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
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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.