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Kaiser Daily Global Health Policy Report

In The News

Ebola Zaire Identified In North Kivu Outbreak; Health Officials Plan Use Of Vaccine Amid Logistical, Safety Challenges

Associated Press: Response to Congo’s new Ebola outbreak ‘highly complex’
“The International Federation of Red Cross and Red Crescent Societies says the response to the new Ebola virus outbreak in Congo’s North Kivu province will be ‘highly complex’ given the armed unrest in the region…” (8/2).

New York Times: The Latest Ebola Outbreak Is Centered in a War Zone
“…North Kivu Province, the volatile region in the Democratic Republic of Congo where the new outbreak is centered, creates security complications that health officials did not confront in the outbreak they just defeated in northwest Équateur Province, 1,550 miles away. The World Health Organization is worried about the safety of medical workers in North Kivu and their access to areas controlled by militants…” (Specia, 8/2).

Reuters: WHO sees complex vaccine and security questions in Ebola response
“…It will be complicated and perhaps impossible to use a vaccine to tackle Democratic Republic of Congo’s new Ebola outbreak, the World Health Organization’s emergency response chief said on Thursday. … Armored personnel carriers and support from U.N. peacekeepers may be needed, making it very difficult to deploy the kind of far-reaching contact tracing used in the previous outbreak…” (Miles, 8/2).

STAT: Ebola outbreak in DRC sets up another test for experimental treatments
“…Officials in the DRC said Thursday that testing has shown that the virus causing disease in North Kivu province in the northeast of the country is Ebola Zaire. That is the virus targeted by Merck’s experimental vaccine, which was tested during the West African outbreak in 2014 and 2015, and used in eastern DRC in an outbreak earlier this year. … [Peter Salama, the head of the World Health Organization’s emergency response program,] said consideration is being given to an ‘out-in strategy,’ which would create a ring around an area where there had been cases, rather than trying to find and vaccinated specific individuals. The idea would be to start ‘with a protective buffer around a whole geographical zone,’ and then moving inward, offering vaccine to everyone in the area…” (Branswell, 8/3).

Additional coverage of this story is available from Newsweek, NPR, Reuters (2), Science, and VOA News.

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Deutsche Welle Examines Proposal To Begin Compulsory HIV Testing Of Students In Uganda

Deutsche Welle: Outcry in Uganda over compulsory HIV test
“Uganda wants to begin compulsory HIV/AIDS testing of students due to the rising number of new infections. The proposal has raised concerns over privacy…” (Yiga, 8/2).

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Measles Epidemic Spreads Throughout Latin America

Associated Press: Measles infects more than 1,000 in Brazil; 5 reported deaths
“Brazil’s Health Ministry says more than 1,000 people have been infected and five have died in a measles outbreak linked to cases imported from neighboring Venezuela. The ministry says on its website that 1,053 cases of the disease have been reported so far this year…” (8/2).

The Lancet: Measles outbreak in the Americas
“Venezuela’s ongoing health crisis is spilling over into neighboring countries, as a year-long measles epidemic has spread to Brazil, Ecuador, Colombia, and Peru, almost two years after the Pan American Health Association (PAHO) declared the Americas free of measles. Measles is particularly threatening to indigenous people near the remote, heavily forested border between Venezuela and Brazil…” (Fraser, 8/4).

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WHO Calls For Ceasefire In Yemen To Allow For Cholera Vaccinations

Reuters: WHO warns of new Yemen cholera surge, asks for ceasefire to vaccinate
“Yemen may be on the brink of a new cholera epidemic, with a heightened death rate due to widespread malnutrition, and the United Nations is hoping for a ceasefire in the north to allow for vaccinations, the World Health Organization said on Friday…” (Miles, 8/3).

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The Lancet Examines Chinese Vaccine Scandal

The Lancet: China’s vaccine production scare
“China’s Changchun Changsheng Biotechnology and the food and drug supervision authority have been the focus of widespread outrage after vaccination scandals have involved both parties. These cases were brought to the public’s attention on July 2 by The King of Vaccines, an article that swept across social media posted online by anonymous writer Shouye…” (Yuan, 8/4).

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More News In Global Health

Agence France-Presse: U.N. moves to unblock humanitarian aid to North Korea (Landry, 8/2).

Devex: How can we address violence against women and girls with disability? (Cornish, 8/3).

Devex: Q&A: What could cheaper satellite imagery do for the SDGs? (Cheney, 8/3).

New York Times: Saudis Escalate Siege of Port in Yemen, Alarming Aid Groups (Kalfood/Coker, 8/2).

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Editorials and Opinions

Global Health Community Must Train, Empower Strong Leaders

Global Health NOW: Global Health Leadership: The Urgent Need
Claire Bayntun, director of global leadership programs at the London School of Hygiene & Tropical Medicine

“The consensus for the need for strong leadership within global health has been growing over a number of years. … Leaders who lack the required leadership skills and essential political and cultural acumen pose significant organizational, team, and individual risks. … By contrast, those with excellent leadership skills are invaluable in these settings — ensuring long-term sustainable change to the health of numerous populations. … Reflection and refocus is needed, allowing leaders to think, operate, fund, collaborate, and behave differently. It is imperative that the global health community embraces the need for change, seizes this momentum, and recognizes the importance of exceptional leadership to be able to achieve ambitious health goals. Training and empowering our global health community in this, the ‘Art of Leadership,’ is fundamental to ensuring a healthier global future” (8/3).

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Chronic Exposure To Violence May Affect Mental Health, Contribute To Rising Suicide Rates In Mexico

The Conversation: Rising suicides in Mexico expose the mental health toll of living with extreme, chronic violence
Cecilia Farfán-Méndez, postdoctoral scholar at the Center for U.S.-Mexican Studies at the University of California, San Diego

“…[N]ew data from the northern Mexican state of Chihuahua reveals the dangerous mental health toll of living with extreme, chronic violence: suicides. … According to government data from 2016, Chihuahua state had the highest and fastest-growing suicide rate in Mexico. … Local researchers believe that chronic exposure to traumatic events causes the kind of severe mental distress that can lead to suicidal behavior. … These results are consistent with mental health surveys in other conflict zones. … Such results have contributed to the World Health Organization’s classification of disaster, war, and conflict as suicide risk factors. … Chihuahua’s suicide crisis may well indicate a simmering public health emergency in other Mexican states with high murder rates, including Michoacan and Guerrero — not to mention in neighboring countries like El Salvador and Honduras that remain far more violent than Mexico. With 2018 on track to be another year of record murders in Mexico and president-elect Andrés Manuel López Obrador taking office in December, this [is] the moment for Mexico to begin grappling with the hidden, longer-term costs of its bloody drug war” (8/2).

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China Must Reform Vaccine Regulatory System, Restore Public's Confidence In Vaccination Programs

The Lancet: Vaccine scandal and confidence crisis in China
Editorial Board

“…[The latest vaccine scandal in China involving the country’s vaccine regulatory system and the administration of substandard vaccines] follows on from a series of fake and substandard food and drugs issues in China. As a result, many parents have lost faith in the vaccine system. … The national immunization program has helped China achieve tremendous health gains. However, the current vaccine confidence crisis seriously threatens this program. Above all, it is the government’s responsibility to ensure that the vaccines produced and used in China are effective and safe. To restore and sustain the public’s confidence in China’s vaccine quality and safety, it is urgent for the government to reflect on and reform where necessary the country’s vaccine regulatory system. A better understanding of the concerns of the public and more transparent and open regulation are essential to protect millions of children from preventable illnesses” (8/4).

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U.K. Report Summarizes Challenges Of Heatwaves, Aims To Direct Efforts Of Government To Mitigate Threat To Public Health

The Lancet: Heatwaves and health
Editorial Board

“…The world is facing a true planetary health emergency. … [Heatwaves] exacerbate existing problems like drought and present profound risks to health. … Heatwaves increase deaths from cardiovascular and respiratory conditions and are also associated with more suicides. People at the extremes of age are most susceptible to heat, but so are those who are poor or socially isolated. … To summarize the challenges presented by hotter summers in the future and to direct the [U.K.] government’s response, the U.K. House of Commons Environmental Audit Committee released a report … [that] catalogs poorly judged decisions by the U.K. government that have increased vulnerability to heatwaves. … This is an important opportunity to place health at the center of decision-making about climate change, to recognize that threats to health, like heatwaves, are shared internationally, to build more resilient communities, and, most importantly, to limit further emissions of greenhouse gases” (8/4).

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From the Global Health Policy Community

Study Aims To Identify Factors Influencing Adoption, Scale-Up Of Innovative Health Interventions

FHI 360’s “Research for Evidence”: From innovation-to-scale: Identifying innovative health interventions to better understand factors influencing their adoption and scale-up
Lauren Bader, regional program manager for the USAID Control and Prevention of Tuberculosis Project and the USAID Challenge TB project at FHI 360, discusses a research project that aims to examine factors that influence the adoption and scale-up of innovative health interventions. Bader highlights four interventions that were selected for the study: methadone maintenance treatment in Vietnam, early infant diagnosis of HIV in Nepal, a patient-centered care model for treating multidrug-resistant tuberculosis in China, and online-to-offline reservations for HIV testing in Thailand (8/1).

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IDPs Pose Humanitarian, Political Challenges For National Governments, International Community, Expert Says

Council on Foreign Relations’ “Africa in Transition”: The Humanitarian Crisis You Haven’t Heard About
In this guest post, Cheryl Strauss Einhorn, adjunct professor at Columbia Business School and author, discusses the political, social, and psychological challenges related to internally displaced persons (IDPs). Einhorn writes, “But the real problem is the issue of sovereignty. … [IDPs] represent a state’s failure to take care of its own people on its home turf. Acknowledging that reality — and seeking or accepting outside help — is politically fraught for a sovereign state. Hence, perhaps, the difficulty of the international community to create a humanitarian architecture for IDPs parallel to the U.N. High Commissioner for Refugees” (Einhorn, 8/2).

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Post Discusses Health-Related Aspects Of China's Belt And Road Initiative, Role In Global Health

Political Insights: One Belt, One Road, One Health
Ana Zhelyazkova, masters student at the Ludwig-Maximilians University, public information officer for the Association for U.N. Interns, student employee at the Max Planck Institute for Social Law and Social Policy, and volunteer for the German branch of Médecins du Monde, discusses the health-related aspects of China’s Belt and Road Initiative (BRI) and evaluates the state of China’s health care and its role in the international arena. Zhelyazkova writes, “Chinese authorities’ failure on public health level puts a question mark behind [China President] Xi Jinping’s pledges of action in the context of BRI and poses a challenge for the WHO and the international community in finding an approach to effectively utilize all provided resources while assuring the quality of the provided aid” (8/2).

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'Science Speaks' Discusses Study Using Xpert TB Diagnostic Tool Among HIV Patients In Malawi

IDSA’s “Science Speaks”: Use of Xpert TB diagnostic tool linked to lower death rates from all causes among HIV patients entering care in Malawi study
Antigone Barton, senior editor and writer of “Science Speaks,” discusses results from a study on the use of the Xpert TB diagnostic tool versus fluorescent microscopy among patients newly diagnosed with HIV showing TB symptoms in rural Malawi. Barton notes that among these patients, “death rates in the year that followed were 22 percent lower among those in rural clinics assigned to use the Xpert point-of-care TB diagnostic tool, as opposed to those in rural clinics using smear microscopy aided by fluorescent dye” (8/1).

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'Science Speaks' Discusses Report Suggesting Former TB Patients Can Help Identify Active TB Cases In DRC

IDSA’s “Science Speaks”: Former patients aid search for missing TB cases in DRC province
Antigone Barton, senior editor and writer at “Science Speaks,” discusses results from a report published in the WHO Bulletin on patient-led active tuberculosis case-finding in the Democratic Republic of the Congo. Barton writes, “[E]nlisting former tuberculosis patients and their family members in a nonprofit focused on screening people at high risk for the disease and referring them for testing and treatment made a difference” (8/2).

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Single-Dose Hepatitis A Vaccine Strategy Reduces Cases, Need For Liver Transplants Among Children In Argentina

Pan American Health Organization/WHO: Putting the brakes on hepatitis A in Argentina
This post discusses a single-dose hepatitis A vaccination strategy for infants, implemented in Argentina in 2005, which “dramatically reduces cases and has eradicated the need for transplants due to acute liver failure in children” (8/1).

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