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Kaiser Daily Global Health Policy Report

In The News

Trump Administration's FY18 Health Budget Proposal Posted Online Shows Cuts To Health Agencies Similar To 'Skinny Budget' Released In March

BuzzFeed News: Trump Budget Plan Calls For Cuts To Medicaid And Public Health Agencies
“The Trump administration’s health budget, mistakenly put online Monday afternoon, calls for hundreds of billions of dollars in new cuts to Medicaid and [cuts] for many health science agencies…” (McLeod, 5/22).

STAT: Trump budget proposes massive cuts to Medicaid, science, and biomedical funding
“…The National Institutes of Health’s budget would be reduced … from 2017 spending levels to $26 billion. The National Cancer Institute would receive $4.47 billion… As with the skinny budget, the new proposed budget eliminates an NIH program, known as the Fogarty International Center, that promotes medical research overseas. The Centers for Disease Control and Prevention would get [$5.1 billion] … It’s possible the budget proposal briefly posted on Monday could still change…” (Robbins et al., 5/22).

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World Health Assembly Opens In Geneva; Member States To Elect New DG, Address Budget, Outbreak Preparedness, Other Issues

Agence France-Presse: Reform on the menu as WHO votes for new chief
“The World Health Organization’s 194 members on Tuesday choose among three candidates to replace Margaret Chan as global health supremo, with each pledging to reform an agency under scrutiny…” (5/23).

CIDRAP News: WHA hears Chan’s farewell, prepares to pick new WHO head
“…About 3,500 delegates from the WHO’s 194 member states, many of them health ministers, are at the WHA, the decision-making body of the WHO. The meeting runs through May 31. Topics will include the WHO’s budget for 2018-19, emergency response programs and policies, the International Health Regulations, and pandemic influenza preparedness. Discussions will also cover polio, antimicrobial resistance, access to medicines and vaccines, and improving vector control…” (Schnirring, 5/22).

Global Health NOW: #WHA70’s Opening Day: Not Quite All Together
“…One opening speaker even quoted Alexandre Dumas’s Three Musketeers: ‘One for all and all for one!’ While the meeting kicked off in that spirit, things went south pretty quickly. The routine selection of the president of the Assembly president drew an angry response from the Ukrainian delegation. When Veronika Skvortsova, Russia’s minister of health, was nominated for the position, Ukraine’s delegate rejected the proposal because of Russia’s actions in Ukraine. … Skvortsova was elected by acclamation…” (Simpson, 5/22).

Global Health NOW: Inside the WHO Director-General Election
“Though puffs of white smoke won’t be used to signal a decision, Tuesday’s election of director general of WHO has all the secrecy and drama of a Papal conclave. Having wrapped up their globetrotting campaigns, the three finalists — Tedros Adhanom Ghebreyesus, David Nabarro, and Sania Nishtar — have one last pitch to make to the member states on Tuesday morning to the 70th World Health Assembly…” (Simpson, 5/22).

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Margaret Chan Gives Final Keynote Address As WHO Director General, Defends Agency's Relevancy

Agence France-Presse: Outgoing WHO chief says world ‘better prepared’ for health crises
“The World Health Organization’s outgoing chief Margaret Chan defended her legacy Monday, insisting the world had become better prepared to face health emergencies like Ebola on her watch…” (Larson, 5/22).

Associated Press: AP Exclusive: Outgoing WHO head practiced art of appeasement
“…During her decade-long tenure as WHO’s leader, Chan has often described herself as a ‘servant’ of the agency’s 194 member countries. She says she accomplishes more with stern, behind-the-scenes diplomacy than with public criticism. But confidential notes detailing her work trips show that even in private, Chan, whose successor will be chosen Tuesday, sometimes was more inclined to appease heads of state than to challenge them on health issues…” (Cheng, 5/23).

Devex: In final speech, Chan argues against irrelevance
“In her last opening speech before the World Health Assembly on Monday, Director-General Margaret Chan paid homage to her decade in office, but also fought to dispel notions of WHO’s irrelevance. ‘The facts tell a different story,’ she said. ‘We falter sometimes, but we never give up’…” (Ravelo, 5/23).

U.N. News Centre: In final address, U.N. health chief urges world body to ‘remember the people’ behind the facts and figures
“[Chan] highlighted the relevance of the World Health Organization (WHO), and offered its decision-making body parting advice that included protecting scientific evidence, pushing for innovation, and thinking of people in every decision that is taken. ‘Remember the people,’ WHO Director-General Margaret Chan told the 70th World Health Assembly in Geneva. ‘Behind every number is a person who defines our common humanity and deserves our compassion, especially when suffering or premature death can be prevented’…” (5/22).

VOA News: Outgoing WHO Director Says Agency Remains Relevant
“…Chan’s tenure as head of WHO will soon end and after 10 years of service, she appears intent on handing her successor, who will be elected Tuesday, an organization that is viable and remains the essential leader in global health…” (Schlein, 5/22).

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After Lobbying For WHA Invitation, Taiwan Officially Locked Out Of Meeting; U.S. Secretary Of Health Voices Support For Taiwan's Attendance

Associated Press: Taiwanese minister: China is playing politics with health
“Taiwan’s health minister on Monday accused China of playing politics with health after Taiwan was blocked from taking part in the annual meeting of the governing body of the World Health Organization for the first time since 2008. Health and Welfare Minister Chen Shih-chung lashed out at China’s actions, which Beijing said was taken because Taiwan’s year-old government has reneged on the ‘One China’ principle…” (Keaten, 5/23).

Associated Press: The Latest: U.S. ‘disappointed’ Taiwan not at WHO assembly
“President Donald Trump’s top health official says the United States is ‘disappointed’ that Taiwan wasn’t invited to the World Health Organization’s most important annual meeting. U.S. Secretary of Health and Human Services Tom Price says the U.S. ‘remains committed that Taiwan should not be excluded from WHO’ and will work to enable all countries to help prevent, detect, control, and fight outbreaks…” (5/23).

Intellectual Property Watch: Taiwan Lobbies For Invitation To World Health Assembly, China Firmly Bars The Way
“…[On Monday,] Taiwan’s minister of health gave a press conference to denounce the fact that the country has not been invited by the World Health Organization, and saying that Taiwan needs the WHO, and the WHO needs Taiwan…” (Saez, 5/22).

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Cuts To U.S. Foreign Aid To Africa Could Encourage Extremism, African Development Bank Head Says

Newsweek: Donald Trump’s Foreign Aid Cuts Could Turn Africa Into a ‘Terrorist Recruiting Field’: African Bank Chief
“Cutting U.S. foreign aid to Africa could turn the continent into ‘a recruiting field for terrorists,’ the head of the African Development Bank (AfDB) tells Newsweek. Akinwumi Adesina, the president of the 78-member AfDB — Africa’s version of the World Bank — says that cash from Washington plays a vital role in creating jobs in rural parts of Africa, where young people may otherwise turn to extremism when faced with unemployment and poverty due to environmental issues or conflict…” (Gaffey, 5/22).

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New WFP Executive Director David Beasley Calls South Sudan's Famine 'Deplorable,' Expects 'Dog Fight' Over U.S. FY18 Funding For Agency

Associated Press: AP Interview: WFP chief says 600,000 kids risk famine death
“A tough-talking former Republican governor with friends in the Trump administration has become the unexpected booster of one of the United Nations agencies facing potentially deep U.S. funding cuts. David Beasley, the new executive director of the World Food Programme, told the Associated Press that he will use his Washington connections to defend the cash-strapped U.N. agency in what he expects to be a ‘dog fight’ over the 2018 U.S. budget…” (Laub, 5/22).

Associated Press: New WFP leader calls South Sudan’s famine ‘deplorable’
“The new American director of the World Food Programme called the suffering in South Sudan’s famine ‘deplorable’ as he visited the country and called on the government to allow aid groups safe access. ‘We want to feed the hungry children and the innocent civilians,’ David Beasley told the Associated Press before departing Tuesday for the affected area. ‘If you let us do our job, we’ll get it done’…” (Mednick, 5/23).

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Study Examines Health Care Access, Quality, Ranks Nations; U.S. Scores Low Given Expenditures, Study Author Says

New York Times: A Global Health Scorecard Finds U.S. Lacking
“Over the last 25 years, China, Ethiopia, the Maldive Islands, Peru, South Korea, and Turkey had the greatest improvements in ‘deaths avoidable through health care at their economic level,’ a complex but intriguing new measure of global mortality described last week in the Lancet. By that standard, the United States improved slightly over the same period, 1990 to 2015. But the American ranking is still so low that it’s ‘an embarrassment, especially considering the U.S. spends $9,000 per person on health care annually,’ said the report’s chief author, Dr. Christopher J. L. Murray, director of the University of Washington’s Institute for Health Metrics and Evaluation, [supported] by the Bill & Melinda Gates Foundation…” (McNeil, 5/22).

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Myanmar's Ongoing Reforms Not Yet Benefiting Children, UNICEF Alert Says

The Guardian: Up to 150 children under five die each day in Aung San Suu Kyi’s Myanmar
“As many as 150 children die every day in Myanmar before they reach their fifth birthday, the U.N. children’s agency said on Tuesday, in a report calling for the government to end blocks on humanitarian access to conflict areas. Despite reform and reconciliation efforts undertaken by the one-year-old government headed by Aung San Suu Kyi, children affected by widespread fighting and poverty are not reaping the benefits, UNICEF added…” (Holmes, 5/23).

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Editorials and Opinions

Trump Administration's Expansion Of Mexico City Policy 'Will Hamper' Health Care Delivery In Developing World

Los Angeles Times: Trump’s new global gag rule will devastate health care in poor countries
Editorial Board

“…[T]he new Trump administration incarnation of the [Mexico City policy] is far more expansive [than previous iterations]. Instead of applying specifically to [foreign NGOs’] family planning programs, … [h]ealth care providers overseas working in HIV/AIDS, maternal and child health, malaria, global health security, and other fields will be required to sign on the agreement. … State Department officials say that the gag rule is necessary to ensure that U.S. tax dollars do not support foreign organizations that ‘perform or actively promote abortion as a method of family planning.’ But there is already a law in place that prohibits the use of U.S. funds for abortions. So the gag rule is … just a way to pressure — and ultimately punish — organizations that provide abortions or abortion counseling. … [P]roviders are faced with a horrible choice: either refuse to provide patients with necessary information or important reproductive rights services or sacrifice desperately needed funding from the U.S. … In the end, it’s possible that this anti-abortion policy will result in more abortions, not fewer. … The global gag rule will hamper the delivery of desperately needed health care in the developing world. If the administration truly cares about protecting life, it should scrap this policy immediately” (5/22).

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Opinion Pieces Discuss Election Of, Highlight Issues To Be Addressed By Next WHO Director General

Foreign Policy: Who’s Going to Be the Next Leader of WHO?
Laurie Garrett, senior fellow for global health at the Council on Foreign Relations

“…This week, the Donald Trump administration will send a delegation to Geneva, casting its first U.N. leadership votes and weighing in on a long roster of reforms and controversies slated for debate in the 70th World Health Assembly. … It is widely assumed, though not confirmed by HHS, that the [U.S. Secretary of Health and Human Services Tom Price] will cast his first vote for Britain’s David Nabarro, reflecting the Trump administration’s warm relationship with the post-Brexit government of Prime Minister Theresa May. It is also widely believed that the Barack Obama administration backed a different candidate, Ethiopia’s Tedros Adhanom Ghebreyesus … While most observers give [Pakistan’s Sania] Nishtar little chance of defeating Nabarro or Tedros, there is a good possibility neither man will claim a 60 percent majority in the first round, freeing the process for some wild hallway horse-trading. I would hope that Nishtar’s transparency policies, commitment to NGOs and civil society, and her willingness to serve a single term might then prevail. Perhaps some of the 194 voters might then recall that the greatest leader WHO ever had, Gro Harlem Brundtland, brought the institution back from another existential moment because she, too, insisted on serving a single term” (5/22).

Thomson Reuters Foundation: New World Health Organization head must act on climate
Mark Porter, chair of the British Medical Association; Gemechis Mamo Fetene, president of the Ethiopian Medical Association; and S.M.Qaisar Sajjad, secretary general of the Pakistan Medical Association Centre

“…The [WHO’s] work has never been easy and the challenges always great, but the WHO’s job will be made harder still by the growing threat and worsening impacts of climate change. … Over the years and more recently under the leadership of Margaret Chan, the WHO has worked to better understand how climate change threatens public health. Chan called climate change ‘the defining issue of the 21st Century.’ The next director general must build on this legacy and do more, by increasing funding to help countries and health systems respond to climate change, and better integrating climate concerns throughout all the WHO’s programs. … [C]limate change threatens to undermine the fundamental determinants of public health, and will exacerbate many of the health challenges the WHO faces. No country — high, middle, or low income, developed or developing — is immune to the impacts. … The WHO has come a long way in its role on climate change, and has been a global leader in recognizing the threats that a hotter, wetter, and more volatile planet poses to public health. The next director-general must build on this progress, while doing even more to ensure that partners are prepared to protect public health in a warmer, wetter, more dangerous world” (5/23).

The Hill: World Health Organization needs new leadership for a changing world
Ian Scott, executive director of the Emerging Markets Symposium at the University of Oxford

“…The new director general will have to drive serious structural reforms to enable the organization to regain its position as the preeminent global authority on health. One major change in the last several years has been the rise of emerging markets. These countries include Brazil, China, India, Russia, South Africa (known as the BRICS), and several other countries around the world. What is particularly interesting in the context of global health is their shared challenges and their potential to reshape the development landscape. … To support emerging market countries, indeed all countries, in attaining the highest level of health possible, dramatic reforms at WHO are both necessary and urgent. … As I consider the emerging market countries and their role in global health, I am reminded of the significance of the decision facing all countries on their choice of a new leader for the WHO. I urge all countries to consider selecting Dr. Sania Nishtar of Pakistan for this incredibly important position. … Her honesty, integrity, and passion would help accelerate the reforms the organization desperately needs…” (5/22).

Devex: Opinion: Factory farming is a global crisis. The next WHO director general must address it.
Scott Weathers, master of science candidate at the Harvard T.H. Chan School of Public Health and an associate project director at Charity Science: Health, and Sophie Hermanns, Ph.D. candidate at Cambridge and a visiting fellow at Harvard

“…At last year’s World Health Assembly, Director-General Margaret Chan highlighted three ‘slow motion’ disasters of central importance to global health: Climate change, antibiotic resistance, and the rise of non-communicable diseases. Factory farming is central to all three of these disasters. In an open letter signed by over 200 of the world’s foremost experts in medicine, public health, biology, environmental science, ethics, and moral philosophy, we ask the next director general of the WHO to acknowledge the harms that factory farming inflicts on global health and to take action to mitigate them. … The extent to which factory farming is prioritized among a variety of important issues will come down to the next director general. … As a new director general takes the helm, we encourage them to consider a set of sensible policies to mitigate the harms that factory farming presents to global health” (5/22).

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Science-Based Approach Can Improve Efficiency, Effectiveness Of Public, Private Development Financing

Project Syndicate: Science and International Development Policy
Anne-Marie Slaughter, president and CEO of New America and professor emerita of politics and international affairs at Princeton University, and Kate Himes, foreign policy interrupted fellow and adjunct faculty at the Evergreen State College

“…A team of scientists and engineers, rather than diplomats and conflict-resolution experts, can provide a valuable pragmatic lens on what may appear to be a tangled set of political and cultural issues. … Science- and engineering-based solutions to global challenges have also sparked major innovations … Mark Green, who has just been nominated to head up the U.S. Agency for International Development, should bear [real-world examples] in mind. Green’s commitment to the ‘aid reform agenda’ has been hailed by organizations like the U.S. Global Leadership Coalition … To advance his goals, Green would do well to increase the role of science and technology in development practice, building on the work of the Global Development Lab at USAID, launched by Barack Obama’s administration. Scientific experimentation and technological innovation advance effectiveness and accountability through clear metrics of success and failure. … Evidence-based solutions call for evidence: results delivered, not resources invested. Original development solutions grounded in science are thus created in parallel with innovative monitoring systems that require program evaluation. The result is an efficient and effective use of public and private financing…” (5/22).

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From the Global Health Policy Community

U.N. Working Group Releases New Report On Health, Human Rights Of Women, Children, Adolescents

WHO: Leading the realization of human rights to health and through health
“At a high-level side event [at the World Health Assembly], the Report of the High-Level Working Group on the Health and Human Rights of Women, Children and Adolescents was officially handed over to WHO’s Director-General, Dr. Margaret Chan. The High-Level Working Group on Health and Human Rights of Women, Children and Adolescents was established in May 2016 by the [WHO] and the Office of the United Nations High Commissioner for Human Rights (OHCHR) to secure political support, both nationally and internationally, for the implementation of the human rights-related measures required by the Global Strategy for Women’s, Children’s and Adolescent’s Health (2016-2030)…” (5/22).

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WHO Releases Statement On Travel Costs

WHO: WHO travel to support program work
“Travel is an essential aspect of WHO’s global health work — convening experts for collective decision-making on health interventions or traveling experts anywhere in the world that requires technical assistance for global health. … WHO has clear travel policies, recently strengthened by Director-General Margaret Chan’s request for a policy prohibiting first class travel for all of WHO, regardless of position or grade. … WHO is always looking for ways to reduce travel costs. Overall compliance with WHO’s travel policy is high, and improving each year…” (5/21).

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Blog Post Discusses Global Medicine Quality, WHO's Role In Combating Inferior Products

AEI’s “AEIdeas”: Where does WHO go on medicine quality at the World Health Assembly?
Roger Bate, AEI visiting scholar, discusses the challenges of addressing inferior medicines and the WHO’s past actions related to assuring the quality of medicines (5/22).

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Fact Sheet Outlines How Global Fund Incentives Work To Increase Domestic Health Financing, Private Sector Investments

Friends of the Global Fight Blog: How the Global Fund Encourages Increased Domestic Financing
In this fact sheet, Friends of the Global Fight describes the importance of domestic health financing, noting, “The Global Fund supports greater domestic financing by incorporating requirements for this funding into its own funding model.” The fact sheet highlights these incentives and their successes, as well as the role private sector actors play in raising additional domestic resources (5/22).

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Human Rights Watch Report Documents Women's, Girls' Lack Of Access To Reproductive Health Care In Sudan's Rebel-Held Kordofan

Human Rights Watch: Sudan: Obstruction of Aid Endangers Women’s Lives
“Most women and girls in the rebel-held Nuba Mountains of Sudan lack access to reproductive health care, including emergency obstetric care, Human Rights Watch said in a report released [Monday]. Their plight is one of the little known yet far-reaching effects of years of obstruction of aid to the area by the Sudanese government and armed opposition. The 61-page report, ‘No Control, No Choice: Lack of Access to Reproductive Healthcare in Rebel-Held Southern Kordofan,’ documents how women and girls cannot get contraception and have little access to health care if they face complications during pregnancy and childbirth…” (5/22).

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