Kaiser Daily Global Health Policy Report

In The News

Trump Administration Freezes Some Foreign Aid Accounts Pending Review; Critics Fear Rescission Proposal Will Move Forward

CNN: Trump administration freezes foreign aid funds pending review
“The Trump administration has put a temporary hold on [several accounts] of congressionally approved foreign aid funds, pending a review by the State Department and the U.S. Agency for International Development. Critics say the move undercuts Congress and fear that it is another attempt by the administration to cancel aid programs that advocates see as vital to U.S. interests. The Office of Management and Budget informed the two agencies in a letter Saturday that unobligated funds would be frozen until ‘three business days after’ State and USAID provide an accounting of how much remains in specific accounts and how the funds are being spent. Those funds expire on September 30, the end of the fiscal year…” (Hansler et al., 8/7).

Devex: Trump administration resurrects ‘rescission’ proposal in latest attack on U.S. aid spending
“…The funding in question totals between $2 billion and $4 billion that is set to expire when the current fiscal year ends on Sept. 30, according to people familiar with the accounts. … Last year the White House considered using the same budgetary authority — a relatively obscure process known as ‘rescission’ — to target U.S. global development funding. USAID’s country missions managed to quickly spend much of their remaining unobligated funds, and OMB ultimately abandoned that plan. People with knowledge of the situation, who spoke on the condition of anonymity, told Devex they believe the White House will move forward with the rescission proposal this year. … In a barrage of statements, U.S. development advocates were quick to condemn the administration’s apparent plan…” (Igoe, 8/7).

Roll Call: White House blocks foreign aid funds, demands accounting
“…For the last three years, the White House has produced budget proposals that would [cut] funding for foreign aid, and each year Congress, on a bipartisan basis, has rejected those proposed cuts. The ‘use it or lose it’ mentality of federal agencies to spend appropriated funds before they expire at the end of the fiscal year is a well-known reality of Washington. Still, no other federal agency is known to have received a letter from OMB directing it to freeze spending while an accounting is made of the remaining balances…” (Oswald/Mejdrich, 8/6).

U.N. Dispatch: The White House is Trying to Make and End Run Around Congress to Strip Funding for Diplomacy and Development
“…[Last year,] the U.S. Government Accountability Office ruled that strategically timed rescissions intended to beat the clock on previously appropriated funds did not comport with the 1974 budget law. That ruling has apparently not stopped the White House from trying this procedural and budgetary legerdemain again. Deeper still, the letter from OMB to USAID ordering a spending freeze occurred when [Secretary of State Mike Pompeo] was out of D.C., on a trip to the Asia-Pacific region…” (Goldberg, 8/6).

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U.S. Sanctions Hampering Funding For Humanitarian Work In Flood-Hit Iran, Aid Groups Say

Inter Press Service: U.S. Sanctions Imperil Aid to Iran’s Flood Victims
“Two major humanitarian groups have warned that United States sanctions on Iran are stopping cash flows for vital humanitarian work in the country, adding another complication to the growing rift between Washington and Tehran. This week, the Norwegian Refugee Council (NRC) and the Iranian Red Crescent Society (IRCS) complained that U.S. President Donald Trump’s so-called ‘maximum pressure’ campaign on Iran is also stopping key assistance to flood victims and refugees there…” (Reinl, 8/6).

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U.K. Lawmakers Call On DFID, Donors To Do More To Prevent Violence Against Aid Workers

Devex: Calls for DFID to help tackle violence against aid workers
“U.K. lawmakers have called on the Department for International Development to use its diplomatic power and other measures to tackle violence against aid workers after some 270 were killed or injured in the field last year. In a report published Tuesday, members of the International Development Committee — a cross-party group of politicians tasked with scrutinizing U.K. aid spending — called on DFID to step up its efforts in response to data from the most recent ‘Aid Worker Security Report 2019,’ which identified 2018 as the second worst year on record. … The report recommends that donors do more to ensure that the protection of aid workers under international humanitarian law is upheld…” (Edwards, 8/6).

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DRC, Rwanda Health Ministers Discuss Strengthening Ebola Prevention, Surveillance Efforts At Border; DRC Ebola Lead Muyembe Says Outbreak Can Be Controlled In 3-4 Months

Al Jazeera: Ebola: Rwanda bolsters DRC border restrictions
“The health ministers of the Democratic Republic of Congo and Rwanda are meeting on Tuesday to work out a plan to fight the latest Ebola outbreak. It is hoped the discussions will lead to the adoption of a joint strategy which can be presented to the World Health Organization…” (Dekker, 8/6).

Science: Ebola veteran promises an end to Congo’s epidemic
“Later this month, virologist Jean-Jacques Muyembe-Tamfum from the Democratic Republic of the Congo (DRC) will receive a prestigious award from Japanese Emperor Naruhito ‘for his research to confront Ebola and other deadly viruses and efforts to train legions of disease-fighters.’ … In 1976, at age 34, Muyembe was the first virologist ever to see an Ebola patient, and he has helped fight all nine of the outbreaks to strike his country since. … Speaking to Science on the phone from Goma, Muyembe says the outbreak can be brought under control in 3 to 4 months. ‘It is ambitious,’ he says. ‘But I think we can achieve it’…” (Kupferschmidt, 8/6).

Additional coverage of the DRC Ebola outbreak and response is available from the Associated Press and Xinhua News.

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Nigeria Close To Eliminating Polio Despite Efforts From Boko Haram To Prevent Vaccinations

NBC News: Boko Haram tried to stop Nigeria from eliminating polio. They failed.
“Nigeria is on the verge of eliminating polio, but Boko Haram is standing in the way. Using violence and misinformation, the ISIS-linked militant group has hampered efforts to get every child in the country vaccinated against polio, leaving nearly 66,000 children in remote villages in northern Nigeria without the vaccine, according to UNICEF estimates. But public health officials are pushing back, teaming up with the military and volunteers who have put their lives on the line to get vaccines to everyone…” (Charles, 8/7).

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Media Sources Continue Coverage Of Philippines' National Dengue Epidemic Declaration

Fox News: Philippines declares national epidemic as Dengue fever cases rise past 145,000 (Dedaj, 8/6).

The Guardian: Philippines declares epidemic after dengue fever kills more than 600 (Ellis-Peterson, 8/7).

The Hill: Philippines declares epidemic after more than 600 die from dengue fever (Pitofsky, 8/6).

USA TODAY: After over 600 deaths, epidemic for mosquito-borne dengue virus declared in Philippines (Hines, 8/6).

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Populations Of 17 Nations Experience Extreme Water Stress, Report Says

CNN: A quarter of world’s population are living with extreme water stress
“A quarter of the world’s population is living in regions of extremely high water stress — with ‘once unthinkable’ water crises becoming common, researchers have said. With the climate crisis biting, 17 countries — home to one in four people on the planet — are deemed to be ‘extremely high water-stressed,’ meaning they are now consuming more than 80% of their available water every year, the World Resources Institute (WRI) has revealed in a report. And the growing shortages are fueling the risk of conflict in such countries, concentrated in the Middle East and North Africa, the researchers say…” (Woodyatt, 8/6).

Additional coverage of the WRI report is available from BBC News, Bloomberg, The Guardian, and New York Times.

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More News In Global Health

Agence France-Presse: 1,800 dead as malaria ‘epidemic’ rages in Burundi — U.N. (8/6).

Devex: Leveraging the private sector to fill the global health funding gap (8/6).

NPR: War Is The Enemy Of Breastfeeding (Brink, 8/6).

Xinhua News: Confirmed dengue death toll rises to 23 in Bangladesh (8/7).

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Editorials and Opinions

Opinion Pieces Discuss Ebola Outbreak, Response In DRC

The Conversation: The Uganda vaccine trial: how African researchers are tackling Ebola
Yap Boum, professor in the faculty of Medicine at Mbarara University of Science and Technology

“…Last week researchers from Epicentre, Uganda Virus Research Institute, Mbarara University of Science and Technology, and the London School of Tropical Medicine and Hygiene started a new [Ebola vaccine] trial in Uganda. The aim is to provide additional information and to evaluate the safety and immune response generated by a two-dose Ebola vaccine regimen manufactured by Janssen Vaccines and Prevention. … The outcome of the study will be watched with intense interest for a number of reasons. The first is that it is expected to provide evidence that will enable the vaccine to be registered, opening the door to having another tool with which to fight against Ebola in the [Democratic Republic of the Congo (DRC)] and elsewhere. The second is that the Janssen vaccine could produce stronger and longer-lasting immune responses against different strains of Ebola virus as well as the Marburg virus and Tai Forest virus that affect other African countries. And the trial will provide new evidence about Ebola virus disease and its transmission, as well as perceptions and attitudes about the vaccine. … Another important outcome of this trial is the strengthening of research capacity in Africa. … [T]he initiative will allow African researchers to be on the frontline of the research on Ebola” (8/7).

Washington Times: Ebola, here we go again
Sheldon Jacobson, professor at the University of Illinois at Urbana-Champaign and chair of the INFORMS National Science Foundation Liaison Committee

“…Learning from previous missteps, officials can opt for a more nuanced approach [to screening travelers for Ebola]. An alternative policy that combines the 2014 Centers for Disease Control and Prevention (CDC) protocol with a more comprehensive risk assessment called social contact tracing (SCT). SCT simply uses questions to determine if a traveler may have come into contact with a person infected with the Ebola virus and assesses the potential footprint of contacts that they may have over the 21-day period following their destination arrival. This would place the burden on passengers to provide additional data when traveling from infected areas, as well as share how and where they will travel after arriving at their final destination, filling in information about their 21-day window during which symptoms can appear and limiting opportunities to spread the disease. … Although the implementation of this secondary risk level requires additional data collection costs and time, the potential societal and public health benefits justify such expenditures and efforts. … By adding a second criterion to passenger-risk evaluation, the power of analytics and data science can be unleashed on the Ebola screening process … Now is the time for the CDC to update its Enhanced Entry Screening procedures, so informed public health policy, not a knee-jerk reaction, positions our nation to meet the impending challenges” (8/6).

The Hill: Stop the Ebola crisis in the Congo before it turns into global disaster
Michael O’Hanlon, senior fellow at Brookings Institution and former Peace Corps volunteer in the Democratic Republic of Congo

“…Some international organizations have bravely addressed [the DRC Ebola] crisis for months, while others have lagged, and there is a good deal more that the United States can do. The response should include not only public health care assistance but support for the United Nations peacekeeping mission in that part of the Congo. This could include sending a group of advisers and trainers for the armed forces of the Congo, so that the area can be better stabilized and proper health care treatment can take place. The alternative to getting this problem under control promptly could be devastating. … [W]e need to address this crisis now before it evolves and escalates into something truly horrible, like a global contagion of the first order” (8/6).

Slate: The Real Ebola “Emergency”
Georgina Ramsay, assistant professor at the University of Delaware

“…[I]n the global media, discussions about Ebola rarely emphasize the role of poverty. … Poverty may be more banal than violence, but it is just as important a factor in complicating how Ebola is treated. Poverty leads to densely populated housing and poor sanitation, which increase the spread of infectious diseases. Poverty prevents people from getting adequate nutrition, which helps fight off and lessen the potentially deadly effects of infectious illnesses. Poverty forces people into contagion zones to work, because if it comes to the decision between starving to death and potentially contracting a deadly virus, many people will choose to risk death with a full belly. When it comes to Ebola, we ignore the risks of poverty at our own peril, and especially at the peril of those within the contagion zone. We need to take seriously the concerns of Congolese people, … whose poverty directs [their] attention to the possibility of whether [they] will eat that night, rather than whether they will contract Ebola. If not, we remain complicit in a system of global relations that continues to privilege the lives of the advantaged few over the lives and concerns of ordinary people in Africa” (8/6).

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Sanctions, Funding Gaps Prevent UNICEF, WFP From Providing Food, Nutrition Aid To North Korean Children, Opinion Piece Says

Global Health NOW: How Sanctions Hurt North Korea’s Children
Jeongyoon Kim, research assistant at the Program in Global Surgery and Social Change at Harvard Medical School and student at Bowdoin College, and Kee B. Park, director of the North Korea programs at the Korean American Medical Association and lecturer with the Program in Global Surgery and Social Change at Harvard Medical School

“UNICEF and the World Food Programme provide food and nutrition aid to North Korean children — but a lack of funds, fueled by political tension and the U.S.-led strategy of pressure and isolation of North Korea, have limited their reach. The country’s most vulnerable children are paying the ultimate price. … The lives of ordinary North Korean people … should never be placed at risk when trying to achieve political objectives. The U.N.’s appeal for urgent humanitarian needs in North Korea should be fully funded. The protection of the marginalized and the vulnerable is paramount” (8/5).

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From the Global Health Policy Community

PLOS Special Issue Focuses On Maternal, Child Health, Nutrition

PLOS Medicine: Maternal and Child Health & Nutrition
This Special Issue of PLOS Medicine highlights the importance of nutrition for maternal and child health and includes articles on the impact of maternal metformin treatment for treatment of gestational diabetes, the impact of nutritional supplementation during pregnancy on antibody responses to diptheria-tetanus-pertussis vaccination in infants in Gambia, and the association between pregnancy after bariatric surgery and adverse perinatal outcomes (8/6).

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FAO Provides Regional Overview Of Food Insecurity, Malnutrition In Sahel

Food and Agriculture Organization of the U.N.: Sahel — Regional overview (July 2019)
In this piece, FAO provides an overview of food insecurity and malnutrition in the Sahel region, including the organization’s planned response from July to December 2019, the response to date since 2018, and the region’s challenges facing food security and agriculture (August 2019).

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Heads Of Fred Hutch, Gates Foundation Visit Center In Uganda To Understand Linkages Between Infectious Disease, Cancer

Fred Hutch: In Uganda: Treating twin threats of HIV and cancer
Gary Gilliland, president and director at Fred Hutch, discusses a recent trip he took with Sue Desmond-Hellmann, chief executive officer at the Bill & Melinda Gates Foundation, to Uganda to visit the Uganda Cancer Institute-Fred Hutch Cancer Centre, where they examined the linkages between infectious disease, especially HIV, and cancer and how to better treat and prevent both (8/6).

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From the U.S. Government

USAID Continues To Support Families' Efforts To Breastfeed Exclusively For 6 Months

USAID/Medium: Six Months Strong
Catherine Korona, communications analyst with USAID’s Office of Maternal and Child Health and Nutrition, discusses how USAID helps support families to overcome key barriers to breastfeeding and exclusively breastfeed for six months (8/5).

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