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1.
Pan Afr Med J ; 40: 1, 2021.
Article in English | MEDLINE | ID: covidwho-1538842

ABSTRACT

The world confronts today a disease which was unknown as recently as early 2019. Now that there is a safe and effective vaccine against COVID-19, lessons can usefully be drawn from previous well documented vaccination efforts. Of these, the best documented and most successful is the Smallpox Eradication Program (SEP). A review was made of publications by major players in smallpox eradication, respecting the important differences between the disease, this review revealed several points of connection. Cultural factors loomed large both in the eradication of smallpox and progress, to date, in the control of COVID-19. Other points of similarity included political commitment, the set-up of strong surveillance mechanisms, and assurance of uniformly high quality vaccines tested and approved by the World Health Organization. The future of COVID-19 control depends, in part, on lessons learned from previous vaccination efforts. A review of those efforts will avoid repetition of past errors and permit adoption of best practices from the past. Such analyses must, of course, respect the important differences between COVID-19 and smallpox.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Smallpox Vaccine/administration & dosage , Smallpox/prevention & control , Disease Eradication/methods , Global Health , Humans , Vaccination/methods , Vaccination Refusal
2.
Glob Health Sci Pract ; 9(3): 682-689, 2021 Sep 30.
Article in English | MEDLINE | ID: covidwho-1449261

ABSTRACT

Lessons learned from one global health program can inform responses to challenges faced by other programs. One way to disseminate these lessons is through courses. However, such courses are often delivered by and taught to people based in high-income countries and thus may not present a truly global perspective. The Synthesis and Translation of Research and Innovations from Polio Eradication (STRIPE) is a consortium of 8 institutions in Afghanistan, Bangladesh, the Democratic Republic of the Congo, Ethiopia, India, Indonesia, Nigeria, and the United States that seeks to carry out such a transfer of the lessons learned in polio eradication. This short report describes the collaborative process of developing content and curriculum for an international course, the learnings that emerged, the barriers we faced, and recommendations for future similar efforts. Various parts of our course were developed by teams of researchers from countries across South Asia and sub-Saharan Africa. We held a series of regional in-person team meetings hosted in different countries to improve rapport and provide a chance to work together in person. The course content reflects the diversity of team members' knowledge in a variety of contexts. Challenges to this effort included team coordination (e.g., scheduling across time zones); hierarchies across and between countries; and the coronavirus disease (COVID-19) pandemic. We recommend planning for these hierarchies ahead of time and ensuring significant in-person meeting time to make the most of international collaboration.


Subject(s)
Curriculum , Disease Eradication/methods , Global Health/education , Immunization Programs/methods , Internationality , Poliomyelitis/prevention & control , Afghanistan , Bangladesh , Democratic Republic of the Congo , Ethiopia , Humans , India , Indonesia , Nigeria , Poliomyelitis/drug therapy , United States
3.
PLoS Negl Trop Dis ; 15(8): e0009595, 2021 08.
Article in English | MEDLINE | ID: covidwho-1416859

ABSTRACT

BACKGROUND: Sustainability within neglected tropical disease (NTD) programs is a complex and challenging issue. The need for a shared understanding about what sustainability means for NTD programs is more important than ever as stakeholders are currently realigning for the next decade of NTD programming with the launch of WHO's new NTD roadmap for 2012-2030. The aim of this paper is to assess different perspectives to generate a working definition of sustainability for NTD programs. METHODOLOGY/PRINCIPAL FINDINGS: This study surveyed affiliates of the NTD NGO Network (NNN) about their definitions of sustainability and then analyzed the data using an inductive and deductive process. The research team drafted a sustainability statement based on the survey findings and then solicited and incorporated feedback on the statement from a diverse group of expert reviewers. The final statement includes a working definition of sustainability for NTD programs that highlights three key essential components to sustainability: domestic commitment, responsive resource mobilization, and accountability. CONCLUSIONS/SIGNIFICANCE: This research resulted in a sustainability statement, based on a survey and extensive consultation with stakeholders, that represents a starting point for shared understanding around the concept of sustainability for NTD programs. Future collaborative work should build off this definition and seek to incorporate indicators for sustainability into programmatic decision-making.


Subject(s)
Disease Eradication/methods , Disease Eradication/organization & administration , Neglected Diseases/prevention & control , Program Evaluation , Global Health , Humans , Social Responsibility , World Health Organization
4.
Can J Public Health ; 112(5): 872-876, 2021 10.
Article in English | MEDLINE | ID: covidwho-1405565

ABSTRACT

The greatest human cost of the rapidly moving pandemic of SARS-CoV-2 may be due to its impact on the response to other diseases. One such other disease is tuberculosis (TB). All indications suggest that COVID-19-related diversions of healthcare resources and disruptions to public health programming will exacerbate the slower moving pandemic of TB. This is expected to set back TB elimination efforts by years. This is a prediction that is especially relevant to Canada, which has repeatedly failed to meet pre-set targets for the elimination of TB even before the COVID-19 pandemic began. A collaborative approach to achieve TB elimination, one that engages all care providers, has recently been emphasized by the STOP-TB Partnership. Among TB elimination strategies, frontline providers (e.g., family physicians, emergency room physicians, and others) are well positioned to identify candidates for the treatment of latent TB infection, and make the diagnosis of infection-spreading cases of TB in a timely manner, thereby interrupting forward-moving chains of transmission. Electronic medical records offer the promise of automating these processes. In this commentary, we promote broader engagement of the workforce across multiple sectors of medicine to reduce TB associated morbidity and mortality, interrupt transmission, and shrink the reservoir of latent TB infection.


Subject(s)
Disease Eradication , Health Personnel , Tuberculosis , COVID-19 , Canada/epidemiology , Developed Countries , Disease Eradication/methods , Health Personnel/organization & administration , Humans , Tuberculosis/epidemiology , Tuberculosis/prevention & control
7.
Viruses ; 13(5)2021 05 07.
Article in English | MEDLINE | ID: covidwho-1224256

ABSTRACT

The future prevalence and virulence of SARS-CoV-2 is uncertain. Some emerging pathogens become avirulent as populations approach herd immunity. Although not all viruses follow this path, the fact that the seasonal coronaviruses are benign gives some hope. We develop a general mathematical model to predict when the interplay among three factors, correlation of severity in consecutive infections, population heterogeneity in susceptibility due to age, and reduced severity due to partial immunity, will promote avirulence as SARS-CoV-2 becomes endemic. Each of these components has the potential to limit severe, high-shedding cases over time under the right circumstances, but in combination they can rapidly reduce the frequency of more severe and infectious manifestation of disease over a wide range of conditions. As more reinfections are captured in data over the next several years, these models will help to test if COVID-19 severity is beginning to attenuate in the ways our model predicts, and to predict the disease.


Subject(s)
COVID-19 Vaccines/supply & distribution , COVID-19/epidemiology , SARS-CoV-2/pathogenicity , COVID-19/immunology , COVID-19/transmission , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/immunology , Communicable Disease Control/methods , Disease Eradication/methods , Humans , Immunity, Herd/immunology , Models, Theoretical , SARS-CoV-2/immunology , Seasons
10.
Expert Rev Vaccines ; 20(4): 465-481, 2021 04.
Article in English | MEDLINE | ID: covidwho-1099508

ABSTRACT

OBJECTIVES: As efforts to control COVID-19 continue, we simulate hypothetical emergence of wild poliovirus assuming an immunologically naïve population. This differs from the current global experience with polio and serves as a model for responding to future pandemics. METHODS: Applying an established global model, we assume a fully susceptible global population to polioviruses, independently introduce a virus with properties of each of the three stable wild poliovirus serotypes, and explore the impact of strategies that range from doing nothing to seeking global containment and eradication. RESULTS: We show the dynamics of paralytic cases as the virus spreads globally. We demonstrate the difficulty of eradication unless aggressive efforts begin soon after initial disease detection. Different poliovirus serotypes lead to different trajectories and burdens of disease. In the absence of aggressive measures, the virus would become globally endemic in 2-10 years, and cumulative paralytic cases would exceed 4-40 million depending on serotype, with the burden of disease shifting to younger ages. CONCLUSIONS: The opportunity to eradicate emerging infections represents an important public policy choice. If the world first observed the emergence of wild poliovirus in 2020, adopting aggressive control strategies would have been required to prevent a devastating global pandemic.


Subject(s)
Global Health , Health Policy/trends , Poliomyelitis/epidemiology , Poliovirus/isolation & purification , COVID-19/epidemiology , COVID-19/immunology , COVID-19/prevention & control , Disease Eradication/methods , Disease Eradication/trends , Disease Outbreaks/prevention & control , Humans , Poliomyelitis/immunology , Poliomyelitis/prevention & control , SARS-CoV-2/isolation & purification
11.
Adv Ther ; 38(3): 1397-1403, 2021 03.
Article in English | MEDLINE | ID: covidwho-1085619

ABSTRACT

The availability of pangenotypic direct-acting antivirals for treatment of hepatitis C (HCV) has provided an opportunity to simplify patient pathways. Recent clinical practice guidelines have recognised the need for simplification to ensure that elimination of HCV as a public health concern remains a priority. Despite the move towards simplified treatment algorithms, there remains some complexity in the recommendations for the management of genotype 3 patients with compensated cirrhosis. In an era where additional clinical trial data are not anticipated, clinical guidance should consider experience gained in real-world settings. Although more experience is required for some pangenotypic therapeutic options, on the basis of published real-world data, there is already sufficient evidence to consider a simplified approach for genotype 3 patients with compensated cirrhosis. The coronavirus disease 2019 (COVID-19) pandemic has highlighted the need to minimise the need for complex patient pathways and clinical practice guidelines need to continue to evolve in order to ensure that patient outcomes remain optimised.


Subject(s)
COVID-19 , Communicable Disease Control , Critical Pathways , Disease Eradication , Hepatitis C , Antiviral Agents/pharmacology , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Critical Pathways/standards , Critical Pathways/trends , Disease Eradication/methods , Disease Eradication/organization & administration , Global Health/trends , Hepatitis C/epidemiology , Hepatitis C/therapy , Humans , Practice Guidelines as Topic , SARS-CoV-2
12.
Risk Anal ; 41(2): 393-406, 2021 02.
Article in English | MEDLINE | ID: covidwho-1084249

ABSTRACT

Despite a strong global commitment, polio eradication efforts continue now more than 30 years after the 1988 World Health Assembly resolution that established the Global Polio Eradication Initiative (GPEI), and 20 years after the original target of the year 2000. Prior health economic analyses estimated incremental net benefits of the GPEI of 40-50 billion in 2008 U.S. dollars (US$2008, equivalent to 48-59 billion US$2019), assuming the achievement of polio eradication by 2012. Given the delays in achieving polio eradication and increased costs, we performed an updated economic analysis of the GPEI using an updated integrated global model, and considering the GPEI trajectory as of the beginning of 2020. Applying similar methods and assuming eradication achievement in 2023, we estimate incremental net benefits of the GPEI of 28 billion US$2019, which falls below the prior estimate. Delays in achieving polio eradication combined with the widescale introduction of relatively expensive inactivated poliovirus vaccine significantly increased the costs of the GPEI and make it less cost-effective, although the GPEI continues to yield expected incremental net benefits at the global level when considered over the time horizon of 1988-2029. The overall health and financial benefits of the GPEI will depend on whether and when the GPEI can achieve its goals, when eradication occurs, the valuation method applied, and the path dependence of the actions taken. Reduced expected incremental net benefits of the GPEI and the substantial economic impacts of the COVID-19 pandemic pose large financial risks for the GPEI.


Subject(s)
Disease Eradication/methods , Economics, Medical , Global Health , Poliomyelitis/economics , Poliomyelitis/prevention & control , Poliovirus Vaccine, Inactivated/economics , Poliovirus Vaccine, Oral/economics , Algorithms , COVID-19/economics , COVID-19/epidemiology , Cost-Benefit Analysis , Health Care Costs , Humans , Immunization Programs/economics , Models, Theoretical , Pandemics , Poliomyelitis/epidemiology , Retrospective Studies , United States
13.
Lancet Glob Health ; 8(10): e1345-e1351, 2020 10.
Article in English | MEDLINE | ID: covidwho-755423

ABSTRACT

On Aug 25 2020, the Africa Regional Commission for the Certification of Poliomyelitis Eradication declared that the WHO African region had interrupted transmission of all indigenous wild polioviruses. This declaration marks the African region as the fifth of the six WHO regions to celebrate this extraordinary achievement. Following the Yaoundé Declaration on Polio Eradication in Africa by heads of state and governments in 1996, Nelson Mandela launched the Kick Polio out of Africa campaign. In this Health Policy paper, we describe the long and turbulent journey to the certification of the interruption of wild poliovirus transmission, focusing on 2016-20, lessons learned, and the strategies and analyses that convinced the Regional Commission that the African region is free of wild polioviruses. This certification of the WHO African region shows the feasibility of polio eradication in countries with chronic insecurity, inaccessible and hard-to-reach populations, and weak health systems. Challenges have been daunting and the sacrifices enormous-dozens of health workers and volunteers have lost their lives in the pursuit of a polio-free Africa.


Subject(s)
Disease Eradication/methods , Global Health , Poliomyelitis/prevention & control , World Health Organization , Africa , Humans , Poliomyelitis/transmission
14.
BMC Med ; 19(1): 2, 2021 01 05.
Article in English | MEDLINE | ID: covidwho-1007167

ABSTRACT

BACKGROUND: Through a combination of strong routine immunization (RI), strategic supplemental immunization activities (SIA) and robust surveillance, numerous countries have been able to approach or achieve measles elimination. The fragility of these achievements has been shown, however, by the resurgence of measles since 2016. We describe trends in routine measles vaccine coverage at national and district level, SIA performance and demographic changes in the three regions with the highest measles burden. FINDINGS: WHO-UNICEF estimates of immunization coverage show that global coverage of the first dose of measles vaccine has stabilized at 85% from 2015 to 19. In 2000, 17 countries in the WHO African and Eastern Mediterranean regions had measles vaccine coverage below 50%, and although all increased coverage by 2019, at a median of 60%, it remained far below levels needed for elimination. Geospatial estimates show many low coverage districts across Africa and much of the Eastern Mediterranean and southeast Asian regions. A large proportion of children unvaccinated for MCV live in conflict-affected areas with remote rural areas and some urban areas also at risk. Countries with low RI coverage use SIAs frequently, yet the ideal timing and target age range for SIAs vary within countries, and the impact of SIAs has often been mitigated by delays or disruptions. SIAs have not been sufficient to achieve or sustain measles elimination in the countries with weakest routine systems. Demographic changes also affect measles transmission, and their variation between and within countries should be incorporated into strategic planning. CONCLUSIONS: Rebuilding services after the COVID-19 pandemic provides a need and an opportunity to increase community engagement in planning and monitoring services. A broader suite of interventions is needed beyond SIAs. Improved methods for tracking coverage at the individual and community level are needed together with enhanced surveillance. Decision-making needs to be decentralized to develop locally-driven, sustainable strategies for measles control and elimination.


Subject(s)
Disease Eradication , Immunization Programs , Immunization, Secondary , Measles , Regional Health Planning/organization & administration , Vaccination Coverage/trends , Africa/epidemiology , Asia, Southeastern/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , Child , Disease Eradication/methods , Disease Eradication/statistics & numerical data , Humans , Immunization Programs/methods , Immunization Programs/organization & administration , Immunization, Secondary/methods , Immunization, Secondary/statistics & numerical data , Measles/epidemiology , Measles/prevention & control , Measles Vaccine/therapeutic use , Mediterranean Region/epidemiology , SARS-CoV-2
16.
Glob Health Sci Pract ; 8(3): 396-412, 2020 09 30.
Article in English | MEDLINE | ID: covidwho-809678

ABSTRACT

This article assesses the CORE Group Polio Project (CGPP) experience over a 20-year period in 5 countries. It examines how a program designed to provide social mobilization to eradicate one disease, and which did so effectively, functioned within the general framework of community health workers (CHWs). Vertical health programs often have limited impact on broader community health. CGPP has a 20-year history of social mobilization and effective program interventions. This history provided an opportunity to assess how CGPP community mobilizers (CMs) functioned in polio and maternal and child health. The Updated Program Functionality Matrix for Optimizing Community Health Programs tool of the CHW Assessment and Improvement Matrix (AIM) was used to examine CGPP CM roles across different contexts. The analysis determined that CGPP CMs met the basic level of functioning (level 3) for 6 of the 10 components of the AIM tool. This cross-country descriptive analysis of the CGPP demonstrates the importance of embracing the full range of CHW AIM components, even in a vertical program. Use of data, community involvement, local adaptation, and linkage with the health system are especially critical for success. This general lesson could be applied to other community mobilization and disease/epidemic control initiatives, especially as we face the issues of the COVID-19 pandemic.


Subject(s)
Community Health Workers , Disease Eradication/methods , Poliomyelitis/prevention & control , Program Evaluation/methods , Rural Health Services , Africa , Asia , Humans , Rural Population
18.
Am J Prev Med ; 59(4): 493-503, 2020 10.
Article in English | MEDLINE | ID: covidwho-645862

ABSTRACT

INTRODUCTION: Given the continuing COVID-19 pandemic and much of the U.S. implementing social distancing owing to the lack of alternatives, there has been a push to develop a vaccine to eliminate the need for social distancing. METHODS: In 2020, the team developed a computational model of the U.S. simulating the spread of COVID-19 coronavirus and vaccination. RESULTS: Simulation experiments revealed that to prevent an epidemic (reduce the peak by >99%), the vaccine efficacy has to be at least 60% when vaccination coverage is 100% (reproduction number=2.5-3.5). This vaccine efficacy threshold rises to 70% when coverage drops to 75% and up to 80% when coverage drops to 60% when reproduction number is 2.5, rising to 80% when coverage drops to 75% when the reproduction number is 3.5. To extinguish an ongoing epidemic, the vaccine efficacy has to be at least 60% when coverage is 100% and at least 80% when coverage drops to 75% to reduce the peak by 85%-86%, 61%-62%, and 32% when vaccination occurs after 5%, 15%, and 30% of the population, respectively, have already been exposed to COVID-19 coronavirus. A vaccine with an efficacy between 60% and 80% could still obviate the need for other measures under certain circumstances such as much higher, and in some cases, potentially unachievable, vaccination coverages. CONCLUSIONS: This study found that the vaccine has to have an efficacy of at least 70% to prevent an epidemic and of at least 80% to largely extinguish an epidemic without any other measures (e.g., social distancing).


Subject(s)
Communicable Disease Control , Computer Simulation , Coronavirus Infections , Pandemics , Pneumonia, Viral , Vaccination , Viral Vaccines/pharmacology , Betacoronavirus/isolation & purification , COVID-19 , COVID-19 Vaccines , Communicable Disease Control/methods , Communicable Disease Control/statistics & numerical data , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Disease Eradication/methods , Disease Eradication/statistics & numerical data , Humans , Needs Assessment , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , SARS-CoV-2 , Treatment Outcome , United States/epidemiology , Vaccination/methods , Vaccination/statistics & numerical data , Vaccination Coverage , Viral Vaccines/standards
19.
Autophagy ; 16(12): 2267-2270, 2020 12.
Article in English | MEDLINE | ID: covidwho-592167

ABSTRACT

At a time when the world faces an emotional breakdown, crushing our dreams, if not, taking our lives, we realize that together we must fight the war against the COVID-19 outbreak even if almost the majority of the scientific community finds itself confined at home. Every day, we, scientists, listen to the latest news with its promises and announcements. Across the world, a surge of clinical trials trying to cure or slow down the coronavirus pandemic has been launched to bring hope instead of fear and despair. One first proposed clinical trial has drawn worldwide hype to the benefit of chloroquine (CQ), in the treatment of patients infected by the recently emerged deadly coronavirus (SARS-CoV-2). We should consider this information in light of the long-standing anti-inflammatory and anti-viral properties of CQ-related drugs. Yet, none of the articles promoting the use of CQ in the current pandemic evoked a possible molecular or cellular mechanism of action that could account for any efficacy. Here, given the interaction of viruses with macroautophagy (hereafter referred to as autophagy), a CQ-sensitive anti-viral safeguard pathway, we would like to discuss the pros, but also the cons concerning the current therapeutic options targeting this process.


Subject(s)
Anti-Inflammatory Agents/therapeutic use , Autophagy/drug effects , COVID-19/drug therapy , Chloroquine/therapeutic use , SARS-CoV-2/drug effects , Anti-Inflammatory Agents/pharmacology , Antiviral Agents/pharmacology , Antiviral Agents/therapeutic use , Autophagy/physiology , COVID-19/epidemiology , COVID-19/immunology , COVID-19/pathology , Chloroquine/analogs & derivatives , Chloroquine/pharmacology , Disease Eradication/methods , Drug Repositioning/methods , Drug Repositioning/trends , Drug-Related Side Effects and Adverse Reactions/epidemiology , Ebolavirus/drug effects , HIV/drug effects , History, 21st Century , Humans , Hydroxychloroquine/pharmacology , Hydroxychloroquine/therapeutic use , Malaria/drug therapy , Pandemics , Plasmodium malariae/drug effects , SARS-CoV-2/immunology , SARS-CoV-2/pathogenicity , Signal Transduction/drug effects , Signal Transduction/immunology
20.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 32(2): 113-118, 2020 Mar 18.
Article in Chinese | MEDLINE | ID: covidwho-414878

ABSTRACT

Currently, the local transmission of coronavirus disease 2019 (COVID-19) has been effectively contained in China; however, the epidemic situation of this highly infectious disease is more and more serious outside of China. Importation of COVID-19 cases from other countries and territories is therefore becoming a new challenge for the control of COVID-19 in China. Malaria was once widely epidemic in China. Nevertheless, the local transmission of this parasitic disease has been interrupted in China since the launch of the national malaria elimination programme in 2010, and great successes have been achieved in the management of appropriately 3 thousand malaria cases imported from other countries and territories annually. Hereby, the epidemiological characteristics and current epidemic situation of COVID-19 in China were analyzed and compared with malaria. Based on the successful experiences from the management of overseas imported malaria in China, the strategy and countermeasures for COVID-19 control were proposed, so as to provide insights into the response to the importation of COVID-19 from other countries and territories and the consolidation of the control achievements in China.


Subject(s)
Communicable Diseases, Imported/prevention & control , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Disease Eradication/methods , Malaria/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Betacoronavirus/isolation & purification , COVID-19 , China/epidemiology , Coronavirus Infections/epidemiology , Humans , Pneumonia, Viral/epidemiology , SARS-CoV-2
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