Browsing by Author "Rees, Helen"

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    Advocating for efforts to protect African children, families, and communities from the threat of infectious diseases : report of the First International African Vaccinology Conference
    (African Field Epidemiology Network, 2016) Wiysonge, Charles Shey; Waggie, Zainab; Hawkridge, Anthony; Schoub, Barry; Madhi, Shabir Ahmed; Rees, Helen; Hussey, Gregory
    One means of improving healthcare workers' knowledg e of and attitudes to vaccines is through running v accine conferences which are accessible, affordable, and relevant to their everyday work. Va rious vaccinology conferences are held each year wo rldwide. These meetings focus heavily on basic science with much discussion about new develo pments in vaccines, and relatively little coverage of policy, advocacy, and communication issues. A negligible proportion of delegates at the se conferences come from Africa, home to almost 40% of the global burden of vaccine- preventable diseases. To the best of our knowledge, no major vaccinology conference has ever been held on the African continent apart from World Health Organization (WHO) meetings. The conte nt of the first International African Vaccinology C onference was planned to be different; to focus on the science, with a major part of discussi ons being on clinical, programmatic, policy, and ad vocacy issues. The conference was held in Cape Town, South Africa, from 8 to 11 November 2012 . The theme of the conference was “Advocating for e fforts to protect African children, families, and communities from the threat of infect ious diseases”. There were more than 550 registered participants from 55 countries (including 37 African countries). There were nine pre-conferen ce workshops, ten plenary sessions, and 150 oral an d poster presentations. The conference discussed the challenges to universal immunisation in Africa as well as the promotion of dialogue and communication on immunisation among all stakeholders. There was general acknowledgment that giant strides have been made in Africa since the g lobal launch of the Expanded Programme on Immunisation in 1974. For example, there has bee n significant progress in introducing new and under -utilised vaccines; including hepatitis B, Haemophilus influenza type b, pneumococcal conju gate, rotavirus, meningococcal A conjugate, and hum an papillomavirus vaccines. In May 2012, African countries endorsed the Global Vaccine Action Plan at the World Health Assembly. However, more than six million children remain incompletely vaccinated in Africa leading to more t han one million vaccine-preventable deaths annually . In addition, there are persistent problems with leadership and planning, vaccine stock managem ent, supply chain capacity and quality, provider-pa rent communication, and financial sustainability. The conference delegates agreed to move from talking to taking concrete actions around children's health, and to ensure that African governments commit to saving children's liv es. They would advocate for lower costs of immunisa tion programmes n Africa, perhaps through bulk buying and improved administration of vaccine rollout through the New Partnership for Afr ica's Development.
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    COVID-19 in Africa : care and protection for frontline healthcare workers
    (BioMed Central, 2020) Chersich, Matthew F.; Gray, Glenda; Fairlie, Lee; Eichbaum, Quentin; Mayhew, Susannah; Allwood, Brian W.; English, Rene; Scorgie, Fiona; Luchters, Stanley; Simpson, Greg; Mosalman Haghighi, Marjan; Duc Pham, Minh; Rees, Helen
    Medical staff caring for COVID-19 patients face mental stress, physical exhaustion, separation from families, stigma, and the pain of losing patients and colleagues. Many of them have acquired SARS-CoV-2 and some have died. In Africa, where the pandemic is escalating, there are major gaps in response capacity, especially in human resources and protective equipment. We examine these challenges and propose interventions to protect healthcare workers on the continent, drawing on articles identified on Medline (Pubmed) in a search on 24 March 2020. Global jostling means that supplies of personal protective equipment are limited in Africa. Even low-cost interventions such as facemasks for patients with a cough and water supplies for handwashing may be challenging, as is ‘physical distancing’ in overcrowded primary health care clinics. Without adequate protection, COVID-19 mortality may be high among healthcare workers and their family in Africa given limited critical care beds and difficulties in transporting ill healthcare workers from rural to urban care centres. Much can be done to protect healthcare workers, however. The continent has learnt invaluable lessons from Ebola and HIV control. HIV counselors and community healthcare workers are key resources, and could promote social distancing and related interventions, dispel myths, support healthcare workers, perform symptom screening and trace contacts. Staff motivation and retention may be enhanced through carefully managed risk ‘allowances’ or compensation. International support with personnel and protective equipment, especially from China, could turn the pandemic’s trajectory in Africa around. Telemedicine holds promise as it rationalises human resources and reduces patient contact and thus infection risks. Importantly, healthcare workers, using their authoritative voice, can promote effective COVID-19 policies and prioritization of their safety. Prioritizing healthcare workers for SARS-CoV-2 testing, hospital beds and targeted research, as well as ensuring that public figures and the population acknowledge the commitment of healthcare workers may help to maintain morale. Clearly there are multiple ways that international support and national commitment could help safeguard healthcare workers in Africa, essential for limiting the pandemic’s potentially devastating heath, socio-economic and security impacts on the continent.
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    Ethical considerations for vaccination programmes in acute humanitarian emergencies
    (World Health Organization, 2013-02-07) Moodley, Keymanthri; Hardie, Kate; Selgelid, Michael J.; Waldman, Ronald J.; Strebel, Peter; Rees, Helen; Durrheim, David N.
    Humanitarian emergencies result in a breakdown of critical health-care services and often make vulnerable communities dependent on external agencies for care. In resource-constrained settings, this may occur against a backdrop of extreme poverty, malnutrition, insecurity, low literacy and poor infrastructure. Under these circumstances, providing food, water and shelter and limiting communicable disease outbreaks become primary concerns. Where effective and safe vaccines are available to mitigate the risk of disease outbreaks, their potential deployment is a key consideration in meeting emergency health needs. Ethical considerations are crucial when deciding on vaccine deployment. Allocation of vaccines in short supply, target groups, delivery strategies, surveillance and research during acute humanitarian emergencies all involve ethical considerations that often arise from the tension between individual and common good. The authors lay out the ethical issues that policy-makers need to bear in mind when considering the deployment of mass vaccination during humanitarian emergencies, including beneficence (duty of care and the rule of rescue), non-maleficence, autonomy and consent, and distributive and procedural justice.