KFF Daily Global Health Policy Report

In The News

Trump Nominates State Department Spokesperson Heather Nauert As U.S. Ambassador To U.N.

The Atlantic: Trump Chooses a Loyal Foot Soldier for the U.N.
“…On Friday, Trump revealed that he will nominate Heather Nauert, the State Department spokesperson, to succeed [U.S. Ambassador to the U.N. Nikki] Haley, who in October announced that she would leave her post at the end of the year. Nauert is ‘very talented, very smart, very quick, and I think she’s going to be respected by all,’ Trump told reporters…” (Friedman, 12/7).

New York Times: Heather Nauert’s Pick as U.N. Envoy Hints at Reshaping of the Role
“…[Nauert] would bring less experience in government or international affairs to the high-profile job than almost anyone who has held it, generating instant skepticism that may complicate her Senate confirmation. If confirmed, Ms. Nauert may serve more as a public face for the administration than as a policymaker, leaving Secretary of State Mike Pompeo and John R. Bolton, the president’s national security adviser, to dominate decision-making back in Washington. Many in Washington saw the appointment as a way for Mr. Bolton to consolidate power…” (Baker/Grynbaum, 12/7).

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Trump Administration Freezes Acquisition Of Fetal Tissue For Research, Including HIV Experiments

Science: Trump administration has quietly barred NIH scientists from acquiring fetal tissue
“U.S. President Donald Trump’s administration has ordered scientists employed by the U.S. National Institutes of Health (NIH) to stop acquiring new human fetal tissue for experiments, ScienceInsider has learned. The suspension, imposed this past September without a public announcement, came as the government launched a review of all fetal tissue research funded by the federal government. The pause affects two laboratories run by the Bethesda, Maryland-based agency, NIH officials say. In one case, it disrupted a study probing how the virus that causes AIDS initially colonizes human tissues…” (Wadman, 12/7).

STAT: HIV research halted after NIH freezes acquisition of fetal tissue
“…Spokespeople for the Department of Health and Human Services and the NIH institutes with affected labs did not respond to STAT’s request for comment on Sunday. Researchers use fetal tissue to create mice with human-like immune systems — which is useful for biologists like Dr. Warner Greene [of the Gladstone Institute] who do HIV research. … His NIH collaborator was told in September that fetal tissue could no longer be ordered. ‘To have them removed — to have experimental programs stopped — because of politics is really disturbing,’ Greene said. ‘I believe it’s scientific censorship’…” (Sheridan, 12/9).

Washington Post: Trump administration halts study that would use fetal tissue ‘to discover a cure for HIV’
“…[The governments’ actions have] fanned a controversy that pits the biomedical research community against antiabortion activists and other social conservatives pressing the administration to stop the flow of federal grants and contracts for work involving fetal tissue. Such tissue comes from elective abortions. … An NIH spokeswoman said that when HHS began its review of fetal tissue in September, the NIH put in place a ‘pause’ in the procurement of that kind of tissue. Researchers were instructed to notify top officials if they needed more. The spokeswoman said the NIH is investigating why that didn’t happen…” (Goldstein et al., 12/9).

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Canada Announces Additional Funding For CEPI As Coalition Looks To Test 'Vaccine Platform' For Multiple Pathogens

Homeland Preparedness News: Canada to donate additional CA$10 mil to CEPI for anti-epidemic efforts
“Canadian Prime Minister Justin Trudeau affirmed another 10 million Canadian dollars for the Coalition for Epidemic Preparedness Innovations (CEPI) [last] week, in an effort to bolster the development of vaccines. The announcement was made following the recent G20 summit and supports that body’s efforts on global health. It builds on the initial CA$4 million provided after the coalition was founded in 2017…” (Galford, 12/6).

Reuters: Scientists to test tailor-made vaccine tech to fight epidemics
“A global coalition set up to fight disease epidemics is investing up to $8.4 million to develop a synthetic vaccine system that could be tailor-made to fight multiple pathogens such as flu, Ebola, Marburg, and rabies. The deal, between the Coalition for Epidemic Preparedness Innovations (CEPI) and a team of scientists at Britain’s Imperial College London is aimed at progressing a ‘vaccine platform’ which uses synthetic self-amplifying RNA (saRNA)…” (Kelland, 12/9).

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Violence, Shrinking Vaccine Supply Complicate Ebola Response In Congo, Surrounding Nations

CIDRAP News: Rebels strike again near Beni as DRC Ebola total hits 477
“A pair of violent attacks that resulted in civilian deaths were reported [last week] in Beni, one of the Democratic Republic of the Congo’s (DRC’s) main Ebola hot spots, as six more cases were reported in the ongoing outbreak. … The developments lift the overall outbreak total to 477 cases, 429 of them confirmed and 48 listed as probable. The fatality count has risen to 275. Health officials are still investigating 94 suspected Ebola cases…” (Schnirring, 12/7).

The Hill: Congo’s Ebola epidemic spreads to larger city
“Public health officials are sounding new warnings about the spread of the deadly Ebola virus in an eastern province of Congo as cases pop up in a city of more than a million people and as stockpiles of a lifesaving vaccine dwindle…” (Wilson, 12/7).

Additional coverage of the Ebola outbreak in Congo and the regional response is available from ABC News, Associated Press, Nature, Reuters, and Washington Times.

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Around 20M Yemenis Facing Food Insecurity, Many Risk Famine In World's Worst Humanitarian Crisis, U.N. Report Says

Agence France-Presse: Around 20 million Yemenis food insecure due to ongoing conflict
“Around 20 million Yemenis are food insecure, U.N. agencies said on Saturday, adding the conflict ravaging the impoverished country was the key driver behind rising hunger levels. ‘As many as 20 million Yemenis are food insecure in the world’s worst humanitarian crisis,’ a joint statement by the U.N.’s Food and Agriculture Organization (FAO), the children’s fund UNICEF, and the World Food Programme (WFP) said…” (12/8).

Reuters: Yemen food survey finds majority in ‘dire’ crisis, famine a danger
“Yemen’s war and the ensuing economic collapse has left 15.9 million people, 53 percent of the population, facing ‘severe acute food insecurity’ and famine was a danger if immediate action was not taken, a survey said on Saturday. The report was released as the United Nations brought Yemen’s warring sides together for the first peace talks in two years. Humanitarian groups say peace is the only way of ending the world’s largest humanitarian crisis…” (Miles, 12/8).

Additional coverage of the report and Yemen’s humanitarian crisis is available from CBS News, UPI, and VOA News.

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More Than 9M People Estimated Living With Undiagnosed HIV, UNAIDS Report Says

Fortune: More Than 9 Million People May Not Know They Have HIV, New UNAIDS Report Says
“Roughly 9.4 million people may be positive for HIV, the human immunodeficiency virus that causes AIDS, and not know it, according to a new report from UNAIDS, the United Nations joint program on HIV/AIDS…” (Shoot, 12/7).

NPR: UNAIDS Report: 9 Million Are Likely HIV-Positive And Don’t Know It
“…People aren’t being tested for the reasons you’d expect: fear of facing stigma and discrimination if a person learns they are HIV-positive. Then there are more practical concerns: from living far from where testing is offered to long wait times to be tested at health facilities. … The upside of being tested, of course, is that someone who is HIV-positive can take medications to keep AIDS at bay. But that doesn’t always happen…” (Schreiber, 12/7).

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Road Injuries Leading Cause Of Death Among Children, Adolescents, 8th Leading Cause Of Death Globally, WHO Report Shows

BBC News: Road accidents biggest killer of young people — WHO
“Road injuries are now the biggest killer of children and young adults worldwide, according to the World Health Organization (WHO)…” (12/7).

CNN: Traffic accidents are eighth leading cause of death globally, according to WHO
“The number of traffic-related deaths reached a high of 1.35 million in 2016, according to the 2018 Global Status Report on Road Safety, released by the World Health Organization on Friday. It has also moved up to the eighth leading cause of death for people of all ages, ahead of HIV/AIDS and tuberculosis…” (Thomas, 12/7).

UPI: Traffic crashes now the leading cause of death for children, young adults
“…The report noted the rate in Africa is highest in the world, with 26.6 per 100,000 citizens — compared with 9.3 deaths per 100,000 in Europe, which is the lowest. The average is 18 per 100,000…” (Adamczyk, 12/7).

VOA News: WHO: Traffic Crashes Are Leading Killer of Children
“…The report said more than half of those killed are pedestrians, cyclists, and motorcycle riders and passengers. Etienne Krug, head of the U.N. Agency’s Department on Disability, Violence and Injury Prevention, called these deaths a huge inequality issue…” (Schlein, 12/7).

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WHO DG, Officials Discuss Agency's Budget, Plans For Resource Mobilization In Devex Interviews

Devex: WHO needs $14B — here’s how it plans to raise it
“When the World Health Organization’s executive board meets next month, one of the top items on the agenda is expected to be the agency’s proposed budget for the next two years. … In interviews, [WHO Director-General Tedros Adhanom Ghebreyesus] and two of his directors — Imre Hollo, director for strategic planning, and Dominique Hyde, director for strategic engagement at WHO — laid out the strategies they are exploring and implementing to raise funds. These range from changing the narrative around resource mobilization, to employing different mechanisms to broaden the donor base. They also shared with Devex details behind the numbers WHO is seeking from member states…” (Ravelo, 12/10).

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UNAIDS In 'Crisis' Following Sexual Harassment Allegations, Independent Panel Report Says, Calls For Change In Leadership

Associated Press: UNAIDS found in ‘crisis’ after sex harassment claims
“Independent experts looking into allegations of sexual harassment at the U.N. agency that fights AIDS say it is plagued by ‘defective leadership,’ a culture of impunity, and a toxic working environment that cannot be changed unless its top official is replaced. In a damning new report released Friday, the four experts cited a ‘vacuum of accountability’ and said UNAIDS leaders had failed to prevent or properly respond to allegations of sexual harassment, bullying, and abuse of power…” (Keaten/Chang, 12/7).

CNN: U.N. AIDS agency in crisis over abusive and patriarchal culture, report says
“…The report was commissioned by UNAIDS earlier this year after a raft of allegations against managers, including revelations in an exclusive report by CNN. In that report, three women made allegations of sexual assault against the then-deputy director of the agency…” (Krever, 12/7).

The Guardian: Pressure grows on U.N. official accused of encouraging ‘harassment and abuse’
“…The independent four-member panel that conducted the assessment were fiercely critical of the agency’s approach to handling complaints, describing its processes as ‘confusing, non-confidential, slow, and ineffective.’ Such methods were not free from interference of management, the report added…” (Ratcliffe, 12/7).

New York Times: U.N. AIDS Agency Is in ‘State of Crisis’ and Needs New Leader, Report Says
“…The panel’s four members pinned responsibility for the crisis on the program’s executive director, Michel Sidibé, saying that under his autocratic leadership the agency had become a cult of personality marked by ‘favoritism, preferment, and ethical blindness’ that failed to prevent harassment and abuse or respond swiftly to accusations of ill treatment. ‘A change in leadership has become necessary,’ the experts concluded…” (Cumming-Bruce, 12/7).

Science: Panel investigating bullying, harassment at UNAIDS finds ‘boy’s club,’ calls for firing of head
“…UNAIDS issued a 54-page ‘management response‘ to the panel report, but Sidibé shows no signs of stepping down immediately. ‘I have taken on board the criticisms made by the Panel,’ he said in a statement. ‘In proposing this agenda, I am confident that we can focus on moving forward. I will spend the next 12 months implementing this agenda for change and making the UNAIDS workplace one where everyone feels safe and included’ (Cohen, 12/7).

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Gates Foundation Official Calls U.S. Fake Vaccination Scheme To Capture Bin Laden 'Huge Mistake'

The National: Fake U.S. vaccine scheme to catch Bin Laden was ‘huge mistake’
“The United States made a ‘huge mistake’ by launching a fake immunization program in its quest to find Osama bin Laden, an expert seeking to eradicate polio has claimed. Chris Elias, president of the Global Development Division at the Bill & Melinda Gates Foundation, said the CIA plot had fueled conspiracy theories about vaccines in Pakistan, one of only two countries which continues to report polio cases…” (Sanderson, 12/10).

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More News In Global Health

Associated Press: Nobel peace winners demand action against sex abuse (Keyton, 12/9).

Associated Press: Slovak hospitals hold new Roma mothers against their will (Cheng, 12/10).

CNN: How low tech is making a big impact on maternal deaths in Nigeria (Adeoye, 12/7).

The Guardian: ‘No world to leave our children’: progress on women’s rights still lags, shows study (Hodal, 12/7).

The Guardian: Peter Hotez: ‘What happens when the anti-vaccine movement moves into India?’ (Anthony, 12/8).

Health Policy Watch: New Study Tracks Global Children’s Antibiotic Use, Finds Deviation From WHO Guidelines (Branigan, 12/7).

New York Times: Toxic Smoke Is Africa’s Quiet Killer. An Entrepreneur Says His Fix Can Make a Fortune (Goodman, 12/6).

NPR: Pakistan Ousts 18 Aid Agencies. Human Rights Minister Tweets ‘They Must Leave’ (Hadid, 12/7).

SciDev.Net: Country-owned strategies to fight malaria (Adepoju, 12/7).

U.N. News: U.N. emergency relief fund has ‘never been more critical’: Guterres (12/7).

Vox: Gene drives could end malaria. And they just escaped a U.N. ban (Matthews, 12/7).

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Editorials and Opinions

Editorial, Opinion Piece Mark 70th Anniversary Of Universal Declaration Of Human Rights, Examine Evolution Of Human Rights In Global Health

The Lancet: The right to health
Editorial Board

“Human Rights Day is recognized annually on Dec. 10, and this year is especially important since it is the 70th anniversary of the day that the U.N. General Assembly adopted the [Universal Declaration of Human Rights (UDHR)]. … [In a Lancet viewpoint article,] Lawrence Gostin and colleagues, including the director general of WHO, look back at the evolution of human rights in global health over the past 70 years and outline key messages for the future of health as a human right. Gostin and colleagues describe how human rights became embedded in global health governance … [and] how it was not until the AIDS pandemic in the 1980s that momentum grew behind universal access to treatment. Global health law, such as the WHO Framework Convention on Tobacco Control, and security, through the International Health Regulations, helped to embed health-related rights. Now, WHO considers universal health coverage through strengthened primary health care as core to the right to health and to achieving the Sustainable Development Goals. … As a common standard of achievement for all nations, promoting respect for these rights and freedoms is critical. But with constant rights violations taking place worldwide, and global threats such as climate change, armed conflict, and mass migration, the future of rights-based global health efforts is in the balance” (12/9).

The Lancet: 70 years of human rights in global health: drawing on a contentious past to secure a hopeful future
Lawrence O. Gostin, director of the O’Neill Institute for National and Global Health Law at the Georgetown University Law Center, and colleagues

“…Human rights have brought the world together in unprecedented solidarity over the past 70 years, recognizing the inherent dignity of every person as an imperative for global health. … While we celebrate the enduring legacies of human rights, we must also strive to identify and rectify the constraints on rights-based governance for public health in a globalizing world. It is more important than ever for the health and human rights communities to stand together as partners to uphold the values of the UDHR and resist contemporary threats to human rights. The human rights progress of the past, bringing together top-down leadership in global health governance with bottom-up civil society advocacy, highlights the importance of sustained political engagement to realize the right to health. Health practitioners have a crucial role in this political engagement, advancing rights-based public health policies, programs, and practices that are essential to secure the future of human rights in global health” (12/9).

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BMJ Opinion Pieces Discuss Value Of Multisectoral Collaboration In Health, SDGs

The BMJ: Multisectoral collaboration for health and sustainable development
Wendy J. Graham, professor at the London School of Hygiene and Tropical Medicine, and colleagues

“…[M]uch of the power of the Sustainable Development Goals (SDGs) is in the 17th goal: ‘partnerships for the goals.’ This final goal could easily be overlooked by cynics as an administrative add-on, aiming merely to scoop up financing. It is here, however, that the goals’ power is hidden within broad indicators such as ‘policy coherence’ and ‘multistakeholder partnerships.’ … This week, The BMJ publishes a series of articles [involving 12 country case studies] that attempt to unpick how best to work across sectors to achieve better health and sustainable development. … But let’s be clear, the learning environment in which knowledge was developed and shared across sectors, as described in the 12 country case studies, is not easy to create or sustain. … One particular tension … is the challenge of asking leaders to judge and report on the success of their own initiatives. … In the drive for ‘progress,’ … there is often pressure to suppress key lessons on what has not worked. … But all failures are opportunities to learn … We call upon the diverse communities in the readership of The BMJ and those attending the [Partners’ Forum in New Delhi in December 2018] to push for more effective and open communication, not just on successes but also on the ‘heroic failures’ in health and development — namely, those other opportunities from which we must learn” (12/7).

BMJ Blog: To achieve the SDG health goals we need to recognize the goals and outcomes of other sectors
Tobias Alfvén, associate professor in global child health at the Department of Public Health Sciences at Karolinska Institutet; Agnes Binagwaho, vice chancellor of the University of Global Health Equity, senior lecturer in the department of global health and social medicine at Harvard Medical School; and Måns Nilsson, executive director of Stockholm Environmental Institute

“Since the Sustainable Development Goals (SDGs) were introduced in September 2015, we have read the phrase ‘we cannot continue with business as usual’ many times. It is now common to hear calls to transform the way we work by taking an integrated approach and pursue multisectoral partnerships. However, it is still rare for proponents to explain how collaboration between different sectors can happen or what such collaboration looks like in practice. It is therefore inspiring to read the article by Shyama Kuruvilla and colleagues that explores how health and development programs have navigated the challenges of multisectoral collaboration. … This is what the SDGs are about; a coherent and integrated approach to resolve some of the world’s major development challenges across environmental, social, economic, and institutional domains. To make sense of this, and to foster multisectoral collaboration, we need a structured way of identifying interactions between sectors. … To make this approach work, and avoid only ad-hoc successes, it should include the mapping of interactions and structuring collaboration as part of the institutional procedures of decision making — not only national but also at local, district, and regional levels and wherever the planning, resourcing, and management of health care systems take place” (12/7).

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Male-Adapted Health Services Key Component To Shrinking Gaps In HIV Outcomes Between Males, Females In South Africa

Health24: To end AIDS in South Africa, we can’t afford to ignore men
Laura Trivino-Duran and Bubele Makeleni, both with Médecins Sans Frontières South Africa

“South Africa’s HIV program is the biggest in the world, and according to the latest data of the Human Sciences Research Council (HSRC), good progress is being made in addressing the HIV epidemic in terms of the UNAIDS 90-90-90 targets … But close analysis of the data confirms that most of the gains are occurring in females. … The HIV community is realizing that male-adapted services are urgently needed to address the gap in outcomes for HIV between males and females. … But [even with male-adapted health care services,] MSF has not been able to reach men in the numbers hoped for … The search for effective ways to bring HIV-positive men into care is far from over, and needs to be prioritized now for the sake of men’s health, and in order to reduce transmission of HIV in communities. Male-adapted health care services are a key component to shrinking the gap existing between women and men and bringing men to care, yet they are not enough on their own and should be accompanied by other interventions, including community awareness campaigns and innovative approaches that address obstacles to improving their health-seeking behavior. Only when men are engaged in a holistic way will we start to see significant gains in HIV indicators for men” (12/7).

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From the Global Health Policy Community

Letter To U.S. State Department Expresses Opposition To Reported Proposal To Censor Sexual, Reproductive Health Language

People for the American Way: Reports of State Department Censorship Continue to Surface
Jen Herrick, senior policy analyst for public policy at People for the American Way, highlights a letter sent by People for the American Way and other organizations to U.S. Secretary of State Mike Pompeo. The letter expresses opposition to the reported proposal being considered by the State Department to ban the use of phrases such as “sexual and reproductive health” and “comprehensive sexuality education” by U.S. diplomats and other State Department personnel. The letter states, “Sexual and reproductive health and reproductive rights are fundamental to gender equality, as well as women’s, girls’, and young people’s empowerment and decision-making. By banning the use of these terms and support for these vital issues, the U.S. isolates itself and sends the message that advancing an extreme political agenda matters more than the health and rights of individuals and communities around the world” (12/7).

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World Bank Post Outlines 5 Ways To Achieve UHC By 2030

World Bank: Lack of Health Care is a Waste of Human Capital: 5 Ways to Achieve Universal Health Coverage By 2030
This post discusses the importance of universal health coverage (UHC), describing how the “denial of health care is not only unjust, it is also a waste of human potential and a country’s human capital.” The post outlines five recommendations for accelerating progress toward UHC: “1. More money for health, and more health for the money … 2. Focusing on quality of care … 3. Protecting all people from pandemics … 4. Embracing innovation … 5. Mobilizing for collective action” (12/7).

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CSIS Releases December 2018 Issue Of Global Health Policy Center Monthly Newsletter

Center for Strategic & International Studies: Global Health Policy Center Monthly Newsletter: December 2018
In the December 2018 CSIS Global Health Policy Center Newsletter, J. Stephen Morrison, senior vice president of CSIS and director of the CSIS Global Health Policy Center, highlights publications, podcasts, and past and upcoming events hosted by CSIS. The newsletter includes links to a World AIDS Day commentary by Sara Allinder, executive directer and senior fellow at the CSIS Global Health Policy Center, on the importance of addressing human rights issues in mitigating the risk of a resurgence of new HIV infections globally; a report by Janet Fleischman, senior associate at the CSIS Global Health Policy Center, “calling on Congress to more intentionally align U.S. support for economic empowerment with U.S. investments in women’s health services”; and an upcoming event on women’s leadership in global health (December 2018).

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