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Kaiser Daily Global Health Policy Report

In The News

Experimental Malaria Vaccine Shows Positive Results In Early Clinical Trial In Humans, Researchers Report

“An experimental malaria vaccine proved highly effective in a small, early-stage clinical trial in people, raising hope in the global effort to combat the deadly disease, U.S. researchers reported on Thursday in the journal Science,” Reuters reports (Stewart, 8/8). “Researchers found the vaccine, which is being developed in the U.S., protected 12 out of 15 patients from the disease, when given in high doses” intravenously, BBC News writes (Morelle, 8/8). “The vaccine — called PfSPZ because it is made from sporozoites (SPZ), a stage in the life cycle of the malarial parasite Plasmodium falciparum (Pf) — uses a weakened form of the whole parasite to invoke an immune response,” Nature notes (Butler, 8/8). Of 57 healthy adult participants, “40 participants received the vaccine and 17 did not,” an NIH press release states, noting, “To evaluate the vaccine’s safety, vaccinees were split into groups receiving two to six intravenous doses of PfSPZ vaccine at increasing dosages” (8/8). “Of the 15 participants who received higher dosages of the vaccine, only three became infected, compared to 16 of 17 participants in the lower dosage group who became infected,” Xinhua writes, noting 11 of the 12 participants who received no vaccine became infected (8/9).

“‘With this intravenous vaccine, we are striving to reach the [WHO] goal of a [malaria] vaccine with 80 percent efficacy by 2025,’  Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases (NIAID), told Nature Medicine,” a post in the magazine’s blog states. “The clinical study was led by Robert Seder, an immunologist at the NIAID Vaccine Research Center, and involved a vaccine developed by Stephen Hoffman and his colleagues at Sanaria, a biotechnology company based in Rockville, Maryland,” the blog notes (Devitt, 8/8). “Though the results were promising, more extensive field testing will be required, the researchers wrote,” CNN reports (Smith/Hudson, 8/9). “The study was extremely small and short-term. And the candidate vaccine still has a long way to go before it could be used in the developing world,” according to NPR’s “Shots” blog (Beaubien, 8/8). “To date, only one experimental vaccine, called RTS,S or Mosquirix, developed by GlaxoSmithKline Biologicals and the PATH Malaria Vaccine Initiative, with funding from the Bill & Melinda Gates Foundation, has demonstrated a consistent protective effect,” the Nature Medicine blog adds, noting “last year the results of a phase III clinical trial indicated that it offered only about 30-35 percent protection when given to infants between six weeks and 12 weeks of age” (8/8).

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Researchers Find MERS Antibodies Among Camels, Providing Clue To Virus's Origin

“Camels may be a carrier of the mysterious virus that has infected at least 94 people in the Middle East and killed half of them, scientists are reporting,” the New York Times reports (Grady, 8/8). “Since the virus was first identified last September, there have been 94 illnesses, including 46 deaths, from MERS, or Middle East respiratory syndrome, mostly in Saudi Arabia,” the Associated Press notes, adding, “Aside from several clusters where the virus has likely spread between people, experts have largely been stumped as to how patients got infected” (Cheng, 8/8). “In a paper in the Lancet Infectious Diseases journal, a team led by Chantal Reusken from the National Institute for Public Health and the Environment in the Netherlands described antibodies specific to [the MERS coronavirus] found in the blood of all 50 Omani camels they tested,” according to the Financial Times, which notes the virus also was found in the same breed of camel stabled for many years in the Canary Islands. “The findings will help researchers probing whether the disease may have spread to humans via camels from an original ‘reservoir’ in bats” and “will also trigger fresh debate over infection control and a search for human cases, including in Oman, where no cases of the disease in humans have been reported,” the newspaper writes (Jack, 8/8). “‘Camels may be involved in (MERS) transmission but there could also be cows, goats, or something else involved,’ said Vincent Munster, a virologist at the National Institutes of Health, who co-wrote an accompanying commentary,” the AP adds (8/8).

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Children In South Sudanese Refugee Camps 'Dying Needlessly' Due To Vaccine Delays, MSF Warns

“Many children living in South Sudanese refugee camps have died needlessly because of bureaucratic delays rolling out new vaccines, the medical charity Médecins Sans Frontières (MSF) said on Thursday,” Thomson Reuters Foundation reports. “MSF said it had taken 11 months to procure affordable drugs to vaccinate children against pneumonia in Yida refugee camp in South Sudan due to bureaucratic and legal red tape,” the news service writes (Migiro, 8/8). “New vaccines have been introduced in poor countries with support from the [GAVI Alliance],” MSF notes in a press release. However, “GAVI does not cover vaccination in refugee and crisis-affected populations, leaving major needs unmet,” the press release adds (8/8). “MSF was eventually able to obtain the vaccine from GSK at a reduced price,” the organization notes in an article on its webpage, adding, “The delays have now pushed the planned vaccination campaign into the rainy season, complicating the logistics” (8/8).

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FAO Food Price Index At Lowest Level Since June 2012

“Global food prices declined for the third consecutive month, largely driven by lower international prices for grains, soy and palm oil, while sugar, meat and dairy prices were also down, the United Nations Food and Agriculture Organization (FAO) reported” on Thursday, the U.N. News Centre reports (8/8). The FAO “price index … fell in July for a third month running to 205.9 points compared to 210.1 points in June, reaching its lowest level since June 2012,” Reuters writes (8/8).

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IRIN Examines Innovation, Adaptation For Humanitarian Response

As part of its series titled “Humanitarian Futures,” IRIN examines how humanitarian response programs are changing in light of technological innovation, as well as a host of emerging risks including climate change, global population growth and a population shift toward urban centers. Because “donors, local [non-governmental organizations (NGOs)], citizens groups, private sector actors, militaries, and diaspora members are gaining prominence” and aid from privatized donors is growing, “agencies will be forced to adopt more business-like models to raise and sustain funding, say analysts,” the news service notes. The article also suggests humanitarian agencies embrace and experiment with new technologies in funding and aid response, as well as assess how they can add value in the shifting aid environment (8/6).

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Head Of Georgian Health Policy Group Discusses HIV/AIDS, Public Health Trends

In partnership with the Skoll World Forum, Forbes features an interview with George Gotsadze, who since 1996 has led Georgian think tank Curatio International Foundation, which focuses on health policy and health systems issues, primarily in the post-Soviet states. According to the interview transcript, Gotsadze reflects on public health in countries of the former Soviet Union, highlights “some of the ways in which non-profits can successfully partner with governments in the developing world in order to maximize impact,” discusses where “multilaterals like the [WHO] fit into today’s global health paradigm,” and “rate[s] the U.S. governments’ efforts to advance global health in comparison to other Western countries,” among other topics (Kanani, 8/8).

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Researchers Examine Feasibility Of Preventing Rotavirus Through Genetically Modified Rice

“A genetically modified strain of rice might one day be used to prevent life-threatening rotavirus infections among children in the developing world, according to researchers,” the Los Angeles Times’ “Science Now” blog reports. “A study published Thursday in the Journal of Clinical Investigation concluded that genetically modified rice seeds helped to prevent and treat rotavirus-induced diarrhea in young lab mice,” according to the blog. “While traditional vaccines are used to fight rotavirus infection in the Western world, they have proved much less effective in poor nations, where vaccine refrigeration and purification can be difficult,” the blog notes, adding researchers, who call the product MucoRice, still must determine the product’s proper human dosage and show its efficacy in clinical trials (Morin, 8/8).

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Editorials and Opinions

Recognizing Health Improvements In Uganda

In a post in the Huffington Post’s “Impact” blog, CDC Director Tom Frieden reflects on a recent trip to Uganda, “the only country served by [PEPFAR] with a rising HIV incidence,” writing, “Although Uganda will have challenges for many years as a result of increased HIV infections over the past decade, and has much more to do, I was struck by how much headway they’ve made in the past couple of years.” He recounts his time in the country, where he helped break ground on a PEPFAR-funded national reference laboratory building and “visit[ed] with Ambassador Scott DeLisi to launch a system to transport laboratory specimens by motorcycle and courier.” He writes, “The country has scaled up life-saving anti-HIV treatment as well as voluntary medical male circumcisions, which sharply reduce the chance of becoming infected,” adding, “Perhaps the most impressive success is how quickly maternal health care services have improved. In one year, Uganda’s ‘Saving Mothers, Giving Life’ project has made striking progress in its goal to cut maternal deaths by half.” He states, “CDC is proud to work closely alongside Ugandans to build these programs,” concluding, “It was an honor to see first-hand how much progress is being made, and know that our work will improve the health of people not just in Uganda, but also throughout Africa and around the world” (8/8).

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U.N. Women Has Opportunity To Improve Women's Health

“U.N. Women has an important role as a global champion for women and girls; and the change in leadership later this month will have important implications for the welfare of women, especially in terms of health,” a Lancet editorial states. “A change in leadership” — from former President of Chile Michelle Bachelet to former Deputy President of South Africa Phumzile Mlambo-Ngcuka — “provides an opportunity to reflect on U.N. Women’s strategic priorities and direction,” the editorial writes, adding, “U.N. Women must not allow the world to neglect women’s health, nor to forget that physical and mental health involve far more than bearing and raising children.”

“The challenge will be to identify the comparative advantage of U.N. Women over other established U.N. entities, such as those for population, development, children, refugees, and health,” The Lancet writes. “At a time when the role of women in society is under particular scrutiny, violence against women and adolescents is increasing, and political attention has been brought to U.N. Women, a priority for the new Executive Director, Mlambo-Ngcuka, will be to convert the powerful advocacy for gender equity of Bachelet into practical and effective programs,” according to the editorial, which concludes, “The test — as for any U.N. institution — will not be the output of words, nor even changes in attitudes, but the extent to which the policies of U.N. Women actually improve the lives of women in their own countries” (8/10).

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'Time Is Right' To Address Viral Hepatitis

With the number of deaths worldwide caused by viral hepatitis comparable to the numbers caused by HIV, malaria and tuberculosis (TB), “it is clear that a major cause of global mortality has been consistently overlooked and neglected,” Charles Gore, president of World Hepatitis Alliance, writes in The Guardian’s “Global Development Professionals Network” blog. Addressing the viruses that cause hepatitis is challenging because they “cut across many parts of a health ministry; for example immunization, HIV, food and water safety, blood safety, injection safety and cancer,” Gore writes, adding, “Yet in a world increasingly skeptical of vertical programs, this is an advantage because a comprehensive hepatitis policy looks much more like a program to strengthen the whole health system. Equally, because most of these areas will have their own programs, any hepatitis program will need to be integrated, leveraging existing infrastructure.”

“There has been some recent progress in persuading governments to develop national hepatitis strategies, and adopting the 2010 WHO resolution,” which created World Hepatitis Day, Gore notes, adding that “[a]dvocacy is working and viral hepatitis is on the agenda for the World Health Assembly in 2014.” However, “one of the biggest challenges lies just ahead,” he writes, noting negotiations of the post-2015 development goals. “If HIV/AIDS, TB and malaria are included, for example as indicators in the health goal, but viral hepatitis is not, it will be a huge setback,” he states, adding, “The omission of viral hepatitis from all major global health initiatives to date has massively impeded the flow of resources.” Gore concludes, “Too much of health prioritization is decided by what one might call fashion and so often fashion is about timing. Hepatitis has never been in fashion. Maybe finally the time is right” (8/9).

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From the Global Health Policy Community

Examining Need For Integrated HIV, Maternal Health Solutions

According to recent estimates, HIV-positive pregnant women in sub-Saharan Africa “had eight times the risk of death during pregnancy than HIV-negative pregnant women,” Senior HIV/AIDS Technical Adviser Jennifer Albertini, Health Program Adviser for the Office of Sustainable Development’s Health Team Karen Fogg, and Senior Maternal Health (MH) Adviser in the Office of Health, Infectious Diseases and Nutrition Allisyn Moran write in USAID’s “IMPACTblog.” They examine efforts to “improve HIV and maternal health programs to save the lives of these women.” In order “to move the HIV and maternal health communities to action, USAID, CDC, and the Maternal Health Task Force convened a meeting in early June on ‘Maternal Health, HIV and AIDS: Examining Research through a Programmatic Lens,'” the authors write and reflect on the meeting (8/8).

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Price Reduction Agreement For Cytomegalovirus Might Help Improve Screening, Awareness

The Center for Global Health Policy’s “Science Speaks” blog describes “an agreement [.pdf] announced this week between the Medicines Patent Pool and Roche, the maker of the oral drug valganciclovir, which treats cytomegalovirus retinitis,” an infection common among people living with HIV, particularly in Asian countries. “The agreement, signed in July, will increase access to the drug in 138 countries by reducing its price up to 90 percent,” the blog notes. “The price reduction is a first step in what is hoped to be a series to improve screening and treatment of cytomegalovirus, [Kaitlin Mara of the Medicines Patent Pool] said,” according to the blog. “Other steps, she added, include country programs boosting diagnostic efforts, clinics strengthening training for diagnosing the disease, and public health programs spreading awareness of its impact,” the blog writes (Barton, 8/8).

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Senior Officials From 17 Countries Gather At Sabin Vaccine Institute Meeting To Discuss National Programs

“The Sabin Vaccine Institute’s Sustainable Immunization Financing (SIF) Program [on Monday] assembled senior officials from 17 countries to share their successes in increasing government budget allocations for national immunization programs,” a press release from the institute reports. “During the two-day colloquium, delegates [participated] in an open exchange of strategies and best practices that have helped their countries increase commitments to fund national immunization programs,” the press release states, adding, “In panel sessions, delegates [presented] their legislative activities, conduct[ed] peer assessments and discuss[ed] innovations in financing, budgeting and advocacy” and also to “prepare[d] short-term, country specific advocacy plans designed to make progress on sustainable immunization financing by 2016” (8/5).

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Chicago Council On Global Affairs Launches New Website With Focus On Maternal, Child Nutrition

The Chicago Council on Global Affairs launched a new website this week — outrageandinspire.org — which “will feature [Senior Fellow on Global Agriculture and Food Policy] Roger Thurow’s 1,000 Days Project — telling the story of the vital importance of good nutrition and health from the beginning of a woman’s pregnancy to her child’s second birthday,” according to an email alert from the council. The alert notes the site “will host videos and photos as well as key infographics, reports, and commentaries” (8/8). In his inaugural post, “Making the invisible visible,” Thurow examines the issues of maternal and child nutrition, writing, “In short order, stunting and nutrition marched to the top of the political agenda this summer” (8/6).

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