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Kaiser Daily Global Health Policy Report

In The News

Global Progress On Reducing New HIV Infections Stalls, Donor Government Funding For Disease Declines Slightly, New Reports Show

The BMJ: Global effort to reduce new HIV infections is stalling, U.N. warns
“The global pace of progress in reducing new HIV infections and increasing access to treatment is slowing down, says a report from the Joint United Nations Programme on HIV/AIDS (UNAIDS). Communities at the Centre shows that, while some countries are making very good progress towards U.N. targets, others are seeing rises in new infections and AIDS-related deaths…” (Wise, 7/19).

Inter Press Service: U.S. Leads Donor Funding to Fight HIV/AIDS Amidst Overall Decline
“…[Jen Kates, senior vice president and director of global health & HIV policy at the Kaiser Family Foundation (KFF),] worries that ‘because of many of the successes, [there is] a false sense that HIV is no longer a problem.’ … [A new] KFF/UNAIDS report argues that if the current [funding] trends continue, ‘future funding from donor governments is likely to remain stable at best, and will hinge largely on future U.S. support’…” (Pigliucci, 7/19).

The Telegraph: ‘AIDS is not over’: lack of funding hampers progress
“…Gunilla Carlsson, UNAIDS executive director, said political leadership was crucial to ending the epidemic. ‘This starts with investing adequately and smartly and by looking at what’s making some countries so successful. Ending AIDS is possible if we focus on people not diseases, create road maps for the people and locations being left behind, and take a human rights-based approach to reaching people most affected by HIV,’ she said…” (7/16).

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VOA News Examines Impacts Of Trump Administration's Expanded Mexico City Policy

VOA News: Pregnant Women Overseas Lose Access to Prenatal Care Due to Trump’s ‘Global Gag Rule’
“Medical providers say some pregnant women in developing countries have lost access to prenatal health care because of the Trump administration’s expanded ‘global gag rule’ [– also known as the Mexico City policy –] that cut [U.S. global health] aid to international organizations involved in abortion-related activities. A recent study in the Lancet Global Health journal also reports that abortions actually increased in Africa when these aid restrictions were enacted in the past. … U.S. anti-abortion groups like the National Right to Life Committee say the impact of these U.S. restrictions have been exaggerated by opponents, and they note that more than 700 international aid organizations are still receiving nearly all of the allocated global health assistance funding. … These ‘global gag rule’ opponents object to the Trump administration imposing what they see as partisan, politically driven restrictions that impede comprehensive medical information and treatment in the best interests of the patient…” (Padden, 7/18).

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USAID Initiative To Facilitate Work With Faith-Based Organizations, Deputy Administrator Says

Devex: New USAID procurement strategy targets increased work with religious groups
“The U.S. Agency for International Development’s new procurement strategy will help facilitate work with faith-based organizations in conflict and fragile settings, the agency’s Deputy Administrator Bonnie Glick said Wednesday. … Glick, speaking at the second annual Ministerial to Advance Religious Freedom in Washington, D.C., outlined the agency’s strategy for working with faith-based groups in development and humanitarian contexts…” (Welsh, 7/18).

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DRC Ebola Screeners Boost Surveillance Following WHO's Emergency Declaration For Outbreak

Al Jazeera: DRC health workers optimistic after WHO’s Ebola announcement
“…Health workers in the DRC have expressed optimism over the World Health Organization’s decision to declare Ebola a public health emergency of international concern, hoping the move will help with getting more resources needed to fight the disease…” (Soi, 7/19).

Bloomberg: Ebola Screeners Boost Surveillance as Outbreak Becomes Emergency
“Authorities in eastern Democratic Republic of Congo intensified efforts to screen suspected cases of Ebola as the World Health Organization declared the outbreak a global emergency…” (Ssuuna, 7/18).

CIDRAP News: Ebola cases climb in Beni as groups laud emergency decision
“…After [Wednesday’s] PHEIC announcement, several international non-governmental organizations and public health institutions applauded the WHO’s decision. ‘Ending the Ebola outbreak is one of the Trump administration’s top global health priorities,’ said HHS Secretary Alex Azar in a press release from the Centers for Disease Control and Prevention (CDC)…” (Soucheray, 7/18).

Reuters: WHO flags Ebola risk in Rwanda, but then withdraws its report
“The World Health Organization on Thursday withdrew a report that said an Ebola patient may have entered Rwanda, suggesting the deadly virus could spread to that country for the first time. The report, and others written by Uganda’s Health Ministry and published as daily updates by the WHO’s Africa office, detailed the case of a Congolese fishmonger who died of Ebola after going to Uganda and vomiting four times. … [WHO] said late on Thursday that several of the reports had been removed. The website where they were posted was also disabled. ‘Two situation reports … have erroneously included unverified information,’ the statement said…” (Miles et al., 7/18).

The Telegraph: Ebola has been raging in DRC for 12 months: why is it proving so hard to control?
“…To bring the outbreak under control experts say that 70 percent of patients should be treated within three days of displaying symptoms. Treatment times are currently nowhere near this because people are still not coming forward quickly enough — and this is mainly due to a lack of trust. … ‘To build trust we must demonstrate we are not parachuting in to deal with Ebola and leaving once it’s finished,’ [WHO Director-General Tedros Adhanom Ghebreyesus] told [Wednesday’s] meeting in Geneva…” (Gulland, 7/18).

Washington Post: WHO declared the Ebola outbreak in Congo a global health emergency. Here’s what that means.
“…Experts say the next step will probably be a pledging conference, which will convene the WHO, World Bank, United Nations, United States, Britain and other major donor countries to commit funds to stopping the crisis. … Not everyone is happy about the declaration. Congo’s government raised concerns about affixing the emergency label to the outbreak, fearing it could generate paranoia and damage trade and travel. … WHO officials called on neighboring countries Wednesday to keep their borders open after the emergency declaration. … [I]t’s unclear whether an emergency declaration will prove more effective at nipping Ebola in the bud this time around. … Armed conflict further complicates the response to this outbreak…” (Parker, 7/18).

Additional coverage of the DRC Ebola outbreak and response is available from Al Jazeera, Associated Press, The Atlantic, The Economist, Fox News, NPR, PRI, and Reuters.

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Cost Of Preventing Maternal Mortality Estimated To Increase Sixfold By 2030, UNFPA Says

The Guardian: Cost of global push to prevent women dying in childbirth to increase sixfold
“The cost of preventing women from dying in childbirth is projected to increase sixfold by 2030, requiring billions of dollars to achieve global targets, according to the U.N. The estimate was released by the U.N. Population Fund (UNFPA) on Thursday, offering a snapshot of the scale of the challenge the agency has set itself to end preventable maternal deaths by 2030. … Donor aid for maternal health care fell between 2013 and 2017, from $4.4bn to $3.9bn…” (Ford, 7/19).

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World Off Track To Meet Some Food-Related SDGs, Asia-Pacific To Miss All Targets, High-Level Forum On Sustainable Development Hears At Close

U.N. News: World ‘off track’ to meet most Sustainable Development Goals on hunger, food security and nutrition
“Key parts of the Global Goals agenda linked to achieving zero-hunger are ‘off-track,’ the U.N. Food and Agriculture Organization (FAO) said on Thursday, in an appeal for much greater public investment in farming. … In a new report focusing on Goals 2 (Zero Hunger), 6 (Clean Water And Sanitation), 14 (Life Below Water), and 15 (Life On Land), the agency also warns of unsuccessful efforts to make farming sustainable, as well as the long-term management of land and ocean-based resources…” (7/18).

U.N. News: Asia and Pacific on course to miss all Sustainable Development Goals, says U.N. region chief
“Unless progress is accelerated, Asia and the Pacific are on course to miss all of the 17 Goals of the U.N.’s 2030 Agenda for Sustainable Development, the executive secretary of the U.N. regional commission for Asia and the Pacific (ESCAP), told U.N. News at the organization’s headquarters on Wednesday…” (7/18).

U.N. News: ‘Stay together and step up’ action to meet Global Goals, ECOSOC President tells development forum
“We can realize the Sustainable Development Goals (SDGs) by 2030 ‘if we all stay together and step up our actions,’ Inga Rhonda King, President of the United Nations Economic and Social Council (ESOSOC), said on Thursday. ‘Even though the global picture is mixed,’ she stated during the closing of the High-level Political Forum on Sustainable Development (HLPF), ‘we have made encouraging progress, sometimes despite political and other headwinds’…” (7/18).

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Lancet Series Addresses Shortcomings In Global Dental Care, Calls For Reform

The Guardian: ‘Inadequate’ health response leaves 3.5bn with poor dental care
“Scientists are calling for radical reform of dental care, tighter regulation of the sugar industry, and greater transparency around conflict of interests in dental research to tackle the high and rising toll of oral disease such as mouth cancers. In a challenge to the global health community, a series in The Lancet medical journal argues that 3.5 billion people suffering from oral disease have been let down…” (Boseley, 7/18).

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U.N. Calls On UAE, Saudi Arabia To Meet Humanitarian Funding Pledges On Yemen, Says Deal To End Aid Suspension In Capital Close

Al Jazeera: Yemenis die as UAE and Saudi withhold aid funds: U.N.
“Yemenis are dying from cholera, hunger, and other ills because Saudi Arabia and the United Arab Emirates (UAE) are not making good on funding pledges they made earlier this year, a top United Nations official warned on Thursday. Mark Lowcock, the U.N.’s emergency relief coordinator and under-secretary general for humanitarian affairs, told the U.N. Security Council while most of the 40 countries that made pledges in February had stumped up aid cash, Abu Dhabi and Riyadh were holding out…” (Reinl, 7/17).

VOA News: U.N.: Close to Deal to End Aid Suspension in Yemen’s Capital
“The head of the World Food Programme said Thursday that his agency is close to reaching agreement with Houthi rebel leaders to end a suspension of food aid in areas of Yemen that the group controls. … Last month, [WFP Executive Director David] Beasley ordered a partial suspension of food distribution in the capital, Sana’a, which is controlled by Houthi rebels. He said it was necessary because the rebels were diverting aid for profit and not allowing aid agencies to operate independently…” (Besheer, 7/18).

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More News In Global Health

Devex: How health care workers can protect themselves from occupational illness (Root, 7/19).

Inter Press Service: The Road to Zero Hunger (Gunawardena, 7/17).

New Humanitarian: Betting on biometrics to boost child vaccination rates (Parker, 7/18).

New Humanitarian: Somalia’s displacement camp ‘gatekeepers’ — ‘parasites’ or aid partners? (Mumin, 7/18).

NPR: The Water Crisis In Chennai, India: Who’s To Blame And How Do You Fix It? (Frayer, 7/18).

The Telegraph: Afghanistan’s health system threatened as Taliban order 42 clinics to close (Farmer, 7/17).

U.N. News: Monsoon rains turn millions of children’s lives ‘upside down’ across South Asia (7/18).

Washington Post: Latin America’s war on obesity could be a model for U.S. (Reiley, 7/16).

Washington Times: Large-scale experimental HIV vaccination trial launched (Tan, 7/18).

Xinhua News: Uganda receives over 20 mln doses of measles, rubella vaccines (7/19).

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Editorials and Opinions

Mexico City Policy, New Regulations For Title X Family Planning Programs Deny Women Their Health, Rights, Opinion Piece Says

Ms. Magazine: Trump’s Gag Rules Hurt the Most Vulnerable Women
Elena Sarver, legal adviser at the Global Justice Center

“The Global and Domestic Gag Rules [– otherwise known as the Mexico City policy and new regulations for the federal Title X family planning program, respectively –] are just two of the repressive policies that the Trump administration has put in place to deny abortions to women. … While these policies impact different sources of funding, they have several key similarities. For one, they violate international law, including the right to free speech. Women should be able to exercise their fundamental right to make decisions about their own bodies and lives, informed by the comprehensive care and guidance offered by their medical care providers. These restrictions also interfere with the relationship between provider and patient, as doctors are unable to fully inform patients of their options for care. … Additionally, these policies are so highly complicated and technical, they often silence — or gag — people from engaging in permitted abortion-related speech, whether it be information, referral, or advocacy. … Finally, these policies attack the populations that are the most vulnerable. … In this fight, women everywhere lose. But those unable to access the health care they need — including safe abortion services — are paying the highest price” (7/18).

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U.S. Should Provide Humanitarian Aid To North Korea

Foreign Policy: The Case for Humanitarian Aid to North Korea
Victor D. Cha, professor at Georgetown University and senior adviser at the Center for Strategic and International Studies, and Lindsay Lloyd, George W. Bush Institute Bradford M. Freeman director of the Human Freedom Initiative

“…[T]he United States should open its pocketbook [to North Korea]. U.S. aid will certainly not fundamentally alter [Kim Jong Un’s] regime’s posture on security issues, nor will it resolve North Korea’s long-term problems without fundamental reforms to its system of government. But at its core, providing food and medical assistance is an issue of morality and humanity. … According to [a recent U.N. report], some 10.9 million people in the country — approximately 43 percent of the population — suffer from food insecurity, and nearly as many lack access to water, sanitation, and hygiene services. … [P]roviding humanitarian assistance shouldn’t be thought of as a lever to bring about political change in North Korea. While North Korea’s government may have a callous attitude toward its people, Americans believe that every life has value. Right now, lives are at stake. We can help to save them, and we should” (7/17).

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Editorials Discuss DRC Ebola Outbreak Response

The Guardian: The Guardian view on Ebola in the DRC: help needed — and dialogue too
Editorial Board

“Are we able to learn the right lessons when disaster strikes? … [The Ebola outbreak in the Democratic Republic of the Congo] is not only a public health but a humanitarian crisis, taking place in a conflict zone, with widespread malnutrition, a struggling health system, and deep suspicion hampering efforts to control the disease … The need for community understanding and engagement … is more critical than ever. … But if solutions must be implemented on the ground, they require proper support. … One lesson from the 2014 outbreak was that real international commitment can bring the disease under control. Another was that without such efforts it poses a far broader risk” (7/18).

The Lancet: A wake up call for the Ebola outbreak response
Editorial Board

“…Nearly a year since the Ebola outbreak began, WHO convened a High-Level meeting to review the response and to call for a more system-wide coordinated approach with U.N. partners ahead of publication of the fourth strategic response plan (SRP4) by the government [of the Democratic Republic of the Congo (DR Congo)]. … [WHO Director-General Tedros Adhanom Ghebreyesus] affirmed that the long-standing conflict is the principal challenge and that Ebola, measles, and cholera are all symptoms of the underlying cause, which is political insecurity. He reemphasized that ‘[DR Congo’s] government leadership is key to the success of this fight,’ as is community ownership. But some experts argue that conflict, poverty, and issues of governance go beyond the remit of the health sector and should not detract from dealing with the epidemic now. The approach proposed seems to be a scale-up of the existing strategies led by DR Congo, which calls on donors to increase their funding. However, by WHO recognizing the political nature of this crisis it acknowledges that the solution will require much more than technical capacity and financial investment. Will the awaited SRP4 under the leadership of DR Congo’s government be enough? … What is paramount now is for the international community to come together more assertively to rapidly contain the virus” (7/20).

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'Ethical Cowardice Afflicts Global Health,' Lancet Editor-In-Chief Argues

The Lancet: Offline: The ethical darkness of global health
Richard Horton, editor-in-chief of The Lancet

“…The ethical cowardice that afflicts global health today is unacceptable. … WHO seems happy to present an award to Turkey’s President Erdoğan for his work to address non-communicable diseases, while the government represses media and imprisons journalists. Gavi, the Vaccine Alliance seems comfortable accepting a donation from Saudi Arabia’s leaders without condemning the regime’s dire human rights record. And UNICEF has not been squeamish about collaborating with Myanmar’s government, despite the widespread torture, rape, and murder of the Rohingya. … The 21st century is being defined by diminished outrage and accountability. … Civilians are expendable. Ethnic cleansing is tolerated. The shame of international inaction during Rwanda’s genocide has been forgotten. The notion of a rules-based international order is no longer taken seriously. … Global health leaders must engage with all nations. But those same leaders have also turned their backs on some of the world’s gravest atrocities. Smiling and shaking hands with representatives from murderous regimes is one way of doing global health. But it is a way that will end with the normalization of indecency, inhumanity, and slaughter” (7/20).

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International Community Must Increase Investments In Early Childhood Nutrition

Project Syndicate: The Nutrition Challenge
Bjørn Lomborg, visiting professor at the Copenhagen Business School and director of the Copenhagen Consensus Center

“…[I]mproving child nutrition is one of the most transformative investments that governments and donors can make. … Malnutrition … has an extensive impact on society … In fact, malnutrition continues to be one of the main barriers preventing children, communities, and countries from realizing their full potential. … The next 12 months will be critical to keeping the spotlight on nutrition and mobilizing the resources needed to make global targets reachable. The World Bank’s Investment Framework for Nutrition estimates that $70 billion is needed over ten years to achieve key World Health Organization targets on undernutrition by 2025. But progress has not been rapid enough to meet the globally agreed nutrition targets in the U.N. Sustainable Development Goals — in particular, ending hunger and all forms of malnutrition by 2030. Additional investments in early childhood nutrition are crucial, and should be a high priority for donor and recipient governments, multilateral development organizations, and philanthropic foundations. The case for such spending is clear, and the payoffs will almost certainly be enormous” (7/18).

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From the Global Health Policy Community

Letter Urges Senators To Oppose Confirmation Of Trump Administration Nominee For U.S. Ambassador To Office Of U.N. In Geneva

People for the American Way: United Nations Nominee Andrew Bremberg’s Record and Rhetoric Clearly Demonstrate His Hostility to Human Rights
In a letter to the Senate Foreign Relations Committee, People for the American Way and other organizations express opposition to the Trump administration’s nomination of Andrew Bremberg as U.S. ambassador to the Office of the United Nations and Other International Organizations in Geneva, writing, “Andrew Bremberg’s record and rhetoric clearly demonstrate he would not promote human rights, which is a fundamental requirement for this critical role. We urge all senators to oppose his confirmation” (7/18).

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Podcast Episode, Blog Post Examine Challenges Of DRC Ebola Outbreak

Center for Strategic & International Studies’ “Take as Directed”: Unpacking the DRC Ebola Crisis with Jason Stearns
In this podcast episode, J. Stephen Morrison, senior vice president of CSIS and director of the CSIS Global Health Policy Center, speaks with Jason Stearns, director of the Congo Research Group at the Center for International Cooperation at New York University, about “the opaque networks in eastern Congo which are deliberately and violently targeting health providers, paralyzing the international and local response to the Ebola outbreak” (7/16).

Council on Foreign Relations: Ebola Reaches DRC Border City of Two Million, WHO Responds
John Campbell, Ralph Bunche senior fellow for Africa policy studies at the Council on Foreign Relations, discusses the WHO’s recent designation of the Democratic Republic of the Congo’s (DRC) Ebola outbreak as a public health emergency of international concern and examines the humanitarian situation in the country (7/18).

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Changes In Brazil's Government Could Threaten Country's Progress On HIV/AIDS, Expert Says

BMJ Opinion: Elize Massard da Fonseca: Brazil’s HIV/AIDS policy is under siege
Elize Massard da Fonseca, assistant professor of public administration at Getulio Vargas Foundation in Brazil and visiting scholar at the Center for Latin American Studies at the University of California Berkeley, discusses the ways in which changes in Brazil’s government potentially threaten HIV/AIDS progress in the country, writing, “This government’s demotion of those working on HIV and AIDS, and its support of ideologies that associate negative moral attributes with people living with these infections, risk turning back the clock on progress. Brazil’s achievements over the past 30 years on preventing and treating HIV and AIDS could suffer major setbacks that will be difficult to overturn” (7/19).

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Brookings Senior Fellow Examines Trends Of Rising Hunger, Obesity, Explores Global, Local Efforts On SDGs

Brookings Institution’s “The Current”: What does a new U.N. report reveal about global hunger and obesity?
In this podcast episode, “Brookings Senior Fellow John McArthur examines the trends of rising hunger and obesity [from a recent U.N. Food and Agriculture Organization report] and recommends using all the Sustainable Development Goals as a North Star to design policies to meet these twin challenges. McArthur also explores how global momentum toward the Sustainable Development Goals has progressed at the local level even while official intergovernmental cooperation stalls” (7/18).

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From the U.S. Government

USAID Endorses OECD-DAC Recommendation On Ending Sexual Exploitation, Abuse, Harassment In Development, Humanitarian Assistance

USAID: USAID Endorses the Recommendation of the DAC of the OECD on Ending Sexual Exploitation, Abuse, and Harassment in Development and Humanitarian Assistance
“The U.S. Agency for International Development (USAID) confirmed its commitment to addressing and preventing sexual exploitation, abuse, and harassment by joining other donors in endorsing the Organisation for Economic Cooperation and Development Development Assistance Committee (OECD-DAC) Recommendation on Ending Sexual Exploitation, Abuse, and Harassment in Development Co-operation and Humanitarian Assistance: Key Pillars of Prevention and Response. The OECD-DAC’s recommendation is the first international instrument that addresses these issues in development and humanitarian assistance, and reflects agreement on standards by all major donor countries…” (7/18).

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