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Kaiser Daily Global Health Policy Report

In The News

U.K. Development Secretary Asks International Community To Fulfill Syrian Aid Commitments

“Justine Greening, the U.K. international development secretary, has urged countries to fulfill their aid commitments to Syria as the country faces a humanitarian ‘crisis of catastrophic proportions,'” The Guardian reports. “[W]e’re all starting to take a longer-term view … at some point, we want to see Syria being rebuilt. We are looking at priorities and what will be a long-term commitment,” Greening said, according to the newspaper, which notes the U.K. “has committed £348 million [$544 million] in humanitarian aid to Syria, of which £170 million [$265.7 million] has already been allocated.” The U.N. in June “launched the largest emergency appeal in its history — $5.2 billion (£3.2 billion),” warning that 10 million Syrians will need humanitarian assistance by the end of the year, as the crisis enters its third year, The Guardian notes. “Greening voiced concern about the reported mistreatment of Syrians inside the country and refugees outside,” the newspaper writes, adding, “Sexual abuse of women and children has ‘been a concern and is always going to be in a situation where 70 percent of refugees are women and children,’ she said. ‘I think we don’t focus enough attention on vulnerable groups, especially women and girls'” (Tran/Bax, 8/15).

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U.N. Appeals For Humanitarian Aid To Assist North Korea With Food, Health Care, Sanitation

“U.N. Secretary-General Ban Ki-moon … on Thursday [welcomed an appeal] for funding to urgently provide food, health care and sanitation to millions of North Koreans, stressing that donors should not be deterred by the reclusive state’s nuclear ambitions,” Reuters reports (Nichols, 8/15). The U.N. “said $98 million is urgently needed to address critical humanitarian needs in the Democratic People’s Republic of Korea (DPRK), where some 2.4 million people need regular food assistance,” the U.N. News Centre notes, adding, “The funds would be used for food and agricultural support, health and nutrition services, and water and sanitation interventions for the remainder of the year, the U.N. Office for the Coordination of Humanitarian Affairs (OCHA) said in a news release.” Ban’s spokesperson said in a statement, “The lives of many people are at stake, including children who are vulnerable to lasting suffering if they do not receive aid,” according to the news service. U.N. Resident Coordinator Ghulam Isaczai said, “External assistance continues to play a vital role in safeguarding the lives of millions whose food security, nutritional status and essential health needs would otherwise be seriously compromised. … Separating humanitarian needs from political issues is a prerequisite for a sustainable improvement in the condition of people,” the news service notes (8/15).

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Singapore Facing Record Dengue Outbreak

“An unusually severe dengue epidemic in Singapore has claimed its fifth fatality this year, even as health officials try to beat back the city-state’s worst-ever outbreak of the tropical disease,” the Wall Street Journal’s “Southeast Asia Real Time” blog reports. “The death of a 52-year-old man Tuesday came despite signs that government efforts to contain the mosquito-borne dengue virus — which has spread at an unusually rapid pace this year — were having an effect in reducing the pace of new infections in recent weeks,” the blog writes, adding, “As of Tuesday afternoon, officials had logged 14,363 cases of dengue fever this year, according to the National Environment Agency.” The blog notes, “The scale of the current epidemic has surpassed that of Singapore’s worst dengue outbreak in 2005, when authorities logged 14,006 confirmed cases and 27 deaths,” and continues, “According to Singaporean health officials, factors behind this year’s outbreak include lower immunity to dengue among the population, thanks to intensive dengue-carrier controls.” The blog adds, “Other factors for the outbreak include a higher mosquito population and ‘fitter’ viruses with higher epidemic potential” (Wong, 8/14).

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Europe Facing Rising Cost Of Drug-Resistant TB, Study Says

“Europe is facing a multi-billion-euro time bomb of rising costs to control tuberculosis (TB) as drug-resistant forms of the lung disease spread, a pioneering study found,” Reuters reports. “Often thought of as a disease of the past or one restricted to marginalized communities, TB is already inflicting annual direct costs of more than 500 million euros on the region and another 5.3 billion euros in productivity losses,” the news service notes, adding, “The study, by health economists based in Germany, also suggests the economic burden of TB far outweighs the likely costs of investing in much-needed research to develop more effective medicines and vaccines — something they said governments and the drug industry should do urgently.”

“For this study, published online in the European Respiratory Journal on Friday and the first of its kind, researchers used a systematic review of literature and institutional websites for the 27 E.U. member states to summarize data on TB treatment costs in 2011,” Reuters writes. “The total treatment cost of all TB cases in 2011 was 536,890,315 euros ($712.26 million),” according to the news service, which notes, “While the number of drug-resistant TB cases in Europe is currently only a tiny fraction of the total of around 70,000 cases per year, [Roland Diel, a health economics professor at Germany’s University Hospital Schleswig-Holstein in Kiel, who led the study,] said that would swiftly change.” Reuters adds, “Beyond the direct costs, Diel’s team also calculated TB’s impact in terms of the monetary value of lost productivity” using disability-adjusted life years, or DALYs, and “found the total years lost was 103,104 in 2011. In monetary terms, this amounted to more than 5.3 billion euros” (Kelland, 8/15).

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Aid Workers In Somalia Struggle To Contain Polio Outbreak, U.N. Reports

“Aid workers in war-torn Somalia are struggling to contain a dangerous outbreak of the crippling polio virus, with rampant insecurity hampering efforts, the United Nations said Friday,” Agence France-Presse/Fox News reports. “Six years after the Horn of Africa nation was declared free of the virus, at least 105 cases have been confirmed in Somalia, the ‘worst outbreak in the world in a non-endemic country,’ the U.N. Office for the Coordination of Humanitarian Affairs [OCHA] said in a statement,” the news agency writes, noting, “While some four million people have been vaccinated, getting drugs to more than 600,000 children in southern and central Somalia — areas partly under control of the Al-Qaeda linked Shebab, who block vaccination efforts — is ‘extremely challenging,’ it added” (8/16). In an article on its webpage, UNICEF examines “the urgent effort to deliver vaccinations” in the country (Price, 8/14).

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IRIN Examines Gaps In Childhood Immunization Efforts In South Sudan

“South Sudan is doing its bit for global polio eradication efforts, but huge gaps in immunization against other diseases remain,” IRIN reports. “Targeted polio immunization efforts started in the area more than a decade before the country’s independence in 2011 and have remained a top priority,” the news service writes, adding, “Health officials and humanitarian groups are trying to build on this success to improve other immunization efforts, including neonatal tetanus and measles, but more funding and a better health infrastructure are urgently needed.” According to IRIN, “[e]very child in the country is supposed to be vaccinated against tuberculosis, polio, diphtheria, tetanus, whooping cough and measles by its first birthday,” but Anthony Kirbak, director of South Sudan’s expanded program on immunization (EMI), “said that only happens for about 65 percent of the country’s children due to a scant health infrastructure, poor roads and cyclical violence in some areas of the country.” The news service details the country’s polio vaccination efforts, noting “the Ministry of Health sends thousands of volunteers out across the country four times a year to immunize every child they can find who is under six,” and highlights a three-part pneumococcal vaccination campaign in Yida refugee camp started by Médecins Sans Frontières (MSF) last month (8/15).

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IPS Interviews Cuba's National Center For Sex Education Director At LAC Population Conference

Inter Press Service correspondent Raúl Pierri interviews Mariela Castro, director of Cuba’s National Center for Sex Education (CENESEX) and a member of the high-level task force for the International Conference on Population and Development, during the Regional Conference on Population and Development in Latin America and the Caribbean, taking place Aug. 12-15 in Montevideo, the Uruguayan capital. “As director of CENESEX, Castro has led campaigns in Cuba against the spread of HIV/AIDS and to advocate the rights of the lesbian, gay, bisexual, and transgender (LGBT) community,” IPS writes. Castro discusses reproductive health and sex education advances in Cuba, sexual diversity, marriage equality, and abortion, among other issues (8/15).

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Editorials and Opinions

Open Letter Urges U.N.'s Ban To Act On Girl Declaration

In an open letter to U.N. Secretary General Ban Ki-moon, published in The Guardian’s “Global Development Professionals Network,” Havi Murungi from the market research company Havis and Sarah Waithera from the non-governmental organization (NGO) Carolina For Kibeira, write on behalf of girls in Liberia about gender-based violence and a lack opportunities for female empowerment in the country. “[W]e spoke to dozens of Liberian girls recently as part of the consultations the Girl Effect and its partners are doing with girls living in poverty” about “what you need to do to empower them to drive global development forward,” they state, noting, “The girls told us that crime and gender-based violence have created a culture of fear. … Understandably, they want to live in a much safer, healthier, crime-free and developed environment.”

“If you extrapolate the conditions of the girls we met nationally, Africa-wide, and globally, then the extent of deprivation and abuse is phenomenal — so the interventions will have to be equally exceptional,” Murungi and Waithera write. “You can help unleash the exceptional potential of girls that we saw in Liberia,” they state, noting, “They want to become professionals in diverse areas such as law, medicine, education and journalism.” They write, “As secretary general of the U.N., you have the power to make this happen,” concluding, “The consultations will culminate in the Girl Declaration. When it’s presented to you at the U.N. on International Day of the Girl in October, you must act on it” (8/15).

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Innovations For Lower-Income Countries Developed Through Invention Need Implementation

Nathan Myhrvold, head of Intellectual Ventures and former Microsoft chief technology officer, writes about invention — “an inherently risky thing” — in a Huffington Post “TED Weekends” opinion piece, stating, “We apply all of the same brain power and capabilities used in our for-profit invention work and focus them on inventions to improve life in developing countries.” He continues, “For every idea that works, there are dozens of others that fail at the same task. … Those failures aren’t an argument against inventions to help the world’s poor; they’re an argument for more inventions to help them.” He says inventions must be “applicable, affordable and accessible,” because “this combination is a recipe for the ultimate measure of success — impact.” Myhrvold, who delivered a 2010 TED speech titled “Could This Laser Zap Malaria?,” writes, “So, to the critics who say we’ll fail, I offer this: You’re absolutely right. But that’s part of being an inventor. … At best, we’ll invent technology that transforms life for the people who need it most and, in the process, inspire more technology companies to work their magic for the developing world” (8/16).

In an accompanying opinion piece, Stuart Rennie, associate professor in the Department of Social Medicine at the University of North Carolina-Chapel Hill and core faculty at the UNC Bioethics Center, writes, “Nathan Myhrvold’s talk … got me thinking about the relationship between inventors and implementers of health-related technology, particularly technology aimed at tackling important health issues in developing countries.” He continues, “Developing a technological innovation (be it a drug, device or a machine) is generally not enough in itself to make a significant impact on a disease on a population level.” Because “[i]n order to effect real change, you need more than inventors: You need implementers” — “those who take innovations, and try to turn them into the ‘new normal’ in the field, in communities, in health care systems,” he states. “Of course, in the face of serious and persistent diseases like malaria, we do need inventors and their innovations,” Rennie writes, concluding, “But to fulfill the promise of human ingenuity, and ensure inventions to improve global health are more than laser light shows at prestigious conferences, we desperately need the implementers too” (8/16).

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From the Global Health Policy Community

Examining U.S. Efforts To Expand HIV Testing, Counseling Globally

“With an AIDS-free generation within our reach, PEPFAR continues to prioritize combinations of interventions that are based on sound scientific evidence and have a significant impact on reducing new HIV infections and saving lives,” Ambassador Eric Goosby, head of the U.S. State Department’s Office of Global Health Diplomacy and the U.S. global AIDS coordinator, writes in the State Department’s “DipNote” blog, adding, “HIV testing and counseling (HTC), which has been a cornerstone of PEPFAR since its inception, is one such activity.” Noting “HTC is the gateway to many high-impact interventions, such as treatment, prevention of mother-to-child transmission, and voluntary medical male circumcision,” he examines U.S. efforts “to engender an unprecedented expansion in the number of people accessing HTC” and discusses existing challenges (8/15).

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WHO Report Addresses Mental Health In Emergency Situations

“Humanitarian agencies work hard to help people with their mental health and psychosocial needs in the aftermath of emergencies, but too often opportunities are missed to strengthen mental health systems for the long-term, according to a new World Health Organization (WHO) report, ‘Building back better: Sustainable mental health care after emergencies’ released for World Humanitarian Day (August 19),” a WHO press release states. “The possibilities presented by emergency situations are significant because major gaps remain worldwide in the realization of comprehensive, community-based mental health care,” the press release notes, adding, “By releasing this report, WHO aims to help guide policymakers to reform their mental health systems, especially those which may be susceptible to future emergencies” (8/16).

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EGPAF, Lesotho Ministry Of Health Launch Mobile Health Clinics

“Last month, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) teamed up with the Lesotho Ministry of Health (MOH) to launch two mobile health care clinics that will provide HIV/AIDS and other health care services to residents in Lesotho’s rural communities,” Mapalesa Lemeke, an EGPAF communications officer based in Lesotho, writes in the foundation’s blog. “The clinics are made possible thanks to generous support from [PEPFAR and USAID],” she notes, adding, “EGPAF will work with the MOH to provide integrated health services to patients in the remote areas of the mountainous districts of Thaba-Tseka and Mohale’s Hoek, where there is a high prevalence of HIV among pregnant women along with high rates of malnutrition among children and overall limited access to maternal, neonatal, and pediatric care” (8/13).

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