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Kaiser Daily Global Health Policy Report

In The News

WHO Update Reports 102 Recorded MERS Cases, 49 Deaths

“Eight more people in Saudi Arabia have contracted the MERS coronavirus, bringing the number of confirmed infections worldwide in the past year to 102, of whom almost half have died, the [WHO] said on Wednesday,” Reuters reports. “The Middle East Respiratory Syndrome Coronavirus (MERS-CoV), which can cause coughing, fever and pneumonia, emerged in Saudi Arabia last year and has been reported in people in the Gulf, France, Germany, Italy, Tunisia and Britain,” the news agency notes (Nebehay, 8/28). “Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns,” according to the WHO statement, which noted 49 of the 102 cases have died (8/28).

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NPR Profiles Health Clinic In South Africa Working To Combat HIV Among Prostitutes

NPR’s “Shots” blog and “All Things Considered” program profile a “health clinic in the heart of Johannesburg [that] is attempting to break the HIV cycle by focusing on people at extremely high risk for infection — prostitutes.” According to the blog, “[s]ome researchers estimate that about two-thirds of sex workers in South Africa are HIV positive,” and “[p]roviding them with basic health care, including access to antiviral drugs, can save their lives while reducing the chance that they’ll spread HIV to clients.” The clinic, run by the University of the Witwatersrand and located in the city’s Hillbrow neighborhood, “an area known for drugs, poverty and prostitution,” “offer[s] the same general health care as others, but the staff also goes out to meet with women in the streets, in brothels and at truck stops,” the blog writes. “The hope is that by treating conventional [sexually transmitted diseases (STDs)], the risk of HIV spreading either from the sex workers to their clients or from clients to the sex workers is reduced,” the blog notes, adding, “The staff also can get women started on antiviral drugs, give them condoms and tries to stress the importance of safe sex” (Beaubien, 8/28).

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Myanmar Working To Improve Access To HIV Treatment, IRIN Reports

IRIN reports on efforts to improve access to antiretroviral drugs (ARVs) for people living with HIV in Myanmar, particularly in rural areas. “According to UNAIDS, there are about 220,000 people with HIV in Myanmar of whom 120,000 are in need of ARVs,” the news service writes, adding, “From 2011 to June 2013, ARV treatment coverage climbed from 32 percent of diagnosed patients to nearly 50 percent, inching closer to the government target of 85 percent by the end of 2016.” However, 70 percent of people on treatment are in the country’s two largest cities, according to IRIN. The news agency discusses funding for Myanmar’s national HIV/AIDS program and includes comments from representatives of the Global Fund to Fight AIDS, Tuberculosis and Malaria, UNAIDS, and the Burmese non-profit Social Action for Women (8/28).

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IRIN Examines Malnutrition in Laos

“Economic growth in Laos is propelling the country towards achieving middle income status by 2020, yet chronic malnutrition among children under five years old remains a pervasive challenge, experts say,” IRIN reports. “Steady economic growth over the past decade — eight percent in 2012 — has contributed to a drop in poverty levels,” the news service writes, adding, “Yet Laos struggles with the second-highest rate of malnutrition in East Asia and the Pacific after Timor-Leste, a country that has experienced civil war and unrest over the past two decades.” According to IRIN, experts say the country faces challenges such as “geographic isolation, the need for greater dietary diversity and poor awareness about nutritional health,” as well as a “heavy reliance on subsistence farming in rural areas, [and] seasonal and weather-induced food insecurity.” The news service continues, “Nutritional knowledge is also in short supply, especially in isolated highland villages, and ‘particularly for pregnant mothers and children under the age of five, who are most at risk of immune deficiencies and hindered learning abilities resulting from inadequate food intake,’ said [Uma Palappian, a nutrition specialist with UNICEF Laos]” (MacLean, 8/29).

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J&J, Wellcome Trust, Academics To Research Dengue Therapies

“Johnson & Johnson is joining the hunt for drugs to treat dengue fever — the world’s fastest-spreading tropical disease — by linking with academic researchers in Belgium and the Wellcome Trust medical charity,” Reuters reports. “The tie-up between J&J’s Janssen unit and researchers at the University of Leuven, who have received backing from Wellcome, will build on the discovery of a series of chemical compounds that are highly potent in preventing the replication of dengue virus,” for which there is no treatment or vaccine, according to the news agency. “Experts estimated in April that there may be as many as 390 million dengue infections around the world each year, although not all patients get seriously sick,” Reuters notes (Hirschler, 8/29).

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Xinhua Interview Reflects On Global Food Security Solutions

“The challenges in improving global food security are so daunting that no one country or one company can solve them by itself, so the resolution really needs to be collaborative, Dupont Pioneer Vice President Daniel Jacobi said Monday” in an interview with Xinhua, the news agency reports. “Jacobi, who is responsible for the leading U.S. seed producer’s Asia Pacific, Europe, Africa commercial business group, said that everyone can see the demand for agricultural output is to continue to increase over time,” the news agency writes. Jacobi “praised the accomplishments made by China in improving agricultural production, citing that the world’s most populous country feeds 19 percent of the world’s population on seven percent of the arable land,” but “at the same time, Jacobi said China is going to have to do better in the future as more and more migrant workers are moving to the cities of China and are going to have more reliable sources of food” (Fan, 8/28).

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Editorials and Opinions

Midwives Play Important Role In Reducing Maternal Morbidity, Mortality In Afghanistan

“Midwives are an integral and inseparable component of the health care delivery system …, play[ing] a vital role in improving maternal and neonatal health worldwide,” public health consultant Aziz Baig writes in the Huffington Post’s “Global Motherhood” blog. “In developing countries like Afghanistan, midwives bring great hope to the tens of thousands of women who have no access to doctors or clinics,” he states, noting “[j]ust 10 years ago, Afghanistan was the most dangerous place in the world for a woman to give birth.” However, he adds, “[a]ccording to a report released by [WHO] in 2012, the maternal mortality worldwide has dropped by 47 percent since 1990,” and “[t]he most encouraging news is that the number of maternal deaths in Afghanistan has declined by 65 percent.”

“The intent of this article is not to defend the above stated findings of the WHO report, rather to shed light on those avant-garde interventions and indefatigable community-based approaches that led to a significant reduction in maternal mortality in Afghanistan,” Baig continues, noting, “In order to support and complement Basic Package of Health Services (BPHS) and Essential Package of Hospital Services (EPHS) projects in Afghanistan, the Ministry of Public Health in collaboration with [USAID] and other donor agencies established community midwifery schools in almost all provinces of Afghanistan.” He describes the program, profiles one of “the first batch of eighteen students who enrolled in the community midwifery school in 2005,” and writes, “Due to their untiring efforts, devotion, insatiable interest and everlasting commitment to their nation, all maternal and child health indicators have now improved in Afghanistan” (8/28).

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Education, Training Key To Improving Health Care

“When I visit [communities] on behalf of Every Mother Counts (EMC), the campaign I founded to reduce preventable deaths related to pregnancy and childbirth around the world, I am reminded that what’s often most needed is education and access to others who are educated,” Christy Turlington Burns writes in the Huffington Post’s “Global Motherhood” blog. “Sexual and reproductive health education and human rights education are almost always lacking, even when others are available,” she states, adding, “When you look at education through a global health lens, the ripple effects of higher education on communities and populations sharpen immensely.” She continues, “My trips to Haiti over the past few years have taught me that the people of this beautiful country are quite capable of combating their current climate of high maternal and newborn death rates (the highest in the region) through training, mentoring and the education of nurses, midwifes, and skilled birth attendants.”

Burns discusses EMC’s support of a program at Haiti’s University Hospital, which is run by Partners In Health and their Haitian sister organization Zanmi Lasante (ZL), to train “Haitian nurses including auxiliary nurses, nurse-midwives, and birth attendants in normal birth management; how to better diagnose and manage complications; and to provide emergency obstetric care at University Hospital.” She concludes, “We are so excited about the potential of this new group of health workers who will undergo training through this partnership because we know that the ripple effect of the knowledge and skills they will gain at University Hospital will spread beyond their communities and that someday, everyone in Haiti will have access to the same quality of health care” (8/28).

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Opinion Pieces Address Terminology Surrounding FGM

The following is a summary of opinion pieces examining the practice of female genital mutilation (FGM) and the terminology used to discuss it.

  • Hilary Burrage, Huffington Post U.K.’s “Impact” blog: “Wednesday, August 28 is the day when a small group of women, me included, launch our Feminist Statement On Female Genital Mutilation,” Burrage, a sociologist from the U.K. writing a book on eradicating FGM, writes. “The basic premise of our statement is this: Patriarchal oppression is the bedrock of [FGM] and related harmful traditional practices … [and] female genital mutilation in all its forms is cruelty and abuse,” she writes, adding, “[O]ur aim in publishing the statement is: … to gather support, from concerned citizens and from people directly working to abolish FGM, for research, dialogue and activism which derive from such an understanding. To that end we insist, for instance, that FGM be correctly named — as specifically ‘mutilation’ and not, in formal discourse, by any evasive or softening euphemism.” Burrage provides some statistics regarding FGM, and she concludes, “Until nations everywhere perceive FGM not as a custom, but rather as an epidemic which must be addressed by governments as well as community workers, it will continue to blight the lives of millions” (8/28).
  • Kim Thuy Seelinger and Hernan Reyes, Huffington Post’s “World” blog: The “[r]ecent release of UNICEF’s fascinating report [.pdf] about the practice it refers to as ‘female genital mutilation or cutting (FGM/C)’ triggered lively coverage in national and international news outlets,” Seelinger, director of the Sexual Violence Program at the University of California Berkeley School of Law’s Human Rights Center, and Reyes, an obstetrician and gynecologist who spent 28 years as medical coordinator for the International Committee of the Red Cross, write. “While the UNICEF report sparked critical discussion about the practice itself, the issue of terminology and its implications must not be overlooked,” they state, noting, “Debate over vocabulary has persisted in the West for decades.” They examine the use of different terminology in media coverage, stating, “Of the different terms used in the West, at least ‘female circumcision’ should be abandoned. At best, it is inaccurate. At worst, it inches the practice into the realm of the medicalized or sanitary, obscuring aspects that still undermine girls’ and women’s human rights.” The authors conclude, “It is medically inaccurate, falsely reassuring, and distracts from the fundamental question of whether alteration of the female genitalia for no medical benefit — and, indeed, to limit a woman’s full sexual integrity — is a human rights violation” (8/28).

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From the Global Health Policy Community

Kaiser Family Foundation Reports Map Global Efforts To Address Malaria, TB In Low-, Middle-Income Countries

The Kaiser Family Foundation today released two new reports in its “Mapping the Donor Landscape in Global Health” series “examin[ing] donor nations and multilateral organizations involved in addressing different global health challenges in recipient countries worldwide,” a summary on the foundation’s webpage states. The two new reports, which address funding for malaria and tuberculosis, “seek to provide perspective on the geographic presence of global health donors, and to enable more effective coordination and delivery of services globally and within individual recipient nations,” according to the webpage (8/29). “An analysis on HIV/AIDS was released in June, and a future analysis is planned for family planning and reproductive health assistance,” an email alert from the foundation states (8/29).

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Examining USAID's Efforts To Strengthen Food Security In South Sudan

“As USAID’s Food for Peace Officer assigned to South Sudan since October 2011, I have seen firsthand how U.S. government food assistance programs are simultaneously supporting communities’ efforts to create assets that strengthen their food security while providing vital timely assistance to food insecure South Sudanese,” C.W.T. Hagelman writes in USAID’s “IMPACTblog.” He continues, “Pockets of continuing civil conflict and erratic weather patterns plus a massive influx of refugees from Sudan and the return of thousands of people of South Sudanese origin after years of living in Sudan have strained food security in this new nation struggling to find its footing.” Hagelman describes the “innovative approach called ‘Food-for-Assets,'” which he says “citizens have embraced” (8/28).

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Examining Free Maternity Care In Kenya

Writing in the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog, Jane Otai, a 2013 New Voices Fellow at the Aspen Institute and a senior program adviser for Jhpiego, a non-profit global health affiliate of Johns Hopkins University, writes about the “positive step” of free maternity care in Kenya, but adds “it is … imperative to ensure that free care equals quality care.” She states, “[A]s someone with over 15 years of experience talking with women and families in Kenya’s informal settlements, I also know that tradition and what many Kenyans perceive as poor-quality hospital care will stand in the way of this well-intentioned program.” She adds, “So while the government celebrates free maternity care in our health facilities, there is still a need to convince women that they will get a high quality service from the health providers” (8/28).

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Study Supports Linking Disease Control Efforts For Filariasis, Malaria

Noting a recent study published in the New England Journal of Medicine that found bed nets can help eliminate lymphatic filariasis (LF), Greg Simon, senior technical officer for the Global Network for Neglected Tropical Diseases (NTDs) at the Sabin Vaccine Institute, writes in the “End The Neglect” blog that this research and other studies help support the use of bed nets to prevent both LF and malaria. “This study provides excellent examples of ways to combat two different diseases that use the same mechanisms of infection and that affect millions of people worldwide,” Simon writes, concluding, “Linking these disease controls can also promote effective partnerships with national strategic plans and country ownership; investment in human capital; introduction of innovative financing strategies and improvement in health service delivery models” (8/28).

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