KFF Daily Global Health Policy Report

In The News

Impacts Of U.S. Funding Cuts Felt Across UNFPA, Agency Official Tells Devex

Devex: UNFPA assess extent and impact of U.S. cuts
“The United Nations Population Fund is still assessing the full impact of the United States cutting $32.5 million in core funding earlier this month. But the effects are already clear at almost all of the country offices and programs that rely on the U.S., the agency’s second largest donor, Arthur Erken, the agency’s head of communications and partnerships, told Devex. … While no single program is facing an imminent risk of termination, all work will be scaled back across the more than 150 countries UNFPA operates in, he added. Fourteen countries received ‘non-core’ UNFPA funding from the U.S. in 2016, but the U.S. funding has backed the UNFPA’s work in all of its countries, except China and a few ‘rogue’ states, such as North Korea…” (Lieberman, 4/18).

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Sens. Corker, Coons Call On Congress To Defend Foreign Aid Budget, Implement Food Aid Reforms

The Chattanoogan: Corker, Coons Visit World’s Largest Refugee Camp To Get Firsthand Look At Global Food Crisis
“Senators Bob Corker [R-Tenn.] and Chris Coons (D-Del.), both members of the Senate Foreign Relations Committee, on Friday visited the Bidi Bidi refugee camp in Uganda, where more than 270,000 people reside after fleeing war-torn South Sudan. The senators witnessed firsthand one of the countries hardest hit by the current global food crisis in which 20 million people in Nigeria, Somalia, South Sudan, and Yemen are at risk of starvation…” (4/18).

Humanosphere: Senators say U.S. needs to reform food aid to save lives amid historic hunger crisis
“The U.S. government’s approach to delivering food aid overseas is endangering lives, say a bipartisan pair of senators who recently returned from a visit to a refugee camp in Uganda. … Food aid represents a significant chunk of the White House’s proposed cuts to the State Department. At a time when more aid is needed, the U.S. under President Donald Trump is mostly looking inward. Coons and Corker are among those in Congress who are defending the aid budget — which represents less than one percent of the federal budget. The senators also say the country’s inefficient food aid system is making a bad global crisis much worse…” (Murphy, 4/17).

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Financial Times Special Report Focuses On Neglected Tropical Diseases

Financial Times: Special Report: Neglected Tropical Diseases
“Neglected tropical diseases affect more than a billion people. These diseases of the poor are notorious for their disabling symptoms. Progress has been slow, but the drug industry and communities are redoubling efforts to eliminate treatable conditions.” The special report contains 14 articles on various NTDs, prevention and treatment efforts, clinical research progress, and an opinion piece by WHO Director-General Margaret Chan (Multiple authors, 4/18).

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World Must Act To Provide Food, Humanitarian Assistance To Northeast Nigeria Or Risk More Refugees To Europe, Nation's Humanitarian Coordinator Warns

Thomson Reuters Foundation: World must aid famine-threatened Nigeria to avoid ‘mass exodus’
“The devastation wrought by Boko Haram, which has left millions of people in northeast Nigeria on the brink of famine, could exacerbate Europe’s migration crisis if the world fails to act urgently, the country’s chief humanitarian coordinator said. Nearly five million people in the region are desperately hungry and risk starving to death this year if they do not receive food aid, according to figures from the United Nations…” (Guilbert, 4/18).

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German Merck Plans To Introduce Child-Friendly Version Of Schistosomiasis Drug For Use In African Donation Program

Reuters: German Merck aims to roll out child formula for schistosomiasis drug
“Merck KGaA said it is developing a children’s formula of its drug to treat schistosomiasis, a parasitic worm disease that infects millions of poor people in Africa and Asia. … The company said it has donated 500 million tablets of praziquantel to the World Health Organization (WHO) over the last 10 years for use in 39 African countries, primarily targeting children who catch the disease in contaminated rivers and lakes. But the pill is large, bitter, and difficult for children to swallow, Belen Garijo, CEO of health care at Merck KGaA, told reporters in Geneva. The new formula will be sweeter…” (Nebehay, 4/18).

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Editorials and Opinions

U.S. Congress Should Pass HER Act, Ensure Long-Term Strategy To Protect Women's Rights, Health

Huffington Post: Putting HER First: A Step Toward a Long-Term Strategy for Women’s Rights
Savannah Fox, human rights fellow at Young Professionals in Foreign Policy (YPFP) and regional advocacy coordinator in the advocacy and policy unit at CARE International

“…When U.S. policy restricts access to global health services, women and children suffer the most. However, methods that support, protect, and invest in the rights of women and girls show a positive impact on their entire communities. Instead of embarking on another iteration of the outdated Mexico City policy, the United States must make a lasting commitment to support family planning by supporting the newly introduced Global Health, Empowerment and Rights (HER) Act. The HER Act would ensure that eligible foreign NGOs can continue to provide health services with U.S. funds, while paying for abortions services and education on their own with non-U.S. funds. … The HER act … seeks to repeal the Mexico City policy indefinitely in order to stabilize funding through long-term strategies. While the multiplier effects of investing in women and children are typically not seen immediately within a four-year presidential term, long-term benefits will be seen well beyond clinic doors. U.S. policymakers must not allow human rights, especially of some of the most vulnerable, to continue to be dictated by dated political ideology. They should pass the HER Act allowing access to family planning to improve the lives of women, boost economic growth, and secure stable societies worldwide” (4/17).

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Cuts To U.S. Funding For Global Health, Including Family Planning, Could Be 'Dangerous'

The Conversation: Will Trump’s global family planning cuts cause side effects?
Rachel Sullivan Robinson, associate professor at American University School of International Service

“…Rolling back U.S. support for family planning in developing countries is dangerous for two main reasons. First, contraception saves lives by limiting the total number of pregnancies, including those endangering mothers’ lives. Second, … past U.S. funding for family planning had an unintended upside: it helped form the backbone of many countries’ early HIV prevention efforts and created organizations that remain central to the response to HIV. … [T]he impact of the U.S. government’s cessation of United Nations Population Fund support will be largely symbolic. … Previously, when the U.S. has refused to support the global agency, other countries stepped in to fill the gap. It’s unclear whether other countries or additional funders, like the Bill & Melinda Gates Foundation, would be willing to do so if Congress embraces Trump’s broader proposed cuts to global health assistance. … Cutting U.S. funding for global health efforts, including family planning, would leave the poorest countries ill-prepared for epidemics, pandemics, and other emerging health threats — including the kinds that easily cross borders. This negligible budgetary savings will ultimately cost rich and poor nations in the future” (4/17).

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U.S. Congress Should Fully Fund PEPFAR, Build On Progress Made On Global HIV

New York Times: Letter to the Editor: Trump and AIDS Relief
Asia Russell, executive director of the Health Global Access Project

“President George W. Bush was right to challenge President Trump’s proposed budget, given the life-or-death consequences of the foreign aid cuts he seeks. … Maintaining funding should be the floor for congressional support for PEPFAR. … At this critical moment in the global HIV response, Congress is best advised to ignore President Trump’s cruel, fact-free prescription and instead fully fund PEPFAR and build on the progress made over the last 14 years. Failure to fully fund PEPFAR will result in increasing rates of HIV, more unnecessary and avoidable deaths, and a more expensive global HIV response in the future” (4/17).

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'Tide Is Turning' On NTDs, But 'Broader Attack' Needed, Including Efforts To Reach SDG Targets

Financial Times: Dr. Margaret Chan: The tide is turning for neglected tropical diseases
Margaret Chan, director general of the WHO

“Eleven years ago, shortly before I became its director general, the World Health Organization and a group of more than 25 partners met in Washington to unveil a new strategy to rescue some of the world’s poorest people from four neglected tropical diseases. … In 2012, the partners elevated the program to a new level, meeting in London, to unite around a new set of ambitious goals to eradicate, eliminate, or accelerate the control of a wider group of 17 neglected tropical diseases, which were outlined in a WHO ‘roadmap.’ The London Declaration catalyzed a massive expansion of support … These neglected tropical diseases, so long starved of resources, were finally getting the support they require. The tide is turning. … In the midst of progress, however, we must recognize that medical interventions alone cannot solve the problem of neglected tropical diseases. A broader attack on the social, environmental, and economic determinants of health is needed. The targets set for water supply, sanitation, nutrition, and housing by the 2030 Agenda for Sustainable Development will have the largest long-term impact. On current trends, though, many of these ancient diseases may be brought to their knees before that 2030 deadline arrives”

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Humanitarian Aid Should Be Coupled With Resilience-Building Programs To Address Famines

Washington Post: Letters to the editor: Humanitarian aid isn’t enough to address famines
Kathleen Colson, chief executive and founder of the Boma Project

“In Africa and the Middle East, where 20 million people are in danger of starving to death, famine may seem like a result of ‘natural’ catastrophes such as drought, but it cannot be addressed without looking at the consequences of human action or inaction. … The arid and semi-arid lands of northern Kenya have seen cycles of humanitarian aid over the past 50 years, and, although these efforts have saved lives, they treat residents as passive beneficiaries, trapping them in cycles of vulnerability and dependence. Humanitarian aid is also often limited in its ability to reach remote areas and is at risk of being diverted by opposing factions. While humanitarian response is important, it must be coupled with proven, holistic, resilience-building programs to help residents make a meaningful transition from dependence to self-reliance, even in the face of severe and frequent shocks such as climate change and conflict” (4/17).

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Global Community Should Formally Integrate Community Health Workers Into Health Systems

The Lancet Global Health: Community health workers: emerging from the shadows?
Editorial Board

“…[Community health workers (CHWs)] are desperately needed globally because existing health services do not meet health needs, yet despite decades of being used at the front-lines, they often still stand in a grey area at the fringes of the health system, undefined and unsupported and therefore unable to completely fulfill their potential while shouldering the responsibility for those most in need. Change may be on the way, though. CHWs feature prominently in WHO’s strategy on human resources for health, in which the International Labour Organization is called upon to urgently ‘streamline and rationalize’ the standard definition of a CHW, which should help in integrating them formally into health systems. From a policy standpoint, successful programs have included a set budget for incentives and essential supplies, supervision, training (ideally via an accredited curriculum), and a clear career path. Major steps have been taken to explore and promote a sustainable model: WHO is currently developing guidelines for the design, implementation, and management of CHW programs, which should be available later this year. Regional efforts are also in the works. … These efforts put a welcome spotlight on CHWs, whose critical role deserves and requires the recognition that comes with a formal job description and a stable paycheck” (May 2017).

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'Big Bond' Approach To Foreign Aid Could Maximize Efficiency Of Donor Resources In Africa

Project Syndicate: A Big Bond for Africa
Nancy Birdsall, president emeritus and senior fellow at the Center for Global Development (CGD), and Ngozi Okonjo-Iweala, former finance minister of Nigeria and managing director of the World Bank and distinguished visiting fellow at CGD

“…While governments in Africa are spending more on public infrastructure themselves, outside finance is still required, especially for regional projects, which are rarely a top priority for national governments. Yet aid from Africa’s traditionally generous foreign donors, including the United States and Europe, is now set to shrink, owing to political and economic constraints. But there may be a solution that helps Africa recover its growth in a way that Western leaders and their constituents find acceptable. We call it the ‘Big Bond’ — a strategy for leveraging foreign aid funds in international capital markets to generate financing for massive infrastructure investment. … The Big Bond approach represents a much-needed update to the ODA framework — one that supports higher and more sustainable growth in recipient countries, while lowering the burden on donor countries. At a time when aid is under political pressure, perhaps such a bold approach to maximizing the efficiency of donor resources is exactly what the world needs” (4/17).

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From the Global Health Policy Community

Health Affairs Blog Highlights Key Studies On PEPFAR's Role In Addressing Global AIDS

Health Affairs Blog: The Future Of Investment In PEPFAR: Understanding PEPFAR’s Multiple Economic, Health, And Diplomatic Impacts
Margaret K. Saunders, deputy editor of global health at Health Affairs, highlights keys studies Health Affairs has published exploring PEPFAR’s role in addressing the global AIDS epidemic. The studies discuss PEPFAR’s role in contributing to economic stability in countries that received PEPFAR funding, supporting health governance and health systems, improving access to health services such as maternal-child care for African women not infected with HIV, and providing lessons for U.S. global health diplomacy. Saunders also highlights a study on the ineffectiveness of PEPFAR’s abstinence and faithfulness programs in sub-Saharan Africa (4/17).

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Public Health Experts Make Case For Why U.S. Should Spend On Global Health

Health Affairs Blog: Why President Trump Should Use Foreign Aid For Health To Make America Great
Robert Hecht, president of Pharos Global Health Advisors, and Sten Vermund, the Anna Lauder professor of public health and dean of the Yale School of Public Health, write, “Investing in global health is essential to the safety, security, and future prosperity of the United States, in addition to being a highly effective way to fight extreme poverty and avert illness, suffering, and premature death for millions of our fellow human beings. … In addition to the humanitarian case for foreign aid, there are three very powerful reasons, which are aligned with President Donald Trump’s populist ‘America first’ vision, why the administration should maintain and even spend more on global health. 1. Deadly Epidemics Threaten U.S. Lives And Prosperity … 2. Foreign Aid For Health Yields Huge Returns For The United States … 3. Foreign Aid For Health Strengthens U.S. Leadership On The Global Stage And Counters Our Rivals…” (4/17).

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USGLC Blog Post Summarizes Comments From U.S. Armed Forces Commanders Supporting U.S. Foreign Assistance, State Department, USAID

U.S. Global Leadership Coalition: U.S. Armed Forces Commanders Speak Out: State Department, USAID Essential to Success of Military
Abhik Pramanik, USGLC policy assistant, writes, “Every year, our nation’s top military leaders — the heads of each Combatant Command, the Chairman of the Joint Chiefs of Staff, and the Defense Secretary — give testimony to Congress. Each addresses their current command mission, potential threats the U.S. may face, and how the Department of Defense will respond. These annual posture statements have already begun on Capitol Hill, with the current Combatant Commanders appearing in front of the Senate and House Armed Services Committees. This year, all of them commented on the recent proposed cuts to the International Affairs Budget. As former Secretary of Defense Gates has said, ‘You would find…extraordinary support across the entire Defense Department’ for the State Department ‘and for their budget,’ a fact that been made readily apparent over the last month. In written and oral testimony in Congress, our military’s most senior officers have made it clear that the administration’s proposed cuts would not only make their jobs harder, but that a strong, fully resourced International Affairs Budget is vital to an effective national security strategy…” (4/17).

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Stanford Visiting Professor David Heymann Urges Global Health Community To Position Needs To Resonate With Policymakers

Stanford Medicine’s “Scope”: Visiting scholar urges global health community to “think like a politician”
“With funding for global health on the chopping block in many nations, Stanford visiting professor David Heymann, MD, offered practical advice for the global public health community recently: Think like a politician. In a talk on campus with Paul Costello, the School of Medicine’s chief communications officer, Heymann … discussed the importance of understanding how foreign policy decisions are made and positioning public health needs in a way that resonates with policymakers…” (Leslie, 4/17).

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From the U.S. Government

CDC's Field Epidemiology Training Program Aims To Strengthen Countries' Health Systems, Disease Detection, Prevention Efforts

CDC’s “Our Global Voices”: Preventing Local Outbreaks from Becoming Global Pandemics: FETP Enhances Capabilities to Track Diseases and Stop Them at the Source
David Sugerman, assistant professor at Emory University, commander in the U.S. Public Health Service, and medical officer at the CDC, discusses CDC’s Field Epidemiology Training Programs (FETPs) and the role residents and trainees have played in addressing outbreaks and emerging disease threats in their home countries, writing, “Having a well-trained public health workforce on the ground, prepared to quickly detect and respond to health threats and stop them at their source is essential. Establishing FETPs and having trained disease detectives on the ground, is our best frontline defense against public health emergencies and threats. CDC stands with them, ever-ready to face known and unknown disease threats” (4/17).

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From KFF

Kaiser Family Foundation Explainer Provides Overview, History Of UNFPA Funding & Kemp-Kasten Amendment

Kaiser Family Foundation: UNFPA Funding & Kemp-Kasten: An Explainer
On March 30, the Trump administration announced that it would withhold FY 2017 funding to the United Nations Population Fund (UNFPA), the lead U.N. agency focused on global population and reproductive health, citing the Kemp-Kasten amendment in its decision. A new explainer from the Kaiser Family Foundation provides an overview of the history and application of this provision on global family planning funds (4/17).

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