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Kaiser Daily Global Health Policy Report

In The News

U.S. President Trump Expected To Sign Bill Reauthorizing PEPFAR

Wall Street Journal: Trump Set to Extend Program Aimed at Fighting AIDS
“The Trump administration is expected to sign a bill extending for five years a global aid program aimed at combating HIV/AIDS — and giving faith-based organizations an expanded role. Aid groups praised the decision to extend the mandate of the President’s Emergency Plan for AIDS Relief through 2023. Mr. Trump had repeatedly sought to cut funding to the program, known as PEPFAR, raising concerns among advocates that his administration might seek to block its extension…” (Donati, 11/30).

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President Trump Yet To Decide On Replacement For U.S. Ambassador To U.N. Nikki Haley

CNN: Trump struggles to replace Nikki Haley at the United Nations
“Almost two months after President Donald Trump said he would quickly name a replacement for Nikki Haley, he is still struggling to pick his next ambassador to the United Nations. … The new ambassador will take the position amid a roster of thorny global challenges, ranging from North Korea’s nuclear program to Yemen’s famine and the growing divide between the U.S. and its closest allies over the Iran nuclear deal, climate change, and other issues. … It remains to be decided whether the role remains a cabinet level post or is downgraded” (Gangel et al., 11/30).

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NIH Director Discusses Research In STAT Interview; 'Gene Drive' Research To Help Prevent Diseases Can Proceed With Caution, U.N. Group Says

STAT: NIH director says there’s work to do on regulating genome editing globally
“The apparent birth this month of the first genetically modified babies is ‘a lesson in the potential for human hubris to overtake us,’ Dr. Francis Collins, the director of the National Institutes of Health, told STAT Thursday, but he said there is little U.S. officials can do to influence how China sanctions the rogue scientist who claims to have led the ethically dubious scientific breakthrough…” (Facher, 11/29).

Washington Post: ‘Gene drive’ research to fight diseases can proceed cautiously, U.N. group decides
“Scientists hoping to fight diseases with genetically engineered organisms that spread their genes in the wild will be able to proceed cautiously under an agreement reached this week. That was the compromise outcome of a protracted debate, conducted in Egypt at a major U.N. conference on biodiversity, over a technology known as ‘gene drives’…” (Achenbach, 11/30).

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WHO Officials Discuss Ebola's Continued Spread In DRC; Other Experts Call On U.S. To Provide Specialists To Region

Al Jazeera: Q&A: Conflict, resistance hampering WHO’s Ebola efforts in DRC
“…Al Jazeera spoke to Dr. Matshidiso Moeti, regional director of WHO Africa, about the spread of the outbreak [in the Democratic Republic of Congo (DRC)], lessons learned from the earlier outbreaks, and what the future holds for health issues in Africa…” (Ghani, 12/2).

Associated Press: U.S. urged to send Ebola experts in as Congo outbreak worsens
“Global health experts are urging the Trump administration to allow U.S. government disease specialists — ‘some of the world’s most experienced’ — to return to northeastern Congo to help fight the second-largest Ebola outbreak in history. The U.S. experts have been sidelined for weeks, ordered away from the region because of State Department security concerns. Two top medical journals [last week] published commentaries calling on the U.S. to change its mind and send them back where they are sorely needed…” (Anna, 11/30).

STAT: As Ebola outbreak spreads in Congo, concern grows over supplies of experimental vaccine
“The Ebola outbreak in the Democratic Republic of the Congo appears to be spreading southward from its current epicenter at Beni, raising concerns it will take root in some larger population centers, including a major regional hub, warned a senior World Health Organization official. Should the outbreak spread more widely in cities … the scale of the outbreak could tax the available supplies of an experimental vaccine being used to help contain spread, said Dr. Peter Salama, who heads the WHO’s emergencies program…” (Branswell, 12/3).

Vox: Why the Ebola outbreak in DRC is so difficult to contain
“…To unpack how the outbreak got so bad, and what the WHO needs right now, I sat down with Peter Salama, the head of the new Health Emergencies Program at the WHO. His team was created in 2016 as a direct response to the WHO’s fumbling of the West Africa Ebola outbreak. This year alone, he’s helped the organization respond to 50 health emergencies in 47 countries…” (Belluz, 12/2).

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Polio Remains Public Health Emergency Of International Concern, WHO Committee Says

Devex: WHO says international spread of polio still a public health emergency
“The international spread of polio virus continues to be a problem four years after the WHO’s Emergency Committee designated it a public health emergency of international concern. The committee on Friday announced it would extend the emergency by another three months, after data showed an uptick in the number of polio cases worldwide in 2018, including a doubling in Afghanistan. The decision was made after the committee met at World Health Organization’s headquarters in Geneva on Nov. 27 to review the data on wild poliovirus cases and circulating vaccine derived polioviruses. The committee was also concerned that weakened immunization systems in several regions in Africa and Pakistan were leading to an increased risk of outbreaks…” (Ravindran, 11/30).

Additional coverage of this story is available from the Associated Press, Becker’s Hospital Review, CIDRAP News, CNN, Reuters, and VOA News.

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U.N., WHO, Media Outlets Recognize 30th World AIDS Day

U.N. News: World response to AIDS epidemic at a ‘critical juncture’
“Thirty years after the first World AIDS Day, the HIV response stands at a crossroads, U.N. Secretary-General António Guterres has said, marking this year’s commemorations. The direction taken now, may determine whether the epidemic can be ended by 2030, or if future generations will have to continue the battle, he said…” (11/30).

VOA News: WHO: Fear, Stigma and Ignorance Keep AIDS Epidemic Going
“As the 30th World AIDS Day approaches, the World Health Organization says fear, stigma, and ignorance are the reasons the AIDS epidemic is not over, because doctors can treat HIV, the virus that causes AIDS. With treatment, no one needs to die from AIDS, and those with the virus can’t give it to someone else. In addition, with prevention therapy, no one needs to get infected…” (Pearson, 11/30).

Additional coverage of World AIDS Day, the history of the epidemic, and advancements in treatment and prevention is available from ABC News, Al Jazeera, The Guardian, New York Times, Thomson Reuters Foundation, TIME (2), and USA TODAY.

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Conditions In Yemen Continue To Deteriorate, U.N. Says; Authorities Sterilizing Water Supplies To Stem Cholera Outbreak

Reuters: Yemen sterilizes Sanaa water supplies as cholera outbreak picks up again
“Authorities in the Houthi-held Yemeni capital Sanaa are sterilizing water supplies at wells, distribution networks, and houses to help stem the world’s worst outbreak of cholera…” (Khalid et al., 12/2).

U.N. News: Conditions deteriorating alarmingly in Yemen, warns senior U.N. official
“Conditions in Yemen have deteriorated alarmingly, and the country is on the ‘brink of a major catastrophe’ said Mark Lowcock — under secretary general for humanitarian affairs and emergency relief coordinator — on returning from his mission to Yemen on Saturday…” (12/1).

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More News In Global Health

Agence France-Presse: Papua New Guinea scrambles to vaccinate as polio returns (12/3).

BBC News: Namibia’s success in the fight against HIV (Carelse, 12/1).

CNBC: Malnutrition and obesity are ‘unacceptably high’ around the world, costing the world trillions each year: Global Nutrition Report (Galligan, 12/1).

The Guardian: Hope for male ‘pill’ breakthrough after huge cash injection (Boseley/Devlin, 11/30).

New York Times: ‘From Nothing to Gangbusters’: A Treatment for Sickle-Cell Disease Proves Effective in Africa (McNeil, 12/1).

New York Times: Quiet Casualty of Sri Lanka’s Political Crisis: A Sugar Tax (Ives, 12/3).

Reuters: Measles threat looms in Philippines as trust in vaccines declines: health officials (Mogato, 12/3).

Thomson Reuters Foundation: Domestic violence rates fall in parts of Latin America — U.N. (Moloney, 11/29).

SciDev.Net: The human face of digital health (Makri, 11/30).

VOA News: WHO: HIV Epidemic Spreads at Alarming Rate in Pakistan (Gul, 12/2).

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Editorials and Opinions

Opinion Pieces Recognize World AIDS Day

Forbes: 15 Years Later: How Well Are We Doing Addressing AIDS
Bill Frist, former U.S. Senate majority leader and founder and chair of Hope Through Healing Hands

“This World AIDS Day, we celebrate the astounding progress made in the past 15 years! … PEPFAR is about more than just diagnostics and drugs. PEPFAR is the flagship example of strategic health diplomacy, the idea that by addressing global health, America advances its own national strategic interests. Our investments in health serve America as well as the countries we help. This World AIDS Day, there is still work to be done. … It is our privilege and responsibility to continue creating a future where there was none before” (12/1).

STAT: To end HIV/AIDS, invest in community workers and other health care providers
Vanessa Kerry, CEO and co-founder of Seed Global Health

“…[T]he standard of HIV/AIDS prevention, treatment, and care remains woefully uneven because we simply have not invested enough in the people who serve on the front lines of communities hardest hit by, and most vulnerable to, HIV/AIDS. … We must invest where we have not fully ever done so before: in health workers on the front lines of HIV. We should: Invest in their training. … Invest in their mentorship. … Invest in their well-being. … Invest in retaining them in hard-to-reach places. … By doing that we not only create an opportunity for equity and progress, but also a path towards greater empathy, understanding, and compassion as better-equipped providers offer stronger, more confident care to the people in their communities” (11/30).

Washington Post: On World AIDS Day, why the politics of AIDS is so important
Amy S. Patterson, professor of politics at University of the South and author, Mark Daku, assistant professor of political science at Texas Christian University

“…From the outset, AIDS has been intensely ‘political.’ Power and inequalities shape vulnerability to HIV infection, and representation and decision-making processes affect resource allocation and policies. To end the AIDS epidemic by 2030, a goal set by the Joint U.N. Programme on HIV/AIDS, means analyzing the politics of the disease. … [M]eeting this goal will require learning from experiences in responding to the disease, including paying closer attention to socioeconomic, gender, and political inequalities. … [A] commitment to greater power and representation of marginalized groups may be more important than ever” (12/1).

USA Today: The AIDS crisis is not over. We need help from Trump and Congress to continue the fight.
Gayle E. Smith, president and CEO of The ONE Campaign

“…[U.S.] Secretary of State Mike Pompeo should ensure that his budget proposal is consistent with President Trump’s campaign commitments, continues funding the Global Fund at one-third of its total, and includes full funding for PEPFAR. Requesting an amount of money that supports a robust pledge to the Global Fund in the president’s budget is the best way to send a strong signal to other donors and ensure that other countries contribute their fair share. For the past 15 years, Republicans and Democrats, conservatives and liberals have stood as one in a decidedly non-partisan act of generosity and self-enlightenment. And as a result, we have made historic progress in the fight against AIDS. But we still have a long way to go. Our immense progress should be a feather in our cap, not our Achilles heel. Programs like the Global Fund and PEPFAR have made winning this fight possible. Complacency will make losing it inevitable” (11/30).

Additional opinion pieces discussing World AIDS Day are available from:

ABC News: World AIDS Day 2018: How far we’ve come and how far we still have to go (Kreafle, 12/1).

The Hill: We’re advancing to a cure after 30 years of HIV/AIDS treatment (Heimer, 11/30).

The Hill: Testing, knowing, treating — Taking action this 30th World AIDS Day (Tang, 12/1).

The Conversation: AIDS treatment has progressed, but without a vaccine, suffering still abounds (Miller, 11/30).

The Conversation: World AIDS Day: Let’s stop criminalizing HIV status (Timothy, 11/28).

Thomson Reuters Foundation: PrEP is the most effective HIV prevention tool we have (Hodson, 12/1).

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New Strategies To Engage Men In Prevention, Treatment Crucial To Controlling HIV Epidemic

The Lancet: Engaging men in HIV treatment and prevention
Adeola O. Adeyeye of the Division of AIDS at the NIH National Institute of Allergy and Infectious Diseases; Michael J. Stirratt of the Division of AIDS Research at the NIH National Institute of Mental Health; and David N. Burns of the Division of AIDS at NIAID

“…[U]nless we move beyond the status quo, the global community will fall far below the goal of ending AIDS. The vital step is implementation … And perhaps the greatest implementation challenge of all is engaging men. … New strategies are needed to improve the involvement of men in HIV prevention and care. … [T]reatment and prevention services that are designed and delivered in a way that engages men and affirms an individual’s masculinity could help. … Men form a crucial link in almost all HIV transmission networks, whether they partner with women, men, or both sexually and as fellow injection drug users. … No one prevention strategy will be sufficient to bring the epidemic under control, nor will focusing efforts on one target population or one gender. We must continue to expand programs to protect adolescent girls and young women from HIV infection, but we must not give up on reaching men. Success in controlling the HIV epidemic depends on it” (12/1).

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Food, Nutrition Security, Especially In Conflict Areas, Vital To Achieving Peace

Devex: Opinion: Malnutrition in conflict zones is rife — here’s how to save lives and build peace
Michael Klosson, vice president for policy and humanitarian response at Save the Children

“…Conflict has been repeatedly cited by the United Nations as a major driver of hunger in 2018. Failure to get nutritious food to children trapped in war zones has a double whammy long-term effect on a country’s development. Impaired development and poor health in children will result in lost gross domestic product when they become adults, with increased health care costs as they suffer from additional diseases. … Several lessons have been learned in recent years that can shape a better response today: 1. Addressing hunger and conflict requires a whole of government response … 2. Safeguarding and expanding access to vulnerable communities … 3. Sustaining humanitarian and development responses to malnutrition … 4. Cash aid can empower impacted communities to meet their needs … Food insecurity is a self-evident driver of instability and conflict. … But we can also flip this notion around and recognize that food and nutrition security is a foundation for peace. To foster peaceful and prosperous societies, we need to get food and nutrition security, particularly in conflict areas right” (11/30).

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From the Global Health Policy Community

Study In Lancet Global Health Examines Provision Of Post-Abortion Care In 10 Health Systems

The Lancet Global Health: Health systems’ capacity to provide post-abortion care: a multicountry analysis using signal functions
Onikepe O. Owolabi, senior research scientist; Ann Biddlecom, director of international research; and Hannah S. Whitehead, senior research assistant, all with the Guttmacher Institute, discuss results from a study examining the provision of post-abortion care at facilities that offer childbirth delivery services in 10 countries in three regions. The authors write, “The results highlight the gap between political commitments to address the consequences of unsafe abortion and the capacity of health systems to provide post-abortion care.” In a press release, Guttmacher notes, “The evidence from this study underscores the importance of increased government investments in their health care system to ensure that [post-abortion care] includes all of the critical components of care” (11/29).

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BMJ Editor, Colleagues Discuss Potential Implications Of Further Restrictions To Norway's Abortion Law

BMJ Opinion: Instrumentalizing women’s reproductive vulnerability for political gain: where in the world does it stop?
Sandy Goldbeck-Wood, editor in chief of BMJ Sexual and Reproductive Health, and colleagues discuss Norway’s abortion law and the debate surrounding potentially restricting abortion in the second trimester. The authors write, “The threat … is that any pregnant woman might find herself trapped with a second trimester anomaly diagnosis and no choice but to carry the pregnancy to term unless the anomaly were fatal” (11/30).

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December 2018 Issue Of WHO Bulletin Available Online

WHO: Bulletin of the World Health Organization
The December 2018 WHO Bulletin features articles on various topics, including an editorial on global health governance and the Sustainable Development Goals, an article discussing hepatitis in Europe, and research examining oral cholera vaccination in hard-to-reach communities (December 2018).

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FT Health Highlights 2 Climate Reports, Features Interview With Rotary International President On Polio Eradication

FT Health: Climate change and the threat to health
The latest issue of the Financial Times’ weekly global health newsletter highlights results from two reports released last week: the 2018 report of the Lancet Countdown on health and climate change and the Fourth National Climate Assessment. The newsletter also features an interview with Barry Rassin, president of Rotary International, who discusses polio eradication efforts, as well as a round-up of global health-related news stories (Dodd/Jack, 11/30).

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From the U.S. Government

U.S. Global AIDS Coordinator Recognizes World AIDS Day 2018, PEPFAR Achievements, Announcement

U.S. Department of State’s “DipNote”: World AIDS Day 2018 — PEPFAR Reauthorized and 17 Million Lives Saved
Ambassador Deborah Birx, U.S. global AIDS coordinator and U.S. special representative for global health diplomacy, recognizes World AIDS Day, which takes place annually on December 1, and discusses the achievements of PEPFAR, including the initiative’s latest results and congressional reauthorization. Birx also highlights the announcement of a U.S. investment of $100 million, “subject to congressional notification, [to] support innovative approaches to reaching young men, adolescent girls and young women, and HIV-positive children with HIV prevention and treatment services, including by leveraging the unique capacities and compassion of faith-based organizations and communities” (11/30).

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U.S. Agency Heads Release Statements Recognizing World AIDS Day 2018

USAID: U.S. Agency for International Development Administrator Mark Green on World AIDS Day (11/30).

HHS: Statement from HHS Secretary Alex Azar ahead of World AIDS Day (11/30).

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