Public health round-up

WHO has prequalified the first conjugate vaccine to prevent typhoid fever. The vaccine is Typbar-TCV® developed by Indian pharmaceutical company Bharat Biotech. The vaccine confers long-lasting immunity, requires only one dose and can be given to children as young as six months through routine childhood immunization programmes. Other typhoid vaccines are recommended for children over 2 years of age. Prequalification by WHO means that the vaccine meets standards of quality, safety and efficacy, thus making it eligible for procurement by the United Nations Children’s Fund and other United Nations agencies. A conjugate vaccine is one that is composed of a polysaccharide antigen that is fused to a carrier molecule. In October 2017, the Strategic Advisory Group of Experts (SAGE) on immunization, which advises WHO, recommended typhoid conjugate vaccine for routine use in children over six months of age in typhoid endemic countries. SAGE also called for the introduction of typhoid conjugate vaccine to be prioritized for countries with the highest burden of typhoid disease or of antibiotic resistance to Salmonella typhi, the bacterium that causes the disease. Use of the vaccine should also help to curb the frequent use of antibiotics for treatment of presumed typhoid fever, and thus help slow the increase in antibiotic resistance in Salmonella typhi. Shortly after SAGE’s recommendation, the board of Gavi, the Vaccine Alliance approved US$ 85 million funding to support the introduction of typhoid conjugate vaccines in eligible countries in 2019–2020. bit.ly/2mmrDo4


bial resistance


Surveillance of antimic
obial resistance
E915E25ED93044F02277CACFA4EB234C10.2471/BLT.18.010318
Bacterial infections in people living in many countries show high levels of antibiotic resistance, according to data released from the World Hea th Organization's (WHO) new Global Antimicrobial Surveillance System.The data -the first to be released since Global Antimicrobial Surveillance System was set up last year -reveal widespread occurrence of antibiotic resistance in a ange of bacterial infections in 500 000 people across 22 countries.The most commonly reported resistant bacteria were Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, and Streptococcus pneumoniae, followed by Salmonella spp.The surveillance system does not include data on resistance of Mycobacterium tuberculosis, because WHO has been tracking this pathogen since 1994 and providing annu l updates on drug resistance in the Global tuberculosis report.Among patients with suspected bloodstream infection, the proportion that had bacteria resistant to at least one of the most commonly used antibiotics rang d tremendously between different countries, from zero to 82%.Resistance to penicillin -the medicine that has been used for decades to treat pneumonia -ranged from zero to 51% among reporting countries.Moreover, between 8% and 65% of E. coli isolates associated with urinary tract infections showed resistance to ciproflo acin, an antibiotic co

only used to treat this co
dition.

Economic losses to cancer

An estimated US$ 46.3 billion was lost in productivity in 2012 due to premature cancer deaths in Brazil, China, India, the Russian Federation and South Africa, known as BRICS countries, according to a study released ahead of World Cancer Day on 4 February.

The BRICS countries account for more than 40% of the world's population, 25% of the global gross domestic product a d 42% of the world's cancer deaths.

These countries have undergone rapid demographic and economic growth in recent years, and are particularly affected by hepatitis B virus infections and dietary exposure to aflatoxins, b th of which can cause liver cancer.

Across the BRICS countries, liver and lung cancer have the largest impact on total productivity lost, the study found.The largest total productivity loss (US$ 28 billion) was in China, due to the country's large populati n and high burden of liver cancer.

In the Russian Federation, liver cancer and cancers of the head and neck were probably associated with high consu ption of alcohol, the study found.

In India, the use of chewing tobacco was a leading cause of economic loss due to premature mortality from ancers of the lip and oral cavity.

The study, led by the International Agency for Research on Cancer was published in C

cer Epidemiology.bit.ly/2o27UuS


Low i
fluenza vaccine uptake in Europe

Influenza vaccination coverage among older persons has decreased in several countries in the WHO European Region in recent years.In some countries, access to inf uenza vaccines remains limited.

This analysis of seasonal influenza vaccine coverage in the Region between 2008-09 and 2014-15 was published by the WHO Regional Office for Europe and the European Centre for Diseas Prevention and Control (ECDC).

An estimated 44 000 people die every year of respiratory diseases associated with seasonal influenza in the WHO European Region.According to annual surveys funded by ECDC and WHO, 34 000 (over 75%) of these deaths in Europe are of people aged 65 years or above, and vaccine up ake remains low in this group.

Several countries including France and Germany have seen a rapid increase in severe cases of influenza during the 2017-18 influenza season in western Europe.According to EuroMOMO, the European organization for monitoring excess morta

ty for public health ac
ion,


Public health round-up


Mobile health clinics: reaching people in need

WHO/Faizza Tanggol A mother taking her child to a mobile health clinic after they were displaced during the conflict in the city of Marawi in the Philippines in 2017.This is one of many mobile clinics deployed in emergencies all over the world by the World Health Organization (WHO) and its partners.bit.ly/2EzcATbNews News some of these countries are reporting e cess mortality among the elderly.

Influenza vaccination is generally recommended for people with chronic illnesses, but coverage for this group was below 40% in most countries that reported on this indicator.Almost all countries recommend influenza vaccination for health-care workers, but most of them reported vaccine uptake i this group to be less

han 40%.

http://bit.ly/2C
jo6a


Funds for crisis in Yemen

The United Nations (UN) has released US$ 9.1 million to WHO to provide urgent health assistance to 630 000 vulnerable people in districts around Sana'a and al-Hudayda in Yemen, including 189 000 internally displaced persons and 441 000 people from host communities.The funds were released from the new UN Central Emergency Response und (CERF) grant on 2 February.

"WHO is working with partners to fill critical gaps in the provision of basic health care, to respond to disease outbreaks, to strengthen disease surveillance, to distribute medical supplies and to deliver life-saving services to mothers and their children," said Dr Nevio Zagaria, he WHO Representative in Yemen.

Only 50% of Yemen's health facilities are fully functional and some 16.4 million people in the conflict-torn country require assistance to ensure adequate access to health care with 9.3 million of them in acute need, he said.

As lead of the Health Cluster that coordinates the emergency health response in Yemen, WHO is working with 49 partners to deliver health services to 12.3 million people

n need.

http://bit.ly
2EqMDoJ


Cholera outbreak ends

South Sudan declared the end of its cholera outbreak on 7 February.

The outbreak was first declared on 22 July 2016 and spread from Juba to 26 other counties of South Sudan, which is facing se eral complex health emergencies.

The government worked closely with several partners in the outbreak response, including the European Union Humanitarian Aid, the United States Agency for International Development and WHO.About 2.2 million doses of the oral cholera vaccine were released from the global stockpile that is funded by GAVI, the Vaccine Alliance.Vaccination played a major role in bringing the outbreak under control alongside with water, sanita ion and hygiene interventions.

In 2017, more than 885 000 people were immunized in a first round and nearly 500 000 people also receive a second dose of the vaccine.

Due to security challenges, not everyone was able to receive the recommended two doses, which would significantly decrease their ris of being affected by cholera.

By the time the last person with confirmed cholera was discharged on 18 December 2017, more than 20 000 suspected cases an 436 deaths had been reported.http://www.afro.who.int/news/south-sudan-declares-end

ts-longestcholera-outbreak


Disparities in hea
th research and development

There are striking disparities in health research investment between countries and topics, according to the Global Observatory on Health Res arch and Development (R&D).

WHO established the observatory in 2017 to gather data on where and how research funds are being spent so that governments, funders and researchers can use these data to decide how to invest in health research and which topics and cou tries should take priority.

According to the observatory, the level of investment in certain topics does not correspond to t e actual burden of disease.

As little as 1% of all funding for health R&D is allocated to diseases such as malaria and tuberculosis that affect mainly low-and middle-income countries, despite these diseases accounting for more than 12.5% of t e global burden of disease.

"Most product-related health R&D is profit-driven.This initiative is important because it shows policy-makers and health research funders that we cannot rely on market forces when it comes to making the investments that are needed in health R&D," said Taghreed Adam, wh works on the observatory.

The 2014 outbreak of Ebola virus disease in West Africa dramatically exposed the lack of investment in prevention and treatment of infections caused by pathogens with ep demic potential, she said.

High-income countries have on average 40 times more health researchers than low-income countries.

World Health Day devoted to universal health coverage 24-30 April -World Immunization Week 21-26 May -Seventy-first World Health Assembly 31 May -World No Tobacco Day

woman washes clothes in a newly constructed water, anitation and hygiene (W

H) facility
hat is supported by the United Nations Children's Fund (UNICEF) in the Bo District of Sierra Leone.Some 175 WASH facilities, like this one, are being