KFF Daily Global Health Policy Report

In The News

U.N. Security Council Approves Watered-Down Version Of German-Proposed Resolution On Sexual Violence In Conflict After U.S. Threatens Veto Over Reproductive Health Language

Foreign Policy: How a U.N. Bid to Prevent Sexual Violence Turned Into a Spat Over Abortion
“The Trump administration pressured Germany into watering down a United Nations resolution aimed at preventing rape in conflict situations, forcing it to remove language on sexual and reproductive health that key Trump administration officials say normalizes sexual activity and condones abortion, according to U.N.-based diplomats and an internal State Department cable reviewed by Foreign Policy. The United States was set to veto the resolution, underscoring the growing rift between Washington and its European allies and the increasing U.S. isolation in multilateral institutions under President Donald Trump. But Germany relented and stripped the resolution of the language to secure the U.S. vote. It passed on Tuesday afternoon with 13 votes in favor. Two countries, Russia and China, abstained…” (Gramer/Lynch, 4/23).

The Guardian: U.N. waters down rape resolution to appease U.S.’s hardline abortion stance
“…Other omissions included calls for a working group to review progress on ending sexual violence. The U.K. backed the resolution, but expressed regret about the omission on reproductive health care. … France and Belgium also expressed disappointment at the watered down text. … The agreed-upon resolution was a sliver of what the Germans had put forward earlier this month. The zero draft included progressive text on strengthening laws to protect and support lesbian, gay, bisexual and transgender people who could be targeted during conflict. It also made specific mention of the need for women to have access to safe terminations. But the resolution — number 2467 — did for the first time make specific calls for greater support for children born as a result of rape in conflict, as well as their mothers, who can face a lifetime of stigma. It also gave prominence to the experiences of men and boys…” (Ford, 4/23).

Reuters: Bowing to U.S. demands, U.N. waters down resolution on sexual violence in conflict
“…The language promoting sexual and reproductive health is long-agreed internationally, including in resolutions adopted by the Security Council in 2009 and 2013 and several resolutions adopted annually by the 193-member General Assembly. The text adopted on Tuesday simply reaffirms the council’s commitment to the 2009 and 2013 resolutions. A reference to the work of the International Criminal Court in fighting the most serious crimes against women and girls was also watered-down to win over Washington, which is not a member of the institution. … The council voted after hearing briefings from Nobel Peace Prize winners Nadia Murad, an Iraqi Yazidi woman who was held as a sex slave by Islamic State militants, [and] Congolese doctor Denis Mukwege, who treats rape victims, [as well as] Libyan rights activist Inas Miloud and international human rights lawyer Amal Clooney…” (Nichols, 4/23).

Washington Post: The U.N. wanted to end sexual violence in war. Then the Trump administration had objections
“…For advocates dedicated to ending sexual violence in conflict, the U.S. resistance appeared especially contradictory for an administration that has often portrayed itself as championing the rights of Yazidi women, who have faced sexual violence by the Islamic State in recent years. Human rights groups argue that the U.S. move sends the wrong message, after decades in which sexual violence has become a more systematically used weapon of war. Whereas rape has often accompanied conflict in history, the use of sexual violence as a systematic intimidation tool mostly emerged in the 20th century…” (Noack, 4/24).

Additional coverage of the U.N. resolution is available from ABC News, Agence France-Presse, Al Jazeera, Associated Press, BBC News, CNN, Daily Beast, Deutsche Welle, The Hill, The Independent, NPR, TIME, and U.N. News.

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Trump Expected To Formally Nominate Kelly Knight Craft As U.S. Ambassador To U.N. Next Week

POLITICO: Months later, Trump closes in on U.N. nomination
“President Donald Trump is expected to formally nominate Kelly Knight Craft next week to be the new United States ambassador to the United Nations, a position that has remained unfilled for months at a time of global concerns that president is not committed to such diplomatic institutions. But Craft, the U.S. ambassador to Canada, faces a tough Senate confirmation process…” (Toosi/Orr, 4/23).

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Violent Attacks On Ebola Treatment Centers, Health Workers In DRC Hinder Response Efforts As Disease Spreads

The Guardian: Rumor and violence rife as Congo Ebola outbreak surges out of control
“…Since the [Democratic Republic of the Congo (DRC)] epidemic began last August, 1,340 confirmed and probable cases of Ebola have been recorded, more than 250 cases since the beginning of April, and 874 people have died … Agencies blame the recent surge in transmission on a continued lack of trust in communities and violent attacks on treatment centers in February and March, which forced health workers to wind down some services. … April has already seen a higher number of cases reported than any other month since the outbreak began…” (Tsongo/Ratcliffe, 4/24).

NPR: The Doctor Killed In Friday’s Ebola Attack Was Dedicated … But Also Afraid
“…[W]ith each attack, [health workers have] had to take time to re-group and re-assess their security precautions. And that’s required pausing key activities like vaccinating people exposed to the virus. The result has been a surge of new infections. Before the first major attack in February there were roughly 30 new cases a week; this month the weekly new case count has regularly hovered around 70 and even reached as high as 110…” (Aizenman, 4/23).

The Telegraph: Ebola doctor killed as violence hampers response to outbreak in DRC
“A World Health Organization doctor has been killed by armed militia when a hospital at the epicenter of the Ebola outbreak in the Democratic Republic of Congo was stormed by rebels. … [Dr. Richard Valery Mouzoko Kiboung, an epidemiologist from Cameroon,] who had four children, had been deployed by the WHO in response to the epidemic — the second largest Ebola outbreak in history. Just hours after the incident at Butembo University Hospital attackers armed with machetes targeted an Ebola treatment center in the Katwa region a separate incident…” (Newey, 4/23).

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Malaria Vaccine Pilot Program For Young Children Begins In Malawi

CIDRAP News: World’s first malaria vaccine program launches in Malawi
“Given that malaria is one of the world’s leading killers, especially of African children, [Tuesday’s] launch of a pilot program to immunize babies in Malawi with the RTS,S vaccine offers global health officials and scientists a chance to see if it can jump-start stalled progress in the battle against the disease…” (Schnirring, 4/23).

The Guardian: Malawi starts landmark pilot of first ever child malaria vaccine
“…Although the vaccine protects only a third of children aged under two years from life-threatening or severe malaria, clinical trials have found those who are immunized are likely to have less severe cases of the disease. Earlier, smaller trials also showed the vaccine prevented four in 10 cases of malaria overall, in babies aged between five and 17 months…” (McVeigh, 4/23).

NPR: World’s First Malaria Vaccine Launches In Sub-Saharan Africa
“…On Tuesday, toddlers in Malawi started receiving the immunization. Then children in Ghana and Kenya will follow shortly. The goal is to vaccinate about 360,000 children in this large-scale pilot project…” (Doucleff, 4/23).

U.N. News: New malaria vaccine trial in Malawi marks ‘an innovation milestone,’ declares U.N. health agency
“…The pilot program is a collaboration between the U.N. and ministries of health in Ghana, Kenya, and Malawi and a range of other national and international partners, including PATH, a non-profit organization, and GSK, the vaccine developer and manufacturer, which is donating up to 10 million doses for this pilot…” (4/23).

Additional coverage of the malaria vaccine pilot program is available from CNN, Healio, The Hill, HuffPost, and International Business Times.

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Health Workers, Parents Raise Questions About Measles Vaccine Viability In South Sudan Amid Outbreak

Associated Press: South Sudan measles outbreak raises questions about vaccines
“…As South Sudan emerges from a five-year civil war, more than 750 measles cases, including seven deaths, have been reported since January. That’s almost six times the number of cases for all of 2018, according to World Health Organization data. … Though an emergency vaccination campaign is underway in South Sudan’s 12 affected counties, the outbreak is spreading, leading some health officials and residents to doubt the vaccine’s viability in some cases. … While the AP could not independently verify that [two] children [who died of measles] had been vaccinated, medical workers at Kuajok hospital are seeing some vaccinated children contract measles, said Dr. Garang Nyuol…” (Mednick, 4/24).

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False Polio Vaccine Rumors Spread Panic In Pakistan, Send 25K Children To Hospital

Agence France-Presse: Polio vaccine fears spread panic in Pakistan
“More than 25,000 children were rushed to hospitals in northwest Pakistan after rumors spread that some had suffered reactions to a polio vaccine, officials said Tuesday…” (4/23).

The Telegraph: 25,000 children in Pakistan rushed to hospital after spread of false polio vaccine rumors
“…The scare, which travelled widely online, followed inaccurate reports that students attending a private school in a village near Peshawar fell sick after receiving their polio drops. Many residents of the region have long been suspicious of the vaccine with local militants and extremists claiming it is a Western conspiracy to harm or sterilize children…” (Wallen, 4/23).

VOA News: Scaremongering Video Undermines Anti-Polio Drive in Pakistan
“Police in northwestern Pakistan have detained a man and are hunting down his suspected associates for spreading unfounded rumors through fake social media videos that a polio vaccine led to fainting and vomiting. The detainee, Nazar Muhammad, who teaches at a private school near the Peshawar city, is seen in the scaremongering Twitter videos instructing his students to faint and pretend to be sick from the oral polio vaccine (OPV)…” (Gul, 4/23).

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Drones To Deliver Medicines, Vaccines, Blood Supplies Across Ghana

Financial Times: Drones to deliver medicines to 12m people in Ghana
“The world’s largest drone delivery network, ferrying 150 different medicines and vaccines, as well as blood, to 2,000 clinics in remote parts of Ghana, is set to be announced on Wednesday. The network represents a big expansion for the Silicon Valley start-up Zipline, which began delivering blood in Rwanda in 2016 using pilotless, preprogrammed aircraft…” (Munshi, 4/24).

Reuters: Drones to deliver vaccines, blood and drugs across Ghana
“…Medics will place orders by text message when supplies run dry, said GAVI Chief Executive Seth Berkley. Drones will then fly in from four distribution centers, hover over health posts, and drop deliveries using tiny parachutes. … The aim is for deliveries to arrive within 30 minutes, Berkley added, meaning emergency treatments such anti-snake venom or rabies shots could arrive in time to save lives…” (Kelland, 4/24).

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More News In Global Health

Devex: Partnering for health security in the Indo-Pacific (Cornish, 4/24).

Devex: Communities come to the rescue of Nigeria’s local hospitals (Adepoju, 4/24).

New Humanitarian: Outcry at U.N. plans to consolidate Syria aid operations in Damascus (Parker/Slemrod, 4/23).

The Telegraph: India doctor shortage drives rise in superbugs, report warns (Wallen, 4/23).

U.N. News: Libya: Thousands seek shelter in health clinics from Tripoli fighting, U.N. warns (4/23).

Xinhua News: Fresh polio case detected in Afghanistan: official (4/23).

Xinhua News: Rwanda launches fresh campaign to ensure healthy living (4/23).

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Editorials and Opinions

Progress Toward TB Elimination Requires Collective Effort To Develop Novel, Effective Vaccines

PLOS Medicine: Tuberculosis vaccines: Rising opportunities
Johan Vekemans, medical officer at the Initiative for Vaccine Research at the WHO; Katherine L. O’Brien, director of the WHO’s Department of Immunization, Vaccines and Biologicals; and Jeremy Farrar, director of Wellcome

“…[T]ransforming discovery and vaccine candidates into products that can have impact takes more than declarations of support. … Progress toward TB elimination will require vigorously pursuing the potential contribution of novel TB vaccines propelled by new evidence recently made available. Advocates working on TB as a major global health problem should lead decision-makers toward this realization. The possibility to transform the opportunities into action will be a test of the collective ability of the global health community to succeed in developing and using vaccines aimed at addressing diseases disproportionately affecting the poor. The world needs better operating models supporting prompt progress from vaccine efficacy proof-of-concept to evaluation for use and impact in support of policy decision and funding for implementation. A sense of responsibility toward global health from the corporate sector manufacturing vaccines is needed as well as from the public and philanthropic sector, through the setup of functional public-private partnerships supported by innovative funding mechanisms. Opportunities are rising in the search for tools to prevent TB; let us not squander this chance. Now is the time for mobilization toward vaccine impact against TB” (4/23).

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Achieving Sustainable Food, Energy Systems Critical To Health Of Global Environment

Devex: Opinion: Food, fuel, and the future of human development
Craig Hanson, vice president for Food, Forest, Water & The Ocean at the World Resources Institute

“…The food system has significant — but often underappreciated — impacts on the environment … Nearly a quarter of the world’s annual greenhouse gas emissions are linked to agriculture. … Food and fuel are critical not only for the global environment but also for the global economy. … If the aspirations of Earth Day are ever to be realized, then figuring out how to achieve sustainable food and energy systems — addressing both the production and consumption sides of the equation — will need to be a strong focus of the environmental movement. Such a focus would directly tackle the underlying causes of most of the world’s environmental challenges, getting beyond putting just a Band-Aid on symptoms. It would ensure environmentalism aligns with human development since little is more basic to human well-being than food and energy. And such a focus would be relevant for all nations since food shortages and fuel shortages can topple governments. In short, this and future Earth Days should boil down to food and fuel…” (4/22).

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Oversight Of Technical Platforms Critical In Preventing Spread Of Medical Misinformation

Financial Times: Measles outbreak is a reminder of the power of viral information
Marietje Schaake, Dutch politician and member of the European Parliament

“…While authorities scramble to contain [measles], the influence of information taken from the internet on people’s real-life choices is undeniable. … It is now time for systematic scrutiny of the algorithms that make anti-vaccination and other toxic information go viral. … Without oversight, the public interest is not protected. … Tech platforms cannot remain immune to regulation when their tools lead to the spread of diseases, lies, or hatred. … Transparency rules should require platforms to make clear when bots are involved and the sources of advertising. Knowing who is paying to amplify and spread medical hoax messages is as important as knowing the sources of political ads. With more information, we may better understand the links between the anti-vaccination movement and politicians … who have … questioned the medical, as well as political, establishments. The recent measles outbreaks remind us that our understanding of the toxic impact of algorithms on people’s actions is proven, and that ad hoc protection measures are not enough. Systematic oversight of the way the online information ecosystem steers people’s behavior is needed to prevent future epidemics, whether medical or political” (4/23).

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From the Global Health Policy Community

Sanofi Pasteur Executive Discusses Value Of Life-Course Approach To Immunization

World Economic Forum: Why vaccines are not just for children
David Loew, executive vice president at Sanofi Pasteur, discusses the value of vaccines and the importance of applying a life-course approach to immunization, including key policy considerations and opportunities for advancing life-course immunization (4/23).

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Journalist Discusses Efforts To Reduce Japanese Encephalitis Cases Through Vaccination Efforts

Bill & Melinda Gates Foundation’s “The Optimist”: The secret journey of an effective vaccine
Caroline Lambert, journalist and former visiting fellow at the Center for Global Development, discusses efforts to address Japanese Encephalitis (JE) in countries in Asia and the Pacific, including the role of PATH in leading vaccination efforts to reduce cases. Lambert writes, “In spite of this success, there is no room for complacency. … Work indeed remains to be done to improve surveillance and better measure the impact of interventions. More granular data will help refine where vaccination is most needed. National authorities facing competing immunization choices have to decide where to roll out the JE vaccine at the subnational level. Better data would also help make the case for JE immunization in countries … where JE is endemic but the vaccine is still not being offered as part of public health programs…” (4/22).

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Joint Report Explores Ethical Challenges For Humanitarian Health Organizations Working In Conflict Situations

Johns Hopkins Bloomberg School of Public Health: Reality Makes Our Decisions: Ethical Challenges in Humanitarian Health in Situations of Extreme Violence
“…This project, a collaboration involving researchers and staff from the Johns Hopkins Bloomberg School of Public Health, the Johns Hopkins University Berman Institute of Bioethics, the Syrian American Medical Society (SAMS), and the International Rescue Committee, explores the ethical challenges organizations face in situations of extreme violence, particularly when health care facilities and personnel become targets in the conflict…” (April 2019).

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From the U.S. Government

Professor Discusses Efforts To Address Meningitis In Burkina Faso

CDC’s “Our Global Voices”: From Mangoes to Meningitis: A Tale of One Laboratory Scientist in Burkina Faso
Rasmata Ouédraogo-Traoré, chief of the Medical Analysis Laboratory of the Charles De Gaulle Pediatric Hospital, which houses the National Reference Laboratory for meningitis in Burkina Faso, and professor of bacteriology-virology, medical sciences, and pharmacy at the University of Ouagadougou, discusses the challenges of addressing meningitis in Burkina Faso, including the epidemiology, role of laboratories in supporting surveillance and guiding the epidemic response, and future of meningitis in the country (4/24).

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From KFF

KFF Updates Fact Sheet Examining President's Malaria Initiative, Other U.S. Government Global Malaria Efforts

Kaiser Family Foundation: The President’s Malaria Initiative and Other U.S. Government Global Malaria Efforts
Ahead of World Malaria Day, which takes place annually on April 25, KFF updated its fact sheet examining the U.S. government’s role in global malaria efforts. The fact sheet includes an overview of the global situation, the President’s Malaria Initiative, multi- and bilateral funding, malaria interventions, and global goals for control and eradication (4/23).

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