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Kaiser Daily Global Health Policy Report

In The News

Concerns Rise Over Food Insecurity In Africa's Sahel Region

“Despite early indications the Sahel would not suffer pangs of hunger this year, experts now worry that food insecurity could be worse than in 2012 — the year of the West Africa food crisis,” Thomson Reuters Foundation reports. “Ten million people in the Sahel remain food insecure, and 4.5 million children under-five are at risk of acute malnutrition,” the news service notes, adding, “Floods in northern Nigeria as well as conflict throughout the region are thought to be the main causes for increasing food insecurity throughout the Sahel.” In addition, “[t]he conflict in Mali has also caused strains, with supply routes closing and Arab traders who supplied markets in the country’s north fleeing,” the news service writes (Hussain, 4/26). “On Thursday four international agencies warned that northern Mali will descend to emergency levels of food insecurity in less than two months if conditions do not improve,” The Guardian reports. “[T]he war — which since January has led to the intervention of French and African military forces — has created long-term instability and huge displacement in northern Mali,” the newspaper notes, adding, “The U.N. says 282,548 people are now registered displaced in Mali, and almost 50,000 refugees are in Burkina Faso and Niger, and 74,000 in Mauritania.” According to the newspaper, “[m]any organizations working on food distribution in northern Mali say they are facing a funding shortfall” (Hirsch, 4/29).

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Health Services For Syrian Refugees Overstretched, U.N. Report Warns

“The refugee crisis sparked by the conflict in Syria is increasingly straining health services in surrounding countries, while refugees are finding it harder to access the quality treatment they need, the United Nations refugee agency warns in report released [Friday],” the U.N. News Centre reports (4/26). “The report is the first assessment of the health situation of Syrian refugees in neighboring Iraq, Jordan and Lebanon,” VOA News writes, adding, “The report says the Syria refugee crisis is putting an enormous strain on the health systems and refugees are having difficulty getting the care they need.” VOA continues, “The report, which covers the first three months of this year, shows refugees need treatment for injuries, psychological illnesses and communicable diseases, as well as chronic diseases such as diabetes and hypertension” (Schlein, 4/26).

“With more than one million Syrian refugees in these three countries, and above 1.4 million around the region, there are two major problems facing the health system,” a UNHCR press release states. “First, with low funding for the refugee crisis, the challenge of providing access to quality health care for Syrian refugees is growing — particularly for people living outside of camps,” the press release continues, adding, “Secondly, the increasing numbers of people needing medical help is straining existing health services in each of the affected countries” (4/26). “‘The challenges of providing access to affordable and quality health care for Syrian refugees will only increase in the months to come,’ the UNHCR said in its report,” according to Reuters (Nebehay, 4/26).

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IPS Examines Work Of U.N. High-Level Task Force On Population, Development To Eliminate Stigma Surrounding Reproductive Health

Inter Press Service examines efforts by the U.N. High-Level Task Force for the International Conference on Population and Development (ICPD) to overcome stigma surrounding sexual and reproductive health in global discussions about population growth and development. “The task force’s work — titled ‘Policy Recommendations for the ICPD Beyond 2014: Sexual and Reproductive Health and Rights for All’ — reaffirms values established almost 20 years ago in Cairo, where 179 governments gathered to adopt a Programme of Action that placed the human rights of women at the center of international development goals,” the news service writes, adding, “The task force calls on the governments to address Cairo’s ‘unfinished agenda’ by: ensuring sexual and reproductive rights through law; working towards universal access to sexual and reproductive health services; providing sexuality education for all young people; and eliminating violence against women and girls.”

“It argues that governments should expand access to safe abortion and to services for victims of gender-based violence, and that the international community should adopt a definition of ‘comprehensive sexuality education,'” IPS notes. “The task force’s work will inform U.N. negotiations for a new development framework, to replace the expiring Millennium Development Goals (MDGs) post-2015,” according to the news service, which adds, “According to the task force, the sexual and reproductive health of young women and girls are particularly compromised.” The news service quotes a number of members of the task force, including Joaquim Alberto Chissano, a former president of Mozambique and co-chair of the task force; Ishita Chaudhry, founder of the YP Foundation, a non-profit organization in India; and Tarja Halonen, former president of Finland and co-chair of the task force, among others (Gao, 4/26).

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H7N9 Bird Flu Virus Continues To Spread Throughout China

“China on Saturday reported its first case of H7N9 bird flu in the southern province of Hunan, the latest sign the virus that has killed 23 people in the country is continuing to spread,” Reuters reports (Ruwitch, 4/29). “A 64-year-old woman surnamed Guan, a resident in Shaoyang City, started suffering from a fever on April 14, and laboratory tests confirmed her H7N9 infection on Saturday, Hunan Provincial Health Department said in a statement,” Xinhua writes (4/27). “Six more cases of H7N9 bird flu were reported on Friday in the Chinese provinces of Fujian, Jiangsu, Jiangxi and Zhejiang,” Xinhua notes in a separate article (4/26). And “[o]n Thursday, the eastern province of Jiangxi confirmed its first case of H7N9, in a 69-year-old-man,” Agence France-Presse adds, noting, “More than 110 people in mainland China have been confirmed with H7N9, with 23 deaths, since the government announced on March 31 that the virus had been found in humans” (4/26). “The reports of new cases come just a day after a Taiwanese man was found to have the H7N9 virus, which he caught in China. It is the first report of the flu outside of the mainland, according to Reuters,” GlobalPost writes (Ralph, 4/27).

Last week, the WHO “called the virus, known as H7N9, ‘one of the most lethal,’ and said it is more easily transmitted than an earlier strain that has killed hundreds around the world since 2003,” Reuters notes in a separate article, adding, “Chinese scientists confirmed on Thursday that chickens had transmitted the flu to humans” (Rajagopalan, 4/26). “In a fast-track study published in leading medical journal the Lancet on Thursday, a team of scientists from mainland China and Hong Kong showed that strains of the virus that infected some of the earliest patients were genetically very similar to strains found in infected chickens and pigeons at wet markets,” the Wall Street Journal writes (4/26). “There is no evidence yet of it spreading from person to person, but the WHO has warned that the virus could gain that ability in the future, increasing the threat,” the Los Angeles Times reports (Alpert, 4/26). The “CDC noted in a news release Friday that ‘the number of human infections with avian influenza A (H7N9) in China has risen to 109 with 23 deaths. There are still no reports of H7N9 in the United States. While there is no evidence of sustained human-to-human spread of this virus, CDC is taking routine pandemic preparedness measures to prepare for that possibility,'” CQ HealthBeat writes (Reichard, 4/29).

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At Library Dedication, U.S. Presidents Praise Bush For Work On HIV/AIDS, Malaria While In Office

Last week, “[t]he George W. Bush Presidential Library dedication brought together five living presidents who have been at odds about much of the 43rd president’s foreign policy legacy, particularly the Iraq war … [b]ut they all agreed on, and offered effusive praise for, Bush’s work on Africa,” ABC News’ “The Note” blog reports. “From the historic peace agreement between Sudan and South Sudan in 2005, to Bush’s work on HIV/AIDS and malaria, all the presidents, regardless of party, thanked No. 43 for his involvement in African policies and issues,” the blog states, noting, “His administration’s aid was largely targeted to fight the major global health issues facing the continent, HIV/AIDS and malaria.” ABC News discusses the creation of PEPFAR and the President’s Malaria Initiative and includes comments from some of the speakers at the dedication. “Since leaving office the former president and his wife, Laura, have continued to stay active in global health issues in Africa, now taking on cancer,” the blog notes, adding, “The George W. Bush Institute has launched the Pink Ribbon Red Ribbon initiative to try and bring together both public and private investment to fight cervical and breast cancer in Africa and Latin America” (Hughes, 4/26).

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Somalia Launches Pentavalent Vaccine With Support From GAVI, UNICEF, WHO

“Coinciding with World Immunization Week, the Somali government announced on 24 April its intention to vaccinate all children under the age of one with a new five-in-one vaccine, known as a pentavalent vaccine, funded by the GAVI Alliance, with [UNICEF] and the [WHO] as implementing partners,” IRIN reports. “Currently, fewer than half of children in Somalia have received the mandatory diphtheria, tetanus and pertussis (DTP) vaccine,” but “[t]he pentavalent will protect immunized children against these three diseases, as well as hepatitis B and Haemophilius influenzae type B,” according to the news service (4/26). “President Hassan Sheikh Mohamud, speaking at the new vaccine’s launch in Mogadishu on Wednesday, said all Somali children deserve the good health that children from rich countries enjoy,” Bloomberg Businessweek writes, adding, “He blamed much of the country’s vaccination problem on al-Shabab, the al-Qaida-linked militant group that controls much of south-central Somalia and up until August 2011 controlled Mogadishu” (Straziuso, 4/25). A GAVI Alliance press release notes, “The launch of the vaccine is being accompanied by an outreach campaign to make parents aware of the importance of the new vaccine which replaces the DTP vaccine for diphtheria, tetanus and pertussis (whooping cough)” (4/23).

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Al Jazeera Programs Examine Vaccine Funding, Efforts To Fight Malaria, TB, HIV

Al Jazeera’s “Inside Story” on Friday examined whether funding and political will can keep pace with efforts to vaccinate every child worldwide. The 25-minute video program, “with presenter Shiulie Ghosh, discusses with guests: Kate Elder from Doctors Without Borders; Adel Mahmoud, a global health specialist at Princeton University, and former president of Merck Vaccines,” Al Jazeera writes. The news service notes the WHO “estimates that immunization prevents up to three million deaths every year, but it says an estimated 22 million children worldwide are missing out on basic vaccines” (4/26).

The news agency’s “South to North” on Sunday examined efforts to fight malaria, tuberculosis and HIV/AIDS, “three infectious diseases that account for 10 percent of all deaths worldwide.” In the 25-minute video program, host “Redi Tlhabi speaks to Dr. Lucica Ditiu, the executive secretary of the Stop TB Partnership based at the [WHO] in Geneva; and Dr. Mphu Ramatlapeng, the executive vice president at the Clinton Health Access Initiative and Lesotho’s former health minister,” Al Jazeera notes. “Tlhabi also speaks to music legend Yvonne Chaka Chaka, the ‘Princess of Africa,’ about her work in creating awareness around malaria, as the world marks Malaria Day on 25 April,” the news service writes (4/28).

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PBS Blog Features Stories Looking At Mobile Technology And Health In Africa

PBS’s “Rundown” blog features two stories as part of the “Cheers Report,” a “series of reports on the impact of mobile technology and health in 10 African countries.” In the first story, Imani Cheers, the director of educational resources and a multimedia producer for the PBS NewsHour, describes how mobile phones are helping to fight malaria in Zambia, where community health workers receive cell phones in return for their rapid reporting of malaria cases (4/25). The second story describes how “the Malawi Ministry of Health and [non-governmental organizations (NGOs)] such as Village Reach are collaborating with communities to use cell phones to address some of the causes of poor health care for women and children,” such as “limited availability of timely and reliable health information, access and use of health facilities and delays in services,” Cheers reports (4/26).

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Editorials and Opinions

Editorial, Opinion Pieces Address Proposed Food Aid Reform

The following is a summary of an editorial, opinion pieces, and a blog post addressing proposed reform to the U.S. food aid program contained in President Obama’s FY 2014 budget request.

  • New York Times: “Since the mid-1950s, the United States has spent nearly $2 billion annually to feed the world’s poor, saving millions of lives. But the process is so rigid and outdated that many more people who could be helped still go hungry,” the editorial states, adding, “Reforms proposed by President Obama will go a long way toward fixing that problem and should be promptly enacted by Congress.” The editorial continues, “Under a proposal in Mr. Obama’s new budget, nearly half the $1.5 billion requested for food aid in 2014 could instead be used to buy food in bulk in countries in need or to provide individual recipients with vouchers or debit cards for local food purchases.” The newspaper concludes, “Obama’s proposed reforms will feed more people for the same amount the United States spends now. There is no excuse for not putting them into effect” (4/27).
  • Ryan Alexander, Albany Tribune: “Unsurprisingly, the existing system’s boosters are outraged,” Alexander, president of Taxpayers for Common Sense, writes. “Supporters tout this [current food aid] system as being good for farmers, good for shippers, and even good for the aid groups. But it’s horribly inefficient,” he continues, adding, “If we as a nation decide that for humanitarian, diplomatic, and strategic reasons we’ll keep providing food aid, then we should do it in a cost-effective manner that gets the most bang for our buck. That means not lining the pockets of U.S. agribusiness and shipping interests along the way” (4/28).
  • David Beckmann, Huffington Post’s “Impact” blog: Obama’s FY14 budget “proposal is particularly encouraging because it includes important reforms to our international food aid system — allowing greater flexibility and increasing efficiency so that food aid reaches millions more people,” Beckmann, president of Bread for the World, writes. “This is a major step forward,” he states, adding, “First, food aid under the president’s proposal would reach up to four million more people than do current programs. Second, it gains efficiencies at a time when every penny counts, and lawmakers are deadlocked on the budget” (4/26).
  • Ambassador David Lane, U.S. State Department’s “DipNote” blog: “The announcement of a major reform to U.S. food aid in President Obama’s proposed 2014 budget has spawned considerable reaction, both praise and criticism,” Lane, U.S. representative to the U.N. agencies in Rome, writes. “From my perspective as the U.S. ambassador to the United Nations agencies that provide food assistance and promote agricultural development, it is a welcome development long in the making,” he continues, adding, “We must remain flexible and innovative, learn from our experiences and tailor our interventions based on evidence and the best that science and technology have to offer, so that we can end hunger and undernutrition and help meet the challenge of feeding a rapidly growing population in the future” (4/26).

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Congress Should Maintain Support Of Global Health Programs 'Despite Fiscal Challenges'

“U.S. support for global health has had a major impact around the world, particularly our contributions to fighting malaria through the President’s Malaria Initiative and the Global Fund to Fight AIDS, Tuberculosis, and Malaria,” Rep. Ander Crenshaw (R-Fla.), co-chair of the Congressional Caucus on Malaria and Neglected Tropical Diseases, and Steve Davis, CEO of PATH, write in a Washington Times opinion piece. “Since the launch of the malaria initiative in 2005, malaria cases have decreased by 50 percent in 43 countries, saving the lives of more than one million children and improving economic growth and national security in malaria-endemic countries,” they state. “What is remarkable about these numbers is that we have been able to accomplish so much with relatively little,” they continue, noting, “Less than one percent of the U.S. budget is spent on foreign assistance, and our contribution to fighting malaria is less than three-hundredths of one percent of total U.S. government spending.”

“As we enter into budget negotiations for fiscal 2014, U.S. policymakers will have some difficult decisions to make,” Crenshaw and Davis continue, adding, “Whether to continue funding malaria work should not be one of them.” They conclude, “The United States has an opportunity to strengthen its role as a global leader in this fight — to decide, despite fiscal challenges, to sustain the impressive progress made by maintaining robust funding for the Global Fund and the President’s Malaria Initiative, as well as support for malaria research and development through the [NIH], the [CDC], the Department of Defense, and [USAID]. Through these commitments, we will demonstrate to the world our dedication to ending malaria once and for all” (4/26).

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From the Global Health Policy Community

Continued Work Needed In Vaccine Development

Reflecting on World Immunization Week, April 21-28, Angeline Nanni, director of market access at Aeras, discusses the “remarkable results” of expanded immunization programs in a guest post on the Global Health Technologies Coalition’s “Breakthroughs” blog. “Immunization has saved the lives of more children than any other medical intervention in the last 50 years. However, one in five children still do not have access to these lifesaving vaccines,” she notes. Nanni discusses the importance of developing tuberculosis and HIV vaccines, writing, “Prevention through vaccination would be the most cost-effective tool to mitigate these global epidemics.” She adds, “Vaccines have made the world a vastly different place by reducing the incidence of disease, providing freedom from worry and fear of the death and disability that they cause. Vaccines hold the key to a healthier and wealthier world for all of us” (4/26).

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Blog Examines Role Of Islamist Leadership In Combating Polio

Noting the Global Vaccine Summit held in Abu Dhabi last week, Ayesha Malik, a campaigner at the Muslim-led campaigning charity MADE in Europe, writes in a post in the charity’s blog about the role of Islamic leadership in the global push to eradicate polio. “As Muslims, we should be the pioneers of safeguarding human welfare and now we have been given this opportunity to contribute towards something miraculous, we must support it wholeheartedly. The invitation and the responsibility of course extends beyond the participants of the summit to each one of us in our own capacity,” Malik writes in the blog post, which also was published in the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog (4/25).

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Chart Presents Timeline Of HIV Prevention Options

The Center for Global Health Policy’s “Science Speaks” blog examines a chart, titled “HIV Prevention Options Timeline,” which “was part of AVAC Director Mitchell Warren’s presentation at a Jhpiego-sponsored” event on Thursday, titled “The Present and the Future of HIV Prevention.” According to the blog the “chart of clinical research trials seeking ways to control HIV transmission makes for an impressive display of tenacity, with interrupted trials, ongoing trials, trials that led to other trials, and new trials in their earliest stages. It includes trials of microbicides, vaccines, antiretroviral drug-based approaches and all of that in different combinations” (Barton, 4/26).

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