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Kaiser Daily Global Health Policy Report

In The News

NIH Director Speaks To Huffington Post About Effects Of Sequestration

The Huffington Post features an interview with NIH Director Francis Collins, who speaks about the effects of sequestration on the agency’s budget. Because of forced cuts, “[i]nternal NIH estimates show that it will end up cutting more than the 700 research grants the institutes initially planned to sacrifice in the name of austerity,” the Huffington Post writes, adding, “If lawmakers fail to replace sequestration at the end of September, that number could rise above 1,000 as the NIH absorbs another two percent budget cut on top of the five percent one this fiscal year.” Collins said, “If you want to convert this into real meaningful numbers, that means people are going to die of influenza five years from now because we don’t yet have the universal vaccine. … And God help us if we get a worldwide pandemic that emerges in the next five years, which takes a long time to prepare a vaccine for. If we had the universal vaccine, it would work for that too,” according to the news service. He said that if sequestration is not fixed over the next decade, “I think we’ll be no longer the world leader in the production of science, technology and innovation. You can’t look at the curves and say, ‘oh, well, it’ll be fine,’ if we stay on this track. It will not be,” the news service writes (Stein, 8/23).

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U.N. Secretary-General Calls For African Countries, Partners To Increase Efforts To Achieve MDGs

“Now is the time for African countries, development partners and the international community to boost action towards achieving the anti-poverty targets known as the Millennium Development Goals (MDGs) and to shape a shared vision for a universal sustainable development agenda, United Nations Secretary-General Ban Ki-moon declared” on Friday in Seoul, Korea, where he was “addressing the diplomatic corps on the topic of acceleration action towards the goals,” the U.N. News Centre reports. “He noted that human development in Africa has been accompanied by economic growth across the continent making it the world’s second fastest growing region” but added “that poverty rates remain extremely high with rising inequalities and hunger as an ‘unacceptable obstacle’ to human dignity,” the news service writes.

“The U.N. chief also said that he was ‘deeply disturbed’ by persistent food shortages and nutrient deficiencies especially in children and pregnant women” and “noted the threats climate change and natural disasters have on local communities, increasing risks to fisheries, livestock, agriculture and tourism,” according to the U.N. News Centre. The news service highlights a key report issued by Ban last week “outlining his vision to galvanize efforts to achieve the MDGs as well the sustainable development agenda to follow them after 2015” and provides quotes from an interview with U.N. Radio in which Ban’s special adviser on post-2015 development planning, Amina Mohammed, “underlined the progress on the MDGs while stressing much more needs to be done” (8/23).

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Campaigners Against Child Marriage In South Asia Receive $23M Donation For Bangladesh, Nepal, India

Campaigners against child marriage in south Asia have received a $23 million donation to help “underpin awareness and empowerment efforts in Bangladesh, Nepal and India, which “have three of the highest rates of child marriage, with 68.7 percent, 56.1 percent and 50 percent respectively of girls married before the age of 18,” The Guardian reports. “Care USA, the U.S. arm of the anti-poverty [non-governmental organization (NGO)], and the American Jewish World Service (AJWS) [last] week received grants of $7.7 million and $15.3 million respectively from the Kendeda fund to tackle child marriage in south Asia,” where “[b]oth organizations will use the money to support local NGOs,” the newspaper writes. “Founded 10 years ago, the Kendeda fund worked initially on environmental sustainability in the U.S., but last year created a girls’ rights portfolio,” The Guardian notes, adding, “AJWS will focus on India, Care on Nepal and Bangladesh.” The newspaper writes, “Child marriage is not just a question of poverty — although that is a critical issue — but also of how girls are viewed in society,” adding, “All three countries have laws against child marriage, but implementation has proved difficult. Civil child marriage laws are not enforced, and religious or social customs prevail.” The newspaper continues, “For Care and AJWS, the logical route is to work through local partners familiar with regional conditions and practices, and based where the pressure points are” (Tran, 8/23).

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PRI Series Examines Fertility, Infertility In Africa

PRI’s “The World” features a three-part series examining fertility and infertility in Africa, which “has the highest fertility rate in the world, yet some nations also face extremely high rates of infertility,” according to the series summary. The series looks at how “African governments, charities, and health workers [are] giving couples more control over their reproduction” in three different countries. Part I examines the concept of family size in Ethiopia (Kelto, 8/15). Part II highlights efforts to engage men in women’s reproductive choices in Kenya (8/15). Part III focuses on infertility in South Africa (8/15). The series also features an interactive global fertility map (8/15).

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South African School Provides Education For Pregnant Teens

Agence France-Presse profiles the “Pretoria Hospital School where students, some as young as 13, are given the chance to carry on learning in a country where expectant schoolgirls — and their numbers are alarming — are often expelled.” The news agency notes, “Teenage pregnancy rates remain high in South Africa, despite years of campaigns against unprotected sex in a country where more than 10 percent of the population live with the HIV virus that causes AIDS.” The school “has 108 students, aged 13 to 18, following a peak in 2011 with 134 girls,” AFP writes, adding, “After giving birth, the teens return to finish the academic year as new mothers.” AFP includes comments from the school’s principal, Rina van Niekerk, and Andile Dube, director of LoveLife, the country’s “largest youth-targeted HIV/AIDS campaign” (Khumalo, 8/23).

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Aid Agencies Using Technology To Assist Hard-To-Reach Communities

As part of its series titled “Humanitarian Futures,” IRIN examines how humanitarian aid organizations are using technology and innovation to improve access to hard-to-reach communities, especially following conflict or disaster. The news service “explores five access innovations being piloted by aid agencies,” such as using mobile phones to assess food insecurity and trace missing children (8/23).

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Editorials and Opinions

Bringing New Voices Into Development Discussion

“At a 2012 TEDxChange conference in Berlin, African Women’s Development Fund CEO Theo Sowa turned the spotlight on an uncomfortable truth: African women may be the focus of many development campaigns, but they are rarely represented as drivers of the discussion,” Andrew Quinn, director of the New Voices Fellowship at the Aspen Institute, writes in an opinion piece in The Guardian’s “Global Development Professionals Network” blog. “Of course, experts from Africa and other parts of the developing world are pioneering solutions to a vast range of development challenges on everything from improving maternal health to boosting sustainable crop output,” he continues, adding, “Bringing their perspectives to light should be an integral part of development work, particularly as the international community contemplates the next steps in the global development agenda beyond the 2015 [Millennium Development Goals (MDGs)].”

“Celebrity advocates, government officials and major funders all have ready-made platforms for spreading their views — the power of their brand is often enough to build an audience,” Quinn states, adding, “But for those without immediate recognition, the task is harder.” He writes, “The explosion of online and issue-driven media over the past decade has created a wide range of outlets, many of which are eager to bring new voices to light,” and he continues, “Add to this the increasingly crowded schedule of conferences and meetings ranging from the Clinton Global Initiative and Skoll World Forum to TEDx events held around the world and it’s clear that there are a wealth of opportunities to reach important audiences with new stories.” He highlights the Aspen Institute’s New Voices Fellowship, launched this year with support from the Bill & Melinda Gates Foundation, writing it “is one attempt to start figuring out an answer by providing both media coaching and contacts for development experts from Africa and, eventually, other parts of the developing world” (8/23).

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Shared Responsibilities Will Bring Sustainable Solutions In Global Health Care

“Across the developing world, health facilities sit vacant” because “[d]onors who were delighted to help build a hospital or clinic move on to other causes, and eventually the doors close, leaving communities with broken promises,” Elizabeth Sheehan, founder of Containers 2 Clinics, writes in the Huffington Post’s “Impact” blog. “Experts in global health care are currently searching for ways to deliver services in a more responsible way, to harness the power of local markets to sustain services and alleviate the burden of annual philanthropic fundraising,” she writes, adding, “Empowering communities to support their own health care by sharing costs with them means that non-profit service delivery organizations can direct philanthropic aid to growth instead of annual operating costs, and also opens the door to for-profit social enterprises.”

“Funders and investors alike must support the growth of creative solutions that combine the agility of free market capitalism with the social mission of the non-profit and the public mandate of government agencies,” Sheehan states. “In global health care we strive to provide proven, inexpensive life-saving health care with cost-sharing models that ensure long-term sustainability,” she continues, concluding, “Only by leveraging the very best aspects of the public, private and government sectors will we find solutions that have the durability and social impact to provide health care to vulnerable communities worldwide” (8/23).

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'Underground' Abortions In Kenya Lead To High Rates Of Complications, Strain Health System

In a Mother Jones opinion piece, journalist Alex Park writes that in Kenya, “keeping abortions underground has led to an incredible rate of complications, putting a strain on an already overburdened health care system.” According to a report (.pdf) by the Kenyan Ministry of Health, “one change could go a long way toward reducing stress on a hugely overburdened system: allowing more women to have an abortion,” he writes, noting, “Though Kenyans reconsidered an existing abortion ban when writing their 2010 constitution, the nation’s top legal document still virtually forbids the procedure.” Noting that “[i]n 2012, almost 120,000 Kenyan women, or more than a third of all women who underwent [abortion], experienced complications,” Park adds, “The vast majority of these complications, the researchers found, followed ‘unsafe abortions’ carried out by untrained people or ‘in an environment that does not conform to minimal medical standards.'”

“Out of 100,000 unsafe abortions in Kenya today, the researchers estimated, 266 women die,” according to Park. “That rate is lower than the [WHO’s] estimate for all of sub-Saharan Africa (520 deaths per 100,000 unsafe abortions), but far higher than in developed regions, where the rate is estimated to be 30 per 100,000,” he notes, and writes, “Loosening the virtual abortion ban may not end Kenya’s flood of post-abortion complications overnight, but it could save innumerable lives.” He highlights Ethiopia as an example, noting a “legislature decriminalized abortion under certain conditions” in 2004, and “as of 2008, the rate of abortion-related complications in Ethiopia was only 20 percent — still high, but far lower than in Kenya.” However, “the real takeaway from this study, and why U.S. states pondering their own supercharged abortion restrictions should pay attention, is how unsafe abortions harm more than just the women on whom they are performed” because caring for women who have complications puts a strain on health system resources (8/24).

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From the Global Health Policy Community

CSIS Report Examines U.S. Global Health Efforts

A new report (.pdf) by J. Stephen Morrison, a senior vice president at the Center for Strategic & International Studies (CSIS) and director of the CSIS Global Health Policy Center, “highlights achievements of U.S. global health programs over the past decade and the challenges that remain,” according to the summary. Titled “U.S. Health Engagement In Africa: A Decade Of Remarkable Achievement: Now What?,” the report summary says programs such as PEPFAR and the President’s Malaria Initiative (PMI), “fulfill American humanitarian values by saving and enhancing lives; they strengthen health security against common and emerging threats; and they promote the stability and long-term development of vulnerable communities in low-income countries” (8/23).

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Blog Posts Address First-Ever Ministerial Forum On China-Africa Health Development

The following is a summary of blog posts examining the first-ever Ministerial Forum on China-Africa Health Development, held in China earlier this month, and the resulting Beijing Declaration.

  • Victoria Fan, Center for Global Development’s (CGD) “Global Health Policy” blog: “At this meeting China’s president Xi Jinping heralded a ‘new era’ of China-Africa cooperation on health, while commemorating its 50-year history beginning in 1963 when China first sent its first medical team to Algeria,” Fan, a research fellow at the center, writes. “This inaugural forum on health and Beijing Declaration may well mark a turning point in the history of Chinese development and health cooperation to Africa,” she states. However, “[t]here are some areas where both the Beijing Declaration and the Beijing Action Plan could improve,” she continues, and provides recommendations (8/23).
  • Anupama Tantri and Anna Johnston, Global Network for Neglected Tropical Diseases’ “End the Neglect” blog: “A key outcome of the forum included a call for the development and implementation of joint pilot projects between China and Africa on schistosomiasis and other high burden diseases in Africa,” Tantri and Johnston of the Global Network write. Noting “[a]dditional outcomes of the meeting are outlined in the Beijing Declaration … which recognizes health as a central component of cooperation between China and African countries,” they continue, “The Ministerial Forum on China-Africa Health Development is a significant step towards [neglected tropical disease (NTD)] control and elimination and presents a model for further South-South collaboration on NTDs” (8/23).

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Indonesia Launches Pentavalent Vaccine

Nicole Bates, who leads the advocacy strategy for polio and vaccines at the Bill & Melinda Gates Foundation, writes in the foundation’s “Impatient Optimists” blog about the launch on Thursday of a pentavalent vaccine in Indonesia. Bates, who attended the launch ceremony, writes, “Yesterday’s launch was remarkable and is testament to the progress we’re making as a global immunization and health community,” and she lists three reasons. “First, this single vaccine protects children from five diseases that are responsible for preventable illness and death among young children”; “[s]econd, the vaccine is produced by BioFarma, a company owned by the Indonesian government”; and “[l]astly, Indonesia is on track to graduate from financial support from the GAVI Alliance … at the end of 2016,” she states (8/23).

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