IKEA Foundation [to 26 March 2016]
https://www.ikeafoundation.org/category/press-releases/

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March 22, 2016
IKEA Foundation announces new grant to Water.org on World Water Day
IKEA Foundation today, World Water Day, announced a new grant to Water.org to expand efforts to provide safe water and sanitation to one million people in India and Indonesia. IKEA Foundation is committing €12.4 million to Water.org to expand its WaterCredit model, helping families have access to small, affordable loans so they can get safe water and sanitation…

MacArthur Foundation [to 26 March 2016]
http://www.macfound.org/

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March 25, 2016
Report Says Dirty Bomb Threat Must Be Addressed
Most of the 23 countries that pledged at the 2014 Nuclear Security Summit to secure radiological materials have fulfilled that commitment or are on track to do so by the end of 2016, according to report by the MacArthur-supported Nuclear Threat Initiative. However, the report finds significant gaps in the system for securing dangerous radiological materials from theft. It recommends that governments and the private sector work together to develop a more effective system for securing radiological sources, and replace the use of dangerous isotopes with alternate technologies, where feasible.

Gordon and Betty Moore Foundation [to 26 March 2016]
https://www.moore.org/newsroom/press-releases

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March 24, 2016
More than $90 Million Awarded to Promote Sustainable Supply Chains
PALO ALTO, – The Gordon and Betty Moore Foundation, one of the world’s largest conservation funders, announced more than $90 million in grants designed to advance conservation by decoupling food production from negative environmental impacts.

The grant funds will support the formation of a series of collaborations supporting the Moore Foundation’s Forests and Agriculture Markets Initiative, Conservation and Financial Markets Initiative, and Oceans and Seafood Markets Initiative. Collaborators will include Ceres, FishWise, Monterey Bay Aquarium Seafood Watch, National Wildlife Federation, New Venture Fund, Sustainable Fisheries Partnership, The Nature Conservancy, World Business Council for Sustainable Development and World Wildlife Fund. Their involvement illustrates the growing importance of partnerships between the non-profit and private sectors to address the market pressures placed on the world’s forests and oceans.

“The anticipated global population growth and related demand for richer diets, including more protein, sugars and oils, will place unprecedented pressures on our natural resources,” said Aileen Lee, program director for the conservation and markets strategies and incoming chief program officer for environmental conservation at the Gordon and Betty Moore Foundation. “Now more than ever, the need to produce food without causing severe environmental degradation is essential to maintaining the productive capacity and integrity of the Earth’s ecosystems.”…

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Moore Foundation commits $100 million to consolidate Andes Amazon Initiative conservation gains
PALO ALTO, March 21, 2016 – The Gordon and Betty Moore Foundation, one of the world’s largest private conservation funders, announced a renewed commitment to its Andes Amazon Initiative with a new pledge of $100 million through 2020.

Today, the protected areas and indigenous lands in the Amazon basin cover nearly 400 million hectares – almost two thirds of the remaining forest. Since the Moore Foundation first began supporting conservation efforts in the region in 2001—with an aim to help secure the biodiversity and climate function of the Amazon basin—the area legally protected has nearly doubled. While this increase is significant, formal designation often does not ensure that effective conservation of those lands will be achieved in the long run.

“Over fifteen years, our grantees have helped conserve more than 140 million hectares in the Amazon,” explained Avecita Chicchón, Ph.D., Andes Amazon Initiative director at the foundation. “We are proud of their significant impacts in protecting forest cover and biodiversity. Threats to those lands have intensified, however, with increased and unsustainable logging, cattle ranching and soy farming, and poorly planned mining, hydrocarbon and infrastructure development. We want to help make sure that local communities and the management and finance structures for conservation units have the resilience and long-term resources they need so conservation gains can withstand current and foreseeable pressures.”

For the next five years, the Gordon and Betty Moore Foundation’s Andes Amazon Initiative will continue its focus on three priority strategies to help reinforce and advance effective management of protected areas and indigenous lands across Brazil, Peru, Colombia, Ecuador and Bolivia that grantees have helped conserve:
:: Individual conservation units. Creating and consolidating already existing individual indigenous lands and protected areas.

:: Land-use planning. Conserving forest cover by incorporating protected areas and indigenous lands into relevant state, municipal or district jurisdictional development and land-use plans.

:: Protected area systems. Securing long-term, effective funding mechanisms for national park systems, as well as effective monitoring and management systems informed through participatory processes…

Open Society Foundation [to 26 March 2016]
https://www.opensocietyfoundations.org/issues/media-information

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March 24, 2016
Journalists in Pakistan Unite to Fight Violence Against Media
by Owais Aslam Ali
In a country where violence against media is common, an initiative is creating a united front—and a sense that an attack on one media outlet is an attack on them all….
…Launched in December 2015, the Editors for Safety (EfS) initiative has improved news coverage of violence against Pakistani media professionals. Comprised of the country’s leading editors, publishers, and media owners, EfS’s philosophy is that an attack on one media professional or organization should be considered an attack on the entire Pakistani media…

Pew Charitable Trusts [to 26 March 2016]
http://www.pewtrusts.org/en/about/news-room/press-releases

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March 22, 2016
Pew Announces Grants to Support Philadelphia’s Low-Income Children and Families
Funding to assist more than 22,000 children annually through 45 local organizations
Press Release
The Pew Charitable Trusts announced today that it will provide $8,728,000 over the next three years to 46 Philadelphia-area organizations that work to improve the lives of the region’s low-income children, youth, and their families. More than 22,000 local young people will be assisted through these grants on an annual basis

Wellcome Trust [to 26 March 2016]
http://www.wellcome.ac.uk/News/2016/index.htm

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24 March 2016
Immunotherapy for diabetes being trialled in London
A new treatment for Type 1 diabetes is being evaluated in a phase I clinical trial at Guy’s Hospital in London. Developed with Wellcome Trust Innovations funding, the new therapy, called MultiPepT1De, targets the autoimmune attack that leads to the development of the condition.

Exploration of dementia announced as second project of The Hub at Wellcome Collection
A group exploring dementia and the arts have been invited to take up the 2016-2018 residency in The Hub at Wellcome Collection, a flagship space and resource for interdisciplinary projects exploring health and wellbeing. Bringing together a rich network including scientists, artists, clinicians, public health experts and broadcasters, the group will examine and challenge perceptions of dementia through scientific and creative experimentation. They have been awarded £1 million to develop the project over two years.
24 March 2016

26 Zika projects receive £3.2m funding boost
Research into the link between Zika virus infection and neurological disease, an online data-sharing platform for images of newborn heads and improved diagnostic tests are among 26 new projects to receive funding through the Zika Rapid Response initiative.
21 March 2016

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 26 March 2016)
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Research article
Characterization of outbreak response strategies and potential vaccine stockpile needs for the polio endgame
Radboud J. Duintjer Tebbens, Mark A. Pallansch, Steven G. F. Wassilak, Stephen L. Cochi and Kimberly M. Thompson
BMC Infectious Diseases 2016 16:137
Published on: 24 March 2016
Abstract
Background
Following successful eradication of wild polioviruses and planned globally-coordinated cessation of oral poliovirus vaccine (OPV), national and global health leaders may need to respond to outbreaks from reintroduced live polioviruses, particularly vaccine-derived polioviruses (VDPVs). Preparing outbreak response plans and assessing potential vaccine needs from an emergency stockpile require consideration of the different national risks and conditions as they change with time after OPV cessation.
Methods
We used an integrated global model to consider several key issues related to managing poliovirus risks and outbreak response, including the time interval during which monovalent OPV (mOPV) can be safely used following homotypic OPV cessation; the timing, quality, and quantity of rounds required to stop transmission; vaccine stockpile needs; and the impacts of vaccine choices and surveillance quality. We compare the base case scenario that assumes aggressive outbreak response and sufficient mOPV available from the stockpile for all outbreaks that occur in the model, with various scenarios that change the outbreak response strategies.
Results
Outbreak response after OPV cessation will require careful management, with some circumstances expected to require more and/or higher quality rounds to stop transmission than others. For outbreaks involving serotype 2, using trivalent OPV instead of mOPV2 following cessation of OPV serotype 2 but before cessation of OPV serotypes 1 and 3 would represent a good option if logistically feasible. Using mOPV for outbreak response can start new outbreaks if exported outside the outbreak population into populations with decreasing population immunity to transmission after OPV cessation, but failure to contain outbreaks resulting in exportation of the outbreak poliovirus may represent a greater risk. The possibility of mOPV use generating new long-term poliovirus excretors represents a real concern. Using the base case outbreak response assumptions, we expect over 25 % probability of a shortage of stockpiled filled mOPV vaccine, which could jeopardize the achievement of global polio eradication. For the long term, responding to any poliovirus reintroductions may require a global IPV stockpile. Despite the risks, our model suggests that good risk management and response strategies can successfully control most potential outbreaks after OPV cessation.
Conclusions
Health leaders should carefully consider the numerous outbreak response choices that affect the probability of successfully managing poliovirus risks after OPV cessation.

BMC Infectious Diseases
http://www.biomedcentral.com/bmcinfectdis/content
(Accessed 26 March 2016)
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Debate
End TB strategy: the need to reduce risk inequalities
M. Gabriela M. Gomes, Maurício L. Barreto, Philippe Glaziou, Graham F. Medley, Laura C. Rodrigues, Jacco Wallinga and S. Bertel Squire
BMC Infectious Diseases 2016 16:132
Published on: 22 March 2016
Abstract
Background
Diseases occur in populations whose individuals differ in essential characteristics, such as exposure to the causative agent, susceptibility given exposure, and infectiousness upon infection in the case of infectious diseases.
Discussion
Concepts developed in demography more than 30 years ago assert that variability between individuals affects substantially the estimation of overall population risk from disease incidence data. Methods that ignore individual heterogeneity tend to underestimate overall risk and lead to overoptimistic expectations for control. Concerned that this phenomenon is frequently overlooked in epidemiology, here we feature its significance for interpreting global data on human tuberculosis and predicting the impact of control measures.
Summary
We show that population-wide interventions have the greatest impact in populations where all individuals face an equal risk. Lowering variability in risk has great potential to increase the impact of interventions. Reducing inequality, therefore, empowers health interventions, which in turn improves health, further reducing inequality, in a virtuous circle.

BMC Medicine
http://www.biomedcentral.com/bmcmed/content
(Accessed 26 March 2016)

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World TB Day 2016 – Article Collection
In recognition of World TB Day 2016, BMC Medicine and BMC Infectious Diseases have launched an article collection. In collaboration with the UCL-TB Centre and the LSHTM TB Centre, guest edited by Ibrahim Abubakar, Helen Fletcher, Marc Lipman and Tim McHugh. The collection includes articles addressing the most up-to-date evidence and innovation in the diagnosis, management and prevention of TB, as well as particular challenges affecting vulnerable populations.

BMC Pregnancy and Childbirth
http://www.biomedcentral.com/bmcpregnancychildbirth/content
(Accessed 26 March 2016)

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Call for papers: The Role of Structural and Interpersonal Violence in the Lives of Women
BMC Pregnancy and Childbirth is currently accepting submissions to a thematic series entitled ‘The Role of Structural and Interpersonal Violence in the Lives of Women’.

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Research article
Towards universal access to skilled birth attendance: the process of transforming the role of traditional birth attendants in Rural China
Institution-based childbirth, with the ultimate goal of universal access to skilled birth attendance (SBA), has been selected as a key strategy to reduce the maternal mortality rate in many developing countries…
Hong Jiang, Xu Qian, Lili Chen, Jian Li, Erin Escobar, Mary Story and Shenglan Tang
BMC Pregnancy and Childbirth 2016 16:58
Published on: 21 March 2016

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 26 March 2016)

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Research article
Fish, food security and health in Pacific Island countries and territories: a systematic literature review
Pacific Island countries and territories (PICTs) face a double burden of disease, with a high prevalence of household food insecurity and childhood micronutrient deficiencies, accompanied by a burgeoning incre…
Karen E. Charlton, Joanna Russell, Emma Gorman, Quentin Hanich, Aurélie Delisle, Brooke Campbell and Johann Bell
BMC Public Health 2016 16:285
Published on: 24 March 2016

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Research article
The role of micro health insurance in providing financial risk protection in developing countries- a systematic review
Out of pocket payments are the predominant method of financing healthcare in many developing countries, which can result in impoverishment and financial catastrophe for those affected.
Shifa Salman Habib, Shagufta Perveen and Hussain Maqbool Ahmed Khuwaja
BMC Public Health 2016 16:281
Published on: 22 March 2016

Conflict and Health
http://www.conflictandhealth.com/
[Accessed 26 March 2016]

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Debate
Why don’t humanitarian organizations provide safe abortion services?
Therese McGinn and Sara E. Casey
Published on: 24 March 2016
Abstract
Background
Although sexual and reproductive health services have become more available in humanitarian settings over the last decade, safe abortion services are still rarely provided. The authors’ observations suggest that four reasons are typically given for this gap: ‘There’s no need’; ‘Abortion is too complicated to provide in crises’; ‘Donors don’t fund abortion services’; and ‘Abortion is illegal’.
Discussion
However, each of these reasons is based on false premises. Unsafe abortion is a major cause of maternal mortality globally, and the collapse of health systems in crises suggests it likely increases in humanitarian settings. Abortion procedures can be safely performed in health centers by mid-level providers without sophisticated equipment or supplies. Although US government aid does not fund abortion-related activities, other donors, including many European governments, do fund abortion services. In most countries, covering 99 % of the world’s population, abortion is permitted under some circumstances; it is illegal without exception in only six countries. International law supports improved access to safe abortion.
Summary
As none of the reasons often cited for not providing these services is valid, it is the responsibility of humanitarian NGOs to decide where they stand regarding their commitment to humanitarian standards and women’s right to high quality and non-discriminatory health services. Providing safe abortion to women who become pregnant as a result of rape in war may be a more comfortable place for organizations to begin the discussion. Making safe abortion available will improve women’s health and human rights and save lives.

Ethics & International Affairs
Spring 2016 (Issue 30.1) | March 10, 2016
http://www.ethicsandinternationalaffairs.org/2016/spring-2016-issue-30-1/

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Essay
Defining Down Sovereignty: The Rights and Responsibilities of Nations
Amitai Etzioni | March 10, 2016
[Initial text]
“Defining down sovereignty” refers to the normative thesis that sovereignty should not grant a state absolute protection against armed intervention in its internal affairs by other states, and that instead the international community should condition such immunity on states living up to particular standards. This essay suggests two modifications to this thesis. First, the international community should spell out the kinds of failures to protect civilians that can justify armed interventions by other states, as well as which agency has the authority to determine when such failures have occurred. In other words, the international community should determine how low to set the bar for intervention, and who makes the rules. Second, the international community needs to establish an additional international responsibility, namely, a responsibility to prevent international terrorism. The essay treats both of these modifications as shared international normative understandings; it does not attempt to translate these changes into international law…

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FEATURES
Democracies and the Power to Revoke Citizenship
Patti Tamara Lenard
[Initial text]
Citizenship status is meant to be secure, that is, inviolable. Recently, however, several democratic states have adopted or are considering adopting laws that allow them the power to revoke citizenship. This claimed right forces us to consider whether citizenship can be treated as a “conditional” status, in particular whether it can be treated as conditional on the right sort of behavior. Those who defend such a view argue that citizenship is a privilege rather than a right, and thus in principle is revocable. Participating in a foreign state’s military, treason, spying, or committing acts that otherwise threaten the national security of one’s state may all warrant revocation. This article assesses the justifications given for the claimed power to revoke citizenship in democratic states and concludes that, ultimately, such a power is incompatible with democracy…

The European Journal of Public Health
Volume 26, Issue 2, 1 April 2016
http://eurpub.oxfordjournals.org/content/26/2?current-issue=y

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Viewpoint
A Global Charter for the Public’s Health—the public health system: role, functions, competencies and education requirements*
M. Lomazzi
DOI: http://dx.doi.org/10.1093/eurpub/ckw011 210-212 First published online: 8 March 2016
Introduction
Growth, development, equity and stability
Political leaders increasingly perceive health as being crucial to achieving growth, development, equity and stability throughout the world. Health is now understood as a product of complex and dynamic relations generated by numerous determinants at different levels of governance. Governments need to take into account the impact of social, environmental and behavioural health determinants, including economic constraints, living conditions, demographic changes and unhealthy lifestyles in many of the World Health Organization (WHO) Member States. This understanding and increasing globalization means it is very timely to review the role of (global) public health in this changing societal and political environment.

Globalization
The positive and negative impacts of globalization need to be better understood by public health professionals and more widely acknowledged by policy makers. Globalization is marked by increased interconnectedness and interdependence of peoples and countries, based on the opening of borders to increasingly fast flows of goods, services, finance, people and ideas across international borders and the changes in institutional and policy regimes at the international and national levels that facilitate or promote such flows. It is recognized that globalization has both positive and negative impacts on health development. Increasingly trade agreements provide frameworks for intergovernmental relationships; however, possible impacts on human health are not routinely assessed prior to signing.

The proposal for a Global Charter for the Public’s Health
In this context, the World Federation of Public Health Associations (WFPHA) has developed the A Global Charter for the Public’s Health (GCPH) as the main output of its collaboration plan with the WHO to adapt today’s public health to its global context in the light of and in conjunction with the Sustainable Development Goals (SDGs). GCPH brings together the best of all the existing models and provides a comprehensive, clear and flexible framework that can be applied globally and within individual countries, whether low, middle or high income.

Outcome of literature review and consultation
As part of the consultation process, several key points were raised:
:: The need for genuine political engagement was stressed, underlying that too often politicians only paid lip service to public health.
:: Commercial, social and environmental determinants of health, as well as social inequalities should be tackled and resources allocated in a sustainable and accountable way.
:: The impacts of underlying ideologies should be taken into consideration.
:: More comprehensive and reliable data are needed in many programmatic areas of the public’s health.
:: The multisectoral and holistic approach should be reached, engaging public health in big dialogues and in the concerted decision-making processes.
:: Participants of the consultation stressed that WHO should provide leadership in this process.
:: New leaders for public health are required.
:: A flexible common framework of instruments to influence governments has been suggested.
:: New creative solutions are needed.
:: Specific projects of selected countries where public health has a strong voice and is integrated in government policies and initiatives might be possible models for other settings.

While publications on global public health are exponentially increasing in the literature, the term ‘Global public health’ itself remains ill defined. The term is frequently used though, but more in the context of a ‘problem’ or a ‘challenge’. The framing of global public health is frequently medical and technical. This may be a result of the vertical technically oriented programs that are run throughout the world. Political and economic constraints found in the literature are important but there is not a large body of literature around this topic.

Despite the evidence that the different public health functions need to be much better integrated into health systems, a ‘know-do-gap’ is apparent. While multi-sectoral approaches in public health are increasingly chosen, they are by no means mainstream.

A Global Charter for the Public’s Health
Resilient public health systems are needed locally to globally and within each country. However, the current reality consists of fragmented, variable and incomplete public health services and functions, with little common understanding of what a good public health service looks like.

Currently, there is no global agreement on what public health functions or services consist of, and the lack of a common vocabulary in public health adversely affects the efforts of public health systems, including security and workforce development and quality standards across the world. Many public health policies, especially those that look at disease specific topics, remain vertical, even if they outline some inter-sectoral components. Many are not well coordinated with other related societal fields and, therefore, have a huge impact on population health. A GCPH has the potential to become an established framework to allow public health systems to communicate globally, compare capacity and improve performance through systematic action.

Functions and services
The proposed GCPH consists of two groups of functions/services including:
:: Services: a group of core services—Protection, Prevention and Promotion
:: Functions: a group of enabler functions—Governance, Advocacy, Capacity and Information

Headings for the GCPH
There exists overlap between all these services and functions, especially between health promotion, primary prevention and environmental health, which benefit from a cross-sector approach. Specific public health topics require components drawn from across the range of services and functions. These include:
.1. Governance: public health legislation; health and cross-sector policy; strategy; financing; organisation; assurance: transparency, accountability and audit.
.2. Information: surveillance, monitoring and evaluation; monitoring of health determinants; research and evidence; risk and innovation; dissemination and uptake.
.3. Protection: international health regulation and co-ordination; health impact assessment; communicable disease control; emergency preparedness; occupational health; environmental health; climate change and sustainability.
.4. Prevention: primary prevention: vaccination; secondary prevention: screening; tertiary prevention: evidence-based, community-based, integrated, person-centred quality health-care and rehabilitation; healthcare management and planning.
.5. Promotion: inequalities; environmental determinants; social and economic determinants; resilience; behaviour and health literacy; life-course; healthy settings.
.6. Advocacy: leadership and ethics; health equity; social-mobilization and solidarity; education of the public; people-centred approach; voluntary community sector engagement; communications; sustainable development.
.7. Capacity: workforce development for public health, health workers and wider workforce; workforce planning: numbers, resources, infrastructure; standards, curriculum, accreditation; capabilities, teaching and training.

Recommendations
Recommendation 1–Consensus: A common conceptualization of global public health should be defined and adopted by the WFPHA and its members and used as a basis for public health education and training. It should be followed by a process of engagement with partners and Member States to adopt a WHO action plan on public health functions, based on the approved GCPH.

Recommendation 2–Co-ordination: WFPHA in association with partners supports and recognises WHO’s leadership role to facilitate global public health in global multi-sectoral dialogues, co-ordination and decision making.

Recommendation 3–Leadership: Public health leadership to be strengthened to integrate the public health charter into cross-sector policy, health systems policy and governance mechanisms, building on and enhancing existing frameworks.

Recommendation 4–Workforce: Applying the GCPH encompassing functions, services and healthy public policy to scale up the public health workforce to ensure global health security and the sustainability of health systems.

Recommendation 5–Tools and application: Case studies, tools and standards to be developed to illustrate the application of the GCPH at the global, national and local levels and for use in public health education and training. Adoption of a GCPH will require skilful communication and practical application.

Recommendation 6–Resources: In order to strengthen Global Public Health, political commitment is needed, with co-ordinated roles and resources with partners and donors.

Conclusion
In the broadest sense, public health in our globalized world is multi-faceted, serving as a basis for everyday life, crucial for growth and development, equity and stability and is a function of numerous social, environmental and behavioural determinants, not least of which are the impacts of globalization itself. To realize the potential of a healthy global citizenry to support economic growth and development, equity and stability, there is an urgent need for genuine political acknowledgement of, engagement with and leadership for the public’s health supported by a global public health system.

Action on two levels is required. First, consensus on a conceptualization of global public health and on a framework for sustainable and secure health infrastructures and services are essential first steps to underpin health in everyday life and to minimize the negative economic, social and environmental impacts of globalization on health development and community stability. Additionally, new models and skill sets are needed to address new and re-emerging public health challenges within the different socio-economic realities around the world, varying political capacities and new political entities.

Second, development of global public health requires political engagement, use of social networks, identification of political leverage points and steerage of public health agendas through the new societal and political environments. Importantly, global public health values should inform, be embedded within and be used to assess political and policy decisions.

The European Journal of Public Health
Volume 26, Issue 2, 1 April 2016
http://eurpub.oxfordjournals.org/content/26/2?current-issue=y

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Health services research
Substantial between-country differences in organising community care for older people in Europe—a review
Liza Van Eenoo, Anja Declercq, Graziano Onder, Harriet Finne-Soveri, Vjenka Garms-Homolová, Pálmi V. Jónsson, Olivia H.M. Dix, Johannes H. Smit, Hein P.J. van Hout, Henriëtte G. van der Roest Eur J Public Health (2016) 26 (2): 213-219 DOI: http://dx.doi.org/10.1093/eurpub/ckv152 First published online: 2 September 2015 (7 pages)

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Child and adolescent health
Relative deprivation in the Nordic countries—child mental health problems in relation to parental financial stress
Hrafnhildur Gunnarsdóttir, Gunnel Hensing, Lene Povlsen, Max Petzold Eur J Public Health (2016) 26 (2): 277-282 DOI: http://dx.doi.org/10.1093/eurpub/ckv191 First published online: 21 October 2015 (6 pages)

Eurosurveillance
Volume 21, Issue 12, 24 March 2016
http://www.eurosurveillance.org/Public/Articles/Archives.aspx?PublicationId=11678

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Editorials
Impact of migration on tuberculosis epidemiology and control in the EU/EEA
by MJ van der Werf, JP Zellweger

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Research Articles
The effect of migration within the European Union/European Economic Area on the distribution of tuberculosis, 2007 to 2013
by V Hollo, SM Kotila, C Ködmön, P Zucs, MJ van der Werf
Abstract
Immigration from tuberculosis (TB) high-incidence countries is known to contribute notably to the TB burden in low-incidence countries. However, the effect of migration enabled by the free movement of persons within the European Union (EU)/European Economic Area (EEA) on TB notification has not been analysed. We analysed TB surveillance data from 29 EU/EEA countries submitted for the years 2007–2013 to The European Surveillance System. We used place of birth and nationality as proxy indicators for native, other EU/EEA and non-EU/EEA origin of the TB cases and analysed the characteristics of the subgroups by origin. From 2007–2013, a total of 527,467 TB cases were reported, of which 129,781 (24.6%) were of foreign origin including 12,566 (2.4%) originating from EU/EEA countries other than the reporting country. The countries reporting most TB cases originating from other EU/EEA countries were Germany and Italy, and the largest proportion of TB cases in individuals came from Poland (n=1,562) and Romania (n=6,285). At EU/EEA level only a small proportion of foreign TB cases originated from other EU/EEA countries, however, the uneven distribution of this presumed importation may pose a challenge to TB programmes in some countries.

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Migration-related tuberculosis: epidemiology and characteristics of tuberculosis cases originating outside the European Union and European Economic Area, 2007 to 2013
by C Ködmön, P Zucs, MJ van der Werf
Abstract
Migrants arriving from high tuberculosis (TB)-incidence countries may pose a significant challenge to TB control programmes in the host country. TB surveillance data for 2007–2013 submitted to the European Surveillance System were analysed. Notified TB cases were stratified by origin and reporting country. The contribution of migrant TB cases to the TB epidemiology in EU/EEA countries was analysed. Migrant TB cases accounted for 17.4% (n = 92,039) of all TB cases reported in the EU/EEA in 2007–2013, continuously increasing from 13.6% in 2007 to 21.8% in 2013. Of 91,925 migrant cases with known country of origin, 29.3% were from the Eastern Mediterranean, 23.0% from south-east Asia, 21.4% from Africa, 13.4% from the World Health Organization European Region (excluding EU/EEA), and 12.9% from other regions. Of 46,499 migrant cases with known drug-susceptibility test results, 2.9% had multidrug-resistant TB, mainly (51.7%) originating from the European Region. The increasing contribution of TB in migrants from outside the EU/EEA to the TB burden in the EU/EEA is mainly due to a decrease in native TB cases. Especially in countries with a high proportion of TB cases in non-EU/EEA migrants, targeted prevention and control initiatives may be needed to progress towards TB elimination.

Global Health: Science and Practice (GHSP)
March 2016 | Volume 4 | Issue 1
http://www.ghspjournal.org/content/current

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EDITORIALS
Birthing Centers Staffed by Skilled Birth Attendants: Can They Be Effective … at Scale?
Peripheral-level birthing centers may be appropriate and effective in some circumstances if crucial systems requirements can be met. But promising models don’t necessarily scale well, so policy makers and program managers need to consider what requirements can and cannot be met feasibly at scale. Apparently successful components of the birthing center model, such as engagement of traditional birth attendants and use of frontline staff who speak the local language, appear conducive to use in other similar settings.
Glob Health Sci Pract 2016;4(1):1-3. http://dx.doi.org/10.9745/GHSP-D-16-00063
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COMMENTARIES
Social Entrepreneurship: A Case Study From Brazil
Through careful sourcing of commodities, cost-cutting efficiencies, and realistic pricing, 3 large contraceptive social marketing programs evolved into profit-making enterprises while continuing to make low-priced contraceptives available to low-income consumers on a substantial scale.
Phil Harvey
Glob Health Sci Pract 2016;4(1):6-12. http://dx.doi.org/10.9745/GHSP-D-15-00182
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Mapping the Prevalence and Sociodemographic Characteristics of Women Who Deliver Alone: Evidence From Demographic and Health Surveys From 80 Countries
An estimated 2.2 million women surveyed in low- and middle-income countries between 2005 and 2015 gave birth alone. This practice was concentrated in West and Central Africa and parts of East Africa. Women who delivered with no one present were very poor, uneducated, older, and of higher parity. Experience from northern Nigeria suggests the practice can be reduced markedly by mobilizing religious and civil society leaders to improve community awareness about the critical importance of having an attendant present.
Nosakhare Orobaton, Anne Austin, Bolaji Fapohunda, Dele Abegunde, Kizzy Omo
Glob Health Sci Pract 2016;4(1):99-113. First published online March 9, 2016. http://dx.doi.org/10.9745/GHSP-D-15-00261
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Original Articles
Routine Immunization Consultant Program in Nigeria: A Qualitative Review of a Country-Driven Management Approach for Health Systems Strengthening
Meghan O’Connell, Chizoba Wonodi
Glob Health Sci Pract 2016;4(1):29-42. http://dx.doi.org/10.9745/GHSP-D-15-00209
ABSTRACT
Background: Since 2002, the Nigerian government has deployed consultants to states to provide technical assistance for routine immunization (RI). RI consultants are expected to play a role in supportive supervision of health facility staff, capacity building, advocacy, and monitoring and evaluation.
Methods: We conducted a retrospective review of the RI consultant program’s strengths and weaknesses in 7 states and at the national level from June to September 2014 using semi-structured interviews and online surveys. Participants included RI consultants, RI program leaders, and implementers purposively drawn from national, state, and local government levels. Thematic analysis was used to analyze qualitative data from the interviews, which were triangulated with results from the quantitative surveys.
Findings: At the time of data collection, 23 of 36 states and the federal capital territory had an RI consultant. Of the 7 states visited during the study, only 3 states had present and visibly working consultants. We conducted 84 interviews with 101 participants across the 7 states and conducted data analysis on 70 interviews (with 82 individuals) that had complete data. Among the full sample of interview respondents (N = 101), most (66%) were men with an average age of 49 years (±5.6), and the majority were technical officers (63%) but a range of other roles were also represented, including consultants (22%), directors (13%), and health workers (2%). Fifteen consultants and 44 program leaders completed the online surveys. Interview data from the 3 states with active RI consultants indicated that the consultants’ main contribution was supportive supervision at the local level, particularly for collecting and using RI data for decision making. They also acted as effective advocates for RI funding. In states without an RI consultant, gaps were highlighted in data management capacity and in monitoring of RI funds. Program design strengths: the broad terms of reference and autonomy of the consultants allowed work to be tailored to the local context; consultants were often integrated into state RI teams but could also work independently when necessary; and recruitment of experienced consultants with strong professional networks, familiarity with the local context, and ability to speak the local language facilitated advocacy efforts. Key programmatic challenges were related to inadequate and inconsistent inputs (salaries, transportation means, and dedicated office space) and gaps in communication between consultants and national leadership and in management of consultants, including lack of performance feedback, lack of formal orientation at inception, and no clear job performance targets.
Conclusions: While weaknesses in managerial and material inputs affect current performance of RI consultants in Nigeria, the design of the RI consultant program employs a unique problem-focused, locally led model of development assistance that could prove valuable in strengthening the capacity of the government to implement such technical assistance on its own. Despite the lack of uniform deployment and implementation of RI consultants across the country, some consultants appear to have contributed to improved RI services through supportive supervision, capacity building, and advocacy.

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Original Articles
Meeting Postpartum Women’s Family Planning Needs Through Integrated Family Planning and Immunization Services: Results of a Cluster-Randomized Controlled Trial in Rwanda
Lisa S Dulli, Marga Eichleay, Kate Rademacher, Steve Sortijas, Théophile NsengiyumvaGlob Health Sci Pract 2016;4(1):73-86. First published online February 22, 2016. http://dx.doi.org/10.9745/GHSP-D-15-00291
ABSTRACT
Objective The primary objective of this study was to test the effectiveness of integrating family planning service components into infant immunization services to increase modern contraceptive method use among postpartum women.
Methods The study was a separate sample, parallel, cluster-randomized controlled trial. Fourteen randomly selected primary health facilities were equally allocated to intervention (integrated family planning and immunization services at the same time and location) and control groups (standard immunization services only). At baseline (May–June 2010), we interviewed postpartum women attending immunization services for their infant aged 6 to 12 months using a structured questionnaire. A separate sample of postpartum women was interviewed 16 months later after implementation of the experimental health service intervention. We used linear mixed regression models to test the study hypothesis that postpartum women attending immunization services for their infants aged 6–12 months in the intervention facilities will be more likely to use a modern contraceptive method than postpartum women attending immunization services for their infants aged 6–12 months in control group facilities.
Results We interviewed and analyzed data for 825 women from the intervention group and 829 women from the control group. Results showed the intervention had a statistically significant, positive effect on modern contraceptive method use among intervention group participants compared with control group participants (regression coefficient, 0.15; 90% confidence interval [CI], 0.04 to 0.26). Although we conducted a 1-sided significance test, this effect was also significant at the 2-sided test with alpha = .05. Among those women who did not initiate a contraceptive method, awaiting the return of menses was the most common reason cited for non-use of a method. Women in both study groups overwhelmingly supported the concept of integrating family planning service components into infant immunization services (97.9% in each group), and service data collected during the intervention period did not indicate that the intervention had any negative effect on infant immunization service uptake.
Conclusion Integrating family planning service components into infant immunization services can be an acceptable and effective strategy to increase contraceptive use among postpartum women. Additional research is needed to examine the extent to which this integration strategy can be replicated in other health care settings. Future research should also explore persistent misconceptions regarding the relationship between return of menses and return to fertility during the postpartum period.

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METHODOLOGIES
Simplified Asset Indices to Measure Wealth and Equity in Health Programs: A Reliability and Validity Analysis Using Survey Data From 16 Countries
Many program implementers have difficulty collecting and analyzing data on program beneficiaries’ wealth because a large number of survey questions are required to construct the standard wealth index. We created country-specific measures of household wealth with as few as 6 questions that are highly reliable and valid in both urban and rural contexts.
Nirali M Chakraborty, Kenzo Fry, Rasika Behl, Kim Longfield
Glob Health Sci Pract 2016;4(1):141-154. http://dx.doi.org/10.9745/GHSP-D-15-00384

Globalization and Health
http://www.globalizationandhealth.com/
[Accessed 26 March 2016]

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Commentary
A critical analysis of the review on antimicrobial resistance report and the infectious disease financing facility
David M. Brogan and Elias Mossialos
Globalization and Health 2016 12:8
Published on: 22 March 2016
Abstract
Over the past year, two major policy initiatives have been introduced focusing on stimulating antibiotic development for human consumption. The European Investment Bank has announced the development of the Infectious Disease Financing Facility (IDFF) and the British government commissioned the Review on Antimicrobial Resistance, led by Jim O’Neill. Each constitutes a major effort by the European community to address the evolving crisis of antimicrobial resistance. Though both have similar goals, the approaches are unique and worthy of consideration.
This manuscript utilizes a previously published framework for evaluation of antibiotic incentive plans to clearly identify the strengths and weaknesses of each proposal. The merits of each proposal are evaluated in how they satisfy four key objectives: 1) Improve the overall net present value (NPV) for new antibiotic projects; 2) Enable greater participation of Small to Medium Sized Enterprises (SME); 3) Encourage participation by large pharmaceutical companies; 4) Facilitate cooperation and synergy across the antibiotic market. The IDFF seeks to make forgivable loans to corporations with promising compounds, while the O’Neill group proposes a more comprehensive framework of early stage funding, along with the creation of a stable global market.
Ultimately, the proposals may prove complementary and if implemented together may form a more comprehensive plan to address an impending global crisis. Substantial progress will only be made on these efforts if action is taken at an international level, therefore we recommend consideration of these efforts at the upcoming G20 summit.

International Migration Review
Spring 2016 Volume 50, Issue 1 Pages 1–266, e1–e16
http://onlinelibrary.wiley.com/doi/10.1111/imre.2016.50.issue-1/issuetoc

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IMMIGRANTS IN WESTERN EUROPE
Constructing Immigrants: Portrayals of Migrant Groups in British National Newspapers, 2010–2012 (pages 3–40)
Scott Blinder and William L. Allen
Article first published online: 23 OCT 2015 | DOI: 10.1111/imre.12206

As French as Anyone Else: Islam and the North African Second Generation in France (pages 41–69)
Jean Beaman
Article first published online: 4 MAY 2015 | DOI: 10.1111/imre.12184

Cultural Integration in the Muslim Second Generation in the Netherlands: The Case of Gender Ideology (pages 70–94)
Mieke Maliepaard and Richard Alba
Article first published online: 8 MAY 2015 | DOI: 10.1111/imre.12118

Social Position and Place-Protective Action in a New Immigration Context: Understanding Anti-Mosque Campaigns in Catalonia (pages 95–132)
Avi Astor
Article first published online: 2 SEP 2014 | DOI: 10.1111/imre.12115

Long-Term Effects of Language Course Timing on Language Acquisition and Social Contacts: Turkish and Moroccan Immigrants in Western Europe (pages 133–162)
Jutta Hoehne and Ines Michalowski
Article first published online: 10 APR 2015 | DOI: 10.1111/imre.12130

Native Friends and Host Country Identification among Adolescent Immigrants in Germany: The Role of Ethnic Boundaries (pages 163–196)
Benjamin Schulz and Lars Leszczensky
Article first published online: 6 FEB 2015 | DOI: 10.1111/imre.12163

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DEPORTATION AND REMITTANCE EFFECTS
Deporting Fathers: Involuntary Transnational Families and Intent to Remigrate among Salvadoran Deportees (pages 197–230)
Jodi Berger Cardoso, Erin Randle Hamilton, Nestor Rodriguez, Karl Eschbach and Jacqueline Hagan
Article first published online: 3 JUL 2014 | DOI: 10.1111/imre.12106

Is Money Enough?: The Effect of Migrant Remittances on Parental Aspirations and Youth Educational Attainment in Rural Mexico (pages 231–266)
Adam Sawyer
Article first published online: 2 SEP 2014 | DOI: 10.1111/imre.12103

JAMA
March 22/29, 2016, Vol 315, No. 12
http://jama.jamanetwork.com/issue.aspx

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Viewpoint
Pregnancy in the Time of Zika: Addressing Barriers for Developing Vaccines and Other Measures for Pregnant Women FREE
Saad B. Omer, MBBS, MPH, PhD; Richard H. Beigi, MD, MSc

Three recent infectious disease outbreaks of global importance—H1N1 influenza, Ebola, and now Zika—have had specific implications for pregnant women. For the H1N1 pandemic, pregnant women and their infants were high-risk groups for severe complications and death. During the Ebola outbreak, there were concerns about worse outcomes among pregnant women and specific concerns regarding vertical transmission of infection to newborns. The current Zika outbreak, with its ostensible association with microcephaly, has direct and highly concerning implications for pregnant women and women of reproductive age.

Yet the global public health community again lacks the optimal tools for dealing with a disease that has specific and important implications for pregnant women. There are substantial knowledge gaps in current understanding of Zika, irrespective of the affected population. However, Zika’s association with adverse fetal outcomes requires that pregnant women be a priority group for developing and evaluating vaccines and other measures. There are several current scientific and structural barriers to developing vaccines for pregnant women. These barriers challenge the ability to prepare and respond to epidemics and are particularly highlighted during a public health emergency that has pregnant women and their unborn fetuses as the primary affected population.

One barrier is a lack of a broadly accepted ethical framework for guiding clinical research during pregnancy. For example, the term minimal risk1—a concept that informs ethical review of research—is not well defined for research in pregnancy. Therefore, institutional review boards (IRBs) often resort to categorizing most intervention research in pregnancy as high risk, often without a balanced consideration of the risks of not performing the research. Moreover, the risks and benefits to the fetus also need to be considered along with risks and benefits to the mother, adding to the challenge. This lack of a broadly accepted ethical framework has a chilling effect on both academic and industry-led clinical research in pregnancy.2,3 Therefore, there is a need for development and articulation of a pregnancy-specific ethical framework that can offer guidance to investigators and IRBs.

Pregnancy is a physiologically dynamic state. The immune profile of a pregnant woman is responsive to the changing levels of sex hormones and evolves through the course of pregnancy.4 However, most of the current knowledge base for vaccine response is derived from observational studies conducted in the latter part of pregnancy, with limited data available from the first and early second trimester or from randomized clinical trials. On the other hand, clinical, practical, and public health considerations require that vaccine use not be restricted to women with advanced gestational age. Given that a substantial portion of Zika’s teratogenic effects may occur in the earlier phase of pregnancy, administration of any forthcoming Zika vaccine will be most beneficial prior to or during the early parts of pregnancy. The knowledge gap for early pregnancy vaccine responses and safety will make the task of developing and recommending an effective Zika vaccine for use across pregnancy challenging.

Until recently, the pregnancy and lactation sections of US Food and Drug Administration (FDA)-approved labels for vaccines and pharmaceuticals contained ambiguous information with limited clinical utility. For example, the labels were required to contain determination of letter risk categories (A, B, C, D, or X) for pregnancy. These categories were an attempt to summarily convey risk of reproductive and developmental adverse effects. However, the categories were somewhat simplistic and challenging to translate into practice in a clinically meaningful manner.

After years of deliberations, revisions, and public comment, FDA recently issued the Pregnancy and Lactation Labeling Rule (PLLR).5 This rule will enable inclusion of clinically relevant and interpretable information in drug and vaccine labels and creates a consistent format for communicating information on risks as well as benefits relevant to pregnant and lactating women and for males and females of reproductive potential. Moreover, the new rule allows for incorporating information about risk and benefits from a variety of sources, including non–industry-sponsored epidemiological and interventional studies. Although the release of the PLLR is important and holds promise to provide more clinically useful information, its implementation faces many logistical challenges. For example, there is a need for a “mock label” (ie, a sample label providing examples of information to be included in the sections relevant to pregnancy and lactation) to provide guidance for inclusion and format of pregnancy-related information in sections relevant to pregnant women.

General understanding of the new categorization system is insufficient among clinicians who provide obstetrical care. Therefore, it will take concerted efforts to phase in this categorization. Having clarity regarding vaccine (and drug) labeling related to pregnancy will help ensure that clinicians have a higher level of confidence in pregnancy-related vaccines and could provide a road map for conducting research that can inform labeling and hence clinical decisions.
Robust safety evaluation is a cornerstone of any vaccine development and deployment program. There has been an increase in the number of studies evaluating the safety of currently recommended maternal vaccines, such as influenza and pertussis vaccines.6 Despite increased attention on the evaluation of safety of immunization in pregnancy, barriers remain. For example, a review commissioned by the World Health Organization highlighted the lack of standard definitions of outcomes, and standards for measurement of these outcomes, relevant to evaluation of vaccines in pregnancy.7 This lack of standardization poses a challenge for conduct of clinical trials, generalizability of safety data, and merging of large safety data sets. This last point is critical because large multilocation data sets could optimize the evaluation of rare but clinically important outcomes, such as microcephaly.

Moreover, safety assessment for pharmaceutical interventions against emerging public health threats requires real-time assessment of risk vs benefit. Baseline outcome rates are an essential input for such an assessment. The value of baseline rates was recognized during the H1N1 pandemic.8 Since then, there has been little progress in ascertaining baseline rates in different geographic locations of outcomes such as first trimester miscarriages. Ascertainment of baseline rates of outcomes is even more important when a disease emerges in the context of other infections (eg, malaria) that are associated with adverse birth outcomes.

Drug and vaccine development and evaluation in children may provide some context for the current outbreak response. Pediatricians and child health researchers recognized many parallel challenges in the amount and quality of data available for the care of children. The term therapeutic orphans was coined for children, stressing the concept of the lack of information available to prevent and treat disease in children. To address these challenges, efforts were mobilized around the conceptualization and passing of legislation (Best Pharmaceuticals for Children Act and the Pediatric Research Equity Act). These efforts have contributed to improving the quantity and quality of research that has been conducted in children.9 A similar approach may also be relevant to fostering research in pregnancy.

Pregnant women have been a high-risk group requiring special consideration for several recent global public health emergencies. Currently, pregnant women and their unborn children are the focal point of the Zika outbreak. Although there are several barriers for developing vaccines and other measures for pregnant women, these barriers are surmountable with concerted efforts and leadership. Strategic planning and action have allowed for advances in pediatric drug development and provide a good model. However, the time to act is now, before the next epidemic takes its toll.
[References at link above]