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Kaiser Daily Global Health Policy Report

In The News

Vox Examines PEPFAR's History, Impact, Reauthorization

Vox: Trump signed a good law this week. Yes, really.
“On Tuesday, something odd happened in Washington: A bill became a law. It passed by unanimous consent in the Senate and voice vote in the House (typically taken when a measure faces no significant opposition), and was signed by President Donald Trump. … The bill reauthorized PEPFAR — the President’s Emergency Plan for AIDS Relief — through 2023. PEPFAR provides billions in annual funding and technical support for antiretroviral treatment, HIV-preventing male circumcisions, and other efforts to treat and prevent HIV. … Shockingly, PEPFAR is a major government program that is mostly uncontroversial. … ‘Bipartisanship is not dead,’ Jennifer Kates, the vice president and director for Global Health and HIV Policy at the Kaiser Family Foundation, told me…” (Matthews, 12/12).

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USAID To Strengthen Work With Private Sector, Launches New Engagement Policy

Devex: USAID launches new private sector engagement policy
“The U.S. Agency for International Development launched a new private sector engagement policy Wednesday designed to change the culture and operations of the organization as it works to help countries develop. ‘Private enterprise is perhaps the most powerful force for lifting lives out of poverty, strengthening communities, and building self-reliance,’ USAID Administrator Mark Green wrote in a message to staff…” (Saldinger, 12/13).

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Bill Gates Discusses U.S. Foreign Aid, Global Health During Visit To Washington, D.C.

Devex: Bill Gates talks hurdle rates and aid in ‘America First’ era on visit to Washington
“Bill Gates is in the U.S. capital this week making the case for continued U.S. engagement abroad. On Tuesday, he spoke at the U.S. Chamber of Commerce about the current politics of aid and what it will take to help countries become more self-reliant. Gates, the chair of the Bill & Melinda Gates Foundation, praised Congress for rejecting the Trump administration’s attempts to cut the U.S. aid budget…” (Saldinger, 12/12).

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Foreign Policy Examines Trump Administration's Restrictions On Aid To North Korea

Foreign Policy: Washington Wants Pyongyang to Choose: Humanitarian Aid or Nukes
“The administration of U.S. President Donald Trump is restricting some international relief agencies from delivering humanitarian assistance to needy North Koreans, in the latest effort to compel Pyongyang to dismantle its nuclear arms program. In recent months, U.S. diplomats have delayed the export of surgical equipment and supplies for fighting tuberculosis and malaria to North Korea, and held up the delivery from Canada of 300 stainless steel soy-milk cans for daycare centers and orphanages there, according to several diplomatic sources and internal United Nations documents. The measures, which the United States is channeling through the U.N. Security Council committee responsible for monitoring sanctions on North Korea, appears to be part of Washington’s maximum pressure campaign against North Korean leader Kim Jong Un’s regime…” (Lynch, 12/12).

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Media Outlets Continue To Cover Trump Administration's Actions Related To Fetal Tissue Research

New York Times: Fetal Tissue Research Is Curtailed by Trump Administration
“Should the government pay for medical research that uses tissue from aborted fetuses? This debate, ever smoldering, has erupted again, pitting anti-abortion forces in the Trump administration against scientists who say the tissue is essential for studies that benefit millions of patients…” (Grady, 12/12).

STAT: Freeze on fetal tissue procurement may impede work at NIH cancer lab, agency says
“…The Trump administration is in the midst of a wide-ranging audit into research involving human fetal tissue. As part of that review, the NIH asked staff scientists to ‘pause’ purchases of fetal tissue beginning in September, as Science first reported…” (Swetlitz, 12/12).

Washington Post: Fetal tissue research targeted by abortion foes inside administration
“…At stake is critical federal funding for research into diseases that range from HIV to cancer to Zika, vaccine production, and treatment for maladies such as Parkinson’s disease…” (Bernstein/Goldstein/Sun, 12/12).

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Washington Post Discusses Climate Talks In Poland, U.S. Stance

Washington Post: Climate talks at risk of failure as U.S. leaves a leadership void
“Global talks to combat climate change risked breaking up with little to show for them, participants [at the climate change conference in Poland] said Wednesday, with the hostile U.S. stance on aggressive action leaving a leadership void that other countries have been reluctant or unable to fill. The year’s largest gathering of climate negotiators, with nearly 200 countries represented, is seen as a crucial moment when the world will either commit to ramping up its ambitions to attack the issue or risk falling even further behind in staving off the worst effects of global warming. Yet with two days to go before the talks are scheduled to close, participants say they have seen scant progress…” (Dennis/Witte, 12/12).

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Sweden Withholds UNAIDS Funding Following Report On Agency's Culture, Calls For Executive Director To Resign

The Guardian: Sweden suspends funding for U.N. AIDS agency as Britain urged to follow suit
“The Swedish government has announced it is to withhold funding to a U.N. agency until its director resigns in a row over his ‘dysfunctional leadership.’ UNAIDS, which spearheads the global fight against AIDS and HIV, will receive no further funding until its executive director, Michel Sidibé, stands down, said Isabella Lövin, Sweden’s minister for international development cooperation and climate. The warning follows a scathing report that condemned a patriarchal culture within the organization. Britain has been attacked by campaigners for not taking a similarly strong stance. The U.K.’s Department for International Development (DfID), is also a key donor…” (Ratcliffe, 12/12).

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Tuberculosis Research Funding Hits High, Falls Short Of Global Target

Nature: Global funding for tuberculosis research hits all-time high
“Global spending on tuberculosis research hit a high in 2017, according to a report released on 3 December. Investment reached US$772 million, up from $726 million in 2016, says the report, from the activist organization Treatment Action Group (TAG) in New York City. The report, which tracked funding since 2005, shows that investment has gone up and down over the years, with a general upward trend. The 2017 total is the most spent on research into tuberculosis (TB) in a year, according to the data, but it still falls short of the $2 billion a year that the TB research community says is needed…” (Makoni, 12/12).

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Gavi Working To Get More Vaccines To People In Rural Areas, Conflicts, Emergency Situations

Reuters: Vaccines group plots path through conflict, instability, epidemics
“More children worldwide are now immunized against killer diseases but the task has become harder due to conflicts, epidemics, urbanization, and migration, the head of a global vaccine group said. Seth Berkley, chief executive of [Gavi, the Vaccine Alliance], said his agency was now focusing on how to get vaccines to people in rural areas, those isolated by war, and refugees…” (Kelland, 12/12).

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Ebola Cases In DRC Continue To Increase, Officials Concerned About Spread To Goma

CIDRAP News: Ebola outbreak grows as DRC issues alerts in Goma
“The Democratic Republic of the Congo’s (DRC’s) health ministry [on Wednesday] in its daily Ebola update reported five new cases and nine new deaths and added that 100 suspected cases are under investigation. Outbreak totals now stand at 505 cases, including 298 deaths. … At least one of the newly recorded deaths occurred in the community, in Katwa, an event that heightens the risk of virus spread, the DRC said. Officials also issued two health alerts about possible disease spread in Goma, the capital and largest city in North Kivu province. For weeks, officials have warned that Ebola could spread in the city…” (Soucheray, 12/12).

Additional coverage of the Ebola outbreak in the Democratic Republic of the Congo is available from Becker’s Hospital Review and Reuters.

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More News In Global Health

Associated Press/POLITICO: U.N. chief calls for compromise, sacrifice at climate talks (12/13).

Devex: How hard to reach are the ‘hard to reach’? (Abrahams, 12/13).

Devex: Supporting disability advocacy: Insights from Savina Nongebatu (Cornish, 12/12).

Devex: Older generation at risk of being left behind in push for UHC (Root, 12/12).

Global Health NOW: Hemophilia’s Crippling Cost (McNeish, 12/12).

The Guardian: The untold story of how India’s sex workers prevented an AIDS epidemic (Dhillon, 12/13).

The Guardian Nigeria: Stepping up investment in response to HIV, TB, malaria (Onyenucheya, 12/13).

STAT: Developmental delays persist as Brazil’s Zika babies grow up (Branswell, 12/12).

U.N. News: ‘Fire-fighting approach’ to humanitarian aid ‘not sustainable’: Deputy U.N. chief (12/12).

U.N. News: U.N. pushes for universal health care on International Day (12/12).

U.N. News: Better care, stronger laws needed to save 30 million babies on the brink of death (12/12).

Xinhua: Study maps malaria parasite giving hope for vaccine (12/13).

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Editorials and Opinions

U.S. Congress, Administration Must Act To Address Climate Change

New York Times: John Kerry: If We Fail on Climate, It Won’t Be Just Trump’s Fault
John Kerry, former U.S. secretary of state

“…People are dying today because of climate change, and many more will die and trillions of dollars of damage to property will occur unless America gets back in the fight. The evidence is hard to miss. … Historic droughts are matched by historic floods. … Infectious diseases are moving into new areas and higher altitudes. Crop yields are down in more than two dozen countries … But this is a mere preview of what’s to come. … Future generations will measure us by whether we acted on facts, not just debated or denied them. The verdict will hang on whether we put in place policies that will drive the development and deployment of clean technologies, re-energize our economies, and tackle global climate change. … Instead of tacitly accepting that inaction is preordained for the remaining two years of the Trump presidency, Congress should send Mr. Trump legislation addressing this crisis. … If we fail, future generations will judge us all as failures, not just this president. They will have no time for excuses. Facts matter. Act on them” (12/13).

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Opinion Piece Examines U.S. Involvement In Saudi War In Yemen, Humanitarian Impact Of Conflict

New York Times: This Is What Our Yemen Policy Looks Like
Nicholas Kristof, New York Times columnist

“…Members of the United States Congress are considering measures that would end our country’s support for the [Saudi Arabian war in Yemen]. … United States policies are contributing to the deaths of children in Yemen by the tens of thousands. … The most common war casualty in Yemen is not a soldier with a bullet but a child who is starving. … True, there are complex roots to the suffering in Yemen, but the United States is a partner in a war that has collapsed Yemen’s economy … American and Saudi officials think of the Yemen war as a way to check Iran. It has failed in that and has accomplished little more than leaving 12 million Yemenis on the brink of famine. Already, 85,000 children may have died. We are complicit…” (12/12).

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Investing In Health Of Women, Girls Critical To Achieving UHC

Thomson Reuters Foundation: Without investing in women and girls, there will be no health for all
Diane Gashumba, minister of health in Rwanda, and Carin Jämtin, director-general at the Swedish International Development Cooperation Agency

“…Improving the health of women, girls, and adolescents — populations who are key to social and economic progress — can be a driver for health and sustainable development goals, which makes closing the gap in [sexual and reproductive health and rights (SRHR)] interventions especially urgent. … The majority of SRHR interventions are health promotive, preventive, cost-effective, and can be delivered at the primary health care level, making them highly feasible to incorporate into universal health coverage (UHC) programs. We, as ministers of health and finance and as development cooperation partners, must make a resolute call for the prioritization and integration of services. … All countries, no matter how rich or how poor, owe it to their citizens to progressively realize gender equality and their population’s right to health. … It will take dedicated and accelerated efforts from the global community and governments … to fulfill the promise of health for all. The upcoming High-Level Meeting on Universal Health Coverage at the United Nations General Assembly in September 2019 is an important opportunity for the international community to turn our commitments into action. … All states have a responsibility to provide high-quality, affordable health care for its citizens. On this UHC Day, let us make this rallying call a reality. Let us partner and stand together to ensure that no one — and particularly not one woman or one girl — is left behind” (12/12).

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Addressing Poor-Quality Medicines Vital To Sustaining Progress Against, Ending Malaria

Devex: Opinion: To end malaria, we cannot ignore the reality of poor-quality medicines
Ronald T. Piervincenzi, chief executive officer of USP, and Delese Mimi Darko, pharmacist and chief executive officer of Ghana’s Food and Drugs Authority

“…WHO estimates that one in 10 medicines in low- and middle-income countries are substandard or falsified. At best, these drugs simply fail to work, promising to help a patient while delivering nothing; at worst, they can further sicken or kill. … Alongside antibiotics, anti-malarials are among the most commonly reported to WHO for quality issues. While existing data can only paint a partial picture, by some estimates, about a third of all anti-malarial medicines in sub-Saharan Africa are poor-quality; by others, the numbers are as high as 60 percent. … Thankfully, the challenge of poor-quality medicines is fixable — and Ghana offers cause for hope. … To sustain progress and succeed against malaria, we need to apply some of the lessons from Ghana and elsewhere. To start, we need to shine a brighter spotlight on this problem. … Additionally, as part of efforts to strengthen health systems in every country, governments must keep quality top of mind when buying and obtaining medicines for distribution. … Finally, we need to ensure that physicians, pharmacists, and health workers have the training and tools they need to detect poor-quality medicines before they ever reach our patients’ hands. … Today, we have the life-saving medicines to put an end to malaria for good. By protecting medicines quality, we can carry this promise forward not just for malaria, but for all diseases whose progress is threatened by poor-quality medicines and systems that don’t reach patients with the care they deserve” (12/12).

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U.N. Secretary General Must Act On Independent Expert Panel's Recommendations On UNAIDS

The Lancet: Offline: How to restore the credibility of UNAIDS
Richard Horton, editor-in-chief of The Lancet

“…Astonishing does not even begin to describe the findings and recommendations of an Independent Expert Panel, set up to investigate harassment, including sexual harassment, bullying, and abuse of power at UNAIDS. … The Panel identified four areas for reform: governance, leadership, management, and policy and process. Its recommendations are far reaching. An external, independent, investigation, disciplinary, and redress mechanism must be implemented to deal with complaints. … Accountability at all levels of the organization must be strengthened. Human resources procedures should be upgraded. An external and independent review of progress should be completed in 12 months. And there is one further wretched element to the Panel’s findings and proposals. … It is the U.N. Secretary-General who has the power to hire and fire the executive director. Both the [Programme Coordinating Board (PCB)] and António Guterres now have a duty to deliver on the recommendations of the Expert Panel. The reputation of UNAIDS and the U.N. system depends on it” (12/10).

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From the Global Health Policy Community

'Science Speaks' Highlights Recent Pieces On HIV, TB Treatment, Intellectual Property, PEPFAR

IDSA’s “Science Speaks”: What We’re Reading: In HIV and TB treatment, science supports human rights
Antigone Barton, senior editor and writer of “Science Speaks,” discusses several global health-related articles addressing various topics, including a blog post on HIV criminalization, an opinion piece on the value of providing rights-based interventions to TB patients, a publication exploring drug pricing and intellectual property, and a statement on the signing of the PEPFAR Extension Act of 2018 (12/12).

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Report Examines How Data Used To Strengthen Primary Care, Accelerate Progress Toward UHC

IntraHealth International’s “Vital”: Primary Health Care Data Is Key to Attaining Universal Health Coverage
Allyson English, senior program associate, and Laurel Hatt, program director, both at Results for Development, discuss findings from a report examining “how data is being used to strengthen primary health care and accelerate progress toward universal health coverage (UHC)” in five countries. The authors highlight four key themes from the report: “1. Local data (as well as regional and national-level data) should be used and shared to inform priority-setting. … 2. Various data systems must be integrated with one another and provide a comprehensive view in order to move toward patient-centered care. … 3. Leveraging technology to collect, connect, and disseminate data will increase coordination and continuity of care and improve access for hard-to-reach populations. … 4. Strengthening primary health care depends not only on the generation of new data but on the better analysis and use of existing data to identify areas of weakness and develop innovative solutions” (12/12).

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Global Health Experts Discuss How Applying Lessons From GPEI Could Help Strengthen Health Systems

BMJ Opinion: Building health security into health systems: one legacy of polio eradication that must not be lost
Stephen A. Matlin, senior fellow at the Global Health Centre at the Graduate Institute of International and Development Studies; Judith Diment, coordinator for the Advocacy Task Force on Polio Eradication at Rotary International; and David L. Heymann, head and senior fellow at the Centre on Global Health Security at Chatham House, discuss how applying lessons from the experiences of the Global Polio Eradication Initiative (GPEI) could help strengthen health systems and achieve universal health coverage (UHC). The authors write, “As the GPEI plans for the future, it has become increasingly clear that ‘finishing the job’ must mean not only certifying that the last case of polio in a human being has been seen, but that the assets of polio eradication and the knowledge gained are put to good use for the benefit of health everywhere. Stronger health security and accelerated movement towards UHC are the prizes to be won” (12/12).

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Aidspan Publishes New Issue Of 'Global Fund Observer'

Aidspan: Global Fund Observer
Aidspan, an independent watchdog of the Global Fund to Fight AIDS, Tuberculosis and Malaria, published Issue 347 of the ‘Global Fund Observer.’ The newsletter includes articles on various topics, including the Global Fund Board’s approval of another $98 million in country grants from the 2017-2019 allocations, the launch of the WHO’s new “country-led” response to malaria, and an overview of reactions to the World Malaria Report’s findings that malaria is rising in some regions (12/12).

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