KFF Daily Global Health Policy Report

In The News

Double Burden Of Malnutrition Impacting 1 In 3 Low-, Middle-Income Nations, Lancet Series Shows

The Guardian: Malnutrition and obesity now a global problem, say experts
“…Experts warn of a double burden of malnutrition, with underweight and obese children living in the same communities and even within the same families. One in three low- and middle-income countries are now affected, according to experts led by the World Health Organization. The root of both problems is the same — a dearth of nutritious food. … A series of papers in the Lancet medical journal by experts including the WHO says more than a third of low- and middle-income countries are now affected by the double burden of malnutrition. The authors call for action to improve the food supply and protect children’s health…” (Boseley, 12/16).

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Children In Low-, Middle-Income Countries Prescribed Excessive Amounts Of Antibiotics, Study Shows

IBT Singapore: Children from lower and middle-income countries are on excessive antibiotics, says study
“At a time when concerns about increasing antibiotic resistance across the world are on the rise, a new study claims that children in low and middle-income countries (LMICs) are receiving excessive antibiotic prescriptions, which could exacerbate the problem. The study published by researchers from the Swiss Tropical and Public Health Institute (Swiss TPH) and Harvard TH Chan School of Public Health says that children from LMICs — within the first five years of their lives — receive 25 antibiotic prescriptions on an average. This can adversely affect the ability of their immune systems to combat disease-causing pathogens and increase resistance to antibiotics…” (Biswas, 12/16).

PTI/The Week: Over-prescription of antibiotics puts children in poor countries at risk, says Lancet study
“…In the first-of-its-kind study, published in the journal The Lancet Infectious Diseases, the researchers looked at the total antibiotic prescription given for children under the age of five in eight LMICs—including Nepal, Namibia, Kenya, and Haiti. … Citing a prior study for comparison, they said, children under five in Europe receive less than one antibiotic prescription per year on average. ‘This number is still high given that the vast majority of infections in this age group are of viral origin,’ said Valerie D’Acremont, a study co-author from the Swiss Tropical and Public Health Institute in Switzerland…” (12/16).

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Global Gender Equality Will Take Another Century At Current Pace, WEF Report Says

CNN Business: Global gender equality will take another 100 years to achieve, study finds
“Most of us won’t live to see gender equality achieved worldwide, according to a new study, which predicts the milestone is almost 100 years away. The World Economic Forum’s annual Global Gender Gap Report ranked Iceland as the most gender-equal country for the 11th consecutive year, followed by its Nordic neighbors, Norway, Finland, and Sweden. Syria, Pakistan, Iraq, and Yemen ranked lowest…” (Yeung, 12/17).

The Guardian: U.K. falls six places in gender equality rankings
“… ‘This year’s report highlights the growing urgency for action,’ said Klaus Schwab, the founder and executive chairman of the WEF. ‘Without the equal inclusion of half of the world’s talent, we will not be able to deliver on the promise of the fourth industrial revolution for all of society, grow our economies for greater shared prosperity, or achieve the U.N. Sustainable Development Goals. At the present rate of change, it will take nearly a century to achieve parity, a timeline we simply cannot accept in today’s globalized world, especially among younger generations who hold increasingly progressive views of gender equality’…” (Neate, 12/16).

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More Than 40 People Killed In DRC Violence Over Weekend, Hindering Ebola Outbreak Response Efforts

CIDRAP News: More violence in Beni as DRC tracks new Ebola cases
“Over the weekend at least 43 people, including a pregnant woman, were killed in Beni, one of the epicenters of the Democratic Republic of the Congo’s current Ebola outbreak, as officials tallied eight new cases of the deadly disease. … The violence has made contact tracing and vaccination difficult, and have since led to an uptick of cases just weeks after WHO officials said the outbreak was almost contained…” (Soucheray, 12/16).

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Dengue Thriving In War-Torn Yemen, Health Workers Say

Reuters: Dengue fever finds breeding ground in war-weary Yemen
“…Mosquito-borne dengue is the latest challenge facing Yemenis who have endured almost five years of a conflict that has killed thousands, pushed millions to the brink of famine, and caused major cholera outbreaks. … Medical staff in Yemen said the disease is thriving among crowded populations of people displaced and weakened by war living in unsanitary conditions…” (Rajehy et al, 12/16).

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Washington Post Examines Plight Of Indian Workers Who Clean Toilet Sewers By Hand

Washington Post: Down in the pits: Modi’s cleanliness drive has made little difference for those who toil in India’s sewers
“…Indian Prime Minister Narendra Modi has received international plaudits for his campaign to build millions of toilets across the country. But the cleanliness drive has failed to eliminate the country’s most stigmatized and hazardous sanitation work: dealing with human waste by hand. … Despite a 2013 law forbidding the practice, cleaning sewers and removing blockages is still done by hand and without any safety equipment in many parts of the country. Employers who violate the law are not punished…” (Slater, 12/16).

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UNAIDS Dismisses Two Staffers After Investigation Into Sexual, Financial Misconduct; One Claims Action Is Retaliation For Sexual Assault Allegations

AP: U.N. AIDS agency fires whistleblower after misconduct probe
“The United Nations’ AIDS agency has fired two staffers for financial and sexual misconduct, including a whistleblower whose allegations of being sexually assaulted sparked months of turmoil at the organization. Last March, Martina Brostrom publicly accused a senior UNAIDS director of forcibly kissing her and trying to drag her out of a Bangkok elevator in 2015. She also said he had sexually harassed her on other occasions…” (Cheng, 12/17).

CNN: U.N. worker who accused official of sexual assault has been fired
“…Reached for comment, UNAIDS did not confirm the firing of Brostrom but told CNN that ‘two staff members were dismissed from UNAIDS after an independent investigation proved beyond reasonable doubt, that they had misused UNAIDS corporate funds and resources and had engaged in other misconduct, including sexual misconduct.’ ‘Any claims of retaliation are baseless and misleading,’ UNAIDS spokeswoman Sophie Barton-Knott told CNN…” (Krever, 12/17).

The Guardian: U.N. #MeToo whistleblower sacked for alleged sexual and financial misconduct
“…Brostrom denies the claims, adding: ‘My performance and professional integrity has never been questioned during my 14 years with UNAIDS, as [is] reflected in my performance appraisals.’ She added that she believes her dismissal is an act of ‘retaliation,’ and that she was not aware that she was subject to an investigation until she was contacted by the media this year. ‘I spoke up about what happened to me and what was happening in UNAIDS. As a consequence, I have suffered tremendously,’ Brostrom said in a statement…” (Ratcliffe/Beaumont, 12/16).

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More News In Global Health

CIDRAP News: Samoa extends measles emergency (Schnirring, 12/16).

Devex: Q&A: Local leadership is ‘only hope’ for SDGs, says mayor of Sierra Leone’s capital (Cheney, 12/17).

The Independent: Gabon becomes 70th country to make gay sex illegal (Savage, 12/14).

Infection Control Today: Quick Hit: A Conversation With Anthony Fauci, MD: What Challenges Face Infection Preventionists in the Coming Year (Diamond, 12/16).

U.N. News: Nine children killed or maimed in Afghanistan every day: U.N. Children’s Fund (12/16).

Xinhua: Kenya sees progress in malaria elimination (12/17).

Xinhua: Sri Lanka to experiment genetically altered breed of mosquito to combat dengue (12/17).

Xinhua: Over 5,600 malaria cases recorded in Laos in 2019 (12/17).

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Editorials and Opinions

Sen. Rubio, U.S. Congress Should Pass End TB Now Act Of 2019 To Help Combat Disease Globally, Opinion Piece Says

Orlando Sentinel: Rubio should co-sponsor bill to fight tuberculosis worldwide
Rachel Miller, student at the University of South Florida majoring in public health and volunteer with Partners in Health

“…If we know how to drive down TB rates, why is TB still the biggest infectious disease killer globally? 10 million will fall sick — and 1.5 million will die — during this year, and countries like Lesotho have rates of 665 cases per 100,000 people. … Unlike in all 50 states in the U.S., treatment in developing countries is much more scarce and less comprehensive, if existing at all. But, a solution exists in the form of legislation introduced [in August] in the Foreign Relations Committee. The End TB Now Act of 2019 establishes new goals for the United States to employ prevention and treatment efforts based on the latest scientific data to give access and improve the prevention of tuberculosis globally. … I urge Sen. Marco Rubio to co-sponsor The End TB Now Act of 2019 because of the impact it could have to end this disease worldwide. He has been supportive of efforts to stop tuberculosis in the past. I hope we can all count on him because the time to end tuberculosis is now” (12/16).

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Fellowships, Collaborations Foster Equity In Global Health Workforce, Atlantic Institute Senior Fellows Write In Opinion Piece

IPS: Four Lessons to Reverse Inequity in the Global Health Workforce
Ifeanyi Nsofor, medical doctor, CEO of EpiAFRIC, and director of policy and advocacy for Nigeria Health Watch, and Shubha Nagesh, medical doctor and director of the Research, Community follow-up and Autism Assessment Programs at the Latika Roy Foundation

“…From our combined experiences of benefiting Erasmus Mundus Fellowship, Ford Foundation International Fellowship, Aspen New Voices Fellowship, and Atlantic Fellowship, there are four lessons that the global health community can learn to gradually reverse the inequity in global health workforce. First, talent is universal, but opportunities are not. … Fellowships help create platforms for development experts from different countries to interact … Second, prioritize women in global health workforce appointments because women face more inequities than men. … Third, fellowships can amplify global south voices on the global stage. … Fourth, collaborations are for life and reduce inequities. … The world must realize that fostering a global village requires that different geographical locations do not attempt to solve problems alone. … As Senior Fellows for health equity at the Atlantic Institute, we will collaboratively continue to advance fairer, healthier and more inclusive societies” (12/16).

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Implementing Multiple Micronutrient Supplementation Worldwide Could Improve Pregnancy Outcomes, Maternal, Child Health, Opinion Piece Says

Devex: Opinion: Engaging nutrition to improve pregnancy outcomes
Klaus Kraemer, managing director of Sight and Life and adjunct associate professor at the Johns Hopkins Bloomberg School of Public Health

“…For mothers, ensuring a healthy pregnancy limits the risk of life-threatening complications. And for their children, good nutrition during pregnancy can be the difference between being born healthy and being born physically or mentally disadvantaged. … [I]t is imperative that we reach women and girls with effective interventions for improving maternal nutrition that are ready for global scale-up now. Multiple micronutrient supplementation, or MMS, during pregnancy could be one way to help meet maternal nutrition needs. … [P]opulations that would especially benefit from MMS are those in countries with a high prevalence of anemia or underweight in women of reproductive age. … Implementing MMS globally would save lives and give more babies the healthy start they deserve, no matter where they live. … Collaboration is key: Governments, civil society, and the private sector must work together to build a supply of MMS at a high quality that is readily accessible and affordable” (12/17).

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Women In Sahel Need Tools, Knowledge To Improve Farming Practices, Nutrition, End Malnutrition, Opinion Piece Says

Thomson Reuters Foundation: OPINION: How women hold the power to end malnutrition in the Sahel
Peter Gubbels, co-founder of Groundswell International and director of Action Learning and Advocacy for West Africa

“…Women, as wives and mothers, are the invisible hand that shape a family’s nutrition and diets in the Sahel. Yet, in a region largely reliant on family farming, they are often excluded from decision-making, and deprived of the means to produce food, or earn an income. … But, studies have found that women, once empowered through land and credit, invest into improving the health, well-being, and education of their families, much more than their male counterparts. If women across the Sahel had their own land to farm, as well as the knowledge of a diverse and nutritious diet, they would be able to greatly improve the nutrition and health of their families as well as the wider community. … At the very least, farming families should be able to improve nutrition from their land and locally produced nutrient-rich crops. This, more often than not, starts with women. If she is given the right tools, knowledge and resources to do so, her entire family and the wider community benefit” (12/16).

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From the Global Health Policy Community

Duke Policy Experts Examine Health Financing As Countries Transition From Lower- To Middle-Income

Brookings: What happens to health financing during the middle-income transition?
Ipchita Bharali, policy associate with the Center for Policy Impact in Global Health at the Duke Global Health Institute, and Indermit Gill, nonresident senior fellow in Global Economy and Development and professor of the practice of public policy at Duke University, examine health financing transitioning as countries move from lower- to middle-income levels. The authors examine external funding and domestic funding, as well as private and out-of-pocket spending. They note, “Duke University’s Center for Policy Impact in Global Health is partnering with think tanks and universities in sub-Saharan Africa and South Asia to better understand health financing and delivery in countries at various stages of transition from donor financing…” (12/16).

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Action Against Hunger, WaterAid, World Bank Conference Session Summary Examines WASH, Nutrition Evidence, Impacts For Programming, Policymaking

Action Against Hunger: What Does Evidence on Nutrition and Water, Sanitation, and Hygiene Mean for Program and Policy?
“This past year has seen a lot of debate around major studies on the impact of water, sanitation and hygiene (WASH) interventions on childhood stunting, which is when a child experiences reduced growth rate and development due to chronic malnutrition. What are the implications of new evidence for nutrition programming and policy? Below, Action Against Hunger, WaterAid, and the World Bank share outcomes from a session on collaboration and partnership at the University of North Carolina WASH and Health conference…” (12/16).

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Paper Examines Hunger-Focused SDG 2, Discusses Progress, Challenges, Strategies To Meet Goal

ECDPM: The global institutional landscape of food and agriculture: How to achieve SDG 2
Francesco Rampa, head of team, and Koen Dekeyser, junior policy officer, both with the Sustainable Food Systems Programme of the Economic and Agricultural Transformation Programme at ECDPM, summarize their paper authored with other experts examining Sustainable Development Goal (SDG) 2, focused on hunger. The summary states, “The world is not on track to meet Sustainable Development Goal (SDG) 2. Hunger has risen for the fourth year in a row, fueled particularly by growing food insecurity in sub-Saharan Africa. Achieving SDG 2 requires urgent action at country level, but also a more effective food and agriculture global institutional landscape. This paper describes this landscape and its challenges and looks at ongoing reform efforts and their shortcomings” (December 2019).

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Article Discusses Health System Strengthening Agenda Setting In Guinea

BMJ Global Health: ‘Never let a crisis go to waste’: post-Ebola agenda-setting for health system strengthening in Guinea
Delphin Kolie with the Centre National de Formation et de Recherche en Santé Rurale de Maferinyah in Forécariah, Guinea, and colleagues address health system strengthening in Guinea following the West African Ebola outbreak. The article’s abstract states, “Guinea is a country with a critical deficit and maldistribution of healthcare workers along with a high risk of epidemics’ occurrence. However, actors in the health sector have missed opportunities for more than a decade to attract political attention. This article aims to explain why this situation exists and what were the roles of actors in the agenda-setting process of the post-Ebola health system strengthening program. It also assesses threats and opportunities for this program’s sustainability. … Domestic policy entrepreneurs must realize that agenda-setting of health issues in the Guinean context strongly depends on the construction of the problem definition and how this is influenced by international actors” (12/15).

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Blog Post Reviews Global Health Innovation Stories Of 2019

Global Health Technologies Coalition’s “Breakthroughs Blog”: A year in review: The global health innovation stories that shaped 2019
GHTC Senior Communications Lead Marissa Chmiola, GHTC Senior Program Assistant Ansley Kahn, and GHTC Policy and Advocacy Associate Julien Rashid write, “Two thousand nineteen was a tumultuous year for the global health community. From a major reorganization of the World Health Organization (WHO), to steps forward and backward in quashing the smoldering Ebola epidemic, to welcome approvals of new desperately needed health tools, 2019 took us on a topsy-turvy ride. Though the landscape may be constantly shifting under our feet, we at GHTC feel heartened by the clear evidence of our community’s shared progress and impact — and we remain emboldened by our belief that science serves and science saves. So, as the year comes to a close, we are taking a look back at the top global health innovation stories and news that shaped 2019…” (12/13).

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From the U.S. Government

CDC Center For Global Health Lists 5 Top Viewed Stories In 2019

Centers for Disease Control and Prevention: 5 Most Viewed Public Health Stories in 2019 from CDC’s Center for Global Health
“…The Center for Global Health works around the world on some of the most challenging issues and diseases affecting global health today. Before the end of 2019, we are counting down some of the biggest headlines of the year. Below are this year’s 5 most viewed stories. From preparing and responding to Ebola in Uganda to preventing the spread of waterborne diseases in Bangladeshi refugee camps, these stories offer a glimpse into the efforts, progress, and impact of CDC’s global work…” (12/16).

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