KFF Daily Global Health Policy Report

In The News

U.S., International Community Announce Global Fund Contributions; Obama Announces $100M For HIV Research, Signs PEPFAR Reauthorization

“President Obama pledged Monday to give up to $5 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria over the next three years, saying that an ‘AIDS-free generation’ may be within reach,” the Washington Post reports (Cha, 12/2). “Obama made the announcement … at a White House event marking World AIDS Day, which was Sunday — and as health leaders and philanthropists gathered in Washington to determine how to replenish the major global health fund,” the Associated Press writes (Neergaard, 12/2). According to Reuters, “the president said the United States would contribute $1 for every $2 pledged by other donors over the next three years to support the [fund],” up to $5 billion (Felsenthal, 12/2). “Bill Gates, co-founder of the Bill & Melinda Gates Foundation, spoke after President Obama and announced a major new contribution to the Global Fund, committing up to $500 million for the 2014-2016 period,” a Global Fund press release states (12/2). Secretary of State John Kerry spoke at a Global Fund partnership symposium on Tuesday, according to a separate Global Fund press release (12/2). The E.U. announced “new support of over $500 million,” the Delegation of the European Union to the United States writes in a press release (12/2). Canada increased its contribution “to $650 million over three years — up from $500 million,” the Globe and Mail reports (Galloway, 12/2). In two press releases, the Global Fund examines contributions from Japan as well as the private sector (12/2).

At the White House event, Obama “said he is steering $100 million to the [NIH] for research into a cure for HIV/AIDS, a prospect about which some scientists are increasingly optimistic, despite huge challenges,” the Wall Street Journal notes (McKay/Favole, 12/2). He also “signed legislation enacted last month to extend the 10-year-old [PEPFAR program], started by President Bush,” according to NPR’s “Shots” blog. “Obama boasted that PEPFAR has exceeded the goal — thought to be ambitious when he set it on World AIDS Day two years ago — of getting anti-HIV treatment to six million people in developing countries,” the blog notes (Knox, 12/2). “[W]e have helped 6.7 million people receive lifesaving treatment and we’re going to keep at it,” Obama said, according to the speech transcript (12/2). “Members of Congress and activists including Archbishop Desmond Tutu had called on the administration to commit to double the reach of [PEPFAR] over the next few years, but Obama made no such announcement on Monday,” Politico notes (Epstein, 12/2). “The president also said he first seeks to name a replacement for Ambassador Eric Goosby, who until October served as the U.S. global AIDS coordinator tasked with administering PEPFAR, before setting a new target for the program,” according to USA TODAY (Madhani, 12/2).

Additional coverage is available from Agence France-Presse, CNN’s “Political Ticker,” CQ HealthBeat, The Hill, New York Times, NBC News, United Press International, VOA News, and the Wall Street Journal.

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Lancet Commission Calls For Increased Investment In Health To Remove Disparities Among Rich, Poor Nations

“Health disparities between rich and poor nations could be banished in a generation by investment in research, vaccines and drugs to combat diseases such as AIDS, malaria and tuberculosis, global health experts said on Tuesday,” Reuters reports. “The report also recommended taking bold preventative steps in public health, such as increasing taxes on tobacco and other substances that can be harmful, like alcohol and sugar,” the news agency notes (Kelland, 12/3). “Written by a group of 25 leading health experts and economists from across the globe and chaired by Larry Summers, a Harvard economist and former adviser to the Obama and Clinton administrations, the Lancet Commission report says ‘health disparities between nations could be eliminated within a generation’ if around $60 billion (£37 billion) a year was injected into health care systems,” The Guardian writes (Ramesh, 12/2).

Summers “said that governments and donors could create ‘a grand convergence’ and prevent 10 million avoidable deaths per year by 2035,” The Independent notes. Summers wrote, “For the first time in human history, we are on the verge of being able to achieve a milestone for humanity: eliminating major health inequalities, particularly inequalities in maternal and child health, so that every person on Earth has an equal chance at a healthy and productive life,” according to the newspaper (Cooper, 12/3). “The ‘convergence plan’ is summarized by the commission as ‘16-8-4’ — reducing under-five mortality to 16 per 1,000 live births, cutting annual AIDS deaths to eight per 100,000 population and bringing down annual tuberculosis (TB) deaths to four per 100,000 population,” The Guardian notes (12/2). “The report points to the success of the ‘4Cs’ — China, Chile, Cuba and Costa Rica — in reducing [mortality] despite starting from low-income levels in the 1980s,” BBC News adds (Dreaper, 12/2).

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Polio Outbreak In Syria Expected To Worsen; Refugees, Children Need Humanitarian Aid

The polio outbreak in Syria “has grown to 17 confirmed cases, the WHO said last week” and declared a polio emergency in the country, NPR’s “Shots” blog and “All Things Considered” reports. “The Syrian government has pledged to immunize all Syrian children under age five. But wartime politics is getting in the way. And the outbreak is expected to grow,” the blog writes (12/2). In addition, “[a]t least a million Syrians are going hungry, as fighting and checkpoints prevent aid deliveries, the international Red Cross warned on Monday,” Agence France-Presse/GlobalPost reports (12/2). “More than two million Syrians have fled their country’s civil war, now in its third year, seeking shelter in neighboring countries such as Jordan, Lebanon, Turkey and Iraq,” according to the Associated Press, which adds, “At least half of the refugees — 1.1 million — are children. Of those, some 75 percent are under the age of 12, according to the United Nations refugee agency.” A “65-page report issued Friday by the UNHCR highlighted the plight of the children, who are growing up in fractured families, missing out on education as they turn to manual labor, sometimes under dangerous or exploitative conditions, the report said,” the AP writes (Surk, 11/29).

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Hong Kong Reports First Case Of H7N9 Bird Flu

“Hong Kong has reported its first case of the H7N9 bird flu strain, in a possible sign the virus is spreading beyond mainland China since it first emerged there earlier this year,” the Associated Press reports (12/2). “A 36-year-old Indonesian woman who works as a domestic helper fell ill on November 21, four days after she bought, slaughtered and ate a chicken in mainland China’s Shenzhen City, Food and Health Secretary Ko [Wing-man] said” Monday, the Bangkok Post writes (12/3). The city on Monday “elevated the response level under its influenza pandemic preparedness plan to ‘serious,’ prompting public hospitals to activate a ‘serious response’ alert … and step up infection controls,” according to Bloomberg (Khan/Fellman, 12/3). “Secretary Ko said Hong Kong had suspended the import of live poultry from Shenzhen,” Agence France-Presse adds (12/2). “The case coincides with the 10th anniversary of the outbreak of Severe Acute Respiratory Syndrome, which killed nearly 300 people in Hong Kong and had a significant impact on the city’s travel and retail industry,” Reuters notes (Siu/Kwok, 12/2).

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Another 3 People In UAE Sick With MERS, 2 Die In Qatar, WHO Reports

“Another three people in the United Arab Emirates are sick with the Middle East respiratory syndrome (MERS) virus and two people infected with it in Qatar have died, the [WHO] said on Monday,” Reuters reports. “Human cases of MERS have so far been reported in Saudi Arabia, Qatar, Kuwait, Jordan, United Arab Emirates, Oman, Tunisia, France, Germany, Spain, Italy and Britain,” the news agency notes (Kelland, 12/2). “Globally, from September 2012 to date, WHO has been informed of a total of 163 laboratory-confirmed cases of infection with MERS-CoV, including 70 deaths,” according to a WHO press release (12/2).

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Reuters Examines Myanmar's Efforts To Improve Health Sector

Reuters examines efforts by Myanmar’s government to improve health in the country “as it ratchets up spending on the sector and seeks foreign investment to revive one of Asia’s sickest health care systems.” The news service writes, “In 2000, during the dark days of dictatorship, the [WHO] ranked Myanmar second-last out of 191 countries surveyed for ‘overall health system performance,'” adding, “By the 2009/2010 fiscal year, patients in Myanmar had to cover 81 percent of their health care costs themselves, the highest of any country in Asia, according to World Bank data.” Reuters notes, “The administration of President Thein Sein has cut military spending and raised health care funding to three percent of government spending this fiscal year to March 31, from one percent the previous year.” “Attracting foreign investment is part of an overhaul of the health care system by the quasi-civilian government that took over from the army in 2011,” Reuters writes (Ferrie, 12/2).

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More African Men Seeking Circumcision To Lower HIV Risk

“Circumcision for AIDS prevention is increasing rapidly in eastern and southern Africa, according to newly released figures,” the New York Times reports. “UNAIDS … said about 3.2 million African men had been voluntarily circumcised since word began spreading in 2007 of studies showing that it lowered the risk of infection by about 60 percent,” the newspaper writes, noting, “The goal is to circumcise more than 20 million by 2015” (McNeil, 12/2). VOA News examines the use of “the PrePex device, a non-surgical means to circumcise men,” in Rwanda and other African countries (Lewis, 12/2).

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Editorials and Opinions

Opinion Pieces, Editorial Address World AIDS Day

The following is a summary of opinion pieces and an editorial marking World AIDS Day, which was observed on Sunday, as well as a replenishment meeting for the Global Fund to Fight AIDS, Tuberculosis and Malaria’s taking place this week in Washington, D.C.

  • Georgia Arnold, Huffington Post’s “Impact” blog: “There are over 1.6 billion people between the ages of 12 and 24 years in the world today; if we can mobilize them in the fight against HIV, then we really do have an opportunity to turn the tide of this epidemic once and for all,” Arnold, executive director of the Staying Alive Foundation, writes (12/1).
  • Rose Caldwell, Huffington Post U.K. Blog: “As we approach World AIDS Day it is vital to highlight that people who live with HIV and AIDS in the developing world need to receive more than just medicine. They need nutritious food as well,” Caldwell, executive director of Concern Worldwide (U.K.), writes (11/29).
  • Joanne Carter, The Hill’s “Congress Blog”: “At this week’s Global Fund pledging conference, world leaders will help make [success against HIV/AIDS, tuberculosis, and malaria] a reality,” Carter, the executive director of RESULTS, writes. “If we were to miss this chance, not only would we lose lives and squander our progress, but also risk rebounding infection rates, growing drug resistance, and the epidemics outpacing the science to combat them,” she states (12/2).
  • Kevin Robert Frost and Sharon Stone, CNN: “[J]ust as a cure for HIV/AIDS is beginning to seem like a realistic proposition, the belt-tightening measures of the age of austerity could halt our momentum, cripple our progress and dash our hopes for ending AIDS in our lifetime,” Frost, the chief executive officer of amfAR, The Foundation for AIDS Research, and Stone, an actress and amfAR’s global fundraising chair, write. “Backpedal on AIDS, and you’ll pretty much guarantee that we’ll be dealing with it for generations to come,” they state (12/1).
  • Warner Greene, Los Angeles Times: “The scientific community has made tremendous strides against this disease,” Greene, a physician and the director of virology and immunology research at the Gladstone Institutes in San Francisco, writes, adding, “But it will take a renewed commitment of research funds if we are deliver on that hope. We are unlikely to put an end to the disease if we allow AIDS fatigue to take hold” (12/1).
  • Alicia Keys, Huffington Post’s “The Big Push” blog: “World AIDS Day reminds us all of the role we have in ending this disease: We can encourage our representatives to expand funding for PEPFAR and the Global Fund,” Keys, a singer and AIDS activist, writes. “Let’s be bold enough to imagine that in 10 years — 2023 — all people living with HIV in the world will have access to life-saving antiretroviral treatment,” she adds (12/1).
  • Rep. Barbara Lee (D-Calif.), Huffington Post’s “Politics” blog: “[N]ow is the time to redouble our efforts to support a strong $5 billion pledge for the Global Fund and new program targets for PEPFAR,” Lee writes, adding, “The ultimate goal of the end of AIDS, an AIDS-free generation, is achievable, if we remain committed to funding treatment and prevention programs, provide comprehensive sexual education to young people around the world, and continue to make AIDS funding a priority in Congress while searching for a cure and vaccine” (12/2).
  • Gayle Northrop, Thomson Reuters Foundation: “We can see an AIDS-free generation, in our lifetime — even in Africa, where 91 percent of the world’s HIV-positive children live. But this is only possible with skilled health staff and competent managers who can plan and coordinate the resources needed to orchestrate a continuum of care from pregnancy through delivery and beyond,” Northrop, associate director of Johnson & Johnson’s Partnership for Management Development, writes (12/1).
  • Brian Ssennoga and Amy McDonough, Huffington Post’s “Global Motherhood” blog: “As Global Health Corps fellows at the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), we are inspired by and want to build on the incredible efforts to make HIV/AIDS a menace of the past,” Ssennoga and McDonough write, adding, “On this World AIDS Day, it is time to make the entire world part of the project by making prevention of mother-to-child transmission of HIV a routine service and ensure that every single health center is on track to get new HIV infections to zero” (11/27).
  • James Whiting, Huffington Post U.K.’s “Impact” blog: “Our generation could end deaths from two of the greatest diseases mankind has ever faced, HIV/AIDS and malaria,” Whiting, executive director of Malaria No More U.K., writes. “Britain is willing and ready to commit funding which could put 750,000 people on life-saving antiretroviral therapy, distribute 35 million mosquito nets and help protect a million people from TB,” he states, and he calls on “other governments and donors need to step and share the responsibility” (11/29).
  • Philippine Star: UNAIDS “says it is beginning to control the global epidemic,” the editorial states, noting, “The focus of UNAIDS at this time is to promote AIDS prevention, treatment and care for young victims.” The newspaper writes, “Counseling and timely testing can go a long way in preventing the spread of HIV among vulnerable groups, according to UNAIDS. Getting to zero is not a far-fetched goal” (12/2).

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From the Global Health Policy Community

CGD Blog Highlights BBC's Coverage Of Global Fund

Writing in the Center for Global Development’s (CGD) “Global Health Policy” blog, Amanda Glassman, director of global health policy and a senior fellow at CGD, explains she was interviewed for a recent BBC “Panorama” show examining the Global Fund to Fight AIDS, Tuberculosis and Malaria. The show “will likely take a more critical view of the Global Fund than much of its recent press,” she writes. Glassman continues, “I’m glad the BBC is dedicating 30 minutes of its programming to the Global Fund. But I hope the message isn’t that the U.K. taxpayers — or those of any other donor country — should be weary of their government’s investment in the fund.” She concludes, “We aren’t better off without the Global Fund. We are better off with a better Global Fund. I hope this is reflected on the BBC program, as well in the pledges at the replenishment meeting on December 3. And most importantly, I hope this is reflected in greater progress against AIDS, TB and malaria in the months to come as we begin to see the results of recent Global Fund reforms” (12/2).

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AIDS.gov Blog Posts Address World AIDS Day

The AIDS.gov blog has published several posts in recognition of Worlds AIDS Day, observed annually on December 1. In the first post, Deborah Birx, director of the CDC’s Division of Global HIV/AIDS at the Center for Global Health, reflects on the theme for this World AIDS Day — Shared Responsibility: Strengthening Results for an AIDS-Free Generation (12/2). In a second post, HHS Assistant Secretary for Global Affairs Nils Daulaire examines the need for country ownership under PEPFAR (11/26). In a third post, Daulaire “celebrates the improved well-being of millions of people around the world living healthy and full HIV-positive lives,” and examines the need for health systems “to be prepared to address the long-term care needs of those living — sometimes for decades — with HIV” (12/2).

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USAID Supports 'One Stop Centers' For Victims Of GBV

One Stop Centers in Rwanda “offer critical integrated services to victims [of gender-based violence (GBV)], including immediate counseling, treatment, lab tests for HIV and other sexually transmitted diseases, and a physical examination by a doctor,” Triphine Muganyinka, gender coordinator for USAID/Rwanda, writes in USAID’s “IMPACTblog.” She adds, “Once exams are completed and evidence recorded, an onsite police officer submits the medical report to the court for legal proceedings.” The centers are supported by USAID’s Rwanda Family Health Project and the country’s Ministry of Health, she notes (12/2).

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U.S. Government Policy Prohibits Funding Legal Abortion Overseas

In a post in the RH Reality Check blog, Elizabeth Maguire of Ipas writes about the impact of U.S. government policy on women’s ability to access safe, legal abortion. “[F]or the past 40 years, USAID and its grantees have implemented the Helms Amendment as a complete ban on abortion,” she says, adding, “This means that in Ethiopia and in many other developing countries, health care facilities that receive U.S. government funds treat women only after they are already suffering or dying from a botched abortion, under the umbrella of sanctioned post-abortion care.” She continues, “The current restrictive interpretation of the Helms Amendment is at odds with U.S. domestic policy on abortion, whose allowance of government funding for abortion in cases of rape, incest, and life-endangerment is supported by even the most conservative members of Congress,” and she calls on the Obama administration “to correctly implement the Helms Amendment now, by allowing the U.S. Department of State and USAID to support abortion overseas in cases of rape, incest, or to save the life of the woman” (11/27).

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CGD Blog Reviews Recent AIDS News

Jenny Ottenhoff, a policy outreach associate for global health at the Center for Global Development (CGD), presents a round up of World AIDS Day news in the center’s “Global Health Policy” blog. She highlights events such as Congress’s passage of the PEPFAR Stewardship and Oversight Act of 2013, Ambassador Eric Goosby’s resignation as U.S. global AIDS coordinator, and several PEPFAR meetings, among others (12/2).

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MSF Criticizes Global Fund's Support For Tiered Pricing

“Médecins Sans Frontières (MSF) has warned the Global Fund to Fight AIDS, Tuberculosis and Malaria of the consequences of spearheading a new pricing initiative that could result in middle-income countries paying significantly higher prices for medicines to combat diseases, including HIV and tuberculosis,” an MSF news article states. “The Global Fund needs to reconsider its support for tiered pricing — people with HIV and TB can’t afford to pay a premium on the price of life-saving drugs,” Sharonann Lynch, HIV/TB policy adviser for MSF’s Access Campaign, said, adding, “Action is needed to improve access to drugs in middle-income countries, but the proposed approach of the Global Fund is not the answer and would ultimately only worsen the situation,” according to the article (12/2).

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Gates Delivers 2013 David E. Barmes Global Health Lecture

Bill Gates, co-chair of the Bill & Melinda Gates Foundation, on Monday presented the 2013 David E. Barmes Global Health Lecture at the Fogarty International Center in Bethesda, Md., according to a press release from the center (12/3). A video of the lecture, titled “Why the Future Needs Biomedical Innovation,” is available online (12/2).

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