KFF Daily Global Health Policy Report

In The News

The Telegraph Examines PEPFAR's DREAMS Initiative In Uganda

The Telegraph: Daring to dream: The women and girls on HIV’s new front line
“…Women and girls … now occupy the front line of the war on HIV in Uganda and much of sub-Saharan Africa. There are other high risk groups but, by weight of numbers, it is this group — the young female poor — who are most vulnerable and numerous. … What is being rolled out is DREAMS. … DREAMS stands for Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe women, and its goal is to reduce new HIV infections among adolescent girls and young women in 15 countries across Africa and the Pacific, including Uganda. … [I]t is the brainchild of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) … The program targets not just health, but the ‘structural drivers’ that increase girls’ HIV risk. These include poverty, gender inequality, sexual violence, and lack of education but also their lack of ‘agency’ or self-confidence. … The impact of DREAMS is being monitored closely and early data has encouraged the Global Fund and others to invest in similar programs…” (Nuki, 7/31).

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Senate Confirms Kelly Craft As Next U.S. Ambassador To U.N.

New York Times: Kelly Craft Is Confirmed as U.S. Ambassador to United Nations
“Kelly Knight Craft, the United States ambassador to Canada, was confirmed on Wednesday to serve as the next ambassador to the United Nations…” (Fortin, 7/31).

UPI: Senate confirms Kelly Craft as U.N. ambassador
“…The chamber voted 56-34 in favor of Craft, who was the U.S. ambassador to Canada since October 2017. Five Democrats sided with Republicans in the vote…” (Haynes, 7/31).

Washington Post: Kelly Knight Craft confirmed as Trump’s next U.N. ambassador in vote largely on party lines
“…Throughout her confirmation process, Craft struggled to allay Democrats’ concerns about her family’s significant investments in the fossil fuel industry, though notably she separated herself from the president on climate change. During her confirmation hearing in June, Craft declared that she believes fossil fuels and human behavior contribute to the planet’s shifting weather phenomena. ‘Let there be no doubt,’ she said…” (Demirjian, 7/31).

Additional coverage of Craft’s confirmation is available from POLITICO, Reuters, Roll Call, and USA TODAY.

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Aid Experts Remain Wary Of Potential Changes At DFID Under Prime Minister Johnson

Devex: DFID and U.K. aid still under threat, experts warn
“The U.K. Department for International Development is still at risk of being merged, scrapped, or having its budget plundered by other departments, despite having survived the first week of aid-skeptic Boris Johnson’s premiership, aid experts have warned. … [W]hile [Alok] Sharma’s appointment may have secured DFID’s status as an independent department for the immediate future, many in the sector fear the department is not yet out of the woods. They called on the aid community to keep pushing the government to maintain DFID’s independence and the U.K.’s reputation as a ‘development superpower’…” (Edwards, 8/1).

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DRC Marks 1 Year Of Ebola Outbreak, Confirms 3rd Case In Goma As Rwanda Closes Border Over Fear Of Disease Spread

Agence France-Presse: DR Congo Ebola epidemic spreads as second Goma patient dies, third case is confirmed
“An Ebola epidemic in eastern DR Congo continues to spread, with two deaths and another diagnosis reported this week in the city of Goma. Rwanda closed its frontier with the country on Thursday over fears of the virus. Authorities have also quarantined 15 people in a previously unaffected province…” (8/1).

Becker’s Hospital Review: Ebola by the numbers: Agencies release joint statement at outbreak’s 1-year anniversary
“Aug. 1 marks one year since the Democratic Republic of the Congo’s government declared an Ebola outbreak in North Kivu province, and the country still needs urgent aid from the international community, according to a joint statement from the World Health Organization, the United Nations, UNICEF, and the World Food Programme released July 31…” (Kommers, 7/31).

CIDRAP News: On eve of 1-year mark, WHO calls Ebola in DRC ‘relentless’
“Employing an effective vaccine, conducting extensive surveillance, and building community trust have all gone a long way in limiting the spread of Ebola in the Democratic Republic of the Congo (DRC). But 1 year after the first cases were identified in North Kivu and Ituri provinces, experts from the World Health Organization (WHO) said [Wednesday] at a press conference that the fight against the virus must continue. WHO officials called the disease ‘relentless and devastating’…” (Soucheray, 7/31).

Wall Street Journal: Rwanda Shuts Border With Congo Over Ebola Outbreak
“Rwanda shut its border with the Democratic Republic of Congo on Thursday, escalating its response to an Ebola outbreak that has killed more than 1,800 people since the first case was discovered a year ago. The government took the decision, which was quickly condemned by the Congolese, after a third case of the virus was discovered in Goma, a city of 2 million on the border with Rwanda…” (Bariyo/Steinhauser, 8/1).

Washington Post: A year on, Congo’s Ebola outbreak is only getting worse
“…It is Congo’s 10th outbreak, and the world’s second-worst, trailing only the epidemic that killed more than 11,000 across West Africa between 2014 and 2016. If just this July were considered on its own, it would be the fourth-biggest outbreak in history, with more than 350 cases confirmed. … The [Rwandan] border was reopened in the afternoon, after loud protests from the Congolese government…” (Bearak, 8/1).

Additional coverage of the DRC Ebola outbreak and response is available from Agence France-Presse, Al Jazeera, BBC News, Becker’s Hospital Review, Bloomberg, CNN, Devex, Financial Times (2), The Guardian (2), NPR, Reuters, U.N. News, VICE News, and VOA News.

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UNAIDS Launches New Website Highlighting National Laws, Policies Related To AIDS Response

Xinhua News: UNAIDS launches website to identify national AIDS laws, policies
“The Joint U.N. Programme on HIV/AIDS, better known as UNAIDS, launched a new website to identify national laws and policies related to AIDS response, a U.N. spokesman said Wednesday. The Laws and Policies Analytics website covers areas as diverse as a country’s ability to diagnose HIV among babies, the existence of discriminating laws against transgender people, or whether people are prosecuted for even carrying condoms, Stephane Dujarric, spokesman for the U.N. secretary general, said at a press briefing…” (8/1).

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Number Of HIV-Related Deaths Increased In 2018 In Russia, Health Ministry Data Show

Moscow Times: HIV-Related Deaths on the Rise in Russia — Health Ministry
“More people have died from HIV-related causes in Russia last year than in 2017 as the country grapples with a rise in infections, according to Health Ministry data cited by the Kommersant business daily on Wednesday…” (7/31).

TASS: Over 20,000 HIV-positive people died in Russia last year
“More than 20,000 HIV-positive Russians died in 2018, with the death toll related to this infection growing 2.2% year-on-year, a report of the Russian Health Ministry’s research center revealed on Wednesday…” (7/31).

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Bangladesh Records More Than 13K Dengue Cases In July In Worst Outbreak In History

NPR: Bangladesh Reports More Than 13,000 Dengue Cases In July
“Bangladesh is grappling with a record-breaking spike in dengue fever, with 1,477 new patients diagnosed just within the past 24 hours, according to the health ministry. Experts say the rise is part of a regional trend, driven by climate change and other factors…” (Khan/Chappell, 7/31).

The Telegraph: Bangladesh struggles to control the worst dengue outbreak in its history
“…But this year’s outbreak is unprecedented. There have been more than 15,000 infections up to July 30 this year, compared to around 10,000 by the same point last year. … In June there were 1,820 cases but this increased to 13,182 in July…” (Wallen, 7/31).

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More News In Global Health

Associated Press: Nicaragua declares alert over dengue fever (7/31).

Nature: ‘Mosaic’ HIV vaccine to be tested in thousands of people across the world (Mega, 7/31).

NBC News: Nigeria is on the brink of eliminating polio, thanks to women (Charles, 7/31).

STAT: To mitigate the effects of climate change, one researcher calls for a ‘contraception revolution’ (Chakradhar, 8/1).

Xinhua News: Feature: Kenyan HIV/AIDS patients get lifeline in generic drugs (7/31).

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Editorials and Opinions

U.S. Congress Should Increase Funding For Global Nutrition Efforts, Opinion Piece Says

Clarion Ledger: Funding for global nutrition needs to be raised
Rita Way, founder & CEO of Wray Enterprises, Inc.

“…Whether near or far, nutrition provides the proper foundation for physical and cognitive growth for children. That first 1,000 days in a child’s life, from conception to age two, is a critical period to intervene with the mother and the baby, to provide the right vitamins, micro-nutrients, and proteins which will combat lifelong chronic disease and stunting for the child. … Nutrition is the cornerstone of global health and development for families, communities, and nations. Good nutrition increases economic empowerment and growth for all, equalizing opportunities for those living in poverty. … Despite the clear return on investment, nutrition has been historically underfunded … This is why I am urging our Senators [from Mississippi] to increase, if feasible, the funding for global nutrition in the Global Health account. … We know how to address undernutrition and malnutrition; we just need the will to do so. Through the investment of the private sector, our faith communities, and our government working together, we can end hunger worldwide” (7/31).

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Opinion Piece Offers 3 Strategic Shifts To End Ebola Outbreak In DRC

Thomson Reuters Foundation: Opinion: There is no quick-fix solution to the Ebola crisis in Congo
Emanuele Capobianco, global director of health and care at the International Federation of Red Cross and Red Crescent Societies

“It is worrying that one year into the Ebola outbreak in the Democratic Republic of Congo (DRC), there is still no end in sight. … If we aim to end this outbreak within the next twelve months, we need three strategic shifts. First, we need to move beyond an exclusively Ebola-focused response. … Second, we need to use this response as an opportunity to strengthen the fragile health system in Eastern Congo. … Third and most importantly, we need to put communities at the center of this response and strengthen their own resilience. … These changes require sustained financial investments to tackle this Ebola outbreak and to address the other humanitarian needs in the region. This includes continuous technical support to local authorities and deep, sincere community engagement at all levels. There is no shortcut. It’s a long journey, but one which needs to start now, as we enter the second year of this deadly outbreak” (8/1).

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Providing Quality Care That Addresses Local Contexts Critical To Maternal, Newborn Health

Global Health NOW: Saving Lives at Birth Starts with Quality Care, Everywhere
Jacob Hughes, senior technical director and health systems practice lead for Management Sciences for Health

“…As the Lancet Commission [for High Quality Health Systems] report points out, increasing access to health services alone is not enough to achieve sustainable progress. In fact, contrary to the prevailing approach of urging women with low-risk pregnancies to give birth at the nearest clinic — which is often unprepared to effectively recognize and manage complications — the commission calls on health system managers to refer all deliveries to hospitals with the infrastructure and highly skilled staff needed to provide emergency surgery and specialized care. However, increasing deliveries in hospitals brings different challenges and risks. … Women might travel farther and spend more money for compassionate, safe care, but they shouldn’t be forced to travel for low-quality care. The millions of dollars and decades of hard work that the world has dedicated to maternal and newborn health delivered an obvious lesson: We can’t oversimplify and broadly apply maternal and newborn health blueprints across every setting. Women have a right to evidence-based, quality care that meets their needs, no matter where they live, and countries must find the will to provide it” (7/31).

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Southern Africa Must Address Health, Needs Of Women, Girl Migrants

The Conversation: Southern Africa needs better health care for women and girls on the move
Rebecca Walker, postdoctoral fellow at the African Centre for Migration & Society, and Jo Vearey, associate professor, both at the University of the Witwatersrand

“[T]he implementation of the [2030 Sustainable Development Goals] presents major and complex challenges in the southern African region, not least due to the high disease burden and increasing levels of inequality. And there are fundamental policy gaps in addressing the health needs of migrants. Where they do exist, gender is inadequately considered. … Our findings highlight the need for improved migration and health governance to address the needs of women and girls on the move in the region. This requires effective engagement across different sectors — including state, civil society, academia, international organizations, and the private sector — at multiple levels, from local to global. The Southern African Development Community struggles to design, coordinate, and implement evidence-informed responses at a regional level, [so] member states need to drive their own responses. This requires engagement in bilateral arrangements with neighboring states to ensure that migration is built into all health responses” (7/31).

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6 Actions To Offer Hope, Ease Humanitarian Crisis In Yemen

Devex: Opinion: 6 actions to help alleviate the humanitarian crisis in Yemen
Alexander Matheou, executive director for international at the British Red Cross

“…Yemen is back in the news again, amid reported efforts to enforce a ceasefire. Even for Yemen experts, the consequences of those events on the humanitarian crisis are hard to predict. In the face of such uncertainty, it is easy to feel helpless but there are actions that must be taken to help alleviate the crisis. First, we must continue to fund humanitarian assistance in Yemen and advocate for other governments to do the same. … Second, we must support the import of essential items that maintain food security and health care in Yemen. … Third, work with all parties to promote safe access for neutral and impartial humanitarian organizations … Fourth, work with all parties to encourage respect for international humanitarian law, with an emphasis on the principles of proportionality and precaution. … Fifth, do everything possible to ensure that salaries of public sector workers are paid so that essential services can continue to run. … Sixth, keep an open and active dialogue with all parties and encourage the parties to commit to the agreement reached in Stockholm during the peace talks consultations…” (8/1).

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From the Global Health Policy Community

Organizations Discuss DRC's Ebola Outbreak One Year Into Response

Brookings Institution’s “Future Development”: Can public works help fight Ebola in the Democratic Republic of Congo? (Bisca/Bance, 7/31).

Columbia News: The Global Response to Ebola Outbreak: What Took So Long? (Cantor, 7/31).

IDSA’s “Science Speaks”: A year into DRC Ebola outbreak, control eludes the response while funding remains in question (Barton, 7/31).

Médecins Sans Frontières: Not contained, new cases: three questions on vaccines and the Ebola outbreak in DRC (7/31).

U.N. Dispatch: It is the One Year Anniversary of the Ebola Outbreak in the Democratic Republic of the Congo (Goldberg, 7/31).

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Friends Of The Global Fight Piece Highlights Takeaways From IAS 2019

Friends of the Global Fight Against AIDS, Tuberculosis and Malaria: Reflections from IAS 2019: Policies to End the HIV/AIDS Epidemic
Shannon Kellman, deputy policy director at Friends of the Global Fight, highlights takeaways from the International AIDS Society (IAS) annual conference that took place July 21-24 in Mexico City. Kellman discusses a new report about how progress on ending the HIV/AIDS epidemics in six locations — San Francisco, London, Malawi, Rakai, Thailand, and New South Wales — can inform the global response; barriers to ending the epidemic in Latin America; and PEPFAR’s focus on women and girls (7/31).

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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, has published Issue 361 of the “Global Fund Observer.” The newsletter features several articles, including an article on the Global Fund Board approval of initiatives worth $18 million from the Unfunded Quality Demand Register; an analysis that finds domestic financial contributions to HIV, TB, and malaria programs remain low in “high-impact” Asian countries; and an interview with Global Fund Head of Resilient and Sustainable Systems for Health Viviana Mangiaterra on the fund’s approach to health system strengthening (7/31).

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Heads Of WHO, UNICEF Deliver Statement Recognizing World Breastfeeding Week

World Health Organization: Empower parents, enable breastfeeding
In a statement recognizing World Breastfeeding Week, WHO Director-General Tedros Adhanom Ghebreyesus and UNICEF Executive Director Henrietta Fore note, “The theme of this year’s World Breastfeeding Week is ‘Empower Parents, Enable Breastfeeding.’ … As the world marks World Breastfeeding Week, WHO and UNICEF call on governments and all employers to adopt family-friendly policies — including paid maternity leave for a minimum of 18 weeks, and preferably, for a period of six months — as well as paid paternity leave. … [W]e also call for greater investments in comprehensive breastfeeding programs, improved breastfeeding counseling and support for women in health facilities and the community, and an end to the promotion of breast-milk substitutes to enable parents to make informed decisions on the best way to feed their infants…” (8/1).

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From the U.S. Government

USAID Releases July 2019 Issue Of Innovation And Impact Newsletter

USAID: Innovation and Impact Newsletter — July 2019
The latest issue of USAID’s Innovation and Impact Newsletter features a report on attracting private capital for global health innovation; highlights a stakeholder meeting hosted by the Nigerian government to validate the country’s integrated pneumonia control strategy and action plan; and discusses an event in Sweden that convened representatives from international development donors and stakeholders to share ways to address “challenges that managers in innovation-supporting organizations face in making informed decisions and impactful investments” (July 2019).

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USAID Partners With Private Hospitals To Implement DOTS, Treat TB In Afghanistan

USAID: Partnering with Private Hospitals to Treat Tuberculosis
This program update discusses the Urban Directly Observed Treatment Short Course (DOTS) system and USAID’s partnership with Emam Zamam hospital in Afghanistan to treat tuberculosis (7/31).

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