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Kaiser Daily Global Health Policy Report

In The News

Drought In Namibia Leaves Roughly One-Third Of Country's Population Food Insecure

“Namibia’s worst drought in three decades has left roughly one-third of the country’s population moderately or severely food insecure,” according to UNICEF, Nature World News reports (Kemsley, 8/12). “According to the country’s Directorate for Disaster Risk Management, all 13 regions have been affected by the drought, with major shortages of water, both for humans and animals, and food,” the U.N. News Centre notes (8/12). “Bearing the brunt of the burden are women and children, [UNICEF] explains, as many are forced to sell their livestock and migrate to the cities in search for work as the summer rains have failed to flood the country’s plains for the second year in a row,” Nature World News writes. “Namibian President Hifikepunye Pohamba declared a state of emergency as early as May, explaining that crop yields were expected to come in around 50 percent below average due to the dry weather,” the news service continues (8/12). “Following the emergency declaration, the government allocated 200 million Namibian dollars ($20.1 million) to the drought response, but [Hellen Likanda, deputy director of the Directorate of Disaster Risk Management, which is coordinating the drought response,] said that more funding was needed and that the government was currently drafting a gap analysis that would be used to appeal to international donors to help meet the shortfall,” IRIN reports, noting UNICEF “has launched its own appeal to raise $7.4 million to respond to the needs of women and children while the International Federation of Red Cross and Red Crescent Societies (IFRC) is appealing for $1.48 million” (8/12). BBC News provides a slideshow of photos from the country (8/12).

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Australian Government Commits $358M In Aid To Asia-Pacific Region For Attainment Of 3 MDGs

“The Australian government has committed A$390.9 million (around $358 million) through its AusAID program to help countries in the Asia-Pacific region attain three Millennium Development Goals (MDGs) — poverty and hunger, universal education and maternal health,” SciDev.Net reports. “The aid, spread over four years, will finance nutrient supplements and supplementary feeding to over one million people, provide 100,000 vision screenings and 10,000 sight restoring surgeries, as well as support an additional 1.2 million children to have a better education and help 900,000 women to access improved maternal and child health services,” the news service writes, noting “AusAID spokesperson Sophie Gordon tells SciDev.Net that research will help ensure that the aid will go towards achieving these targets.” The news service adds, “AusAID did not give a breakdown on how much of the funding will actually be used for research, though its policy framework revealed that medical and agricultural research together with education will be the flagship of the aid program” (Sarmiento, 8/12).

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Devex Interviews WFP Country Director For CAR About Humanitarian Efforts, Security Concerns

Despite security concerns for humanitarian groups working in the Central African Republic (CAR), the World Food Programme (WFP) “has chosen to overcome the threat and is scaling up its operations inside the country, strengthening its presence on the ground, reopening sub-offices and hiring more staff to deliver and monitor food aid,” Devex reports, noting Médecins Sans Frontières last month “reported that United Nations and [non-governmental organization (NGO)] staff had become targets of violence, and a few weeks later the country director of Caritas was shot.” The news service provides excerpts from an interview with “Housainou Taal, WFP country director in Bangui, whose job is to try to respond as quickly as possible to the rapidly worsening humanitarian emergency in the lawless Central African Republic, where a starving and fearful population faces a dilemma: continue living hidden in the bush or return to crime and human rights violations in urban areas.” According to the transcript, Taal reflects on the conflict, highlights “solutions and measures [being] implementing to scale up operations and reach those most in need,” and discusses coordination efforts among the various organizations working on the ground, among other topics (Pasquini, 8/12).

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New Scientist Interviews ColaLife Founder, CEO

The New Scientist interviews Simon Berry, founder and CEO of ColaLife, “a non-profit organization that aims to use the Coca-Cola distribution model to get vital medicines to children in rural Africa.” According to the interview transcript, Berry reflects on how he developed the idea for ColaLife into a full business plan, discusses how he came up with the design for the kits distributed through the program, and examines the organization’s next steps (Viney, 8/5).

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Afghan Officials Quarantine Village Experiencing Cholera Outbreak To Prevent Spread

“A cholera outbreak at a village in northeast Afghanistan has infected 1,492 people, killed a young woman and left another 100 in critical condition, a provincial official said Tuesday,” the Associated Press/Boston.com reports. “Abdul Marouf Rasekh, a spokesman for the governor of Badakhshan province, said the outbreak began three days ago and was restricted to one town that has been quarantined,” the news agency writes, adding, “Rasekh said the source of the infection had been traced to a single spring of water that supplies the entire town’s drinking water.” According to the AP, “Afghanistan has had cholera outbreaks in the past but they are not common.” The news agency continues, “Access to clean drinking water is a problem in rural Afghanistan and health care is rudimentary in large parts of the country, which has one of the world’s lowest life expectancies at 50. Only 12 percent of Afghans living in rural areas have access to clean drinking water, according to [USAID]” (8/13).

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FDA Approves GSK Antiretroviral Drug Dolutegravir

The FDA on Monday approved GlaxoSmithKline’s antiretroviral dolutegravir, an integrase strand transfer inhibitor “that was developed by ViiV Healthcare Ltd., its joint venture with two other drugmakers,” Bloomberg reports (Edney, 8/12). “The pill is taken daily in combination with others and can be prescribed to patients who have never taken therapy before, as well as those that have,” The Hill’s “RegWatch” blog notes (Hattem, 8/12). The drug, known under the brand name Tivicay, “was tested in adults in four clinical trials in combination with other antiretroviral drugs, and in one trial involving children,” according to Reuters (8/12).

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Editorials and Opinions

Despite Challenges, Experimental Malaria Vaccine Offers Hope

In a Washington Post opinion piece, columnist Michael Gerson reflects on the development of an experimental malaria vaccine which U.S. researchers last week reported proved highly effective in a small, early-stage human clinical trial. He details the research and writes, “If the vaccine works as promised, it would be an extraordinary scientific milestone: the first highly effective vaccine against a parasite.” Noting “[h]undreds of thousands of people die of malaria each year, mainly children under five,” Gerson states, “A vaccine that prevents infection — rather than treatments that modify the severity of the disease — is important to malaria eradication.” However, he notes “[t]here are serious obstacles in moving this type of vaccination to the necessary scale (beyond, say, to tourists and soldiers),” such as a complicated production process; the fact that the vaccine is delivered intravenously, which would require some level of training for health workers; and the need for a continuous cold chain delivery system.

“There is, of course, one additional obstacle on the issue of malaria,” Gerson writes. Noting that “[b]y one estimate, 58 percent of malaria deaths occur among the world’s bottom 20 percent in income — the most economically unequal suffering of any major public health crisis,” he continues, “In practice, this means the profile of the average malaria victim is a child in sub-Saharan Africa. Hardly the most promising market for expensive medical innovations.” But “if public health officials were content to whine about obstacles, mass treatment for AIDS never would have been undertaken,” he states, concluding, “So any adequate response will require a combination of public and private resources — from governments, international institutions, foundations and innovative privates companies — along with the crazy, humane determination to go for it” (8/12).

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Cash Transfer Behavior Change Programs Used In Developing Countries Could Work In U.S.

In an opinion piece for The Atlantic, international development worker Antara Ganguli examines how programs used in Malawi and other countries to encourage positive sexual behavior change among teenagers might be used in Mississippi, which has the highest teen pregnancy rate among U.S. states. “The typical American antidote for reducing sexual behavior amongst teenagers — sex education — cannot work in Mississippi because of religious opposition by school boards,” she writes, adding, “Meanwhile, conditional cash transfers reduced sexual behavior in a well-received randomized control trial in Malawi.” She discusses the study findings as well as the positive results of another cash transfer study among poor students in New York City. Ganguli proposes a pilot study of the method for Mississippi students, concluding, “Adapting and trying out tactics from developing countries could achieve specific goals in specific circumstances without getting mired in the politics and bureaucracy of the endless welfare debate” (8/12).

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Working Toward Water Independence In Western Uganda

Kyle Westaway, a founding partner at Westaway Law, writes in the Huffington Post’s “Water” blog about his experience traveling to Uganda as “a member of the board of the Adventure Project, a non-profit focused on innovative solutions for poverty.” In the district of Kamwenge, 43 percent of the wells are non-functional, he notes, adding, “I joined our team on this trip to search for the answer to one simple question … What does it take to ensure consistent, long-term access to clean water?” He discusses Diana Keesiga, a civil engineer who works “with Water For People in rural Western Uganda to train and empower local entrepreneurs to take ownership and maintain wells.” Westaway writes, “Diana is working with the local district government to institute a ‘pay-as-you-fetch’ system,” which appoints an overseer of the well who collects fees from users and who uses those fees to maintain the well. “This approach creates jobs for the water entrepreneur catalyzing for upward social mobility for his or her family. Their children are healthy and stay in school and have better opportunities for the future,” Westaway states, adding, “Most importantly, the community moves from dependence on [non-governmental organizations (NGOs)] or the government to independence.” He concludes, “As with any new innovation, there will be challenges along the way. But Diana is not content to sit idly by and watch her country return to the scoop hole. She is committed to charting a new course for sustainable access to clean water in Uganda for generations to come” (8/11).

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From the Global Health Policy Community

CDC Perspective Examines 'New Global Health' Era

In a perspective published in the CDC’s “Emerging Infectious Diseases” journal last week, researchers reflect on a “new global health” era, which they write “requires broader engagement by health organizations and all countries for the objectives of health equity, access, and coverage as priorities beyond the Millennium Development Goals are set.” The researchers examine the complexities of global health architecture, highlight the “overlapping themes [that] determine global health action and prioritization,” and conclude with recommendations for moving forward (8/8).

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Blogs Discuss International Youth Day

The theme of International Youth Day, recognized on August 12, was “Youth Migration: Moving Development Forward.” The following blog posts discuss youth and sustainable development issues.

  • Cate Lane, USAID’s IMPACTblog: “Migration displaces and separates youth from their homes and the protective structure and guidance of families and communities,” Lane, youth adviser for the Bureau for Global Health, writes, adding, “Developmentally appropriate reproductive health and family planning information and youth friendly services can prevent poor health outcomes, and can ensure young people receive adequate care and support for pregnancy, unsafe abortion, STIs/HIV, and violence.” She discusses USAID and U.S. government health programs impacting urban youth worldwide, and she concludes, “The U.S. government’s Action Plan for Children in Adversity recommends that U.S. government assistance support and enable families to care for their children; prevent unnecessary family-child separation; and promote appropriate, protective, and permanent family care” (8/12).
  • Bisola Ojikutu, USAID’s IMPACTblog: Ojikutu, a senior treatment officer with AIDSTAR-One, discusses the importance of communication and information in adolescent HIV care. “AIDSTAR-One, in partnership with Baylor International Pediatric AIDS Initiative (BIPAI), created ‘Teen Talk: A Guide for Positive Living,’ a resource written for teens to use on their own, or for use in consultation with medical providers or caregivers. Covering issues such as adherence, nutrition, and safe sex, ‘Teen Talk’ helps youth living with HIV think through their concerns and make healthy decisions,” she writes, adding, “Living with HIV will always be a challenge. However, with tools such as ‘Teen Talk,’ youth living with HIV can thrive and remain healthy in their adolescent years, bringing us one step closer to reaching the global goal of an AIDS-free generation” (8/12).
  • Zeenat Rahman, State Department’s DipNote: “Young people are key drivers to solving some of the world’s most pressing strategic challenges, from rebuilding the global economy to peace building and creating sustainable democracies, and will play a prominent role in shaping the 21st century world,” Rahman, the secretary of state’s special adviser for global youth issues, writes. “Addressing the challenges that youth face around the world — in education, employment, health care — is smart foreign policy,” she says, adding, “But it is also an opportunity; young people represent a pool of human capital whose potential has yet to be tapped. I am inspired by the energy and passion of this generation and am committed to working in partnership with them to solve some of our biggest global challenges” (8/12).
  • Maryanne Yerkes, USAID’s IMPACTblog: “Many USAID programs support young migrants or potential migrants. This includes our anti-trafficking and human rights programs, which help mitigate the risks associated with migration,” Yerkes, acting agency youth coordinator in the Bureau for Policy, Planning, and Learning, writes. “However, I would like to draw attention to our broader youth development programs, which aim to provide youth with the support structures, skills, knowledge and opportunities they need to navigate the challenges they face while growing up,” she says and describes several programs in this area (8/12).

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Working To Ensure Access To Family Planning For East African Youth

“Across East Africa, the majority of young adolescents are living without choice. With little or no access to modern contraceptives and family planning education, they lack the ability to choose when to become pregnant and even how many children to have,” Shane O’Halloran, international team manager for communications for Deutsche Stiftung Weltbevoelkerung (DSW), writes in the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog. “Fortunately, due to the intervention of global initiatives such as FP2020, and the work of organizations like [DSW] in Eastern Africa, this situation is gradually changing for the better,” he continues, highlighting DSW’s “Young Adolescents Project” in the region, which is “aimed at removing barriers faced by young adolescents (10 to 14 years) in accessing age-appropriate sexual and reproductive health and rights information” (8/11).

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