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Kaiser Daily Global Health Policy Report

In The News

WTO Meeting Host Kenya Opens Talks With Call To Decrease Poverty, Diversify Economies

Agence France-Presse: Global trade talks open with call to fight poverty
“Global trade talks opened Tuesday with host Kenya highlighting their role in combating poverty, and urging African nations to diversify their economies. War-torn Afghanistan and Ebola-ravaged Liberia are set to join the World Trade Organization (WTO) as it holds a ministerial conference in the Kenyan capital Nairobi, its first such meeting on African soil…” (Martell, 12/15).

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More Action, Financing Needed To Improve WASH, Prevent Child Deaths In Sub-Saharan Africa, UNICEF Says

U.N. News Centre: UNICEF urges swift action, ‘robust financing’ to close water and sanitation gaps in sub-Saharan Africa
“Some 180,000 children under the age of five die every year — roughly 500 a day — in sub-Saharan Africa due to diarrheal diseases linked to inadequate water, sanitation, and hygiene, the United Nations Children’s Fund (UNICEF) warned [Tuesday] ahead of a conference in the region on boosting financing for the sector…” (12/15).

Xinhua/GlobalPost: Roundup: 500 children die each day from lack of safe water in sub-Saharan Africa: UNICEF
“…UNICEF said that without speedy action, the situation can drastically worsen within the next 20 years, as rapidly rising populations outstrip the efforts of governments to provide essential services. The first West and Central Africa Innovative Financing for Water Sanitation & Hygiene conference is being convened by UNICEF in cooperation with the government of Senegal and the African Ministers’ Council on Water…” (12/15).

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Cease-Fire In Yemen Allows U.N. Health Convoys To Deliver Medical Supplies; WHO Appeals For $31M In Funding For Continuity Of Services

New York Times: Yemen Agrees to Cease-Fire With Rebels as Peace Talks Begin
“The Yemeni government and Houthi rebels called an immediate halt to hostilities on Tuesday as they started peace talks mediated by a United Nations special envoy at an undisclosed location in Switzerland, a United Nations spokesman confirmed. … The United Nations estimates that the war has caused close to 40,000 casualties and inflicted significant damage on the impoverished country’s infrastructure, deepening its humanitarian crisis…” (Cumming-Bruce, 12/15).

VOA News: Yemen Ceasefire Provides Opening for Distribution of Medical Supplies
“…The World Health Organization reports U.N. and private aid agencies are set to bring desperately needed relief supplies to the Yemeni people during the weeklong cease-fire. WHO Representative in Yemen Ahmed Shadoul says 19 trucks are loaded with urgently needed medical supplies from the agency’s warehouses in the capital Saana and the major port city of Aden…” (Schlein, 12/15).

WHO EMRO: WHO: Urgent support needed to provide health services for 15 million people in Yemen
“The World Health Organization and health partners are appealing for US$ 31 million to ensure the continuity of health services for nearly 15 million people in Yemen affected by the ongoing conflict. Funding is urgently needed as the Yemeni health system has collapsed, leaving millions of vulnerable people without the care and medications they urgently need…” (12/15).

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Taliban Begin Supporting Polio-Eradication Efforts In Afghanistan, Bloomberg Reports

Bloomberg Business: Taliban Join Global Effort to Kill Off Polio in 2016
“…The insurgent group, whose anti-government attacks have stoked insecurity in Afghanistan and hampered vaccinators, is working alongside local and international health authorities to wipe out the last vestiges of polio, marshaling thousands of people to immunize vulnerable children…” (Najafizada, 12/15).

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Hepatitis C Treatment Experiment In Egypt Testing Strategy To Provide Low-Cost Drugs While Protecting Western Markets

New York Times: Curing Hepatitis C, in an Experiment the Size of Egypt
“…Once demonized for withholding lifesaving AIDS drugs from poor countries in Africa, chastened pharmaceutical companies are testing an alternative strategy [in Egypt]: a complicated deal to sell hepatitis drugs at a fraction of their usual cost while imposing tight restrictions intended to protect lucrative markets in the West. The strategy has raised howls of outrage from public health advocates in some quarters. If it succeeds, though, the arrangement in Egypt may serve as a blueprint not just for curing hepatitis around the world, but also for providing other cutting-edge medicines to citizens in poor countries who could never afford them…” (McNeil, 12/15).

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Unregulated Sales Of Combination Antibiotics In India Could Be Contributing To Drug Resistance, Reuters Reports

Reuters: Special Report: U.S. pharma giant profits as combination drugs flood India
“…Under India’s complex drug-approval regime, many pharmaceutical manufacturers have obtained permission from a single state to make new fixed-dose combination drugs, or FDCs, … and are selling them in other parts of the country without the approval of the central government. FDCs combine two or more drugs in a single pill. … Doctors and public health experts both in India and abroad say the proliferation and misuse of antibiotic combinations here may be contributing to antibiotic resistance, making India a potent incubator of so-called superbugs…” (Mahr et al., 12/15).

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Sierra Leone President Expected To Sign Bill Legalizing Abortion

BuzzFeed News: What Legalized Abortion Means For The Women Of Sierra Leone
“Sierra Leone President Ernest Koroma is expected to sign a bill legalizing abortion, after declaring the country’s maternal health crisis a ‘national emergency’ in a speech to Parliament on Friday. … The Safe Abortion Act, which the country’s parliament passed on December 8, allows for unrestricted abortion in the first 12 weeks [of pregnancy]; girls under age 18 require the permission of a guardian…” (Moore, 12/15).

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Final Installment Of Global Health NOW Mycetoma Series Examines Efforts To Test Antifungal Drug In Sudan

Global Health NOW: The Opposite of Martin Shkreli: Drug Development Without Profit
In the third and final installment of its series on mycetoma, Global Health NOW follows new research efforts in Sudan by the Drugs for Neglected Diseases initiative and the Mycetoma Research Center in Sudan (Maxmen, 12/14).

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Cancer Incidence, Mortality Rising In LMICs While Decreasing In High-Income Countries, Analysis Shows

News outlets continue to report on an analysis published this week in the journal Cancer Epidemiology, Biomarkers & Prevention mapping cancer incidence and mortality worldwide.

NPR: Most Of The World’s Cancer Cases Are Now In Developing Countries
“…The majority of cancer cases — 57 percent — now occur in low- and middle-income countries. And 65 percent of cancer deaths worldwide occur in these countries, according to an analysis by the American Cancer Society. But there’s a flip side to that story: Rates of certain cancers, including cervical and liver cancer, have gone down in high-income countries…” (Singh, 12/15).

SciDev.Net: Cancer soars in global South
“…In the timeframe studied, Zimbabwe saw an average of 87 deaths per 100,000 women from cervical cancer, while in Malawi and Uganda death rates stood at 76 and 54 women out of 100,000, respectively. These rates are more than twice as high as those in all other cancer databases studied as part of the research, the authors say. The study adds that around 21 percent of African women have a HPV infection at any given time, compared with just five percent in North America…” (David, 12/15).

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Editorials and Opinions

U.S. Trade Representative Should Support Policies To Enhance Food Security At WTO Talks

Huffington Post: Anti-Hunger Groups Make Impassioned Pleas: the United States Should Support, Not Object, to Removing WTO Obstacles to Global Food Security
Deborah James, director of international programs at the Center for Economic and Policy Research

“…Removing WTO obstacles to food security — by allowing developing countries to invest in their own agricultural production, and feed their own populations, thus reducing their dependence on foreign aid — is achievable. … These changes … would bring the WTO more in line with the global consensus on agricultural investment and food security. It would allow developing countries to be more self-sufficient and less dependent on foreign aid. … It would help nations reach the new Sustainable Development Goals, to which the United States subscribed, of eradicating hunger and malnutrition. It … will remove key barriers that currently hamstring the ability of developing countries to reduce hunger at home. … Anti-hunger groups have taken a stand, and now can bring their powerful advocacy to bear on the WTO negotiations. Given the particular role of the U.S. in these talks, members of Congress who care about global food security are in a position to play a pivotal role in pushing the U.S. Trade Representative to rethink its current stance in the negotiations that is currently based on agribusiness export-lobby interests. This work can be achieved in partnership with farmers and right to food campaigns across the developing world…” (12/15).

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Companies Must Not Place Pharmaceutical Profits Ahead Of People's Health

Forbes: Why Martin Shkreli’s Price Hike May Hurt Everyone … Including You And The Pharmaceutical Industry
Bruce Y. Lee, associate professor of international health at the Johns Hopkins Bloomberg School of Public Health, director of the Global Obesity Prevention Center, and director of operations research at the International Vaccine Access Center

“Why should you care if former hedge fund manager and current pharmaceutical executive Martin Shkreli plans to raise the price of benznidazole, a treatment for Chagas disease, by potentially over 100,000 percent? … Shkreli’s medication price hikes could end up hurting many industries and sectors, most notably the biotechnology and pharmaceutical industry. … Raising the price of a medication (especially one that people desperately need) may seem like an easy method of quickly raising profits. … But such profits could be very ephemeral and lead to a series of increasing ripples throughout the pharmaceutical industry. And since health is integral to all that we do, the health care industry is to intimately integrated through all of society. Therefore, a strong ripple in the pharmaceutical industry could eventually become a tidal wave for all” (12/16).

Project Syndicate: America’s Real Drug Problem
Akash Goel, a physician and journalist, and Prashant Yadav, director of health care research at the William Davidson Institute at the University of Michigan

“…In addition to raising worries about the [toxoplasmosis drug Daraprim’s] availability, the move [of the drug’s marketing rights to Turing Pharmaceuticals, which resulted in price hikes,] exposes one of the great flaws of the U.S. health care system: profits can be — and often are — placed ahead of people. … Most people would expect life-saving medications to be treated differently from consumer goods … But no such distinction exists in the U.S. Indeed, the U.S. is the only developed country that allows drug makers to set their own prices. … Turing’s attempt to profit at the expense of those suffering from HIV [and other diseases] has clearly shown that regulators and drug manufacturers need to explore new ways of doing business. Access to life-saving medicines should not depend on the extent of one person’s benevolence. Rather, we should work to embed in our institutions practices and policies that safeguard the interests of patients” (12/14).

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Ending HIV, TB, Malaria Requires Stronger Health Systems, Universal Access To Care

Huffington Post: We Are in This Boat Together
Mustapha Kaloko, Africa Union commissioner for social affairs

“…This week, I will join fellow global health leaders and representatives of the Global Fund partnership in Tokyo to address the challenge of funding stronger health systems to end HIV, TB, and malaria as epidemics, better contain emerging health threats like last year’s Ebola outbreak, and provide universal access to health care. It is these types of systems that make the difference in a disease outbreak. … Our mission to end HIV, tuberculosis, and malaria is far from over and we need to reach deep into the communities where the diseases are most concentrated and build sophisticated, bespoke responses. … We are on the right side of the tipping point for ending AIDS, TB, and malaria as epidemics, but our eventual success hangs in the balance of our health systems and capacity to realize universal health care” (12/15).

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International Community 'Must Recommit Our Respect And Gratitude' To Ebola Workers

New York Times: Letter to the Editor: Ebola Stigma in Liberia
Joseph Cahalan, chief executive of Concern Worldwide U.S.

“Re ‘Liberia’s Shunned “Ebola Burners”‘ … Liberia is still not Ebola-free, but the epidemic has ended. This would not have been possible without the courage and selflessness of the men and women who took on the most terrible but essential of responsibilities: body removal, burial, and cremation. Our burial teams in Sierra Leone were instrumental to the end of the outbreak there … [and t]hey face the same stigma and ostracism that you report ‘virtually destroyed’ the lives of Liberia’s crematory workers. … All of us — the humanitarian community, media, government, international bodies — who so proudly celebrated the Ebola fighters just a year ago must recommit our respect and gratitude. They are the heroes who played a leading role in ending one of the most serious public health emergencies of our time” (12/15).

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Governments Should Focus On Providing Poor Citizens Cost-Effective Health Interventions, Maintaining Quality Standards

LiveMint: Reasons to invest in health: an OECD perspective
Stefan Kapferer, deputy secretary general of the OECD

“Investing in the health system not only saves lives, it is also a crucial investment in the wider economy. … OECD’s experience is that additional [health] expenditure places pressure on scarce resources. With only so many doctors, nurses, health workers, and physical facilities at a moment in time, higher spending means higher prices as well as more services. Some of the most successful examples of expanding coverage among middle-income countries in recent years have addressed this challenge by defining a limited set of essential, cost-effective services. … To this end, … governments should be incentivized to expand health coverage to the poor, focusing on cost-effective interventions. … Governments also need to work closely together so that minimum quality standards are maintained, and specialist resources are used efficiently. … [F]unding can be linked to cost-effective interventions, such as preventive and primary care activities, rather than less cost-effective (but more visible, and therefore more politically attractive) interventions, such as construction of new hospitals” (12/16).

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From the Global Health Policy Community

Kaiser Family Foundation Budget Summary Analyzes Global Health Aspects Of FY16 Omnibus Released By Congress

Kaiser Family Foundation: Congress Releases FY16 Omnibus
This budget summary highlights global health-related funding contained in the FY 2016 Omnibus bill released by Congress on Wednesday. The bill “…includes funding for U.S. global health programs at the U.S. Agency for International Development (USAID), the Department of State, and the Centers for Disease Control and Prevention (CDC). Total known funding for U.S. global health programs in the FY 2016 Omnibus is $9.2 billion, which is approximately $58 million (<1%) higher than the FY 2015 enacted level, and $312 million (4%) above the President’s FY 2016 Budget Request. … It is important to note that the Global Gag Rule (Mexico City Policy), which was included in the House version of the State and Foreign Operations (SFOPs) appropriation bill, was not included in the FY 2016 Omnibus.” The analysis includes tables that “compare U.S. global health funding in the FY 2016 Omnibus to the FY 2015 enacted levels and the President’s FY 2016 Budget Request” (12/16).

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New CGD Report Examines Next Generation Financing Models For Global Fund, Other Donors

The Center for Global Development published two blog posts related to the release of its new report, titled Aligning Incentives, Accelerating Impact. The report “addresses the how of next generation financing models — that is, the concrete steps needed to change the basis of payment from expenses to something else: outputs, outcomes, or impact,” and is the result of the Next Generation Financing Models in Global Health Working Group, co-chaired with the Global Fund to Fight AIDS, Tuberculosis and Malaria.

CGD’s “Global Health Policy Blog”: To Defeat AIDS, TB, and Malaria, a New Generation of Financing Models
Rachel Silverman, senior policy analyst at CGD, discusses the report, including how “next generation financing models … offer an opportunity for the Global Fund to push forward its strategic interests and accelerate the impact of its investments…” (12/15).

CGD’s “Global Health Policy Blog”: Leveraging Nobel Prize Economics for Improved Global Fund Grant Performance
CGD Senior Fellow Mead Over discusses “Cash on Delivery” aid, or COD, and how this approach to foreign assistance figures in the new report (12/15).

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Coordinated Partnerships Essential To U.S. Ebola Response Efforts In West Africa

USAID’s “IMPACTblog”: Unprecedented Coordination Helped Turn the Tide of an Unprecedented Outbreak
Justin Pendarvis, public health adviser with USAID’s Office of U.S. Foreign Disaster Assistance, discusses U.S. involvement in responding to the Ebola crisis in West Africa and the importance of coordinated partnerships in those efforts (12/15).

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Focus On Learning What Policies Work To Achieve SDG Targets

Council on Foreign Relations’ “Development Channel”: Will Setting Goals End Hunger? What’s Next for the SDGs…
In a guest post, Dean Karlan, professor of economics at Yale University, president and founder of Innovations for Poverty Action, and founder of ImpactMatters, “a newly launched organization that helps nonprofits use and create evidence to assess their impact,” discusses the Sustainable Development Goals (SDGs) and proposes a “tongue-in-cheek” idea to “randomize the way the 169 targets are assigned.” He says the proposal “highlights the challenge of measuring the new SDGs” and notes, “[W]hile the SDGs motivate us towards aspirational outcomes, they do not tell us what to do. Learning what policies actually work is a much more useful basis for a study, and where we should focus our attention” (O’Neil, 12/15).

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