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Kaiser Daily Global Health Policy Report

In The News

Impacts Of Expanded Mexico City Policy On Global Health Services, HIV/AIDS Efforts Unknown

The Atlantic: Will Trump’s Expanded Policy Against Abortion Harm HIV/AIDS Relief?
“[Last] week, the Trump administration moved forward with plans to withhold global health funding for [foreign] organizations that ‘perform or actively promote abortion’ abroad. This move revives an older policy that restricted funds for family planning organizations — groups that focus on things like contraception and maternal health — and goes further to apply to all global health funding. … [C]ritics say the revised version of the rule could do significant harm to PEPFAR, which has been called George W. Bush’s greatest legacy…” (Frankel, 5/19).

NPR: The Ripple Effect Of Cuts To U.S. Funds For Overseas Abortion Services
“…[The expanded policy] ‘has a bigger reach than it’s ever had before, and many of the organizations that could now be affected have never confronted it before,’ says Jennifer Kates, [vice president and] director of global health and HIV policy at the Henry J. Kaiser Family Foundation. … It’s difficult to assess the full impact of the expanded Protecting Life in Global Health Assistance plan, partly because it’s unclear whether other donors like the Bill & Melinda Gates Foundation (which is a funder of NPR) will fill any gaps that occur because of the new policy. It’s also not clear how many NGOs will comply with the new policy and how many will refuse to do so. But a Kaiser Family Foundation report looking at countries that got U.S. federal funding in 2016 notes that 37 countries allowed abortions in at least one circumstance that would violate the Mexico City policy…” (Shaikh-Lesko, 5/19).

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Leaked Trump Administration Budget Document Shows Cuts To U.S. Global Health, Humanitarian Efforts

Devex: Leaked U.S. budget document suggests deep humanitarian, global health cuts
“Yet another document that appears to outline the Trump administration’s budget intentions leaked on Friday. While the numbers are preliminary — the document is dated May 8, and the official White House budget is expected May 23 — the spreadsheet, if authentic, paints another grim picture of how the president views U.S. foreign assistance. … In addition to the food aid cuts, USAID’s international disaster assistance account is down … Global health accounts also face a big reduction if the official budget matches what is presented in the leaked document. … When the full budget proposal arrives Tuesday, it should be accompanied by a budget justification, which explains how the budget reflects the White House’s priorities. At that point the U.S. development community could get a clearer picture of the president’s views on global development’s role within U.S. foreign policy…” (Saldinger/Igoe, 5/19).

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HHS Secretary Price In Liberia To Promote Global Health Security

Newsweek: Ebola: Three Reasons Why Trump’s Health Secretary Is In Liberia
“…Dr. Tom Price, the secretary of Health and Human Services appointed by Trump in February, [visited Liberia last week]. While Liberia, a country of 4.5 million people with a GDP of just $2 billion, may not carry much international clout, there are three good reasons why the Trump administration may wish to bolster a longtime U.S. ally. 1. It Was the Epicenter of the Ebola Outbreak … 2. The U.S. is a Major Investor in Liberia … 3. Liberia is Threatened By Other Diseases…” (Gaffey, 5/19).

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WHO Member States To Cast Ballots For New Director General In Tuesday Election

Associated Press: 3 vie for top WHO post in U.N. health agency election
“A British physician, an Ethiopian former health minister, and a Pakistani expert in non-communicable diseases are the three finalists vying for the top job at the World Health Organization in an election on Tuesday, aspiring to land a key U.N. post that confers great power to set worldwide medical priorities — and great responsibility as the world’s go-to person when emergencies like Ebola, Zika, and SARS strike…” (5/20).

BBC News: Wanted: Top doctor to care for 7 billion people
“…Health ministers and officials from 194 countries are due to vote for a new director general of the World Health Organization in Geneva on Tuesday. … The new boss could make or break the WHO, which is still trying to prove it is fit for purpose after admitting it was slow to respond to what became the worst Ebola outbreak in history…” (Mazumdar, 5/21).

Devex: What we know as WHO heads into historic election
“…The director general, though bound by what member states want, still carries a weight of influence and authority in setting priorities, providing the right policies and guidance for important global health issues, and maneuvering a cadre of global health experts in addressing health threats and emergencies. He or she can choose to use the high-profile role to be an outspoken advocate, making the case for global health with publics around the world and pushing back on member states’ demands in order to control and reform the unwieldy agency…” (Ravelo, 5/19).

STAT: Behind closed doors, WHO prepares to elect its next leader
“…This election — the first time the WHO’s entire membership will be involved in selecting a director general — involves secret balloting. Few if any countries have tipped their hands about how they are casting their votes. … The U.S. government has not indicated who it is supporting for WHO director general…” (Branswell, 5/22).

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Taiwan Locked Out Of World Health Assembly; Taiwanese Health Minister In Geneva To Attend Bilateral Meetings

Associated Press: China warns Taiwan of continued lockout from WHO assembly
“China’s health minister has all but slammed the door on any more participation for Taiwan at the World Health Organization’s annual assembly until the island’s government accepts the ‘One China’ principle…” (Keaton, 5/22).

Reuters: Interview: Shut out of U.N. forum, Taiwan slams China’s ‘coercion and threats’
“Taiwan hopes its allies will stand up to China’s ‘coercion and threats’ that have shut it out of the U.N.’s annual World Health Assembly (WHA), Taiwanese Health Minister Chen Shih-chung told Reuters on Saturday. Thousands of delegates from the World Health Organization’s 194 members will attend the Geneva meeting this week, but Chen’s delegation and Taiwanese media are barred from entry…” (Miles, 5/21).

Taiwan News: Taiwan’s minister of health to attend bilateral meetings during WHA
“Taiwan’s Minister of Health and Welfare Chen Shih-chung has arrived in Geneva last Saturday and will attend bilateral meetings during the World Health Assembly (WHA) despite the exclusion from the summit…” (Chang, 5/22).

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Associated Press Examines WHO's Travel Expenses

Associated Press: AP Exclusive: Health agency spends more on travel than AIDS
“…According to internal documents obtained by the Associated Press, the United Nations health agency routinely has spent about $200 million a year on travel expenses, more than what it doles out to fight some of the biggest problems in public health, including AIDS, tuberculosis, and malaria combined. … At a time when the cash-strapped health agency is pleading for more money to fund its responses to health crises worldwide, it has struggled to get its travel costs under control. … In a statement to the AP, the U.N. health agency said ‘the nature of WHO’s work often requires WHO staff to travel’ and that costs were reduced 14 percent last year compared to the previous year — although that year’s total was exceptionally high due to the 2014 Ebola outbreak in West Africa…” (5/22).

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G20 Health Ministers Agree To Address Drug Resistance, Strengthen Health Systems To Improve Outbreak Preparedness

Intellectual Property Watch: No Free Lunch, G20 Health Ministers Find At First Meeting
“Group of 20 health ministers [Saturday] finished their first joint table top exercise to simulate the outbreak of a new deadly viral pandemic in ‘Anycountry’ and passed a seven-page final resolution on pandemic preparedness and antimicrobial resistance. Non-governmental experts and health organizations welcomed the first-ever meeting of health ministers in the G20 format, but see a risk of framing the debate from a global North security perspective. And despite a call of urgency with regard to antimicrobial resistance, the G20 could not agree to include the de-linking of the cost of investment in R&D from the price of medical products…” (Ermert, 5/20).

Reuters: G20 health ministers agree to tackle antibiotics resistance
“Health ministers of the G20 leading economies, meeting for the first time on Saturday, agreed to work together to tackle issues such as a growing resistance to antibiotics and to start implementing national action plans by the end of 2018. … Saying that globalization caused infectious diseases to spread more quickly than previously, the 20 nations also pledged to strengthen health systems and improve their ability to react to pandemics and other health risks…” (Heller/Chambers, 5/20).

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The Guardian Examines Foreign Aid, Development Aspects Of U.K. Political Party Manifestos Ahead Of June 8 Election

The Guardian: What the U.K. election will mean for aid and development: key manifesto vows
“Britain will go to the polls on 8 June with aid and development spending under unprecedented scrutiny. Two years after the U.K. became the first major economy to meet the U.N. target of devoting 0.7 percent of gross national income to aid, the Whitehall vultures are circling. Government departments including the Ministry of Defence and the Foreign Office are casting covetous glances at the £12bn aid budget, while allegations of wasteful spending on contractors and ill-conceived projects have fueled wider criticism. How are the main parties planning to negotiate this political minefield? Outlined below are the key commitments on aid and development contained in the Conservative, Labour, and Liberal Democrat manifestos…” (Ratcliffe, 5/19).

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37 Suspected Ebola Cases Reported In DRC Outbreak; WHO Africa Director 'Very Encouraged' By Response

Reuters: Fourth person in probable Ebola death in Congo: WHO
“A fourth person has likely died from Ebola in remote northeastern Democratic Republic of Congo, the World Health Organization said on Sunday, as the overall number of cases rose to 37 from 29…” (Ross, 5/21).

VOA News: WHO Optimistic on Controlling DRC Ebola Outbreak
“…While not underestimating the difficulties that lie ahead in bringing this latest outbreak of Ebola to an end, [WHO’s Africa Regional Director] Matshidiso Moeti told VOA she is ‘very encouraged’ by the speed with which the government and its national and international partners have responded to this crisis…” (Schlein, 5/21).

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Yemen's Cholera Outbreak Spreading At 'Unprecedented' Rate, WHO Official Says

U.N. News Centre: Cholera outbreak in war-torn Yemen spreading at ‘unprecedented’ speed, U.N. warns
“As war-torn Yemen grapples with heavy rains, a collapsed health care system, and crippled economy, a resurgent cholera outbreak has spread with ‘unprecedented’ speed and taken medical professionals by surprise, the World Health Organization warned Friday…” (5/19).

United Press International: Cholera outbreak spreading at ‘unprecedented’ speed kills 315 in Yemen
“…More than 29,300 suspected cases have been reported in 19 of the country’s 22 provinces, the agency posted on Twitter. The highest number of likely cases — more than 6,000 — are in the capital city, Sana’a, where the Houthi government declared a state of emergency one week ago…” (5/21).

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Editorials and Opinions

Editorial, Opinion Piece Discuss Election For Next WHO Director General

Financial Times: The challenge that awaits a new leader of the WHO
Editorial Board

“…[W]hen officials gather in Geneva this week to select a new leader for the U.N. agency, they should take their vote seriously: the outcome matters deeply. … [U]nless the new director general is able to overhaul the WHO’s sclerotic bureaucracy, focus its work on priorities, and stand up to national governments and industry lobbies, the agency’s role will gradually dwindle. … Unless [the new leader tackles certain] challenges, the agency’s government funders may lose faith and cut financial support. That would increase its unhealthy dependence on a few backers such as the Bill & Melinda Gates Foundation. It could also trigger some countries to turn inwards or build up bilateral networks, which do not always serve the global interest. Whichever candidate is elected, governments should hold the winner to account and offer him or her the support they will need to deliver” (5/21).

Huffington Post: This World Health Organization Leadership Election Is Crucial, And It’s Getting Ugly
Ezekiel J. Emanuel, chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania

“…The race has boiled down to a contest between Dr. Tedros Adhanom Ghebreyesus of Ethiopia and Dr. David Nabarro of Britain. … [Last week,] Larry Gostin of Georgetown Law School, a frequent WHO consultant and prominent global health scholar, released an unsubstantiated charge against Tedros. He claimed Tedros and the Ethiopian government covered up cholera outbreaks going back to 2006, calling them acute watery diarrhea. … It is unclear why a decade-old charge was launched only in the waning days of the WHO campaign. … Whatever the basis of Gostin’s charge, all global health experts agree that because of the community health care workers and other programs initiated by Tedros, Ethiopia has made dramatic improvements in infant and maternal mortality, malaria mortality, immunization rates, and childhood nutrition. … We should not let rumor and political ‘dirty tricks’ launched without time for careful consideration to sway such an important vote. It is finally time for an African — especially one of Tedros’ tremendous achievements — to head the WHO” (5/19).

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Prevention Should Be Key Objective Of U.S. Foreign Assistance, National Security Strategy

CNN: What’s the real value of U.S. foreign aid?
Mina Chang, chief executive officer of Linking the World and international security fellow with New America

“…There are a lot of misconceptions about the value of foreign aid, at times seen as some form of naïve humanitarianism. But modern foreign aid is not charity. It is strategic and an investment in a stronger America abroad. … America has benefited from its leadership in the world, and in an increasingly interconnected society, we should continue to make investments in our shared future. An unstable world is not good for the United States. ‘America First’ must not be a zero-sum strategy. … A real cost calculus actually shows that cutting funds for resilience-building solutions would inevitably sacrifice more with blood, through military intervention, when a conflict hits a boiling point; or toward emergency and disaster response when there are food shortages, refugee influxes, and health epidemics. … Today’s funding challenges carry an opportunity to start the changes that practitioners have wanted for decades. Yes, we must win the wars we engage in and continue to have the strongest military in the world. But we cannot continue operating in civilian/military silos or relying on hard power alone. But for this to work, prevention must be the objective key part of our national security strategy. Then, and only then, will aid no longer be seen as charity — but as an essential, modern tool of U.S. national security, and an investment in our economic prosperity” (5/20).

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New Research Project Provides Donors, Haiti's Government With List Of Development Priorities

Project Syndicate: Changing the Narrative About Haiti
Bjørn Lomborg, visiting professor at the Copenhagen Business School and director of the Copenhagen Consensus Center

“…Focusing on the problems … tells us little about where donors or Haiti’s government could make the biggest difference. A new research project, Haïti Priorise, funded by the Canadian government and led by … the Copenhagen Consensus, does just that, by generating data about the most powerful opportunities to boost prosperity and health for generations. … In their top-ten list are six proposals that would take advantage of the short window before and after birth when the largest difference to a child’s life can be made. … The panel’s findings reveal powerful, lasting benefits from investments that focus on a child’s earliest and most crucial years. But ensuring that those children can one day contribute meaningfully to Haiti requires improving conditions for doing business. Many people believe the biggest barrier to the economy is the lack of reliable electricity. The eminent panel’s top-ranked proposal is to reform the public utility, Electricité d’Haïti (EDH). … [Haïti Priorise] provides NGOs and government officials with the intellectual ammunition to advocate for more funding for effective solutions, and it gives donors and elected officials a wealth of data on which to base tough decisions. Prioritizing problems, and then focusing on the most effective solutions, is a narrative that would benefit every country” (5/19).

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From the Global Health Policy Community

Joint Analysis Examines Trump Administration's FY18 Budget Blueprint, Implications For U.S. Development Aid

Center for Global Development’s “U.S. Development Policy”: U.S. Already $26 Billion Short of ‘Fair Share’ Standard for Development Aid
Scott Morris, senior fellow and director of the U.S. Development Policy Initiative at CGD, and Isaac Shapiro, senior fellow at the Center on Budget and Policy Priorities, discuss a joint analysis on the Trump administration’s FY18 budget blueprint released in March. They examine the potential implications of the proposed cuts to foreign aid programs, writing, “[I]f President Trump truly wants countries to pay their ‘fair share,’ then the United States has some considerable stepping up to do under a reasonable approximation of this standard. Unfortunately, the president’s budget is a big step in the wrong direction” (5/19).

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Blog Post Discusses Future Of U.S. Role In Financing Global Health

APHA’s “IH Blog”: What’s next for U.S. global health funding?
Jean Armas, program coordinator at Global Strategies, discusses the future of U.S. global health funding, writing, “The bipartisan deal reached by Congress [to keep the U.S. government funded through the end of September] provides a small glimmer of hope that Trump’s proposed cuts [for FY18] may be dead on arrival, but in such an unpredictable political climate, our collective cynicism is teaching us to expect the unexpected” (5/16).

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Bill Gates Outlines How Promoting Health, Development 'Keeps Americans Safe'

Gates Notes: Foreign Aid Keeps Americans Safe
Bill Gates, co-chair of the Bill & Melinda Gates Foundation, discusses how promoting health and development “keeps Americans safe,” including through “preparing for the next epidemic … stabilizing vulnerable countries … [and] shoring up national security” (5/18).

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Expanded Mexico City Policy Threatens Free Speech, Women's Health

ACLU: Trump’s Version of the ‘Global Gag Rule’ Threatens Global Health and Free Speech
Esha Bhandari, staff attorney with the ACLU Speech, Privacy, and Technology Project, and Georgeanne M. Usova, legislative counsel at the ACLU’s Washington Legislative Office, discuss the potential implications of the Trump administration’s expansion of the Mexico City policy, writing, “[W]ith this policy, the administration is not only trying to control the flow of information — an unworthy goal for the U.S. government and contrary to the values of the First Amendment — but also threatening the health and lives of women and families across the globe” (5/19).

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FT Health Discusses Recent Research Pledge, Features Interview With Head Of UNFPA

FT Health: Research pledge must go further
The latest issue of the Financial Times’ weekly global health newsletter discusses a pledge made last week by leading funders and researchers to publicly register and publish the results of all their clinical trials. The newsletter also features an interview with Babatunde Osotimehin, executive director of the United Nations Population Fund (UNFPA), on the agency’s work and the U.S. decision to stop funding UNFPA. In addition, FT Health provides a roundup of other global health-related news stories (Jack/Dodd, 5/19).

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