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Kaiser Daily Global Health Policy Report

In The News

Women's, Girls' Reproductive Health, Rights Being Pushed To 'Bottom Of The Heap,' UNFPA Executive Director Says, Calls For 'Moral Leadership'

Devex: Family planning sector needs ‘moral leadership,’ says UNFPA chief
“The newly appointed executive director of the United Nations Population Fund has described a situation of injustice when it comes to women and girls’ access to reproductive health and rights, saying that their needs are being ‘relegated to the bottom of the heap.’ Dr. Natalia Kanem, who was promoted to the position earlier this month, talked to a small audience of stakeholders in London on Tuesday about changes to family planning policy in the United States…” (Abrahams, 10/19).

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Despite Decrease In Overall Child Mortality, 60M Children, Half Newborns, Could Die Through 2030 If Current Trends Continue, U.N. Report Says

The Guardian: ‘Unconscionable’: 7,000 babies die daily despite record low for child mortality
“The number of children who die before reaching their fifth birthday has fallen to an all-time low, yet children around the world continue to die at an alarming rate, with 5.6 million deaths recorded last year. In its annual report on child mortality, the U.N. said many of the deaths — which averaged 15,000 a day in 2016 — were from preventable diseases…” (Lyons, 10/18).

Newsweek: 30 million newborns could die by 2030, U.N. study says
“…Despite this progress, neonatal deaths — babies who die within the first 28 days of life — accounted for 46 percent of all under-five deaths last year, up from 41 percent in 2000. That’s a staggering 2.6 million newborns worldwide who died in the first month of life in 2016, or 7,000 every day. One million of them died the very day they were born, and nearly one million more died within their next six days. Another 2.6 million babies were stillborn last year…” (Jones, 10/18).

Xinhua News: U.N. report warns of rising newborn mortality in near future
“A latest report by U.N. agencies warned on Thursday that at current trends of child mortality, nearly 60 million children could die before their fifth birthday between 2017 and 2030, half being newborns. The report, Levels and Trends in Child Mortality 2017, was jointly released by the U.N. Children’s Fund (UNICEF), the World Health Organization, the World Bank, and the Population Division of U.N. Department of Economic and Social Affairs…” (10/19).

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TB Advocates, Organizations Seek To Implement Funding Targets, Create More Innovative Finance Mechanisms

Devex: Advocates to seek TB funding targets at 2018 high-level meeting
“Global tuberculosis experts want to see numerical funding targets for combating the epidemic set at the first United Nations high-level meeting on the disease next year. Experts want to set additional targets for 2020 and 2025 linked with the World Health Organization’s End TB Strategy, as well as a corresponding accountability mechanism. … Advocates are seeking a commitment to hold a high-level meeting on TB every four years…” (Cousins, 10/18).

Devex: Q&A: Global TB efforts turn to innovative finance
“…The Global Fund to Fight AIDS, Tuberculosis and Malaria and the International Union against Tuberculosis and Lung Disease (The Union) last week announced a new partnership to spur investment among the private sector to help end the TB epidemic by 2030. … [T]he Global Fund, along with partners including the World Health Organization and Stop TB Partnership, last week also launched a new ‘catalytic funding’ program to find and treat an additional 1.5 million ‘missing’ people with TB in 13 high-burden countries by 2019. … Devex sat down with Dr. Christoph Benn, director of external relations at the Global Fund, to discuss the two new initiatives and what they will mean for combating the disease…” (Cousins, 10/18).

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Gateses Remain Optimistic About Progress On Health, Development Targets, Warn Positive Outcomes Not Guaranteed

Financial Times: Bill and Melinda Gates on the fight against global inequality
“…Bill Gates, talking from his office in Seattle shortly before [last month’s Goalkeepers] event, cautioned that further [health and development] advances were not guaranteed. ‘We want to have people be positive about what’s happened, particularly since 1990,’ he said. ‘But we also want people to understand that the potential range of outcomes between now and 2030 is very large and that (with) donor generosity, innovation, spreading best practices, we can actually do a lot better if everything comes together — or a lot worse.’ One reason for the ambivalence is the attitude of Trump himself, as president of the country that is the world’s largest provider of foreign aid. Since he took office at the start of this year, the White House has mooted significant funding cuts and has expressed a notable dislike for U.N. institutions…” (Jack, 10/18).

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Devex Examines New Data Showing Increases In Overweight, Obese Populations In Pacific Nations

Devex: New global obesity data: Which countries top the list?
“Since 1975, Pacific nations have seen staggering increases in the number of overweight and obese children and adults, putting them at the center of a growing health epidemic impacting developing communities. Released to coincide with World Obesity Day on October 11, new data from the Imperial College London and World Health Organization provides country level information on the prevalence of unhealthy body weights among adult and child populations since 1975. … Using the data from the study, Devex produced an interactive visualization highlighting the extent of the crisis in the Pacific…” (Cornish, 10/19).

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Muslim Rohingya Continue To Stream Into Bangladesh From Myanmar; Advocates Warn Against Creation Of One Large Refugee Camp

Devex: Humanitarian agencies lobby against Rohingya ‘mega camp’ creation
“In Bangladesh’s Cox’s Bazar, construction has started on the roads and bridges for access to what will be the world’s largest refugee camp. At the same time, humanitarian actors on the ground have come together to advocate against the creation of one condensed ‘mega camp’ for Rohingya refugees, instead calling for the identification of separate land to create several smaller camps…” (Rogers, 10/19).

New York Times: Rohingya Refugees Fleeing Myanmar Await Entrance to Squalid Camps
“Nearly two months after Muslim Rohingya began fleeing a military-led campaign of violence in western Myanmar, thousands of refugees continue to mass on the Bangladesh border, seeking the relative safety of squalid, muddy camps. An estimated 582,000 Rohingya have fled into Bangladesh since Aug. 25 … The United Nations high commissioner for human rights has called the campaign a ‘textbook example of ethnic cleansing’…” (Ramzy/Beech, 10/18).

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74 People Dead, More Than 800 Infected In Madagascar Plague Outbreak; Suspected Cases In Seychelles Test Negative

The Guardian: ‘It is a dangerous moment’: Madagascar plague death toll reaches 74
“…Since that first ‘case zero’ [in late August], the outbreak of the highly contagious strain of plague has claimed 74 lives over two months, infecting more than 800 people. Marking the outbreak as doubly dangerous, many cases have also featured the most virulent form of what was known in the Middle Ages as the Black Death — pneumonic plague…” (Beaumont, 10/19).

HuffPost: In A Single Week, Plague Cases More Than Doubled In Madagascar
“…While plague is endemic in the island country of Madagascar, which typically sees 400 or so cases in the September-to-April outbreak season, this recent outbreak has several differences. First, the infections began earlier in the season, with the first case in August. And, crucially, more than 70 percent of infections have been pneumonic … making them far more infectious and easily spread than the more typical bubonic cases, which are spread by fleas on rats…” (Weber, 10/18).

Reuters: Plague ruled out in Seychelles but islands on guard: WHO
“Plague has been ruled out in the Seychelles following lab results from 10 patients, including one earlier deemed a ‘probable’ case, the World Health Organization (WHO) said on Wednesday as the disease continued to spread in Madagascar…” (Nebehay, 10/18).

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Yemen's Cholera Epidemic Now Largest In Modern History, Result Of War

FRONTLINE: How Yemen’s Cholera Outbreak Became the Fastest Growing in Modern History
“…At last count on October 11, the World Health Organization reported that there have been more than 822,000 suspected cases of cholera and 2,160 cholera-related deaths since the end of April, when the outbreak emerged. … What’s especially troubling, experts say, is that the outbreak was entirely man-made — the result of the violence that erupted in 2014 when the Houthis, a rebel group from the north of Yemen, seized the capital of Sanaa…” (Einbinder, 10/18).

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Local Advocates, International NGOs Speak Out Against Restrictive Family Planning Policy Proposals In Timor-Leste

Devex: How a policy scare galvanized a small island’s family planning sector
“A restrictive family planning policy first presented to the public in July met strong opposition in Timor-Leste, where local and international nongovernmental organizations and youth groups rose up to quash it in the months following. The show of activism is welcome in a country with a historically weak family planning NGO network, where it remains largely taboo to speak about contraceptive methods. It is perhaps a sign of more change to come, several groups tell Devex…” (Rogers, 10/19).

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Increasing Trend Of Drug-Resistant TB In India, Among Children In China, Studies Show

CIDRAP News: Studies show rise in drug-resistant TB in India, China
“A systematic review and meta-analysis of previously published studies reveals a significant rise in drug-resistant pulmonary tuberculosis (DR-TB) prevalence in India over the past two decades, researchers reported [Tuesday] in BMC Infectious Diseases. Another study in China, meanwhile, revealed an increase in DR-TB among children…” (Dall, 10/18).

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Experimental Drug Shows Promise As Simplified Cure Of Sleeping Sickness, Researchers Report

Nature: Sleeping sickness can now be cured with pills
“For the first time, researchers have cured the deadly neurological disease sleeping sickness using pills instead of a combination of intravenous infusions and pills. The investigators presented the results from final clinical trials on 17 October at the European Congress on Tropical Medicine and International Health in Antwerp, Belgium, providing hope that the treatment will help to eliminate the malady within a decade. … The relative ease of the treatment with fexinidazole means that if approved, it might save more lives than the current option, say the investigators…” (Maxmen, 10/18).

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Editorials and Opinions

Development Community, Governments Should Focus On Most Cost-Effective SDG Targets

Project Syndicate: The Mis-Measure of Development
Bjørn Lomborg, visiting professor at the Copenhagen Business School and director of the Copenhagen Consensus Center

“…[T]oday’s development agenda is trying to be all things to all people. The MDGs worked because they were few in number and sharply focused. The SDGs comprise an eye-watering 169 targets, which means there is no focus at all. … Countries themselves are now doing the prioritization that the U.N. failed to do. They cannot possibly achieve all 169 targets at once, so they focus on only some of them. The real danger is that their selection will not be those targets that could do the most good per dollar, pound, rupee, or peso spent, but those that have the most media appeal, NGO attention, or corporate interest. We need to strip back the development agenda to its core issues, and focus on those areas where each dollar spent can achieve the most for humanity. Only by doing so can a scorecard help us maximize development progress” (10/18).

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Governments Should Address Link Between Trade, Global Rise Of NCDs

The Conversation: The hidden connection between obesity, heart disease, and trade
Ronald Labonte, professor and Canada research chair at the University of Ottawa

“…There is plenty of research evidence of the impact of trade and investment agreements on [noncommunicable diseases (NCDs)] such as heart disease, and on major risk factors such as obesity and tobacco use. … [T]here are three simple steps [governments] can take to ensure the ‘policy coherence’ that is the theme of the [WHO global conference to address NCDs in] Uruguay … First, governments should agree that all future trade and investment agreements contain a full carve-out for any non-discriminatory public health measure aimed at controlling NCD risks (or any other health concern) … Second, … governments should commit to not initiating a dispute against another country’s non-discriminatory public health measure. Third, governments should refrain from increasing patent protection on drugs used to treat NCDs. … These three commitments should be written into the final Uruguay agreement…” (10/18).

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Rural Communities Need To Be 'Resilient, Diverse, Interconnected' To Achieve Food Security, Withstand Climate Change, Conflict

The Conversation: World hunger is increasing thanks to wars and climate change
Leah Samberg, research associate at the Institute on the Environment at the University of Minnesota

“…Around the world, social and political instability are on the rise. … At the same time, these regions are experiencing increasingly powerful storms, more frequent and persistent drought, and more variable rainfall associated with global climate change. These trends are not unrelated. Conflict-torn communities are more vulnerable to climate-related disasters, and crop or livestock failure due to climate can contribute to social unrest. … To reduce world hunger in the long term, rural populations need sustainable ways to support themselves in the face of crisis. This means investing in strategies to support rural livelihoods that are resilient, diverse and interconnected. … In many places, one of the best ways to bolster food security is by helping farmers connect to both traditional and innovative social networks, through which they can pool resources, store food, seed and inputs and make investments…” (10/17).

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Africa's History With Malaria Indicates 'Urgent Need' To Focus On High-Burden Countries

The Conversation: What 115 years of data tell us about Africa’s battle with malaria past and present
Bob Snow, professor at the Centre for Tropical Medicine & Global Health at the University of Oxford’s Nuffield Department of Medicine

“…Despite an impressive overall decline in malaria prevalence since 1900, Africa has the highest infection risks globally. … There is an urgent need to focus on the high-burden countries in Africa; they should not be left behind in a new global agenda for malaria elimination. It is complex and predicting a future malaria landscape based on climate or economic development alone would be foolhardy. It needs a more integrated approach. … [T]he malaria map in Africa might shrink a bit at the margins but that middle belt isn’t going anywhere in our lifetimes with what we have at our disposal now — bed nets and drugs. When insecticide and drug resistance becomes established, unless we have new classes of both drugs and insecticides or a natural period of drought, malaria will revert in large parts of Africa to what it was in the 1990s, another perfect storm” (10/17).

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'Diseases Of The Past' Continue To Infect Humans Worldwide, Mainly In Regions Of Unrest, Poverty

Financial Times: Medieval diseases are making a grim comeback
Anjana Ahuja, science commentator

“…While the plague seems to us a medieval affliction, it has never fully disappeared. … Now the World Health Organization has noted an unusually large outbreak of plague in Madagascar. … It is no coincidence the disease has found fertile pickings in a troubled part of the country characterized by the lack of clean water, electricity, nutrition, and basic health provision. History shows that natural disaster, poverty, and war, along with the absence or destruction of protective infrastructure, threaten our ability to keep pathogens at bay. The world bears this out today: war-torn Yemen is in the grip of the worst cholera epidemic of modern times. … Unvaccinated children, particularly in conflict zones and impoverished regions, are succumbing to conquerable diseases such as polio and rubella. The haunting truth is that future generations are still being struck down by diseases of the past” (10/18).

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From the Global Health Policy Community

Grand Challenges To Invest In Mental Health Of Adolescent, Young Mothers

Bill & Melinda Gates Foundation’s “Impatient Optimists”: Strong Minds for Stronger Adolescent and Young Mothers
Janna Patterson, senior program officer with the Maternal, Newborn, and Child Health (MNCH) team at the Bill & Melinda Gates Foundation; Karlee Silver, vice president of Targeted Challenges for Grand Challenges Canada; and Nicole Sirivansanti, associate program officer with the MNCH team at the Gates Foundation, discuss how depression and other mental health conditions can affect adolescent and young mothers. The authors write, “The need to focus on adolescent and young mothers has become crystal clear given the high rates of mental disorders that begin during adolescence. … The opportunity to put a dent in maternal morbidity by facilitating stronger minds for adolescent and young mothers is substantial” (10/17).

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HRW Urges Mexico Commission To Revise Mental Health Bill To Reflect Rights Of Persons With Disabilities

Human Rights Watch: Mexico: Mental Health Bill Undermines Disability Rights
“Mexico’s Congressional Mental Health and Drug Commission is considering a national mental health bill that proposes to improve mental health services for all in Mexico but would seriously jeopardize the rights of people with disabilities, Human Rights Watch said [Tuesday]. In a letter sent on October 16, 2017, to the Commission on Health and Drugs in the Chamber of Deputies, Human Rights Watch urged the commission to reject the bill in its current form. … The final bill should ensure the right to mental health for all in Mexico on an equal basis, without resort to forced treatment, and be consistent with Mexico’s laudable international commitments to the rights of persons with disabilities…” (10/17).

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From the U.S. Government

HHS Statement Addresses Montevideo Roadmap At WHO Conference On NCDs

U.S. Department of Health and Human Services: United States Government Statement on the Montevideo Roadmap at the WHO Global Conference on Non-Communicable Diseases
This release highlights a statement made by Tom Alexander, principal deputy director for Global Affairs at HHS and U.S. head of delegation to the WHO Global Conference on Non-Communicable Diseases (NCD), on the Montevideo Roadmap. “The United States strongly supports efforts to combat non-communicable diseases. We believe that the best approach to addressing the global rise in incidence of NCDs requires identifying and pursuing comprehensive, cost-effective, evidence-based, and multi-sectoral strategies…” (10/18).

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