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Kaiser Daily Global Health Policy Report

In The News

Escalation Of Syrian Crisis Following Chemical Weapons Investigation Would Aggravate Civilian Suffering, ICRC Warns

“Any escalation of the Syrian crisis following an apparent chemical weapons attack will aggravate civilian suffering, the International Committee of the Red Cross said on Thursday,” Reuters reports. “Areas plagued by heavy fighting, including the countryside around Damascus, eastern Aleppo and Deir Ezzor province, are already reeling from breakdowns of services such as water, electricity and garbage collection, it said in a statement,” the news service writes, adding, “There are acute shortages of medical supplies, food and water in several areas in Syria cut off from aid supplies for months, according to the ICRC, which called for unconditional access to deliver relief supplies.” According to Reuters, “[t]he Geneva-based ICRC has tried to reach civilians trapped in the old city of Homs since early July but it says it has been blocked by Syrian government authorities.” The news service adds, “At least 100,000 people have been killed in the conflict that began in March 2011, and every day hundreds of people die or struggle with injuries, according to the ICRC” (Nebehay, 8/29).

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Researchers Continue Search For MERS Origin

The Economist reports on the search for the origin of the MERS virus, noting of 103 cases recorded by the CDC, 49 have been fatal — “a scary death rate.” The magazine details the search, which “was started by Ali Zaki of the Dr. Soliman Fakeeh Hospital in Jeddah, Saudi Arabia, and Ron Fouchier of Erasmus University Medical Centre in Rotterdam, in the Netherlands” with the sequencing of the virus’s genome, allowing them “to construct an evolutionary tree which showed it is related to two previously identified viruses, both of which infect bats” (8/31). In a paper released last week, “a team led by Columbia University virologist Ian Lipkin reports finding an RNA fragment in the feces of an Egyptian tomb bat that matched the MERS virus exactly,” Science notes, adding, “They didn’t find the virus itself, and the snippet was only 182 nucleotides long — but it made the species a prime suspect as the MERS reservoir” (Kupferschmidt, 8/30).

“People do not commonly come into contact with bats, so an intermediate host is probably involved,” The Economist notes and highlights research looking at camels as a potential source. “To provide that proof, someone would have to isolate MERS virus from a camel and show it was the same strain as that found in those who have caught the disease. If it were not, the hunt would have to continue. Sheep or goats, for example, might be to blame,” the magazine adds (8/31).

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Cleveland Plain Dealer Profiles Case Western Reserve University's Center For Global Health And Diseases

The Cleveland Plain Dealer profiles the work of researchers at Case Western Reserve University’s Center for Global Health and Diseases, writing, “When they’re not in Cleveland, they work in parts of the world that are remote, poor, and often road-less. They see people suffering and dying from treatable and preventable illnesses. Their goal, quite simply, is ‘to make life better in developing countries.'” The newspaper notes “[t]he center, which is currently involved in 32 ongoing projects overseas, has secured more than $80 million in funding, mostly from [NIH] and the Bill & Melinda Gates Foundation, since its creation.” The newspaper details some of the center’s research, highlighting Director James Kazura’s “decades-long search” for methods to eliminate lymphatic filariasis, a mosquito-borne illness affecting more than 100 million people worldwide, and noting his latest research recently published in the New England Journal of Medicine (Zeltner, 8/29).

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Guatemala's Government Announces Child Malnutrition Statistics

Guatemala’s government on Wednesday announced at least 62 children under age five have died of malnutrition so far this year, and “[n]early 9,800 youngsters have been diagnosed with chronic malnutrition, the secretary for food security, Luis Monterroso, told reporters,” Agencia EFE/GlobalPost reports. “Half of Guatemalan kids under five do not receive adequate nourishment on a regular basis, according to official statistics that also show 52 percent of the country’s 15 million people are living in poverty,” according to the news agency. “President Otto Perez Molina’s administration is implementing anti-poverty programs that will bear fruit in the coming months, Monterroso said,” EFE writes, adding, “The flagship program is an initiative to provide adequate nutrition and health care for mothers-to-be to reduce the incidence of low birth weight” (8/28).

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Devex Profiles Breastfeeding Device Under Development To Help Prevent Disease Transmission, Deliver Nutrients

Noting that infants who are breastfed have better survival rates, Devex profiles a device under development “that could disinfect breast milk and thus prevent viruses such as HIV from being transferred from a mother to her infant.” According to the news service, “The so-called nipple shield delivery system from JustMilk was recently nominated to receive a seed grant from Saving Lives at Birth Challenge.” In addition to helping prevent disease transmission, “[t]he nipple shield is intended to be a low-cost, safe and effective way to administer medication or nutrients to breastfeeding babies in developing countries,” Devex notes. The team of U.S. and U.K. researchers “plan[s] to carry out a rigorous stakeholder analysis as well as acceptability and clinical studies to optimize the design,” the news service writes (Villarino, 8/28).

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Editorials and Opinions

Global Health Community Must Recognize, Address Health Care Crisis In Syria

Noting that UNICEF reported last week that the number of child refugees fleeing conflict in Syria has reached one million, a Lancet editorial states, “Syria has presented the world with a geopolitical crisis. The global community must not ignore the health crisis that continues to deepen.” The editorial continues, “After three years of decimation to Syria’s health system — and an estimated 100,000 deaths — the global community finally now seems to be waking up to the seriousness of this conflict for civilians,” especially following the alleged use of chemical weapons. “But beyond the immediate urgency of these latest events, the chronicity of the humanitarian catastrophe in Syria and neighboring countries must not be forgotten,” The Lancet writes.

“The disruption to routine health services for children, women, and those who rely on stable supplies of medicines and health services … will inevitably cause substantial increases in preventable mortality,” the editorial states, adding, “The cruelty of the destruction of the health system is one of the deepest tragedies for Syria today.” According to the editorial, “The medical humanitarian response to these desperate predicaments is being hampered by lack of coordination and insufficient funding, and above all a lack of access to all parts of the population,” as reported by Adam Coutts and Fouad Fouad in The Lancet. “The world should be truly shocked by the civilian costs and consequences of this conflict — the simply unacceptable toll on health workers who struggle to maintain what few health services and facilities remain,” the editorial states, concluding, “While The Lancet does not take a position on whether or not a military solution to the Syrian crisis is right or wrong politically, we agree [that] the slow and now accelerating asphyxiation of an entire population cannot continue” (8/31).

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Inclusive Rights-Based Foreign Policy Promotes 'Health And Wellness For All'

“In 2011, in recognition of the importance of an inclusive rights-based foreign policy, U.S. President Barack Obama issued a memorandum that raised [lesbian, gay, bisexual, and transgender (LGBT)] rights to the status of a foreign policy priority,” Joseph Tucker of the UNC Project-China, and Deborah von Zinkernagel and U.S. Global AIDS Coordinator Ambassador Eric Goosby of the U.S. Office of Global Health Diplomacy write in a Lancet opinion piece. “An inclusive rights-based foreign policy can improve the health and wellbeing of LGBT communities” because it “nurtures an environment that is conducive to stable, healthy same-sex partnerships”; “decreases barriers for HIV-infected LGBT individuals to receive antiretroviral therapy”; and “prioritizes the safety of LGBT individuals,” they write.

Though the “inclusive foreign policy agenda has … elicited criticism,” the authors state it “is gaining traction and could generate considerable health benefits” and note, “LGBT rights are human rights.” While “an inclusive foreign policy has advanced most rapidly in high-income nations where discrimination and violence are less common, 29 U.S. states and 12 European countries still have laws that discriminate against homosexual individuals,” the authors write, concluding, “Advancement of LGBT rights is about embracing health and wellness for all, irrespective of sexual orientation or gender” (8/31).

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U.S. Has 'Unique Opportunity' To Help Africa Implement Modern Energy Sources

“In my country, the West African nation of Liberia, living without power has become a way of life,” Ellen Johnson Sirleaf, president of Liberia and winner of the 2011 Nobel Peace Prize, writes in a Foreign Policy opinion piece. She states, “This is why I was delighted when U.S. President Barack Obama put energy poverty at the center of his trip to Africa this summer” with “[h]is new initiative, called Power Africa, [which] aims to double electricity access in sub-Saharan Africa by responsibly building on the continent’s potential in gas and oil as well as its huge potential to develop clean energy.” In addition, “Rep. Ed Royce (R-Calif.), chairman of the House Foreign Affairs Committee, and Rep. Eliot Engel (D-N.Y.), the committee’s ranking member, have introduced the ‘Electrify Africa Act of 2013,’ a bill that would address some of the limitations of the Power Africa initiative and have the complementary goal of providing electricity access to more than 50 million people by installing 20,000 MW of energy capacity by 2020,” she continues.

“It is heartening to see Obama, Congress, the United Nations, and the World Bank focused on increasing energy access in sub-Saharan Africa,” she writes, adding, “They are keenly aware that without a reliable power supply, patients are treated in under-equipped hospitals, vaccines requiring refrigeration can become unusable, students cannot study after dark, and routine business transactions are exceedingly difficult.” She notes, “Globally, at least 1.2 billion people — nearly a fifth of the planet — lives without access to electricity, according to the World Bank,” and she adds, “The highest concentration is in sub-Saharan Africa, where more than 550 million people do not have electricity.” She states, “African leaders are doing their part, putting in place bold plans to increase energy access for our people and committing to responsibly harness our own energy resources,” adding, “Now, the United States has a unique opportunity to partner again with Africans as we work to bring modern energy access to the continent” (8/29).

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Indian Government Deserves Praise For Food Security Bill

“To legislate food as a right for every citizen in a country is a bold step for our nation, and with 810 million people expected to benefit from the biggest program in the world to fight hunger, we hope that no child will ever go to bed hungry again,” Jayakumar Christian, national director and CEO of World Vision India, writes in a Devex opinion piece. The Food Security Bill, approved by India’s lower house of Parliament this week, “is a great opportunity to move from responding to hunger to addressing malnutrition,” he states and discusses the logistics of food distribution under the bill. “Every Indian has to be free from hunger and malnutrition,” Christian states, concluding, “The government has to be commended for giving the nation this very important right — a law that will ensure that children … have a right to live their lives to the fullest” (8/29).

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From the Global Health Policy Community

Examining Human Resources For Health Ahead Of Upcoming Global Health Meetings

In a post in IntraHealth’s “Global Health” blog, senior consultant Richard Seifman highlights “two important global conferences: the Third Global Forum on [Human Resources for Health (HRH)] in November 2013 (Recife, Brazil) and the Prince Mahidol Award Conference on ‘Transformative Learning for Health Equity’ in January 2014 (Bangkok, Thailand),” writing, “[L]eading up to these events, high-level, intensive discussions about the global health architecture will be generated by the forthcoming publications and recommendations of the Oslo Commission and the American Journal of Public Health symposium. The recommendations and discussions could spell out a new approach to health development, and the HRH community knows that health workforce strengthening must be central to that approach.” He adds, “Whatever the findings and recommendations may be, the HRH community must take them into account during the upcoming conferences and use them to contribute to the global health system dialogue” (8/22).

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Inaugural Issue Of GHD-NET's Journal of Health Diplomacy Available Online

Volume 1, Issue 1 of GHD-NET’s Journal of Health Diplomacy is now available online. The inaugural issue includes an introduction (.pdf) from editors Rachel Irwin and Mark Pearcey, a review article (.pdf) on global health diplomacy and the governance of counterfeit medicines, and a commentary (.pdf) on the Trans-Pacific Partnership Agreement, among other articles (August 2013).

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Blog Highlights New Articles Published In PLOS NTDs, PLOS Pathogens

The PLOS “Speaking of Medicine” blog highlights a number of new articles published in the current issues of PLOS NTDs and PLOS Pathogens. In PLOS NTDs, “A. Desiree LaBeaud and Hannah McKeating explore the consequences of declining funding in America for all kinds of research, including [neglected tropical diseases (NTDs)],” and “Sheila West and colleagues find that the WHO’s recommendation [for annual antibiotic mass drug administrations (MDA) to prevent trachoma] falls short of what is necessary for an MDA to achieve maximum efficacy, even with high coverage rates,” the blog states. In PLOS Pathogens, researchers examine HIV superinfection among a Kenyan cohort of women and multidrug-resistant gonorrhea strains, the blog notes (8/29).

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