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Kaiser Daily Global Health Policy Report

In The News

U.S. President Trump Reinstates Mexico City Policy, Broadens Executive Order To Apply To All Global Health Aid

BuzzFeed News: Here’s How Trump’s Anti-Abortion Rule Will Affect Women Worldwide
“President Donald Trump has reinstated the controversial ‘global gag rule’ — a policy reversal that women’s rights and health advocates fear will bring a rise in unsafe abortions around the world. The Reagan-era rule essentially prevents foreign organizations that receive U.S. money from talking to women about abortion. President Trump’s decision to reinstate the rule comes one day after the 44th anniversary of Roe v. Wade, the U.S. Supreme Court decision that legalized abortion. Conservatives welcomed the move, while some Democrats and many public health experts decried the change as dangerous…” (Moore, 1/23).

CQ News: Trump Administration Bans Foreign Aid for Abortion Providers
“…At least $500 million in USAID funding on family planning and reproductive health could be affected by a change in the rule. In addition to rescinding Obama’s order and restoring Bush’s, Trump’s memorandum also instructs the secretary of State and secretary of Health and Human Services to implement a plan to extend the policy’s guidelines to other global health programs that receive federal funding…” (Siddons, 1/23).

Devex: Trump executive order cuts funding to NGOs that provide abortion services, information
“…Already, a political rebuttal to the Gag order has taken form. Democratic Senator Jeanne Shaheen [N.H.] plans to introduce bipartisan legislation on Tuesday to permanently repeal the global gag rule to stop the back and forth as administrations change and safeguard women’s access to reproductive care, she said in a statement. But with Republicans in control of Congress, a fight to repeal the rule could face an uphill battle…” (Saldinger/Lieberman, 1/23).

The Guardian: ‘Global gag rule’ reinstated by Trump, curbing NGO abortion services abroad
“…The rule will put thousands of international health care workers in the difficult position of deciding whether to continue to offer family planning care that includes abortion at the expense of a critical funding stream. Many international health advocates insist that their efforts are not comprehensive without abortion services. Unsafe abortions are a major cause of maternal mortality and kill tens of thousands of women every year…” (Redden, 1/23).

The Hill: Trump reinstates ban on U.S. funds promoting abortion overseas
“… ‘I think the president, it’s no secret, has made it very clear that he’s a pro-life president,’ White House Press Secretary Sean Spicer told reporters at his first briefing Monday afternoon. ‘And I think the reinstatement of this policy is not just something that echoes that value, but respects tax payer funding as well’…” (Hellman, 1/23).

New York Times: Trump Revives Ban on Foreign Aid to Groups That Give Abortion Counseling
“…United States law already prohibits the use of American taxpayer dollars for abortion services anywhere, including in countries where the procedure is legal. But Mr. Trump’s order takes the prohibition further: It freezes funding to nongovernmental organizations in poor countries if they offer abortion counseling or if they advocate the right to seek abortion in their countries. … The impact of Mr. Trump’s order is likely to be felt beyond abortion services, which cannot be carried out with federal funding under a 1973 law known as the Helms Amendment, after former Senator Jesse Helms…” (Sengupta, 1/23).

POLITICO: Trump revives funding ban to groups providing abortion overseas
“…Now, [the executive order] will apply to organizations that get global health money, potentially including maternal health programs, anti-Zika efforts and the expansive PEPFAR program to stop HIV/AIDS. ‘The intent is to extend the policy to apply not just to family planning assistance but to global health, including PEPFAR and maternal health,’ said Jennifer Kates, vice president and director of global health and HIV policy at the Kaiser Family Foundation, who added that the full scope of the policy isn’t yet known. She estimated that when the policy has been applied in the past, it covered about $600 million in foreign aid spending. The new policy could potentially cover up to $8 billion…” (Haberkorn, 1/23).

Vox: Trump just reinstated the global gag rule. It won’t stop abortion, but it will make it less safe.
“…The global gag rule has become something of a political seesaw since Ronald Reagan first implemented it in 1984 at a United Nations population conference in Mexico City (which is why it’s also called the ‘Mexico City policy’). Bill Clinton repealed it immediately when he took office. George W. Bush immediately reinstated it when he took office. Then Barack Obama immediately repealed. But the effects of reinstating the gag rule now — especially after eight years of the Obama administration, which supported sexual and reproductive health in foreign aid — will be nothing like a seesaw. It will be very messy, advocates say, with ripple effects and unintended consequences that will have devastating effects on the health of women and girls around the globe. And while it will export the U.S. abortion wars overseas, only foreign women will be the casualties…” (Crockett, 1/23).

Wall Street Journal: Donald Trump Reinstates Antiabortion Policy for Overseas Groups
“…Maine Sen. Susan Collins is the lead Republican sponsor of Ms. Shaheen’s bill [to repeal the Mexico City policy] and doesn’t support Mr. Trump’s move to reinstate the policy. ‘My concern is that it will diminish family planning services for women around the world and as someone who would like to reduce the number of abortions, the best way to do that is ensuring that people have access to family planning services,’ she said. Other Republicans welcomed Mr. Trump’s move…” (Schwartz et al., 1/23).

Washington Post: Trump reverses abortion-related U.S. policy, bans funding to international health groups
“…In 2011, researchers at Stanford University School of Medicine found that implementation of the Mexico City policy was linked to increases in abortion rates in sub-Saharan African countries. But they said that they couldn’t draw ‘definitive conclusions about the underlying cause of this increase’…” (McGinley/Goldstein, 1/23).

Additional coverage also is available from the following sources: Agence France-Presse, Africa TimesCBS NewsCNNCosmopolitanHuffington PostHuffington Post U.K., Miami HeraldMother JonesMSNBC, NBC News, NPR, Quartz, Reuters, TIME, USA TODAY, and Vogue.

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Christian Science Monitor Examines Trump Administration's 'Divergent Views' On PEPFAR In Africa

Christian Science Monitor: U.S. AIDS program in Africa: ‘massive entitlement’ or biggest success of 50 years?
“…Although PEPFAR has attracted significant criticism over the years — much of it around the moralizing bent of some of its early funding provisions — it is nearly universally regarded, even by detractors, as a turning point in the AIDS epidemic [in Africa]. … But the Trump administration has expressed divergent views about the program, leaving beneficiaries across the continent uncertain about its future at a crucial junction in the global fight against HIV…” (Brown, 1/23).

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WHO Director-General Chan Calls On Agency's Executive Board To Improve Health Care Equity Worldwide

VOA News: WHO: All People, Rich and Poor, Entitled to Good Health Care
“The World Health Organization’s director general, Margaret Chan, is calling for greater equity in the delivery of health care for rich and poor alike. The WHO chief is urging delegates attending the agency’s annual executive board meeting to do more to close the health gap between the haves and have-nots…” (Schlein, 1/23).

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Candidate Field For WHO Director General To Be Narrowed Down From 6 To 3 This Week

ScienceInsider: Wanted: A leader for the toughest job in global health
“Global health watchers will pay close attention to Geneva, Switzerland, on Wednesday, when the World Health Organization (WHO) will announce the final three candidates to take the agency’s top job. The decision by WHO’s Executive Board, made up of representatives of 34 member states, follows months of behind-the-scenes jockeying, campaigning by the candidates, and intense speculation. It will be followed in May by a final vote by WHO’s 194 member states…” (Kupferschmidt, 1/23).

STAT: A guide to the selection of the new head of the World Health Organization
“…If you haven’t been paying much attention up until now, you’re not alone. With Brexit and the U.S. election, this campaign has been getting little attention. So let’s explore the three Ps — the people, the process, and the predictions. … Four Europeans, one African, and one South Asian are vying to succeed Dr. Margaret Chan, whose second term as WHO director general ends on June 30. (Directors general can only serve two five-year terms. Chan, who was nominated by China, served a little longer because her predecessor, J.W. Lee of South Korea, died before his term ended.)…” (Branswell, 1/23).

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Countries Must Do More To Prepare For Disease Outbreaks, Study Says

United Press International: Countries ‘grossly underprepared’ for disease outbreaks: Study
“An analysis of reports on the response to the Ebola virus outbreak in West Africa has researchers sounding the alarm about worldwide infectious disease outbreak preparedness. Suerie Moon of the Graduate Institute of International and Development Studies in Geneva, Switzerland, and a team of researchers examined seven post-Ebola reports…” (Wallace, 1/23).

Xinhua News: World “grossly underprepared” for infectious disease, warn scientists
“…They found that the diagnosis of the key problems and recommendations for action in these reports converged in three critical areas: strengthening compliance with the International Health Regulations; improving outbreak-related research and knowledge sharing; and reforming the World Health Organization (WHO) and broader humanitarian response system. To address these issues, countries have started to take action, but that progress has been mixed with many critical issues that have largely gone unaddressed, according to the team…” (1/24).

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Editorials and Opinions

Reinstatement Of Mexico City Policy Threatens Women's Health, Access To Safe Family Planning Methods

CNN: Gag me: Trump’s anti-abortion executive order
Laurie Garrett, senior fellow for global health at the Council on Foreign Relations

“Here we go again. … President Donald Trump signed an executive order reinstating the global gag rule on overseas discussion of abortion by individuals and organizations receiving federal funding. We have been here twice before — under Presidents Ronald Reagan and George W. Bush — and we know that this order often backfires, leading to increased abortion rates. … The world begrudgingly worked around the gag rule in the 1980s, fought it … and will likely do battle with reinstated gags in 2017. Limiting family sizes to slow population expansion and prevent maternal mortality is a matter of policy throughout the United Nations and most of the 194 nations today. All the failures, bureaucratic nightmares and — yes — increases in abortion rates will now follow the gag rule reinstatement. It is an irrational 2017 policy that will produce a backlash. I cannot imagine what effect Trump imagines, but reinstating the gag rule in 2017 will certainly fail to have the effect Reagan envisioned…” (1/24).

Huffington Post: The Global Gag Rule: A Political Game With Severe Consequences For Women’s Lives
Ann Furedi, chief executive of British Pregnancy Advisory Service (BPAS)

“…The action [to reinstate the Mexico City policy] shows the extent to which abortion is seen, not as a fundamental health care necessity for women, but as a plaything for politicians who want to posture and demonstrate their traditional, conservative commitments. … It’s not just [U.S. President] Trump who is the problem. Every donor who refuses to accept that abortion is a necessary part of health care, and cannot be set apart from other methods of birth control, must be challenged. .‎.. Politicians will only stop treating abortion as a separate and negotiable part of health care when we stop allowing them to do it…” (1/24).

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CDC Must Ensure New Quarantine Measures Grounded In Science; Congress Must Ensure Agency Has 'Respected Leadership, Appropriate Funding'

New York Times: Why the CDC’s Power to Quarantine Should Worry Us
Kyle Edwards, student at Yale Law School; Wendy Parmet, director of the Program for Health Policy and Law at Northeastern University; and Scott Burris, director of the Public Health Law Research Program at Temple University

“…It’s imperative that whenever the next outbreak hits, emergency health measures are grounded in scientific evidence and guided by clear, fair rules to protect people from wrongful deprivation of their liberties. … [W]e want to ensure that federal officials applying the new [CDC] regulations [on quarantines] will act on the basis of science and evidence and not on politics and public fear. … Congress must make sure that the nation’s top health agency has what it needs to do its job effectively and constitutionally: respected leaders and appropriate funding. In the confirmation hearings ahead, the Senate should insist that the nominees to lead the Department of Health and Human Services, the Public Health Service, and the CDC have the experience, scientific knowledge, and integrity to respond to frightening health threats appropriately. And Congress should ensure that the CDC has the funding and mandate to fulfill the broader role it seeks. It should amend the federal quarantine law to ensure the availability of immediate judicial review of all CDC quarantines. With good leadership and good law, we can protect public health without compromising basic rights” (1/23).

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From the Global Health Policy Community

Global Health, Development Experts Discusses Implications Of Mexico City Policy Reinstatement

Center for Global Development’s “Global Health Policy Blog/U.S. Development Policy”: Zombie Policy on International Family Planning Rises Again
Amanda Glassman, chief operating officer and senior fellow at CGD, discusses President Trump’s executive order reinstating the Mexico City policy, also known as the global gag rule, writing, “[I]f you want to reduce abortion, this is the wrong way to go. Not only is it empirically counterproductive on its intended policy goal, the gag rule demonstrably causes harm. … So if you want to reduce abortion around the world, here’s a better idea: help women in low-income countries gain access to voluntary, high-quality family planning” (1/23).

Rewire: Trump Reinstates Anti-Choice ‘Global Gag Rule’ Restriction
Ally Boguhn, political and campaigns editor at Rewire, discusses issues around reinstating the Mexico City policy, writing, “The global gag rule has had major global consequences for reproductive health care.” Boguhn includes comments from Ilyse Hogue, president of NARAL Pro-Choice America, and Nancy Northup, president and CEO of the Center for Reproductive Rights (1/23).

U.N. Dispatch: This One Paragraph Shows How Harmful the Global Gag Rule is to Fighting HIV/AIDS and Preventing Abortion
Mark Leon Goldberg, managing editor of U.N. Dispatch, discusses the policy’s implications, writing, “Even if the dollars used [by NGOS to provide abortion services, counsel patients that abortion is a family planning option, or advocate for the legalization of abortion in their countries] do not come from the USA, the entire organization is nonetheless banned from receiving U.S. funding. The stated purpose is to restrict abortions even though laws on the books since the 1970s prohibit the U.S. from funding abortion services. The practical effect of this policy results in increased numbers of unwanted pregnancies, more abortions, and the spread of sexually transmitted diseases like AIDS…” (1/23).

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'Science Speaks' Discusses Global Health-, Science-Related Developments During Trump Administration's Transition

Center for Global Health Policy’s “Science Speaks”: Transition 2017: PEPFAR and Global Health, NIH leaders remain in place for now
Antigone Barton, senior editor and writer of “Science Speaks,” discusses the Trump administration’s retention of U.S. Global AIDS Coordinator Ambassador Deborah Birx and NIH Director Francis Collins, at least temporarily. “The announcement was welcomed by global HIV research and response advocates, as well as domestic nonprofit patient and research advocacy organizations who had urged the incoming administration not to allow the momentum spurred by the leaders to be interrupted,” Barton notes. Barton also discusses hearings for Secretary of State nominee Rex Tillerson and HHS Secretary nominee Tom Price, as well as President Trump’s reinstatement of the Mexico City policy (1/23).

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Experts Discuss Election Of Next WHO Director General; Candidates Address Issues Surrounding Drug Affordability, R&D

Chatham House: Decision Time: Who Will Be the Next Leader of the World Health Organization?
“As the World Health Organization begins to produce a shortlist of candidates vying to lead it, David Heymann talks to Jeremy Farrar, Devi Sridhar, and Ilona Kickbusch [in this podcast] about the election of the next director general of the U.N. health agency” (1/23).

Infojustice.org: Candidates for Director General of the World Health Organization Outline Their Plans for Tackling Unaffordable Medicines and the Lack of Innovation in Priority Areas
Mike Palmedo, assistant director of American University’s Washington College of Law’s Program on Information Justice and Intellectual Property, discusses an open letter in which 18 civil society organizations asked the six WHO director general candidates to outline their plans for the future of WHO’s work in promoting a new system for equitable drug R&D. The post also contains links to each of the candidates’ responses (1/23).

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IntraHealth International Outlines 7 Global Health Issues To Track In 2017

Humanosphere: 7 global health issues to watch in 2017
Margarite Nathe, senior editor and writer for IntraHealth International, discusses seven global health issues the organization is tracking in 2017 including drug-resistant bacteria, potential complacency around HIV, reproductive health, Zika, vaccine development, shortages in the global health care workforce, and uncertainty around global health and international aid (1/23).

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From the Kaiser Family Foundation

Kaiser Family Foundation Releases Mexico City Policy Explainer

Kaiser Family Foundation: The Mexico City Policy: An Explainer
A new explainer from the Kaiser Family Foundation looks at the history of the Mexico City policy and its impact. “The policy requires foreign non-governmental organizations (NGOs) to certify that they will not ‘perform or actively promote abortion as a method of family planning,’ using funds from any source (including non-U.S. funds), as a condition for receiving U.S. government global family planning assistance and, as of Jan. 23, 2017, any other U.S. global health assistance…” (1/23).

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