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Accelerating Pneumococcal Conjugate Vaccine introductions in Indonesia:key learnings from 2017 to 2022

Infectious Diseases of Poverty 2023年第6期12卷 91-95页

作者： Anithasree Athiyaman Putri Herliana Atiek Anartati Niken Widyastuti Prima Yosephine Gertrudis Tandy Sherli Karolina Global vaccines Delivery Clinton Health Access InitiativeBostonUSA Country Ofce Clinton Health Access InitiativeJakartaIndonesia Directorate of Immunization Ministry of HealthRepublic of IndonesiaJakartaIndonesia

Despite high pneumococcal disease and economic burden in Indonesia and interest to introduce pneumococcal conjugate vaccine (PCV), there were challenges in establishing a comprehensive strategy to accelerate and enable the introduction in country in the early 2010s. Starting in 2017, Clinton Health Access initiative and partners supported the government of Indonesia with evidence-based decision-making and implementation support for introducing PCV into the routine immunization program. Indonesia has since accelerated PCV roll out, with nationwide reach achieved in 2022. On the path to PCV introduction, several challenges were observed that impacted decision making on whether and on how to optimally roll out PCV, resulting in significant introduction delays;including (1) a complex country context with a devolved government structure, fragmented domestic funding streams, and an imminent transition out of major immunization donor (Gavi) support;(2) strong preference to use domestically sourced products, with limited experience accessing global pooled procurement mechanism including for vaccines;and (3) concerns around programmatic feasibility and sustainability. This case study documents key insights into the challenges experienced and how those were systematically addressed to accelerate new vaccine introduction in Indonesia, with support from local and global stakeholders over time. The learnings would be beneficial for other countries yet to introduce critical new vaccines, in particular those with similar archetype as Indonesia e.g., middle-income countries with domestic manufacturing capacity and/or countries recently transitioning out of Gavi support.

关键词： New vaccine introduction Immunization Indonesia Pneumococcal conjugate vaccines Sustainability Coverage Gavi

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Hepatitis B virus infection and hepatocellular carcinoma in sub- Saharan africa: Implications for elimination of viral hepatitis by 2030?

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World Journal of Gastroenterology 2021年第36期27卷 6025-6038页

作者： Edina Amponsah-Dacosta vaccines for africa initiative School of Public Health and Family MedicineUniversity of Cape TownCape Town 7925Western CapeSouth Africa

Elimination of viral hepatitis in sub-Saharan africa by 2030 is an ambitious feat.However,as stated by the World Health Organization,there are unprecedented opportunities to act and make significant contributions to the elimination target.With 60 million people chronically infected with hepatitis B virus(HBV)of whom 38800 are at risk of developing highly fatal hepatocellular carcinoma(HCC)every year,sub-Saharan africa faces one of the greatest battles towards elimination of viral hepatitis.There is a need to examine progress in controlling the disproportionate burden of HBV-associated HCC in sub-Saharan africa within the context of this elimination target.By scaling-up coverage of hepatitis B birth dose and early childhood vaccination,we can significantly reduce new cases of HCC by as much as 50%within the next three to five decades.Given the substantial reservoir of chronic HBV carriers however,projections show that HCC incidence and mortality rates in sub-Saharan africa will double by 2040.This warrants urgent public health attention.The trends in the burden of HCC over the next two decades,will be determined to a large extent by progress in achieving early diagnosis and appropriate linkage to care for high-risk chronic HBV infected persons.

关键词： Hepatitis B virus Viral hepatitis,Hepatocellular Carcinoma Elimination Human Immunodeficiency Virus Sub-Saharan africa

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Chronic hepatitis B-associated liver disease in the context of human immunodeficiency virus co-infection and underlying metabolic syndrome

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World Journal of Virology 2020年第5期9卷 54-66页

作者： Edina Amponsah-Dacosta Cynthia Tamandjou Tchuem Motswedi Anderson vaccines for africa initiative School of Public Health and Family MedicineUniversity of Cape TownCape Town 7925Western CapeSouth Africa Health Economics Unit School of Public Health and Family MedicineUniversity of Cape TownCape Town 7925Western CapeSouth Africa Botswana Harvard AIDS Institute Partnership GaboroneBotswana

Globally,a shift in the epidemiology of chronic liver disease has been observed.This has been mainly driven by a marked decline in the prevalence of chronic hepatitis B virus infection(CHB),with the greatest burden restricted to the Western Pacific and sub-Saharan african regions.Amidst this is a growing burden of metabolic syndrome(MetS)worldwide.A disproportionate co-burden of human immunodeficiency virus(HIV)infection is also reported in sub-Saharan africa,which poses a further risk of liver-related morbidity and mortality in the region.We reviewed the existing evidence base to improve current understanding of the effect of underlying MetS on the development and progression of chronic liver disease during CHB and HIV co-infection.While the mechanistic association between CHB and MetS remains poorly resolved,the evidence suggests that MetS may have an additive effect on the liver damage caused by CHB.Among HIV infected individuals,MetS-associated liver disease is emerging as an important cause of non-AIDS related morbidity and mortality despite antiretroviral therapy(ART).It is plausible that underlying MetS may lead to adverse outcomes among those with concomitant CHB and HIV co-infection.However,this remains to be explored through rigorous longitudinal studies,especially in sub-Saharan africa.Ultimately,there is a need for a comprehensive package of care that integrates ART programs with routine screening for MetS and promotion of lifestyle modification to ensure an improved quality of life among CHB and HIV coinfected individuals.

关键词： Hepatitis B virus Human immunodeficiency virus Metabolic syndrome Fatty liver disease Chronic liver disease Sub-Sharan africa

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What impact would an HIV/AIDS vaccine have on the HIV/AIDS epidemic in Kenya?

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Open Journal of Immunology 2012年第4期2卷 195-201页

作者： Omu Anzala Gaudensia Nzembi Mutua Fredrick Jack Odia Oyugi Bashir Farah Mohamed Thomas Achia John Stover Futures Institute Glastonbury USA Kenya AIDS Vaccine initiative Department of Medical Microbiology University of Nairobi Nairobi Kenya School of Mathematics University of Nairobi Nairobi Kenya

Objective: To estimate the potential impact of an HIV/AIDS Vaccine in Kenya. Design: The Kenyan HIV/AIDS epidemic was modeled using the most current data from national sources including epidemiology and behavioral surveillance. The model’s baseline projection was validated against adult HIV prevalence at antenatal clinics and general population surveys. The model was used to analyze the effects of scaling up current prevention programs and adding potential HIV vaccines with varying levels of effectiveness and coverage. Results: Even with full scale-up of currently available prevention, care and treatment programs, new infections will continue to burden Kenya. The introduction of a partially effective AIDS vaccine could significantly alter the trajectory of the epidemic. Conclusion: The game changing impact that an AIDS vaccine could have on the AIDS epidemic in Kenya under-scores the importance of sustaining political support and financial investment to accelerate HIV/AIDS vaccine research and development.

关键词： HIV Vaccine Modelling

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Setting Research Priorities for Cervical Cancer Prevalence, Prevention and Treatment in WHO africa Region

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Advances in Reproductive Sciences 2021年第1期9卷 41-49页

作者： Leopold Ouedraogo Triphonie Nkurunziza Assumpta Muriithi Chilanga Asmani Hayfa Elamin Souleymane Zan Bigirimana Françoise Mihretu Belete Gbenou Dina Dadji Kwami Kim Caron Rahn Ali Moazzam Tolu Lemi Blami Dao Issiaka Sombie Okech Mollent Reproductive Maternal Health and Ageing WHO Regional Office for Africa Brazzaville Congo Department of Reproductive Health and Research World Health Organization Geneva Switzerland JHPIEGO Ouagadougou Burkina Faso West africa Health Organization Ouagadougou Burkina Faso Peak Moments Global HR Solutions Nairobi Kenya

Background: Cervical cancer has been ranked among the leading causes of deaths among women in africa. Despite this, priority setting mechanisms used in planning for programmes and interventions that respond to sexual and reproductive health and rights services particularly in cervical cancer prevalence, prevention and treatment have not adequately taken into account research based evidence to respond appropriately. Methods: We adapted the Child Health and Nutrition Research initiative method. A wide range of stakeholders identified potential research areas in an online survey. A technical working group comprising of 67 participants reviewed the questions for modification and removal of out scope questions. Finally, scoring and ranking was done to provide the top ten priorities questions. Results: “Cost-benefit analysis of systematic human papillomavirus vaccination compared to the current cost of cervical cancer in public health care systems” scored 27. This was followed by two research questions ranked at 24 points: “assessment of women’s and girls’ knowledge on the importance of early cervical cancer screening,” and “human papilloma virus vaccination and contributions of new technologies to the supply and storage of vaccines, including human papillomavirus vaccine”. Conclusion: The study identified 10 priority research questions that can guide the agenda for cervical cancer prevalence, prevention and treatment in the WHO africa region. The identified priorities will be of use to policy makers, researchers and programmers and other stakeholders who can invest in areas that greatly affect cervical cancer prevalence, prevention and treatment.

关键词： Cervical Cancer Screening Secondary Prevention HPV Vaccination Sexual and Reproductive Health

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结核病新疫苗展望

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结核与肺部疾病杂志 2004年第1期7卷 10-13页

作者： U.Fruth D.Young 张宗德 initiative for Vaccine Research World Health Organization Geneva Switzerland Imperial College London London United Kingdom

研制开发更好的结核病疫苗的研究现在正处于重要的转折点。在过去的十余年中,由实验室模型得到的备选疫苗如改良卡介苗、减毒结核杆菌疫苗、蛋白质或DNA亚单位疫苗现在正在准备进行临床试验。它们从实验室走向临床试验具有广泛的战略和... 详细信息

研制开发更好的结核病疫苗的研究现在正处于重要的转折点。在过去的十余年中,由实验室模型得到的备选疫苗如改良卡介苗、减毒结核杆菌疫苗、蛋白质或DNA亚单位疫苗现在正在准备进行临床试验。它们从实验室走向临床试验具有广泛的战略和技术意义。需要确认生产临床疫苗所需的设施和资金,一个难题是有些备选疫苗含有活菌;需要克服常规困难;制订试验规程,选择试验地点,Ⅲ期临床实验尤其如此。遏制结核病工作组结核疫苗发展中心组织了一个全球论坛,组织实验室和临床研究人员及结核病控制专家、商业代表、非赢利性基金机构一起讨论这些问题,加快实现共同目标-改进结核病疫苗策略。

关键词：结核病疫苗前期开发临床试验挑战实验设计

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