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Kaiser Daily Global Health Policy Report

In The News

Media Outlets Examine Potential Implications Of Trump Administration's Budget Decisions, Unfilled Public Health Positions On Pandemic Preparedness, U.S. Global Health Programs

Los Angeles Times: Trump pushes historic cuts in global health aid, stoking fears of new disease outbreaks and diminished U.S. clout
“Half a century after the United States led a global expansion of international efforts to combat infectious disease and promote family planning, the Trump administration has embarked on a historic retrenchment that many fear threatens the health of millions and jeopardizes America’s standing in the world. … Since taking office, President Trump has proposed dramatic cuts to the U.S. Agency for International Development, which has historically spearheaded U.S. efforts to improve women’s and children’s health. … The White House is urging reductions this year to major international heath initiatives, including the President’s Emergency Plan for AIDS Relief, or PEPFAR, which provides life-saving medicines to millions of AIDS patients in developing nations. The Trump administration has imposed tough new restrictions on U.S. support for aid organizations that provide family planning and other health services. And last week, the White House announced it is cutting all U.S. contributions to the United Nations Population Fund, or UNFPA, the lead international agency dedicated to promoting family planning and child and maternal health…” (Levey, 4/10).

The Washington Post: The Trump administration is ill-prepared for a global pandemic
“The Trump administration has failed to fill crucial public health positions across the government, leaving the nation ill-prepared to face one of its greatest potential threats: a pandemic outbreak of a deadly infectious disease, according to experts in health and national security. No one knows where or when the next outbreak will occur, but health security experts say it is inevitable. Every president since Ronald Reagan has faced threats from infectious diseases, and the number of outbreaks is on the rise…” (Sun, 4/8).

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Former President Bush Promotes HIV/AIDS, Cervical Cancer Programs In Africa, Urges Continued U.S. Funding For PEPFAR

The Hill: George W. Bush pens op-ed urging full funding for anti-AIDS program
“Former President George W. Bush is urging lawmakers to continue fully funding the President’s Emergency Plan for AIDS Relief (PEPFAR), an initiative he founded during his presidency to fight the AIDS epidemic in Africa. … The budget proposal put forward by the Trump Administration includes a $300 million cut from PEPFAR. Bush, who in his work for the George W. Bush Institute has formed partnerships to combat diseases like cervical cancer, said Americans ‘should keep going until the job is done’ making an AIDS-free generation in Africa…” (Shelbourne, 4/8).

The New York Times: Bush Steps Back Into Spotlight to Help Africa Fight Epidemics
“…As Congress heads for a bruising showdown over funding this month, [former President] Bush was in Africa this past week to publicize a $6.8 billion assistance program that has done much to save this continent’s future and more than a little to rehabilitate his image. In visits to clinics and schools in Botswana and Namibia, Mr. Bush argued that the President’s Emergency Plan for AIDS Relief, or PEPFAR, which he established in 2004, should not only continue to fight the AIDS crisis in Africa but also expand to tackle the deadly and preventable epidemic of cervical cancer…” (Harris, 4/8).

The Raw Story: ‘On the verge of an AIDS-free generation’: George Bush pleads with GOP to continue funding Africa program
“In a stirring op-ed published in the Washington Post, former President George W. Bush pressed Republican lawmakers and President Donald Trump to continue to fully fund an anti-AIDS program he created in 2003 to battle the HIV/AIDS pandemic in Africa. … Bush acknowledged the new reality in Washington D.C. with Trump as president and cost-cutting a primary goal, saying it was imperative Congress keep the program alive…” (Boggioni, 4/8).

The Southern Times: Bush urges Africa to fight HIV, cancer
“Former United States of America president George W. Bush has urged Namibia, Botswana and Africa at large not to rest on their laurels now that a breakthrough in reducing HIV/AIDS and cancer on the continent has been made. … His visit comes 14 years after he announced in his 2003 State of the Union Address the $15 billion President’s Emergency Plan for Aids Relief (PEPFAR) to combat global HIV/AIDS…” (Shihepo/Mhaladi, 4/10).

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Documentary Examines Recent Disease Outbreaks, Potential For Global Pandemics

Monsters & Critics: CNN documentary Unseen Enemy is terrifying look at human vulnerability in face of pandemics
“On CNN [Friday], director Janet Tobias’s chilling documentary Unseen Enemy is a sobering wake-up call — as we learn about the looming potential crises of diseases like Ebola and Zika, as well as things that might seem common, like the flu. SARS, Zika, AIDS, bird flu, MERS, Ebola; all words which spark fear and panic worldwide. The documentary examines the insidious biological chatter of viruses which can lead to them staying one step ahead of technology with their cunning…” (Neale, 4/7).

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Taliban Allows Polio Vaccination Team Access To Kunduz Following Cases Among Children

The Guardian: Polio in Afghanistan: ‘Americans bomb our children daily, why would they care?’
“Just over a fortnight ago, a 14-month-old girl in the Afghan province of Kunduz was diagnosed with polio. Within days, the Taliban granted health workers access to parts of northern Afghanistan for the first time in 15 months, enabling them to resume a polio vaccination program. Until it was blocked, leaving about 170,000 children in Kunduz province without inoculations, the scheme had almost eradicated the disabling viral disease in Afghanistan. But polio can spread quickly, with even a single case potentially enough to widen the disease’s footprint. … Speaking to the Guardian, [Taliban health chief in the province, Qari] Bashir confirmed his demand for a clinic but said there were other concerns. Chief among them was a suspicion among villagers that polio teams could be infiltrated by spies…” (Rasmussen/Tasal, 4/10).

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LGBT People In Tanzania Facing Increased Discrimination, Health Workers Concerned About Impact on HIV/AIDS Programs

BuzzFeed: How Tanzania Is Cracking Down On LGBT People — And Getting Away With It
“…Gay sex has been a crime in Tanzania, punishable with life in prison, since British colonial rule, but there is no record of anyone serving serious time for it. LGBT Tanzanians have always been able to quietly go about their lives, despite stigma and discrimination. But now the Tanzanian government is getting aggressive. … Government ministers have threatened to release lists of LGBT people across Tanzania, and health workers say it’s begun interfering with HIV prevention and treatment. Tanzania’s crackdown could not have come at a worse time. With the election of Donald Trump and the ascent of nativist movements in Europe, LGBT rights advocates worry that the Trump administration will surrender the U.S.’s role as a global leader in pressuring foreign governments to recognize the rights of their LGBT citizens…” (Honan, 4/8).

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Editorials and Opinions

Opinion Pieces Express Support for PEPFAR, Urge Continued Funding

Washington Post: George W. Bush: PEPFAR saves millions of lives in Africa. Keep it fully funded.
George W. Bush, former U.S. president and founder of the George W. Bush Institute in Dallas

“…It is clear that the generosity of the American people has had a huge impact — one that reflects the view that all lives are precious, and to whom much is given, much is required. [The] lifesaving work [of PEPFAR] also has a practical purpose for Americans. Societies mired in disease breed hopelessness and despair, leaving people ripe for recruitment by extremists. When we confront suffering — when we save lives — we breathe hope into devastated populations, strengthen and stabilize society, and make our country and the world safer. As the executive and legislative branches review the federal budget, they will have vigorous debates about how best to spend taxpayers’ money — and they should. Some will argue that we have enough problems at home and shouldn’t spend money overseas. I argue that we shouldn’t spend money on programs that don’t work, whether at home or abroad. But they should fully fund programs that have proven to be efficient, effective, and results-oriented. Saving nearly 12 million lives is proof that PEPFAR works, and I urge our government to fully fund it. We are on the verge of an AIDS-free generation, but the people of Africa still need our help. The American people deserve credit for this tremendous success and should keep going until the job is done” (4/7).

Huffington Post: A Bush-Obama Alliance Might Save PEPFAR
Philip Seib, professor at the University of Southern California

“…At a time of global consternation about how America views its relationships with the rest of the world, protecting the commitment to PEPFAR is particularly important. … Given its remarkable record, PEPFAR should be proudly sustained by whoever occupies the White House, but in the current political atmosphere all aid programs are vulnerable to drastic budget cuts or even elimination. The behavior of Donald Trump’s administration and Congress is unpredictable, to put it mildly, and so Presidents Bush and Obama should join forces to ensure that PEPFAR continues. If need be, the two former presidents should appear together at the appropriate congressional hearing to support PEPFAR funding. Such a bipartisan gesture — an exceedingly rare occurrence these days — would capture the public’s attention and generate political momentum. PEPFAR would be protected. … The moral and political case for PEPFAR remains strong. Presidents Bush and Obama should rally bipartisan support for the program’s funding, and President Trump should endorse their effort. George W. Bush and the American people can be proud of what PEPFAR has accomplished so far. It deserves the chance to do more” (4/9).

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Investing In Malaria Eradication Critical To Eliminating Poverty, Ending Preventable Child Deaths

Project Syndicate: Finishing Off Malaria
Shamas-ur-Rehman Toor, senior program management specialist at the Islamic Development Bank Group’s Islamic Solidarity Fund for Development

“…[T]he Lives and Livelihoods Fund (LLF) — a grant facility launched by the Islamic Development Bank (IsDB) and the Bill & Melinda Gates Foundation — has joined Senegal’s fight against malaria. … Administered by the IsDB, the LLF is the biggest initiative of its kind based in the Middle East, aiming to increase the resources available for development across the 30 least-developed and lower-middle-income countries in the Muslim world. … One of the LLF’s first projects will be a $32 million malaria pre-elimination project in Senegal. … Investments in combating malaria, like those by the LLF, are among the most cost-effective health interventions, yielding broad socioeconomic benefits. A healthy child is more likely to attend school, resulting in improved learning outcomes, just as a healthy adult can earn a steady income, resulting in reduced poverty and hunger. Healthy workers are more productive, boosting economic output. Malaria-free communities can divert their health budgets to fight other scourges, such as non-communicable or neglected tropical diseases. Progress in the fight against malaria will mean progress toward several Sustainable Development Goals (the United Nations targets to which world leaders agreed in 2015), from eliminating poverty to ending preventable deaths in children under age five. If we are to win the fight, more financing from funds like the LLF, particularly in Sub-Saharan Africa, is the way to do it” (4/7).

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Monitoring Successes, Failures Vital To Achieving Clean Water, Sanitation For All By 2030

The Guardian: When it comes to water access we keep doing the same thing. And failing
Ajay Paul, thematic ​coordinator for the sustainable services initiative at Welthungerhilfe

“…[T]oo many water and sanitation services in developing countries are still unreliable, sub-standard, and need major repairs after three to five years. … We falsely attribute the breakdown of a pump to poor government policies, corrupt local officials, or weak management by the water-user committee. So we put ourselves in opposition to the government, we ignore policies, and we do not work with local government officials. We run our projects in parallel to theirs, and we do not link up to or support local government plans. When the project is finished, we hand over the management of the pump to the water-user committee and walk away. But we haven’t worked with the local government, so it has no incentive to support the local community when the pump breaks down. … We know that achieving [Sustainable Development Goal 6 (SDG6)] — clean water and sanitation for all by 2030 — will require monitoring, reporting, and greater transparency about failures and success after projects are over…” (4/7).

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From the Global Health Policy Community

U.S. Aiming To 'Prevent Global Health Threats Before They Emerge'

U.S. Global Leadership Coalition: Before the Spread: How the U.S. is Working to Stop the Next Ebola
Elizabeth Holton, digital communications manager at USGLC, discusses U.S. efforts to address health challenges through its Preparedness & Response project, writing, “With adequate funding to prevent global health threats before they emerge, the U.S. is working to improve and save lives around the world – keeping Americans healthy and safe, both at home and abroad” (4/7).

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Brookings Report Examines Health Governance Capacity In 18 Low-, Middle-Income Countries

Brookings Institution: Figure of the week: Findings from the Brookings Health Governance Capacity report
Amy Copley, research analyst and project coordinator for the Africa Growth Initiative at the Brookings Institution, discusses findings from a new Brookings report on health governance capacity and enhancing private sector investment in global health to strengthen health systems and promote research and development. Copley notes, “[T]he report examines the quality of health care governance in 18 low- and middle-income countries in sub-Saharan Africa and Asia along five dimensions: health management capacity, health policies, health regulations, health infrastructure and financing, and health systems. Using data on 25 indicators related to these dimensions, the study finds that the factors that can enable greater private sector investment in public health are: ‘improving transparency, strengthening management capacity, lowering tariffs on incoming medical products to the extent that is fiscally possible, expediting regulatory reviews of new drugs, building effective health infrastructure, and increasing appropriately-targeted and efficient public spending on health care'” (4/7).

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Financial Times Highlights Global Burden Of Depression, Other Health-Related Issues In Newsletter

Financial Times: FT Health: The burden of depression
The latest issue of the weekly FT Health newsletter discusses the global burden of depression and mental illness and the U.N.’s appeal related to the potential famines in Africa, and includes a roundup of global health related news (4/7).

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Educating Communities Critical To Ending Female Genital Mutilation

ONE: YES: First ladies vow to fight “barbaric” genital mutilation
Robyn Detoro, digital assistant at the ONE Campaign, discusses the practice of female genital mutilation (FGM) in Africa, as well as the role of education in ending FGM, writing, “Armed with the knowledge about the harmful effects of FGM, future generations can better make educated decisions for their families and independently decide to abandon the practice” (4/7).

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