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Kaiser Daily Global Health Policy Report

In The News

Global Health Experts Approach Trump's Budget Blueprint Language Regarding PEPFAR Funding With Caution

Devex: Is PEPFAR a Trump budget winner? Not so fast…
“Global health leaders in the United States are urging development advocates to think twice before declaring international HIV and AIDS programs safe from President Donald Trump’s pursuit of sweeping foreign affairs budget cuts. … The relevant budget text says the president’s spending plan — which is expected to arrive with greater detail sometime in May — ‘provides sufficient resources to maintain current commitments and all current patient levels on HIV/AIDS treatment under [PEPFAR].’ … U.S. global health experts say the budget language is too vague to warrant too much optimism, and the integration of global health and development programs means that cuts in other areas could still harm efforts to achieve an AIDS-free generation. ‘On the one hand, the skinny budget — which does not have a lot of detail — does call out PEPFAR, and I think that’s an intentional signal, which is good for PEPFAR,’ said Jen Kates, vice president and director of global health & HIV policy at the Kaiser Family Foundation. ‘On the other hand it is not specific about any funding amount,’ she added…” (Igoe, 3/24).

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Foreign Policy Articles Examine How Trump Administration's Proposed FY18 Budget Outline Would Affect U.N. Funding, Aid To African Nations

Foreign Policy: Trump Administration Eyes $1 Billion in Cuts to U.N. Peacekeeping
“The White House is seeking to cut $1 billion in funding for U.N. peacekeeping operations and to eliminate hundreds of millions of dollars for other U.N. programs that care for needy children and seek to lift the world’s poorest out of a life of grinding poverty, according to two diplomatic sources briefed on the plan. … The White House budget office informed State Department officials this week that the administration plans to eliminate all U.S. funding to the … International Organizations and Programs account, which provides [funding to UNICEF and the U.N. Development Programme]…” (Lynch/Hudson, 3/23).

Foreign Policy: Trump’s America First Budget Puts Africa Last
“…Sub-Saharan Africa is grappling with record levels of displacement and hunger due to conflict and drought, but President Donald Trump is proposing ‘deep cuts to foreign aid’ that would hit this continent the hardest. … Until the Trump administration submits a more detailed budget proposal in May, it’s impossible to say which programs will be hit the hardest. Given that much of the State Department and USAID budget is fixed, however, it’s their discretionary spending on development and humanitarian relief that’s likely to get the chop, according to former USAID officials. … Although the budget is unlikely to pass in its current form, it sends a powerful message to one of the world’s most aid-dependent regions that the Trump era will be anything but business as usual…” (McCormick, 3/22).

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New TB Drugs Risk Becoming Ineffective If Misused, Lancet Report Warns

CIDRAP News: Report warns of rise in drug-resistant tuberculosis
“A new report warns that some of the incremental progress made in the global fight against tuberculosis (TB) could be lost with the emergence and spread of drug-resistant strains of the disease…” (Dall, 3/23).

Humanosphere: Emerging epidemic of multidrug-resistant TB ‘threatens decades of progress’
“…According to the report published in [The Lancet Respiratory Medicine] ahead of World TB Day (March 24), roughly one in five cases are now resistant to at least one major anti-TB drug. About five percent of all cases are considered ‘multidrug-resistant’ — to two vital first-line drugs, isoniazid and rifampicin — or ‘extensively drug-resistant’ — to fluoroquinolones and second-line injectable drugs as well…” (Lu, 3/23).

Inter Press Service: New Tuberculosis Drugs May Become Ineffective: Study
“…Multidrug-resistant tuberculosis reflects the meeting of an ancient and under-addressed disease — tuberculosis — with an emerging modern threat — antimicrobial resistance. The inappropriate use of antibiotics, including taking them without prescription or not following doctor’s orders closely is slowly rendering many antibiotics useless…” (Rowlands, 3/24).

VOA News: On World Tuberculosis Day, Doctors Warn Of New Drug-Resistant Bacteria
“…The report warns the new drugs must be prescribed as individually targeted treatments with clear dosing guidelines, to prevent further resistant TB strains from emerging…” (Ridgwell, 3/24).

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Overcoming Barriers Of Stigma, Marginalization Of TB Patients Vital To Ending Disease, WHO Says

VOA News: Protecting Rights of TB Patients Critical in Ending Global Epidemic
“In advance of World TB Day (March 24), the World Health Organization is warning the battle to wipe out the global tuberculosis epidemic will not be won unless stigma, discrimination, and marginalization of TB patients is brought to an end. VOA was in Geneva at the launch of new WHO ethics guidance for the treatment of people with tuberculosis. … The agency says protecting the human rights of all those affected will save many lives and will make it possible to end this global scourge” (Schlein, 3/23).

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News Outlets Examine Efforts To Prevent, Treat TB In Southeast Asian Nations

CNN: What happens when health care is scarce and TB rates are high
“…TB is now the leading cause of death by an infectious disease, globally, and Cambodia has among the highest rates in the world, with 380 people estimated to be infected per 100,000 in the population in 2015. … [S]ince the end of the civil war more than 15 years ago, great efforts have been made to get the country back on track, with marked progress in terms of TB control. … But having seen the decline, external donors have begun to extract themselves, said [Jamie Tonsing, South-East Asia regional director for the International Union Against Tuberculosis and Lung Disease], believing the national government should now be able to handle the burden, leaving doctors in the region worried that progress made over the past few decades could soon be reversed…” (Senthilingam, 3/24).

The Lancet: New plan to end tuberculosis in South and Southeast Asia
“…11 countries in the South and Southeast Asia — India, Bangladesh, Bhutan, Nepal, Sri Lanka, Maldives, Indonesia, Thailand, Myanmar, North Korea, and Timor-Leste — constitute WHO’s South-East Asia Region and account for almost half the global burden of tuberculosis while being home to 26 percent of the global population. … [H]ealth ministers of these countries committed at a high-level meeting in Delhi, India (March 15-16), to a set of national and regional actions to expedite the fight against tuberculosis. … The New Delhi meeting comes ahead of a WHO Global Ministerial Conference on the fight against tuberculosis in Moscow and the U.N. General Assembly meeting on tuberculosis later this year” (Sharma, 3/25).

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In Coordinated Effort, 13 African Nations Aim To Vaccinate More Than 115M Children Against Polio Next Week

Associated Press: U.N. aims to immunize more than 115 million kids against polio
“The World Health Organization says it’s aiming to vaccinate more than 115 million children against polio across Africa next week, in its continuing bid to wipe out the crippling disease. In a statement Thursday, the U.N. health agency said all children under five are being targeted by more than 190,000 vaccinators in 13 Central and West African countries, including Nigeria, Congo, and the Central African Republic…” (3/23).

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Gates Foundation, Others Look To Provide Medical Research Findings Free-Of-Charge, More Quickly

The Economist: The findings of medical research are disseminated too slowly
“On January 1st the Bill & Melinda Gates Foundation did something that may help to change the practice of science. It brought into force a policy, foreshadowed two years earlier, that research it supports (it is the world’s biggest source of charitable money for scientific endeavors, to the tune of some $4bn a year) must, when published, be freely available to all. On March 23rd it followed this up by announcing that it will pay the cost of putting such research in one particular repository of freely available papers. … One criticism, in a world where most non-commercial scientific research is sponsored by governments, is that there should be no further charge for reading the results of taxpayer-funded work…” (3/25).

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Editorials and Opinions

U.S. Global Health Leadership, Funding Encourages Other Nations To Prioritize Public Health Policies, Spending

Washington Post: When the U.S. funds global health, other countries do too
Amy S. Patterson, professor of politics at University of the South in Sewanee, Tenn.

“…Public health experts say that cuts to U.S. global health funding … threaten the health of U.S. citizens, since pathogens such as Zika, influenza, and Ebola can cross borders. For other policymakers and advocates, it is morally unjustifiable to cut health programs that save millions of lives. My research on the politics of health in Africa shows another benefit. U.S.-funded programs interface with domestic politics to create incentives for governments to take action on health issues. … Global health programs — supported by U.S. and other donor countries — helped leaders to prioritize health … Global efforts establish the expectation that governments should promote health. Funding and technical assistance from Western donors, U.N. agencies, and NGOs empower national efforts. … Global health for all depends on getting these politics right” (3/21).

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U.S. Must Protect 'Critical Investments In Women's Health Globally'

Huffington Post: From Here To Uganda: Why U.S. Leadership On Reproductive Rights Matters
Seema Jalan, executive director at the Universal Access Project

“…Unprecedented efforts are under way to roll back gains in sexual and reproductive health and rights around the world. The U.S. administration’s January reinstatement and dramatic expansion of the [Mexico City policy] will make it more difficult for millions of girls and women to access the contraception and health care they need. Just last week, the president’s proposed budget outlined slashed funding for the United Nations, which would drastically impact U.N. agencies providing humanitarian assistance — including reproductive health and family planning — across the globe. … This impact is not limited to women and girls. Access to reproductive health care and family planning generates a ripple effect, creating healthier and more prosperous families, communities, societies, and economies. Now is the time to build on progress, not to reverse it. We can support the dreams of millions of girls and women … but only if the U.S. protects critical investments in women’s health globally” (3/23).

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New Global Leadership Must Redouble Efforts To Achieve NTD Elimination

PLOS Neglected Tropical Diseases: Will a new 2017 global leadership commit to NTDs?
Peter J. Hotez and Serap Aksoy, editors in chief of PLOS Neglected Tropical Diseases

“…At the start of 2017 we will see new leadership at the U.N., WHO, and the U.S. and U.K. governments. Together with the World Bank and other U.N. agencies, there will be a need to regroup, refocus, and redouble global efforts towards NTD elimination. A multipronged and multinational approach will be required that includes expanding [mass drug administration (MDA)], advancing additional disease elimination targets, and creating an ambitious R&D agenda. So far, the U.S. and U.K. governments together with the governments of Japan, Germany, the Netherlands, and the E.U. have been mostly alone in providing external funds for the NTD programs. This situation must change to a broader G20 remit, hopefully through an expansion in NTD support and activities initiated by the new global leaders in 2017” (3/23).

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U.S. Government Should Commit More Funding, Scientific Research To TB Diagnosis, Treatment

Forbes: World TB Day — How Budget Cuts Threaten Progress In Tuberculosis Globally
Judy Stone, Forbes contributor and infectious disease specialist

“…For the first time in 40+ years, new drugs are being tested in major Phase III clinical trials against MDR (multidrug-resistant) and XDR (extensively drug-resistant) TB. But without pharma and governments stepping up more, it won’t be enough to help most of those in need, given price and access issues. … With Trump’s proposed budget, slashing [funding] from NIH, and vast sums from foreign aid and other services, these trials will likely be victims of his administration’s mistaken priorities. … [T]o have the U.S. government pull back from their important support in this area now would be incredibly short-sighted and misguided. … We have seen what can be accomplished when a concerted effort is made, with sufficient funding, to tackle a major infectious disease. HIV/AIDS has been transformed from a death sentence to being a chronic, but controllable condition. While this success is the result of many different actors, few would argue that PEPFAR, NIAID, and the U.S. government’s significant support for this cause played a large role. … The U.S. government should recall this and commit the same type of sustained funding and scientific effort to control tuberculosis…” (3/24).

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Ensuring Migrants Have Access To HIV, TB Treatment Critical To Reversing Epidemics In Eastern Europe, Central Asia

Huffington Post: The Shifting Diplomacy around Migration, HIV/AIDS, and Tuberculosis in Central Asia
Michel Kazatchkine, U.N. special envoy for HIV/AIDS in Eastern Europe and Central Asia

“…To reverse the rising HIV and [multidrug-resistant TB (MDR-TB)] epidemics, the [Eastern Europe and Central Asia] region will need to move forward on a number of fronts: Firstly, there must be a halt to the deportation of migrants based on health status in the countries where it is still in practice. Currently, in too many instances in the region, a diagnosis of TB, MDR-TB, or HIV means deportation, a practice that is widely known to be ineffective to public health, violate human rights, and may lead to drug-resistant forms of infection. Secondly, the region needs to ensure migrants have access to HIV services, including ART, and to full course TB/MDR-TB treatment in the host country. It will be vital that a funding mechanism be established to cover HIV and TB treatment costs for migrants who choose to stay in the host country to be treated. Lastly, national and regional responses around infectious diseases like HIV and TB urgently need to be reviewed to include migrants as a vulnerable group. It is no exaggeration to say that unless we see collective movement around the above fronts, all the ingredients of a brewing regional public health crisis will continue to bubble away” (3/23).

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From the Global Health Policy Community

Ensuring Investments In TB R&D Critical To Confronting Drug Resistance

PLOS Blogs’ “Speaking of Medicine”: Why Tuberculosis is an R&D priority
On World TB Day, which takes place annually on March 24, Grania Brigden, lead of the 3P Project at the International Union Against TB and Lung Disease, discusses the importance of developing new treatments for TB and highlights a new funding mechanism, the 3P Project, which aims to “incentivize collaboration research, reward investment in TB R&D, and develop shorter [TB treatment] regimens” (3/24).

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'Science Speaks' Examines CDC Report On Foreign-Born Individuals Diagnosed With TB

Center for Global Health Policy’s “Science Speaks”: CDC: Domestic TB data shows need to expand screening, testing, treatment reach
Antigone Barton, senior editor and writer of “Science Speaks,” discusses findings from a recent CDC report that says the number of foreign-born individuals diagnosed with TB more than 10 years after their arrival in the U.S. exceeds the number of foreign-born individuals diagnosed within 10 years of their arrival. Barton writes, “The findings … indicate [the need] to make screening and testing for tuberculosis infection and illness routine among people whose risks are higher, and to expand those efforts beyond current public health programs into private practice and community care settings” (3/23).

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CGD Blog Post Discusses Reductions In Global Poverty

Center for Global Development’s “Views from the Center”: Really, Global Poverty *Is* Falling. Honest.
Charles Kenny, senior fellow at CGD, discusses a Humanosphere piece by Martin Kirk and Jason Hickel that was written in response to the annual Gates letter and addresses the status of global poverty. Kenny discusses global poverty measures and writes, “So, by the most common international definition (adopted by the United Nations), poverty has been cut by more than half since 1990. That poverty line is surely too low as a measure of what we would like to see as the minimum quality of life worldwide, but under pretty much any income definition of a poverty, the proportion of the world living under that line has declined since 1990 as incomes have grown for the vast majority of humanity. And that’s a clear sign that global poverty has been falling — not increasing dramatically” (3/23).

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From the U.S. Government

CDC Recognizes World TB Day, Commits To Eliminating Disease In U.S. With Expanded Domestic, International Initiatives

CDC’s “Morbidity and Mortality Weekly Report”: World TB Day — March 24, 2017
World TB Day is recognized each year on March 24, which commemorates the date in 1882 when Dr. Robert Koch announced his discovery of Mycobacterium tuberculosis, the bacillus that causes tuberculosis (TB). … In 2017, for the second year, CDC will join the global Stop TB Partnership in adopting the World TB Day theme ‘Unite to End TB.’ … CDC is committed to eliminating TB in the United States. This will require expanded initiatives, both in the United States and globally…” (3/24).

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