Latest IVAC News
Mathu Santosham, MD, MPH, wins the 2017 Prince Mahidol Award
IVAC's Senior Advisor recognized for landmark scientific contribution to controlling Hib, pneumococcal disease
Mathu Santosham, MD, MPH, has received the Prince Mahidol Award 2017 in the field of Public Health, which recognizes “outstanding contribution in the field of public health for the sake of the well-being of the peoples.”
Santosham, who serves as Director Emeritus of the Johns Hopkins Center for American Indian Health and Special Advisor in the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health, has been recognized for his landmark scientific contribution to the control of Hib and pneumococcal disease around the world.
The Prince Mahidol Award was established in 1992 to honor the late Prince Mahidol of Songka, the Royal Father of His Majesty the King of Thailand. Prince Mahidol modernized medical services and education in Thailand and is known to the country as the “Father of Modern Medicine and Public Health.” Dr. Santosham will jointly receive the award with Professor Porter Warren Anderson Jr., Dr. Rachel Schneerson, and Dr. John B. Robbins.
Santosham has been a pioneer of the Hib scientific field in a 30-year campaign to understand the global burden and epidemiology in various populations. He worked on pivotal efficacy studies in high-risk populations enabling the licensure of Hib conjugate vaccine for infants. Over the past decade, Santosham has served as a leader in global, regional, and country-focused post-licensure work that moved evidence to policy and onward to implementation and scale-up, ensuring that children around the world, especially those most in need, had access to these life-saving vaccines.
As of 2017, 190 countries (98% of all) countries in the world now include Hib conjugate vaccine and 140 (72%) countries include pneumococcal conjugate vaccine in their routine infant immunization programs. In 1990, less than 30 years ago, no country was using these vaccines. It is estimated that over 3 million deaths will have been averted from 2000 through 2020, and millions more in the decades to follow, because of Hib conjugate and pneumococcal conjugate vaccines. An incalculable burden of morbidity is not captured in these numbers: devastating consequences children often suffer following meningitis, pneumonia, and sepsis.
Supporting letters from leading experts extolled Santosham’s “compassion, humility, integrity, and humanitarianism.”
Previous winners of the Prince Mahidol Award from the School of Public Health include former chair of International Health Robert Black, MD, MPH in 2011 for his work studying the impact of daily zinc supplementation on diarrhea and pneumonia in Bangladesh, India, Peru, and Zanzibar; Alfred Sommer, MD, MHS in 1997 for his vitamin A discoveries; former dean D.A. Henderson, MD, MPH in 2015 for his leadership of the World Health Organization’s global smallpox eradication campaign; and former chair of the Department of Epidemiology Jonathan Samet, MD, MS in 2014 for his role in protecting the public’s health from air pollution.
Learn more about the award.
IVAC Progress Report finds stubborn gap in reaching intervention targets among countries heavily burdened by childhood pneumonia and diarrhea
Why are pneumonia and diarrhea still responsible for 1 of every 4 deaths in children under 5? Released today, IVAC's 2017 Pneumonia and Diarrhea Progress Report: Driving Progress through Equitable Investment and Action (PDPR) explores factors slowing progress in the most impacted countries against the world's two biggest killers of young children.
Efforts to work and invest more strategically in immunization, nutrition, and treatment are critical to meaningfully reducing the nearly 1.5 million childhood deaths that still occur each year as a result of pneumonia and diarrhea.
IVAC’s Progress Report, issued annually since the Johns Hopkins Center helped establish World Pneumonia Day in 2009, also delves for the first time into the economic cost of the illnesses and sheds light on the complex relationship between childhood illnesses and poverty. Children in low-resource settings are at higher risk for illness; at the same time, pneumonia and diarrhea can contribute to the cycle of poverty.
Read the full report here.
Key findings included:
India registers significant score improvement
All 15 focus countries—those with the highest number of deaths from pneumonia and diarrhea—fell below the 86 percent target, but scores varied widely from a low of 19 percent (Somalia) to a high of 69 percent (Tanzania). Scores are compiled by measuring the degree to which interventions that protect against, prevent, and treat pneumonia and diarrhea are readily available to children.
Rotavirus vaccine coverage: Sudan and Tanzania achieved or exceeded the 90 percent target for rotavirus vaccine coverage. Ten of the fifteen countries failed to meet a threshold of 45 percent for this vaccine, which prevents a substantial portion of diarrhea deaths and hospitalizations. This includes nine countries (Afghanistan, Chad, China, DRC, Ethiopia, Nigeria, Pakistan, and Somalia) that had not yet introduced the vaccine and India, who began a phased introduction in 2016.
Pneumococcal conjugate vaccine coverage: Three of the fifteen countries achieved or exceeded the 90 percent target (Sudan, Tanzania, and Bangladesh) for pneumococcal conjugate vaccine coverage.
Antibiotic treatment for suspected pneumonia: In the eleven out of fifteen countries with available data, coverage of antibiotic treatment ranged from 7 percent (Ethiopia) to 59 percent (Sudan). Two countries met or exceeded 45 percent of children with suspected pneumonia treated (Afghanistan and Sudan).
ORS treatment for diarrhea: In the fourteen out of fifteen countries with available data, ORS treatment ranged from 20 percent (Chad and Sudan) to 77 percent (Bangladesh). Four countries met or exceeded 45 percent of children with diarrhea receiving ORS: Afghanistan, Bangladesh, Somalia, and Tanzania.
Breastfeeding: About half of all diarrhea episodes and about one third of respiratory infections could be averted by breastfeeding. The global target for exclusive breastfeeding within the first six months of a child's life is 50 percent coverage. Based on 2015 data, the report finds five out of fifteen countries met or exceeded the target: Bangladesh, Ethiopia, India, Sudan, and Tanzania.
Worldwide, pneumonia takes the lives of more young children than any other disease – more than 100 every hour of every day. The single biggest cause of fatal pneumonia in childhood is preventable with a vaccine. On November 7th, the International Vaccine Access Center, in collaboration with the National Geographic Society and the Bill Melinda Gates Foundation, will host a panel in light of the upcoming World Pneumonia Day (Nov. 12) and a recent National Geographic feature story on the crucial need for vaccine access around the world.
The panel will feature child health experts, advocates and researchers to discuss the successes, and remaining hurdles, towards achieving full protection against vaccine-preventable pneumonia and other diseases for the world’s most vulnerable children. Reception and refreshments to follow.
- Cynthia Gorney, (University of California, Berkeley, National Geographic) – moderator
- Dr. Samir Saha, (Head of Microbiology Department at the Dhaka Shishu Hospital, Bangladesh and Executive Director of the Child Health Research Foundation, Bangladesh),
- Dr. Cynthia Whitney, (Chief of Respiratory Diseases Branch, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control)
- Dr. Keith Klugman, (Director for Pneumonia, The Bill & Melinda Gates Foundation)
- Dr. Chizoba Wonodi, (Nigeria Director, International Vaccine Access Center)
- Martha Rebour, (Executive Director, Shot@Life, United Nations Foundation)
This event is open to all non-ASTMH affiliates.
Please RSVP here (registration opens on Wednesday, November 1st)
Livestream will be available here.
Email firstname.lastname@example.org for more information.
More on this month’s National Geographic Feature:
The highlighted National Geographic article offers an introduction to the history of the PCV and the global efforts currently being undertaken to make the vaccines accessible to all children, featuring input from Dr. Orin Levine, Director of Vaccine Delivery at the Bill and Melinda Gates Foundation, Dr. Katherine O'Brien, Director of the International Vaccine Access Center, and Dr. Samir Saha, Director of the Child Health Research Foundation.
Read the article here.
IVAC Remembers Olga Popova
Olga Popova, Janssen’s Head of Global Vaccine Policy & Partnerships and member of the company’s Vaccines Leadership Team, passed away on Monday, July 10, 2017 after fighting a brave battle with cancer. IVAC worked with Olga Popova over the course of the past decade in many capacities. She will be missed and her contributions are deeply appreciated.
Most recently, Olga oversaw Janssen’s relationships and ongoing dialogue with international stakeholders, such as IVAC as well as the WHO and GAVI Alliance, philanthropic foundations, and industry associations. Through her expert support for the Board of Gavi, leadership in the rollout of pentavalent vaccines, involvement in development of Johnson and Johnson’s Ebola vaccine, and helping find solutions to policy solutions, Olga’s commitment to the families and children in low income countries was always very evident. Her passion and drive to make things happen will never be forgotten.
Bill Moss Explains Need for Strengthening Health Systems and Building Trust with Communities for Measles Campaigns
In a tragic turn in South Sudan, 15 children all under age 5, died of severe sepsis and toxicity due to a improperly managed vaccination campaign for measles. In a recent interview with NPR Goats and Soda, Dr. William Moss, professor of epidemiology and immunology at the Johns Hopkins Bloomberg School of Public Health and head of epidemiology at the International Vaccine Access Center, talks about the factors needed to ensure a safe and effective vaccination campaign.
Read the full news article.
A Public Health Milestone for India
May 18, 2017 - On Saturday, India’s government announced a much-anticipated decision to include the pneumococcal conjugate vaccine (PCV) in the government’s Universal Immunisation Programme (UIP). The vaccine will protect children against severe forms of pneumococcal disease, such as pneumonia and meningitis—a major cause of illness and death in the country and around the world. GHN reached out to Kate O'Brien, executive director of the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health, who described the significance and expected impact of India’s decision.
- India loses 1 child every 8 minutes to pneumococcal disease, a leading cause of vaccine-preventable illness and death among children under-5 years old.
- Some of the 90+ strains of pneumococcus are antibiotic-resistant.
- The pneumococcal conjugate vaccine (PCV) that India will introduce provides protection against more than 2/3 of all the disease-causing strains.
3 Questions & Answers:
India now joins 130 countries that have already introduced PCV, including Pakistan, Afghanistan, Nepal, and Bangladesh; why did it take India longer?
The decision to introduce a new vaccine is complex and every country’s process is different. India’s immunization decision-making process engages Indian scientists and public health experts who consider local and global technical evidence on disease burden, vaccine efficacy, costs, and many other topics before recommending introduction of a new vaccine. While many other countries, including India’s neighbors, have already introduced PCV, the important thing is that India has now decided to introduce PCV and started rolling out the vaccine in the first states. Introducing PCV will go a long way to help reduce pneumonia burden and improve child health in India. The launch, which took place at Mandi, Himachal Pradesh, on Saturday, May 13, is an incredible public health milestone for India and the world.
How many people will receive the vaccine in this initial launch, and how were they chosen?
PCV was previously available in the private market, meaning it was expensive and out-of-reach for millions of children. With this launch, the Government of India aims to provide PCV free of cost to approximately 2.1 million children across 3 states—Himachal Pradesh and select districts of Bihar and Uttar Pradesh—in the first year, ultimately scaling up to the entire country. Many of the states planned for the first few years of the phased rollout are those with the highest pneumococcal disease burden. With this strategy, the government has prioritized high-burden areas and demonstrated its commitment to promoting equitable access to PCV and ensuring it reaches the children and communities at greatest risk of severe disease.
What do you expect the impact to be?
Pneumococcal disease is a leading cause of vaccine-preventable death and illness in children under 5, both globally and in India. As it is rolled out across India, PCV has the potential to prevent tens of thousands of deaths and many more illnesses due to pneumococcal pneumonia, meningitis, and other syndromes each year. PCV also helps protect the broader community, including the elderly and children too young or old to receive the vaccine; even those who are not vaccinated themselves will benefit from the herd protection conferred by this vaccine’s use in the national immunization program. Another major concern in India and around the world is antibiotic resistance, and PCV is a critical tool to help combat this. The vaccine that India is using includes the pneumococcal serotypes that have been linked to antimicrobial resistance. Finally, by helping prevent disease and reduce hospitalizations, PCV will help Indian families and the broader health system avoid millions of dollars in treatment-related costs each year.
This article was first published in Global Health NOW, a news website and free weekday e-newsletter of essential global health news and views. Global Health NOW is an initiative of the Johns Hopkins Bloomberg School of Public Health.
The Journey Matters: Why Vaccine Supply Chains Deserve Much More Attention
This piece was originally published in Global Health NOW and was cross-posted here with permission.
By Bruce Lee, MD, MBA, Director of Operations Research at the International Vaccine Access Center
No matter how effective, no matter how technologically advanced, no matter how inexpensive a vaccine may be, if it cannot get to the person who needs the vaccine, it cannot work. Period. Herein rests the vital, yet under-recognized, importance of vaccine supply chains.
Vaccine supply chains involve complex procedures, logistics, storage facilities, vehicles, refrigerators, freezers, and other equipment involved in getting vaccines from where they are manufactured to people who need them. Think supply chains are simple? Businesses of all types routinely invest substantial time, effort, and resources to ensure that they have effective supply chains. Many of the world’s leading businesses such as Amazon and Walmart owe their successes to having supply chains that are superior to their competitors.
A supply chain is like an orchestra, lots of moving parts that need to be coordinated. And when an orchestra is not coordinated, your ears may hurt. When a vaccine supply chain is not well coordinated, people may fall ill or die from preventable diseases such as measles, mumps, rubella, hepatitis, tetanus, polio, and rotavirus. Supply chains affect everyone. Not just supply chain experts. Not just those in the vaccine world. Not just the people who get infected. Not just the businesses that lose productivity or the health systems that have to care for the sick. Everyone.
For many years, vaccine supply chains and the people working to improve them have been neglected by the vaccine world and have not received the attention and resources they deserve. As a result, many vaccine supply chains around the world are outdated and in serious need improvements, and even substantial re-design. Vaccine stockouts of at least one vaccine, lasting at least one month are occurring in 38% of countries in sub-Saharan Africa. These stockouts interrupt immunization services in 80% of cases (Patrick Lydon et al.). A literature review of 45 temperature monitoring studies found that 37% of vaccine storage units in lower-income countries are exposed to freezing temperatures before they are administered. Freezing can reduce the potency of certain vaccines (Celia Hanson et al.)
Breaks in the supply chain leave many children and adults unprotected from common diseases. Unless things change, the situation will only get worse. With the introduction of new vaccines that protect against rotavirus, pneumococcal disease, and cervical cancer, immunization programs are storing and transporting 4 times the volume of vaccines. Health workers are administering up to six 6 times as many doses per person, including older children, adolescents and adults. Outdated supply chains just can’t keep up.
That’s why the recently-published special issue on immunization supply chains in the scientific journal Vaccine is so important. It brings needed attention to a topic that should concern everyone involved in human vaccines. Vaccine is the pre-eminent journal focused on vaccines, read by the full spectrum of people in the vaccine world, ranging from those involved in discovering and developing new vaccines to those testing vaccines, to those determining how best to administer vaccines, to those making policies about vaccines, to those funding vaccine-related activities.
It’s key to remember that vaccine supply chains matter to everyone in the vaccine world. Think about it. Nearly every characteristic of a vaccine—its size and shape, the number of doses required, its ability to withstand temperature extremes, its target population—affects and is affected by vaccine supply chains. Every component of vaccines and vaccine supply chains is interconnected (e.g., the design and implementation of injection devices, refrigerators, various monitoring devices, vehicles, personnel and training, and information systems). Again, like an orchestra, if one component is out of synch, the rest could easily go haywire.
It’s key to remember that vaccine supply chains matter to everyone in the vaccine world. Think about it. Nearly every characteristic of a vaccine—its size and shape, the number of doses required, its ability to withstand temperature extremes, its target population—affects and is affected by vaccine supply chains. Every component of vaccines and vaccine supply chains is interconnected (e.g., the design and implementation of injection devices, refrigerators, various monitoring devices, vehicles, personnel and training, and information systems). Again, like an orchestra, if one component is out of synch, the rest could easily go haywire.
The special issue is an important step. But more steps need to follow. While vaccine supply chains have gotten more attention over the past decade in large part because of the efforts of those contributing to the special issue, there is much work to be done. Vaccine supply chain experts can’t get it all done by themselves without more attention and support from everyone else in the global community. Remember, in all aspects of life, the journey matters.
New PCV Product Assessment for Vaccine Decision-Makers
The availability of multiple pneumococcal vaccines, with overlapping but non-identical characteristics, including formulation, poses decision-making challenges for countries and partners. The PCV Product Assessment addresses the pressing need for a vaccine decision-making framework—populated by unbiased evidence—that helps to inform product choice, in order to optimize and sustain PCV use.
Download the PCV Product Assessment (April 2017, 162 pages)
What is the scope of this document?
- This technical document synthesizes the epidemiologic and biologic evidence regarding pneumococcal conjugate vaccine (PCV) products, as well as the programmatic considerations surrounding performance, effectiveness, and impact for current PCVs: 10-valent (PCV10) and 13-valent products (PCV13).
- The information here focuses on pre-qualified and globally marketed PCVs, but does not include a systematic review of evidence from previously marketed products (i.e. PCV7), or information on unlicensed products of the past (i.e. PCV9, PCV11), or those that are currently under evaluation.
- This document should not be viewed as formal WHO recommendations as it has not yet undergone formal WHO guideline review.
- The document is not intended as the primary source of information to support decision-making about whether to include PCV in the vaccine program or on dosing schedules, and it does not itself provide any recommendations for product choice.
How can countries use this document?
- As a technical tool to inform PCV decision-making on product choice at the time of introduction and within established PCV programs
- As a resource to readily access key evidence, data and tools for PCV product choice
How can Gavi use this document?
- As a technical tool to inform PCV demand forecasts, including supply planning for country allocation
- As a resource to readily access key evidence, data and tools for PCV product choice
- As a resource to create country guidance on PCV product choices
World Immunization Week 2017: Why it matters now more than ever
This event announcement originally appeared on the World Health Organization website.
World Immunization Week – celebrated in the last week of April (24th-30th) – aims to promote the use of vaccines to protect people of all ages against disease. Immunization saves millions of lives and is widely recognized as one of the world’s most successful and cost-effective health interventions. The theme this year: #VaccinesWork.
2017 marks the halfway point in the Global Vaccine Action Plan (GVAP) – endorsed by 194 Member States of the World Health Assembly in May 2012 – which aims to prevent millions of deaths from vaccine-preventable diseases by 2020 through universal access to immunization.
Despite improvements in individual countries and a strong global rate of new vaccine introduction, all of the targets for disease elimination—including measles, rubella, and maternal and neonatal tetanus—are behind schedule. In order for everyone, everywhere to survive and thrive, countries must make more concerted efforts to reach GVAP goals by 2020. Additionally, those countries that have achieved or made forward progress towards achieving the goals must work to sustain those efforts over time.
Read the full event announcement by WHO.
Dr. O'Brien: It is time to introduce pneumococcal conjugate vaccine in India
In a recent interview with ETHealthworld, Dr. Kate O'Brien, Professor of International Health, Executive Director, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, USA, talks about the major role of PCV vaccines in prevention of deaths among children under the age of five in India.
Read the full news article here.
Three Nigerian organizations win small grants to conduct advocacy for immunization financing
As Nigeria begins the five-year transition from Gavi funding for immunization programs, the International Vaccine Access Center (IVAC) kicks-off a small grants program to support three civil society organizations (CSOs) in advocating for adequate vaccine funding from government.
The small grants program is led in Nigeria by IVAC’s initiative Women Advocates for Vaccine Access (WAVA), a coalition of 34 women-led and women-focused CSOs spanning six geopolitical zones. WAVA members advocate for sustainable immunization financing and equitable access to vaccines for all those who need them in Nigeria.
“Small grants can be catalytic and can provide the momentum to sustain activities long after these grants have ended,” says Kate O’Brien, Executive Director of IVAC.
Each award, valued at 2 million Nigerian nairas (approx. USD $6,400), is earmarked to support the development and implementation of innovative advocacy strategies that will promote adequate vaccine funding at the national and subnational levels. Integral to each project is advancing partnerships and interactions with policymakers, key stakeholders, and communities.
For the first round, applications were evaluated based on:
- Originality and uniqueness of the advocacy strategy
- Connection to a clear and identified problem
- Feasibility of implementation within the specific timeline, with key phases
- Relevance to small grants program objectives
- Clear monitoring and evaluation framework
- Detailed and reasonable budget proposal
A rigorous assessment by IVAC staff and external partners led to the selection of three Nigerian CSOs as award winners:
- African Youth Initiative on Population, Health and Development (AfrYPoD)
Background: AfrYPoD is building a strong network of individuals and youth-led organizations in Africa that promote, lead, and/or support the implementation of the recommendations of multiple internationally agreed upon conventions on health, development, and human rights. The organization’s focus areas are health, governance, migration, and environment. AfrYPoD is based in Abuja, North Central Nigeria.
Project: AfrYPoD will conduct a school debate on vaccine funding, a training for youth-led CSOs on immunization funding advocacy, and a comprehensive social media campaign to engage at least one million young persons.
- Development & Integrity Intervention Goal Foundation (DIG)
Background: DIG is a youth-, children-, and women-focused organization. This sustainable platform advocates for healthy people and healthy environments by promoting integrity, transparency, accountability, and citizen participation in governance. DIG is based in Ebonyi State, South East Nigeria.
Project: DIG will conduct high-level meetings on sustainable immunization financing with key stakeholders in five South East states, weekly radio appearance, social media outreach, and press releases on sustainable immunization financing.
- Women's Initiative for Self-Actualization (WISA)
Background: WISA works to promote women’s rights, gender equity, and sustainable development for poor and excluded women, youth, and children. The organization’s four thematic areas are right to health, right to education, right to food and security, and right to democratic governance. WISA is based in Akwa Ibom State, South-South Nigeria.
Project: In collaboration with two fellow WAVA members, Women United for Economic Empowerment (WUEE) and Dynamic Youth Development Organization (DYDO), WISA will organize advocacy and roundtable meetings, in addition to developing a fact sheet to enhance engagement with policy makers, community leaders, media, and key stakeholders.
The first set of winners will carry out their projects over three months, through the end of May 2017. A second round of the small grants program will take place in early July 2017.
“In the end, even if some didn't win this round of grants, WAVA members are all winners,” says Chizoba Wonodi, the WAVA Convener and the Nigeria Country Director at IVAC. “In our own little ways, we are giving voice to the voiceless and hope to the hopeless by pushing for equitable access to vaccines for all. Contributing to saving one life makes you a winner in my playbook.”
For more information, please contact Hany Helmy, Nigeria Policy and Advocacy Associate, at email@example.com.
New Study Shows that SMS Reminders and Incentives Improve Immunization Coverage and Timeliness in Kenya
A new study published in The Lancet Global Health found that in a setting with high baseline immunization coverage levels, SMS reminders coupled with small monetary incentives significantly improved immunization coverage and timeliness in rural western Kenya. Given that global immunization coverage levels have stagnated around 85%, the use of text message reminders and incentives might be one option to reach the remaining 15% -- which are typically the hard-to-reach populations.
Dustin Gibson, PhD working with Danny Feikin, MD, Kate O’Brien, MD and other colleagues at IVAC, led the study with key partners from the Kenya Medical Research Institute (KEMRI) and CDC Public Health Collaboration. In the study, 152 villages were randomized to one of four arms: (1) control; (2) SMS reminders only; (3) SMS reminders plus a 75 Kenya Shilling (KES) incentive; and (4) SMS reminders plus 200 KES (85 KES = USD$1). Participants in the intervention groups received SMS reminders before scheduled pentavalent and measles immunization visits. Participants in incentive groups additionally received small amounts of money if their child received timely immunization (immunization within 2 weeks of the due date). Children were followed-up to age 12 months where the proportion of children who were fully immunized (receiving BCG, three doses of polio vaccine, three doses of pentavalent vaccine, and measles vaccine) and immunization timeliness (receiving vaccines within two weeks of their Expanded Programme on Immunization scheduled date) were compared across study arms.
The investigators found an 8% increase in full immunization between children of caregivers who received SMS reminders plus a 200 KES (90%) versus those in the control arm (82%). The authors also looked at timely immunization; which is often understudied but very important from a herd immunity perspective. Timely measles immunization significantly improved by 9% in children of caregivers who only received text message reminders – with a 21% increase in those who received SMS reminders and a 200 KES incentive. Gains in measles coverage and timeliness are particularly important because measles is a highly infectious virus; outbreaks can occur in populations when even 5% of children are immunologically susceptible. Equally important, the authors’ findings suggest that interventions did not exacerbate existing inequities in coverage; the text messages and incentives reached many of the traditionally disadvantaged populations who would benefit most. “Making vaccines accessible is sometimes not enough,” explains Dr. Gibson. “Even with high access, people do not receive all vaccines. This research looked at ways to generate demand for immunizations in rural Kenyan caregivers and we may have found one way to increase immunization coverage and timeliness.”
Amidst the Decade of Vaccines and the backdrop of global access to mobile phones, global health experts are searching for ways to meet the Global Vaccine Action Plan targets and reach all children with life-saving vaccines. This study provides rigorous scientific evidence for one potential solution to vaccinate the hardest to reach children – using mobile technology and small financial incentives to enhance demand for immunization and increase full, timely vaccine coverage.
Read the full study here. A commentary written by Abdul Momim Kazi (Aga Khan University) is also available.
In Memoriam: Professor Hans Rosling (1948-2017)
Dr. Hans Rosling, global development champion and data visionary, passed away on Tuesday, February 7, surrounded by his family.
Dr. Rosling brought statistics to life allowing an understanding of development issues in an innovative and captivating way. He spent over 20 years studying konzo, an epidemic paralytic disease, and mentoring research students in Africa. He further dedicated his career to studying the links between economic development, agriculture, poverty and health; he was a valued advisor to WHO, UNICEF, and many global development agencies. At the time of his death Dr. Rosling was a professor of International Health at the Karolinska Institutet and served as Professor and Edutainer at Gapminder an organization he co-founded. Gapminder is a Swedish foundation that produces free teaching resources making the world understandable based on reliable statistics. His career was inspiring to millions through his presentations and TED talks.
“Not only was Dr. Rosling’s work and vision of 'data for action' transfixing and transformative, but he was a charming and engaging person,” remarked Dr. Kate O’Brien, IVAC’s Executive Director. “You could not help but be mesmerized by his work, his vision and his passion for making data, statistics, and evidence dance before you.”
IVAC joins colleagues, friends, and the family of Dr. Hans Rosling in celebrating his life and mourning his passing.
To read more about Dr. Rosling and his career, please visit Gapminder.
New Malawi PCV13 Pneumonia Study Shows Substantial Impact and Uses New Measures
A new study of PCV13 impact on pneumonia in children under 5 years has just been published from Malawi. This time series analysis of routinely collected data from all health system levels includes rarely studied rural community hospitals, health centers, and lay community health workers. Between 2012-2014, following PCV13 introduction in 2011, McCollum, Colbourn and colleagues, documented substantial reductions in the case burden and incidence of severe clinical pneumonia, pneumonia with hypoxemia, and hospital pneumonia mortality.
The authors conducted active surveillance of routine care by public-sector healthcare providers in two central region districts. The analysis employed pre-post comparisons and multivariable time series regression over a two and half year period. In addition to being one of the first studies to report the impact of PCV13 routine programmatic use on pneumonia in a low-income setting, this study is notable for being conducted in an HIV-endemic sub-Saharan African country, and for being one of the first to use a surveillance case definition that includes low oxygen saturation measurements, a measure of disease severity, to monitor PCV impact. This research adds to the expanding body of regional and global evidence that PCV is highly effective at preventing life-threatening pneumonia in children. Other African sites that have reported PCV impact on pneumonia include the Gambia, Kenya, Rwanda, and South Africa with ongoing pneumonia impact studies in Mozambique and Togo.
IVAC names Dr. Chizoba Wonodi Nigeria Country Director
November 28, 2016. The International Vaccine Access Center (IVAC) at Johns Hopkins Bloomberg School of Public Health (JHSPH) is pleased to announce that Dr. Chizoba Wonodi has been named IVAC Nigeria Country Director in recognition of her accomplishments within Nigeria on behalf of IVAC. Dr. Wonodi, will continue to have oversight of IVAC projects in Nigeria including advocacy, health systems research and technical support. As a regular advisor to government and partners on routine immunization and primary health care reforms, Dr. Wonodi has been instrumental in helping drive efforts amongst government, CSOs and partners to focus on both routine and new vaccines in Nigeria.
Under her leadership, Dr. Wonodi has expanded the portfolio of IVAC projects in Nigeria, serving as the principal investigator to multiple Gavi and Gates Foundation-funded projects. The efforts of the Nigeria IVAC team include projects designed to address the need for immunization financing, advocacy for immunization, accountability at the state and national level, including use of score cards, as well as training initiatives that promote the adoption of adult learning approaches.
Prior to joining JSHPH, Dr. Wonodi worked in various positions in the Rivers State Ministry of Health in Nigeria, including work as a medical officer in family planning, ante-natal care, HIV AIDS and immunization, as a primary health care coordinator for a local government and as a program director and consultant for work on HIV AIDS.
Dr. Wonodi is an Assistant Scientist in the Department of International Health at JHSPH. She has a medical degree (MBBS) from University of Benin and a MPH and DrPH from JHSPH. At JHSPH, she was named a Gates Institute and Caroline Cochrane Scholar. Her work with IVAC started with the PneumoADIP in 2005 and over the past several years has been focused on building a portfolio of projects to support decision making and implementation of vaccine programs in Nigeria. She is a member of Nigeria Immunization Financing Task Team (NIFT), Chair of its Advocacy-sub Committee and Convener of Women Advocates for Vaccine Access (WAVA).
We are delighted that Dr. Wonodi has agreed to take on the leadership role and wish her continued success as she builds IVAC’s Nigeria country programs.
Dr. Kate O’Brien
Executive Director, IVAC
REPORT: PNEUMONIA AND DIARRHEA CONTINUE TO KILL HUNDREDS OF THOUSANDS OF YOUNG CHILDREN IN MANY COUNTRIES
--New report highlights need for additional resources and innovations to prevent and treat two common illnesses
November 10, 2016 -- A new report finds some progress in combatting pneumonia and diarrhea among young children in the nations most severely impacted by the two diseases, but they remain responsible for hundreds of thousands of preventable deaths around the world.
In 2015, pneumonia and diarrhea together led to one of every four deaths globally that occurred in children under five years old. These two diseases are largely preventable with vaccines and simple and inexpensive treatments.
Of the 15 countries profiled in the report – those with the highest rates of death globally due to the two diseases – seven have mortality rates of 25 per 1,000 live births or higher due to pneumonia and diarrhea alone. This translates into an estimated 450,000 deaths among children under age five in these countries.
The 2016 Pneumonia and Diarrhea Progress Report: Reaching Goals Through Action and Innovation
is being issued by the International Vaccine Access Center (IVAC) at the Johns Hopkins Bloomberg School of Public Health today ahead of World Pneumonia Day, which takes place every year on November 12. IVAC began publishing its annual report in 2010 with the goal of highlighting two diseases that would, if more children received vaccinations and/or treatment, lead to fewer deaths.
“Pneumonia and diarrhea fly under the radar,” says Kate O'Brien, MD, MPH, a professor in the Bloomberg School’s Department of International Health and IVAC’s executive director. “These illnesses are so common that many people and organizations fail to recognize the need to step up efforts and identify creative solutions to fight them. Although most cases are easily prevented and treated, they often prove deadly when families cannot access basic health services such as vaccines and antibiotic treatment.”
In the report, IVAC identifies the 15 countries with the greatest number of deaths from pneumonia and diarrhea among children under the age of five in a given year. IVAC then uses a scoring method based on the Global Action Plan for the Prevention of Pneumonia and Diarrhea (GAPPD) developed by the World Health Organization and UNICEF. A country’s “GAPPD score” measures the use of interventions that protect against, prevent and treat pneumonia and diarrhea. The higher the score, the more interventions are being used.
These interventions include vaccination, exclusive breastfeeding, access to care and use of antibiotics, oral rehydration solution and zinc to treat the illnesses. These measures are known to prevent childhood deaths due to pneumonia and diarrhea and could help achieve the United Nations’ Sustainable Development target goal of reducing under-five mortality to at least 25 per 1,000 live births by 2030.
Key report findings include:
- Overall GAPPD scores in 2016 varied widely from a low of 20 percent (Somalia) to a high of 74 percent (Tanzania), with all 15 focus countries falling below the 86 percent target for the overall GAPPD score. In 2015, the scores varied from 20 percent (Somalia) to 72 percent (Tanzania), virtually unchanged compared to this year’s scores.
- Twelve countries improved their GAPPD scores since 2015, with Niger making the biggest gain, up 11 points. In 2015, seven countries improved their score.
- Only six of the highest-burden countries (Angola, Ethiopia, India, Niger, Sudan and Tanzania) have introduced rotavirus vaccines in their routine immunization program to help prevent a substantial portion of diarrhea deaths and hospitalizations. India introduced rotavirus vaccines in four states in 2015.
- Fifteen years after pneumococcal conjugate vaccines’ first introduction globally in 2000 (the United States was first to implement the vaccine), five of the highest pneumonia burden countries (India, Indonesia, Chad, China and Somalia) are still not using the vaccine in their routine immunization programs. India recently announced a partial introduction in five states, beginning in 2017.
- Antibiotic use to treat pneumonia in the 15 highest-burden countries varies greatly, from seven percent in Ethiopia to 64 percent in Afghanistan.
- Rates of exclusive breastfeeding during a child’s first six months of life remain low. Currently, 10 of the 15 countries with the most child pneumonia and diarrhea deaths have exclusive breastfeeding rates that still fall short of the 50 percent GAPPD target. There is strong evidence demonstrating that about half of all diarrhea episodes and about a third of respiratory infections could be averted by breastfeeding.
The rate of death from all causes in children under the age of five years has been cut by more than half worldwide since 1990, from 91 deaths per 1,000 live births to 43 in 2015.
“The report highlights incredible progress in child health since 1990, but cautions against complacency in fighting the two leading killers of children,” O’Brien says. “We can do better, we can make better use of the tools in hand and we have great opportunities to create innovations that will save lives.”
The report was funded by the Bill & Melinda Gates Foundation.
Experts in Dengue Control Form New Alliance to Bridge Vaccine and Vector Approaches and Expand Efforts to Zika and Other Aedes-transmitted Diseases
This announcement was originally published on the Dengue Vaccine Initiative website on August 31, 2016, available publically here. It is cross-posted here with permission. IVAC is a member of the Dengue Vaccine Initiative (DVI) and the newly formed Global Dengue and Aedes-transmitted Diseases Consortium (GDAC).
Mexico City, Mexico – August 31, 2016 – Today, four leading institutions at the forefront of dengue prevention and control—the International Vaccine Institute (IVI), the International Vaccine Access Center (IVAC) of the Johns Hopkins University, the Partnership for Dengue Control Foundation (PDC) and the Sabin Vaccine Institute—announced a new global alliance to integrate approaches to fight dengue and other Aedes-transmitted diseases under one strategic umbrella. Named the Global Dengue and Aedes-transmitted Diseases Consortium (GDAC), this new partnership will expand its expertise in dengue to other Aedes-transmitted diseases including Zika, chikungunya and yellow fever, responding to the urgent need for coordination in the currently fragmented efforts to control the diseases transmitted by one of the world's most dangerous animals—the Aedes mosquito.
“Dengue has emerged as one of the most important infectious diseases over the past 40 years, today infecting 400 million people worldwide each year in over 100 countries. Efforts to reverse this trend have fallen short for many reasons, but limited funding, lack of effective tools, and fragmented leadership have been among the most important” said Dr. In-Kyu Yoon, Deputy Director General of Science at the International Vaccine Institute and now Director of GDAC. “Other rapidly spreading Aedes-borne infections such as Zika and chikungunya remind us that Aedes-transmitted diseases will continue to spread as irreversible global trends such as population growth, urbanization and globalization continue to provide the ideal conditions to promote the spread of these diseases. We need a global, unified strategy to prevent and control known and as yet unknown Aedes-transmitted diseases.”
Today we are entering a new era in the fight against dengue and other Aedes-transmitted diseases, with the recent licensure of the first dengue vaccine and recent innovations in mosquito control and diagnostics. Many of these new technologies will become available for use in the next three to five years, but when used alone none will be as effective as when they are used in combination. GDAC proposes the use of these methods in combination to substantially decrease transmission and prevention of major epidemics of dengue and other Aedes-transmitted viruses.
Working closely with the World Health Organization (WHO), GDAC will provide scientific evidence to facilitate comprehensive Aedes-transmitted disease control, incorporating research and public health projects, technical meetings and consultancies, regulatory and policy support, financing frameworks and communications and advocacy. GDAC’s key objectives are to accelerate innovation and application of vaccines, vector control, antivirals, clinical management, therapeutics, diagnostics and surveillance, and licensure and post-marketing oversight of vaccines. GDAC will also focus on strengthening social mobilization, advocacy and capacity building. It will continue its members’ work with vaccine early adopter countries to develop integrated control strategies specific to those countries. GDAC will work with all stakeholders to develop strategies designed to prevent outbreaks caused by other viruses transmitted by Aedes mosquitoes.
“We propose to provide the leadership for integrated program implementation under one umbrella, working closely with the WHO and international funders, to reverse the trend of expanding epidemic dengue and other Aedes-transmitted viruses as public health problems” said Prof. Duane J Gubler, Chairperson of GDAC and Prof. Emeritus of the Program in Emerging Infectious Diseases, Duke-NUS Medical School. While much has been achieved in the past decade in developing new tools, it is unlikely that any of these new tools will be successful in controlling these diseases when used alone. Success will largely depend on integration of tools, effective partnerships, and coordinated leadership in program implementation. Our collective efforts are essential to eliminating the Aedes-mosquito as a public health threat worldwide.”
GDAC brings together the Dengue Vaccine Initiative (DVI) and the Partnership for Dengue Control (PDC). Established in 2011 by IVI, IVAC, Sabin and the WHO, DVI focused on accelerating the development and introduction of safe and protective dengue vaccines into public-sector programs, especially for the poor, stimulating the development of safe and effective dengue vaccines. PDC was created in 2013 by a group of international dengue and public health experts to build synergies among exciting new tools in the development pipeline. Hosted by Fondation Mérieux, its mission is to promote development and implementation of innovative integrated approaches for the prevention and control of dengue.
Now as GDAC, the four partners will combine their expertise across major spheres within global health, including epidemiology, health economics, advocacy and communication and surveillance. With a global presence, spanning Asia, America and Europe, they will build a common agenda to lead the new era for Aedes-transmitted diseases prevention and control.
About the International Vaccine Institute
The International Vaccine Institute (IVI) is an international organization devoted to developing and introducing new and improved vaccines to protect the world's poorest people, especially children in developing countries. Established in 1997, IVI operates as an independent international organization under a treaty signed by 35 countries and the World Health Organization. The Institute conducts activities in more than 20 countries of Asia, Africa and Latin America on vaccines against a variety of diseases, and develops new and improved vaccines at its headquarters in Seoul, Republic of Korea. For more information, please visit http://www.ivi.int.
About the International Vaccine Access Center
The International Vaccine Access Center (IVAC) aims to accelerate equitable and sustainable access to vaccines through the generation, synthesis, and use of evidence to inform decision making and action. IVAC accomplishes this by drawing upon expertise from the Johns Hopkins Bloomberg School of Public Health faculty and partners. IVAC works to build knowledge about the value of vaccines to help support strong immunization programs through targeted, policy-focused research and practice in areas such as disease burden, cost-effectiveness, vaccine policy, financing, demand forecasting and disease epidemiology. For more information, please visit www.jhsph.edu/ivac.
About the Sabin Vaccine Institute
The Sabin Vaccine Institute (Sabin) is a non-profit, 501(c)(3) organization of scientists, researchers and advocates dedicated to reducing needless human suffering from vaccine-preventable and neglected tropical diseases (NTDs). Since its founding in 1993 in honor of Dr. Albert B. Sabin, the developer of the oral polio vaccine, Sabin has been at the forefront of global efforts to eliminate, prevent and cure infectious and neglected diseases. Sabin develops new vaccines, advocates for increased use of existing vaccines and promotes expanded access to affordable medical treatments in collaboration with governments, academic institutions, scientists, medical professionals and other non-profit organizations. For more information, please visit www.sabin.org.
About the Partnership for Dengue Control Foundation
The Partnership for Dengue Control (PDC) was created in 2013 to spearhead an integrated approach to sustainably control and prevent dengue. As a non-profit foundation, it brings together leading experts in the dengue-prevention community from different fields to address key issues, with an emphasis on combining vector control and vaccination strategies. PDC seeks to build synergies among the many new and innovative tools in the development pipeline. Its unique approach is developed through workshops, multidisciplinary task forces, research agenda, advocacy and other initiatives. Hosted by Fondation Mérieux, PDC is led by an independent board with Prof. Thomas W. Scott as chairman and Prof. Annelies Wilder-Smith as director. They replace PDC’s founding chairman, Prof. Duane Gubler, and founding director, Dr. Rémy Teyssou, who both continue on the PDC Foundation board. To find out more: www.controldengue.org
IVAC Launches The Pneumonia Newsletter
The Pneumonia Newsletter, a new resource for child health champions compiled by the International Vaccine Access Center, is now available.
The goal: to connect advocates around the world who are fighting pneumonia, not just on World Pneumonia Day but year-round. The newsletter includes updates on pneumonia innovation, country progress, advocacy and research. This one-stop resource for all things childhood pneumonia keeps advocates informed, and it serves as a platform to share their stories and work with the global community.
The June issue is available, here
Sign up to receive routine updates, here
GAPS IN VACCINE COVERAGE HIGHLIGHTED WITH NEW REPORT AND ONLINE TOOL
New report informs WHA dialogue on the leading killers of children: pneumonia and diarrhea
As the 69th World Health Assembly discusses progress on the Global Vaccine Action Plan, a new data visualization platform—from the International Vaccine Access Center (IVAC) at the Johns Hopkins Bloomberg School of Public Health (JHSPH)—provides stark numbers on where shortfalls exist in vaccine introduction and coverage.
The Vaccine Information Epidemiology Window (VIEW-hub) incorporates data on Haemophilus influenzae type B (Hib) vaccine, pneumococcal conjugate vaccine (PCV) and rotavirus vaccine. Despite their effectiveness in preventing pneumonia and diarrhea, these pathogens and the conditions they cause continue to be leading causes of death worldwide among children under 5 years of age.
VIEW-hub shows where children are unvaccinated because either their country has not introduced the vaccine, or the country’s routine immunization services are not reaching them. For example:
- 42 percent of the world’s infants (56.1 million) are not receiving Hib vaccine;
- 60 percent (80.7 million) are not receiving PCV;
- 76 percent (102.8 million) are not receiving rotavirus vaccine.
What’s more, 72 percent of the global burden of pneumonia and diarrhea child deaths occur in just 15 countries—India, Nigeria, Pakistan, DRC, Angola, Ethiopia, Indonesia, Chad, Afghanistan, Niger, China, Sudan, Bangladesh, Somalia and the United Republic of Tanzania. The two countries with the greatest absolute burden, Nigeria and India, are in the early stages of introducing these vaccines.
“Asia, in particular, lags in rotavirus vaccine introduction,” points out Mathuram Santosham, MD, MPH, senior advisor at IVAC and chair of the Rotavirus Organization of Technical Allies (ROTA) Council. “No country in South or South-East Asia has introduced rotavirus vaccine nationally, and only three—India, Thailand and the Philippines—have introduced sub-nationally.”
Even among countries that have introduced Hib, PCV and rotavirus vaccines, coverage is not reaching target levels. According to the Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD), from WHO and UNICEF, at least 90% of children should be immunized in countries where the vaccines are available.
In Africa, for example, 44 out of the 54 countries have introduced the PCV vaccine. However, only 8 countries have reached very high coverage rates (90-100 percent); close behind are only 9 countries with high coverage rates (80-89 percent), based on the 2015 WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) for 2014. This suggests that governments have made progress in decision making, but are lagging in policy implementation.
“If the ultimate goal is to reach as many children as possible with vaccines, introduction data isn’t enough,” says Kate O’Brien, MD, MPH, Executive Director of IVAC, “we need to look at coverage, how many kids in the country are actually getting the vaccines. New policies to allow vaccines into a country’s routine schedule does no good for children if they aren’t actually receiving them.”
With real-time data updates, VIEW-hub can be used to monitor introduction and implementation, and to develop strategies for accelerating progress on global and country levels. Data sources include the World Health Organization, Centers for Disease Control and Prevention, UNICEF, Gavi, Bill and Melinda Gates Foundation, government Ministry of Health websites and vetted media sources. VIEW-Hub is also monitoring vaccine impact evaluations, including for PCV and rotavirus vaccine. The full report is available here: http://www.jhsph.edu/research/centers-and-institutes/ivac/view-hub/IVAC-VIEWHub-Report-2016May.pdf
VIEW-hub is supported by grants from Gavi and the Bill and Melinda Gates Foundation.
IVAC Launches VIEW-hub Interactive Data Visualization Platform
IVAC’s new VIEW-hub (Vaccine Information and Epidemiology Window) platform is now live. VIEW-hub is a publicly accessible, interactive platform that enables users to instantly visualize data about vaccine introductions, product usage, dosing schedules, access, coverage, and more for a number of vaccines. Custom queries and maps, exportable data and graphics, and a map gallery are just some of the interactive features users can access.
VIEW-hub compiles data from a variety of official and unofficial vetted partner sources—WHO’s Immunization Data Repository and other official WHO sources, UNICEF, Gavi, government ministry of health websites, CDC, the Bill & Melinda Gates Foundation, recurring literature sources, and vetted media—in a central platform where data visualization and summaries can be easily generated and customized. Data are gathered systematically across official sources as needed to ensure validity. VIEW-hub extends the functionality and content of the former Vaccine Information Management System (VIMS), allowing users to track progress and strategize ways to accelerate and optimize vaccine implementation.
To learn more about the new tool and view video tutorials on how to use the platform, click here. For any further inquiries related to VIEW-hub, please contact Linh Nguyen at firstname.lastname@example.org.
Recent Publications Highlight the Costs of Pneumococcal Disease and Impact of Vaccines in The Gambia
As celebration of World Immunization Week continues, two recently published studies shed light on the economic costs of pneumococcal disease and the health impact of the vaccines designed to prevent it.
Researchers at the Medical Research Council Unit The Gambia (MRC) estimate that diseases caused by pneumococcal bacteria – which can include both mild and severe pneumonia as well as devastating invasive diseases like sepsis and meningitis – cost Gambian society between $15 and $170 per case, on average. These costs include direct medical costs to treat the disease as well as family out-of-pocket costs for illness-related expenses like transportation to hospitals and a caretaker’s time off from work while children are sick (kids under five are most susceptible to pneumococcal infections).
The $170 price tag for the average case of pneumococcal meningitis, the most expensive form of pneumococcal disease in the Gambia, is nearly five times the average monthly household income of $38 per month. Although much of the total cost is borne by the Gambian government, the $48 average cost to households means families are often left in dire financial straits after treatment – if their child recovers at all. The reality is that about one in five children who developed pneumococcal meningitis in the study died.
The devastating health and financial consequences of these diseases is important to contextualize. According to Dr. Grant Mackenzie, one of the studies’ lead authors, “a substantial portion of families in The Gambia cannot afford to stock up on rice, the main food staple, so spending to ensure a child is treated for pneumococcal disease will leave most families hungry for two to three weeks.”
But there’s hopeful news from The Gambia, too. Researchers at MRC also found that the introduction of pneumococcal conjugate vaccine (PCV) in The Gambia in 2009 has had a significant effect on the number of children suffering from severe pneumococcal disease. The vaccine has reduced the incidence of the deadliest kinds of pneumococcal disease in children (invasive pneumonia, sepsis and meningitis) by 55%. This means that, thanks to the vaccine, kids are significantly less likely to become infected with – and die from – pneumococcal disease.
Dr. Mackenzie sees these results as key indicators of the importance of PCV throughout the African region. “There are few sites in Africa which can determine the impact of PCV, so we hope other African governments will use our results as evidence demonstrating the effectiveness of PCV in similar settings. This is critical so that governments will have confidence that their continuing financial investments in PCV are worthwhile.”
For families in The Gambia and elsewhere, PCV continues to prove a critical tool in minimizing the financial and human costs of pneumococcal disease.
WHO Recommends Dengvaxia® Use in Areas of High Dengue Risk
December 2015 was a very decisive month, witnessing the first approvals ever granted to a dengue vaccine manufacturer for use of their candidate in a country. Mexico registered Sanofi Pasteur’s Dengvaxia® on December 10, followed a few weeks later by the Philippines, Brazil and El Salvador for people aged 9-45 years living in dengue endemic areas. Four months later, on April 15, 2016, the World Health Organization (WHO) Strategic Advisory Group of Experts (SAGE) on Immunization issued a recommendation to use Dengvaxia® only in high-risk geographic settings.
As SAGE emphasizes, vaccine introduction requires careful considerations of local priorities, dengue epidemiology, and vaccine impact with rates and costs. But perhaps the greatest challenge facing dengue-endemic countries will be how to finance vaccine introduction. Vaccine price, availability of funding, and ability to negotiate pricing all play a critical role in the ability of a country to finance a dengue vaccine. While the Philippines has began to rollout the vaccine in the most affected areas of its country, Mexico, Brazil and El Salvador continue to negotiate pricing with the manufacturer.
For the last six years, IVAC—a core partner in the Dengue Vaccine Initiative—has been working steadily to address issues regarding vaccine funding and affordability, soliciting input from key stakeholders about how to effectively and efficiently finance the introduction of dengue vaccines, developing financing strategies for vaccine introduction, generating evidence-based information that supports countries’ decisions on dengue vaccine introduction, and raising the visibility of the financing challenges and opportunities ahead in vaccine introduction. This work has been critical to laying the groundwork for countries to establish a viable financing plan, which can be immediately implemented following the introduction of a dengue vaccine.
IVAC Joins Newly Launched Dose Per Container Partnership (DPCP) led by JSI
IVAC is pleased to become a member of JSI Research and Training Institute’s Dose Per Container Partnership (DPCP). Three members of IVAC/Johns Hopkins Bloomberg School of Public Health, including Bruce Lee, Lois Privor-Dumm and Dan Salmon are now providing their expertise to an issue that has been an important concern for the team over the past several years. Projects leading up and contributing to this initiative included the Primary Container Roundtable, HERMES modeling efforts and work around vaccine safety and confidence. The aim of the partnership is to use Dose per Container (DPC) information to support vaccine product and program decision making in order to optimize high, equitable, timely, safe and cost-effective coverage. This work will involve documentation of current policies and processes in combination with studies that document the programmatic implications of vaccine presentation. Programmatic implications of DCP, which include cost, cost per dose delivered (including wastage), equitable and timely coverage, compliance with the multi-dose vial policy, healthcare worker perceptions, safety and missed opportunities, will be assessed in country so that the evidence case for sometimes complex decisions can be supported through a better understanding of the relationship between DPC and the various immunization and health system variables. Tools will be developed and data disseminated to help countries make better decisions about the key trade-offs between cost and health impact.
Rwanda Study Demonstrates the Benefits of Routine Vaccination Against Rotavirus in Low-Income Settings
A new study published in February’s edition of the Lancet Global Health offers significant findings about the impact of pentavalent rotavirus vaccine on hospital admission for diarrhea and rotavirus in children in Rwanda, which in 2012 became the first low-income African country to introduce pentavalent rotavirus vaccine into its national immuniation program. Researchers from Rwanda’s Ministry of Health, CDC, WHO, and partner organizations examined trends in pediatric hospital admissions from 2009 to 2014 and looked at other epidemiological evidence from the country.
The study showed hospital admissions for acute gastroenteritis decreased by about half (48-49%) and admissions specific to rotavirus declined by 61-70% following introduction of rotavirus vaccine in the routine national immunization program. The greatest effect was recorded in children of vaccination age, but researchers noted a decrease in rotavirus diarrhea hospitalizations in almost every age group, suggesting herd immunity. Indirect protection of children too old to have been vaccinated has been previously reported in high-income and middle-income countries including the USA, Australia, and El Salvador, but this paper provides the first evidence of indirect protection from rotavirus vaccination in a high-burden, low-income setting.
This paper provides strong evidence of the public health impact of introducing rotavirus vaccine nationally in low-income settings, and the first data demonstrating the impact of routine pentavalent rotavirus vaccination in Africa. The reductions in hospital admissions for diarrhea noted in Rwanda is similar to decreases recorded after national rotavirus vaccine introductions in Brazil, Mexico, and Panama.
Read the full study here.
Thailand Study Uncovers the High Burden of Pneumococcal Pneumonia in Adults
A study led by the Ministry of Public Health in Thailand recently published in the American Journal of Tropical Medicine and Hygiene calculated a 14-fold higher rate of pneumococcal pneumonia hospitalizations among adults than previously estimated. Through a well-established pneumonia surveillance system initiated with support from the PneumoADIP project at the International Vaccine Access Center (IVAC) at Johns Hopkins Bloomberg School of Public Health and the use of a urine pneumococcal antigen test, the study updated estimates of pneumococcal pneumonia among adults in rural Thailand.
Pneumococcal pneumonia is typically diagnosed by detection of Streptococcus pneumoniae by blood culture, a notoriously challenging and insensitive technique. Although not perfect, the urine antigen assay improved case detection substantially over the blood culture. For every case with a positive blood culture, at least three to six additional pneumococcal pneumonia cases are detected by the urine test.
These findings provide important data for policy discussions on pneumococcal conjugate vaccine (PCV) in Thailand, where PCV is not currently part of the national vaccination schedule, and elsewhere in Southeast Asia. Because PCV use among children reduces pneumococcal transmission to unvaccinated persons, PCV use has led to important reductions in rates of pneumococcal pneumonia (and other pneumococcal infections) among adults, a group not typically targeted for vaccination, in many settings. This herd effect among adults is a key factor in cost-effectiveness estimates when considering PCV recommendations for children.
Findings from the study suggest a substantially greater benefit and cost-effectiveness for prevention of pneumococcal disease in adults by vaccinating children than previously estimated in Thailand.
Read full study here.
Anita Shet, MD, PhD, Joins IVAC as Pediatric Infectious Disease Specialist and Epidemiologist
January 20, 2016: The International Vaccine Access Center (IVAC) announced today that Dr. Anita Shet, a Professor in the Department of Pediatrics at St. John’s Medical College Hospital in Bangalore, India, will join the IVAC team as a pediatric infectious disease specialist and epidemiologist. Dr. Shet will be a member of the Epidemiology team, but will work closely with the Policy, Advocacy and Communications team.
Dr. Shet will work on the Baseline Assessment for Streptococcus Pneumoniae of India Serotypes (BASIS) study characterizing the serotype distribution of invasive pneumococcal isolates in India (for which she is currently a site investigator) and the Building an Enabling Environment for Vaccines in India (EEVI) project. EEVI aims to create an environment that enables timely, evidence-based policies and decisions for nationwide introduction and delivery of pentavalent, rotavirus, and pneumococcal vaccines into India’s Universal Immunization Programme, while simultaneously raising the volume of political and public discussion around the value of vaccines and a high quality routine immunization system as a necessary part of cost-effective, integrated public health.
Dr. Shet received her medical degree from St. Johns Medical College, Bangalore, India and doctoral degree from the Department of Public Health Sciences at the Karolinska Institute in Sweden. Her doctoral thesis was on the use of mobile phones to improve the care of HIV-infected patients.
Dr. Shet completed her residency training in pediatrics and post-doctoral Fellowship in Pediatric Infectious Diseases at the University of Minnesota. She was then a Clinical Scholar at the Aaron Diamond AIDS Research Center, Rockefeller University in New York. Since 2008, Dr. Shet has been Laboratory Head of Clinical Virology at St. John’s Research Institute. She established the first pediatric infectious disease clinic at St. John’s Medical College Hospital and the first pediatric infectious disease fellowship program in India.
Dr. Bill Moss, IVAC’s Deputy Director, stated “Dr. Shet’s research and publications have spanned the broad array of pediatric infectious diseases, including rotavirus, tuberculosis and rickettsial diseases, with a strong focus on HIV infection. IVAC is delighted to have such a talented and experienced clinician scientist as a member of our team.”
NEW REPORT HIGHLIGHTS GAINS IN CHILD SURVIVAL, BUT THERE’S STILL WORK TO BE DONE TO ADDRESS LEADING KILLERS
International Vaccine Access Center (IVAC) at Johns Hopkins Bloomberg School of Public Health releases its 2015 Pneumonia and Diarrhea Progress Report: Sustainable Progress in the Post-2015 Era
Baltimore, MD, November 12, 2015: The 2015 Pneumonia and Diarrhea Progress Report: Sustainable Progress in the Post-2015 Era, released today on World Pneumonia Day by the International Vaccine Access Center (IVAC) at the Johns Hopkins Bloomberg School of Public Health, documents the progress of the 15 countries experiencing the greatest burden of pneumonia and diarrhea.
Although global progress has been made towards achieving the Millennium Development Goals and reducing child deaths, in 2015 a projected 5.9 million children around the world will die before reaching their fifth birthday. Of these 5.9 million deaths, pneumonia was responsible for 16% and diarrhea was responsible for 9%, making them two of the leading killers of children worldwide. This report highlights the need for sustained efforts to decrease the global burden of pneumonia and diarrhea, especially in the 15 highest burden countries.
Progress in countries is evaluated through "Global Action Plan for Prevention and Control of Pneumonia and Diarrhea (GAPPD) intervention scores" a calculated average of coverage levels for the vital pneumonia and diarrhea interventions outlined in the World Health Organization (WHO) and UNICEF’s integrated GAPPD for which data are available, including vaccination, exclusive breastfeeding, access to care, and use of antibiotics, oral rehydration solution, and zinc.
“This World Pneumonia Day, we celebrate the progress made in preventing pneumonia and reducing child deaths around the world. This year's Pneumonia and Diarrhea Report highlights the need for sustainable progress as we move beyond 2015 toward achieving the Sustainable Development Goals. This means increasing equitable access to vaccines, diagnostic tools, and medication to prevent unnecessary pneumonia and diarrhea deaths," said Kate O'Brien, Professor, Johns Hopkins Bloomberg School of Public Health and Executive Director of IVAC.
Vaccine introductions and scale ups, promotion of exclusive breastfeeding for the first six months of a child’s life, increasing access to appropriate pneumonia treatment, and ensuring sustainability for the post-2015 agenda are all required to put an end to these preventable diseases.
Key Findings from this year’s report:
- Overall GAPPD scores in 2015 varied widely from a low of 20% (Somalia) to a high of 72% (Tanzania), with all 15 focus countries falling below the 86% target for the overall GAPPD score.
- Rates of exclusive breastfeeding during a child’s first six months of life remain low. Currently, 12 of the 15 countries with the most child pneumonia and diarrhea deaths have exclusive breastfeeding rates that still fall short of the 50% GAPPD target for this protective intervention.
- Currently, 3 of the 15 countries (Sudan, Bangladesh, and Tanzania) have met or exceeded the 90% GAPPD coverage target for Hib vaccination and several countries are relatively close to reaching the target, including Pakistan (73%), DRC (80%), Angola, (80%), Ethiopia (77%), and Afghanistan (75%). Still, many countries continue to have extremely low coverage, such as India (20%), Indonesia (21%), Somalia (42%), and Chad (46%).
- Fifteen years after PCV’s first introduction in 2000, five of the highest burden countries (India, Indonesia, Chad, China, and Somalia) are still not using the vaccine in their routine immunization programs.
- Of the 10 GAPPD interventions evaluated in this report, pneumonia and diarrhea treatment tend to have the lowest coverage rates; some countries are not reporting any data at all, creating blind spots on progress and program performance.
- To meet the Strategic Development Goal 3.2 of ending preventable deaths of neonates and under-five children by the year 2030 and achieving high coverage of GAPPD interventions in places where the most children are dying of preventable causes is undoubtedly needed.
IVAC Co-Hosts Workshop "Polio End Game in India: Critical Role of Medical Professionals"
August 3, 2015 - The medical community gathered in Lucknow, India to discuss their role in India's Polio End Game Plan and IPV introduction. Organizers of the event included Child Health Foundation, Indian Academy of Pediatrics (IAP) Uttar Pradesh, Global Health Strategies, and the International Vaccine Access Center (IVAC) at Johns Hopkins Bloomberg School of Public Health. See the full agenda here.
The meeting, which focused on the Polio Endgame Strategy, the IPV plan in India, and the communications plan for polio in India was attended by more than 50 individuals. Chief guests included: Shri Ahmed Hassan, Honorable Minister of Health & Family Welfare, Uttar Pradesh; Dr. Pradeep Haldar, Deputy Commissioner (Immunization) MOHFW, GOI; Dr. Sachidanand Kamath, President - Indian Academy of Pediatrics; and, Dr. V N Tripathi - Director General Medical Education, Uttar Pradesh. Other dignitaries present were Dr. S Manazir Ali - President, Academy of Pediatrics, Uttar Pradesh; Dr. SAS Yadav - Chief Medical Officer, Lucknow; Dr. Anisur Rahman Siddique - from UNICEF; and, Dr. Arindam Ray from the Bill and Melinda Gates Foundation. Faculties were Dr. T Jacob John, Dr. Naveen Thacker, and Dr. Vipin M Vashishtha.
Health Minister, UP, during his speech stated: "When they called me for meeting, I thought polio is over for three years, why are they talking about polio now. But now I understand and endorse the Endgame Strategy. This is the most important meeting. My full support and blessings to you all." The Health Minister cautioned this will be a new vaccine [IPV] and there may be obstacles. He advised to make sure that right messages reach the community and to use single dose vial otherwise there may be issue of quality and cold chain.
IAP president Dr. S S Kamath announced full support by the Academy to all the partners for IPV introduction and tOPV to bOPV switch.
Remarks from Lois Privor-Dumm, Director, Policy Advocacy & Communications, (IVAC):
Polio is an enormously important topic for India and the world. India has achieved important milestones that help give the public health community hope that polio will soon be eradicated. Just 10 years ago, this seemed to be an impossibility, but now that goal is moving closer and closer.
I wish you a very successful meeting and express my sincere thanks to the commitments you make to the children of India. I also want to thank our fellow organizers, Child Health Foundation, Indian Academy of Pediatrics Uttar Pradesh and Global Health Strategies for organizing this very important event.
Dengue Vaccine Initiative Statement on Results of Studies on the Efficacy and Long-Term Safety of Sanofi Pasteur’s Dengue Vaccine Candidate in Dengue-Endemic Regions
This statement is cross posted from Dengue Vaccine Initiative (DVI), an international consortium that specializes in epidemiology and other research, health economics, policy and advocacy to equip countries with objective information and scientific evidence to fight dengue fever, of which IVAC is a member. The full statement is available here.
July 27, 2015
A study titled “Efficacy and Long-Term Safety of a Dengue Vaccine in Regions of Endemic Disease” (Hadinegoro et al.), published today in The New England Journal of Medicine, assesses vaccine efficacy and interim long-term safety results of Sanofi Pasteur’s dengue vaccine candidate, CYD-TDV, across three clinical trials in dengue-endemic countries within Asia-Pacific and Latin America. This analysis marks a significant scientific milestone in Sanofi Pasteur’s efforts to develop a dengue vaccine.
Analyses of pooled data from the two Phase 3 trials (CYD14 in Asia-Pacific and CYD15 in Latin America) showed a reduction in dengue disease during the first 25 months of the study among children and adolescents 2-16 years of age who received CYD-TDV, consistent with previously published results from each trial. The pooled data allowed for greater post-hoc analysis of age effects. Among individuals aged 9 years and older, efficacy was substantially higher at 65.6% than in younger children. Children aged 9 and older who had evidence of prior dengue virus infection (i.e., were seropositive) had an efficacy of 81.9%; seronegative individuals in this age group had significant efficacy of 52.5%. Serotype-specific efficacy was also significant in the older age group, ranging from 47.1% against serotype 2 to 83.2% against serotype 4. Among children younger than 9 years of age, efficacy was lower at 44.6% with 70.1% efficacy in seropositive and 14.4% in seronegative children. Efficacy against severe dengue and hospitalization was 93.2% and 80.8%, respectively, in individuals aged 9 years or older; and 44.5% and 56.1%, respectively, in children younger than 9 years.
Long-term safety follow up from the third year of the Phase 3 trials and from the third and fourth years of a Phase 2b long-term follow up study (CYD23/57) conducted in Thailand demonstrated reduction in dengue hospitalizations among individuals 9-16 years of age for up to two years after completion of the three-dose vaccine regimen. The pooled relative risk of hospitalization among individuals aged 9 years or older was 0.50, demonstrating significantly decreased risk in vaccine recipients. However, this risk reduction was not observed among vaccinated children under 9 years old. The pooled relative risk of dengue hospitalization in this younger vaccinated group was 1.58 during the third year, suggesting a trend to increased risk. Among the very young children, this increased risk became more apparent. The relative risk of hospitalization in 2-5 year old vaccinated children during the third year of CYD14 was 7.45 and in 4-5 year old vaccinated children in the third year of CYD 23/57 was 2.44.
The Dengue Vaccine Initiative welcomes the demonstrated vaccine efficacy across age groups and geographic regions. In particular, the Initiative is encouraged by the overall level of protection and prevention of severe dengue and hospitalizations among individuals 9 years of age or older, along with the significant reduction in dengue cases among both seropositive and seronegative individuals within this age group without apparent safety issues. However, DVI considers further evaluation in the population at large, especially in children younger than 9 years of age, to be crucial to better understand the effects of this vaccine, as well as to clarify the duration of protection. Of particular importance will be to understand why there appeared to be an increased risk of hospitalization among the very young during the third year, and whether this risk continues into subsequent years. DVI looks forward to further information from the additional years of long-term safety follow up from these three ongoing trials.
Study Suggests Vial Size Can Have Large Impact on Vaccine Supply Chain
May 1, 2015
Vaccine vial size – the total number of doses a single vaccine vial contains – can have a significant impact on vaccine distribution, costs, and use, according to a paper recently published in the journal Vaccine.
In the study titled “One Size Does Not Fit All: The Impact of Primary Vaccine Container Size on Vaccine Distribution and Delivery,” researchers at the International Vaccine Access Center (IVAC) at the Johns Hopkins Bloomberg School of Public Health and the Pittsburgh Supercomputing Center (PSC), in collaboration with the LOGIVAC project with the Agence de Médecine Préventive (AMP), used the simulation modeling platform HERMES to estimate the impact of various vaccine vial sizes on the vaccine supply chain, including vaccine availability and costs. HERMES is a software platform created by the HERMES Logistics Modeling Team that allows users to generate a detailed discrete event simulation model of any health supply chain. This simulation model can serve as a “virtual laboratory” for decision makers to address a variety of questions.
The Vaccine journal article is a major output from IVAC and PSC’s efforts to assist countries in making informed decisions for vaccine delivery optimization and was based on a Primary Vaccine Container Selection Roundtable organized by IVAC, which convened stakeholders from various backgrounds to explore the implications of vaccine container choices on access, cost, and safety. “Other industries, such as the soda industry, have recognized the importance of the design of containers, bottles, cans, etc.,” explains Bruce Lee, the HERMES Team Scientific Lead, Director of Operations Research at IVAC, and Associate Professor of International Health at the Johns Hopkins School of Public Health. “Historically, however, not as much attention has been focused on the vials that contain vaccines. This study shows that vaccine containers matter too and can mean the difference between thousands of people getting life-improving and life-saving vaccines.”
In a HERMES-generated model of the vaccine supply chain of the West African nation of Benin, vial-size decisions had far-reaching and reverberating impacts throughout the vaccine supply chain. Vial size greatly impacted supply chain logistics, increasing and decreasing constraints and bottlenecks depending on the combination of vial sizes used, with considerable effect on the availability of vaccines.
Results from this study suggest that primary container choice also affects critical indicators of immunization system efficiency and costs. For example, increasing vial size reduced total costs by as much as USD 0.25 per dose – a remarkable impact considering that millions of doses of vaccines are administered globally each year.
Overall, the study highlights the importance of careful decision-making in designing and implementing immunization systems. And according to the study’s lead author, HERMES Team Coordinator, and Public Health Applications Manager at PSC Leila Haidari, studies like these are critical to evaluating new technologies and products. “Computational modeling can play a critical role in assessing new technologies and alternative products, whose effects can be difficult or impossible to predict without a tool like HERMES,” Haidari says. “Vaccine supply chains are complex, dynamic systems that can make great use of modeling to inform policy decisions.”
About IVAC: The International Vaccine Access Center (IVAC) aims to improve access to life-saving vaccines by ensuring that the evidence required for decision-making is generated and synthesized, made available to policy makers, and results in concrete action. IVAC’s work spans the fields of vaccine economics, epidemiology, clinical trials, modeling, advocacy and policy to address viral, bacterial and parasitic pathogens and disease syndromes.
About PSC: The Pittsburgh Supercomputing Center (PSC) is a joint effort of Carnegie Mellon University and the University of Pittsburgh. PSC provides high-performance and data-intensive computing resources to the national research community. Established in 1986, PSC is supported by several federal agencies, the Commonwealth of Pennsylvania and private industry, and is a leading partner in the National Science Foundation XSEDE program.
Mathuram Santosham Receives 2014 Fries Prize for Improving Health
Johns Hopkins professor honored for his contribution to children's health around the world
October 7, 2014
Mathuram Santosham, MD, MPH, a professor in the departments of international health and pediatrics at Johns Hopkins University and director of the Johns Hopkins Center for American Indian Health, has been awarded the 2014 Fries Prize for Improving Health. The award was presented today at the Centers for Disease Control and Prevention (CDC) in Atlanta, GA, based on his research and contribution to fighting the deadly Haemophilus influenzae type b (Hib) disease. As a result of this work, every country in the world has made the decision to use the Hib conjugate vaccine. Gavi, an international organization created to improve access to vaccines for children in poor countries, estimates that by the year 2020, approximately 7 million lives will be saved by using the Hib vaccine.
“Dr. Santosham has dedicated himself to assure that all children in the world have access to life-saving Hib vaccines,” says Dr. James F. Fries, professor emeritus of medicine at Stanford University and chairman of the James F. and Sarah T. Fries Foundation, which in partnership with the CDC Foundation awards the annual prize. “Thanks to the work of Dr. Santosham, one of the most lethal diseases of children is near elimination in many countries.”
Santosham is regarded as an international expert in oral rehydration therapy and childhood vaccines. Throughout his career, he has conducted numerous vaccine efficacy trials, including rotavirus vaccine, Hib conjugate vaccine, and pneumococcal conjugate vaccine among American Indian populations. Santosham was principal investigator of the Hib Initiative, which was a $37 million grant awarded by Gavi to the Johns Hopkins University Bloomberg School of Public Health to support a consortium among the School, CDC, the World Health Organization (WHO), and the London School for Hygiene and Tropical Medicine to help encourage evidence-based decision making around the introduction of Hib vaccines in the world’s poorest countries. When the Hib Initiative started, only 20 percent of Gavi-eligible countries had introduced the Hib vaccine. As of this year, all Gavi-eligible countries have introduced the Hib vaccine, with more than 95 percent of all countries now using the Hib vaccine in their national immunization programs.
Prior to the development and adoption of the vaccine, the Hib bacteria was the leading cause of serious bacterial infections such as meningitis and pneumonia in the U.S. and around the world, which resulted in death or long-term neurological consequences among many affected children.
“I am deeply humbled and honored to receive the Fries Prize,” Santosham says. “I want to thank the White Mountain Apache and Navajo tribes and all who have worked with us to prove the efficacy of the Hib vaccine and promote its use worldwide.”
Santosham is the director for the Center for American Indian Health in the Johns Hopkins Bloomberg School of Public Health. He founded the Center in 1991, based on 15 years of public health outreach to southwestern American Indian tribes. It is now one of the largest national resources to advance the health of Native peoples. Working in partnership with tribes, Santosham and his Center have achieved landmark public health breakthroughs that today save and improve millions of lives worldwide. The Center’s current work focuses on the critical needs of Native communities— including obesity, diabetes, suicide, depression, substance abuse and HIV/AIDS. Key initiatives include mental health screening and triage; home-visiting programs to promote maternal health and child development, and prevent diabetes; youth nutrition and physical fitness promotion; HIV-prevention education; and youth entrepreneurship programs.
Santosham is also a senior advisor to Johns Hopkins’ International Vaccine Access Center and chair of the ROTA Council (http://rotacouncil.org). He serves on numerous national and international committees on infant vaccines and oral rehydration therapy, has consulted with international agencies including WHO, USAID and UNICEF and has provided consultation in various aspects of child survival in more than 30 countries. Santosham is the recipient of numerous awards including the Thrasher Research Fund award for excellence in research and the Albert B. Sabin Gold Medal Award for his contributions in the field of vaccinology.
First presented in 1992, the Fries Prize for Improving Health recognizes an individual who has made major accomplishments in health improvement with emphasis on recent contributions to health in the United States, and with the general criteria of the greatest good for the greatest number. It is intended for an individual who has done the most to improve health. For more information on the Fries Prize, visit http://www.friesfoundation.org/friesprize.html.
For more information about the Johns Hopkins Center for American Indian Health, please visit www.jhsph.edu/caih.
Media Contacts: Lindsey Ford, JHCAIH email@example.com | Kelly Healy, IVAC firstname.lastname@example.org
IVAC Congratulates Dr. Rana Hajjeh at CDC on her Federal Employee of the Year Sammies Medal
September 22, 2014
Mathu Santosham, Hib Initiative Principal Investigator and IVAC Senior Advisor, with Rana Hajjeh, Director, Division of Bacterial Diseases at CDC.
Today, the Partnership for Public Service announced the recipients of the thirteenth annual Samuel J. Heyman Service to America Medals (Sammies), recognizing public servants whose work has contributed to significant improvements in the lives of Americans, as well as others throughout the world. Dr. Rana Hajjeh, Director of the Division of Bacterial Diseases at the Centers for Disease Control and Prevention (CDC), and former director of the Hib Initiative, was selected for the high honor of the Federal Employee of the Year Medal.
Dr. Hajjeh is an IVAC partner whom we collaborated with on the Hib Initiative, a Gavi-funded project aimed at addressing evidence, advocacy, and communications gaps to increase the uptake of Hib vaccine in developing countries. The project, which brought together Johns Hopkins University, CDC, the World Health Organization, and the London School of Hygiene & Tropical Medicine, started in 2005 at a time where country adoption of the vaccine was low, even though it was initially offered at no cost to low-income countries eligible for Gavi support. The work and dedication of the Hib Initiative team have helped to achieve Hib vaccine access in all Gavi countries and avert millions of preventable child deaths and diseases globally. Please join us in extending our congratulations to Dr. Hajjeh and the Hib Initiative team for this well-deserved honor.
For the full press release from the Partnership for Public Service, please click here.
Eleventh International Rotavirus Symposium Now Underway in New Delhi, India
September 3, 2014
Every two years, the International Rotavirus Symposium brings together the world's experts on rotavirus diarrhea and rotavirus vaccines. This week, Sept. 3-5, the 11th annual symposium is taking place in Delhi, coming at a pivotal time for India in its fight against rotavirus diarrhea, with the recent announcement by the Prime Minister that India will introduce rotavirus vaccines into its Universal Immunization Programme (UIP). Dr. Mathu Santosham, IVAC's Senior Advisor, served on the Scientific Organizing Committee of the symposium and will speak during several sessions. The ROTA Council will host an interactive advocacy session aimed at empowering scientists to be advocates and provide decision makers with evidence for action. Several IVAC team members are attending the symposium.
For the full press release, please click here.
South Sudan's Introduction of Pentavalent Vaccine: A Historic Moment as the Vaccine Has Now Reached All 73 GAVI Countries
August 4, 2014
South Sudan’s recent launch of pentavalent vaccine (on 16 July 2014) marked a historic milestone in the global fight against vaccine-preventable diseases. This is not only a major accomplishment for the country and its children, but also for the international community, as pentavalent (DTP-HepB-Hib) vaccine is now available in all 73 GAVI countries, accounting for more than half of the world’s children. Although available for nearly three decades in high-income countries, Haemophilus influenzae type B (Hib) vaccine was not accessible in low-income countries until the late 1990s. With a steady rollout of Hib-containing pentavalent vaccine, all children living in low-income countries will now have protection against meningitis and severe pneumonia, as well as diphtheria, tetanus, pertussis, and Hepatitis B.
Since the inception of the GAVI Alliance in 2000, support for Hib vaccine was offered to all GAVI-eligible countries, but uptake rates were slow in the early years. Despite it being initially offered at no cost to GAVI-eligible countries, few countries adopted the vaccine. This led to the formation of the Hib Initiative, a consortium consisting of Johns Hopkins University (JHU), the U.S. Centers for Disease Control and Prevention (CDC), London School of Hygiene and Tropical Medicine (LSHTM) and the World Health Organization (WHO), whose mission was to accelerate evidence-informed decisions about Hib vaccine in low-income countries.
Dr. Mathu Santosham, Principal Investigator of the Hib Initiative and IVAC Senior Advisor commented, “South Sudan’s introduction of pentavalent vaccine is a tremendous milestone. We’ve seen such a dramatic impact of the vaccine on Hib disease. It is gratifying to know that children in countries where Hib disease risk is highest will finally have access to the vaccine”. In 2005, the Hib Initiative, a five-year project funded by the GAVI Alliance, delved into the reasons why countries were not adopting the vaccine and began addressing the issues, including challenges related to data, supply, financing, and communications. The Initiative, which included experts in epidemiology, research, surveillance, economics, and advocacy and communications, along with representatives from many countries, learned invaluable lessons about the challenges of ensuring evidence-informed decisions and the interpretation of data.
At that time, the burden of disease was not clearly understood in part because of a reluctance to rely on high quality vaccine impact studies coming from other countries and in part because of a reliance on inadequate surveillance which predictably underestimated the burden of disease. There were also concerns about supply and longer-term financing. These issues coupled with a lack of awareness and appreciation of vaccine impact led to delays in decision making. In countries where the vaccine had yet to be implemented, there were few champions for Hib vaccine, which also contributed to delayed introduction.
Many of the lessons learned from the Hib vaccine experience have improved the process of decision making for other new vaccines, ensuring that barriers are addressed early and effectively. It has paved the way for a more deliberate, systematic, and coordinated approach to vaccine introduction considerations by countries.
In 2005 at the start of the Hib initiative, only 16 GAVI countries had introduced Hib vaccine. Today, Hib vaccine, in the form of pentavalent vaccine, is included in the routine immunization programs of all 73 GAVI countries. This accomplishment was a result of a collective global effort led by the Hib Initiative to promote equitable access to the lifesaving vaccine, regardless of whether children live in a wealthy or poor country. By anticipating research needs, generating targeted data to support decision making, building capacity for country-led advocacy and communication, and fostering trusting relationships with country stakeholders, the Initiative was able to help bridge the gap between research and policy, which was a major impediment to introduction in the early 2000s. The increase in the number of manufacturers of pentavalent vaccine and reductions in vaccine price have also made it possible for supply to meet the growing demand in low-income countries. Lessons learned from the Hib Initiative have since informed other vaccine strategies, and country-tailored approaches to vaccine research and advocacy have in turn led to the uptake of new vaccines at unprecedented rates in recent years.
Dr. Kate O’Brien, IVAC Executive Director, says “The introduction of Hib vaccine into South Sudan is a major landmark in vaccine history and a triumph for the public health community. As we celebrate this momentous occasion which marks the completion of pentavalent vaccine rollout in GAVI countries, we continue to call for unified advocacy efforts for strengthened immunization programs, sustainable immunization financing, and the addition of other new and underutilized vaccines, in order to maintain and expand gains made in child health and survival.”
ROTA Council Convenes Leading Experts on Rotavirus Vaccines for Scientific Workshop
July 30, 2014
On July 23 and 24, the ROTA Council, along with its core partners the International Vaccine Access Center at Johns Hopkins Bloomberg School of Public Health, PATH, the Sabin Vaccine Institute and the U.S. Centers for Disease Control and Prevention, gathered a group of rotavirus technical experts and public health officials, leading research and advocacy organizations, funders and vaccine manufacturers for “The Rotavirus Vaccination & Intussusception Workshop: Science, Surveillance & Safety.”
The event, held in Washington, D.C., and funded by the Bill & Melinda Gates Foundation, was an important step in helping the global health community understand the benefits and risks of rotavirus vaccines, which offer the best protection against rotavirus and the deadly diarrhea that it causes.
Intussusception is a bowel blockage, which in extremely rare cases is associated with rotavirus vaccines. For every 100,000 children vaccinated, there are an estimated 1-6 extra cases of intussusception. However, numerous studies have demonstrated that the benefits of the vaccine outweigh the risk. Despite this, the lack of understanding about the benefits and risks of rotavirus vaccines can delay introduction of these live-saving vaccines, causing hundreds of thousands of preventable deaths and hospitalizations among young children.
At the workshop, the technical experts in attendance reviewed and evaluated the current evidence on intussusception and rotavirus vaccines, identified and prioritized remaining gaps in the research, discussed challenges and opportunities around new vaccines coming to market or currently in clinical trials, and documented the scientific consensus on best practices for monitoring and communicating the potential risk of intussusception after the introduction of rotavirus vaccines. The meeting outcomes will be published in a peer-reviewed journal and provide a current, reliable source of the latest evidence and scientific consensus on rotavirus vaccine safety and intussusception.
New Study from Kenya Suggests Pneumococcal Conjugate Vaccine Can Protect Even the Unvaccinated
July 16, 2014
In a study recently published in Lancet Global Health, researchers from Kenya found that widespread use of 10-valent pneumococcal conjugate vaccine (PCV10) reduces carriage of the pneumococcal bacterium in both vaccinated and unvaccinated individuals and is therefore expected to provide herd protection against pneumococcal disease.
Researchers at the Kenya Medical Research Institute (KEMRI) conducted the study in Kilifi, Kenya, where infants received the national three-dose primary series of PCV10 and those one to five years of age received up to two doses as part of a catch-up campaign. Using data collected two years before and two years after PCV10 introduction, researchers compared carriage of vaccine-serotype and non-vaccine-serotype pneumococci in children under five years (the vaccinated age group) and unvaccinated persons five years and older.
In an interview with Lancet Global Health, lead author Dr. Laura Hammitt (Assistant Professor at the Johns Hopkins Bloomberg School of Public Health) said, “we chose to study carriage because effects on carriage occur relatively quickly after vaccination, so it provides us with an early indication of the effectiveness of the vaccine in the children who are vaccinated, as well as in children and adults who haven’t been vaccinated but who may be benefiting from herd protection.”
The study found that introduction of PCV10 reduced carriage of vaccine-serotype pneumococci in two-thirds of the population, which includes both vaccinated and unvaccinated people.
“We were really encouraged by these results,” Dr. Hammitt continued, “this tells us that vaccination of young children is reducing transmission of vaccine-type pneumococci within the population as a whole, and this is very likely to lead to herd protection in invasive disease.”
PCV10 only protects against the serotypes contained in the vaccine, and therefore does not reduce carriage of non-vaccine serotypes. The 10 serotypes against which PCV10 protects are estimated to account for at least 70% of pneumococcal disease in every region of the world, so introduction of the vaccine has the potential to greatly reduce the global burden of pneumococcal disease.
IVAC Commemorates the Life of Dr. Ciro de Quadros (1940-2014)
May 29, 2014
Photo Credit: Evan Wilder/Sabin Vaccine Institute
Dr. Ciro de Quadros, global health leader and vaccine champion, passed away yesterday surrounded by his family. He was 74 years old.
Dr. de Quadros’s career was limitless and spanned some of public health’s foremost challenges. From his extensive portfolio of work in the development of smallpox surveillance and containment strategies to overseeing the eradication efforts of polio and measles in the Americas – his contributions to global health were unparalleled. He held numerous senior level positions, including directorship at the Pan American Health Organization and serving as the World Health Organization’s Chief Epidemiologist for the Smallpox Eradication Program in Ethiopia from 1970 to 1976. At the time of his death, Dr. de Quadros was the Sabin Vaccine Institute’s Executive Vice President and Director of the Vaccine Advocacy and Education.
“Today, the public health community mourns the loss of an exceptional leader, pioneer, champion, and friend,” remarked Dr. Kate O’Brien, IVAC’s Executive Director. “Ciro dedicated his life to bringing basic health services to some of the world’s poorest populations and is a hero to many he never met. History will mark his groundbreaking achievements, while those who knew him will forever remember his innovation, perseverance, and unwavering commitment.”
Many staff and faculty at IVAC and the Johns Hopkins Bloomberg School of Public Health had the privilege of collaborating with Dr. de Quadros on a number of programs. As a professor at the Johns Hopkins Bloomberg School of Public Health and the George Washington University School of Medicine and Health Sciences, Dr. de Quadros was also a mentor to many public health practitioners.
“No words can adequately describe my admiration for Ciro. It has been an honor to learn from and work with him over the years.” said Dr. Mathuram Santosham, Senior Advisor at IVAC.
IVAC joins colleagues, friends, and the family of Dr. de Quadros in celebrating his life and mourning his passing.
To read more about Dr. de Quadros and his career, please visit the Sabin Vaccine Institute’s In Memoriam page.
PSC, Hopkins Computer Model Helps Benin Vaccinate More Kids at Lower Cost
(Joint press release from IVAC, Pittsburgh Supercomputing Center, University of Pittsburgh School of Engineering, Vaccine)
May 12, 2014
The HERMES Logistics Modeling Team, consisting of researchers from Pittsburgh Supercomputing Center (PSC), the University of Pittsburgh School of Engineering and the Johns Hopkins Bloomberg School of Public Health, have used HERMES, their modeling software, to help the Republic of Benin in West Africa determine how to bring more lifesaving vaccines to its children. The team reports its findings this month in the journal Vaccine.
Results from the HERMES model have helped the country enact some initial changes in their vaccine delivery system, which may lead to further changes nationwide.
“The paper outlines our engagement with the Benin Ministry of Health in which we worked to choose among some key redesign options of their vaccine supply chain,” says Shawn T. Brown, PhD, Director of Public Health Applications at PSC, Technical Lead of the HERMES team and first author. “It’s a clear use of computational modeling and simulation to help a government figure out how to get the vaccines that are so desperately needed to every child they can.”
The HERMES model also helped show the impact of adding the rotavirus vaccine to the nation’s supply chain. Rotavirus is a major cause of infant mortality in low-income nations, killing nearly half a million children annually, with the highest death rates in Africa and South Asia.
“These are major policy decisions that could affect millions of lives,” says Bruce Y. Lee, MD, MBA; Associate Professor of International Health and Director, Operations Research, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health; Scientific Lead of the HERMES team; and co-author. “Our team’s goal has been to develop state-of-the art computational technology to help such decision-making around the world.”
The team used their HERMES (Highly Extensible Resource for Modeling Supply-chains) tool to evaluate different options of redesigning the Benin vaccine system being considered by the Benin Ministry of Health. These included maintaining the current national system; consolidating the nation’s system of 80 “commune-level” supply depots to a system of 34 “health-zone” depots; eliminating the commune level entirely; and splitting the seven current high-level “department” and “regional” stores into 12 new departments. The investigators also evaluated the effects of changing transportation routes.
The computational model favored the health zone approach along with changing transportation routes, which could save between $50,000 and $70,000 in initial expenses and $50,000 to $90,000 in annual costs compared with the other scenarios, while still reaching 99 to 100 percent of children. Through 2017, the improved plan would save Benin over $500,000 in total costs while improving vaccination rates and facilitating the rotavirus vaccine.
HERMES is a software platform that allows users to generate a detailed discrete event simulation model of any vaccine supply chain. This simulation model can serve as a “virtual laboratory” for policy makers, health officials, funders, investors, vaccine and other technology developers, manufacturers, distributors, logisticians and researchers to address a variety of questions in supplying vaccines as well as other health supplies.
With the support of the Agence de Médecine Préventive, which participated in all steps of this innovative project, the Benin Ministry of Health has launched a successful demonstration following the group’s pre-publication recommendations. The nation is now considering scaling the new system to the entire country.
About PSC: Pittsburgh Supercomputing Center (www.psc.edu) is a joint effort of Carnegie Mellon University and the University of Pittsburgh. Established in 1986, PSC is supported by several federal agencies, private industry and the Commonwealth of Pennsylvania, and is a major partner in the National Science Foundation XSEDE program.
About IVAC: The International Vaccine Access Center (IVAC) aims to improve access to life-saving vaccines by ensuring that the evidence required for decision-making is generated and synthesized, made available to policy makers, and results in concrete action. IVAC’s work spans the fields of vaccine economics, epidemiology, clinical trials, modeling, advocacy and policy to address viral, bacterial and parasitic pathogens and disease syndromes. For more information, please visit: www.jhsph.edu/ivac.
About Agence de Médecine Préventive: Founded in 1972, AMP is a nonprofit organization with headquarters at the Institut Pasteur in Paris and offices in Benin, Burkina Faso, Côte d’Ivoire, and Senegal. AMP’s mission is to promote preventive medicine and public health by developing expertise and applied research in vaccinology; offering training in epidemiology and health program management; organizing scientific and technical meetings; and disseminating information on vaccinology and other health-related fields. For more information, please visit: www.amp-vaccinology.org/
About Vaccine: Vaccine is the pre-eminent journal for those interested in vaccines and vaccination. It is the official journal of The Edward Jenner Society, The International Society for Vaccines and The Japanese Society for Vaccinology.
Notes for Editors: Full text of this article is available to credentialed journalists upon request; contact email@example.com or +31-20-485-3564 to obtain copies of the paper or to set up interviews with the authors.
Contact: Ken Chiacchia, Pittsburgh Supercomputing Center +1-412-268-5869, firstname.lastname@example.org
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Dr. Mathuram Santosham Receives 2014 Albert B. Sabin Gold Medal Award
Press release originally published on Sabin Vaccine Institute.
April 29, 2014
Dr. Santosham with his wife (Pat Santosham) and IVAC faculty/staff at the Sabin Award reception.
WASHINGTON, D.C. – The Sabin Vaccine Institute today presented its annual Albert B. Sabin Gold Medal Award to Dr. Mathuram Santosham for his pioneering role in the prevention of deadly H. influenzae type b (Hib) diseases, including pediatric bacterial meningitis and pneumonia. Dr. Santosham’s leadership in conducting groundbreaking research, vaccine efficacy trials and advocacy to prioritize Hib vaccines spans more than 40 years and has saved millions of children’s lives worldwide.
“We are delighted to honor Dr. Santosham for his advancements against Hib diseases, which caused unnecessary suffering and death prior to his landmark findings and integral policy guidance,” said Dr. Peter Hotez, president of the Sabin Vaccine Institute. “His unwavering commitment to scientific discovery and service to marginalized communities in every country mirrors the late Dr. Sabin’s core mission and has inspired countless other public health achievements.”
Dr. Santosham’s Hib conjugate vaccine efficacy studies in Navajo children ultimately resulted in virtual elimination of the disease in North America, and other western countries thereafter. Dr. Santosham also championed the introduction and use of Hib vaccines for children in low-income countries by leading the Hib Initiative, a GAVI Alliance-funded project. Now, every GAVI-eligible country is either currently using the vaccine or has decided to use the vaccine in the near future. GAVI estimates that by 2020, the Hib vaccine will have prevented 7 million deaths.
“I am honored to receive this prestigious award from the Sabin Vaccine Institute, which is also dedicated to reducing needless human suffering by ensuring the availability of safe, low-cost vaccines,” said Dr. Santosham, Professor of International Health and Pediatrics and the Founder and Director of the Center for American Indian Health at Johns Hopkins University in Baltimore, Maryland. “My hope is that scientists, doctors, and public health advocates continue to partner with governments and communities around the world to wipe out preventable diseases. Our work against Hib diseases demonstrates what is possible.”
In addition to Hib prevention, Dr. Santosham pioneered the use of oral rehydration solution (ORS) –known as Pedialyte – which has become the standard care for treating diarrheal dehydration, and is credited with saving an estimated 60 million lives since 1980. He has also conducted trials to demonstrate the efficacy of rotavirus and pneumococcal conjugate vaccines. Currently, he is the co-chair of the Rotavirus Organization of Technical Allies (ROTA) Council and served as a member of the Pneumococcal Awareness Council of Experts (PACE) from 2008 to 2012.
The annual Albert B. Sabin Gold Medal Award recognizes a distinguished member of the public health community who has made extraordinary contributions in the field of vaccinology or a complementary field. The award commemorates the legacy of Dr. Sabin, who developed the oral live virus polio vaccine that is widely heralded with contributing to the near eradication of polio worldwide.
Dr. Santosham will be honored today at a ceremony in conjunction with the National Foundation for Infectious Disease Annual Conference at the Bethesda North Marriott Hotel & Conference Center in Bethesda, Maryland.
Media Contact: Deborah Elson, Communications Officer, Sabin Vaccine Institute +1-202-621-1691, firstname.lastname@example.org
Efficacy Trial Results Show Promise of New Indian Rotavirus Vaccine ROTAVAC®
March 12, 2014
Today, The Lancet published findings from a phase 3 clinical trial of the rotavirus vaccine ROTAVAC®, which showed safety and efficacy against severe rotavirus diarrhea in Indian infants. India accounts for more than one-fifth of all rotavirus deaths worldwide, underscoring the importance of introducing a safe and effective vaccine to help protect children from the virus.
ROTAVAC® is the first vaccine to be fully tested for efficacy against rotavirus in India. Key findings from the study include an overall efficacy of the vaccine against severe rotavirus diarrhea at 53.6% and an efficacy in the first year of life at 56.4%. The vaccine efficacy of ROTAVAC® is promising and could have significant public health impact on improving child health in India.
“It is very exciting to know that an indigenously developed rotavirus vaccine is efficacious in India,” said Dr. Mathuram Santosham, Senior Advisor at IVAC. “Rotavirus vaccine is a powerful tool to prevent diarrhea which could potentially save many lives around the world.”
Indian manufacturer Bharat Biotech developed the ROTAVAC® vaccine, with support from the Department of Biotechnology of the Indian Government and an alliance of international donors and partners. In a companion commentary piece to The Lancet article, Dr. Shabir A. Madhi of the National Institute for Communicable Diseases in South Africa and Dr. Umesh D. Parashar of the United States Centers for Disease Control and Prevention explain that the public-private partnership model for the vaccine’s development can be an example for an approach to ensuring that safe and effective vaccines are available at an affordable cost in developing countries.
For more information about the results of the study, a viewpoint article, and the commentary, please visit The Lancet.
IVAC's Executive Director, Kate O'Brien, Honored as the Robert Austrian Lecturer for ISPPD-9
March 12, 2014
Dr. Mathu Santosham introducing Dr. Kate O'Brien as the Robert Austrian Lecturer for ISPPD-9
Kate O’Brien, Professor at the Johns Hopkins Bloomberg School of Public Health (JHSPH) and Executive Director of IVAC, has been selected as the Robert Austrian Lecturer for the 2014 International Symposium on Pneumococci and Pneumococcal Diseases (ISPPD-9). The Robert Austrian Lectureship is an ISPPD tradition established in 2002 in honor of Dr. Robert Austrian, which recognizes individuals who have made significant contributions to the field of pneumococcal disease. Selection of the RA Lecturer is based on the individual’s contributions to the scientific understanding of pneumococcus, the public health impact of the individual’s work, and a solid history of mentoring junior colleagues.
Over the past 15 years, Dr. O’Brien has led numerous projects on pneumococcal epidemiology, disease burden, immunology, and ecology, including a clinical trial of pneumococcal conjugate vaccine (PCV) in American Indian populations which contributed to the evidence base for the vaccine’s licensure. Her outstanding research contributions have guided the development of interventions aimed at reducing preventable mortality and morbidity throughout the world and have earned her widespread recognition as an international expert in the fields of pneumococcal disease and immunization. The work of Dr. O’Brien and her colleagues generated key evidence on pneumococcal disease etiology, vaccine efficacy, and impact during a pivotal time in pneumococcal vaccine history, with lasting impacts on global policy making. Dr. O’Brien played a central role in GAVI’s Pneumococcal Accelerated Development and Introduction Plan (PneumoADIP), a seminal project that shaped the fastest, broadest, global rollout of a new vaccine in history, giving rise to the ‘new-normal’ approach to accelerating global vaccine introduction and access. Since the first introduction of PCV in the developing world in 2009, 40 GAVI countries have already introduced the vaccine into their routine child immunization programs, and by 2015, the number is expected to rise to 52 GAVI countries.
IVAC’s Senior Advisor, Dr. Mathu Santosham (also a previous Robert Austrian Lecturer) emphasizes that “Dr. O’Brien’s illustrious career accomplishments are furthered by her willingness and commitment to teach others.” Over the course of her tenure at Johns Hopkins University, Dr. O’Brien has mentored countless young faculty, students, and practitioners in training, many of whom have progressed into leadership positions across the globe and continue to lead great work in advancing scientific research and improving public health.
For the full ISPPD announcement of Dr. O’Brien’s Robert Austrian Lectureship, click here.
To learn more about Dr. O’Brien, please visit her Johns Hopkins faculty profile.
William Moss, MD, MPH, Joins IVAC as New Director of Epidemiology
January 13, 2014
IVAC announced today that Dr. William (Bill) Moss, a global health expert in childhood infectious diseases, will serve as IVAC’s new Director of Epidemiology. Dr. Moss, a Professor at the Johns Hopkins Bloomberg School of Public Health, previously served as the Deputy Chair of the Department of Epidemiology. He is a pediatrician with subspecialty training in infectious diseases, and has worked in Ethiopia, Kenya, South Africa, Zambia, Zimbabwe, and India among other countries.
Dr. Moss played an important role in the Hib Initiative, one of several projects that laid the groundwork for the founding of IVAC and its principles of evidence, policy and access of vaccines. Bill currently supports IVAC’s various vaccine-related projects in India. Dr. Kate O’Brien, IVAC’s Executive Director, stated “Dr. Moss brings to this role broad experience, rigor, innovation, and expertise in epidemiology, clinical studies, and project management. We are extremely fortunate to have him as a Director at IVAC and very much look forward to his leadership of the Epidemiology team.”
His broad research interests are the epidemiology and control of childhood infections in resource-poor countries. His work aims to understand the epidemiology and control of malaria, especially in southern Africa; measles control and eradication, particularly in relation to HIV; and the care and treatment of HIV-infected children in rural Zambia.
In the past, Dr. Moss worked as Project Director of the Community Home Care Project in Kenya and as a pediatrician at Tikur Anbessa Hospital in Addis Ababa, Ethiopia and Harlem Hospital in New York City. He has also served on advisory panels and steering committees for the Global Fund to Fight AIDS, Tuberculosis, and Malaria; Institute of Medicine; World Health Organization; and Save the Children. Dr. Moss is a member of the World Health Organization’s Strategic Advisory Group of Experts (SAGE) Working Group on Measles and Rubella.
Dr. Moss has authored four monographs related to child immunization and pediatric care in humanitarian emergencies and produced more than 100 scientific publications and 20 book chapters. He is also Associate Editor for the American Journal of Epidemiology.
Dr. Moss earned a bachelor of arts from Wesleyan University, a medical degree from Columbia University College of Physicians and Surgeons, and a master of public health from the Division of Epidemiology at the Columbia University Mailman School of Public Health. He completed his residency and chief residency in pediatrics at the Columbia-Presbyterian Medical Center in New York City and his fellowship in pediatric infectious diseases at the Johns Hopkins School of Medicine.
Nigeria Launches National Routine Immunization Strategic Plan 2013-2015
November 21, 2013
Bill Gates launching the National Routine Immunization Strategic Plan in Nigeria
Last week, Nigeria unveiled its National Routine Immunization Strategic Plan (NRISP) 2013-2015, outlining a comprehensive strategy to increase access to live-saving vaccines through strengthened routine immunization (RI) systems. The plan was co-launched by the Nigerian Minister of Health, Prof. Onyebuchi Chukwu and Mr. Bill Gates in an event hosted by the National Primary Health Care Development Agency (NPHCDA) and attended by traditional and religious leaders, private sector representatives, and development partners, including Alhaji Aliko Dangote and the Sultan of Sokoto.
The NRISP outlines responsibilities for implementing RI at the national, state, and local government levels, and integrates three strategies that are already in place in the country’s RI sector: Accountability for RI in Nigeria (AFRIN), Reaching Every Ward (REW), and Health System Strengthening. In line with the government’s Saving One Million Lives Initiative, the plan aims to achieve 87% national vaccine coverage, with at least 80% coverage in 90% of Local Government Areas, for all scheduled childhood immunizations by 2015.
The strategic plan was developed by the NPHCDA in close consultation with State Ministries of Health, State Primary Health Care Agencies, development partners, civil society, and the private sector. Dr. Chizoba Wonodi and Dan Erchick of IVAC provided technical support to NPHCDA for the development of the plan, made possible through grants from the Bill & Melinda Gates Foundation and the GAVI Alliance.
Dr. Wonodi was excited to witness her home country reach this significant milestone: “It was gratifying to see it all come together knowing that IVAC played a significant role in preparing the plan and the launch from start to finish. I was extremely proud of what our Center contributed and helped to achieve in Nigeria." Reflecting on recent achievements for child health in Nigeria, IVAC Executive Director Dr. Kate O’Brien said, “This is a real landmark piece that lays onto paper the summary of thousands of hours of planning, commitments, and public obligations. The challenge will be in putting this into motion, measuring where it is being implemented, documenting where it is not, and adjusting where it is needed.”
While the NRISP marks a critical milestone for Nigeria, much work needs to be done to increase accountability and strengthen health systems if preventable child mortality is to be eliminated.
Fifth Annual World Pneumonia Day - Progress and Remaining Challenges in the Fight Against Pneumonia, the Leading Killer of Children Worldwide
November 12, 2013
Child health advocates today commemorated the fifth annual World Pneumonia Day by calling on global leaders to scale up evidence-based interventions and increase investments in diagnostic tools and treatments to end preventable pneumonia deaths in children worldwide. Pneumonia continues to be the leading cause of death in children under the age of five years, killing more children than AIDS, malaria, and tuberculosis combined. In 2012 alone, pneumonia took the lives of 1.1 million young children, with over 99 percent of these deaths occuring in developing countries, where children often have limited access to healthcare facilities and treatment.
For the full press release, click here. To learn more about IVAC's role in World Pneumonia Day and to access the 2013 Pneumonia and Diarrhea Progress Report (or past reports), please visit our World Pneumonia Day project page.
Johns Hopkins International Vaccine Access Center Names New Executive Director
Press Release: October 4, 2013
Katherine L. O’Brien, MD, MPH, has been appointed as the Executive Director of the International Vaccine Access Center (IVAC) at Johns Hopkins Bloomberg School of Public Health, a year after taking the helm as the Center’s Acting Director. Dr. O’Brien is a Professor in the Departments of International Health and Epidemiology at the Bloomberg School, and brings a wealth of experience as a pediatric infectious disease physician, epidemiologist, and vaccinologist. “Kate has been an exemplary mentor to hundreds of students and junior faculty, and taken on numerous leadership roles that have enriched the Hopkins community,” said David Peters, Chair of the Department of International Health. “As the new Executive Director of IVAC, I am sure that Kate’s leadership will create even greater benefits to the global vaccine community and the millions of families worldwide still awaiting access to lifesaving vaccines.”
In addition to her role with IVAC, Dr. O’Brien serves the Center for American Indian Health at JHSPH as both the Deputy Director and Director of the Infectious Disease Prevention and Control Program.
She has authored over 115 scientific publications, many focusing on Streptococcus pneumoniae and Haemophilus influenzae type b in children, and in 2012 was named to the World Health Organization’s Strategic Advisory Group of Experts on Immunization (SAGE). She is a recipient of the U.S. Presidential Early Career Award for Scientists and Engineers as well as the Sabin Vaccine Institute’s Young Investigator Award. Dr. O’Brien earned her M.D. at McGill University and her MPH at Johns Hopkins University (JHU). After completing her residency and fellowship at JHU, she joined the Respiratory Diseases Branch at the Centers for Disease Control and Prevention as an Epidemic Intelligence Officer. She returned to JHU in 1998 and has been involved with infectious disease research projects at Johns Hopkins since that time.
In 2003, Dr. O’Brien began serving as the Deputy Director for Research of the Pneumococcal Accelerated Development and Introduction Plan (PneumoADIP) based at JHSPH, and out of which IVAC was launched in 2009. She has worked alongside every member of the IVAC team to cultivate broad networks of stakeholders in order to integrate diverse aspects of immunization systems, identify opportunities, anticipate needs, and build effective partnerships. Dr. O’Brien’s appointment as Executive Director will undoubtedly strengthen the Center’s contribution of sound scientific evidence to improve vaccine access and implementation.
Media Contacts: Tim Parsons +1-410-955-7619, email@example.com | Julie B. Younkin +1-410-340-9784, firstname.lastname@example.org
Bruce Lee, MD, MBA, Joins IVAC as the Director of Operations Research
September 16, 2013
IVAC announced today that Dr. Bruce Lee, scientific and technical expert on operations research and modeling, has joined the center as the Director of Operations Research. Dr. Lee brings a wealth of experience in the field of operations research, working across a number of public health initiatives to improve decision-making processes through the application of mathematical and computational methods. At IVAC, Dr. Lee’s work will focus on expanding the use of operations research in global health, specifically in the areas of vaccine development, distribution, and administration.
IVAC’s Acting Executive Director, Dr. Kate O’Brien, said “We are very excited to have Dr. Lee join our team at IVAC. His expertise in modeling health systems and vaccine distribution systems is an excellent complement to IVAC’s work in accelerating global vaccine access.”
Prior to joining IVAC, Dr. Lee was an Associate Professor at the University of Pittsburgh, where he founded the Public Health Computational and Operations Research (PHICOR) group, which is now headquartered at Johns Hopkins. The PHICOR group specializes in designing economic and operational computer models that help decision makers tackle infectious diseases of global importance. In the past, he also served as Senior Manager at Quintiles Transnational, working with clients in the pharmaceutical, biotechnology, and medical devices industries; conducted biotechnology equity research at Montgomery Securities; and co-founded Integrigen, a biotechnology company.
When asked about joining IVAC, Dr. Lee explained that the Center was a natural fit for his work, adding that “I saw it as a situation where you could do one plus one equals ten and really maximize on both ends the synergies that exist. I’ve enjoyed interacting with everyone at IVAC. It’s a great organization with people from diverse backgrounds who tackle vaccine access issues from a variety of perspectives.”
Dr. Lee has authored more than 150 scientific publications (including over 80 as first author and over 35 as last author), as well as three books: Principles and Practice of Clinical Trial Medicine, What If? Survival Guide for Physicians, and Medical Notes: Clinical Medicine Pocket Guide. He and his work have garnered attention in leading media outlets, such as the New York Times, Los Angeles Times, Businessweek, U.S. News and World Report, Nature Medicine, and National Public Radio (NPR).
Dr. Lee earned a bachelor of arts from Harvard University, a medical degree from Harvard Medical School, and a master of business administration from the Stanford Graduate School of Business. He is board-certified in internal medicine, having completed his residency training at the University of California, San Diego.
Rotavirus Advocacy Tools Available from ROTA Council
September 3, 2013
An updated set of tools are available from the ROTA Council for use in rotavirus vaccine advocacy. The toolkit includes: rotavirus fact sheets; vaccine introduction maps; detailed slide decks highlighting disease burden and vaccine information; template slides to be customized for a particular country or region; and how-to resources for advocates.
The ROTA Council is a dedicated team of technical experts working to save children’s lives by accelerating the introduction of rotavirus vaccines. Made up of 18 of the world’s leading experts on rotavirus, it is co-chaired by Dr. Ciro de Quadros, Sabin Vaccine Institute, and Dr. Mathuram Santosham, Johns Hopkins Bloomberg School of Public Health/IVAC. For more information, visit: http://rotacouncil.org/. For questions or suggestions related to the toolkit, contact Kelly Healy at email@example.com.
New Evidence for Hib Vaccines Published in Journal of Pediatrics
July 26, 2013
The July issue of The Journal of Pediatrics features a supplement on Haemophilus influenzae type b (Hib), sponsored by the Hib Initiative and guest edited by Drs. Rana Hajjeh, Kim Mulholland, and Mathuram Santosham. The supplement features 13 original research articles, including several presenting new data on the impact of Hib vaccines in developing countries, including The Gambia, Mongolia, Mozambique, and Bangladesh. Like the studies that have come before them, these studies continue to demonstrate the significant impact Hib vaccines have on reducing pneumonia and meningitis. In addition to disease impact, the supplement also features articles on disease surveillance, vaccine efficacy, and cost-effectiveness. More than 115 authors from around the world contributed to the supplement.
Workshop: Developing Financing Strategies for Dengue Vaccine Introduction in the Americas
June 26, 2013
In January 2013, the World Health Organization (WHO) ranked dengue the world’s fastest growing tropical disease. The region of the Americas continues to experience a significant portion of the global burden of dengue, which is estimated to be 50-100 million dengue cases per year. An effective and affordable dengue vaccine will play a critical role in reducing the human and economic costs of the disease by preventing millions around the world from getting sick. To introduce and implement a dengue vaccine in a timely and equitable manner, countries need to assess their needs and current capacities and develop effective immunization and financing strategies.
IVAC, a core partner of the Dengue Vaccine Initiative (DVI), in collaboration with the International Vaccine Institute (IVI), the Sabin Vaccine Institute, and the Pan-American Health Organization (PAHO), is organizing a two-day workshop, July 22-23 2013, to solicit input from key stakeholders about how to effectively and efficiently finance the introduction of dengue vaccines in the Americas. More than 20 experts in health economics, epidemiology, and financing, plus program managers and decision makers, will work to identify a set of recommendations of financing options that would facilitate equitable and timely introduction of dengue vaccine and to develop a set of key actions that can advance these recommendations. To learn more, see the workshop proceedings. For more information on the workshop, contact Dr. Dagna Constenla at firstname.lastname@example.org.
Gates Foundation Now Accepting Nominations for Vaccine Innovation Award
May 28, 2013
The Bill & Melinda Gates Foundation announced the third year of the Gates Vaccine Innovation Award and is now accepting nominations. The award, open to individuals from any discipline, recognizes innovative ideas that have resulted in improvements in immunization coverage in developing countries. Nominees are assessed on three criteria, including developing country impact, innovation and creativity, and scale. More information can be found here, including specific requirments and how to submit nominations. Nominations will be accepted through 11:59 PM Pacific Standard Time on July 31, 2013.
Indian-Developed Rotavirus Vaccine Demonstrates Strong Efficacy
May 14, 2013
Today, the Government of India’s Department of Biotechnology (DBT) and Bharat Biotech announced positive results from a Phase III clinical trial of a rotavirus vaccine developed and manufactured in India. Data from the trial, presented at the International Symposium on Rotavirus Vaccines for India—The Evidence and the Promise, showed ROTAVAC® to have significant efficacy against severe rotavirus diarrhea and an excellent safety profile. The vaccine, which was created from a neonatal strain of Indian origin, was developed through a unique public-private partnership that brought together Indian and international experts from groups including DBT, Bharat, the U.S. National Institutes of Health (NIH), the U.S. Centers for Disease Control and Prevention (CDC), Stanford University School of Medicine, and PATH.
Bharat Biotech previously announced a price of US$1 per dose for the initial formulation of ROTAVAC® and will soon file for licensure in India. If licensed, the vaccine will be an important contribution to the global rotavirus vaccine supply and provide increased market competition for countries and organizations procuring vaccine. See the full press release for further details.
Global Study Finds Rotavirus Leading Cause of Moderate-to-Severe Diarrhea in Children
May 14, 2013
Results published in The Lancet today from the Global Enteric Multicenter Study (GEMS) of more than 22,000 children across seven sites in Africa and Asia, revealed critical new information about diarrheal disease etiology. Despite numerous possible causes, GEMS, led by the University of Maryland School of Medicine's Center for Vaccine Development, found that just four pathogens – rotavirus, Cryptosporidium (a protozoal parasite) and two bacteria, Shigella and enterotoxigenic E. coli (specifically ST-ETEC) – were responsible for the majority of moderate-to-severe diarrhea in children. Importantly, rotavirus, for which there is an existing vaccine but countries in Asia and Africa have been slow to introduce, was the leading cause of diarrhea in infants across all study sites. GEMS also found that moderate-to-severe diarrheal disease had lasting health repercussions, interfering with development and increasing risk of death, and that much of this impact was seen after the initial acute phase, when children are less likely to be in a healthcare setting. See the press release for more details.
Price Cut for Vaccine That Protects Children From Five Deadly Diseases
April 19, 2013
The cost of immunizing children against five deadly and debilitating diseases has dropped by 30 percent, with the announcement of an Indian manufacturer’s plan to cut the price of the pentavalent vaccine for GAVI countries. The pentavalent vaccine, which protects children from diphtheria, tetanus, pertussis (DTP), Haemophilus influenzae type b (Hib), and hepatitis B, will be made available to GAVI for just $1.19 a dose, compared to the previous average price of $2.17 in 2012.
GAVI recently released a new infographic, showing the reach and price of the pentavalent vaccine over the past ten years. Noted as GAVI’s most widely used vaccine, pentavalent has already been introduced in 70 of the 73 GAVI-eligible countries.
More information on the pentavalent vaccine price reduction can be found here.
New Action Plan to Tackle Childhood Pneumonia and Diarrhea
April 12, 2013
Today, the global health community marks the release of the newest research and a strategic plan for tackling the world’s two leading killers of children – pneumonia and diarrhea. Developed by the World Health Organization (WHO) and UNICEF, The integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhea, outlines the action steps needed to put an end to the preventable deaths caused by these two diseases by 2025. GAPPD’s evidence base comes from the latest pneumonia and diarrhea research, also released today in a new series from The Lancet. IVAC’s Acting Executive Director, Dr. Kate O’Brien, collaborated on one of the papers in the series, which presents the global burden of childhood pneumonia and diarrhea. Updated mortality estimates show that diarrhea and pneumonia took the lives of more than two million children in 2011 alone.
IVAC is pleased to sign onto the NGO Statement of Support for GAPPD, which calls on all stakeholders to redouble efforts to protecting children against pneumonia and diarrhea. Launch events for the releases of GAPPD and the Lancet series will take place in London and Washington, DC on April 12, 2013.
Click here for more information on GAPPD, including report summaries and statements of support from key leaders.
Scientific Declaration on Polio Eradication
April 11, 2013
Today, IVAC's Acting Executive Director, Dr. Kate O'Brien, and Senior Advisor, Dr. Mathuram Santosham, joined hundreds of scientists, doctors and technical experts from around the world to launch the Scientific Declaration on Polio Eradication. The declaration comes at a pivotal time in the world's efforts to eradicate polio, with just 223 cases of polio in five countries last year. The declaration calls for full implementation of the Global Polio Eradication Initiative's Eradication and Endgame Strategic Plan, which details the action steps for achieving an end to polio by 2018. For additional information about the declaration and to view the full list of signatories, please visit the Emory Vaccine Center Website.
Ban Intelligence Efforts Linked to Public Health Interventions
January 15, 2013
Last week, the Deans of twelve U.S. schools of public health sent a letter to President Obama protesting the entanglement of intelligence operations in public health campaigns. The letter describes the negative and lasting impacts of the Central Intelligence Agency’s (CIA) use of a fake vaccination campaign in Pakistan during the hunt for Osama bin Laden in 2011, which exacerbated the already persistent public mistrust of vaccines in the country. A series of deadly attacks against aid and health workers associated with polio eradication campaigns have occurred over the past month in Pakistan. More information, including the Deans’ letter, can be found here.
Additionally, a new online White House petition, Ban Intelligence Involvement in Public Health Campaigns, calls for the U.S. government to ensure intelligence efforts are not linked to public health endeavors in the future. The White House will respond to the petition if it receives 25,000 signatures.
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