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Yellow Fever—The Next Global Health Crisis?

MAY 17, 2016 | SARAH ANWAR

Taking Action Against Yellow Fever

The study authors believe that WHO can implement the Emergency Use Assessment and Listing (EUAL) procedures, previously used to combat Ebola, to “safeguard the yellow fever vaccine supply.” Furthermore, international experts recommend using only one-fifth of the usual vaccine dose on Angolan residents in order to “avert acute shortages” of the vaccine supply in case the virus spreads internationally. Nonetheless, this would not only go against vaccine regulations, it might also alter the vaccine’s duration of effectiveness, particularly in children. However, the authors believe that action should be taken now, rather than after yellow fever becomes a global threat and a vaccine shortage becomes a reality. “Given the world’s viral health security interests, the WHO’s director-general should use EUAL procedures to authorize a reduced vaccine dose to control the epidemic in Angola,” they stated.
The authors acknowledge that an emergency committee is needed before WHO can declare yellow fever to be a public health emergency of international concern. As such, and due to the impending vaccine shortage the authors believe could become a reality, they strongly recommend that WHO convene an emergency committee as soon as possible. They further recommend that, if the emergency committee does not deem the threat of yellow fever to be a global crisis, EUAL be implemented to reduce the yellow fever vaccine dose in order to prevent a shortage in supply. Furthermore, the authors recommend that WHO should meet with vaccine manufacturers “to catalyze a surge in production; incentivize and coordinate innovation in research and development for non–egg-based yellow fever vaccines; [and] coordinate mosquito vector control for yellow fever, benefitting also prevention measures for the ongoing Zika virus epidemic.”
In contrast to WHO’s response time to the threat of Ebola and Zika, the organization has already started taking action against the threat of yellow fever. Nonetheless, the authors believe there should not be a need to form an emergency committee each time there is a health threat of these proportions. They recommend that WHO institute a “standing emergency committee” so as to counsel the director-general on which steps are to be taken: declare an international health threat, take action to prevent a global health crisis, or both.
The study authors further noted that the UN believed that the Ebola crisis was a “preventable tragedy.” In the High-level Panel on the Global Response to Health Crises, it was noted that “if the WHO does not successfully reform, the next major pandemic will cause thousands of otherwise preventable deaths. This may be the last opportunity to ensure that the WHO is empowered to build an effective emergency preparedness and response capacity with the necessary political leadership. Another failure to perform may necessitate consideration of alternate UN institutional response mechanisms.”
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