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Kaiser Daily Global Health Policy Report

In The News

Singapore Records 56 Locally Transmitted Zika Cases, Expects More; SE Asian Countries Step Up Prevention Efforts

New York Times: Singapore Says It Expects More Zika Cases
“Singapore, which has confirmed several dozen cases of the Zika virus in recent days, expects to identify more previously undiagnosed infections as it steps up measures to halt the spread of the mosquito-borne disease, according to the government…” (Lim, 8/30).

Reuters: Singapore steps up Zika prevention effort as confirmed cases rise to 56
“Singapore confirmed 15 new cases of locally transmitted Zika infections on Monday, taking the tally to 56 as authorities step up efforts to contain the outbreak. … Singapore, a major regional financial center and busy transit hub, which maintains a constant vigil against the mosquito-borne dengue virus, reported its first Zika case in May, imported by a middle-aged man who had been to Brazil…” (Nee/Braddick, 8/29).

Reuters: Southeast Asia needs to up its game to combat Zika: experts
“The spread of the Zika virus across tropical Southeast Asia is likely to be significantly under-reported as local health authorities fail to conduct adequate screening, regional experts said on Monday…” (Lefevre/Sipalan, 8/29).

Wall Street Journal: Singapore Zika Virus Transmissions Rise to 56
“…The Singapore cases appear to be the largest single beachhead that the Zika virus has made in Asia during the current epidemic. The tropical island state is prone to other mosquito-borne diseases, notably dengue fever, which, like the Zika virus, is spread by Aedes aegypti mosquitoes. Health authorities warned earlier this year that Singapore could experience a record 30,000 cases of dengue fever this year…” (Venkat, 8/30).

Washington Post: Singapore Zika cases rise to 56 at one construction site; Malaysia starts border screening
“…The outbreak in the city-state of Singapore, a hub for Southeast Asia, has alarmed its neighbors. Indonesia, the Philippines, Thailand, and Vietnam have each seen a case of Zika and have been concerned that the infections might be spreading locally but have not been able to confirm whether that is the case. In the past 48 hours, Taiwan has issued a travel advisory for Singapore, and Malaysia ordered thermal screening at checkpoints for travelers who enter from Singapore by bus…” (Cha, 8/29).

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NYT Examines Current Zika, Polio Outbreaks In Light Of New York's 1916 Polio Epidemic

New York Times: In Reaction to Zika Outbreak, Echoes of Polio
“…Now that the Zika virus has landed in the continental United States, and now that polio has re-emerged in Africa after two years without a case, it may be instructive to look back at New York’s early [polio] epidemic. It featured many of the problems that have bedeviled our response to the Zika epidemic: false rumors, ethnic prejudice, and ineffective measures…” (McNeil, 8/29).

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WHO Launches 3 New Publications To Assist Nations In Improving Stillbirth, Maternal, Neonatal Deaths Data

U.N. News Centre: U.N. health agency takes steps to help improve data on stillbirths, maternal, and neonatal deaths
“Most stillbirths and neonatal deaths are preventable with quality health care during pregnancy and childbirth, the United Nations World Health Organization (WHO) stressed [August 16] as it launched three new publications to help countries address and strengthen their classification, review, and investigation processes on these deaths, which are unrecorded or underreported…” (8/16).

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Up To Half Million People Malnourished In Nigeria's Borno State, MSF Warns

NPR: They’re Caught In A Crisis That Isn’t Hitting The Headlines
“…Malnutrition is at a catastrophic level in northeastern Nigeria, … says Doctors Without Borders. According to the medical aid group, the number of malnourished people could be as high as half a million. Children are starving — and dying. Thousands of these displaced people live in precarious conditions at an informal settlement called Muna outside Maiduguri, the capital of troubled Borno State and birthplace of Boko Haram…” (Quist-Arcton, 8/29).

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Researchers Continue To Conduct PrEP Research Among Women In South Africa

Scientific American: HIV Prevention Runs into Trouble in South Africa
“…Researchers had hoped to break the [HIV transmission] cycle by giving young women HIV drugs before they are infected. It’s a mode of therapy referred to as preexposure prophylaxis, or PrEP. However, when PrEP was given to women as a pill, the results were discouraging because many study participants didn’t take it daily. And the first trial results for the [vaginal] ring are not spectacular. The numbers, reported in February, show that young women don’t adhere well to the treatments. … In the face of this unexpected setback scientists are now trying to develop new, less invasive products as well as giving more forethought into the social circumstances surrounding PrEP use…” (Maxmen, 8/30).

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Egyptian Cabinet Approves Bill To Impose Stricter Punishment For FGM Involvement

Thomson Reuters Foundation: Egypt seeks tougher punishment for female genital mutilation
“Women’s rights activists hailed the Egyptian government on Monday for advocating increased prison sentences for perpetrators of female genital mutilation (FGM) but warned that a new law could shroud the practice in greater secrecy. Egypt’s cabinet on Sunday approved a bill, which must be passed by parliament to become law, imposing jail terms of up to seven years for people who perform FGM and up to three years for those who escort a girl or woman to undergo the practice…” (Zaki, 8/29).

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Report On FGM In Russia Prompts Controversy After Religious Leaders Seemingly Endorse Practice, NPR Reports

NPR: Controversy Erupts In Russia Over Report On Female Genital Mutilation
“It started with a report and erupted into a controversy involving a mufti, a Russian Orthodox priest, and a rabbi. The subject: female genital mutilation. On Aug. 15, the Russian Justice Initiative issued a report called ‘Production of Genital Mutilation of Girls in the Republic of Dagestan.’ … Asked to comment, Mufti Ismail Berdiev — a Muslim religious leader from the area — told a Moscow radio station, ‘Moscow says,’ that female circumcision is a ‘healthy custom’ practiced in one of the republics of Russia’s North Caucasus region. Berdiev even said that all women should be circumcised ‘to end depravity on Earth and reduce sexuality’…” (Flintoff, 8/23).

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Russia Working To Curb Growing HIV Epidemic But Gaps Remain, The Lancet Reports

The Lancet: Gaps remain in Russia’s response to HIV/AIDS
“…If action isn’t taken to curb the current annual growth rate of 10-12 percent, [the head of Russia’s Federal AIDS Centre, Vadim Pokrovksy,] predicts that there will be two million people diagnosed as HIV-positive by 2020. … And it seems that the government has taken notice. Last October, the Prime Minister Dmitry Medvedev asked the health ministry to draw up a national policy. … Pokrovsky adds that the government’s budget of 21 billion rubles (US$325 million) is about a fifth of what’s required to address the problem and says the most vulnerable groups in whom the transmission rates are the highest have been largely overlooked…” (Clark, 8/27).

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Under Year-Old Initiative, Tanzania's Community Health Workers Experience Mistrust In Rural Areas

Thomson Reuters Foundation: FEATURE-Tanzania’s army of community health workers face mistrust as they roll out services
“One of the biggest tests of Justine Michael’s job as a community health worker is not the distances he must travel along remote dirt roads to visit patients in Tanzania’s Mkuranga district, but rather the suspicion he often encounters. … Michael is one of more than 5,000 community health workers the Tanzanian government has deployed to provide essential life-saving services in rural areas where 70 percent of the country’s population of 49 million live. The initiative was introduced a year ago to address gaps in health care in the East African country where there are only 0.1 doctors and 2.4 nurses and midwives for every 10,000 people, according to 2014 data from the World Health Organization…” (Makoye, 8/26).

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Women's Rights, Health Improved In Afghanistan, But Extremism Preventing Further Progress, U.N. Official Says

Associated Press: U.N. official: For Afghan women ‘glass is half full’
“…Abuse of women in Afghanistan remains entrenched and endemic, despite constitutional guarantees of equality, protection from violence, and age-old practices such as trading young women to pay debts. … In fairness, much has improved for Afghan women since the Taliban were ejected from power. … Now millions of girls go to school, compared to practically none in 2001, and access to health care is widespread. … Phumzile Mlambo-Ngcuka, the executive director of U.N. Women, has found that government officials, judges, clerics, and educators are often receptive to the concepts of women’s rights, as enshrined in the Afghan constitution. But, she said, ‘When we are dealing with extremism there is pushback, every step of the way there is pushback’…” (O’Donnell, 8/26).

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Editorials and Opinions

U.S. Must Implement 'Full-Scale Defense Against Zika'

Forbes: The Inconceivable Future Of Zika Inaction
David Barash, chief medical officer at the GE Foundation, and Jonathan Quick, CEO of Management Sciences for Health

“…The longer we wait to mount a full-scale defense against Zika, the worse the consequences will be. … Each one of us can support [the Zika response] effort by urging our legislators and leaders to address the crisis now, not later. With financial support for needed resources and training, and public perception support in the form of advocacy and awareness, we can make a substantial impact in keeping Zika at bay. Zika presents a significant threat now, and the cost of that threat grows the longer we wait to address it. If we want to ensure our country — and children — grow up safe and strong, private and public sector allies must act together to defeat Zika while we still can. Inaction is not simply inadvisable; it will lead to consequences that are truly unacceptable” (8/29).

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U.S. Food Aid Programs Need Reforms To '3 Major Flaws' To Make Progress Toward Ending Global Hunger

The Hill: A great America deserves a great international food aid policy
Ryan Nabil, research associate for the American Enterprise Institute’s Economic Policy Studies Department; Stephanie Mercier, director of policy and advocacy at the Farm Journal Foundation; and Vincent H. Smith, visiting scholar at the American Enterprise Institute and professor at Montana State University

“…To improve the effectiveness of U.S. food aid programs, three major flaws built into those programs should be eliminated: monetization of food aid, the mandate to source almost all food used for aid purposes from the United States, and agricultural cargo preference. … [B]y ending cargo preference, shifting to local and regional sourcing, and terminating the monetization program, the next U.S. president and Congress could go a long way towards providing food aid to an additional four to 10 million people worldwide without expanding the food aid budget. Moreover, reaching more people in need at no additional cost to the U.S. taxpayer is likely to do nothing but good for the standing of the United States in its relationships with developing nations, as well as with other developed countries who are its allies in the mission to end global hunger” (8/29).

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U.S. Congress Should Support International Family Planning Programs

The Hill: Family planning saves lives, so why did the House cut it?
Lisa Bos, director of government relations at World Vision U.S.

“…Culture, religion, and myths drive [some families in developing countries] to have many children, regardless of the health impact. Parents lack information about why timing births to a mother’s healthiest years (ages 18 to 35) is important and why spacing children by at least three years gives them the best chance and best start in life. They lack access to not only the right family planning information about why to time and space their pregnancies, but also to the correct information about family planning methods that can be used consistent with their religious and cultural views. … These are programs that the United States Agency for International Development’s (USAID) International Family Planning account supports, working through partners like World Vision … Congress must do the right thing this year and give strong support to these vital and lifesaving programs” (8/26).

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Global Health Practitioners Should Use Equity As Tool To Improve Health Services Planning, Delivery

The Lancet Global Health: Bridging the global health gap
Editorial Board

“If there is one constant in the evolving global health agenda, it is the need to address disparities in health. … [T]here are notable variations in health outcomes between population groups, and one of the goals of global health practitioners is to reduce them. … [T]he impatient global health observer cannot help but wonder why all the knowledge and discourse on inequalities and inequities have not led to their quicker and more effective reduction. Clearly … the underlying causes of inequities and inequalities are complex and go beyond the remit of the health sector. But could global health practitioners adjust the way they address these issues to reach better results? … [E]quity should go beyond being just a concept and become a tool to be used to improve health planning and drive the nature of health services. With the inclusion of a goal entirely dedicated to equality in the Sustainable Development Goals (SDG 10), the development community — with global health practitioners at its core — seems to have been given a whole new toolbox to work with. Let us hope it proves adept at using it” (September 2016).

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From the Global Health Policy Community

'Blended Financing' Approaches Could Help Achieve Universal Access To Water, Sanitation

World Bank Group’s “Water Blog”: Achieving universal access to water and sanitation by 2030 — how can blended finance help?
Joel Kolker, lead water and sanitation specialist at the World Bank, and Sophie Trémolet, senior economist in the World Bank Water Global Practice, discuss the role of “blended financing” — using financing from commercial sources as well as government and donor funding — to improve universal access to water and sanitation. The authors highlight nine case studies that examine how blended financing has been used to address constraints and facilitate access to water and sanitation in developing countries (8/29).

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