EYE on Yellow Fever

Brazil has long been on the frontlines in the fight against Yellow Fever. In this episode, we hear the story of the country's response to a recent three-year outbreak which tested its resources and cost hundreds of lives. Dr Rivaldo Venâncio da Cunha, Deputy Secretary for Health and Environmental Surveillance at the Ministry of Health in Brazil and the eminent Dr Pedro Vasconcelos, Professor of Pathology and specialist in arbovirology and tropical medicine at Pará State University, share their experience and insights on developing surveillance systems to detect the Yellow Fever virus in communities and launching mass vaccination campaigns, successfully controlling the epidemic in the country.

O Brasil há muito está na linha de frente no combate à febre amarela. Neste episódio, ouvimos a história da reação do país a um recente surto de três anos que testou seus recursos e custou centenas de vidas. O Dr. Rivaldo Venâncio da Cunha, Secretário-Adjunto de Vigilância em Saúde e Meio Ambiente do Ministério da Saúde do Brasil, e o eminente Dr. Pedro Vasconcelos, Professor de Patologia e especialista em arbovirologia e medicina tropical na Universidade do Estado do Pará, compartilham suas experiências e percepções sobre o desenvolvimento de sistemas de vigilância para detectar o vírus da febre amarela nas comunidades e a instauração de campanhas de vacinação em massa, controlando com sucesso a epidemia no país.

In this episode, we delve into the remarkable progress of the Eliminate Yellow Fever Epidemics (EYE) Strategy, which has vaccinated over 350 million people since 2017. This success story is a testament to the power of global partnerships. As the EYE Strategy approaches the end of its 10-year operational period, we explore what has been achieved and what still needs to be done to ensure the continued success of this global immunisation Effort. We hear from Dr Laurence Cibrelus, Global Lead for the EYE Strategy and from Dr Ephrem Lemango, Associate Director and Chief of Immunisation at UNICEF.

Dans cet épisode, nous nous penchons sur les progrès remarquables de la stratégie Éliminer les épidémies de fièvre jaune (EYE), qui a permis de vacciner plus de 350 millions de personnes depuis 2017. Cette réussite témoigne de la puissance des partenariats mondiaux. Alors que la stratégie EYE approche de la fin de sa période opérationnelle de 10 ans, nous explorons ce qui a été réalisé et ce qui reste à faire pour assurer le succès continu de cet effort mondial de vaccination. Cet episode entend  la Dre Laurence Cibrelus, responsable mondial de la stratégie EYE, et le Dr Ephrem Lemango, directeur associé et chef de la vaccination à l'UNICEF.

Since 2020, Africa has witnessed a resurgence of yellow fever. In this episode, we explore the reasons behind this surge and the measures being taken to combat it. We hear a comprehensive overview of the yellow fever situation across the continent, from Dr Charles Shey Wiysonge, Team Leader for Vaccine-Preventable Diseases at the WHO's Regional Office for Africa, examining factors such as vaccine hesitancy, post-Covid immunisation gaps, and population movement. We also hear from Dr. Antoinette Mbailamen Demian, Director of Immunisation at the Ministry of Health in Chad, about how her country is managing the influx of refugees from Sudan and tackling recent outbreaks.

Depuis 2020, l'Afrique connaît une résurgence de la fièvre jaune. Dans cet épisode, nous explorons les raisons de cette recrudescence et les mesures prises pour la combattre. Le Dr Charles Shey Wiysonge, chef d'équipe pour les maladies évitables par la vaccination au Bureau régional de l'OMS pour l'Afrique, nous donne un aperçu complet de la situation de la fièvre jaune dans la région, en examinant des facteurs tels que l'hésitation à se faire vacciner, les lacunes de la vaccination post-Covid et les mouvements de population. La Dre Antoinette Mbailamen Demian, directrice de la vaccination au ministère de la santé du Tchad, nous explique comment son pays gère l'afflux de réfugiés en provenance du Soudan et s'attaque aux récentes épidémies.  

En Afrique, le Ghana fait figure de modèle de réussite en matière de lutte contre la fièvre jaune. Dans cet épisode bonus, nous allons nous entretenir avec deux scientifiques à la tête du programme de vaccination du pays. Le Dr Kwame Amponsa-Achiano, du service de santé du Ghana, et le Dr Fred Osei Sarpong, de l'OMS, nous font part de leur expérience et de leur point de vue quant à la manière dont l'implication des communautés, même les plus inaccessibles, s'est avérée déterminante pour enrayer et endiguer les épidémies de cette maladie mortelle qui sévit dans le pays

À bien des égards, le réchauffement de notre planète est aujourd'hui le principal enjeu de notre époque. Or, nous ne considérons sans doute pas suffisamment le changement climatique en tant que menace pour la santé publique. Par exemple, que se passera-t-il lorsque de nouvelles régions du monde seront suffisamment chaudes et humides pour accueillir des moustiques vecteurs de pathogènes? Cet épisode entend le professeur Rachel Lowe de la London School of Hygiene and Tropical Medicine, le professeur Jonathan Patz, directeur du Global Health Institute de l'Université Madison du Wisconsin, et le Dr Florence Fouque, spécialiste de la lutte anti-vectorielle à l'OMS.

De quelle manière les pays à risque se préparent-ils à réagir rapidement en cas d'épidémie de fièvre jaune en milieu urbain ? La Dre Linda Esso, haute fonctionnaire de la santé publique au Cameroun, évoque les défis auxquels son pays est confronté pour gérer de manière proactive la menace que représente la fièvre jaune. Nous allons également recueillir le témoignage du Dr Peter Mbondji, qui a élaboré des directives afin d'aider les pays à se préparer et à intervenir en cas d'épidémie en milieu urbain. 

Ghana is one of Africa's success stories in the fight against yellow fever. We talk to two scientists leading the country's immunization programme for this bonus episode. Dr Kwame Amponsa-Achiano from the Ghana Health Service and WHO's Dr Fred Osei-Sarpong share their experience and insights on how engaging even the hard-to-reach communities has been crucial in curbing and containing outbreaks of the fatal disease in the country. 

Yellow fever presents a clear and present danger to populations across Africa, with WHO teams and partners working hard to curb outbreaks across multiple African countries. The base of operation for the response coordination is Burkina Faso's capital Ouagadougou. For this episode, incident manager Dr Ado Bwaka and vaccination lead Dr Hadiatou Diallo join us from Burkina Faso to share their learnings.

What part do non-human primates, like monkeys and apes, play in the transmission of yellow fever? This episode focuses on monitoring and response work in the rainforests of Argentina, where yellow fever is present among howler monkeys - and can be passed on to humans. Dr María Morales and Dr Silvina Goenaga are from Argentina's Institute for Human Viral Diseases (INEVH). Sound effects in this episode are obtained from zapsplat.com

Who determines whether suspected yellow fever cases can officially be declared an outbreak? We visit a research centre in Senegal that is at the heart of yellow fever diagnostics. The Institut Pasteur de Dakar is one of three regional reference laboratories for yellow fever  in Africa that tests samples sent from across the continent. Dr Gamou Fall, head of IP Dakar's yellow fever Regional Reference Laboratory, takes us through that painstaking process

The Amazon rainforest is under increasing pressure from climate change, deforestation, extractive industries like mining, and a range of human-induced factors. This episode explores the public health impacts of human-induced pressures on the Amazon, including an increased risk of yellow fever outbreaks. With Dr Anice Sallum, medical epidemiology and entomology professor at Sao Paolo University's School of Public Health, and Dr Amy Vittor, Assistant Professor in Infectious Diseases and Global Medicine at the University of Florida.

We focus on a disease-monitoring system that is literally out of this world. Dr Charalampos Kontoes - Research Director of Greece's National Observatory of Athens - coordinates an early warning system that tracks mosquitoes' movement using satellites. He tells us about the technology and how it's recently been given European money to expand and scale up the operation.

How do at-risk countries prepare to respond quickly in the event of a yellow fever outbreak in an urban area? Dr Linda Esso, a senior public health official from Cameroon, talks about the challenges her country faces in dealing proactively with the threat of yellow fever. We also hear from EYE's Dr Peter Mbondji who has developed guidelines to support countries with their readiness and response plans for urban outbreaks. 

In this final episode of EYE on yellow fever, three key members of the EYE Partnership reflect on key themes from across the series. Also, in the face of COVID-19, global warming, the refugee crisis and increasing urbanisation, will EYE live up to the targets and goals it has set itself by its deadline of 2026? With Dr Christopher Gregory from UNICEF, Cassandra Quintanilla from Gavi, the Vaccine Alliance, and EYE Secretariat lead Dr Laurence Cibrelus. 

Nigeria is a yellow fever hotspot and a big focus for EYE activity. 97 million people have been vaccinated in the country since the EYE Strategy started. Prof Oyewale Tomori, president of the Nigerian Academy of Science and a former WHO Africa virologist, says that preventive yellow fever campaigns can protect economies as well as lives. He also discusses lessons learned from yellow fever campaigns that have helped in the fight against COVID-19. 

Yellow fever and other disease outbreaks often beset vulnerable, conflict-affected places. This increases risk, and makes prevention and response more complex. The challenging reality of tackling infectious disease in humanitarian settings, with Dr Jorge Castilla, the World Health Organization's Senior Coordinator for Health Emergency Response, and Dr Daniela Garone, International Medical Coordinator for Medicins Sans Frontiers.  

From the initial development of the yellow fever vaccine to fractionated dosing in response to the 2016 Angola/DRC outbreak, a key part of the yellow fever story has long been the dedication, commitment and intellect that has gone into advancing the science that combats the disease. But with climate change posing new risks in new parts of the world, what innovation is happening now to help control and minimise vector-borne diseases like yellow fever? We hear from Dr Raman Velayudhan, unit head for vector control, veterinary public health and environment at WHO. 

By 2026, the EYE Strategy aims to have ended yellow fever epidemics, and to have protected up to a billion people in Africa and the Americas with preventative yellow fever vaccinations. This is allied with a broader vaccination framework: Immunization Agenda 2030. In this episode, WHO Director of the Department of Immunisations, Vaccines and Biologicals, Dr Kate O'Brien sets out the priorities of two strategies, and how they jointly make a global impact. The EYE Strategy: https://www.who.int/initiatives/eye-strategy Immunisation Agenda 2030: https://www.who.int/teams/immunization-vaccines-and-biologicals/strategies/ia2030 Documentary film (in French with subtitles) on EYE's recent preventative vaccination campaign in DRC: https://www.youtube.com/watch?v=XvEAUjXPyhA&t=1s

We know from COVID-19 that proximity between people is a major risk factor in the spread of outbreak disease - and yellow fever is no exception. As increasing numbers of people in Africa and South America move to cities, the risk of mass-outbreaks of yellow fever increases. Slums, favelas and other informal dwellings are particular risk hotspots. This episode hears from Dr Erin Staples from the United States Centers for Disease Control and Prevention, and Dr Matthew Steele of the Bill and Melinda Gates Foundation.

The warming of our planet is, for many reasons, among the most significant issues of our age. But we perhaps don't give enough thought to climate change as specifically a health crisis. For example, what will happen when new areas of the world are hot and humid enough to support pathogen-carrying mosquitoes? This episode hears from Professor Rachel Lowe of the London School of Hygiene and Tropical Medicine, Professor Jonathan Patz, director of the Global Health Institute at Madison's University of Wisconsin, and WHO vector control specialist Dr Florence Fouque.

Since COVID-19 emerged in December 2019, it has drained resources in yellow fever hotspots, and delayed lifesaving vaccination campaigns, increasing the risk of outbreaks. Despite this, 48 million people were still vaccinated against yellow fever in 2020. How does this happen in the midst of a pandemic? And what can that pandemic teach us about combatting yellow fever in the future? We get the perspectives of Dr Mike Ryan, who heads up WHO's response, and Dr Chikwe Ihekweazu, Head of the Nigeria CDC.  

In the days before scientists understood how yellow fever was transmitted - and well before there was a vaccine - people referred to the disease by how it manifested itself. They called it “Vómito Negro” - black vomit. In this episode, Dr Sylvain Aldighieri from the Pan American Health Organization helps us chart the deadly history of yellow fever from 3000 years ago through the present day. We also speak to Dr Ibrahima Soce Fall, WHO's Assistant Director-General for emergency response about the setting up of the EYE strategy and the plan to eliminate yellow fever epidemics by 2026. 

In 2016, Angola and the Democratic Republic of the Congo stood on the brink of a major public health disaster. In this episode, we hear about how a yellow fever outbreak on the west coast of southern Africa spread to China and posed a threat to the entire world. We also hear of how the brave experiment to split the limited supply of vaccines into smaller doses helped curtail mass loss of life.

Yellow fever is one of the world's most deadly diseases. If you think it's a disease that can only be found in tropical climates, think again. Even with a highly effective, single shot vaccine, the risk of outbreaks of yellow fever is significant and growing globally. EYE on Yellow Fever is a ten-part series that takes you inside a concerted global effort to ensure that yellow fever does not become the next big global health threat.