KFF Daily Global Health Policy Report

In The News

Humanitarian Situation Continues To Worsen In CAR; Food Security Deteriorating, FAO Says

“The humanitarian situation in the conflict-wracked Central African Republic (CAR) is deteriorating, with 450 people killed in the capital Bangui and 159,000 others driven from their homes in Bangui in the last week alone, United Nations agencies reported [Friday], as the largest airlift of emergency supplies since the violence erupted arrived in the capital,” the U.N. News Centre reports (12/13). In addition, “160 people were reported killed in other parts of the country, Adrian Edwards, a spokesman for the Office of the United Nations High Commissioner for Refugees, told reporters [in Geneva], relaying information provided by Central African Republic’s Red Cross organization and the Danish Refugee Council,” the New York Times writes. “The assessment came as French troops exchanged gunfire with suspected former rebels groups in Bangui, according to the Associated Press, and the African Union announced that it would raise the number of its peacekeeping troops to 6,000 from 2,500 in a bid to curb the anarchy and bloodshed that has swept the country in recent months,” the newspaper adds (Cumming-Bruce, 12/13).

The U.N. Food and Agriculture Organization (FAO) warned Monday that the country is “now facing a looming food crisis” and “call[ed] for urgent action to provide crop seeds to farmers,” the U.N. News Centre writes in a separate article (12/16). “According to the FAO-supported Integrated Food Security Phase Classification, about 1.29 million people, or more than 40 percent of the country’s rural population, are in need of urgent assistance — nearly double the estimated level in February 2013,” an article from the FAO states (12/16). According to the New York Times, Médecins Sans Frontières (MSF) “on Thursday criticized the United Nations in an open letter to its top official responsible for coordinating emergency aid, Valerie Amos, citing ‘the unacceptable performance of the United Nations humanitarian system'” (12/13). “The letter, signed by Joanne Liu, the organization’s international president, spoke of failure to respond to ‘glaring’ humanitarian needs and ‘extreme’ security precautions,” Devex writes (Ravelo, 12/16). In the weekend edition of NPR’s “Listen to the Story,” correspondent Rachel Martin speaks with MSF’s Sylvain Groulx about the humanitarian and security situation in CAR (12/15).

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U.N. Appeals For $6.5B In Humanitarian Aid For Syria As Conflict Continues To Hinder Efforts

“The United Nations and its partners will need nearly $13 billion in funding to reach millions of people with life-saving aid in 2014, with half of that sought for those affected by the deepening crisis in Syria,” the U.N. News Centre reports, noting, “The $6.5 billion sought to assist millions of Syrians inside the country and across the region is the biggest amount so far requested for a single humanitarian emergency” (12/16). The money requested for Syria will cover “food, drinking water, shelter, education, health services and polio vaccines,” according to Reuters (Nebehay/Miles, 12/16). The U.N. “said nearly three-quarters of the country’s population will need help in 2014,” The Guardian writes, adding, “It estimates that close to half of Syria’s population has been displaced, while the World Food Programme [WFP] says a similar number need ‘urgent, life-saving food assistance'” (Chulov, 12/16). A WFP report released Monday estimates “[h]alf of Syria’s population is ‘food insecure’ and nearly a third needs urgent assistance,” Agence France-Presse notes (12/16).

The New York Times examines mounting challenges to aid delivery in Syria, highlighting the work of Valerie Amos, “the top United Nations official responsible for easing the Syrian conflict’s humanitarian crisis.” The newspaper writes that Amos “is facing a conundrum as the 33-month-old conflict enters its second winter,” and notes “Syrians have refused to open access to humanitarian aid from their border with Turkey, which supports the insurgency” (Gladstone et al., 12/16). “[I]t is months since convoys from the United Nations and other agencies have delivered food or medical care to [rebel-held] areas — prevented by a Syrian government accused of using hunger as a weapon of war against its people,” Reuters reports in a separate article, adding, “The United Nations estimates about a quarter of a million Syrians are living under siege as winter bites, most of them encircled by government forces, but also including 45,000 in two towns in the north that are besieged by anti-Assad rebels” (Holmes et al., 12/15).

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Reuters Examines Polio Eradication Efforts In Syria

“The Syrian government excluded the largely rebel-held province of Deir al-Zor — where polio broke out this year — from a 2012 vaccination campaign, arguing that most residents had fled although hundreds of thousands were still there, a Reuters investigation shows,” the news service reports. “Public health researchers say missing out [on] the Syrian province contributed to the reemergence there of polio,” the news service writes, noting the WHO in November confirmed the first outbreak in the country since 1999. “Asked to comment on researchers’ allegations aid groups should have raised the alarm earlier and prepared better, Chris Maher, who is coordinating the regional polio response for the WHO, said it had warned vaccination rates were falling,” according to Reuters.

“Maher said it was reported that 67,000 children under the age of five were subsequently vaccinated in Deir al-Zor in January 2013,” the news service states, adding, “Public health researchers say that is a coverage rate of around 50 percent, insufficient to prevent polio from spreading, based on census data.” Reuters continues, “The WHO says the largest-ever immunization response in the Middle East is under way, aiming to vaccinate more than 23 million children against polio in Syria and neighboring countries,” and “almost two million children in Syria have already been vaccinated, including 600,000 in contested areas of the country, in the first of several rounds” (Holmes, 12/17).

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Security Concerns Hampering Polio Eradication Efforts In Pakistan

Al Jazeera examines how “security concerns and negotiated access” are threatening Pakistan’s polio eradication efforts, writing, “Since July 2012, 31 people have been killed in Taliban-led attacks on anti-polio campaigners in Pakistan.” The news service notes, “Most recently, two policemen providing security to polio vaccinators in Swabi were killed when gunmen on a motorbike attacked them,” adding, “In a separate incident, unidentified gunmen opened fire on polio workers in Peshawar, killing one.” “The good news is that there have been no cases from [Pakistan’s western province of] Baluchistan, and the polio epidemic is now confined to certain pockets. The bad news is the polio [vaccine] ban in certain areas, the killing of the workers and the lack of access that leads to missed children,” Elias Durry, the head of the WHO’s Global Polio Eradication Initiative, told Al Jazeera, according to the news service (Jawaid, 12/17).

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FAO Report Warns Zoonosis Becoming More Common; MERS Can Infect Camels, Research Shows

“About 70 percent of new diseases infecting humans in recent decades have come from animals, the United Nations food agency … reported [Monday], warning that it is getting easier for diseases to jump species and spread as the population, agriculture and food-supply chains grow,” the U.N. News Centre reports. According to the report (.pdf) from the Food and Agriculture Organization (FAO), titled “World Livestock 2013: Changing Disease Landscapes,” “a new, more holistic approach to managing disease threats is needed,” the news service writes (12/16). In related news, “[s]cientists have proved for the first time that the Middle East respiratory syndrome (MERS) virus that has killed 71 people can also infect camels, strengthening suspicions the animals may be a source of the human outbreak,” Reuters reports, noting, “Camels are used in the region for meat, milk, transport and racing” (Kelland, 12/16).

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Thomson Reuters Foundation Examines Efforts To Train Doctors, Nurses In Haiti

The Thomson Reuters Foundation examines “a new crop of doctors hoping to fill the acute shortage of doctors in Haiti and take the lead in reviving a health sector still struggling to recover from the massive earthquake that flattened the capital Port-au-Prince in January 2010.” The news service notes “there are only 0.25 doctors for every 1,000 Haitians, while in neighboring Dominican Republic there are 1.88 doctors per 1,000 people.” The news service profiles the Mirebalais University Hospital, a “300-bed teaching hospital, with more than 30 outpatient consulting rooms, and six operating rooms, [which] is a joint project involving [Partners in Health (PIH)] and its sister group, Zanmi Lasante, with a $5.5 million donation from the American Red Cross and other NGOs and private donors” (Moloney, 12/17).

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Malaysian Authorities Working To Contain Dengue Fever Outbreak

“At least five people have died from dengue fever this month in Malaysia, where authorities are struggling to contain an outbreak of the mosquito-borne virus that claims hundreds of lives annually in Southeast Asia,” the Wall Street Journal’s “Southeast Asia Real Time” blog reports. “The total number of dengue deaths for the year now stands at 79, more than double the 34 deaths recorded in 2012,” the blog writes, adding, “Cases of the virus have also spiked, with 37,698 dengue cases reported as of December 7, an 85 percent increase from the 20,387 cases reported in the same period a year earlier, according to data from Malaysia’s Health Ministry.” According to the blog, “To keep the mosquito population in check, Malaysia’s health ministry is searching thousands of premises around the country to identify potential breeding grounds and is urging the public to drain stagnant water from around their houses. It has also pressed non-profit organizations to boost efforts to educate the public about keeping their premises clean and mosquito free” (Gangopadhyay, 12/16).

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Mobile Money Program Helping Fight Malnutrition In Guatemala

“Known as mobile money, electronic currency can be stored on a mobile phone and, using a personal identification number, converted into cash at designated points and transferred to other mobile phone users,” which facilitates “[g]etting cash … to remote rural communities after a natural disaster like an earthquake or a hurricane,” the Thomson Reuters Foundation/Christian Science Monitor reports. “In Guatemala, which has high levels of child malnutrition, families facing or experiencing hunger are now receiving cash in this way on their mobile phones, thanks to a project in which mobile phone operator Tigo and the charity Oxfam in Guatemala have teamed up to help families in the eastern province of Chiquimula,” the news service writes. “Tigo and Oxfam plan to ramp up the use of mobile money in Guatemala, which is vulnerable to climate change and natural disasters,” the news service states (Moloney, 12/16).

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Rapid Deployment Of Health Workers Lowers Child Mortality In Mali

The New York Times reports on a study published last week in PLOS ONE showing the rapid deployment of community health workers in Yirimadjo, Mali, helped create “a 90 percent drop in deaths among young children from 2008 to 2011.” Lead author Ari Johnson of the University of California San Francisco School of Medicine “argued that the additional expenditure amounted to only $8 per resident per year,” the New York Times notes, adding, “When added to the $45 per person Mali normally spends on health, he said, that is ‘well within the range’ of normal health spending in Africa — less than is spent, for example, in Rwanda and Senegal” (McNeil, 12/16).

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Editorials and Opinions

Leadership Like Mandela's Can Help Transform HIV/AIDS Epidemic Globally

“We are indebted to [Nelson] Mandela for his leadership role in making HIV/AIDS in sub-Saharan Africa an issue that the world could no longer ignore. Mr. Mandela’s speech at the International AIDS Conference in Durban in 2000 changed the course of the epidemic in both his country and the continent,” Sharon Lewin, a professor at Monash University and local co-chair of the XX International AIDS Conference (AIDS2014), writes in the Huffington Post U.K.’s “Impact” blog. “I can’t help thinking that the kind of political leadership he demonstrated on the epidemic is sorely needed in the Asia Pacific today if we are to even get close to universal access to treatment, prevention and care for those most affected by HIV/AIDS,” she states. “Even in these tough economic times, it is this kind of vision and leadership being shown by President Obama that I hope will continue to transform the epidemic globally. Just as Nelson Mandela did for Africa. Just as Doa Aung San Suu Kyi is doing in her beloved Burma. If only we had leaders like this in every century … and in every country,” she concludes (12/17).

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MAMA Helping Women Through Pregnancy, With Childbearing

Sharon D’Agostino, vice president of Corporate Citizenship at Johnson & Johnson, writes in the Huffington Post’s “Global Motherhood” blog about MAMA South Africa, a program “launched with the support of global partners USAID, Johnson & Johnson, the United Nations Foundation, the mHealth Alliance, and BabyCenter.” She notes, “In addition, Vodacom joined the South Africa partnership, offering MAMA’s mobile website, askmama.mobi, free of charge to its 25 million customers.” D’Agostino recounts the experiences of four women with MAMA, and adds, “The goal of MAMA is to deliver health messages that moms need at specific milestones during pregnancy and during the first year of their baby’s development” (12/16).

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All Health Workers In Rural Africa Should Have Access To Bikes For Transportation

In a CNN opinion piece published as part of a series produced in association with the Skoll World Forum “on people who are finding new ways to help solve the world’s biggest problems,” Andrea Coleman and Barry Coleman, co-founders of Riders for Health, an organization that helps health workers in Africa reach more people, write that every health worker who serves rural communities in Africa should have a bike for transportation. “They don’t earn much money and often have to live hundreds of miles away from their families,” they note, adding, “Often they will walk. Walk for hours at a time. In the sun or rain, across tough terrain, carrying whatever they can manage.” They continue, “The situation was unacceptable and made us angry. It is why we re-mortgaged our home and gave up our careers to start Riders for Health.” The Colemans discuss their work with the organization, which “now has programs in seven countries, transforming health care for 14 million people” (12/15).

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From the Global Health Policy Community

Multilateral Banks Could Support LMICs' Anti-Tobacco Policies

Noting a recent report in the New York Times about “Big Tobacco’s use of international trade and investment agreements to undermine anti-tobacco policies in low- and middle-income countries [LMICs],” Amanda Glassman, senior fellow and director of global health policy at the Center for Global Development (CGD), and Bill Savedoff, a senior fellow at the center, write in CGD’s “Global Health Policy” blog, “[A]gencies like the World Bank could use their money, technical assistance and policy dialogue to support cost-effective and inexpensive tobacco control measures.” They conclude, “While the [U.S. Trade Representative] should pursue the sensible strategy laid out by Tom Bollyky at the Council on Foreign Relations, trade is an indirect way to get at the problem. What we really need is for the World Bank, the IMF, the regional development banks and others to provide big visible support for developing countries to implement their anti-tobacco policies. That’s the strongest way to face down the Tobacco Bullies” (12/16).

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Provide 'The Gift Of Vaccines' To All Children Globally

In a post in the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog, José Esparza, a senior adviser on global health and vaccines at the foundation, reflects on the “miracle of vaccination,” which he notes led to the eradication of smallpox in 1980 and has “been critical in reducing the under-five child mortality, from 20 million in 1960 to 6.6 million in 2012.” He states, “That is a real miracle, but we have to get better — our New Year resolution should be to extend the gift of vaccines to all children in the world,” adding, “The next big challenge we have today is to eradicate polio, with vaccines that were originally developed in the 1950s and 60s.” He concludes, “We have come a long way in vaccination since the 1930s …, but there is still a long road ahead to ensuring that all children receive the life-saving vaccines they need” (12/16).

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Food Is A Global Health Issue

Writing in the PLOS “Translational Global Health” blog, Alessandro Demaio, an Australian medical doctor, examines the links between food and global health and provides five reasons “why food is, and must be, a global health issue.” He discusses the emergence of food-related disease, such as diabetes, heart disease and some cancers; examines the relationship between poverty and malnutrition; states the quality of diets can be “an enormous opportunity for creating a healthier future — if managed appropriately”; discusses the influence of top food companies on population health as well as policy development; and notes “there is a growing disconnect between food, cooking and people” (12/16).

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Women's Rights Linked With AIDS Epidemic In Africa

In a post in the Open Society Foundations blog, Tamar Ezer, a senior program officer in the law and health initiative of the group’s public health program, examines the relationship between women’s rights and AIDS in Africa, writing, “Women in Africa are routinely deprived of rights to land, property, and housing — a situation contributing to, and worsened by, the AIDS epidemic.” She notes, “Last month, however, the African Commission on Human and Peoples’ Rights (the main regional human rights body in Africa) [took] a stand on the side of justice,” and she highlights two resolutions urging countries to “‘protect and promote women’s right to land and property’ and ‘to put in place mechanisms to ensure that women living with HIV are not subjected to coercion, pressure or undue inducement by health care providers … in order to secure consent for sterilization'” (12/16).

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Report Examines HIV, TB Treatment Access In Ukraine

The Center for Global Health Policy’s “Science Speaks” blog provides an overview of a new report from the Ukrainian Anti-corruption Action Centre and All Ukrainian Network of People Living With HIV/AIDS that looks at HIV and tuberculosis treatment access in the country. The report examines the public procurement system and “makes recommendations to reform the national system, as well as broader recommendations for international actions,” the blog notes (Barton, 12/16).

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