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Kaiser Daily Global Health Policy Report

In The News

Donor Government Funding For HIV Declines By 7% In 2016, Lowest Level Since 2010

Ghana News Agency: Donor government funding to support HIV dips
“Donor government funding to support HIV efforts in low- and middle-income countries decreased by US$511 million from US$7.5 billion in 2015 to US$7 billion in 2016, a new report has revealed. It was produced by the Kaiser Family Foundation and the Joint United Nations Programme on HIV/AIDS (UNAIDS) … ‘Donor government funding for HIV continues to be on the decline,’ said Kaiser Family Foundation Vice President Jen Kates, director of global health and HIV policy. ‘Recent proposed cuts from the U.S., amidst other competing demands on donor budgets, will likely contribute to an ongoing climate of uncertainty around funding for HIV going forward’…” (Awumah, 7/24).

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'Unacceptably' High Number Of People Dying Of AIDS-Related Diseases In Africa Despite Improved Treatment Access, MSF Says

Thomson Reuters Foundation: Tide turns in AIDS fight yet ‘unacceptable’ death toll across sub-Saharan Africa
“The tide may have turned in the global fight against AIDS, but too many people in sub-Saharan Africa are developing and dying of AIDS-related diseases due to limited testing and problems with treatment, Médecins Sans Frontières (MSF) said on Tuesday. … Despite much improved access to antiretroviral (ARV) drugs in sub-Saharan Africa, an ‘unacceptably’ high number of people are developing AIDS and dying due to drug resistance, treatment being interrupted, and late diagnoses, the medical charity said…” (Guilbert, 7/25).

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Swaziland Achieves Major Reduction In HIV Incidence, 73% Treatment Success With PEPFAR, Global Fund Support

ScienceInsider: Swaziland makes major strides against its AIDS epidemic
“New data from Swaziland, a tiny country in southern Africa, provide some of the most convincing evidence yet that aggressively ramping up treatment for HIV/AIDS works on a population level to cut the rate of new infections. The kingdom has had one of the worst HIV/AIDS epidemics in the world, but since 2011, its massive scale-up of testing and treatment has slashed the rate of new infections by 44 percent. … Today, 171,266 HIV-infected people in Swaziland receive ARVs, thanks to support from the U.S. government President’s Emergency Plan for AIDS Relief program (PEPFAR), and the Global Fund to Fight AIDS, Tuberculosis and Malaria. A seven-month survey, funded by the Washington, D.C.-based PEPFAR and completed in March, found that 73.1 percent of the infected population now has fully suppressed virus…” (Cohen, 7/24).

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New Data On Treatment As Prevention, Medication Administration Presented At IAS 2017

BuzzFeed News: Undetectable Viral Load “Completely Effective” At Stopping HIV Transmission, Study Finds
“A groundbreaking new study found zero transmissions occurred between HIV-positive men with an ‘undetectable viral load’ due to treatment, and their HIV-negative partners, across thousands of instances of anal sex without a condom…” (Sainty, 7/25).

CNN: More evidence treatment zeroes HIV transmission during sex while the world awaits a vaccine
“…In the largest-ever trial on HIV transmission risk among homosexual men, Australian researchers explored the sex lives and HIV rates of more than 350 homosexual couples where one person is HIV-positive. The couples were from Brazil, Thailand, and Australia…” (Senthilingam, 7/25).

Washington Post: Monthly shot could be the ‘next revolution’ in HIV therapy, replacing daily pills
“…On Monday, scientists reported an important advance in the development of a long-acting antiretroviral shot. According to an international study involving 309 patients, an injection that combines two drugs, cabotegravir and rilpivirine, appears to be as safe and effective at suppressing HIV as the daily oral regimen…” (Cha, 7/24).

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Experimental HIV Vaccine Well-Tolerated, Prompts Immune Response In Early Clinical Trials, Researchers Report At IAS 2017

Quartz: There’s a promising new HIV vaccine that can protect against multiple strains at once
“…[R]esearchers from NIAID and Janssen Pharmaceutical Companies, which is owned by Johnson & Johnson, reported results from a successful preliminary clinical trial at the International AIDS Society Conference on HIV Science in Paris. The study, which was called APPROACH, uses a new kind of vaccine that targets several strains of HIV simultaneously, and appears to not cause any lasting side effects in people who receive it…” (Foley, 7/24).

Vox: There’s a promising new HIV vaccine candidate in the pipeline
“…The mosaic vaccine was developed using a computer algorithm to analyze HIV data from around the world and select a range of HIV sequences to include in a shot. It’s called a ‘mosaic’ because it involves taking pieces of different viruses and sticking them together to generate immune responses that can cover a broad range of HIV subtypes. … A word of caution, though: We’re only in the early phase of human testing, and the vaccine could ultimately fail to prevent the virus from spreading among people…” (Belluz, 7/24).

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African Leadership At WHO Can Help Nations Move Toward Universal Health Coverage, Organization's Regional Director Says

African Business Magazine: Africa’s health care challenge will not be met by public finances alone
“In May, the World Health Organization (WHO) elected Ethiopia’s Dr. Tedros Adhanom Ghebreyesus to be its new director general, the first African to be selected for the post. … His appointment is good news for Africa, says the WHO’s regional director, Dr Matshidiso Moeti. … His background in both health and foreign affairs, she argues, puts him in a strong position to drive Africa’s health care agenda…” (7/25).

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High-Level ICRC, U.N. Officials Visit Yemen To Assess Humanitarian Situation, Cholera Epidemic

Al Jazeera: U.N. delegation visits Yemen amid cholera outbreak
“A high-level United Nations delegation arrived in Yemen on Monday to visit areas held both by the government and the Houthi rebels across the crisis-hit country, according to a U.N. source. The executive directors of the World Health Organization (WHO), the U.N. Children’s Fund (UNICEF), and the World Food Programme visited the southern province of Aden, where the government is based, and the rebel-held capital Sanaa, the source said on condition of anonymity…” (7/24).

Associated Press: Red Cross Chief Visits Besieged City on Yemen’s Front Lines
“The chief of the international Red Cross made a rare visit to the front lines in Yemen Monday, taking a dirt road to reach the besieged western city of Taiz, devastated by more than two years of fighting. The visit by Peter Maurer, the head of the International Committee of the Red Cross, is meant to provide the ICRC with a firsthand look at Yemen’s raging cholera epidemic and humanitarian crisis amid the civil war. Maurer already visited the southern port city of Aden and will be ending his trip in Sanaa…” (Michael, 7/25).

Devex: Why was the cholera vaccine shipment to Yemen canceled?
“…The International Coordinating Group overseeing global vaccine stockpiles had approved a shipment of one million doses of cholera vaccine to Yemen in June. However, the plan was canceled earlier this month over concerns it would fail to help contain the outbreak — and that an unsuccessful effort could undermine future vaccination campaigns in the war-torn country. Those worries boil down to a combination of epidemiological reality, overwhelming logistical constraints, and a volatile political situation in which Yemen is effectively controlled by two rival government administrations…” (Dickinson, 7/25).

Reuters: Yemen cholera epidemic slowing after infecting 400,000
“Yemen’s cholera outbreak is set to hit 400,000 cases on Tuesday but there are signs the three-month-old epidemic is slowing, according to World Health Organization data analyzed by Reuters. A dramatic fall over the past month in the number of people dying from the disease each day — from about 30 to single figures — suggests the WHO’s strategy of setting up a network of rehydration points to catch patients early is working…” (Miles, 7/25).

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Sri Lanka Hit With Worst-Ever Dengue Outbreak; Nearly 300 Dead, More Than 100K Cases

Al Jazeera: Worst-ever dengue outbreak kills up to 300 in Sri Lanka
“The worst-ever outbreak of dengue fever has killed nearly 300 people in Sri Lanka, with aid agencies warning against further spread of the mosquito-borne viral disease…” (7/24).

Reuters: Dengue outbreak kills 300 in Sri Lanka, hospitals at limit
“…[Health officials] blamed recent monsoon rains and floods that have left pools of stagnant water and rotting rain-soaked trash — ideal breeding sites for mosquitoes that carry the virus…” (Sirilal/Aneez, 7/24).

Thomson Reuters Foundation: Deaths rising as Sri Lanka struggles with worst-ever outbreak of dengue
“…Sri Lanka’s Ministry of Health said the number of people infected by the mosquito-borne viral disease had reached over 103,000 so far this year — which is nearly double the total number of cases in 2016 — with about 296 deaths…” (Wilson, 7/24).

TIME: Sri Lanka’s Deadly Dengue Fever Outbreak Is ‘Three Times’ Worse Than Previous Years
“…The populous Western Province — including Colombo, the country’s capital city — is the worst hit, with more than 46,000 cases reported so far, making up around 44 percent of the country’s total…” (Lui, 7/25).

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Sexual Violence Rampant In War-Torn South Sudan, Amnesty International Report Shows

Associated Press: South Sudan Sexual Violence on ‘Massive Scale,’ Report Says
“…Four years into South Sudan’s devastating civil war, the world’s youngest nation is reeling from sexual violence on a ‘massive scale,’ a new Amnesty International report says. Thousands of women, children, and some men are suffering in silence, grappling with mental distress. Some now have HIV. Others were rendered impotent. The report is based on interviews with 168 victims of sexual violence in South Sudan and in refugee camps in neighboring Uganda, home to the world’s fastest-growing refugee crisis…” (Mednick, 7/24).

The Guardian: Foreign governments must ‘pressure South Sudan to end epidemic of rape’
“…Thousands of people across the country have been raped since conflict broke out in December 2013, according to the report. The scale and brutality of sexual violence in the country echoes the situation in its neighbor, the Democratic Republic of the Congo, where an epidemic of rape began in 1998. The South Sudanese government had failed to hold perpetrators to account, Amnesty said, and many survivors were reluctant to report what had happened to them, particularly if it had involved a government official…” (Maclean, 7/24).

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'Menstrual Leave' Policies Ignite Debate Over Women's Rights, Gender Equality

New York Times: In Some Countries, Women Get Days Off for Period Pain
“…[The digital media company Culture Machine] is one of a handful of private Indian companies to have started such [‘menstrual leave’] policies in recent months. Menstrual leaves are recognized in few other countries, among them Japan, Taiwan, Indonesia, South Korea, and Zambia. The move has set off fierce debate, not just in India but around the world. Experts say the spread of such policies — despite their best intentions — could actually deter women’s progress in the workplace…” (Pattani, 7/24).

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Editorials and Opinions

Trump Administration Can 'Reimagine And Restructure U.S. Foreign Assistance' While Maintaining U.S. Interests

Foreign Policy: Trump Should Fix Foreign Aid, But Not at the Expense of U.S. Interests
Daniel Runde, William A. Schreyer chair at CSIS

“…The Trump administration has a unique opportunity to reimagine and restructure U.S. foreign assistance to meet the demands of the 21st century. … To help generate concrete ideas, the Center for Strategic and International Studies brought together a bipartisan Task Force on Reforming and Reorganizing Foreign Assistance, co-chaired by Senators Jeanne Shaheen (D-N.H.) and Todd Young (R-Ind.). … In a report released Monday, the task force, which I convened, endorsed three broad recommendations that would ensure U.S. security, prosperity, and leadership by creating a more efficient and future-oriented foreign aid program: 1. Maintain USAID as an independent agency overseeing federal foreign assistance efforts, develop a clearly articulated development strategy, and strengthen the USAID administrator by naming him or her the ‘coordinator of foreign assistance.’ 2. Address duplication of effort and generate budget savings while maintaining functional coherence when appropriate. 3. Modernize the personnel system, make the procurement system more efficient, and streamline reporting…” (7/24).

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Sanofi Remains Committed To Ensuring Vaccines Available To All People

New York Times: Letter to the editor: The Drug Maker Sanofi’s New Dengue Vaccine
Kathleen Tregoning, executive vice president for external affairs at Sanofi

“…Sanofi spent close to $1.5 billion and 20 years developing a new dengue vaccine for the world’s most at-risk populations. We develop lifesaving vaccines for many other diseases that affect the developing world — cholera, yellow fever, polio, and sleeping sickness treatment — and provide them to international organizations at minimal costs. It was our experience with dengue, which is closely related to Zika, that led to our work with the United States Army on a potential vaccine. Should our clinical trials find that the Army’s Zika vaccine candidate is effective, the United States government will receive royalty payments to help offset its investments in our development work. And when it comes to pricing, Sanofi’s long history demonstrates our commitment to ensuring that our vaccines are available to those who need them, no matter where they live” (7/24).

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Community-Led Development Key To Building Resilience

Christian Science Monitor: The bounty that heads off famine
Editorial Board

“…The idea of community-led development has now blossomed worldwide. The change can be seen in the Sustainable Development Goals (SDGs) adopted by the United Nations in 2015. Not only has the U.N. set a goal to end persistent hunger by 2030, it also calls for participatory decisionmaking ‘at all levels.’ … The conceptual shift lies in seeing the poor less as victims or beneficiaries and more as leaders with all the qualities, such as integrity, to deal with a disaster. They may need immediate food aid or tips on how a community can define a new future. But the talents and resources to end their own hunger lie largely within. The poor’s dignity is not so much restored as it is expressed. If given the capacity to set their own goals, the hungry should be seen as partners in solving their problems, not clients or dependents. … In that idea lies resilience” (7/24).

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Global Community Should Adopt Policies That Could Moderate Population Growth

New York Times: Letter to the editor: Population Growth
Philip Warburg, nonresident senior fellow at Boston University’s Institute for Sustainable Energy

“…Population growth will have a big effect on our global environment, yet we seldom face that issue head-on. The United Nations has just updated its ‘World Population Prospects,’ and the numbers are stunning. Under a slow-growth scenario, we will have 9.6 billion people on this planet by 2100. On the high end, there will be 13.2 billion of us — a 76 percent increase above today’s 7.5 billion. It’s time to get serious about encouraging policies at home and abroad that stand a chance of steering us toward the lower end of those United Nations projections. Family planning, birth control, and voluntary abortion aren’t dirty words; they’re keys to our environmental survival” (7/24).

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Hepatitis C 'Buyers' Club' Highlights Issues Surrounding Access To Drugs

New York Times: The Tasmanian Hep C Buyers’ Club
Sophie Cousins, health journalist

“…[After traveling to India to obtain the less-expensive generic version of the hepatitis C drug sofosbuvir, Australian Greg Jefferys] helped other former hepatitis C sufferers set up informal buyers’ clubs in their own countries. … Narcyz Ghinea, a researcher in health ethics at the School of Public Health at the University of Sydney, says the online facilitation of access to unapproved drugs raises a lot of questions. … Ghinea believes the popularity of personal importation could become a powerful negotiating tool to reduce drug prices. But he worries that the purchase of cheaper generic drugs overseas could undercut the market and reduce pharmaceutical companies’ incentive to develop drugs … It could also compromise discount plans provided to low-income countries. Another risk is that the drugs could be fakes. … But those who run the informal buyers’ clubs insist they work only with licensed pharmaceutical suppliers. … Personal importation is not the way the world will get access to a hepatitis C cure. It’s a short-term stopgap for a few, one that highlights problems with drug costs, access, and the role regulatory bodies play…” (7/25).

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From the Global Health Policy Community

Secretary Tillerson's 'Listening Report' Shows State, USAID Should Remain Separate; MFAN Aid Redesign Plan Offers Recommendations, Expert Notes

Brookings Institution’s “Future Development”: Tillerson’s “Listening Report” reinforces that State and USAID should be separate
George Ingram, a senior fellow in the Global Economy and Development program at the Brookings Institution, co-chair of the Modernizing Foreign Assistance Network, and chair emeritus of the U.S. Global Leadership Coalition, says Secretary of State Rex Tillerson’s “Listening Report” “reinforces the aid redesign plan, ‘A New Foreign Aid Architecture Fit for Purpose,’ issued in July by the co-chairs of the Modernizing Foreign Assistance Network (MFAN).” Ingram discusses the findings of Tillerson’s report and the recommendations of MFAN, concluding, “Let us hope he and others take the guidance they have provided that development and diplomacy must be aligned but separate” (7/24).

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Global Fund Partnership In Rwanda Aims To Address Connection Between Gender-Based Violence, HIV/AIDS

Friends of the Global Fight Blog: Gender-based Violence and HIV/AIDS: A Rwandan Project Confronts the Connection
In this blog post, the first in a series of blog posts by Friends of the Global Fight addressing gender equality, Mark P. Lagon, chief policy officer at Friends of the Global Fight, discusses how challenges to gender equality, like gender-based violence (GBV), affect efforts to end the HIV/AIDS epidemic, and highlights the Global Fund’s experience in Rwanda addressing GBV (7/24).

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Human Rights Watch Publishes Q&A On Human Rights, Abortion

Human Rights Watch: Q&A: Human Rights Law and Access to Abortion
HRW discusses human rights law-related issues surrounding access to abortion, health consequences of unsafe abortions, and abortion policies (7/24).

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'Science Speaks' Reports On Findings Presented, Remarks Made At IAS 2017 Conference

Center for Global Health Policy’s “Science Speaks”: IAS 2017: With midpoint numbers showing 90-90-90 goals near for some, eluding others, innovation and equalizers take precedence
Antigone Barton, senior editor and writer of “Science Speaks,” discusses a presentation by UCSF’s Diane Havlir on the East Africa SEARCH trial and remarks made by Wafaa El-Sadr, director of ICAP at Columbia University, on the path forward (7/24).

Center for Global Health Policy’s “Science Speaks”: IAS 2017: UNAIDS numbers show returns, need for greater investment, international leaders say
Christine Lubinski, executive director of the Center for Global Health Policy, discusses data from the most recent UNAIDS report, and highlights remarks made by UNAIDS Executive Director Michel Sidibé, U.S. Global AIDS Coordinator Ambassador Deborah Birx, Global Fund Interim Executive Director Marijke Wijnroks, and others (7/24).

Center for Global Health Policy’s “Science Speaks”: IAS 2017: UNITAID, partners boost HIV self-test access in six African countries
Lubinski discusses the announcement that the UNITAID-led HIV Self-Testing Africa consortium “will expand the reach of its project from Malawi, Zambia, and Zimbabwe to include South Africa, Lesotho, and Swaziland…” (7/25).

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