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Kaiser Daily Global Health Policy Report

In The News

Former Diplomats, Other Officials Issue Report Warning Against Merger Of State Department, USAID, Saying Move Would Harm Efforts To Help Refugees

Washington Post: Former diplomats warn against merger of State Department and USAID crisis roles
“A bipartisan group of former diplomats and other officials warned [August 17] against a merger of the roles of the State Department and the U.S. Agency for International Development in international crises as part of the restructuring and budget cuts planned by the Trump administration. U.S. efforts to help refugees in particular would be jeopardized by some of the proposals that Secretary of State Rex Tillerson and the White House have considered, a report signed by former Deputy Secretary of State William J. Burns and others argued…” (Gearan, 8/17).

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Mark Green Begins Work As USAID Administrator, Travels To Sudan On African Tour

Devex: USAID chief Mark Green’s first day at the office
“…Green takes office at a time when USAID’s future role and standing among U.S. federal agencies is uncertain. In May, President Trump proposed cutting U.S. foreign affairs spending by [nearly] one-third. Secretary of State Rex Tillerson, meanwhile, is overseeing an open-ended reorganization process that has the development community on edge, and USAID continues to operate with few politically appointed leaders in place. Many at the agency and throughout the U.S. development community have welcomed Green’s arrival as a badly needed injection of leadership at an otherwise tumultuous time for U.S. development professionals…” (Igoe, 8/8).

NPR: 5 Quotes From The Head Of USAID On His First Day On The Job
“Mark Andrew Green, the new head of the U.S. Agency for International Development, kicked off his first day on the job with a speech to hundreds of employees. In his speech on Monday, he focused on what they can expect from him and his vision for USAID…” (Columbus, 8/9).

Reuters: In first trip, new USAID chief visits Sudan as sanctions deadline nears
“U.S. President Donald Trump’s new aid chief, Mark Green, kicked off an African tour in Sudan on Sunday, where he will assess whether Khartoum has done enough to get help into conflict areas to deserve eased sanctions. … He is due to visit aid projects in drought-hit zones including neighboring Ethiopia, at a time when Washington is considering an estimated 30 percent cut in the budget of the State Department and USAID…” (Wroughton, 8/27).

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Rockefeller Foundation President Raj Shah Discusses New USAID Administrator, Proposed U.S. Aid Spending

Devex: Former USAID chief Rajiv Shah lays out his advice for Mark Green
“…Mapping out [USAID Administrator Mark] Green’s obstacles in front of a small audience at the Overseas Development Institute in London [recently], Shah — now head of the Rockefeller Foundation — praised Green’s credentials … But he also offered a sobering look at the implications of Trump’s proposed policy shifts…” (Anders, 8/24).

Thomson Reuters Foundation: Interview-Proposed U.S. aid cuts threaten ‘disaster’ for world’s poor — foundation head
“Aid to help developing countries fight poverty, hunger, disease, and climate change is likely to fall 50 to 70 percent under proposed U.S. budget cuts, a ‘disaster’ for the world’s poor, the president of the Rockefeller Foundation has warned. Closing the expected gap through private or charitable spending looks unlikely, added Rajiv Shah, who ran the U.S. Agency for International Development (USAID) from 2009 to 2015…” (Goering, 8/17).

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USAID Intervenes After Global Health Supply Chain Project Reports Poor Outcomes

Devex: Exclusive: Documents reveal largest USAID health project in trouble
“The largest contract ever awarded by the U.S. Agency for International Development — a project described as a ‘cornerstone’ of U.S. efforts to end AIDS, malaria, and maternal and child death — is reporting results that could put access to lifesaving health commodities at risk. The Global Health Supply Chain–Procurement and Supply Management project is a $9.5 billion effort, implemented by Chemonics International, that supports the U.S. government’s most important health initiatives, including the President’s Emergency Plan for AIDS Relief, the President’s Malaria Initiative, and population and reproductive health programs. … Between Jan. 1 and March 31, 2017, only seven percent of the health commodity shipments delivered through the GHSC-PSM project arrived at their destination ‘on time and in full’ — a common metric for measuring the performance of a supply chain. … [T]he dramatic decline in performance caused USAID to intervene in this case…” (Igoe, 8/25).

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$150B Annually Needed To Provide Universal Safe Water, Sanitation, World Bank Report Says

Thomson Reuters Foundation: The cost of clean water: $150 billion a year, says World Bank
“Countries need to quadruple spending to $150 billion a year to deliver universal safe water and sanitation, helping to reduce childhood disease and deaths while boosting economic growth, said the World Bank. Investments should be better coordinated and targeted to ensure services reach the most vulnerable, and governments need to engage the private sector more closely to meet the high costs, said the World Bank in a report released on Monday…” (Hares, 8/28).

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Bill Gates Says U.S. Likely To Maintain African Aid Levels; Gates Foundation To Spend More Than $300M In Tanzania This Year

Bloomberg: Bill Gates Says U.S. Likely to Maintain Aid Levels for Africa
“The U.S. will probably maintain its current levels of aid to Africa despite President Donald Trump’s proposals to slash funding, according to Bill Gates, the world’s richest man. … Gates said he talks with U.S. ‘representatives, senators’ after he returns from visits to the continent and was left optimistic after meeting Defense Secretary James Mattis and National Security Adviser H.R. McMaster. ‘They continue to think long-term and see the U.S. relationship in Africa as being pretty important,’ he said…” (Mohammed, 8/14).

Reuters: Gates foundation to spend over $300m in Tanzania in 2017
“Bill Gates has told Reuters his foundation plans to spend more than $300 million in Tanzania this year on public health and poverty reduction programs. In an interview, the billionaire said aid was now being spent ‘in a smarter way’ in some parts of the world…” (Ng’wanakilala, 8/13).

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IRIN Examines Future Of U.S. Food Aid, Congressional Negotiations On Farm Bill

IRIN: The battle over the future of U.S. food aid
“…[T]he White House, Congress, think tanks, aid agencies, and special interest groups are all jostling for a say in the future of American food aid. The Trump administration had already proposed a budget that would have closed two primary food aid programs — Food for Peace and the McGovern-Dole Food for Education scheme. However, Congress — urged across the board by interest groups, including aid organizations, shippers, and commodity producers — looks unlikely to approve anything close to the White House’s proposal. … But as quadrennial negotiations over the 2018 Farm Bill begin, how food aid will be treated by the Trump administration remains an open question…” (Oakford, 8/8).

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WHO DG Tedros Discusses Agency's Priorities In Foreign Affairs Interview

Foreign Affairs: Global Health Gets a Checkup
“…In May, the WHO’s member countries elected Tedros Adhanom Ghebreyesus as its new director general. A malaria researcher, Tedros, as he is known, served as the health minister of Ethiopia from 2005 to 2012 and as foreign minister from 2012 to 2016. He spoke with Foreign Affairs’ Deputy Managing Editor Stuart Reid in New York in July…” (September/October 2017).

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Global Fund Board To Choose Organization's New Executive Director In November

Devex: The Global Fund to name new director in November
“The Board of Directors of the Global Fund to Fight AIDS, Tuberculosis and Malaria plans to select the organization’s next executive director at its meeting in November 2017, according to an update published [last] week…” (Igoe, 8/23).

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Humanitarian Aid Groups Must Adapt To Survive, Report Says, Outlines Areas Of Concern

NPR: Global Problems Aid Groups Should Prepare For, If They Want To Survive
“…A July report has an alarming message for the aid community: adapt or be left in the dust. ‘The way in which the humanitarian sector has been operating leaves continued need,’ says Eilidh Kennedy, an author of the report published by Action Against Hunger. ‘We’re proposing a new way for NGOs to see their role. What do we need to be able to continue operating in the future?’ That question led Kennedy and her team of researchers to identify 23 areas of concern…” (Gharib, 8/21).

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Immunity To Zika In Latin America, Caribbean Helping Lower Disease Incidence

Science: Zika has all but disappeared in the Americas. Why?
“…Zika cases have plummeted in Latin America and the Caribbean, where the virus raged over the past two years, and much of the population is now immune to it. That, in turn, means fewer infected people entering the United States, reducing the chances of mosquitoes spreading the virus to susceptible people. The respite, experts say, could last for years…” (Cohen, 8/16).

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Humanitarian Aid Seen As Essential To Curb Yemen's Cholera Epidemic, Now Largest Worldwide

Associated Press: Yemen’s civil war turns country into cholera breeding ground
“…Yemen’s raging two-year conflict has turned the country into an incubator for lethal cholera: primitive sanitation and water systems put Yemenis at risk of drinking feces-contaminated water; wells are dirtied by runoff from rainfall on piles of garbage left uncollected for weeks; farmland is irrigated with broken sewers due to lax oversight and corruption; medical intervention is delayed due to unpaid government employees and half of the country’s health facilities are out of service…” (Al-Haj/Michael, 8/10).

The Guardian: Yemen: aid offers ‘only hope of survival’ in cholera epidemic, says Priti Patel
“Humanitarian aid is ‘the only hope Yemeni people have to survive,’ said the U.K. development minister, Priti Patel. She warned Yemen is ‘on the brink of catastrophic disaster’ unless the international community follows Britain’s lead to stem the cholera epidemic…” (Hodal, 8/11).

Washington Post: War, hunger and now cholera: Yemen’s crisis worsens
“…Today, the number of suspected cholera cases in Yemen has reached half a million and nearly 2,000 people have died, the WHO recently reported. It is now the largest cholera epidemic in the world. Only a few years ago, the waterborne disease had been nearly eradicated in Yemen…” (Raghavan, 8/27).

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Editorials and Opinions

U.S. Investments In Foreign Aid, PEPFAR Contribute To U.S. Security, Stability

Orlando Sentinel: Commentary: AIDS, Africa and foreign aid: George W. Bush’s vision
Holly Kuzmich, executive director of the George W. Bush Institute and senior vice president of the George W. Bush Presidential Center

“…Aid that addresses both humanitarian crises as well as security is something we should all care about and support. … PEPFAR is proof that the U.S. government can run a highly effective, results-oriented program that puts taxpayer dollars to work where the return on investment is lives saved. … [E]fforts like PEPFAR, while seeming to be only altruistic, also have an important effect on our own national security. According to the World Bank, since 2004, PEPFAR countries in sub-Saharan Africa reduced political instability and violent activity by 40 percent, compared with only three percent among non-PEPFAR countries in the region. … There is no doubt that the generosity of the American people has been transformational and necessary in reversing the HIV/AIDS crisis in sub-Saharan Africa, and ending investments prematurely puts this progress at risk. … Continued investments in global health, economic growth, and increased trade with Africa are vital. What happens overseas matters more than ever here in the United States, especially to our security and stability” (8/16).

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Devex Special Feature Opinion Pieces Examine U.S. Public Opinion On Foreign Aid

Devex: Special feature: A history of American public opinion on foreign aid
John Norris, executive director of the Sustainable Security and Peacebuilding Initiative at the Center for American Progress

“…While the shape of [President] Trump’s approach to development will still go through many iterations, the fact remains that a sitting U.S. president calculated that there would be no significant political fallout to potentially gutting America’s aid programs. A look at the history of public opinion toward foreign assistance programs helps explain why and is essential in helping the community come to grips with where it now finds itself. … Fortunately, there is a rich collection of opinion polls on attitudes toward foreign assistance dating back to the push to get Congress to approve the Marshall Plan. By taking a dive into the data and history, some very important trends emerge that challenge how the U.S. talks about aid and its importance. … The Obama years brought a slow but steady improvement in the public’s view toward assistance, likely abetted by the relative absence of scandals and a steadily rebounding economy. Few expected the seismic shift in the approach to aid that was to come with the election of Donald Trump as the 45th president of the United States” (8/15).

Devex: Special feature: Ghana, grandma, and the factors affecting American public opinion on foreign aid
John Norris, executive director of the Sustainable Security and Peacebuilding Initiative at the Center for American Progress

“A number of important lessons emerge as we look at the history and trends around U.S. public opinion toward foreign assistance over the past 70 years. Perhaps most importantly, attitudes toward foreign assistance mirror, to a remarkable degree, shifts in the public’s trust in government. … [W]hat emerges is a complex picture for messaging around development: Be cognizant that aid is part of a much larger stream of public opinion toward government. Speak of specifics rather than the aid agenda as a whole, while ensuring that the aid agenda retains a focus on institutions and systems. Remind people again and again that the aid budget is smaller than they think. Have concrete examples of success close at hand. Realize that corruption is a cancer that steadily devours public support for aid. Find a balance between moral arguments, security concerns, and self-interest. Keep it simple and keep it clean…” (8/22).

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Achieving, Maintaining High Levels Of Vaccination Coverage In Africa's Cities Critical To Preventing Outbreaks

Financial Times: Threat of infectious disease outbreaks haunts Africa
Jakaya Kikwete, former president of Tanzania

“…A major shift in the demographic landscape sets up a likely resurgence in outbreaks of preventable infectious diseases across Africa. This would place all the Sustainable Development Goals (SDGs) in jeopardy. … Squalid slums and poor access to basic health services, especially immunization, represent a lethal combination, creating conditions that are ripe for outbreaks. … The most efficient solution is to achieve and maintain high levels of vaccination, which is both effective and affordable. … Health authorities must recognize that the hardest-to-reach communities do not just live in remote villages, but often lie below the radar in cities, right under our noses. Governments urgently need to check their blind-spots and develop new ways to identify and reach these people — or face being left behind with immeasurable, bleak consequences” (8/23).

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More Ambitious Health Targets Needed To Achieve SDG 3

Devex: Opinion: We need more ambitious global health targets
Seth Berkley, CEO of Gavi, the Vaccine Alliance

“…A lack of ambition in how we measure progress toward … [Sustainable Development Goal (SDG) 3 targets, which include ending preventable under-five deaths and achieving universal health coverage with access to affordable and essential vaccines for all,] will not only give us a false assessment of how well we’re doing, but could also hamper our chances of success, putting the lives of millions of the most vulnerable children at risk in the process. Keeping track of how many children receive two doses of a measles-containing vaccine [(MCV2)] is currently the SDG 3 progress indicator being considered for these two targets. … The problem is MCV2 alone simply doesn’t go far enough. … We need to be more ambitious. Even choosing one of the powerful new vaccines that are making a difference in child mortality would make more of a difference. But going even further and making the child the focal point of immunization monitoring would be nothing short of revolutionary. Not only will it help radically reduce childhood mortality, but it will represent a significant step toward the WHO’s goal of achieving universal health coverage, which aims to ensure that everyone has access to affordable, quality health care — no matter who they are or where they live — and that includes ensuring every child has access to the most cost-effective health intervention and is fully immunized” (8/25).

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Trump Administration Enabling Food, Cholera Crises In Yemen

Washington Post: How Trump is enabling famine
Jackson Diehl, deputy editorial page editor at the Washington Post

“Last month, eight large private U.S. relief organizations formed an unprecedented alliance to call Americans’ attention to the worst humanitarian crisis since World War II: 20 million people at imminent risk of famine in four countries, including millions of children the United Nations says are ‘acutely malnourished.’ … But there was no eruption of public interest; news stories about the famine remain few and far between. The reason is fairly obvious: The continuing Trump circus sucks up so much media oxygen that issues that otherwise would be urgent — such as millions of people starving — are asphyxiated. … [Trump’s] larger offense has been his love affair with the despotic regimes of Saudi Arabia and the United Arab Emirates, which are largely responsible for creating — and perpetuating — the food and cholera crises in Yemen [by disallowing access to seaports]. … In fact, Trump is, in more ways than one, enabling famine” (8/20).

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Opinion Piece Offers 5 Recommendations For New USAID Administrator

The Hill: Dear Administrator Green: A five-step vision for the future of USAID
Ann Vaughan, acting vice president and senior director of policy and advocacy for Mercy Corps

“Earlier this month, Mark Green began his tenure as the administrator of USAID. His proven leadership record and ability to navigate bipartisan waters will serve him well, yet he is walking into a hornet’s nest of redesign efforts, staffing freezes, and budget cuts. We have five recommendations as he faces challenges both internally and from an increasingly violent world: 1. Invest in fragile states and ending violence … 2. Strengthen USAID’s independence … 3. Double down on existing reforms … 4. Cut the red tape — not the staff … 5. Money matters … We wish Green good luck as he embarks on this next adventure. Confirmation was the easy part. Now comes the real test: to protect the mission, mandate, and resources of USAID in a particularly trying time, and to continue to promote bold reform that helps us build a safer world” (8/22).

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From the Global Health Policy Community

MFAN Publishes Series Of Blog Posts Responding To Aid Architecture Proposals

Modernizing Foreign Assistance Network: Redesign Reaction: Empowering aid: The real disruptive play for U.S. foreign policy
Anthony Pipa, a senior fellow with the Brookings Institution’s Global Economy and Development Program and former chief strategy officer at USAID, outlines how development, strategy, leadership, measurement, and innovation matter in any plans to restructure U.S. development programs (8/4).

Modernizing Foreign Assistance Network: Redesign Reaction: Reinventing Our Institutions for the Future of Global Development
Ann Mei Chang, former chief innovation officer and executive director of USAID’s Global Development Lab, and Smita Singh, founding director of the Global Development Program at the William and Flora Hewlett Foundation (retired) and former member of President Obama’s Global Development Council, discuss their ideas to create a truly “fit for purpose” U.S. aid architecture (8/9).

Modernizing Foreign Assistance Network: Redesign Consensus: Development Community Defends Independent Lead Aid Agency
MFAN Co-Chairs George Ingram and Connie Veillette, and Tessie San Martin, Plan International USA president and CEO, outline 10 core commonalities that fall under three main themes in various aid architecture proposals, concluding, “As the administration continues its consultations and drafts its own proposal, we hope they will elevate these common threads and meaningfully engage Congress in the process” (8/10).

Modernizing Foreign Assistance Network: Redesign Data: Dueling Dashboards
Sally Paxton, the U.S. representative for Publish What You Fund, and George Ingram, chair of Friends of Publish What You Fund, a senior fellow at the Brookings Institution, and MFAN co-chair, discuss “two websites that purport to publish the same information, one at State (ForeignAssistance.gov) and one at USAID (Foreign Aid Explorer), but the published data is often at odds with each other.” They conclude, “[W]e could both avoid duplication of effort and ensure higher quality and more consistent data by combining these two databases into a single website housed at USAID” (8/15).

Modernizing Foreign Assistance Network: Redesign Reaction: Getting to the nitty gritty to make the most of foreign aid
James Kunder, a member of MFAN’s Executive Committee and former acting deputy administrator of USAID, discusses the details of MFAN’s recent publication “A New Foreign Aid Architecture Fit for Purpose.” Kunder writes, “It has forced us to focus on the nuts and bolts of HOW we organize to effectively reach whatever ultimate goals policymakers set for U.S. foreign aid…” (8/23).

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CGD Working Paper Examines Aid Agency Evaluations In Global Health, Offers Recommendations To Funders

Center for Global Development’s “Global Health Policy Blog”: Taking Stock of Aid Agency Evaluations in Global Health: Here’s What We Know about Evaluation Quality and What Funders Can Do Better
Janeen Madan Keller, policy analyst, and Bill Savedoff, senior fellow, both at CGD, discuss findings from a new CGD working paper on assessing the quality of aid agency evaluations of large-scale public health programs, as well as highlight 10 recommendations “for aid agency staff overseeing and managing evaluations to improve quality” (8/21).

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Trump Administration Should Focus On Foreign Aid, Not Military Spending, To Prevent Terrorism

Council on Foreign Relations “Politics, Power, and Preventive Action”: Why Cutting Foreign Aid Benefits Terrorists
Max Friedman, an intern with CFR’s Center for Preventive Action, writes, “Terrorism is President Trump’s top foreign policy priority, but cutting foreign aid and relying on the military will not help the United States combat it. Terrorism is not a problem for the military alone; its political and economic roots demand instead a USAID-led effort. … [T]he United States should more effectively advance its interests by reevaluating its programs and experimenting on new methods of distributing aid…” (8/9).

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Friends Of Global Fight Blog Series Explores Gender Equality, Efforts To End AIDS, TB, Malaria Epidemics

Friends of the Global Fight: Empowering Women and Girls to Shrink the Global HIV Epidemic
In this blog post, the second in a series of blog posts by Friends of the Global Fight addressing gender equality, Mark P. Lagon, chief policy officer, and Sydney Spencer, global health policy intern, both at Friends of the Global Fight, discuss the role of gender norms in HIV transmission among women and girls and recommend strategies to support programs and activities that address the specific needs of women and girls, including strengthening men’s involvement in these programs (7/27).

Friends of the Global Fight: Economic Growth Needs Women — Healthy Women
In this blog post, Lagon and Spencer discuss the economic burden of gender gaps and the Global Fund’s role in supporting women’s economic empowerment (8/17).

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Study Produces First Estimates Of TB's Role In Under-5 Deaths, Suggests Need For Improved Diagnostics

Center for Global Health Policy’s “Science Speaks”: TB killed an estimated 239,000 children in 2015, nearly all of them untreated, study finds
Antigone Barton, senior editor and writer of “Science Speaks,” discusses findings from a study published in The Lancet that suggest tuberculosis is the sixth leading cause of death in children under five. Barton writes, “Improved efforts to find children who have been exposed to tuberculosis, or are at high risk for the disease … as well as increased use of existing diagnostic tools … that accurately detect the disease in children [and] the development of new tools that can be used with children, would significantly reduce deaths from the disease among children, particularly those younger than five, the authors note” (8/15).

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FT Health Features Global Health-Related Original Interviews, News Roundups

FT Health: Cities lead the way on public health
The latest issue of the Financial Times’ weekly global health newsletter discusses how public health initiatives and urban planning can enhance health promotion within the world’s cities. The newsletter also features a roundup of other global health-related news stories (Dodd, 8/25).

FT Health: Tough times for generics
The August 18 issue discusses access to and regulatory issues surrounding generic drugs in the U.S. and worldwide. The newsletter also features a roundup of other global health-related news stories (Dodd, 8/18).

FT Health: The pursuit of the impossible
The August 11 issue discusses ethical issues surrounding some medical decisions, including the case of Charlie Gard. The newsletter also features an interview with Detlev Ganten, president of the World Health Summit (October 15-17) and former chief executive and chair of the Charité university hospital in Berlin, as well as a global health news roundup (Dodd/Jack, 8/11).

FT Health: The security challenge
The August 4 issue discusses health and biomedical cybersecurity and the challenges of keeping medical data safe. The newsletter also features an interview with Paul Stoffels, chief scientific officer at Johnson & Johnson, about the company’s research into TB and HIV treatments and vaccines, as well as a news roundup (Dodd/Jack, 8/4).

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From the U.S. Government

CDC Epidemiologist Reflects On West African Ebola Epidemic, Emphasizes Importance Of Advancing Global Health Security

CDC’s “Our Global Voices”: Are Ebola response investments making an impact? CDC Epidemiologist reflects on West Africa then and now
John T. Redd, a CDC epidemiologist with the U.S. Public Health Service, reflects on West Africa’s Ebola epidemic, CDC’s efforts to respond to the epidemic, and the importance of advancing global health security. Redd writes, “We don’t know when or where the next epidemic will occur, but these recent experiences reinforce two critical things we do know. One is that when countries can’t respond effectively, outbreaks can quickly cross borders and grow into global epidemics. More critically, stronger public health systems can and do stop the spread of diseases and save lives” (8/7).

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President's Malaria Initiative Recognizes World Mosquito Day

President’s Malaria Initiative: World Mosquito Day — 2017
This fact sheet from PMI discusses World Mosquito Day, recognized on August 20. The day marks “the historic discovery by British doctor Sir Ronald Ross in 1897 that female Anopheles mosquitoes transmit malaria between humans.” The fact sheet also provides information on various mosquito-borne diseases and efforts to monitor, prevent, and treat them (8/18).

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