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Kaiser Daily Global Health Policy Report

In The News

Reported Measles Cases Up 300% Globally In First Quarter Of 2019 Compared With Last Year, WHO Says, Calls For Increased Vaccination Coverage

Al Jazeera: WHO raises alarm over 300 percent rise in measles cases
“The World Health Organization (WHO) has raised alarm over a 300 percent increase in the cases of measles globally in the first quarter of 2019 compared with last year. The statement by the United Nations’ health agency comes as health experts in various parts of the world blame a growing anti-vaccination movement for the rise in outbreaks of the highly contagious but preventable disease…” (4/15).

The Guardian: Measles cases up 300% worldwide in 2019, says WHO
“… ‘Preliminary global data shows that reported cases rose by 300% in the first three months of 2019, compared to the same period in 2018. This follows consecutive increases over the past two years,’ [WHO] said in a statement. ‘While this data is provisional and not yet complete, it indicates a clear trend. Many countries are in the midst of sizable measles outbreaks, with all regions of the world experiencing sustained rises in cases,’ the WHO added…” (Boseley, 4/15).

TIME: Measles Cases Are Still Rising in the U.S. But They’re Even Higher Globally
“…More than 112,000 measles cases in 170 countries have been reported to the WHO so far this year. By contrast, about 28,000 measles cases in 163 countries were reported at this time last year, the WHO says. There are likely many more cases that have gone unreported, the WHO says, but the data provides a good sense of global disease trends…” (Ducharme, 4/15).

U.N. News: ‘A global measles crisis’ is well underway, U.N. agency chiefs warn
“… ‘Cases have soared across the world, including in places where measles had previously been eliminated, like the United States,’ asserted Henrietta Fore, executive director of the U.N. Children’s Fund (UNICEF) and Tedros Adhanom Ghebreyesus, director general of the World Health Organization (WHO). … Following two years of consecutive increases, the Democratic Republic of the Congo (DRC), Ethiopia, Georgia, Kazakhstan, Kyrgyzstan, Madagascar, Myanmar, Philippines, Sudan, Thailand, and Ukraine, are all in the midst of current outbreaks. It is also spreading fast among clusters of people, who are resisting vaccination, in countries with high overall vaccination rates, including the United States, Israel, Thailand, and Tunisia…” (4/15).

Vox: 2019 is shaping up to be a very bad year for measles
“…The reasons for outbreaks differ in each country — from vaccine refusal to problems with health care access or access to vaccines, to civil unrest and low awareness about the need to vaccinate. But what all these causes have in common: These factors are driving down the rate of vaccine coverage…” (Belluz, 4/15).

Additional coverage of WHO’s measles surveillance data is available from Agence France-Presse, BBC News, CNN, Reuters, Science Speaks, USA TODAY, and VOA News.

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Borgen Magazine Examines Introduction Of Bipartisan Global Fragility Act Of 2019

Borgen Magazine: Global Fragility Act Introduced in Congress
“On March 7, the Global Fragility Act of 2019 was introduced by Reps. Eliot Engel (D-N.Y.), Michael McCaul (R-Texas), Adam Smith (D-Wash.), Ann Wagner (R-Mo.), Bill Keating (D-Mass.), and Francis Rooney (R-Fla.). The Global Fragility Act seeks to address the root causes of violence and fragility in order to stabilize conflict-affected areas. The bill calls for the establishment of the Global Fragility Initiative — to be created by the secretary of State, the administrator of USAID and the secretary of Defense — which will integrate ten-year plans to address fragility in priority countries and regions. Additionally, the bill would authorize the Complex Crises Fund to alleviate unforeseen conflicts when funding gaps occur in foreign countries…” (Gambero, 4/15).

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U.S. Envoy Pledges Continued U.S. Support For Taiwan To Join WHO, Other International Organizations

Breitbart News: U.S. Envoy Calls for Taiwan to Join Interpol, World Health Organization
“U.S. envoy Brent Christensen, the de facto American ambassador to Taiwan, on Monday pledged continuing U.S. support for Taiwan to join international organizations like Interpol and the World Health Organization (WHO) despite China’s campaign to isolate the island nation. … He noted Taiwan was invited to annual [World Health Assembly] meetings from 2009 to 2016, at which point it was ‘suddenly no longer welcome to attend’ because a more independence-minded candidate, Tsai Ing-wen, won the Taiwanese presidential election. ‘We continue to work with other like-minded countries to lobby international organizations to put health, security, and economic prosperity above politics,’ Christensen said…” (Hayward, 4/15).

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Lima Group Urges U.N. To Work To Prevent Escalation Of Humanitarian Crisis In Venezuela; Researchers Show 365% Increase In Country's Malaria Cases Since 2000

Agence France-Presse: Lima Group urges U.N. to ‘take action’ over Venezuela crisis
“The Lima Group made up of mostly Latin American countries called on the United Nations on Monday to ‘take action’ to prevent an escalation of Venezuela’s humanitarian crisis. The group of 14 countries, which also includes Canada, exhorted U.N. Secretary-General António Guterres, the General Assembly, and the Security Council to ‘take measures to avoid the progressive deterioration of peace and security, and to provide urgent humanitarian aid to the population of migrants coming from Venezuela’…” (4/15).

Healio: Infectious disease rates skyrocket amid Venezuela’s economic crisis
“Research presented at the European Congress of Clinical Microbiology & Infectious Diseases shows that Venezuela’s political and economic crisis is causing a resurgence of infectious diseases, including malaria and many vaccine-preventable illnesses. … The researchers searched both published and unpublished health data and observed a 365% increase in malaria cases between 2000 and 2015. These cases accounted for 53% of all cases reported in the Americas…” (Bortz, 4/16).

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Ebola Continues To Spread In DRC; Vaccine Shows High Efficacy But Mistrust Remains Prevalent

CIDRAP News: Ebola cases climb by 44 as vaccine trial affirms high efficacy
“The pace of the Democratic Republic of the Congo (DRC) Ebola outbreak showed no sign of slowing over the weekend, with another 20-case day, but with some good preliminary news about the efficacy of the vaccine, which officials hope to parlay into their pitches for community members to be vaccinated. And in new developments [Monday], the country’s health ministry reported 13 new cases and said the number of people vaccinated topped the 100,000 mark…” (Schnirring, 4/15).

Globe and Mail: In worsening Ebola outbreak, many Congolese are shunning Canadian-developed vaccine
“After the worst-ever week of new infections in one of the deadliest Ebola outbreaks in history, there is growing concern that the Canadian-developed Ebola vaccine is still mistrusted by many of the most vulnerable people in the crisis zone. … New data show that the experimental Ebola vaccine, developed at Winnipeg’s microbiology laboratory, has been remarkably effective in preventing the virus. … But a ‘huge portion’ of the Ebola infections are among those who refuse to take the vaccine, and nearly 10 percent of those who could be exposed to the virus are refusing to take the vaccine, according to Michael Ryan, executive director of the WHO’s health emergencies program…” (York, 4/15).

National Geographic: What’s keeping scientists from vanquishing Ebola?
“…Ebola is hard to arrest for many complicated reasons (below). But scientists keep trying — and what they learn will equip us to face this virus, and possibly worse, in the future…” (Preston, May 2019).

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More Funding Needed To Achieve SDGs, U.N. SG Guterres Tells Financing For Development Forum

U.N. News: ‘Critical moment’ for sustainable development, U.N. chief tells major financing forum
“‘Uneven growth, rising debt levels, possible upticks in financial volatility, and heightened global trade tensions’ are hampering progress on reaching the Sustainable Development Goals (SDGs), U.N. chief António Guterres told the Forum on Financing for Development on Monday, during what he called ‘a critical moment’ to ‘accelerate action for sustainable development.’ Ministers, senior U.N. officials, high-level finance officials, civil society, business representatives, and local authorities are meeting at U.N. Headquarters for the four-day FfD Forum, as it is known … ‘Simply put,’ he spelled out ‘we need more money to implement the Sustainable Development Goals’…” (4/15).

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WHO Fair Pricing Forum Examines High Costs Of Medicines, Efforts To Reduce Prices, Improve Transparency

Health-e News: Tackling the high price of medicine
“Profit seems to be the only logic driving medicine prices, with some African countries paying more for medicine than European countries, and U.S. citizens paying some of the highest medicine prices in the world. There are global efforts to rein in excessive profiteering but removing the secrecy around prices is complicated. … Over the past few years, both the United Nations and the World Health Organization (WHO) have launched global initiatives to reduce medicine prices — the latest being the WHO’s second Fair Price Forum, which ended its meeting in Johannesburg on Saturday (13 April)…” (Cullinan, 4/15).

NPR: Why Astronomical Drug Prices Are Bad For Health — And Profits
“…The event [brought] together pharmaceutical executives, government health officials, academics, and advocacy groups to look at ways to make global drug prices more affordable — while also benefiting drug manufacturers. We called up [Fatima Suleman, a professor of pharmaceutical sciences at the University of KwaZulu-Natal in Durban, South Africa,] who specializes in pharmaceutical policy, to ask her how the global health community could help patients get access to medicines they need and allow drug companies to reach much larger markets…” (Beaubien, 4/12).

Philippine Star: World Health Organization: ‘Fair medicine prices a global rights issue’
“Greater transparency and fair pricing for medicine are a ‘global human rights issue,’ the World Health Organization (WHO) said… It said today’s cost of medicine is a worldwide challenge and a key topic of concern at the global medicine forum in South Africa. … ‘This is a global human rights issue,’ said WHO assistant director general for medicine and health products Mariângela Simão. ‘Everyone has a right to access quality health care’…” (Lee-Brago, 4/16).

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AP Examines Ongoing Misconduct Probes At UNAIDS, Including Previously Undisclosed Investigation Into Whistleblower

Associated Press: AP Exclusive: U.N. whistleblower targeted in misconduct probe
“A year after claims of sexual assault and harassment rocked the U.N. agency that fights HIV, UNAIDS looked like it might be on the mend. … But the upheaval is not over. Confidential documents obtained by the Associated Press show UNAIDS is grappling with previously unreported allegations of financial and sexual misconduct involving Martina Brostrom, who went public last March with claims that one of the organization’s top officials assaulted her in 2015. … The sexual assault and harassment case against [Luiz Loures, a former UNAIDS deputy director,] has been reopened and is now in the hands of the U.N. Office of Internal Oversight Services following criticism of how it was handled by UNAIDS and WHO. The investigation into potential misconduct by Brostrom and her former supervisor will resume ‘as soon as appropriate,’ UNAIDS spokeswoman Sophie Barton-Knott said in an email. The lingering inquiries mean UNAIDS’ new leader will inherit unfinished business that casts a shadow over donor support…” (Cheng/Keaten, 4/15).

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More News In Global Health

GMA News Online: PHL must step up efforts to improve Filipinas’ reproductive rights — UNFPA (4/16).

New Humanitarian: The humanitarian fallout from Libya’s newest war (Stephen, 4/15).

New York Times: In African Villages, These Phones Become Ultrasound Scanners (McNeil/Mbabazi, 4/15).

Reuters: Cholera cases rise in Kenya’s capital, top hospital says (Malalo/Miriri, 4/16).

Scientific American: How Can We Increase Trust in Vaccines? (Thacker, 4/15).

Xinhua News: Lebanon receives health donation from Brazil (4/15).

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Editorials and Opinions

Opinion Piece Examines Mexico City Policy's Impacts On Services Provided By PEPFAR Implementing Partners

Devex: Opinion: The ‘global gag rule’ hits PEPFAR implementers, study shows
Jennifer Sherwood, policy associate at amfAR, The Foundation for AIDS Research, and Matthea Roemer, Global Health Corps fellow based in Rwanda

“January marked the second anniversary of U.S. President Donald Trump’s reinstatement and expansion of the ‘global gag rule’ — which bars U.S. global health funding to any [foreign non-governmental] organization that provides abortions, counsels or refers for abortion services, or advocates for access to safe abortion. A new report shows how the policy, which has known detrimental impacts on the reproductive health of women and girls, is now also undermining U.S. investments in global HIV prevention, namely the U.S. President’s Emergency Plan for AIDS Relief. … In a recently published study led by amfAR and Johns Hopkins University, nearly 300 PEPFAR implementing partners from 45 countries responded to a confidential electronic survey. The results were clear: The expanded gag rule has impeded the ability of PEPFAR implementing partners to provide full sexual and reproductive health services, disrupting the provision of contraception and HIV services. … These results extend existing evidence showing the harmful effects of the gag rule on sexual and reproductive health outcomes to U.S.-funded HIV/AIDS programs. U.S. global health policy should be responsive to emerging evidence in the field in order to increase the effectiveness of U.S. investments. One such policy initiative has been the recent introduction of the Global HER Act, which urges Congress to permanently end the global gag rule. This would ensure that U.S foreign assistance such as PEPFAR remains in the hands of the most effective partners in combatting HIV. Sound policy should be based upon effectiveness — not politics and ideology” (4/16).

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Opinion Pieces Discuss Need For Collective Efforts To Protect Against Measles, Other Infectious Diseases

CNN: Measles cases are up nearly 300% from last year. This is a global crisis
Henrietta H. Fore, executive director of UNICEF, and Tedros Adhanom Ghebreyesus, director general of the World Health Organization

“We are in the middle of a global measles crisis. … It is a collective responsibility to support parents and build a more positive environment for vaccination … [I]t will take much more — not only from … online platforms but from governments, individuals, and the health community — to make sure all children get their vaccines at the right time. It will mean empowering all health workers to be champions for vaccination, so that they can engage effectively with the parents and communities they serve. It requires each of us to stand up for science, for health, and for the importance of vaccines. It means building basic scientific literacy — ensuring people can interpret and understand information about their health and vaccines. It means governments must invest in primary care and immunization, and make sure these services are affordable, accessible, and truly responsive to parents’ needs — especially those in the poorest, most disadvantaged communities. … Ultimately, there is no ‘debate’ to be had about the profound benefits of vaccines. We know they are safe, and we know they work. … But children are paying the price for complacency. It will take long-term efforts, political commitment, and continuous investment — in vaccine access, in service quality, and in trust — to ensure we are, and remain, protected together” (4/15).

USA Today: Measles outbreak drains resources we may need for a future epidemic or bioterrorist attack
Former Sen. Joe Lieberman (D-Conn.) and former U.S. Secretary of Homeland Security and Pennsylvania Governor Tom Ridge, co-chairs of the bipartisan Blue Ribbon Study Panel on Biodefense

“…The measles outbreak [in the U.S.] is particularly troubling, because unlike many other infectious disease threats, there is an effective vaccine for measles. Not only should state and local governments continue to strongly advocate for the use of vaccines, families, individuals, and civic organizations all have essential roles to play in encouraging their use to mitigate the effects of infectious diseases like measles. We cannot afford to ignore the lessons that measles, Ebola, pandemic influenza, plague, Zika, and other diseases have been teaching us — and continue to teach us — about our vulnerabilities. Eventually, those vulnerabilities to biological events could overcome our national ability to respond and recover. Emergency declarations will not be able to help us then. Let’s do the work today to effectively prepare for what we know will one day come” (4/16).

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Global Health Diplomacy, Multi-Sectoral Cooperation Essential To Ending TB Epidemic

The Lancet Global Health: Leveraging health diplomacy to end the tuberculosis epidemic
Michael Reid, assistant professor, and Eric Goosby, professor, both in the Division of HIV, Infectious Diseases, and Global Medicine at the University of California San Francisco (UCSF); and Sebastian Kevany, research data analyst, all at the Institute for Global Health Sciences at UCSF

“…The U.N.’s Sustainable Development Goals highlight the importance of the broader multi-sectoral agenda to ending the tuberculosis epidemic … Understanding tuberculosis as a global health security threat is essential to ending the epidemic. … As the Lancet Commission on tuberculosis emphasizes, global tuberculosis efforts are moving beyond traditional siloed development assistance approaches to a new era of country ownership and holistic, multi-sectoral global cooperation. Global health diplomacy is essential both to motivate these new approaches and to create the enabling environment needed to secure substantive progress towards ending the tuberculosis epidemic once and for all…” (3/20).

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Investments In Both Men's, Women's Health Needed To Ensure 'Better Health For All'

The Telegraph: The forgotten sex: why is men’s health ignored by policymakers?
Peter Baker, director at Global Action on Men’s Health

“…Men’s health is notable by its absence in most global and national health policies and funding programs. … World Health Organization (WHO) data published earlier this month show that the probability of a man aged 30 dying from [a non-communicable disease (NCD)] before 70 is almost 50 percent higher than for a woman aged 30. … WHO is now realizing that the [Sustainable Development Goals’] targets simply cannot be met unless greater account is taken of men. … Global Action on Men’s Health, an international network of men’s health organizations, researchers, and advocates, has set out some key ways forward in its new report on men and self-care. These include the development of health policies (including national men’s health policies) that recognize the needs of men, measures to improve men’s health literacy, making health services more accessible to men, and better training in men’s health for health professionals. It is also essential for services to take account of male gender norms, in other words the ways men have been brought up to think and behave. … Programs and policies to improve men’s health must complement those aimed at women. There is no binary choice here. Investment is needed in the health of both sexes to ensure better health for all” (4/15).

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African Governments Must Act Immediately To Address AfCFTA's Potential Negative Health Implications

Project Syndicate: Will Free Trade Make Africans Sick?
Walter Ochieng, doctor, health economist, and Aspen New Voices fellow

“…The African Union views the [African Continental Free Trade Area (AfCFTA)] as an important step toward integrating the continent and promoting regional trade. Given the experience of other free-trade blocs, however, the pact raises concerns about the weakening of government-funded public health systems, increasingly unequal access to care, a medical brain drain, higher drug prices, increased consumption of unhealthy products, and the spread of diseases. African governments should act immediately to assess these threats and counter the AfCFTA’s potential negative health implications. … African governments should learn from the experience of other trading blocs, and act now to protect the poor from the unintended health consequences of open trade policies. … The AfCFTA could yield enormous economic benefits for Africa. But its possible negative impact on Africans’ health should not be ignored” (4/15).

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From the Global Health Policy Community

Bill Gates Explores Use Of Mapping Technology To Address Global Malaria

Gates Notes: These maps could point the way to stopping malaria
In recognition of Mosquito Week, Bill Gates, co-chair of the Bill & Melinda Gates Foundation, explores the science behind malaria and other mosquito-borne diseases and highlights the importance of data and mapping technology in making progress against malaria (4/15).

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WHO Drops Endorsement Of EAT-Lancet Commission's Planetary Health Diet

New Food Economy: World Health Organization drops its high-profile endorsement of the EAT-Lancet diet
Sam Bloch, writer for the New Food Economy, discusses debate over the EAT-Lancet Commission‘s planetary health diet and the World Health Organization’s decision to drop its endorsement of the diet (4/12).

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South Korea's Abortion Law Reform Can Serve As Model For Other Countries

Human Rights Watch: South Korea’s Abortion Reform A Model for Others
Janet Walsh, deputy director of the Women’s Rights Division at HRW, discusses a ruling by South Korea’s Constitutional Court that found the nation’s abortion laws unconstitutional and called for reform, noting the action can serve as a model for other countries. Walsh writes, “Now it’s time for other countries to secure women’s basic reproductive rights, including their access to safe, legal abortion” (4/15).

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Global Dispatches Podcast Interviews Co-Founder Of Social Enterprise mPharma

U.N. Dispatch’s “Global Dispatches Podcast”: A Revolution in Access to Medicine is Underway in Five African Countries
Mark Leon Goldberg, editor of U.N. Dispatch and host of the Global Dispatches Podcast, speaks with Gregory Rockson, “co-founder of a social enterprise called mPharma, which uses data analytics and supply chain management to help small and independent pharmacies control their costs” (4/15).

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From the U.S. Government

USAID Administrator, Adviser To President Discuss Women's Empowerment During Visit To Ethiopia

USAID: USAID Administrator Green’s and Adviser to the President Ivanka Trump’s Visit to Ethiopia
This press release provides an overview of USAID Administrator Mark Green’s and Adviser to the President Ivanka Trump’s recent visit to Ethiopia, during which the delegation “discussed ways Ethiopia and the United States can partner to advance their shared goal of increasing women’s economic empowerment in Ethiopia and worldwide” (4/15).

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