KFF Daily Global Health Policy Report

In The News

U.K. Prime Minister May Pledges To Keep 0.7% Overseas Aid Target; Bill Gates Warns Foreign Aid Cuts By U.S., U.K. Would 'Create A Leadership Vacuum'

Financial Times: Theresa May says Tories will keep 0.7% overseas aid target
“Theresa May has promised to maintain Britain’s commitment to spend 0.7 percent of its national income on overseas aid, dashing the hopes of some Tory MPs that she would divert a portion of the £13.3bn budget to domestic priorities. Mrs. May’s announcement on Friday came just days after Bill Gates, the Microsoft founder, urged the prime minister to retain the aid pledge in the Tory manifesto, saying that any cuts would ‘cost lives’…” (Parker, 4/21).

The Guardian: Foreign aid 0.7% pledge will remain, says Theresa May
“… ‘Let’s be clear, the 0.7 percent commitment remains and will remain,’ [May] said during a factory visit in her Maidenhead constituency. ‘What we need to do, though, is to look at how that money will be spent and make sure that we are able to spend that money in the most effective way. I’m very proud of the record we have, of the children around the world who are being educated as a result of what the British taxpayer is doing in terms of international aid’…” (Elgot/Walker, 4/21).

VOA News: Philanthropist Bill Gates Sounds Warning on Cuts to Development Aid
“The founder of Microsoft, billionaire philanthropist Bill Gates, has given a passionate defense of foreign aid while voicing fears the political climate in the U.S. and in Britain could result in cuts to aid budgets. In a speech this week in London, he warned that withdrawing aid would ‘create a leadership vacuum that others will fill.’ … In a speech at London’s Royal United Services Institute this week, he voiced fears that the political tide is turning against foreign aid…” (Ridgwell, 4/22).

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Ghana, Kenya, Malawi To Participate In WHO Malaria Vaccine Pilot Implementation Program Beginning In 2018

Associated Press: 3 African countries chosen to test 1st malaria vaccine
“Three African countries have been chosen to test the world’s first malaria vaccine, the World Health Organization announced Monday. Ghana, Kenya, and Malawi will begin piloting the injectable vaccine next year with hundreds of thousands of young children, who have been at highest risk of death…” (Anna, 4/24).

BBC News: Malaria: Kenya, Ghana, and Malawi get first vaccine
“…The RTS,S vaccine trains the immune system to attack the malaria parasite, which is spread by mosquito bites. … The vaccine needs to be given four times — once a month for three months and then a fourth dose 18 months later. This has been achieved in tightly controlled and well-funded clinical trials, but it is not yet clear if it can be done in the ‘real-world’ where access to health care is limited…” (Gallagher, 4/21).

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Global Health Workforce Shortages Could Be Filled By Unemployed Youth, WHO Official Says

Devex: Could unemployed youth solve the health care worker crisis?
“According to the World Health Organization, 40 million new health and social care jobs must be created globally by 2030 to meet Sustainable Development Goal 3 of universal health coverage. At the same time, global youth unemployment reached 71 million in 2016, according to International Labor Organization data. Could the two problems be used to solve each other? Director of the Health Workforce Department at the WHO Jim Campbell believes they could. … Campbell told Devex that development practitioners need to approach the solution in a non-traditional way, and create new training models for the next cohort of skilled health professionals…” (Jóźwiak, 4/24).

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Investments In Adolescent Health, Education Can Prompt Up To Tenfold Returns, Lancet Study Shows

Devex: Investments in health and education of adolescents can bring huge returns
“Channeling funds into the well-being, health, and education of adolescents can bring huge benefits — and up to a tenfold return on investment — a new report has found. There are 1.2 billion adolescents alive today — which represents the largest generation of this age group in history, according to a new report by The Lancet commissioned by the United Nations Population Fund, released [Thursday]. … The Lancet estimates a $4.60 per person per year investment in programs to improve outcomes for adolescents could bring a tenfold economic boost…” (Edwards, 4/21).

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Experts Comment On Successes, Challenges Of Addressing Neglected Tropical Diseases

Thomson Reuters Foundation: EXPERT VIEWS — Progress in fighting tropical diseases but funding and conflicts pose challenges
“Progress has been made in tackling diseases that blind, disable, and disfigure millions of poor in tropical countries each year, but drug companies need to step up donations of medicines, the World Health Organization (WHO) said this week. Governments and private donors pledged more than $800 million at a meeting in Geneva [last] week to accelerate the fight against these illnesses, categorized by the WHO as neglected tropical diseases (NTDs). Below are some expert views on how to accelerate the fight against NTDs, which include diseases such as guinea worm, dengue, onchocerciasis (river blindness), trachoma, and sleeping sickness…” (Zweynert, 4/21).

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International Initiative Making Progress Toward Eliminating Trachoma

Thomson Reuters Foundation: Medication, money, and maps: How to fight a debilitating eye disease
“In some of the world’s remotest corners, health workers armed with smartphones, digital maps, and medication are making steady progress in eliminating trachoma, the world’s leading infectious cause of blindness, a leading expert said. Better living conditions have wiped out trachoma in many countries but some 200 million people are still at risk of contracting the disease, according to the International Trachoma Initiative (ITI)…” (Zweynert, 4/21).

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The Lancet Infectious Diseases Profiles Gates Foundation Global Health Division President Trevor Mundel

The Lancet Infectious Diseases: Trevor Mundel: President of the Gates’ Foundation Global Health Division
“Variety is the spice of life, and few scientists have had a more varied career than Trevor Mundel. This serves him well as president of the Bill & Melinda Gates Foundation’s Global Health Division, where he manages a wide range of projects, from mapping child brain development in Africa, to developing genetically modified mosquitos to halt malaria transmission, to the recent launch of the Coalition for Epidemic Preparedness Innovations (CEPI), which aims to prevent the next global pandemic by accelerating vaccine development…” (Kirby, May 2017).

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Editorials and Opinions

U.S. Food Aid In Need Of Reform To Improve Efficiency, Cost Effectiveness

Washington Post: How to get more out of the dollars Americans spend helping the world’s hungry
Editorial Board

“…Title II of the Food for Peace Act, the main source of emergency food aid, requires the United States to supply international famine relief programs with American-grown products and to ship at least half of the materiel on U.S.-flagged vessels. Meanwhile, at least 15 percent of the goods must be ‘monetized’ once they arrive at their destination — that is, resold on local markets by nongovernmental organizations, to fund development projects. … [I]t makes the program less efficient than it might be: The set-aside for U.S.-flagged vessels inflates transportation costs; the buy-American rule for commodities prevents purchases from cheaper producers closer to the famine zones, whose productive efforts are additionally undercut by ‘monetization.’ … Food aid reform has been a bipartisan cause backed by each of the past two presidents and many members of Congress. However, the powerful lobbies that benefit from the status quo have prevented it. … [I]t would take a major push from the White House to achieve even incremental change. If he’s really interested in improving the cost-effectiveness of aid, as opposed to slashing it as an expression of ideology, President Trump would spend some of his political capital on the cause. Of course, that would also require him to depart from the simplistic ‘buy American’ mind-set he has repeatedly expressed — and whose counterproductive effects the U.S. food aid program epitomizes” (4/22).

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Continued Support Of USAID NTD Program, Collaborative Partnerships Necessary To End NTDs

The Hill: Securing America’s legacy in the fight against neglected tropical diseases
Mary Ann Peters, CEO of the Carter Center, former U.S. Ambassador to Bangladesh

“…[N]ews rarely captures one of the biggest global health successes to date: our country’s efforts to eliminate neglected tropical diseases (NTDs). The NTD Program is a great example of what United States leadership in global health can achieve, and remains one of the best investments we can make in the health and economies of some of the fastest growing markets in the world. … The United States has been at the forefront of these efforts since well before the [2012] London Declaration. With bipartisan support, the U.S. Agency for International Development’s NTD Program has been improving the lives of hundreds of millions of people since 2006. This program distributes 300 million treatments annually, reaching 743 million people with 1.6 billion NTD treatments across 31 countries to date. In addition, the NTD Program has invested in research and development to ensure that promising new breakthrough medicines for filarial diseases can be rapidly evaluated, registered, and made available to patients. … The United States should remain in the vanguard of the fight against NTDs to transform these estimates into reality — and better lives for the more than one billion people still needlessly suffering from these preventable diseases…” (4/21).

Huffington Post: Collaboration Drives Efforts To End Neglected Tropical Diseases
Dave Ross, president and chief executive officer of the Task Force for Global Health; Paul Emerson, director of the International Trachoma Initiative; Rubina Imtiaz, director of Children Without Worms; Eric Ottesen, director of the Neglected Tropical Diseases Support Center; Yao Sodahlon, director of the Mectizan Donation Program

“…[S]ince the London Declaration on NTDs was signed in 2012, global partners have made much progress in reducing the burden of these diseases on people around the world. … We at the Task Force for Global Health are proud to be among those partners and to celebrate the successes of these collaborations, even as we continue to work harder to sustain our gains. … We believe collaboration is critical to solving large-scale health problems, a sentiment that was echoed at the most recent meeting of the Coalition for Operational Research on Neglected Tropical Diseases, for which the NTD Support Center at The Task Force serves as secretariat. There, in a keynote address, former U.S. President Jimmy Carter called on researchers, program implementers, donors and policy-makers to work together more closely on NTD elimination. … Whatever pride we take in our organizations, we take infinitely more pride in the collective accomplishments of the partners who are working to end NTDs. … Most importantly, however, the credit for NTD elimination belongs to the countries and communities in which these diseases continue to pose public health threats…” (4/21).

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Trump Administration's Global Women's Health Policies Not 'Pro-Life'

New York Times: Trump Thinks This Is Pro-Life?
Nicholas Kristof, New York Times columnist

“When President Trump and his (male) aides sit at a conference table deciding to cut off money to women’s health programs abroad, they call it a ‘pro-life’ move. Yet here in Haiti, I’ll tell you the result: Impoverished women suffer ghastly injuries and excruciating deaths. Washington’s new women’s health policies should be called ‘pro-death.’ … First came the ‘global gag rule,’ ending funding to overseas health aid groups linked in some way to abortion, including counseling that mentions it as an option. The latest is that Trump just cut every penny the U.S. provides the United Nations Population Fund. … Politicians in Washington don’t have a clue about the hideous things that happen when women are marginalized and health care is unavailable. What the [UNFPA] does is help girls … avoid unwanted pregnancies and the nightmare of a fistula, a prolapse, or cancer. … Yet a group of blundering men in the Trump administration posture as moral leaders, and the result is that women in places like Haiti will suffer fistulas, prolapses, and agonizing deaths in childbirth or from cervical cancer. Some of these women will be humiliated by the failures of their flesh, but the real shame belongs to sanctimonious zealots in Washington who don’t have a clue what they’re doing. And this is pro-life?” (4/22).

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Flexible, Comprehensive Strategy Critical To Eliminating Malaria

The Lancet Infectious Diseases: Is malaria elimination within reach?
Editorial Board

“Released on March 24, in ample time for World Malaria Day on April 25, WHO’s A Framework for Malaria Elimination is the first time WHO returns to this significant topic since 2007. Given the launch of this update to the framework it is fitting that the theme for World Malaria Day will ambitiously be ‘End Malaria for Good.’ … Crucially, WHO has avoided a rigid approach to its framework, acknowledging the need for ongoing revision should new tools and strategies emerge. … This flexibility is refreshingly pragmatic and stands a greater chance of success. … Nonetheless, the promotion of a strategy that is not comprehensive does risk saving up problems for the future. To reach the milestones of WHO’s Global Technical Strategy 2016-2030, the pace of progress must be rapidly accelerated. … A notable addition to the framework is the outlining of the requirements for achieving and maintaining malaria elimination. Included among these requirements is a greater emphasis on health systems. If applied with care, this focus on health systems could have broader benefits than on malaria alone. As with any document aimed at policymakers, the aims (i.e., elimination) can seem very ambitious; however, as evident from progress so far, ambition is a strategy that has served the malaria community well” (May 2017).

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Uganda President Museveni's Imprisonment Of Activist Violates Her Right To Advocate For Girls' Health, Education

Washington Post: A firebrand activist in Uganda spoke up for poor girls. Now she’s in jail.
Editorial Board

“Myriad forces pull girls from school across poor swaths of the globe. One is menstruation, long a taboo subject that causes fear and shame, and as a practical matter forces girls to miss school for lack of basics such as sanitary pads or toilets. … [Stella] Nyanzi, a mother of three and an academic, is a controversial figure who champions LGBT rights in a land where homosexual acts are outlawed. … Her latest campaign involved a broken promise by Uganda’s autocratic President Yoweri Museveni … In the campaign, the president and his wife Janet, who is also education minister, promised to fund free sanitary pads for girls in Uganda. But earlier this year, Ms. Museveni told parliament that the promise wouldn’t materialize because there wasn’t enough money. This appears to have infuriated Ms. Nyanzi … and she began to attack the president and his wife [over Facebook posts]. She also started a campaign to raise the money for the promised sanitary pads. … Mr. Museveni has never hesitated to muzzle his critics, and he swung into action against Ms. Nyanzi. … Mr. Museveni has enjoyed close ties with the United States, and truckloads of aid. This should not give him the sense that he can ignore criticism of his actions. By putting Ms. Nyanzi in prison he is not only violating her right to speak up, but also locking up the hopes of girls in Uganda for a simple measure to keep them in school” (4/23).

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China Should Play More Active Role In Global Health

The Diplomat: Why China Could be a Game Changer for Global Health
Charlotte Röhren, graduate student in international relations in Berlin and Potsdam

“…[C]ompared to China’s international economic and political weight, as well as to the relevance of the health issues at stake, China is not sufficiently engaged in multilateral global health governance. … As host country for the G20 Summit in Hangzhou last year, China missed the opportunity to prioritize global health issues. … It is in China’s own interest to engage in these discussions and related initiatives. The Chinese representative to the G20 Health Working Group will need a strong mandate to participate in global health initiatives. Beijing can also send a strong signal by scaling up its financial and technical contributions to the WHO and other U.N. organizations dealing with global health issues. China has a lot to gain from taking a more active role. Not only would its own population benefit from improving the safety net against global health threats, but China could also reap economic and reputational benefits from more engagement. … Due to China’s size and relevance, Beijing’s increased engagement could be a game changer for global health” (4/22).

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From the Global Health Policy Community

Variety Of Malaria Prevention Tools Needed To Eliminate Disease, WHO Says In World Malaria Day Ceremony

WHO: Prevent malaria — save lives: WHO push for prevention on World Malaria Day, 25th April
“At an event on the eve of World Malaria Day in Nairobi, WHO called today for accelerated scale-up of efforts to prevent malaria and save lives. … Together with diagnosis and treatment, WHO recommends a package of proven prevention approaches, including insecticide treated nets, spraying indoor walls with insecticides, and preventive medicines for the most vulnerable groups: pregnant women, under-fives, and infants. ‘WHO-recommended tools have made a measurable difference in the global malaria fight,’ said Dr. Margaret Chan, director general of WHO. ‘But we need a much bigger push for prevention — especially in Africa, which bears the greatest burden of malaria’…” (4/24).

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FT Health Discusses NTDs, Features Interview With Gavi CEO Seth Berkley

FT Health: Diseases less neglected
The latest issue of the Financial Times’ weekly global health newsletter discusses last week’s meeting on neglected tropical diseases in Geneva and highlights the newspaper’s special report on NTDs and a video discussion with Dirk Engels, head of NTDs at the WHO; Dhekra Annuzaili, public health specialist from Yemen; and Andy Wright from GSK. The newsletter also features an interview with Seth Berkley, chief executive of Gavi, the Vaccine Alliance, and provides a roundup of other global health-related news stories (Jack/Dodd, 4/21).

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From the U.S. Government

CDC Continues Efforts To Eliminate Epidemic Meningitis In Sub-Saharan Africa

CDC’s “Our Global Voices”: Looking back with pride… Looking ahead with Confidence
Nancy Messonnier, director of the CDC National Center for Immunization and Respiratory Diseases, provides a historical overview of CDC’s efforts to eliminate meningitis epidemics as a public health threat in sub-Saharan Africa, including through the use of MenAfriVac, “the first vaccine developed specifically for use in sub-Saharan Africa for children and young adults between ages one and 29 years against serogroup A meningococcal meningitis” (4/20).

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