KFF Daily Global Health Policy Report

In The News

Efforts Must Intensify To Reduce Child Mortality, Study Says

According to a study published on Thursday in The Lancet, there will still be 5.4 million deaths among children under age five in 2035 if historical trends of successful interventions continue, HealthDay News reports (Preidt, 9/19). Researchers, led by Neff Walker of the Johns Hopkins Bloomberg School of Public Health, “project[ed] rates of child and neonatal mortality in 2035 in 74 ‘Countdown to 2015’ priority countries,” the study states. “In June 2012, at a global meeting convened by UNICEF and the governments of Ethiopia, India, and the U.S., a target was proposed of 20 or fewer deaths of children [under five] per 1,000 live births by 2035 in all countries,” the study notes (Walker et al., 9/20). “Rates of child and mother deaths have fallen in most countries since 2000, when the Millennium Development Goals [MDGs] were set,” but “efforts to improve mothers’ and children’s health must intensify to keep achieving significant reductions in the number of child deaths in low- and middle-income countries, according to the authors of the study,” HealthDay writes (9/19).

The study “calls on governments, both of the countries most affected by maternal and child deaths, and of nations providing development assistance, to redouble their efforts to deliver known and proven interventions at high and sustained levels, and search for new interventions that will save the lives of more children,” according to the Information Daily (9/20). “‘Countdown to 2015’ is a movement of academics, governments, international agencies, health care professional associations, donors, and non-governmental organizations worldwide that works in partnership with The Lancet to support progress toward meeting the [MDGs],” HealthDay notes (9/19).

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U.N. Report Gives Mixed Review Of MDG 8 On Partnerships, Trade

“The international community must live up to the commitments it made in support of achieving universally accepted anti-poverty targets, [U.N.] Secretary-General Ban Ki-moon [on Thursday] said launching a new report [.pdf] which finds that despite significant successes, the global economic slowdown continues to hinder progress on the Millennium Development Goals (MDGs),” the U.N. News Centre reports (9/19). “The report, published in the run-up to next week’s special session at the U.N. on the MDGs and what follows their 2015 deadline, focuses on the global partnership for development (MDG 8), the vaguest of the eight goals,” The Guardian writes, adding, “MDG 8 covers aid, trade technology and access to affordable essential medicines” (Tran, 9/19).

“The report, ‘The Global Partnership for Development: The Challenge We Face,’ shows that developing countries gained greater access to technologies, markets for their exports, some essential medicines and greater debt relief,” the U.N. News Centre notes. “However, the report calls for bolder action in areas such as pollution, child and maternal health, HIV prevention and basic education,” the news service writes (9/19). According to The Guardian, Ban said, “The picture is mixed. … We can do better. The best way to prepare for the post-2015 era is to demonstrate that when the international community commits to a global partnership for development, it means it, and directs its resources to where they are most needed” (9/19).

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Number Of Elderly People With Alzheimer's, Dementia Will Nearly Triple By Mid-Century, Report Warns

“By the middle of the century, the number of older people suffering from Alzheimer’s and other forms of dementia will nearly triple, severely straining caregiving resources, the charity Alzheimer’s Disease International [ADI] says in a new study released Thursday,” NPR’s “The Two-Way” blog reports. “Currently, some 100 million people globally suffer from the potentially fatal disease,” the news service writes, adding, “That number is expected to increase to 277 million by 2050, as the graying population increases, the World Alzheimer’s Report 2013 says” (Neuman, 9/19). “Half of all older people who need personal care have dementia, the report by [ADI] said, and governments should make dementia a priority by implementing national plans and starting urgent debate on how to ensure long-term care for future generations,” according to Reuters. “Even now, the worldwide cost of dementia care is more than $600 billion, or around 1.0 percent of global gross domestic product, and that can only increase, ADI’s report said” (Kelland, 9/19).

“More attention needs to be paid to helping dementia patients and their families ‘live well with dementia,’ the report said,” HealthDay News writes, adding the report “also called for a 10-fold increase in research funding to ‘re-energize’ the work on dementia prevention, treatment and care” (Preidt, 9/19). “The report makes a range of recommendations including giving paid and unpaid carers ‘appropriate financial rewards’ and monitoring the quality of care both in care homes and in the community,” according to BBC News (Mazumdar, 9/19).

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Researchers Continue To Search For MERS Origins; Health Officials Prepare For Muslim Pilgrimage

“Genetic analysis of samples of the [Middle East Respiratory Syndrome coronavirus (MERS-CoV)] that has killed 58 people in the Middle East and Europe shows the disease has jumped from animals to humans several times, scientists said on Friday,” Reuters reports. “While the findings, published in The Lancet medical journal, cannot help scientists predict how likely MERS is to become more easily transmissible in people — and how likely to cause a human pandemic — they should help health experts develop more effective infection control measures to limit its spread,” the news agency writes. “Two mass gathering events attracting over eight million pilgrims have occurred in Mecca, Saudi Arabia since the discovery of MERS-CoV 12 months ago — the annual haj in October 2012 and the July 2013 Ramadan Umrah season — and yet no MERS-CoV cases have been reported from these events to date,” Ali Zumla, a professor of infectious diseases at University College London and co-author of the study, said, according to the news agency (Kelland, 9/19).

In an interview with the Wall Street Journal, Saudi Arabia’s Deputy Health Minister Ziad Memish said, “We want to know where this virus is coming from and we want to know the method of transmission and we want to know how to prevent the disease from spreading. … We will continue collaborating with WHO (and other leading international health institutions) in trying to find the source of the virus and how it spreads” (Knickmeyer, 9/19). “Globally, from September 2012 to date, WHO has been informed of a total of 130 laboratory-confirmed cases of infection with MERS-CoV, including 58 deaths,” a WHO press release notes (9/20).

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Devex Examines Singapore's Success In Developing Health System

“Singapore now spends less than one percent of its gross domestic product on health, much less than India where public health services are poor, and even less than the United States where outcomes are way below the average of OECD countries,” Devex writes. The news service interviews U.S. biologist, entrepreneur and philanthropist William Haseltine, chair and CEO of ACCESS Health International, about the country’s success in developing its health system. “Singapore, according to Haseltine, is an excellent example for the developing world because its leaders had the vision to initially adopt a system they could afford, and later on expand it as the nation grew and grew until becoming the Asian economic powerhouse it is today,” the news service writes. Haseltine provides a historical overview of health in the country since gaining independence from the Federation of Malaysia, noting, “Two decades later, as Singapore became a middle-income economy, and always spending within the state coffers’ limits, the government reformed the system and started focusing more on the quality of the services, which slowly progressed into today’s model” (Igoe, 9/19).

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Podcast, Reporting Series, Infographic Examine Global Road Safety

The Guardian’s Global Development Podcast examines “how the roads have become one of the world’s biggest killers.” Hosted by journalist Annie Kelly, the discussion features journalist Sajid Chowdhury reporting from Bangladesh; Overseas Development Institute Executive Director Kevin Watkins; Kate McMahon, formerly with the U.K. Department of Transport and currently a global road safety consultant; and Veronica Raffo, senior infrastructure specialist for the World Bank in Argentina. A transcript and audio version of the podcast are available (Kelly/Chambers, 9/19).

The Pulitzer Center on Crisis Reporting recently published a series of articles looking at road deaths in several countries (9/19). The PBS “Mediashift” blog on Thursday published a piece from Pulitzer Center Senior Editor Tom Hundley detailing the series, as well as an interactive map. “By clicking on a country you can access an assortment of road safety data, ranging from trend lines on highway fatalities to statistics on the types of vehicles most likely to be involved in fatal crashes,” he writes, adding, “You can also rove across the map to access an ever-expanding roster of full reports and brief ‘roads facts’ from around the world” (9/19).

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Editorials and Opinions

Addressing HIV Prevention Among Key Affected Populations 'Of The Utmost Urgency'

Writing in the Huffington Post’s “Global Motherhood” blog, Michel Kazatchkine, the U.N. secretary general’s special envoy on HIV/AIDS in Eastern Europe and Central Asia, recalls a recent International AIDS Society-sponsored meeting in London “on the impact of treatment as prevention (TasP) on Key Affected Populations (KAPS), [which] has the potential to be a pivotal moment in the way we decide to respond to HIV/AIDS in those global ‘hotspots’ where sex workers, men who have sex with men (MSM), people who inject drugs (PWID) and transgender people are en masse being denied access to treatment, care and prevention.” He adds, “As the Millennium Development Goals come to fruition in 2015 we are being faced with a terrible and daunting reality: that these key affected populations are in fact being left behind.”

While there is some “real world” evidence that TasP can reduce HIV incidence in these populations, “we do need to be cognizant of one important fact: there is no precedent for a disease of which the transmission at the population level could be stopped by generalized access to treatment,” Kazatchkine writes. “The fact that treatment is preventative does not mean that it will and should replace prevention. Prevention interventions remains essential,” he continues. “[W]hile we should always acknowledge that the response needs to be thought through and measured (this meeting is a case in point), we’d also do well to acknowledge that the situation facing key affected populations is of the utmost urgency,” he adds (9/19).

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Public, Private Sectors Should Address Antibiotic Resistance After Latest CDC Warning

Noting CDC Director Tom Frieden on Monday released a report showing “two million people in the United States are sickened every year with antibiotic-resistant infections, with at least 23,000 dying as a result,” a Washington Post editorial states, “The global toll is certainly much higher.” The editorial asks, “What is being done about that?” and continues, “Similar warnings have been issued for at least three decades, yet the public has largely shrugged.” In addition, “Big Pharma turned away from antibiotic development in recent years because of economic factors; put simply, drugs for chronic diseases offered higher returns,” the Washington Post writes. “There is a crying public need for more drug development in antibiotics. If the pharmaceutical industry can’t do it, more government involvement may be required,” the editorial states, outlining some steps already undertaken by government agencies. “Let’s hope we won’t look back on the latest CDC report as just another warning that was forgotten,” the editorial concludes (9/19).

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Cross-Sector Partnerships Essential To Reaching Health-Related Development Goals

The race to meet the health-related U.N. Millennium Development Goals (MDGs) and the post-2015 development agenda “requires new thinking and fresh commitments from across all sectors — including industry, governments, multilaterals, [non-governmental organizations (NGOs)], and other organizations — to cross-sector partnerships that drive systemwide change,” Eduardo Pisani, director general of the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), and Aron Cramer, president and CEO of Business Social Responsibility (BSR), write in the Huffington Post’s “Social Entrepreneurship” blog. “Since the MDGs’ launch in 2000, the number of cross-sector partnerships aimed at advancing health-related goals and involving the pharmaceutical industry has increased dramatically,” they write, adding, “By bringing together a broad set of stakeholders from the private sector and beyond, pharmaceutical companies initiated and contributed to partnerships tackling many of the barriers that have blocked progress on health goals.”

Pisani and Cramer discuss an analysis of global health partnerships by BSR, noting the progress on infectious diseases and saying more must be done to address non-communicable diseases (NCDs). They highlight “the Guiding Principles on Access to Healthcare — a call to action and framework for driving progress that was shaped by BSR and signed by 13 pharmaceutical CEOs earlier this year.” They conclude, “As we prepare once again to answer the U.N.’s call for ‘the engagement of responsible business and civil society’ to achieve sustainable and inclusive development, we ask decision-makers and other potential contributors — from all sectors — to engage in multi-stakeholder dialogues together with the pharmaceutical industry. Together, we can set viable goals and plan in advance for the cross-sector partnerships that will drive their achievement” (9/19).

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Huffington Post Opinion Pieces Address Child Mortality Issues Ahead Of U.N. General Assembly Session

Ahead of the U.N. General Assembly’s 68th session and its general debate on the Millennium Development Goals (MDGs) — “Post-2015 Development Agenda: Setting the Stage” (September 24-October 2, 2013) — the Huffington Post’s “Global Motherhood” and “Impact” blogs posted separate series of opinion pieces addressing child health. The following is a summary of these pieces, published on the heels of a new UNICEF, World Bank and WHO report released last week, which shows the number of early childhood deaths worldwide has decreased by half since 1990, but approximately 18,000 children under age five continue to die daily, as well as a study published in The Lancet on Thursday, which shows that if historical trends continue, 5.4 million children worldwide will still die annually of preventable causes in 2035.

  • Ray Chambers, “Impact” blog: Chambers, U.N. special envoy for health financing, calls on the global community to join in the effort to achieve MDG 4 on child mortality (9/19).
  • Patricia Coffey, “Global Motherhood” blog: Coffey, a senior program officer at PATH, examines how cutting the umbilical cord at birth using sterile procedures could save thousands of newborn lives (9/19).
  • Sharon D’Agostino, “Global Motherhood” blog: D’Agostino, vice president of corporate citizenship at Johnson & Johnson, looks at progress made toward achieving MDGs 4, 5 and 6 through the Every Woman, Every Child initiative (9/19).
  • Sarah Edwards, “Impact” blog: Edwards, head of policy and campaigns at Health Poverty Action, looks at health disparities within countries (9/20).
  • Chris Herlinger, “Impact” blog: Herlinger, a freelance journalist, author and Church World Service aid worker, reflects on progress and existing challenges in the effort to reduce child mortality rates by 2015 (9/19).
  • William Lin, “Global Motherhood” blog: Lin, director of worldwide contributions and community relations at Johnson & Johnson, examines efforts to end infections with intestinal worms, also known as soil transmitted helminths (STH), among children in the developing world (9/18).
  • Marissa Miley, “Impact” blog: Miley, a global health correspondent for GlobalPost, reflects on “hopeful progress on the road to ending preventable deaths in some nations, and considerable challenges in others” (9/19).
  • Jonathan Quick, “Global Motherhood” blog: Quick, president and CEO of Management Sciences for Health, writes, “The post-2015 development framework — which United Nations member states discuss next week in New York — needs to redouble efforts on health, including a specific focus on child mortality” (9/19).
  • Dennis Walto, “Global Motherhood” blog: Walto, a senior adviser for innovations and revenue with International Medical Corps, says “[t]he organization’s emphasis on building resilience through training and community education has contributed to reducing child mortality through programs including primary health care, nutrition, water, sanitation and hygiene, among others” (9/19).

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From the Global Health Policy Community

Special Issue Of The Lancet Looks At Progress Toward MDGs, Post-2015 Agenda

“Ahead of the September 25 United Nations General Assembly, which will evaluate the efforts made towards achieving the Millennium Development Goals [MDGs], and look ahead to the post-2015 development agenda,” The Lancet on Friday published a special issue focusing on the “Countdown to 2015.” According to the executive summary, “A new analysis of interventions to reduce maternal and child deaths in developing countries reveals that if current trends continue, just nine Countdown countries will meet internationally agreed targets to reduce the number of deaths of children under five to fewer than 20 deaths per 1000 births by 2035”; “[a] review assesses progress since The Lancet published its child survival series 10 years ago, and states that the decreasing rates of child mortality seen in the past 10 years should not distract from the fact that there is an unfinished agenda in child survival”; and “several leading figures in global health offer insight and analysis into how far the world has come towards meeting the MDG targets, and development priorities post-2015” (9/20). In an editorial, The Lancet writes, “The General Assembly is now an event that cannot be ignored by the health community. Keep an eye on New York next week. Interesting things are likely to happen” (9/21).

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GHTC Fact Sheet, Policy Brief Examine FDA's Role In Global Health

Noting the FDA “has a strong history of sharing its expertise to benefit people worldwide and is playing an increasingly vital role in global health issues,” the Global Health Technologies Coalition’s (GHTC) “Breakthroughs” blog reports, “The GHTC has released two new resources that provide fresh evidence on the FDA’s growing global health presence, while also offering recommendations for how the agency can continue to strengthen its efforts to improve health and save lives worldwide.” According to the blog, a “new fact sheet [.pdf] and policy brief [.pdf] focus on five key areas at the FDA,” including the need to “create an office of neglected diseases,” “build partnerships with global regulatory stakeholders,” “establish formalized processes to report to Congress on its neglected disease activities,” and “dedicate additional staff members and resources to global health engagement.” Finally, “[i]t’s critical that congressional policymakers pass a smart budget agreement that avoids another round of sequestration cuts while protecting key programs at FDA and other federal agencies that work in global health” (Lufkin, 9/19).

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U.N. Must Involve Communities To Form Post-2015 Global Health Agenda

In a Project Syndicate column, Kent Buse, chief of political affairs and strategy at UNAIDS, and Sarah Hawkes, a Wellcome Trust senior fellow in international public engagement at the Institute for Global Health at University College London, examine the post-2015 development agenda discussions surrounding global health issues, particularly non-communicable diseases, writing, “[F]or the most part, a universal set of maladies has emerged over the past decade, accounting for the vast bulk of ill health and preventable death in all regions of the world. Unfortunately, the proposed health agenda seems to ignore this trend.” They continue, “How can we overcome the role that vested interests may be playing in setting a global health agenda that fails to address key drivers of disease? Perhaps one answer lies in listening more to the communities directly affected by major health conditions” (9/19).

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