KFF Daily Global Health Policy Report

In The News

USAID Administrator Mark Green Discusses U.S. Foreign Aid Under Trump Administration In L.A. Times Interview

Los Angeles Times: Q&A: What will U.S. foreign aid look like in the age of Trump?
“As the Trump administration slashes the State Department’s payroll and turns U.S. foreign policy inward, worries have spread through the U.S. Agency for International Development, which directs most of the government’s development assistance worldwide. … USAID Administrator Mark Green acknowledges that in the current political climate the agency must be ‘as effective and efficient as we possibly can.’ Green, a Republican former congressman from Wisconsin who has also served as U.S. ambassador to Tanzania, spoke to the Times following the recent Global Entrepreneurship Summit in Hyderabad, India, where he was part of the U.S. government delegation led by Trumps’s daughter Ivanka…” (Bengali, 12/8).

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Al Jazeera Examines How Mexico City Policy Impacting Mozambique Health Programs, Other Non-Profit Organizations

Al Jazeera: ‘Women and girls will die’: Trump’s foreign aid rule on abortion
“…Sebastiao Muthisse from AMODEFA, the Mozambican Association for Family Development, outlined the dilemma the aid organization faced. They were not prepared to sign Trump’s so-called ‘global gag rule’ forbidding mention of abortion, and, as a result, projects had to close. … In [Mozambique,] where it’s estimated that up to 13 percent of people aged between 15 and 49 live with HIV, the support of organizations like AMODEFA can be a lifeline. But the work AMODEFA does with families … is under threat, due to their refusal to sign up to the Trump policy. Project leader Dr. Marcelo Kantu is concerned about the future. … The charity is now urgently looking at alternative ways to help those they support, seeking new partners and other avenues of funding. … Despite two months of asking, nobody from the U.S. administration was available to be interviewed for our program…” (Spiller/Mcrae, 12/8).

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U.S. House Committee Warns WHO's IARC Funding Could Be Cut If Transparency Not Improved

Reuters: U.S. House committee ‘may reconsider’ WHO cancer agency funds
“U.S. congressional committee members warned on Friday that Washington’s funding of the World Health Organization’s cancer research agency could be halted unless it is more open about its operations. In a letter to the France-based International Agency for Research on Cancer (IARC) — a semi-autonomous unit of the WHO — the U.S. House of Representatives Science, Space, and Technology (SST) Committee warned it ‘may reconsider U.S. taxpayer funding’ if IARC ‘does not demonstrate transparency’…” (Kelland, 12/8).

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USAID Committed To Providing Humanitarian Aid To Help Iraq Recover From War With IS, U.S. Official Says

Reuters: U.S. agency to help Iraq recover from IS despite Trump aid cuts
“The United States is committed to helping Iraq recover from three years of war against Islamic State despite President Donald Trump cutting the foreign aid budget, a senior official in its main government aid agency has said. Thomas Staal, the counselor of the U.S. Agency for International Development (USAID), said the agency would continue to provide basic humanitarian services and additional support for minority groups such as psychosocial support to those who suffered genocide, slavery, and gender-based violence…” (Aboulenein, 12/10).

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Former USAID Administrator Gayle Smith Outlines Blueprint For 'Activist Humanitarian Movement'

Devex: Gayle Smith’s blueprint for an activist humanitarian community
“Former head of the United States Agency for International Development, Gayle Smith, said that she has never been more worried about the scale of crisis in the world and called on aid workers to launch an ‘activist humanitarian movement’ to convince politicians the humanitarian sector needs their support more so than ever…” (Edwards, 12/11).

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Access To Contraception, Family Planning Services Can Improve Girls' Education, Working Paper Shows

The Economist: Contraception does even more good in poor countries than thought
“Few tasks in developing countries are as tricky — or as important — as convincing parents to keep their daughters in school longer. One way of doing so is to make contraceptives available, concludes a new working paper by Kimberly Singer Babiarz at Stanford University and four other researchers…” (12/7).

Romper: Access To Contraception Benefits Girls — Even If They’re Not Using It, New Study Finds
“…As it turns out, in areas where family planning was readily available even during girls’ younger, non-fertile years, girls were less likely to drop out of school before entering secondary school. This wasn’t due to their use of contraceptives, since they weren’t yet adolescents — instead, it seems, parents were more willing to invest in girls when there was a higher likelihood of them being more successful later on…” (Moller, 12/7).

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Puerto Rico's Death Toll From Hurricane Maria Likely Higher Than Official Statistics, NYT Analysis Shows

New York Times: Official Toll in Puerto Rico: 64. Actual Deaths May Be 1,052.
“…A review by the New York Times of daily mortality data from Puerto Rico’s vital statistics bureau indicates a significantly higher death toll after the hurricane than the government there has acknowledged. The Times’s analysis found that in the 42 days after Hurricane Maria made landfall on Sept. 20 as a Category 4 storm, 1,052 more people than usual died across the island. … Officially, just 64 people died as a result of the storm that ravaged the island with nearly 150-mile-an-hour winds, cutting off power to 3.4 million Puerto Ricans…” (Robles et al., 12/9).

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Philippines To Demand Dengue Vaccine Refund From Sanofi Pasteur; Controversy Threatens Public's Trust In Other Vaccines

Associated Press: Philippines wants money back from Sanofi for dengue vaccine
“The Philippine government will demand a refund of 3.5 billion pesos ($69.5 million) from vaccine maker Sanofi Pasteur and look at possible legal action after a study showed the vaccine used in a dengue immunization program could expose some people to severe illness, the health chief said Friday…” (Gomez, 12/8).

Reuters: Exclusive: Philippines defied experts’ advice in pursuing dengue immunization program
“As she announced in January 2016 that the Philippines would immunize one million children with a new dengue vaccine, the nation’s then health secretary Janette Garin boasted it was a world-first and a tribute to her country’s ‘expertise’ in research. … After Garin’s announcement, the Formulary Executive Council (FEC) of advisers urged caution over the vaccine because it said its safety and cost-effectiveness had not been established…” (Allard et al., 12/10).

Reuters: Philippines to seek refund of $59 million from Sanofi amid vaccine risk
“…The Philippines last week suspended a national immunization program after Sanofi’s recent findings that there was a risk of severe dengue occurring in previously uninfected people who were inoculated with Dengvaxia. Manila also halted sale of the vaccine in the country and has ordered a probe into the matter…” (Serapio, 12/8).

STAT: Sanofi scandal in the Philippines could spread dangerous mistrust of vaccines
“…Unfortunately, there are indications that the company, which could use a blockbuster product, should have taken its corporate foot off the gas pedal. And to restore confidence in vaccines, a reckoning is required…” (Silverman, 12/11).

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Diphtheria Immunization Campaigns Begin In Bangladesh's Rohingya Camps, Indonesia

Associated Press: Diphtheria deaths in Indonesia spark immunization campaign
“Indonesia is immunizing millions of children and teenagers against diphtheria after the disease killed 38 people, mostly children, since January…” (Karmini, 12/11).

NPR: Diphtheria: What Exactly Is It … And Why Is It Back?
“…With the introduction of a highly effective vaccine in the 1920s and early ’30s, diphtheria faded away in much of the world. Today it’s largely considered a disease of the past. But now it’s back in the headlines, spreading quickly in places like Bangladesh and Yemen…” (Bichell, 12/8).

Reuters: Indonesia races to contain diphtheria outbreak ahead of 2018 Asian Games
“Health authorities in Jakarta kicked off a special immunization program on Monday to rein in an ‘extraordinary’ outbreak of diphtheria that has sparked concerns about the Indonesian capital’s readiness to host the Asian Games next June…” (Matarani/Kapoor, 12/11).

VOA News: Mass Vaccinations of Rohingya Refugees to Prevent Diphtheria Begins
“A mass vaccination campaign is getting underway to stop diphtheria from spreading among Rohingya refugees in Cox’s Bazar, Bangladesh…” (Schlein, 12/10).

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More News In Global Health

Associated Press: Uganda controls deadly Marburg fever outbreak, WHO says (12/8).
VOA News: WHO: Rapid Action Brings Quick End to Marburg Outbreak in Uganda (Schlein, 12/8).

Devex: To tackle malnutrition, go fish (Sieff, 12/11).

Devex: Q&A: Towards medicines regulatory harmonization — lessons from Zimbabwe (12/11).

Financial Times: Six ways to increase uptake of family planning (Jack, 12/8).

The Guardian: Women in sub-Saharan Africa forced into sex to pay hospital bills, study says (Hodal, 12/8).

NPR: How Women From The U.S. Could Be At Risk Of Genital Mutilation (Katz, 12/9).

Reuters: Feature — Roots, razors and witches — fighting AIDS in Zambia (Griffiths, 12/11).

Scientific American: “Supermalaria” Is on the Way (Midega, 12/8).

STAT: As foreign powers approve Ebola vaccines, U.S. drug makers lag in development pipeline (Branswell, 12/8).

U.N. News Centre: U.N. chief calls for $1 billion in donor contributions to emergency response fund (12/8).

U.N. News Centre: Conflicts, drought drive hunger despite strong global food supply — U.N. agriculture agency (12/7).

U.N. News Centre: Not enough being done to shield civilians from violence in Somalia — U.N. report (12/10).

Wall Street Journal: Sanctions Endanger Drug Maker (Talley, 12/8).

Xinhua News: Doctors urge public to be aware of AIDS as new infection cases increasing in Pakistan (12/10).

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Editorials and Opinions

U.S. Congress, Administration Should Advance 3 'Critical' Reforms To Foreign Aid Put Forward By Development Community

The Hill: A moment for AIDS funding reform
Robert Mosbacher Jr., chair of Mosbacher Energy Company; and Mark Dybul, co-director of the Center for Global Health and Quality and professor at Georgetown University Medical Center; both co-chairs of the Consensus for Development Reform

“…The development community’s response [to the administration’s proposed cuts to global health and development] was no fewer than five major reorganization and reform proposals — really, counter-proposals to the administration — laying out a range of major changes that would be better for development. … Among the varied recommendations, three critical agenda items deserve special attention and cooperation. The first is the embrace of economic growth and access to economic opportunity as an engine for sustainable development. … The second foundation for reform is to ensure a smooth and effective transition from large, donor-funded development programs to true country ownership. … The third foundation is a new management model to ensure effective implementation and accountability across the many parts of government. … What we have at hand is an unexpected and rare opportunity for cooperation that can provide real reforms in our development assistance. Congress and the administration should seize the opportunity to advance reforms put forward by the development community itself. Such reforms will make our work more effective for those we seek to help, a better tool to advance our national interests, and a greater value for the taxpayer. Strengthening our leadership in development, and not leaving a vacuum for others to fill, is essential to putting America first” (12/9).

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WHO Director General Faces Several Challenges As Process To Rewrite WHO Strategy Begins

The Lancet: Offline: The tasks facing Dr. Tedros
Richard Horton, editor-in-chief of The Lancet

“…WHO should focus on a ‘few big things’ rather than producing a long shopping list of undertakings. One overriding priority should be to remake the national investment case for health. At a time when most resources will come from domestic budgets rather than international aid, the case for health needs to be made in countries. It was alarming that national investments in health had mostly flatlined. … Tedros will receive a great deal of well-intentioned advice as he begins to rewrite WHO’s strategy for his skeptical executive board. It will be impossible to satisfy every demand made by member states. He should not try to do so. Tedros will be judged mainly on his ability to protect countries from unexpected epidemic outbreaks. Beyond that, he must choose what is necessary, tempered by what is possible” (12/9).

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Global Health Leadership Should Be Inclusive Of All Genders, Disciplines, Generations

The Lancet: A new vision for global health leadership
Michele Barry, director of Stanford University’s Center for Innovation in Global Health, and colleagues

“…The attendees [of the inaugural 2017 Women Leaders in Global Health Conference (WLGH) at Stanford University] reflected on current gaps and barriers to the advancement of women in global health and the steps needed to achieve gender equity in leadership. A number of key themes emerged. First, the need to diversify leadership is not only an aspiration for inclusivity but is also supported by evidence for better outcomes. … Second, the barriers that impede gender parity in leadership are often deeply embedded in cultural norms, historical events, and stereotyping. … Third, creating capacity for gender parity in leadership will require engaging all genders and generations. … Fourth, transformation of institutions is crucial to ensure that structural barriers do not block women from leadership positions. … This movement is … about collectively embracing a new vision for leadership across many axes, not just gender. Continued efforts should be intergenerational and inclusive of all disciplines. Women need to be courageous and assertive, embracing opportunities when they arise. Men and women should work together to integrate family and career, so that responsibilities in both realms are mutually embraced. We all need to listen more, understand unconscious bias, and call it out when it is seen. Those who have a seat at the table should use these opportunities to diversify and expand the circle of influence…”(11/30).

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From the Global Health Policy Community

HRW Researcher Discusses Potential Impact Of Mexico City Policy On PEPFAR's Efforts

Women’s eNews: Cruel Choices: How Trump’s Global Gag Rule Hurts the Fight Against HIV
Skye Wheeler, women’s rights researcher at Human Rights Watch, discusses the potential impact of the expanded Mexico City policy on PEPFAR’s efforts, writing, “It is too early to know the full scope and impact of the Global Gag Rule on PEPFAR’s success. However, a resounding message from my research was that this policy sabotages trust with the ‘key populations’ that are critical to ending the epidemic. … In the meantime, PEPFAR should closely monitor the effects of the Global Gag Rule by consulting closely with the individuals and organizations they work with. They should investigate what these restrictions mean for the efficacy of PEPFAR’s programs, to the implementation of evidence-based ‘best practices’ for health care, and to the dignity and safety of the people they serve as they seek to create an ‘AIDS-free generation'” (12/7).

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Malaria Investments Critical To Ending Epidemic, Supporting Economic Growth

Friends of the Global Fight: Robust malaria investments see returns and keep progress from sliding backwards
Katie Broendel, senior communications manager at Friends of the Global Fight, discusses findings from the latest World Malaria Report. Broendel also highlights a recent study released by the Malaria Elimination Initiative (MEI) at the University of California, San Francisco, writing, “Making strategic investments in global health, particularly through funding for public-private partnerships such as the Global Fund, is crucial to saving lives and defeating this epidemic. … As MEI’s report illustrates, financing the end of malaria not only saves lives, but supports economic growth in the process” (12/7).

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NASEM Workshop Explores Antimicrobial Resistance Through 'One Health' Lens

National Academies of Sciences, Engineering, and Medicine: Combating Antimicrobial Resistance: A One Health Approach to a Global Threat: Proceedings of a Workshop
This publication discusses proceedings from a two-day public workshop that “explored issues of antimicrobial resistance through the lens of One Health, which is a collaborative approach of multiple disciplines — working locally, nationally, and globally — for strengthening systems to counter infectious diseases and related issues that threaten human, animal, and environmental health, with an end point of improving global health and achieving gains in development” (12/8).

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U.N. Agencies Release Statements Recognizing Human Rights Day

PAHO: Human Rights approach eyed as way to cut maternal deaths
“An approach based on human rights using international legal instruments can help in the effort to reduce maternal mortality in the Americas, according to experts speaking … at a Pan American Health Organization symposium…” (12/8).

UNAIDS: Message on the occasion of Human Rights Day
In a statement recognizing Human Rights Day, Michel Sidibé, executive director of UNAIDS and under secretary general of the U.N., discusses the importance of upholding human rights in AIDS efforts, noting, “We have a moral and legal responsibility to act against discrimination and protect human rights. … On Human Rights Day, I urge everyone to reflect on how the AIDS epidemic has transformed our understanding of the structural, legal, and social determinants of health and on the power of people living with and affected by HIV, who came together to break the conspiracy of silence to demand the protection of human rights. The lessons from the past should reenergize us to face the challenges ahead” (12/10).

WHO: Health is a fundamental human right
In a statement recognizing Human Rights Day, WHO Director-General Tedros Adhanom Ghebreyesus states, “The central principle of the 2030 Agenda for Sustainable Development is to ensure that no one is left behind. I call on all countries to respect and protect human rights in health — in their laws, their health policies, and programs. We must all work together to combat inequalities and discriminatory practices so that everyone can enjoy the benefits of good health, no matter their age, sex, race, religion, health status, disability, sexual orientation, gender identity, or migration status” (12/10).

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GPEI Independent Monitoring Board Publishes 15th Report On Polio Eradication Efforts

Independent Monitoring Board of the Global Polio Eradication Initiative: Fifteenth Report: Every Last Hiding Place
“This is the 15th report produced by the Independent Monitoring Board (IMB) of the Global Polio Eradication Initiative (GPEI). A separate independent monitoring board (the Transition Independent Monitoring Board, TIMB) reviews progress with the task of planning and implementing measures necessary to secure a completely polio-free world. It also examines actions aimed at ensuring successful transfer of polio assets, innovations developed, and lessons learned to countries’ public health programs and other global health priorities. The TIMB’s second report will be published shortly. … This 15th report of the IMB follows a meeting in late October and early November 2017 with GPEI staff, donors, extended partners, together with health ministers and officials from Pakistan, Afghanistan, and Nigeria…” (December 2017).

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Gates Foundation Official Discusses New Technique To Help Establish Number Of Preterm Births In Developing Countries

Bill & Melinda Gates Foundation’s “Impatient Optimists”: Innovation: How a 50-Year-Old Drop of Blood Helps Solve an Urgent Global Health Challenge
Trevor Mundel, president of global health at the Bill & Melinda Gates Foundation, discusses an innovation that researchers have developed to help track the number of preterm births in developing countries. Mundel writes, “[The researchers] took a procedure that we’ve been using in wealthy countries for decades, looked at it anew, retrofitted it, and found an innovative solution for a problem no one had even imagined when the process was invented” (12/7).

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FT Health Discusses Global Impacts Of Dementia, Features Interview With Takeda CEO Christophe Weber

FT Health: The need for fresh approaches on dementia
The latest issue of the Financial Times’ weekly global health newsletter highlights the global costs of dementia, the WHO’s new Global Dementia Observatory, and the Financial Times’ seasonal appeal for Alzheimer’s research. The newsletter also features an interview with Christophe Weber, chief executive of Japanese pharmaceutical company Takeda, and a roundup of other global health-related news stories (Jack/Dodd, 12/8).

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From the U.S. Government

MMWR Article Outlines Progress Toward Global Eradication Of Dracunculiasis

CDC’s “Morbidity and Mortality Weekly Report”: Progress Toward Global Eradication of Dracunculiasis, January 2016-June 2017
This article provides a summary of efforts to eradicate dracunculiasis, including prevention methods and surveillance data. Individual reports for Chad, Ethiopia, Mali, and South Sudan outline progress in each country (Hopkins et al., 12/8).

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