Confronting infectious diseases and the role of vaccination: A global perspective KATE ANTEYI. MD, MPH, MBA
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1 Confronting infectious diseases and the role of vaccination: A global perspective KATE ANTEYI. MD, MPH, MBA Technical Advisor, United States Agency for International Development (USAID) Chair, WONCA Working Party on Women & Family Medicine(WWPWFM):
2 Confronting Infectious Diseases
3 The Framework Setting the stage: Global data Factors in emergence of infectious diseases Fight scene: strategic issues Cool action sequence: Role of vaccines Conclusion: What must family doctors do to tackle EID.
4 Setting the stage
5 Emerging Infectious Diseases (EIDS) Pathogenic microorganisms: bacteria, viruses, parasites or fungi. These bugs do kill! Don t mess with them! Pandemic potential: a threat to global health security. Most new outbreaks come from animals: Zoonoses
6 Emerging Infectious Diseases (EID) Last 40 years: Ebola and Marburg hemorrhagic fevers: Severe acute respiratory syndrome (SARS): 2009 Influenza A (H5N1) Verocytotoxin-producing Escherichia coli O157 Middle East respiratory syndrome coronavirus (MERS-CoV): Zika virus: 2017
7 Smith, K. F. et al. J. R. Soc. Interface 2014;11 Global trends More outbreaks More nonvectorborne Increasing Zoonoses
8 Global Prevalence of HIV: 2017
9 Global TB Incidence rates: 2016
10 8 out of 13 Countries with Triple TB Threat in sub-sahara Africa (SSA)
11 TB is the Top Infectious Disease Killer in the World! IN 2017 WHO: Global tuberculosis report 2018
12 The changing epidemiology of malaria WHO, 2017
13 SARS Epidemic Pathways Near pandemic in 2003 Rapid spread from China to 37 countries Within weeks High Fatality rate: 9.6% WHO 2004
14 Pandemic Influenza H1N1 As a respiratory virus, spreads rapidly Rapidly mutates every year Notorious & kills people
15 Ebola virus epidemic in West Africa
16 Zika virus disease outbreaks
17 Trends in Infectious Disease Mortality, South Korea, Choe Y et al. Trends in Infectious Disease Mortality, South Korea,
18 Groups of drivers of IDTE Determinants and Drivers of Infectious Disease Public health systems Globalization Environment Threat Events(IDTE) European CDC, 2017 Sociodemo graphic Climate Global trade Travel and tourism Top 5 individual drivers of IDTE Food and water quality Natural environment
19 Fitch, P.J Ecosystem & Infectious Diseases Highly interconnected network of hosts and environments. New approaches needed
20 Watch out! The next deadly infectious disease is somewhere out there! Lassa Nipah 2015 WHO top 8 list of diseases likely to cause severe epidemics 1. Ebola 2. Marburg 3. Crimean-Congo hemorrhagic fever 4. Lassa fever 5. MERS 6. SARS 7. Nipah 8. Rift Valley fever
21 Strategic Confrontation of EID
22 Engineering a Global Response to Infectious Diseases Traditional medical systems not enough! Go beyond to public health approaches Integrate frameworks
23 Mitigating EID: Scaling Coordination & Collaboration One-health approach Technologies Trust and global collaborations Political & financial commitment
24 Risk communication Research Partnership Anticipating Epidemics Alert Health Systems Strengthening
25 Networks for Global Infectious Diseases Surveillance WHO-2003
26 Role of Vaccines in infectious diseases prevention
27 Our World in Data Vaccination Innovations
28 National programs and systems
29 Progress and Challenges with achieving Universal Immunization Coverage
30 Coverage of BCG Vaccination 2016
31 Vaccination and Trust A 67-Country study in 2016 shows Positive vaccine safety confidence. Agreement that vaccines are important. Education increases confidence in vaccine Larson, Heidi J. et al 2016 What should we do? Population Resilience Coordination Strengthen systems Relationship
32 Health & Economic Impact of vaccines Vaccines will prevent 36 million deaths by 2030
33 The Future Vaccines: What is coming? Recombinant vaccines Viral vector-based vaccines DNA vaccines Reverse vaccinology Improved vaccine delivery methods Immunological markers and correlates of vaccine-induced protection Evaluation of immunogenicity and efficacy of candidate vaccine adjuvants
34 Some pipeline vaccines where are we going? TB: 15 vaccines candidates in clinical trials HIV: 2 large Phase IIb efficacy trials Malaria: Malaria Vaccine candidates in clinical trials Ebola: Clinical trials of experimental vaccines candidates Vaccines for Tuberculosis, HIV or Malaria Unlikely To Reach the Market soon Researchers estimate it would cost $16.3 billion to move current vaccine
35 The Role of Family Doctors in Confronting EID Leadership Surveillance
36 Conclusion WARFARE
37 Conclusion WARFARE
38
39
40 Acknowledgement Prof Lucy Candib: Massachusetts Medical school for very useful review and edits Mr. Ame Anteyi: Mount Sinai Hospital for formatting the slides
41
42 References 1. WHO, UNICEF, World Bank. State of the world s vaccines and immunization, 3rd ed. Geneva, World Health Organization, Dawood FS, Iuliano AD, Reed C, Meltzer MI, Shay, DK, Cheng PY et al. 2012: Estimated global mortality associated with the first 12 months of 2009 pandemic influenza A H1N1 virus circulation: a modelling study. The Lancet Infectious Diseases. 2012: 12(9): Wilder-Smith A, Vannice K, Durbin A, Hombach J, Thomas SJ, Thevarjan I, Simmons CP Zika vaccines and therapeutics: landscape analysis and challenges ahead. BMC Med:16(1): Christaki E. New technologies in predicting, preventing and controlling emerging infectious diseases. Virulence. 2015;6(6): doi: / Larson, Heidi J. et al The State of Vaccine Confidence 2016:Global Insights through a 67- Country Survey. EBioMedicine;12: The Economic Value of Vaccination: Why Prevention is Wealth. Journal of Market Access & Health Policy. 2015;3: /jmahp.v doi: /jmahp.v
43 References 7. World malaria report Geneva: World Health Organization; 2017 ( 2017/en/, accessed 12 April 2018) Global tuberculosis report Geneva: World Health Organization; 2017 ( report/en/, accessed 12 April 2018) 9. Choe Y, Choe S, Cho S. Trends in Infectious Disease Mortality, South Korea, Emerging Infectious Diseases. 2018;24(2): doi: /eid
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