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Kaiser Daily Global Health Policy Report

In The News

Cuts To U.S. Foreign Aid For Central American Countries Could Increase Migration, Experts Say

Associated Press: U.S. aid cuts will spur Central America migration, experts say
“Government officials, aid workers, and activists in Central America are mystified by U.S. President Donald Trump’s threat to cut off nearly $500 million in aid to Honduras, Guatemala, and El Salvador in response to what he calls an immigration crisis. Over time, they say, it will only worsen the problem…” (Aleman, 4/2).

Devex: ‘Rescission by another name.’ Trump move sparks questions for implementers
“President Donald Trump’s surprise announcement last week that the United States would cease all foreign assistance funds to the ‘Northern Triangle’ countries of El Salvador, Guatemala, and Honduras has left NGOs, implementers, government agencies, and the U.S. Congress scrambling to determine how much funding and what programs could be impacted by a sudden evaporation of money…” (Welsh, 4/3).

New York Times: Trump Wants to Cut Aid to Central America. Here Are Some of the Dozens of U.S.-Funded Programs.
“…Critics of the cuts say they will target programs aimed at preventing violence, curbing extreme poverty and hunger, and strengthening the justice system — the very problems residents of those countries give for leaving home and pursuing a more stable future elsewhere. … Here are some examples of programs financed by American dollars in the three countries targeted by President Trump…” (Specia, 4/2).

New York Times: Where Does Aid to Central America Go? Police Officers, Farmers and NGOs
“…The decision to end aid is likely to provoke anger in Congress, where lawmakers in both parties have supported efforts to address the root causes of migration. If the money is ultimately withheld, it would affect a wide range of programs designed to improve citizen security, promote economic development, and encourage accountable government…” (Malkin, 4/1).

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Iran Hit By 3rd Major Flood In Past 2 Weeks; Foreign Minister Blames U.S. Sanctions For Hindering Rescue Efforts

Agence France-Presse: Iran orders evacuation of flood-hit western cities
“The authorities on Monday ordered the immediate evacuation of flood-stricken cities in western Iran as rivers burst banks, dams overflowed, and vast areas were cut off from communication. … This is the third major flood to hit Iran in the past two weeks after heavy rainfalls in the mostly arid country, which had endured a prolonged drought until this year. The first flood struck the northeast of the country on March 19 and the second hit the west and southwest on March 25, with a combined reported death toll of 45 people…” (4/1).

Associated Press: Iran says U.S. sanctions impede flood rescue operations
“Iran’s foreign minister says sanctions imposed by the Trump administration last year have hampered rescue efforts in flood-stricken areas of the country, where nearly 60 people have died since mid-March, while the U.S. blamed the disaster on the Iranian government’s own ‘mismanagement.’ Mohammad Javad Zarif tweeted late Monday that America’s ‘maximum pressure’ policy on Iran ‘is impeding aid efforts by #IranianRedCrescent to all communities devastated by unprecedented floods.’ He said the sanctions have prevented Iran from acquiring badly needed equipment, including relief helicopters…” (Karimi, 4/2).

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New Republic Examines How Rise Of Nationalism Impacting Global Health

New Republic: How the rise of right-wing nationalism is jeopardizing the world’s health
“…Measles cases are multiplying across the globe for the same reason that the international campaign to eradicate polio has stalled, and that Ebola outbreaks continue, and that opportunistic new diseases like Zika take us by surprise: a rise in nationalist politics, which is causing countries to turn inward, harden their borders, and distrust outsiders. … Pathogens pay no respect to politics or to borders. Nationalist rhetoric seeks to persuade us that restricting visas and constructing walls will protect us. They will not. … Distrust of expertise, suspicion of immigrants, shunning of international cooperation — these all describe nationalist movements in Africa and Europe. But the place where official attitudes toward global public health have changed most sharply is the United States during the presidency of Donald Trump…” (McKenna, 4/1).

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Violence, Mistrust Of Health Workers Continue To Hinder DRC Ebola Outbreak Response

Associated Press: WHO says Ebola cases rising in eastern Congo after violence
“The World Health Organization says Ebola is on the rise in eastern Congo following a series of attacks on health facilities. WHO spokesman Christian Lindmeier says the past two weeks have seen a record number of new cases in this outbreak…” (4/2).

CIDRAP News: WHO: Butembo, Katwa remain hot spots of Ebola activity
“…With 72 Ebola cases reported last week and 56 in the previous week, March was a low point for responders, as activity spiked and the outbreak topped the 1,000-case milestone…” (Soucheray, 4/2).

VOA News: Insecurity, Community Mistrust Stymie Efforts to Control DRC Ebola Epidemic
“…WHO Assistant Director-General for Emergencies Response Ibrahima-Soce Fall attributes the rise to insecurity and violence in the North Kivu hot spots of Butembo and Katwa. He says that has caused major disruptions in the ability of health workers to respond to the disease…” (Schlein, 4/2).

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Cholera Vaccination Campaign Begins In Cyclone-Hit Mozambique; Authorities Record More Than 1,400 Cases

Agence France-Presse: Cholera kills two, infects 1,400 in cyclone-hit Mozambique
“A cyclone-induced cholera outbreak in central Mozambique has killed two people and infected more than 1,400, the government announced Tuesday on the eve of the launch of a mass vaccination drive…” (4/2).

Associated Press: Mozambicans line up for cholera vaccines to fight outbreak
“Mozambicans lined up Wednesday to get cholera vaccines in the cyclone-hit city of Beira, at the start of a drive to inoculate nearly 900,000 storm survivors as part of efforts contain an outbreak of the deadly disease…” (Mukwazhi/Anna, 4/3).

New York Times: Cholera Is Spreading in Mozambique, and It’s Far From the Only Health Threat
“A wide swath of Mozambique devastated by Cyclone Idai two weeks ago is now at a tipping point, humanitarian agencies said on Tuesday. About two million people have seen their homes or crops destroyed, and cholera is spreading fast. Malaria, measles, and starvation may follow unless help reaches enough people quickly. At the same time, there are encouraging signs: 900,000 doses of cholera vaccine arrived on Tuesday, and a vaccination campaign is to start on Wednesday. Water service has been restored to large portions of Beira, a coastal city of 500,000 people…” (McNeil, 4/2).

Additional coverage of the response to Cyclone Idai in Mozambique is available from the Associated Press, Axios, U.N. Dispatch, U.N. NewsVox, and Xinhua News.

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1 In 4 Health Facilities Worldwide Lack Clean Water, Raising Risk Of Infection, WHO/UNICEF Report Says

Deutsche Welle: U.N.: One quarter of the world’s health centers lack clean water
“Some 2 billion people around the world use health facilities that lack basic water services, a United Nations report has found. Data showed that around 1 in 4 health facilities lacked basic water services. In the poorest countries, about half of the facilities had inadequate water services…” (4/3).

Thomson Reuters Foundation: Soap and superbugs: 2 bln people lack water at health facilities — U.N.
“…The World Health Organization (WHO) and U.N. Children’s Fund (UNICEF) said more than 1 million deaths a year were associated with unclean births, and 15 percent of all patients attending a health facility developed infections. ‘Hospitals are not necessarily points of care where you can heal, but points of almost infection. (We) are very alarmed by this,’ WHO public health co-ordinator Bruce Gordon told a media briefing in Geneva. … International charity WaterAid said rising rates of superbugs had been linked to poor sanitary conditions in health facilities which lead to the overuse and misuse of antibiotics…” (Batha/Mantovani, 4/3).

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Benefits Outweigh Risks Of Dolutegravir For Women Of Childbearing Age Living With HIV, Study Shows

Healio: Dolutegravir best option for women of child-bearing age with HIV
“Although dolutegravir was linked to a higher risk for neural tube defects among newborns, it prevented many more deaths and HIV transmissions among women than efavirenz, according to findings published in Annals of Internal Medicine. … [Caitlin M. Dugdale, MD, from Massachusetts General Hospital and Harvard Medical School, and colleagues] used a computer model to project the clinical outcomes of ART policies, including maternal and child deaths, sexual and perinatal transmission, and neural tube defects, for women with HIV of child-bearing age in South Africa. … In an accompanying editorial, Risa M. Hoffman, MD, MPH, from David Geffen School of Medicine at the University of California, Los Angeles, and Lynne M. Mofenson, MD, from the Elizabeth Glaser Pediatric AIDS Foundation, wrote that the study by Dugdale and colleagues underscores the complexity of choosing treatment for pregnant women…” (4/1).

Additional coverage of the study and its implications for HIV treatment is available from MedPage Today and The Telegraph.

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ONE Campaign President/CEO Gayle Smith Discusses Humanitarian Work In Washington Post Interview

Washington Post Magazine: The former head of USAID on the consequences of war and famine
“Gayle Smith, 63, is the president and CEO of the ONE Campaign, a nonpartisan, nonprofit advocacy organization fighting extreme poverty and preventable diseases, particularly in Africa. She served as a top adviser on development issues in the Clinton and Obama administrations, most recently as administrator of the U.S. Agency for International Development. … ‘[T]hroughout my career, as a journalist, in NGOs, inside and outside government, I have been a big believer in investing in our common humanity. I think it’s in our interest to do so. I think it’s right to do so. And it actually works…'” (Ottesen, 4/2).

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More News In Global Health

Broadly: Nigerian Hospitals Are Locking Up Women Unable to Pay Their Childbirth Bills (Bryce/Udobang, 4/1).

CNN: Prostate cancer diagnoses, deaths decreasing worldwide, study says (Powell, 4/2).

The Guardian: Debt crisis warning as poorest countries’ repayment bills soar (Elliott, 4/3).

NPR: Cholera 101: Why This Ancient Disease Is Making Headlines In 2019 (Shreiber/Beaubien, 4/2).

Reuters: Study points to new antibody approach to tackling Ebola, other infections (Kelland, 4/2).

SciDev.Net: Most SDGs ‘going into reverse’ — U.N. expert group member (Deighton, 4/2).

U.N. News: Help prevent children ‘from becoming victims in the first place,’ implores Guterres at campaign launch (4/2).

U.N. News: Acute food insecurity ‘far too high’ U.N. agency warns, as 113 million go hungry (4/2).

U.N. News: Strengthen inclusion, participation of people with autism to ‘achieve their full potential’ says U.N. chief (4/2).

VOA News: Malawi Government Appeals for Aid for Cyclone Floods Victims (Masina, 4/2).

Washington Post: The Islamic State’s refugees are facing a humanitarian calamity (Cunningham/Sadoun, 4/2).

Xinhua News: U.N. humanitarian chief asks for compliance with int’l humanitarian law (4/2).

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Editorials and Opinions

U.S. Development Finance Must Support Investors Moving Into New, Emerging Markets

Financial Times: U.S. development finance must have a domestic imperative
Aubrey Hruby, senior fellow in the Atlantic Council’s Africa Center

“…[I]t is a competitive necessity that U.S. companies and investors continue to expand and seize opportunities in fast-growing markets such as those in Asia and Africa. … Yet, the success of this new era in U.S. international development finance in emerging markets will not be determined outside the U.S., but within it. While, by mandate, the [Development Finance Corporation (DFC)] must operate internationally, it must also embrace a domestic imperative to actively mobilize institutional capital and better support U.S. investors who venture into new markets. This will require the DFC to address key data, network, visibility, and structural gaps that have historically handicapped U.S. investment in the emerging world. … Pervasive data, network, visibility, and structural gaps have slowed the natural movement of capital from the U.S. to emerging markets. With a strong domestic mobilization effort, the DFC could tap into pools of U.S. institutional capital to encourage mutually-beneficial, high-impact investments for decades to come” (4/2).

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Alternative Care Models Could Help Ensure Most Vulnerable In DRC Can Access Health Care

Devex: Opinion: The daily struggle for survival in Congo
Annemarie Loof, operations manager for Médecins Sans Frontières projects in the Democratic Republic of Congo, India, Haiti, and Sierra Leone

“…[T]he needs [in the Democratic Republic of the Congo (DRC)] go well beyond Ebola. People in DRC have been struggling for decades with recurring emergency health needs stemming from violence, displacement, and continuous obstacles to accessing health care — and there is an insufficient response from the international community. … In this context of protracted crisis, difficulties in accessing health care results in increased health risks for the population — due to insecurity, difficult terrain, poverty, and vulnerability. It is therefore essential to look at alternative care models. This means health care systems that are adapted to local settings, simplified, and designed to address barriers for patients. … Humanitarian actors and donor governments can develop and implement, including through their support to the Congolese ministry of health, alternative care models to ensure medicines reach those even in the most remote areas. Whether or not the Ebola epidemic will be under control any time soon, the other needs of millions of Congolese men, women, and children need to be addressed — a child dying of measles is as unacceptable as a person dying of Ebola” (4/2).

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From the Global Health Policy Community

Members Of Congress Call For Continued Support Of PEPFAR, Global Fund In Letter

Friends of the Global Fight Against AIDS, Tuberculosis and Malaria: Members of Congress call for continued PEPFAR and Global Fund support
“On March 28, Members of Congress sent a letter to Chairwoman Nita Lowey (D-N.Y.), Ranking Member Kay Granger (R-Tex.), and Ranking Member Hal Rogers (R-Ky.) of the House Appropriations Committee and Subcommittee on State, Foreign Operations, and Related Programs (SFOPS). The letter calls for continued support in fiscal year 2020 for two extraordinarily successful humanitarian assistance programs — the President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, TB and Malaria…” (4/2).

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CSIS Experts Discuss Challenges Of HIV Epidemic In South Africa, Role Of PEPFAR, Other Partners

Center for Strategic & International Studies: The World’s Largest HIV Epidemic in Crisis: HIV in South Africa
Sara Allinder, executive director and senior fellow, and Janet Fleischman, senior associate, both at the CSIS Global Health Policy Center, discuss the challenges of HIV in South Africa, home of the largest epidemic in the world. The authors highlight the barriers to reducing HIV transmission among young adults in the country, writing, “Without aggressive action to reduce the rate of new infections in young people, HIV will continue to take a tremendous toll on the country for years and generations to come. Collective action is needed to push beyond the complacency and internal barriers to implement policies and interventions that directly target HIV prevention and treatment for young people. PEPFAR should ensure its programs support those efforts” (4/2).

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MFAN Co-Chairs Issue Statement Of Concern Over U.S. Administration's Decision To Block Aid To 3 Central American Countries

Modernizing Foreign Assistance Network: President Trump’s Attempt to Block Aid to Central America Reflects Ineffective Use of American Resources, Influence
In a statement delivered on behalf of the Modernizing Foreign Assistance Network (MFAN), Co-Chairs George Ingram, Lester Munson, and Tessie San Martin express concern over President Trump’s decision to block aid to Honduras, Guatemala, and El Salvador. The co-chairs state, “U.S. foreign assistance is a tool that advances American interests and values by working directly in communities on issues that grow their economy, improve safety and health, and strengthen their infrastructure. … To be most effective, U.S. foreign aid should be directed to where the need is greatest and where it can have the most impact” (4/2).

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From the U.S. Government

Blog Post Describes State Department's Junior Professional Officer Program

U.S. Department of State’s “DipNote”: Americans Making a Difference: Junior Professional Officers at U.N. Humanitarian Organizations
Courtney Fatigato, humanitarian affairs intern at the U.S. Mission to the U.N., provides an overview of the State Department’s Junior Professional Officer (JPO) program, which provides “young Americans an opportunity to expand their experience in refugee protection, refugee status determination, resettlement, and other positions” with U.N. partners (4/1).

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