREE
Helen M. Lazear, PhD; Elizabeth M. Stringer, MD; Aravinda M. de Silva, PhD
Excerpt
…CONCLUSIONS
The size of the current ZIKV epidemic, its potential for further spread, and the potential teratogenic effects of this virus require development of ZIKV-specific diagnostic agents and a better understanding of pathogenic mechanisms. The association between ZIKV infection and microcephaly has been the cause of much alarm and has been the driving force behind a substantial public health response and a drive to develop vaccines and antivirals to combat ZIKV infection.
Zika virus represents just the most recent example of an epidemic of vector-borne disease brought about by the introduction of a virus to a new host population and ecological landscape. Although current research priorities must focus on the immediate need to develop specific diagnostic tools and understand the teratogenic potential of ZIKV, public health efforts to address the current epidemic must be informed by experience with previous outbreaks of viruses transmitted by Aedes mosquitoes.

JAMA Pediatrics
May 2016, Vol 170, No. 5
http://archpedi.jamanetwork.com/issue.aspx
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Editorial
Adolescent and Young Adult Health
The Pertussis Problem and a Possible Solution: Will Parents Go Along?
Mark H. Sawyer, MD
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Adolescent and Young Adult Health
Human Papillomavirus Vaccination and Cervical Cytology Outcomes Among Urban Low-Income Minority Females
Annika M. Hofstetter, MD, PhD, MPH; Danielle C. Ompad, PhD; Melissa S. Stockwell, MD, MPH; Susan L. Rosenthal, PhD; Karen Soren, MD
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Adolescent and Young Adult Health
Impact of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccinations on Reported Pertussis Cases Among Those 11 to 18 Years of Age in an Era of Waning Pertussis Immunity: A Follow-up Analysis
Tami H. Skoff, MS; Stacey W. Martin, MSc
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Epidemiological and Economic Effects of Priming With the Whole-Cell Bordetella pertussis Vaccine
Haedi DeAngelis, MA; Samuel V. Scarpino, PhD; Meagan C. Fitzpatrick, PhD; Alison P. Galvani, PhD; Benjamin M. Althouse, PhD, ScM
Includes: Supplemental Content

Journal of Epidemiology & Community Health
June 2016, Volume 70, Issue 6
http://jech.bmj.com/content/current

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Essay
Birth control policies in Iran: a public health and ethics perspective
Mehdi Aloosh1, Yashar Saghai2
Author Affiliations
1McGill University Health Centre, Montreal, Quebec, Canada
2Berman Institute of Bioethics, Johns Hopkins University, Baltimore, USA
Correspondence to Dr Mehdi Aloosh, McGill University, McGill University Health Centre, Montreal, Quebec, H4A 3J1, Canada; mehdi.aloosh@mail.mcgill.ca
Abstract
In less than one generation, a unique demographic transition has taken place in Iran. A population growth rate of 4.06% in 1984 fell to 1.15% in 1993 and a total fertility rate of 6.4 births per woman in 1984 declined to 1.9 in 2010. In 2012, Iranian policymakers shifted away from a birth control policy towards a pro-natalist policy. At first glance, this may seem reasonable since its goal is to avoid the consequences of an aging population. However, we argue that the policy package raises serious public health, socioeconomic, environmental and ethical concerns and is likely to fail on its own terms.

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The influence of refugee status and secondary migration on preterm birth
Susitha Wanigaratne1,2, Donald C Cole3, Kate Bassil3, Ilene Hyman3, Rahim Moineddin4,
Marcelo L Urquia1,2,3
Author Affiliations
1Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
2Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
3Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
4Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
Correspondence to Dr Marcelo L Urquia, St. Michael’s Hospital, 30 Bond St., Toronto, ON M5B 1W8, Canada; marcelo.urquia@utoronto.ca
Abstract
Background It is unknown whether the risk of preterm birth (PTB) is elevated for forced (refugee) international migrants and whether prolonged displacement amplifies risk. While voluntary migrants who arrive from a country other than their country of birth (ie, secondary migrants) have favourable birth outcomes compared with those who migrated directly from their country of birth (ie, primary migrants), secondary migration may be detrimental for refugees who experience distinct challenges in transition countries. Our objectives were (1) to determine whether refugee status was associated with PTB and (2) whether the relation between refugee status and PTB differed between secondary and primary migrants.
Methods We conducted a retrospective population-based cohort study. Ontario immigration (2002–2010) and hospitalisation data (2002–2010) were linked to estimate adjusted cumulative odds ratios (ACOR) of PTB (22–31, 32–36, 37–41 weeks of gestation), with 95% CIs (95% CI) comparing refugees with non-refugees. We further included a product term between refugee status and secondary migration.
Results Overall, refugees (N=12 913) had 17% greater cumulative odds of short gestation (ACOR=1.17, 95% CI 1.07 to 1.28) compared with non-refugees (N=110 640). Secondary migration modified the association between refugee status and PTB (p=0.007). Secondary refugees had 58% greater cumulative odds of short gestation (ACOR=1.58, 95% CI 1.25 to 2.00) than secondary non-refugees, while primary refugees had 12% greater cumulative odds of short gestation (ACOR=1.12, 95% CI 1.02 to 1.23) than primary non-refugee immigrants.
Conclusions Refugee status, jointly with secondary migration, influences PTB among migrants.

Journal of Pediatrics
May 2016 Volume 172, p1-236
http://www.jpeds.com/current

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Editor’s Persepctive
Lest we forget — the battle against malnutrition
Carlos A. Cuello-Garcia
p1–4
Published in issue: May 2016
Preview
We are now living in an era of postmillennium development goals and, although a significant number of them have been completed, a significant proportion of targets remain to be accomplished. Malnutrition is still a concern that affects millions worldwide. In this issue of The Journal, Chowdhury et al present a large scale population-based survey in Bangladesh, extracted from the Bangladesh Demographic Health Survey (2011). This could be considered a large and representative sample of a region where prevention of malnutrition is (and it should be kept as) a priority as a public health intervention.

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Original Articles
Risk Factors for Child Malnutrition in Bangladesh: A Multilevel Analysis of a Nationwide Population-Based Survey
Mohammad Rocky Khan Chowdhury, Mohammad Shafiur Rahman, Mohammad Mubarak Hossain Khan, Mohammad Nazrul Islam Mondal, Mohammad Mosiur Rahman, Baki Billah
p194–201.e1

The Lancet
May 14, 2016 Volume 387 Number 10032 p1969-2062
http://www.thelancet.com/journals/lancet/issue/current

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Viewpoint
Moving ahead: what will a renewed Countdown to 2030 for Women and Children look like?
Prof Zulfiqar A Bhutta, PhD, Mickey Chopra, MD
Published Online: 15 October 2015
Summary
The Countdown to 2015 initiative (Countdown) represents a remarkable consortium of academicians, UN agencies, and development partners, which over the past decade, has focused its attention on tracking and analysing coverage of key interventions for reproductive, maternal, newborn, and child health (RMNCH) across 75 high burden countries that account for more than 95% of global maternal and child deaths. Initially started to ensure follow-up on the landmark Lancet Child Survival series,1,2 with innovative consolidation and presentation of coverage data on key interventions by country and regions,3 Countdown rapidly evolved with an expansion of its mandate to include reproductive and maternal health indicators across the continuum of care4 and more recently, analysis of nutrition trends and health policies.