Post00372 MEETING PRESENTATIONS + POLIO KAP? ++ NEWS

Post00372 MEETING PRESENTATIONS + POLIO KAP? ++ NEWS 7 September 2001 CONTENTS 1. TECHNET 21 PRESENTATIONS 2. KAP STUDIES DONE ON POLIO ERADICATION? 3. MENINGITIS VACCINE PROJECT ANNOUNCEMENTS 4. RE: EXPERIENCE ON MOBILE CLINICS SOUGHT IN YEMEN 5. INTERNATIONAL HEALTH EXCHANGE WEBSITE MAKES RECRUITING MUCH EASIER 6. STORAGE OF DRUGS MATTER 7. NEWS Moderators Note This Technet Forum posting includes some older messages as the moderator is catching up after more travel. regards, allan ____________________________________*______________________________________ 1. TECHNET 21 PRESENTATIONS ___________________________________________________________________________ From: [[email protected]][email protected][/email] To: Technet Moderator Subject: TechNet 21 presentations Date: Wed, 5 Sep 2001 Dear all, We are in the process of updating the TechNet 21 meeting page in WHO/ATT web site to include the final agenda, list of participants and all presentations. We are hoping to get this done by Monday, 10 September. If you have any problems with downloading the Powerpoint presentations, you can always request an electronic copy by e-mail. Send inquiries to Ms. Cecilia Aedo, [[email protected]][email protected][/email] Visit TechNet 21 Delhi meeting (updated version available on 10 September) http://www.who.int/vaccines-access/index.html Warm regards, Umit Kartoglu Dr. Umit Kartoglu Technical Officer V&B/ATT, HTP Room M230 World Health Organization Avenue Appia 20, CH-1211 Geneva 27 Switzerland Tel: +41 22 791 4972; Fax: +41 22 791 4384 Mobile: +41 79 475 5467 e-mail: [[email protected]][email protected][/email] ____________________________________*______________________________________ 2. KAP STUDIES DONE ON POLIO ERADICATION? ___________________________________________________________________________ Date: Mon, 27 Aug 2001 To: Technet Moderator From: "Moncef M. Bouhafa" Subject: Re: Post00370 GAVI UPDATE We are looking for good examples of KAP studies done on Polio eradication and focusing on families attitudes and knowledge as well as media habits. Is this a valid request for technet? Thanks Moncef Bouhafa ____________________________________*______________________________________ 3. MENINGITIS VACCINE PROJECT ANNOUNCEMENTS ___________________________________________________________________________ From: "Hooks, Carol" To: Technet Moderator Subject: RE: FW: Meningitis Vaccine Project announcements Date: Wed, 22 Aug 2001 Hi! Here is a summary of the MVP announcements. Thank you for posting it in Technet. I've included links to background information and the press releases, but feel free to post the actual pages on Technet if you feel that is more appropriate. Carol Hooks ___________________________________________________________________________ The World Health Organization (WHO) and the Program for Appropriate Technology in Health (PATH) have appointed Dr. Marc LaForce as Project Director of the Meningitis Vaccine Project. This partnership for Africa was launched on May 30, 2001, with initial funding of US $70 million from the Bill & Melinda Gates Foundation. The Meningitis Vaccine Project is a long-term program aimed at eliminating the lethal and disruptive meningitis epidemics in Africa's meningitis belt through the development, production, and introduction of meningococcal conjugate vaccine in Africa. (The new vaccine could also be used in parts of the Middle East.) The program will involve a large number of public and private sector partners, including pharmaceutical companies, national governments, the US Centers for Disease Control and Prevention, NGOs, UN Agencies, and donors. If the project produces the new vaccine in five years, as expected, it will represent an historical milestone in vaccine development through a partnership between the public and private sectors. And, since the target population for meningitis A/C vaccine will be children and adults up to age 30, this project will help lay the groundwork for the introduction of eventual vaccines against HIV and malaria in Africa. Officials from both organizations strongly support the appointment of Dr. LaForce, who has extensive experience in epidemiology, vaccinology and international health, and served for two years as an Epidemic Intelligence Service Officer in the Meningitis and Special Pathogen units at CDC. The project development team included Drs. Teresa Aguado (WHO), Luis Jodar (WHO), Melinda Moree (PATH), Regina Rabinovich (PATH), and Nancy Rosenstein (CDC). The project will be based just outside Geneva. For now, please refer questions and comments about the Meningitis Vaccine Project to: [[email protected]][email protected][/email]. For more information, visit http://www.path.org/resources/meningitis-background.htm or http://www.who.int/vaccines/intermediate/meningococcus.htm. ____________________________________*______________________________________ 4. RE: EXPERIENCE ON MOBILE CLINICS SOUGHT IN YEMEN In Technet Forum Post00359, on 20 July 2001, Dr. Ali Obaid Sallami Deputy Minister of Health Republic of Yemen and Gerrit Weeda of the Yemen Drugs Action Programme, in an e-drug crossposting requested about the experience of using "Mobile Clinics". " We are seeking your experience in this set up, describing success and difficulties. What is the sustainability? What is the life time of vehicles in rugged terrain under such systems? What type of cars would you advice, horse-trailer system, all in one, or other innovative ways. What type of service has been successful in your experience?" * Contributions to: [[email protected]][email protected][/email] or use your reply button! ___________________________________________________________________________ From: [[email protected]][email protected][/email] To: [[email protected]][email protected][/email] Subject: RE: Post00359 MOBILE CLINICS ? Date: Fri, 20 Jul 2001 Allan There have been experiences in Australia (in Aboriginal settlements) of "mobile clinics" in fact these were not really mobile but a container equipped with all the health center equipment (fridge, operating lights, lab and radio) and solar powered and installed in the aborigenal settlements. these worked well as far as I remember but it might be worthwhile establishing contact with the Perth Based Center for the Application of Solar Energy (CASE) ([[email protected]][email protected][/email]) to see whether there are more recent data. Also there was a EU funded research to develop a mobile clinic - this was directed by Peter Ahm and a consortium of European companies - I have not seen the final documents or whether the clinic was in fact installed in countries. Finally, I believe that the cost effectiveness of these mobiles clinic will greatly depend on the type of equipment that is there, its reliability, the maintenance requirements and the training of users and maintenance technicians) Michel --- Date: Wed, 25 Jul 2001 From: "Robert Steinglass" To: Technet Moderator Subject: experience on mobile clinics sought in Yemen Hi. Regarding the mobile clinics, I have some doubts for many of the geographic areas which I remember from the late 1970's and early 1980's. Unless mountain roads have been substantially widened with the bends straightened out, much of the rocky mountainous terrain is not amenable to vehicles much larger than the small box-like Suzukis. Even the short Toyota was too small for much of Hajjah and Mahweet Governorates. Also the vehicle needs to be 4-wheel drive with HIGH clearance for most of the secondary roads I remember. Robert ____________________________________*______________________________________ 5. INTERNATIONAL HEALTH EXCHANGE WEBSITE MAKES RECRUITING MUCH EASIER [Crossposted from hif-net@who with thanks] ___________________________________________________________________________ Date: Sat, 18 Aug 2001 From: [[email protected]][email protected][/email] To: Technet Moderator Subject: [HIF-net at WHO] International Health Exchange Launch of international health recruitment site: www.ihe.org.uk LONDON, 17 August 2001 - Launched today, International Health Exchange's new website makes recruiting health workers for humanitarian posts much easier - benefiting aid agencies, international organisations and mission hospitals. "This is an exciting new development at IHE", says Ivan Scott, Director. "The website will increase our reach and impact. Health workers worldwide will be able to access our recruitment, training and information services instantly. IHE will increase the pool of staff available for hard-to-fill overseas posts." There will also be a much wider reach for organisations that advertise on the website to find qualified and skilled health professionals. But not everyone who works in the aid sector has fast Internet access. With this in mind, IHE's website has been made as accessible as possible to those in developing countries who use old equipment and have slow connections. It uses minimal graphics and there are no flashy effects. "Over half of our members could be working in resource-poor countries at any one time", says Pat Brooke, Recruitment Manager. "It is frustrating and expensive for them to download unnecessarily complicated websites when all they want is to find a job." International Health Exchange will continue to publish the print version of its widely read magazine The Health Exchange and its Job Supplement. They come out monthly on an alternate basis. Notes for editors: International Health Exchange is a London-based charity that seeks to improve health in developing countries by recruiting, training and providing information and advice to health professionals in building the capacity of the health sector. It is a founding member of People in Aid. For advertising and recruitment queries contact: Tanith Richards, 020 7620 3333, [[email protected]][email protected][/email]. For all other queries contact: Sarah Wolf, 020 7620 3333, [[email protected]][email protected][/email]. ____________________________________*______________________________________ 6. STORAGE OF DRUGS MATTER [Crossposted from e-drug with thanks] ___________________________________________________________________________ Date: Thu, 30 Aug 2001 18:18:35 -0400 (EDT) From: Paula Nersesian Subject: [e-drug] Storage of drugs matters (con't) Dear e-druggers, In response to Kim Bessell's message from 28 Aug 2001 requesting standards or guidelines for drug storage, I am attaching storage guidelines developed by the DELIVER Project, a USAID-funded project strengthening health programs logistics in developing countries to increase the availability of critical health products for customers. DELIVER's Guidelines for Proper Storage of Health Commodities is available in English, French, and Spanish as a wall chart or laminated sheet. It lists 13 key points that should be followed by all storage facilities along the supply chain to ensure quality health commodities for the end user. You can visit the DELIVER website to order a hard copy, http://deliver.jsi.com/Index/index.html (go to the publications section, then the Manuals and Guidelines subsection), or look below to see the list. DELIVER uses these basic guidelines in training designed for logistics managers and policymakers as well as during onsite technical assistance visits. The wall charts are printed on sturdy bright yellow plasticised canvas so they might be hung in warehouses and other storage facilities as memory aides for those responsible for managing the storage conditions of health products. Guidelines for Proper Storage of Health Commodities 1. Clean and disinfect storeroom regularly. 2. Store health commodities in a dry, well-lit, and well-ventilated storeroom. Do not store in direct sunlight. 3. Secure storeroom from water penetration. 4. Make sure that fire safety equipment is available and accessible and that employees are trained to use it. 5. Store latex products away from electric motors and fluorescent lights. 6. Maintain cold storage, including a cold chain, for commodities that require it. 7. Keep narcotics and other controlled substances in a locked place. 8. Store flammable products separately with appropriate safety precautions. 9. Stack cartons at least 10 centimeters (4 inches) off the floor, 30 centimeters (1 foot) away from the walls and other stacks, and no more than 2.5 meters (8 feet) high. 10. Arrange cartons so that arrows point up (e) and identification labels, expiry dates, and manufacturing dates are visible. 11. Store health commodities in a manner that facilitates "First Expiry, First Out" (FEFO) stock management. 12. Store health commodities away from insecticides, hazardous materials, old files, office supplies, and equipment. 13. Separate damaged or expired health commodities without delay and dispose of them in accordance with established procedures. DELIVER is a John Snow, Inc. project funded by the United States Agency for International Development. Contract number: HRN-C-00-00-00010-00. All the best, Paula Paula Nersesian, RN, MPH JSI/DELIVER 1616 N Fort Myer Dr, 11th Fl Arlington, VA 22209 USA phone 703.528.7474 fax 703.528.7480 [email protected] deliver.jsi.com --- Date: Wed, 29 Aug 2001 12:33:43 -0400 (EDT) From: Mary Ojoo Subject: [e-drug] Storage of drugs matters (cont'd) I recently paid visits to our suppliers (wholesalers). Some of their storage practices were horrifying, like insulins being kept in the freezer and allowed to thaw before being supplied! Some were not even aware of the implications on their storage practices! There were those who were fantastic while others were definitely out of step. Of course I could now link to why sometimes a doctor would claim that a certain drug is not producing desired results despite it being a well known brand and from a reputable manufacturer. Is there training on good storage practices that these middle men (wholesalers) can attend? Dr Mary Milcah Atieno Ojoo Chief Pharmacist Gertrudes Garden Childrens Hospital P O Box 42325 Nairobi, Kenya Tel: 254 02 763474-7 fax: 254 02 763281 E-mail: [[email protected]][email protected][/email] [Mary is touching on a very important point here: the private sector has so far received insufficient attention in drug supply and use issues. We spent an awful amount of time and energy on improving practices in the public sector, while the private sector is nowadays playing the major role in drug supply and use. I think governments can no longer afford to ignore the private sector. And just as important, drafting new legislations will probably do little to improve things, as in most developing countries there are not that many possibilities to enforce them. So, we will need to find other ways of improving practices in the private sector. Training, as Mary suggests, may be one of the options, but I have become somewhat skeptical about the impact of training based interventions, if it does not come with anything else. I would appreciate hearing other opinions on this. HH] * Information and archives at: http://satellife.healthnet.org/programs/edrug.html ____________________________________*______________________________________ 7. NEWS Selected news items reprinted under the fair use doctrine of international copyright law: http://www4.law.cornell.edu/uscode/17/107.html ___________________________________________________________________________ "Polio Said Nearly Eradicated in South-East Asia" Reuters Health Information Services (www.reutershealth.com) (08/30/01); Hitt, Emma According to the Centers for Disease Control and Prevention (CDC), ramped-up vaccination initiatives have virtually erased polio from South-East Asia. In 1994, six years after the World Health Organization set a plan to eliminate polio worldwide, 10 countries in South-East Asia - including Bangladesh, Sri Lanka, India and Thailand - increased their efforts to fight the disease. According to the CDC, between 1999 and 2000 the number of polio cases cause by wild polio virus in the region dropped from 1,200 to 272. The researchers note that prevention efforts in South-East Asia were again increased late last year - including National Immunization Days, door-to-door and boat-to- boat immunization efforts, and increased polio surveillance - and that the number of confirmed polio cases this year is only 31. --- Disease Outbreaks Reported 5 September 2001 Yellow fever in Cote d'Ivoire- Update PRESS RELEASE ISSUED BY WHO 5 SEPTEMBER 2001 WHO LAUNCHES URGENT APPEAL FOR US$ 2.9 MILLION TO TACKLE YELLOW FEVER EPIDEMIC IN ABIDJAN Preparations Under Way to Send Desperately Needed Vaccine The World Health Organization (WHO) is today launching an urgent appeal for US $ 2.9 million to cover the cost of a mass immunization campaign in response to a potentially disastrous outbreak of yellow fever in Abidjan, the commercial capital of Cote d'Ivoire. WHO is also preparing to deliver vaccine from an international stockpile to Abidjan as soon as possible. Cases of yellow fever have been confirmed in five of the ten communes in Abidjan; suspected cases have also been reported elsewhere. In all, 20 suspected cases have been notified in Abidjan, including four deaths; six of the cases have been confirmed and several others are under investigation. Surveillance data is by no means comprehensive and all indications are that the real situation could be considerably more serious than the number of cases officially suggests. There is also an incubation period of three to seven days before symptoms begin to appear. Urban Yellow Fever is spread by a variety of mosquito that lives in or very close to people's homes and, although very rare, can spread extremely rapidly among a dense urban population, causing many thousands of deaths. Rapid action is essential to purchase stocks of vaccine and deliver them to Abidjan as soon as possible, to prevent this worrying outbreak from becoming a humanitarian disaster. WHO has received an appeal for assistance from the government of the Republic of Cote d'Ivoire, following confirmation of the first cases in Abidjan. The government has asked for WHO's assistance in mobilizing international funds to provide financial and technical aid. "WHO is today appealing to the international community to provide urgent assistance in the purchase and supply of vaccine. WHO will support all the measures necessary to bring this potential human tragedy to a swift conclusion," said Dr David Heymann, WHO Executive Director for Communicable Diseases. A WHO Rapid Assessment Team is in Abidjan, working with the Ministry of Public Health to formulate a response to the outbreak. Plans are under way for a mass immunization campaign in Abidjan, requiring some three million doses of vaccine. WHO is urgently locating stocks of yellow fever vaccine that can be moved quickly to Cote d'Ivoire. In Abidjan, immunization teams will have to be recruited, trained and provided with the necessary resources and logistic support for this huge but vital undertaking. There is a delay of 7-10 days from immunization until protective immunity develops. It is therefore crucial for this campaign to begin as soon as possible in order to protect the population from an epidemic. Yellow fever is endemic in some tropical areas of Africa and the Americas. However, it is most commonly found in jungle areas and spread only sporadically to humans entering the forest. When the virus spreads into urban areas with high population density, it immediately becomes a very serious public health risk. Yellow fever is difficult to recognize in its early stages, when it can easily be confused with malaria, typhoid or other causes of fever. However, a number of cases enter a second "toxic phase" of the disease, in which bleeding can occur from the mouth, nose, eyes and/or stomach. Approximately 20-50% of "toxic" cases die within 10-14 days. "The international community must respond and respond quickly to this urgent appeal to prevent a catastrophic outbreak of yellow fever in Abidjan," added Dr Heymann. --- "Rethinking a Vaccine's Risk" Science (www.sciencemag.org) (09/01/01) Vol. 293, P. 1576 Two years ago, Wyeth Lederle Vaccines pulled a new vaccine against rotavirus off the market because of concerns over side effects, but the medical community is now questioning the risk-benefit calculation. Every year, rotavirus infection--a diarrheal disease--kills up to 800,000 children around the world. Wyeth decided to withdraw its RotaShield vaccine after researchers linked the vaccine to a rare but potentially fatal bowel obstruction called intussusception, and analysts had calculated that the vaccine was too risky too use. According to two recent studies, however, the risk-benefit calculations in 1999 may have been wrong, and the new findings will be discussed at a Sept. 5 meeting in Rosslyn, Va., organized by the U.S. National Vaccine Program Office--which coordinates federal immunization work--and its National Vaccine Advisory Committee. A number of researchers at the U.S. National Institutes of Health, where the vaccine was first created before being licensed to industry, are extremely happy with the recent developments. John La Montagne, deputy director of the National Institute of Allergy and Infectious Diseases (NIAID), says that suspending the vaccine's use was the right decision to make at the time, but that that decision should now be re- examined. A researcher at the NIAID, Albert Kapikian, first started developing the vaccine two decades ago by combining parts of rotavirus strains from rhesus monkeys and human beings. Efficacy trials in Venezuela, Finland, and the United States indicated that this live, "reassortant" virus vaccine could safely protect up to 91 percent of immunized children from the disease. --- "The Hidden Virus: Doctors Try to Alert Asian, Pacific Islander Americans to Increased Risk of Liver Cancer" San Francisco Chronicle (www.sfgate.com) (09/04/01) P. A11; Kim, Ryan With as many as 10 percent of Asian and Pacific Islander Americans infected with hepatitis B, the Asian Liver Center at Stanford University has started an education program to raise awareness of the disease. The effort aims to encourage people, especially Asian and Pacific Islander Americans, to start screening for liver cancer at the age of 30 and also to get vaccinated against hepatitis B. The Asian Liver Center says that Asians are 13 percent more likely than Caucasians to develop liver cancer due to a high hepatitis B prevalence, which can be traced back to a high incidence of the disease in China, Vietnam, Southeast Asia, Philippines, Korea, India, and Japan. Asian Liver Center Director Samuel So believes that increased awareness of the disease will encourage doctors to do more earlier and preventative tests on Asian and Pacific Islander Americans and ensure Asian infants receive the hepatitis B vaccines within the first 12 hours of life.