KFF Daily Global Health Policy Report

In The News

Feed The Future To Focus On Innovation, Women, IPS Reports

“In the face of global climate change and currency devaluation, improved strategies are being used to combat high international poverty and malnutrition rates, and to increase global food security,” Inter Press Service reports, noting the launch last week of two new Feed the Future innovation labs. The news service highlights an annual progress report on the program. “According to the report, Feed the Future has met the majority of the goals it set for fiscal year 2012 in terms of who is receiving aid and how it is benefiting them,” the news service writes, adding, “Leaders at the organization say that they put more of an emphasis on providing food aid to women.” IPS notes, “By fiscal year 2013, Feed the Future hopes to see over 15 million rural households directly benefit from U.S. government intervention, over eight million people apply for technologies or management as a result of intervention, and over 13 million children under the age of five have access to U.S.-supported nutrition programs” (Hargis, 7/27).

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President Carter Congratulates Colombia On Eradicating River Blindness

“Former U.S. President Jimmy Carter today congratulated President Juan Manuel Santos and the people of Colombia for becoming … the first country in the Americas to eliminate river blindness and … the first country in the world to apply for and be granted verification of elimination of river blindness by the [WHO],” Global Dispatch reports. “Colombia’s achievement demonstrates that a future free from river blindness is possible for everyone in the Americas, and is an inspiration for the Carter Center’s recent commitment to not only control the spread of river blindness but to eliminate the disease wherever we are fighting it in Africa,” Carter said, the news service writes. The Carter Center “has led the campaign to wipe out the disease in Latin America through its Onchocerciasis Elimination Program of the Americas (OEPA),” Global Dispatch notes (Herriman, 7/29).

Onchocerciasis is “caused by a nematode worm transmitted by several species of black flies, from Africa, causing severe injuries to the skin and eyes and is the second leading cause of blindness worldwide,” Prensa Latina reports, noting, “At present there are 12 endemic outbreaks in five countries in Latin America and the Caribbean” (7/29). In a post on USAID’s “IMPACTblog,” Natalia Machuca, an infectious disease adviser at USAID, writes, “In the Americas, Ecuador is expected to be the next country to receive verification of elimination and Guatemala and Mexico are soon to follow. In the western hemisphere, only one remote area at the border between Brazil and Venezuela continues to be affected by river blindness” (7/29).

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Actress Charlize Theron, South African President Jacob Zuma Discuss AIDS Response

“Actress Charlize Theron has pledged her support in the campaign against AIDS during a meeting with South African President Jacob Zuma,” the Associated Press reports, noting, “Theron, an ambassador for the United Nations program on AIDS, met Zuma in Pretoria on Monday to discuss the fight against AIDS in South Africa and across the continent” (7/29). “Following the meeting on Monday, Zuma said Theron’s U.N. humanitarian role continued to give South Africa’s fight against HIV a big boost,” South African Government News Agency/TheSouthAfrican.com writes. “Flanked by Health Minister Dr. Aaron Motsoaledi and [UNAIDS Executive Director] Michel Sidibé, Zuma said South Africa needed to play a leading role in the fight against HIV on the continent,” the news agency adds (7/29). “In 2008, the United Nations named Theron, 37, as a Messenger of Peace, tasked with promoting efforts to end violence against women and other issues,” USA Today notes (Oldenburg, 7/29).

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India Continues To Use Dangerous Pesticides Banned In Most Countries

“Nearly a decade ago, the Indian government ruled out a ban on the production and use of monocrotophos, the highly toxic pesticide that killed 23 children this month in a village school providing free lunches under a government-sponsored program,” Reuters reports. “Although the government argues the benefits of strong pesticides outweigh the hazards if properly managed, the school food poisoning tragedy underlined criticism such controls are virtually ignored on the ground,” the news agency writes in an article examining the use of the pesticide and India’s need to feed its growing population. “According to the WHO, swallowing 1,200 milligrams — less than a teaspoon — of monocrotophos can be fatal to humans. In 2009, it called for India to ban the product because of its extreme toxicity,” Reuters states, noting, “WHO officials say the school tragedy reinforces the dangers of the pesticide.” The news agency adds, “But in the fields of rural India, pesticides like monocrotophos continue to be widely used” (Jadhav et al., 7/28).

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Physician Working To Raise Awareness Of, Action On Viral Hepatitis In Asia Pacific

Hundreds of millions of people are living with viral hepatitis in the Asia Pacific region, “but getting the disease on the health policy agenda of some of the worst affected countries has not been easy,” The Guardian’s “Global Development Professionals Network” blog reports. Robert Gish, co-founder of the Coalition to Eradicate Viral Hepatitis in Asia Pacific (Cevhap), “together with colleagues in Vietnam and from U.N. and other international agencies has been working to get hepatitis and liver health on the Vietnamese government’s health agenda,” the news service notes, describing a 2011 white paper that “spelt out the rationale for a dedicated policy for liver health in Vietnam.” Discussing Gish’s work in the Philippines, the blog writes, “Having become interested in hepatitis in Asia when treating Asian patients in his practice in San Francisco, Gish decided he could make a bigger impact on the disease by supporting colleagues to get it more widely recognized in Asia. His interest has spread to central Asia, another hepatitis hotspot, with a regional project underway in Armenia.” Gish said, “Every country I’ve worked with has different customs and problems, but what they have in common is a need to know their hepatitis epidemic, get government on board to find a solution, educate the population and have the right policy in place,” the blog notes (Parry, 7/28).

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The Guardian Profiles New Head Of U.N. Women

The Guardian profiles Phumzile Mlambo-Ngcuka, formerly the deputy president of South Africa, who “takes the helm next month at U.N. Women, a three-year-old agency still striving for enough funds, recognition and a chance to make its mark.” Mlambo-Ngcuka “replaces Michelle Bachelet, who resigned in March to run for another term as president of Chile, at a time when some perceive a global backlash against women’s rights,” the newspaper writes, adding, “Mlambo-Ngcuka arrives at the U.N. as the Millennium Development Goals (MDGs) near their culmination and debate begins in earnest on [the] development agenda after 2015 when the MDGs expire.” The Guardian quotes Mlambo-Ngcuka on a number of issues facing women today — including gender-based violence, cybercrime-related gender-based violations, and child marriage — as well as on the post-2015 agenda and the role of U.N. Women in reaching gender equality (Smith, 7/30).

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'Guardian Development Podcast' Discusses Issues Surrounding FGM

The Guardian’s most recent “Global Development Podcast” examines “the issues around female genital mutilation, including how many people are at risk, why the subject is taboo and what is being done to end it.” According to the podcast summary, the U.N. General Assembly in December “banned the practice,” but “globally, thousands of girls are still at risk.” Guardian contributor Liz Ford talks to Naana Otoo-Oyortey, executive director of the non-governmental organization (NGO) Foreward; Nimco Ali, co-founder of Daughters of Eve; and Bogaletch Gebre, founder and director of KMG Ethiopia, “about the difficulty of dealing with a practice that dates back generations and is considered by some to be a taboo subject,” the summary notes (7/29).

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Editorials and Opinions

'Enormous Determination, Hard Work' Necessary To Stamp Out Polio As Virus Resurfaces In Africa

“Only a few months ago, there was great optimism that polio was on the verge of eradication,” a Washington Post editorial states. But “[t]hose hopes now seem clouded by a poliovirus outbreak in Somalia and Kenya,” the newspaper writes, adding, “This year, there have been 81 cases in these two countries, more than the 59 cases in the three countries where polio remains endemic: Afghanistan, Pakistan and Nigeria.” Noting “[v]accination is the most critical tool in the battle against polio,” the newspaper discusses concern over “immunity gaps,” writing, “[S]ome 500,000 children in Somalia have not been vaccinated in several years, if at all. These vulnerable children are in areas largely outside the control of Somalia’s weak central government, and the fear is these regions could become a cauldron for poliovirus, fueling the outbreak for a long time.”

“In hopes of containing the virus, road posts are being set up along major corridors to vaccinate those going and coming from the remote areas, while fresh vaccination campaigns are targeting Mogadishu, the Somali capital,” the editorial continues. “The latest outbreak underscores how armed conflicts threaten populations not only with bullets but also with disease,” the newspaper writes, noting, “This is not the first outbreak of its kind.” The Washington Post highlights a polio outbreak on the continent in 2003 that “result[ed] in some 700 cases,” and states, “Lessons learned from that experience are being deployed in battling the current outbreak, and it is not likely to derail the global campaign for eradication. But the virus is demonstrating a dogged resilience, and it will take enormous determination and hard work to extinguish the latest scourge” (7/29).

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Global Community Must Work Together To Progress Against AIDS

Noting “[i]t’s been 13 years since the international community adopted the Millennium Development Goals [MDGs], an ambitious, self-imposed ‘report card’ for global development that helped focus attention and resources on issues like HIV and AIDS,” Jonathan Quick, president and CEO at Management Sciences for Health (MSH), and Jonathan Jay, bioethicist and senior writer at MSH, examine the global AIDS response and the future of global health in a Devex opinion piece. They highlight a “rapid scale-up” of antiretroviral therapy (ART), citing a recent UNAIDS report that found treatment today “reaches nearly 10 million,” up from just 300,000 in 2002, and note the WHO last month “revised its recommendations for developing countries to promote an earlier start to treatment.” They write, “‘Raising the bar’ to treat them all would substantially curb new HIV infections and would help bring the epidemic under control, but it’s a formidable task at a time when donor countries’ global health budgets are flatlining and new health priorities continue to emerge.”

“The global AIDS movement has got far to go, and to continue its progress, it must join counterparts to strengthen health systems in developing countries — a change of course for a movement that has been highly successful, often moving fastest when it moved alone,” they continue. They discuss the U.S. response through PEPFAR, highlight “deliberations around the Sustainable Development Goals, which will replace the MDGs when they expire in 2015,” and describe the need for better health systems for HIV care, writing, “Strengthening local health systems could be pivotal to achieving universal ART.” They conclude, “The next era of global health should not be defined by winners and losers, but by ambitious, systematic, country-led reforms that maximize health and eradicate poverty. … The ‘go fast’ era is over — with a long road ahead, the global health community must go together” (7/30).

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Pharmaceutical Companies Must Reduce Cost Of Hepatitis C Treatment

Noting July 28 was World Hepatitis Day, Azzi Momenghalibaf, program officer for the International Harm Reduction Development Program and Access to Essential Medicines Initiative at the Open Society Foundations, writes in the Huffington Post’s “Impact” blog, “Unlike cancer or HIV, hepatitis C is curable in the majority of cases. Unfortunately, cure has been hampered by the fact that the bulk of people living with hepatitis C reside in low- and middle-income countries where the main medicine used in the current standard of care — Pegylated Interferon-alfa (Peg-IFN) — is priced out of reach.” She discusses the high cost of treatment and how some countries, including Egypt and Thailand, have negotiated lower prices with the pharmaceutical companies that make the therapy, Merck and Roche. “To mark World Hepatitis Day this year, activists protested the high price of hepatitis C treatment at rallies in Russia, Armenia, Georgia, Ukraine, and Latvia. And in Asia, groups are preparing to ask Merck and Roche to drop the price to $1,000 USD a year,” she notes.

“So, this World Hepatitis Day, we stand in solidarity with civil society groups in low- and middle-income countries, and their governments as they mobilize in the fight for access to hepatitis C treatment,” Momenghalibaf writes. “Affordable access to life-saving medicines is a human right, and only when governments and pharmaceutical companies commit to making treatment available at fair prices, will we close the hepatitis C treatment gap,” she states, concluding, “If these companies continue to put profits before people, the hepatitis C epidemic will surge, and many more will unnecessarily die” (7/29). A “Graphic Detail” in The Economist presents a map comparing the number of deaths from HIV and viral hepatitis (7/29).

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From the Global Health Policy Community

New CGD Policy Paper Examines PEPFAR Funding

Writing in the Center for Global Development’s (CGD) “Global Health Policy” blog, CGD researchers Victoria Fan and Rachel Silverman describe a new policy paper that attempts to answer the questions, “Where does scarce PEPFAR funding go? Which countries and implementers receive the bulk of PEPFAR funds? And what factors influence PEPFAR’s allocation of resources across recipient countries?” They provide an excerpt of the abstract, as well as a table from the paper (7/29).

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Gates Foundation Blog Posts Discuss Global Family Planning Issues

Writing in the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog, Amie Newman, a communications officer at the foundation, highlights “a documentary about the recent Women Deliver conference — an event held in May of 2013, in Kuala Lumpur — which brought together 4,500 people from 149 different countries to talk about family planning globally,” and she discusses efforts in Malaysia, “which has successfully reduced the number of women who die from pregnancy- and childbirth-related conditions from 570 women for every 100,000 live births to only 29 in large part because of a dedication to expanding access to family planning” (7/29). In a separate family planning-related post, Lester Chinery, director of operations for the Concept Foundation and program director for the Quality of Reproductive Health Medicines program, and John Skibiak, director of the Reproductive Health Supplies Coalition (RHSC), reflect on last year’s London Summit on Family Planning, which they write “united civil society organizations, governments, private sector and foundations around the promise to provide 120 million more women in developing countries with access to contraceptives information, services and supplies by 2020.” They note “the formation of the new Family Planning 2020 (FP2020) global initiative” in the year since and highlight the Generic Manufacturers for Reproductive Health (or GEMS Caucus), “a select group of generic manufacturers that collectively distribute family planning products to more than 50 countries” (7/29).

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Report Examines Access Issues Surrounding Hepatitis C Treatment In Low-, Middle-Income Countries

A new report (.pdf) from the Open Society Foundations, titled, “Hepatitis C Treatment: Price, Profits, and Barriers to Access,” examines “the difference in price of a 48-week course of hepatitis C treatment in low- and middle-income countries, and detail[s] breakthroughs that have been made in countries like Egypt and Thailand to negotiate lower prices and increase access to this lifesaving medicine,” according to the report summary. The WHO “estimates that as many as 185 million people, or three percent of the world’s population, are infected with the hepatitis C virus,” the summary states, adding, “Though it is curable, the vast majority of people living with hepatitis C reside in low- and middle-income countries where treatment is virtually inaccessible” (Momenghalibaf, July 2013).

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Blog Describes Status Of Two Experimental TB Drugs

The Center for Global Health Policy’s “Science Speaks” blog reports on the status of two experimental drugs to treat tuberculosis. “On Friday, the European Medicines Agency issued a statement refusing authorization to market [the experimental drug] delamanid for treatment of drug-resistant tuberculosis, saying the benefits of delamanid ‘had not been sufficiently shown’ [in clinical trials] and ‘did not outweigh its risks,'” the blog notes. The Treatment Action Group (TAG) “responded to the agency’s decision with a statement calling it ‘myopic and deeply disappointing,'” the blog adds. “[E]arlier this month the Maryland-based pharmaceutical company Sequella announced that it had acquired rights to develop the lagging [experimental TB treatment] sutezolid from Pfizer, which had scaled back its work on drugs for infectious diseases,” the blog writes (Barton, 7/29).

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