World Bank launches groundbreaking insurance to protect poorest countries against pandemics

The World Bank Group has launched a Pandemic Emergency Financing Facility (PEF), an innovative, fast-disbursing global financing mechanism designed to protect the world against deadly pandemics, which will create the first-ever insurance market for pandemic risk. Japan, which holds the G7 Presidency, committed the first $50 million in funding toward the new initiative.

“Pandemics pose some of the biggest threats in the world to people’s lives and to economies, and for the first time we will have a system that can move funding and teams of experts to the sites of outbreaks before they spin out of control,” said Jim Yong Kim, President of the World Bank Group. “This facility addresses a long, collective failure in dealing with pandemics. The Ebola crisis in Guinea, Liberia and Sierra Leone taught all of us that we must be much more vigilant to outbreaks and respond immediately to save lives and also to protect economic growth.”

The announcement came a week ahead of the May 26-27 Summit of Group of Seven Leaders in Ise-Shima, Japan. G7 leaders had urged the World Bank Group to develop the initiative during their May 2015 summit in Schloss-Elmau, Germany.

“Innovative financing for crisis responses by the PEF, together with financing for preparedness and prevention in peacetime including through IDA, are important to mitigate human and social losses and to help quickly recover in the event of a crisis. It is cost-effective and should be emphasized at all stages of economic development,” said Deputy Prime Minister and Minister of Finance of Japan Taro Aso.

The new facility will accelerate both global and national responses to future outbreaks with pandemic potential. It was built and designed in collaboration with the World Health Organization and the private sector, introducing a new level of rigor into both the financing and the response.

“Recent years have seen a dramatic resurgence of the threat from emerging and re-emerging infectious diseases,” said Margaret Chan, Director-General of the World Health Organization. “WHO fully supports the Pandemic Emergency Financing Facility as a critical contribution to global health security and a crucial line of defence against high-threat pathogens.” The PEF includes an insurance window, which combines funding from the reinsurance markets with the proceeds of World Bank-issued pandemic (catastrophe, or Cat) bonds, as well as a complementary cash window. This will be the first time World Bank Cat Bonds have been used to combat infectious diseases. In the event of an outbreak, the PEF will release funds quickly to countries and qualified international responding agencies. The insurance window will provide coverage up to $500 million for an initial period of three years for outbreaks of infectious diseases most likely to cause major epidemics, including new Orthomyxoviruses (e.g. new influenza pandemic virus A, B and C), Coronaviridae (e.g. SARS, MERS), Filoviridae (e.g. Ebola, Marburg) and other zoonotic diseases (e.g. Crimean Congo, Rift Valley, Lassa fever). Parametric triggers designed with publicly available data will determine when the money would be released, based on the size, severity and spread of the outbreak.

The complementary cash window will provide more flexible funding to address a larger set of emerging pathogens, which may not yet meet the activation criteria worldwide monitor Update from around the globe for the insurance window.

All 77 countries eligible for financing from the International Development Association, the World Bank Group’s fund for the poorest countries, will be eligible to receive coverage from the PEF. The PEF is expected to be operational later this year.

Recent economic analysis suggests that the annual global cost of moderately severe to severe pandemics is roughly $570 billion, or 0.7% of global GDP. A very severe pandemic like the 1918 Spanish flu could cost as much as 5% of global GDP, or nearly $4 trillion.

During the past two years alone, pandemic threats have included the devastating Ebola crisis in West Africa – which crippled the economies of Guinea, Liberia and Sierra Leone, and cost them an estimated $2.8 billion in GDP losses ($600 million in Guinea, $300 million in Liberia and $1.9 billion in Sierra Leone); the MERS outbreak, which took a toll on the South Korean economy; and the Zika virus that is spreading in the Americas and putting thousands of unborn children at risk.

Four global expert panels that were convened over the past year in the wake of the Ebola crisis concluded that the world must urgently step up its capacity for a swift response to outbreaks before they become more deadly and costly pandemics.

The PEF will do a number of important things to prevent another Ebola crisis:

  • It will insure the world’s poorest countries against the threat of a pandemic.
  • In the event of a severe infectious disease outbreak, it will release funds quickly to the countries and/or to international responders, to accelerate the response – saving lives and reducing human suffering.
  • By mobilizing an earlier, faster, better planned and coordinated response, it will reduce the costs to countries and their people for response and recovery.
  • It will promote greater global and national investments in preparing for future outbreaks and strengthening national health systems.
  • It will combine public and private resources to advance global health security, and create a new insurance market for managing pandemic risk.

HIV vaccine trial to go large-scale after good safety results and immune response

An early-stage HIV vaccine clinical trial in South Africa has determined that an investigational vaccine regimen is safe and generates comparable immune responses to those reported in a landmark 2009 study showing that a vaccine can protect people from HIV infection. Consequently, the US-based National Institute of Allergy and Infectious Diseases (NIAID) and its partners have decided to advance the experimental HIV vaccine regimen into a large clinical trial. This new study, called HVTN 702, is designed to determine whether the regimen is safe, tolerable and effective at preventing HIV infection among South African adults. The trial is slated to begin in November 2016, pending regulatory approval.

“For the first time in seven years, the scientific community is embarking on a largescale clinical trial of an HIV vaccine, the product of years of study and experimentation,” said Anthony S. Fauci, M.D., director of NIAID, part of the National Institutes of Health and a co-funder of the trial. “A safe and effective HIV vaccine could help bring about a durable end to the HIV/ AIDS pandemic and is particularly needed in southern Africa, where HIV is more pervasive than anywhere else in the world.”

The experimental vaccine regimen that will be studied in HVTN 702 is now being tested in the smaller initial trial, named HVTN 100 and is based on the regimen investigated in the U.S. Military HIV Research Program-led RV144 clinical trial in Thailand that delivered landmark results in 2009. The current regimen is designed to provide greater protection than the RV144 regimen and has been adapted to the HIV subtype that predominates in southern Africa.

The experimental vaccine regimen tested in the RV144 trial was found to be 31.2 percent effective at preventing HIV infection during the 3.5 years after vaccination, although the regimen appears to have been 60 percent effective one year after vaccination. In the HVTN 702 study, the design and schedule of the RV144 vaccine regimen have been adjusted to try to increase the magnitude and duration of vaccine-elicited immune responses.

HVTN 100 and HVTN 702 are part of a larger HIV vaccine research endeavour led by a group called the Pox-Protein Public- Private Partnership, or P5 -- a diverse set of public and private organizations committed to building on the success of the RV144 trial. The P5 aims to produce an HIV vaccine that could have a significant public health benefit in southern Africa and to deepen scientists’ understanding of the immune responses associated with preventing HIV infection. P5 members are NIAID, the Bill & Melinda Gates Foundation, the South African Medical Research Council, HVTN, Sanofi Pasteur, GSK and the U.S. Military HIV Research Program.


Study suggests medical errors now third leading cause of death in the US

Analyzing medical death rate data over an eight-year period, Johns Hopkins patient safety experts have calculated that more than 250,000 deaths per year are due to medical error in the US. Their figure, published May 3 in The BMJ, surpasses the US Centers for Disease Control and Prevention’s (CDC’s) third leading cause of death – respiratory disease, which kills close to 150,000 people per year.

The Johns Hopkins team says the CDC’s way of collecting national health statistics fails to classify medical errors separately on the death certificate. The researchers are advocating for updated criteria for classifying deaths on death certificates.

“Incidence rates for deaths directly attributable to medical care gone awry haven’t been recognized in any standardized method for collecting national statistics,” says Martin Makary, M.D., M.P.H., professor of surgery at the Johns Hopkins University School of Medicine and an authority on health reform. “The medical coding system was designed to maximize billing for physician services, not to collect national health statistics, as it is currently being used.”

In 1949, Dr Makary says, the US adopted an international form that used International Classification of Diseases (ICD) billing codes to tally causes of death.

“At that time, it was under-recognized that diagnostic errors, medical mistakes and the absence of safety nets could result in someone’s death, and because of that, medical errors were unintentionally excluded from national health statistics,” says Dr Makary.

The researchers say that since that time, national mortality statistics have been tabulated using billing codes, which don’t have a built-in way to recognize incidence rates of mortality due to medical care gone wrong.

In their study, the researchers examined four separate studies that analyzed medical death rate data from 2000 to 2008, including one by the US Department of Health and Human Services’ Office of the Inspector General and the Agency for Healthcare Research and Quality. Then, using hospital admission rates from 2013, they extrapolated that based on a total of 35,416,020 hospitalizations, 251,454 deaths stemmed from a medical error, which the researchers say now translates to 9.5% of all deaths each year in the US.

According to the CDC, in 2013, 611,105 people died of heart disease, 584,881 died of cancer and 149,205 died of chronic respiratory disease – the top three causes of death in the US. The newly calculated figure for medical errors puts this cause of death behind cancer but ahead of respiratory disease.

“Top-ranked causes of death as reported by the CDC inform our country’s research funding and public health priorities,” says Makary. “Right now, cancer and heart disease get a ton of attention, but since medical errors don’t appear on the list, the problem doesn’t get the funding and attention it deserves.”

The researchers caution that most of medical errors aren’t due to inherently bad doctors, and that reporting these errors shouldn’t be addressed by punishment or legal action. Rather, they say, most errors represent systemic problems, including poorly coordinated care, fragmented insurance networks, the absenceor underuse of safety nets, and other protocols, in addition to unwarranted variation in physician practice patterns that lack accountability.

“Unwarranted variation is endemic in health care. Developing consensus protocols that streamline the delivery of medicine and reduce variability can improve quality and lower costs in health care. More research on preventing medical errors from occurring is needed to address the problem,” says Dr Makary.


Historic Mexico Declaration calls for collaborative voice to prevent premature deaths from CVD

Global organisations on 5 June 2016 signed The Mexico Declaration for Circulatory Health, the first ever global declaration on heart health. The historic declaration is recognition that, health professionals, governments, businesses and the public to must find a common voice to ensure action to prevent an increase in the number of premature deaths as a result of cardiovascular diseases (CVD).

Professor David Wood, President-Elect at the World Heart Federation, said: “The Mexico Declaration is an important milestone in the ongoing efforts to tackle what are largely preventable diseases. Cardiovascular diseases continue to place a huge burden on society, not just financially but also in terms of the role they play in maintaining inequalities, particularly in low to middle income countries.”

The Mexico Declaration for Circulatory Health
http://tinyurl.com/hmsefpa


Diabetes Knowledge Portal adds more data, search tools

The AMP Type 2 Diabetes Knowledge Portal online library and discovery engine has greatly expanded data and search capabilities to accelerate the pace of scientific advancement. Customizable and simplified navigation, along with aggregated data from more than 100,000 DNA samples from research supported by NIH and other institutions, encourage new understanding of diabetes by increasing users’ ability to share and evaluate content.

AMP Type 2 Diabetes Knowledge Portal
www.type2diabetesgenetics.org


US NIH creates free Atlas of Human Malformation Syndromes

Researchers with the National Human Genome Research Institute (NHGRI), part of the US-based National Institutes of Health, have collaborated with physicians and medical geneticists around the world to create the Atlas of Human Malformation Syndromes in Diverse Populations.

Health care providers can use the new atlas to diagnose diverse patients with inherited diseases by comparing physical traits (phenotypes) and written descriptions of their symptoms with photos and descriptions of people with the same condition and ancestry.

Atlas of Human Malformation Syndromes in Diverse Populations www.genome.gov/atlas


WHO issues guidelines on anagement of health complications of FGM

New WHO recommendations aim to help health workers provide better care to the more than 200 million girls and women worldwide living with female genital mutilation.

Female genital mutilation (FGM) describes all procedures that involve the partial or total removal of external genitalia or other injury to the female genital organs for non-medical reasons. FGM has no health benefits, can cause severe harm, and violates the rights of girls and women. Procedures can cause severe bleeding, problems urinating, and later cysts, infections, and death. FGM can also result in complications in childbirth and increased risk of newborn deaths.

International migration has now made the practice, prevalent in 30 countries in Africa and in a few countries in Asia and the Middle East, a global health issue.

Health workers across the world must be prepared to provide care to girls and women who have undergone FGM. But, health workers are often unaware of the many negative health consequences of FGM and many remain inadequately trained to recognize and treat them properly. As a result, many women may suffer needlessly from physical and mental health consequences due to FGM.

“Health workers have a crucial role in helping address this global health issue. They must know how to recognize and tackle health complications of FGM,” says Dr Flavia Bustreo, WHO Assistant Director General. “Access to the right information and good training can help prevent new cases and ensure that the millions of women who have undergone FGM get the help they need.”

The WHO guidelines focus on preventing and treating obstetric complications; treatment for depression and anxiety disorders; attention to female sexual health such as counselling, and the provision of information and education.

The guidelines also warn against the so called “medicalization” of FGM, for example when parents ask health providers to conduct FGM on their daughters because they think it will be less harmful.

Recommendations include:

  • de-infibulation to prevent and treat obstetric complications, as well as to facilitate childbirth, and prevent and treat problems with the urinary tract system;
  • mental health including cognitive behavioural therapy and psychological support to treat depression and anxiety disorders;
  • female sexual health covering sexual counselling to prevent or treat female sexual dysfunction;
  • information and education for all women and girls who have undergone female genital mutilation, and health education and information on de-infibulation, where appropriate, for both healthcare providers and for women and girls.

WHO guidelines on the management of health complications from FGM http://tinyurl.com/jpjkmtt

 

 

Date of upload: 16th July 2016

                                  
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