KFF Daily Global Health Policy Report

In The News

Devex Examines Foreign Aid Funding In FY20 Conference Agreement

Devex: Budget bill includes small increase for foreign aid, but is it a win?
“While foreign aid funding saw a slight increase in the budget bill approved by the U.S. Congress Thursday, the negotiated numbers also reflect an unusual result — a final amount that is below what appropriators in both the House of Representatives and Senate had approved in their respective bills. The total appropriated for the foreign affairs budget is $54.7 billion, up $467 million from what was enacted in fiscal year 2019. But the amount is lower than budget bills approved by the House and Senate, which included $56.4 billion and $55.15 billion, respectively…” (Saldinger, 12/20).

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FDA Approves Merck Ebola Vaccine, First For U.S.

STAT: FDA approves an Ebola vaccine, long in development, for the first time
“The Food and Drug Administration announced Thursday it has approved an Ebola vaccine developed by Merck, making it the first for the deadly disease approved in the United States. The vaccine, Ervebo, protects against Zaire ebolaviruses, the species of the virus that has been the most common cause of Ebola outbreaks. Ebola Zaire is the virus responsible for the current long-running outbreak in the Democratic Republic of the Congo. The FDA’s decision follows similar action taken earlier by the European Commission, which licensed the vaccine on Nov. 11…” (Branswell, 12/19).

Additional coverage of the vaccine’s approval is available from ABC, CNN, Fox News, and Reuters.

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World Bank Announces $2.2B Funding Package For Humanitarian, Development Needs In 14 Low-Income Nations Hosting Refugees

Devex: World Bank pledges $2.2B for refugees and host communities
“The World Bank has announced that it will offer up to $2.2 billion in grants over a three-year period for projects focused on refugees and their host communities. Known as the Window for Host Communities and Refugees, or WHR, the funding package aims to address the long-term development needs of displacement in 14 low-income countries that are hosting a significant number of refugees, including Uganda, Ethiopia, Pakistan, and Bangladesh. … The bank recognizes that there is an increasing overlap between development and humanitarian issues, said Axel van Trotsenburg, the World Bank’s managing director of operations, during the Global Refugee Forum in Geneva, where the funding was announced…” (Root, 12/19).

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WHO Reports 60% Drop In Cholera Cases In 2018 Due To Prevention, Control Efforts In Major Outbreak Areas

U.N. News: World Health Organization reports 60 percent drop in cholera in 2018
“International action to drive down cholera led to a 60 percent decrease in cases in 2018, compared with the previous year, the World Health Organization (WHO) reported on Thursday. This points to what the U.N. agency described as ‘an encouraging trend’ in prevention and control in major cholera hotspots such as Haiti, Somalia, and the Democratic Republic of the Congo (DRC)…” (12/19).

Additional coverage of the drop in cases is available from Xinhua.

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Attacks On Health Workers Slowing Progress To End Ebola Outbreak In DRC

NPR: Ebola Flares Up Amid Attacks On Health Workers In Congo
“The Ebola outbreak in Democratic Republic of Congo is flaring up again. After several attacks on health workers, responders are still struggling to get back into areas where the disease is spreading…” (Aizenman, 12/20).

VOA: WHO: Insecurity, Poor Access Delay End of DR Congo Ebola Outbreak
“…The latest reports put the number of confirmed cases at 3,354, including 2,218 deaths. Health officials are concerned progress made against the Ebola outbreak in the North Kivu and Ituri provinces could come undone because of ongoing fighting among dozens of armed groups…” (Schlein, 12/19).

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Pakistan Reports More Than 100 Polio Cases In 2019; 125 Cases Recorded Globally, More Than 4 Times Number Than Year-To-Date 2018

Dawn: 7 new polio cases take national total to 111 this year
“Seven new cases of polio have been reported from across the country, taking the overall tally of polio cases in the country this year to 111…” (Khan, 12/19).

Outbreak News Today: Pakistan wild polio cases top 100, Global cases quadruple 2018 numbers
“…In addition to the cases in Pakistan, neighboring Afghanistan — the second of three remaining polio endemic countries — two WPV1 cases were reported in the past week, … bringing the total number of WPV1 cases reported in 2019 to 24. Globally, 125 WPV1 cases have been reported, more than four times as many cases as 2018 at this time (30)…” (12/19).

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HIV Infections Among Children In Pakistan Caused By Unsafe Injections, Contaminated Blood Supplies, Study Shows

AP: Pakistan study blames HIV outbreak in kids on bad healthcare
“A group of Pakistani doctors blames a recent outbreak of HIV among children in a southern city on poor healthcare practices such as using dirty needles and contaminated blood, according to a statement released Friday…” (Gannon, 12/20).

The Guardian: Pakistani children infected with HIV ‘exposed to unsafe jabs’
“…A paper in the Lancet Infectious Diseases medical journal reports the findings from the study of more than 30,000 people in the town of Ratodero, who were tested for HIV after the outbreak became obvious in April…” (Boseley, 12/19).

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More News In Global Health

Devex: Preventing deaths from advanced HIV disease: Highlights from ICASA 2019 (12/19).

IPS: Q&A: Initiative Starts Mental Health Sessions for Bangladeshi Garment Workers (Sadeque, 12/19).

Reuters: Water around Rio Tinto’s Madagascar mine is high in lead, uranium — study (Reid, 12/20).

Science: 2019 Breakthrough of the Year (Multiple authors, 12/19).

Xinhua: Dengue fever death toll climbs to 141 in Bangladesh this year (12/19).

VOA: Philippines Approves GMO Rice to Fight Malnutrition (Baragona, 12/19).

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Editorials and Opinions

Lancet Editorial Looks Back At Health, Medicine In 2019, Lessons Learned, Including Need For Political Will

The Lancet: Health and medicine in 2019: what have we learned?
Editorial Board

“2019 has been a tumultuous year in health and medicine. … Events this year have shown how closely politics and health are interconnected and how tension can run high. … We firmly believe that health is a political issue in everyday society. We will continue to cover issues in which politics and medicine intersect and when our concerns for human life warrant attention, whether they be regional conflicts or national crises. … Many ongoing health and medical events of 2019 might seem intractable, but they rest on political choices that are not. Civil society, particularly the younger generation, is energized and unwilling to risk their future and health by leaving decisions to ineffectual politicians. Their right to health and their determination for action, change, truth, and transparency are here to stay. If we can harness and build on civil engagement with evidence and knowledge, and maintain a flexible and progressive attitude to our thinking about health, we will be in a better position to advance health in 2020” (12/21).

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Opinion Piece Reflects On Outgoing E.U. Development Commissioner's Legacy, Looks To Future Cooperation

Devex: Opinion: European development cooperation has reached a fork in the road
Marissa Ryan, deputy director of advocacy at Oxfam International

“As Neven Mimica hangs up his boots as the European Union’s commissioner in charge of development cooperation, it is worth reflecting on his legacy and on whether the machine he steered is set to tackle future challenges under his successor, Jutta Urpilainen. Much is to be lauded when it comes to the E.U.’s engagement in development cooperation. For many years, it has been one of the last bastions of budget support … During his term, Mimica has sought to build bridges between the old-and-tested and the new-and-shiny. Much of what has been done over the last five years is a continuation of established best practice from a unique donor who had proven to be a decent partner to the countries it engaged with. But what he leaves behind is a shift away from the tried-and-true approach to new and shiny things that could fundamentally change how the E.U. engages in development cooperation. It will be up to Mimica’s successor to steer the ship through those waves now — and hope it doesn’t end up on the rocks” (12/20).

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NGOs Must Work Together To Eliminate HIV Transmission By 2030, Opinion Piece Says

Devex: Opinion: Collaborating to lead the region: HIV in Southeast Asia
Leow Yangfa, registered social worker and executive director of Oogachaga

“…[I]t is difficult to see how the region will meet the UNAIDS 2030 HIV elimination target. But it is not impossible, and nongovernmental organizations and civil society groups could be the key to change. … It thus falls upon Singapore’s NGOs and civil society groups to push for change and make a difference in HIV response, especially for the LGBTQI+ community. … By coming together to tackle HIV, more impact can be achieved. … For Oogachaga, we have learned the importance of collaborating with various stakeholders as we recognize, through our clients, the intersectionality that exists in Singapore, especially in the area of HIV, and we would advise others to do the same. … We urge communities around the world, especially here in Southeast Asia, to acknowledge your unique diversities and work inclusively to eliminate HIV transmission by 2030” (12/20).

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Rohingya Refugee Situation In Bangladesh Deserves More International Attention, Lancet Editorial Says

The Lancet: The Rohingya people: past, present, and future
Editorial Board

“Aung San Suu Kyi’s fall from grace is complete. Last week she gave an inhumane defense of Myanmar, a nation being tried for genocide, in a hearing at the International Court of Justice. But while events in The Hague monopolize the world’s attention, the appalling situation for the Rohingya refugees in Bangladesh is being neglected. … Sanitation is poor, food is scarce, and shelters are basic and overcrowded. Humanitarian agencies have brought some stability, but the health situation is precarious. … Meanwhile, a new generation is being born in the camps of Cox’s Bazar, a generation whose health and prospects are in jeopardy. Their future is uncertain. For the present, the very least we can give them is our attention” (12/21).

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From the Global Health Policy Community

GHTC Director Issues Statement On Congressional Passage Of End NTDs Act

GHTC: Federal Spending Package Includes Bill to Boost Fight Against Neglected Tropical Diseases
In a statement, Jamie Bay Nishi, director of the Global Health Technologies Coalition, discusses the passage of the End Neglected Tropical Diseases Act, which was included in H.R. 1865, the Further Consolidated Appropriations Act, 2020, passed by Congress on December 19, 2019 (12/19).

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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, has published Issue 370 of the ‘Global Fund Observer.’ The newsletter features articles on the Global Fund’s country allocations for 2020-2022, the results of an OIG audit on grants to South Sudan, and Executive Director Peter Sands’ call for increased domestic investments in health at a recent ICASA meeting in Rwanda (12/19).

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Midwives Play Important Role In Health Care, Panel At ICPD25 Hears

Woodrow Wilson Center’s Environmental Change and Security Program’s “New Security Beat”: ICPD25: Midwives are a Key Part of any Health Workforce Dream Team
Sarah Barnes, project director for the Wilson Center’s Maternal Health Initiative, discusses the role of midwives in maternal and child health care, summarizing comments from a midwifery panel at the Nairobi Summit on ICPD25 (12/19).

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From the U.S. Government

Sen. Chris Coons Outlines Global Health, International Development Priorities In FY20 Spending Bill

U.S. Senator Chris Coons: In 2020 spending bill, Sen. Coons secures funding for national security and international development priorities
“U.S. Senator Chris Coons (D-Del.), the first Delaware senator in more than 40 years to serve on the powerful Appropriations Committee, secured funding in the Fiscal Year 2020 federal spending bill to ensure the United States remains a global leader by investing in programs to promote national security, cultivate international development, and provide lifesaving global health assistance around the world. … The federal spending bill includes provisions that will ensure the United States remains globally engaged and continues to safeguard national interests and values around the world, including: The Global Fragility Act, Senator Coons’ bipartisan legislation to improve U.S. government efforts to prevent terrorism from taking root in developing countries around the world. $301 million to stand up the new Development Finance Corporation and implement the BUILD Act, Senator Coons’ bipartisan legislation to modernize U.S. development finance tools, double the U.S. lending capacity, and channel U.S. private sector investments to low-income countries around the world…” (12/19).

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CDC's MMWR Publishes DRC Ebola Outbreak Update; HHS Secretary Issues Statement On FDA Approval Of Ebola Vaccine

CDC’s “Morbidity and Mortality Weekly Report”: Ebola Virus Disease Outbreak — Democratic Republic of the Congo, August 2018-November 2019
Aaron Aruna of the DRC Ministry of Health and colleagues summarize the current status of the Ebola outbreak, including epidemiology reports and control efforts. The authors note, “Compared with earlier outbreaks, this outbreak is occurring in a context of armed conflict, and innovative approaches beyond the conventional Ebola response are needed. These approaches include the building of trust with communities amid insecurity, opportunistically timed intensive interventions during periods of relative stability, and intensive training of local residents to manage response activities, with periodic supervision by national and international personnel as a public health priority” (12/20).

HHS: HHS Secretary Azar Statement on FDA Approval of Ebola Vaccine
Following the FDA’s first-ever approval of an Ebola vaccine, Secretary Azar said, “The first-ever FDA approval of a vaccine for the prevention of Ebola is a triumph of American global health leadership. … When I led the U.S. delegation to Central Africa in September to learn more about the situation on the ground, we underscored that ending the Ebola outbreak is one of the top global health priorities for the Trump administration. We will continue strongly supporting the DRC government, other governments in the region, and the World Health Organization in their work until the Ebola outbreak is brought to an end, and we will continue working with governments around the world to prepare for and prevent such infectious disease outbreaks in the future” (12/19).

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New Issue Of NIH Fogarty International Center's 'Global Health Matters' Newsletter Available

NIH Fogarty International Center: FIC Global Health Matters
The most recent issue of the Fogarty International Center’s newsletter contains various articles addressing global health topics, including pieces on humanitarian care, HIV-associated non-communicable diseases, women living with HIV in Uganda and South Africa, and building Ebola-related research capacity in West Africa (November/December 2019).

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Study Of NIH-Developed Zika Vaccine Shows Improved Fetal Outcomes In Animal Model

NIH: NIH-developed Zika vaccine improves fetal outcomes in animal model
“An experimental Zika vaccine lowered levels of virus in pregnant monkeys and improved fetal outcomes in a rhesus macaque model of congenital Zika virus infection, according to a new study in Science Translational Medicine. … NIAID scientists developed the experimental vaccine and currently are evaluating it in a Phase 2 human clinical trial. … [Study authors] note that the ability of a vaccine to prevent persistent Zika virus infection may be an important consideration for future clinical research. Meanwhile, the animal model can be used to learn more about Zika virus transmission from mother to fetus and possible intervention strategies” (12/19).

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From KFF

KFF Updates Ebola Explainer, Analysis Of Donor Funding For Outbreak Response In DRC

KFF: The Current Ebola Outbreak and the U.S. Role: An Explainer (Moss/Michaud/Kates, 12/19).

KFF: Data Note: Donor Funding for the Current Ebola Response in the DRC (Moss/Michaud/Kates, 12/19).

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KFF Updates Legislation Tracker With Recent Appropriations Bill

KFF: U.S. Global Health Legislation Tracker
This tracker provides a listing of global health-related legislation introduced in the 116th Congress. Currently, there are more than 50 pieces of legislation related to global health. The tracker was updated with the recent appropriations bill (12/19).

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