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Kaiser Daily Global Health Policy Report

In The News

President Trump's Decision To Cut Aid To Central American Nations Could Cause More Migration, Experts Say

CBS News: Trump’s move to cut aid to Central America will spur more migration, aid workers warn
“…Although Mr. Trump believes his move [to cut aid to El Salvador, Honduras, and Guatemala, collectively known as the ‘Northern Triangle,’] will force the region’s governments to stop the mass migration of their citizens, Democrats and U.S.-financed non-governmental organizations (NGOs) working in these countries warn the aid cut will have the opposite effect, both prompting more migration and penalizing poor and working-class Central Americans for the failures of their elected leaders…” (Montoya-Galvez, 4/4).

Thomson Reuters Foundation: U.S. aid cuts to Central America may backfire, fueling migration north: charities
“A decision by the U.S. government to cut aid to three Central American nations is ‘counterproductive,’ likely to backfire and fuel rather than stem the flow of migrants north fleeing gang violence and dire poverty, charities said on Tuesday. … Charities that receive funding from the U.S. government to promote economic and social development in El Salvador, Guatemala, and Honduras say aid cuts not only will do little good but will make matters worse…” (Moloney, 4/2).

USA TODAY: U.S. aid to Central America: What it does, why Trump cut it and why that may not end the migration crisis
“…El Salvador, Honduras, and Guatemala have struggled for years with violence, poverty, and insecurity. … All the while, the three countries are struggling with a historic drought that has put more than two million people at risk of food insecurity, according to the United Nations. But a study published by Vanderbilt University said U.S. aid has helped improve conditions little by little. … Trump sees things differently. The combination of violence, poverty and food insecurity in Central America has driven record numbers of families to head north to seek U.S. asylum. On Tuesday, State Department spokesman Robert Palladino said rising migration showed that U.S. aid was not working…” (Gomez, 4/4).

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U.S. Senators Introduce Bipartisan Legislation To Ease Venezuelan Humanitarian Crisis, Speed Transition Of Power

Bloomberg: Senators Propose $400 Million in Aid to Stem Crisis in Venezuela
“A bipartisan group of U.S. senators introduced legislation that seeks to speed the transition of power in Venezuela and ease the humanitarian crisis that has escalated amid a power struggle between President Nicolas Maduro and an emboldened opposition. The legislation introduced Wednesday by New Jersey Democrat Bob Menendez would provide diplomatic support for Juan Guaidó as the interim president of Venezuela, along with $400 million in humanitarian aid…” (Flatley, 4/3).

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U.N. Should Take Lead In Venezuela Relief Efforts, Declare Humanitarian Emergency, HRW/JHSPH Report Says

The Telegraph: Venezuela crisis: U.N. urged to declare humanitarian emergency as health system collapses
“The United Nations is being urged to declare a full-scale humanitarian emergency in Venezuela in the light of the ‘utter collapse’ of its health system and widespread food shortages. A major report by Human Rights Watch and Johns Hopkins Bloomberg School of Public Health details the scale of the humanitarian disaster unfolding in Venezuela, once one of the richest countries in South America but now in the grip of a severe economic and social crisis…” (Gulland, 4/4).

Washington Post: Venezuela’s health system in ‘utter collapse’ as infectious diseases spread, report says
“…The report … is among the few that has sought to quantify Venezuela’s misery, as the country has ceased releasing health and nutrition data and retaliated against those who did. Based on interviews with doctors and other health personnel in Venezuela, conducted by telephone and online; refugees in Colombia and Brazil, including health care professionals; and representatives of humanitarian and international organizations, the report concludes that the United Nations should take the lead providing aid. It calls on U.N. Secretary-General António Guterres to spearhead efforts to declare a complex humanitarian emergency, an official designation that would trigger a major, comprehensive effort under U.N. auspices and unlock the mobilization of international resources…” (DeYoung, 4/4).

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WFP Executive Director Calls On U.S., Western Donors To Provide Food Aid To North Korea Despite Sanctions

The Guardian: U.N. calls for food aid for starving North Koreans despite sanctions
“The head of the U.N. World Food Programme has called for the White House and other western donors to put children’s lives before politics and fund a major injection of aid to North Korea despite the failure of Donald Trump’s summit with Kim Jong-un. David Beasley, a former Republican governor of South Carolina who backed Trump’s campaign for the U.S. presidency, said he had heard concerns that responding to an appeal from Pyongyang would prop up the Kim regime. But in an interview with the Guardian, the World Food Programme’s executive director said, ‘as we speak,’ teams of experts were canvassing the North Korean countryside to provide the donors with evidence of the scale of the crisis. … An estimated 11 million people — 40% of the population — are already undernourished, with one in five children stunted due to chronic malnutrition. … Beasley added: ‘The concerns have been about not helping the regime. We make the case: don’t let innocent children suffer because of politics’…” (Boffey, 4/3).

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Poor Diet Associated With 1 In 5 Deaths Globally, More Than Tobacco, High Blood Pressure, Lancet Study Shows

CBS News: Unhealthy diets now kill more people than tobacco and high blood pressure, study finds
“Poor diet is associated with 1 in 5 deaths worldwide, according to a new, large study. That’s equivalent to 11 million deaths a year, making unhealthy eating habits responsible for more deaths than tobacco and high blood pressure…” (Welch, 4/3).

CNN: What we aren’t eating is killing us, global study finds
“…The large study size means these findings are relevant to everyone, no matter where they live, said Andrew Reynolds, a postdoctoral research fellow at the University of Otago in New Zealand, who was not involved in the study. ‘The findings of the paper will inform policy decisions that shape what food is available in Western countries, how it is marketed and potentially what it costs in the coming years,’ Reynolds said…” (LaMotte, 4/3).

International Business Times: Poor Diet Causes More Deaths Than Smoking, Study Reveals
“…The study published in the journal The Lancet followed trends in the utilization of 15 dietary foods from 1990 to 2017 of 195 nations. These included diets low in foods like vegetables, fruits, nuts, whole grains, fatty acid, milk, and seeds, fiber, calcium, fish omega-3 fats, [and] polyunsaturated fats. Diets high in sugar-sweetened sodas, red meat, proceed meat, and sodium were also included in the study…” (Choudry, 4/4).

New York Times: Eat Your Veggies: Study Finds Poor Diets Linked to One in Five Deaths
“…The study … concluded that one-fifth of deaths around the world were associated with poor diets — defined as those short on fresh vegetables, seeds and nuts but heavy in sugar, salt and trans fats. In 2017, that came to 11 million deaths that could have been avoided, the researchers said. Most of those, around 10 million, were from cardiovascular disease, researchers found. The next biggest diet-related killers were cancer, with 913,000 deaths, and Type 2 diabetes, which claimed 339,000 lives…” (Jacobs, 4/3).

NPR: Bad Diets Are Responsible For More Deaths Than Smoking, Global Study Finds
“…Which countries do best when it comes to diet? Israel, France, Spain, and Japan were among the countries with the lowest rates of diet-related disease. The U.S ranked 43rd, and China ranked 140th. It should be noted that there were data gaps for intake of key foods in some countries, so some estimates could be off…” (Aubrey, 4/3).

TIME: Poor Diets Are Linked to 20% of All Deaths Worldwide, Study Says. But These Foods Could Help
“… ‘Diet is an equal-opportunity killer. People — independent of age, gender, country of residence, and socioeconomic status — to some extent are affected by poor dietary habits,’ says study co-author Dr. Ashkan Afshin, an assistant professor of health metrics sciences at the University of Washington’s Institute for Health Metrics and Evaluation. ‘Low intake of healthy foods and high intake of unhealthy foods is the leading cause of mortality, globally and in many countries’…” (Ducharme, 4/3).

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More Political Commitment Needed To Improve WASH In Health Care Facilities Worldwide, U.N. Says

NPR: Shocking New Statistics About Water And Hygiene In Hospitals Around The World
“…[I]n 17 countries at least one in five health care facilities has no clean water service on site. That’s just one of many disturbing findings in a new report by UNICEF and the World Health Organization. That data, collected in 2016 from 69 low- and middle-income countries and territories, amounts to the first comprehensive global assessment of water, sanitation, and hygiene in health care facilities ranging from hospitals to rural clinics…” (Aizenman, 4/3).

U.N. News: Lack of basic water facilities risks millions of lives globally: U.N. health agency
“…In an appeal for more countries to invest in water and sanitation (WASH) services, [Bruce Gordon, coordinator of WHO’s work on water and sanitation,] said that political commitment was was key. ‘We know WASH generally needs strong public financing through taxes, yes, there is a lot of movement to get private funds … but if we are actually to reach the vulnerable, who have very little resources, public expenditure and taxation needs to be a big part of the equation’…” (4/3).

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Number Of DRC Ebola Cases Reaches 1,100; New Research Examines Ebola Treatment Units' Role In Secondary Spread

CIDRAP News: DRC Ebola total hits 1,100; study targets secondary spread
“The Ebola outbreak in the Democratic Republic of the Congo (DRC) grew by 8 cases today, putting the total at 1,100, and in research developments, new findings from Guinea’s outbreak shed light on the role of Ebola treatment units in preventing secondary spread. … The new DRC cases are reflected in the World Health Organization (WHO) online Ebola dashboard, which notes that 277 suspected cases are still under investigation. The number of deaths held steady, at 683…” (Schnirring, 4/3).

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Mozambique Health Ministry, Partners Begin Cholera Vaccination Campaign Post-Cyclone

Al Jazeera: Mozambique launches cholera vaccine drive amid deadly outbreak
“The Mozambican health ministry has launched a vaccination campaign in cyclone-ravaged Beira city in a bid to contain an outbreak of cholera that has killed at least three people…” (Mbah, 4/3).

Reuters: Cholera vaccinations launched in post-cyclone Mozambique
“…The vaccination campaign is currently planned to last six days and aims to immunize 900,000 people across four districts including 500,000 in Beira. ‘We are pretty confident that we will reach the target,’ WHO spokesman Christian Lindmeier said in Geneva…” (4/3).

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New York Times Examines Faltering Global Efforts To Eliminate Measles

New York Times: Scientists Thought They Had Measles Cornered. They Were Wrong.
“The measles outbreak that led to a state of emergency in New York’s Rockland County began far away: in an annual Hasidic pilgrimage from Israel to Ukraine. It is emblematic of a series of fierce, sometimes connected measles outbreaks — in places as diverse as Indonesia, the Philippines, Madagascar, and Venezuela — that have shaken global health officials, revealing persistent shortcomings in the world’s vaccination efforts and threatening to tarnish what had been a signature public health achievement…” (McNeil, 4/3).

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More News In Global Health

Al Jazeera: Europe set to suffer as climate change brings mosquito threat (Bazley, 4/4).

Associated Press: Ivanka Trump plans Africa trip to promote women’s initiative (Lucey, 4/3).

Bloomberg: Messier Than Opioids, Meth Is Asia’s Worst Narcotics Threat (Gale, 4/3).

Borgen Magazine: Revolutionizing Maternal Health Care in Mexico City (Rosenbaum, 4/3).

The Hill: Brunei enacts laws making gay sex, adultery punishable by stoning to death (Folley, 4/3).

Scientific American: How the World’s First Dengue Vaccination Drive Ended in Disaster (Yasmin/Mukerjee, April 2019).

Thomson Reuters Foundation: Polluted air to shorten lives by 20 months, researchers say (Larson, 4/3).

Xinhua News: HIV cases a growing concern for Fijians: minister (4/4).

Xinhua News: Cuba tests drug preventing HIV (4/4).

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Editorials and Opinions

Editorial, Opinion Piece Discuss Humanitarian Situation In Central America, Impact Of U.S. Foreign Assistance

Bloomberg Opinion: Cutting U.S. Aid to Central America Is Self-Defeating
Editorial Board

“Just a day after the U.S. reached a new agreement on migration with El Salvador, Guatemala, and Honduras, President Donald Trump announced he was cutting off their aid. At a stroke he has thrown the State Department into chaos, and, more important, made it more likely that caravans of Central American migrants will keep heading north. … Ending U.S. aid to El Salvador, Guatemala, and Honduras will not solve that problem. But it will certainly damage the organizations that distribute the aid, and will worsen the plight of their desperate clients. Since desperation drives migration, this is directly counterproductive. … Aid to Central America is no substitute for working with Congress to fix a broken asylum system. Yet helping El Salvador, Guatemala, and Honduras is part of the answer, cheap at the price, and very much in the U.S. interest. The president should reverse his decision” (4/4).

USA TODAY: Does Trump want more Central Americans fleeing to U.S.? That’s what his aid cutoff will do.
Sheba Crocker, vice president of humanitarian policy and practice at CARE USA

“If you want to tackle the problem of Central American migration, the last thing you should do is make the situation in those countries worse. But that’s exactly what would happen if U.S. foreign assistance is cut off to El Salvador, Guatemala, and Honduras. Central American migration is rooted in violence, hunger, political instability, and grinding poverty — the very hardships and challenges U.S. development assistance to the region helps to alleviate. … Right now, people in these countries need more partnership, investments, and support from the U.S. Not less. This week CARE and 62 other humanitarian and development organizations signed a letter calling on Congress to oppose the White House’s self-defeating and counterproductive plan [to cut U.S. foreign assistance to these three countries]. … Every day, we see firsthand the good that these programs do — and the needs of the people they support. We remain resolute that the United States can and should continue to work with the people of Honduras, El Salvador, and Guatemala to fight for a more peaceful and prosperous region” (4/3).

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Venezuela's Juan Guaidó Calls Maduro Government 'Tragedy,' Thanks U.S., Europe For Support Of Transitional Government

Newsweek: Juan Guaidó: This is Not About Trump, Maduro or Me — This is About the People of Venezuela
Juan Guaidó, interim president of Venezuela and president of the National Assembly of Venezuela

“…Maduro’s dictatorship has been a tragedy for Venezuela. … Over the last several years, Venezuela has also become one of the most violent places in the world. … And to this tragic ledger of lives lost to social collapse and criminality we must add the victims of deliberate political repression … At the heart of this is the clinging to power by Nicolás Maduro who has been blatantly usurping the presidency since January 10 of this year. … To overcome this situation we have proposed a three-step political plan aimed at restoring political institutions in Venezuela: an end to the usurpation of the presidency; the constitution of a transitional government; and the calling of free, fair, and transparent elections. … At the same time, given the desperate situation of millions of Venezuelans, we are agitating for admitting humanitarian aid into the country, to ensure access to medicines and food and help those in our population who suffered the most in whatever way is necessary. In this endeavor, we have had the support of the majority of American and European democracies. … We owe great gratitude to them and to all those who have given us support from abroad and welcomed our diaspora and forcefully displaced Venezuelans…” (4/3).

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Restoring Public Confidence In Vaccines Requires 'Open, Participatory' Approach

Devex: Opinion: It’s time to rebuild public confidence in vaccines
Heidi Larson, professor and director of the Vaccine Confidence Project in the Department of Infectious Disease Epidemiology at the London School of Hygiene and Tropical Medicine and clinical professor at the Department of Global Health at the University of Washington

“The announcement by Facebook that it will no longer allow anti-vaccine advertisements on its platform is welcome as measles cases surge in the U.S. Pacific Northwest and double in Europe. But this measure alone is not enough to address the growing global spread of ‘vaccine hesitancy’ and rising rates of disease and death caused by undervaccination. … [T]he answer to combating today’s currents of vaccine dissent is far more complex than addressing the needed technical fixes and must be part of a wider effort involving multiple partners, including citizens. … If we are to change the conversation and start to reverse the negative trend in public trust in vaccination, the first step is actively listening to people’s concerns. … We need to start by being open to discussion and making information available in a language and context relevant to those we are communicating with. … We also need to get much smarter about social media engagement. … This demands a greater collaborative effort, bringing together public health professionals, technology experts, and some members of the public to sit around a table, with the best information available, conveyed sensitively, through honest, not manipulated media. This open and participatory approach is the only way forward in this matter of life and death” (4/3).

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Traditional Chinese Medicines Should Undergo Same Scrutiny As Other Treatments Before WHO Includes Them In Standard Care Practices, Opinion Piece Says

Scientific American: The World Health Organization Gives the Nod to Traditional Chinese Medicine. Bad Idea
Editorial Board

“…Over the past decade proponents of [traditional Chinese medicine (TCM)] have worked hard to move it into the mainstream of global health care — and it appears those efforts are coming to fruition. The latest (11th) version of the World Health Organization’s list known as the International Statistical Classification of Diseases and Related Health Problems (ICD) will include these remedies for the first time. According to its own mandate, the WHO sets the norms and standards for medical treatment around the globe and articulates ‘ethical and evidence-based policy options.’ … To include TCM in the ICD is an egregious lapse in evidence-based thinking and practice. Data supporting the effectiveness of most traditional remedies are scant, at best. … [W]hile it’s a good idea to catalog TCM and make health workers aware of treatments used by millions, their inclusion in the ICD recklessly equates them with medicines that have undergone clinical trials. … Until they undergo rigorous testing for purity, efficacy, dosage, and safety, the WHO should remove traditional medicines from its list. These remedies should be given the same scrutiny as other treatments before being included in standard care practices” (April 2019).

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From the Global Health Policy Community

Guttmacher Institute Analyzes Impact Of U.S. International Family Planning Assistance

Guttmacher Institute: Just the Numbers: The Impact of U.S. International Family Planning Assistance, 2019
This policy analysis discusses the impact of U.S. international family planning assistance and the potential benefits of greater U.S. investment (4/2).

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CSIS Brief Discusses Role Of Multilateral Financing For Health Security Preparedness In LICs, LMICs

Center for Strategic & International Studies: Harnessing Multilateral Financing for Health Security Preparedness
This brief by the CSIS Commission on Strengthening America’s Health Security discusses the financing gaps for health security preparedness in low-income and lower-middle-income countries (LICs and LMICs), the need to create new financial mechanisms that incentivize LICs and LMICs to increase investments in preparedness, and the role of the World Bank in financing health emergency preparedness and response in these countries (4/3).

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Aidspan Publishes New Issue Of 'Global Fund Observer'

Aidspan: Global Fund Observer
Aidspan, an independent watchdog of the Global Fund to Fight AIDS, Tuberculosis and Malaria, published Issue 353 of the ‘Global Fund Observer.’ The newsletter includes pieces on various topics, including the need for improvement in the human resource processes and practices of the Global Fund Secretariat and the launch of a monthly digest of resources to support the Global Fund’s sixth replenishment (4/3).

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Cordaid Post Addresses TB In DRC, Says 'Boost' Needed In Global Campaign To End TB

Cordaid: Global Goal to End Tuberculosis Needs More Support and Funding
This post discusses how Cordaid addresses TB in the Democratic Republic of the Congo (DRC) and the need to “boost the global campaign to end TB” through increased case detection, diagnosis, and treatment, as well as increased national and international funding (4/3).

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From the U.S. Government

USAID Administrator Mark Green Announces Creation Of 4 New Bureaus As Part of Agency's Transformation Process

USAID: Statement by USAID Administrator Green on Transformation Milestone
In a statement, USAID Administrator Mark Green announces the creation of four new Bureaus as a part of USAID’s Transformation process: the Bureau for Humanitarian Assistance, the Bureau for Conflict-Prevention and Stabilization, the Bureau for Resilience and Food Security, and the new Bureau for Asia. Green notes, “The ultimate objective of USAID’s Transformation is to strengthen the agency to meet the challenges of today and tomorrow. Each piece of the Transformation’s restructuring is important and serves a distinct purpose. … I am fully committed to continue working with Congress to seek approvals as quickly as possible for the remaining Congressional Notifications…” (4/3).

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USAID Announces Nearly $33M In Additional Humanitarian Assistance For Those Affected By Cyclone Idai In Mozambique, Zimbabwe

USAID: The United States Announces Nearly $33 Million in Additional Humanitarian Assistance for People Affected by Cyclone Idai
“[On Wednesday], the United States, through the U.S. Agency for International Development (USAID), announced nearly $33 million in additional humanitarian assistance to meet the urgent needs caused by Cyclone Idai and related flooding, including nearly $31 million for the people of Mozambique and over $2 million for the people of Zimbabwe…” (4/3).

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U.S. Pre-Positions Humanitarian Relief Supplies For Venezuela In Curaçao

USAID: The United States Pre-Positions Humanitarian Assistance in Curaçao to Help Venezuelans in Need
“[On Wednesday], the United States is pre-positioning humanitarian relief supplies in Curaçao, a constituent country of the Kingdom of the Netherlands, to help people affected by the political and economic crisis in Venezuela. The collapse of health care in Venezuela has left nearly all hospitals in the country in desperate need of basic medicines and supplies, and prompted outbreaks of diseases that were thought to be under control. [The] commercial delivery to Curaçao contains four emergency health kits manufactured in the Netherlands, which contain medicines and medical supplies — including bandages, gauze, examination gloves, thermometers, and syringes — designed to fill immediate medical gaps for people affected by emergencies. The kits can cover the priority health needs of 40,000 people for three months…” (4/3).

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