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Kaiser Daily Global Health Policy Report

In The News

President Trump Expected To Nominate State Department Spokesperson Heather Nauert For U.N. Ambassador

NBC News: Trump expected to tap State Department spokeswoman Heather Nauert for new U.N. ambassador
“President Donald Trump is expected to announce Friday that he is nominating State Department spokeswoman Heather Nauert as the next U.S. ambassador to the United Nations, multiple sources familiar with the decision told NBC News…” (Alexander, 12/6).

New York Times: Heather Nauert, State Dept. Spokeswoman, Said to Be Trump’s Pick for U.N. Post
“…Ms. Nauert, a former Fox News anchor who has served as the public face of the State Department since last year, would replace Nikki R. Haley, who is stepping down as ambassador at the end of the year. If confirmed, Ms. Nauert would be one of the most prominent promoters of Mr. Trump’s ‘America First’ foreign policy…” (Baker/Haberman, 12/6).

POLITICO: Trump picks State Department spokeswoman for top U.N. post
“…Nauert’s apparent selection came as something of a surprise, since people close to the situation had previously said Nauert had fallen out of contention for the post after emerging as an early favorite…” (Johnson et al., 12/6).

Wall Street Journal: Heather Nauert’s Nomination as U.N. Ambassador Expected Soon
“…The position requires Senate confirmation. Ms. Nauert, 48, had little government or foreign policy experience before joining the State Department. She is a former ‘Fox & Friends’ anchor who joined the State Department in April 2017, and has served as spokeswoman for Mr. Trump’s original Secretary of State Rex Tillerson. She remained in the role when CIA Director Mike Pompeo was appointed to head the State Department, and has gained his confidence and support to take on the job at the U.N…” (Salama, 12/6).

Washington Post: Trump to nominate State Department spokeswoman Heather Nauert as the next U.N. ambassador
“…If confirmed by the Senate, the nomination would elevate a foreign policy novice into the top echelons of U.S. diplomacy as the Trump administration ramps up pressure against Iran and demands that allies take on more responsibility for their own security. … In her new role, Nauert would be responsible for maintaining international support for economic sanctions against North Korea and continuing the Trump administration’s unflinching support for Israel in the face of mounting scrutiny at the United Nations…” (Hudson et al., 12/6).

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Palestinian Refugees Face Crisis Due To U.S. Cuts, U.N. Official Says

The Guardian: ‘We need more food, not less’: U.S. cuts leave Palestinian refugees in crisis
“…Until last year, the U.S. donated roughly one-third of [the U.N. Relief and Works Agency’s (UNRWA)] $1.1bn (£861m) budget — easily the biggest contribution — to cover schooling, health care, and food aid for 5.3 million Palestinian refugees in Jordan, Syria, Lebanon, the West Bank, and Gaza. But the U.S. has decided to end funding, in what Matthias Schmale, UNRWA’s Gaza director, called an unprecedented politicization of aid which risks a ‘Yemen-style crisis.’ Emergency donations made by Britain and other countries to make up the shortfall left by the U.S. decision means schools and health clinics will stay open until next summer. But there are no guarantees that food aid, on which 77 percent of Gaza’s 1.3m registered refugees below the international poverty line depend, can be sustained beyond January, says Schmale…” (Macintyre, 12/7).

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Human Migration Constitutes Important Global Health Issue, UCL-Lancet Commission Says

CNN: Human migration is a pressing public health issue, report says
“Conservative rhetoric about migrants — like the group making their way through Mexico, the one President Donald Trump called an ‘invasion’ — might lead some to believe that migrants are a threat to American health, a strain on the health care system, and damaging to the economy. But a new series of papers presented at a U.N. Intergovernmental Conference this week and published Wednesday in the journal Lancet says that, based on evidence, that’s not true…” (Christensen, 12/5).

The Guardian: Myths about migrants spreading disease ‘inform hostile policies’
“Myths that migrants are responsible for spreading disease and a burden to health services have been used in support of the hostile and restrictive policies introduced in the U.S., U.K., and elsewhere around the world, a two-year commission has concluded. … The evidence shows that the risk of migrants transmitting TB to their host communities is low, the commission says. Their analysis shows that migrants who are usually working, studying, or have joined their families often have better health than the general population…” (Boseley, 12/5).

HuffPost: Migrants Don’t Pose A Threat To Public Health. That’s Just Racism, Report Says
“… ‘In too many countries, the issue of migration is used to divide societies and advance a populist agenda,’ Richard Horton, the editor of The Lancet, said in a statement. ‘Migrants commonly contribute more to the economy than they cost, and how we shape their health and wellbeing today will impact our societies for generations to come. There is no more pressing issue in global health’…” (Visser, 12/6).

NBC News: Migrants don’t bring disease. In fact, they help fight it, report says
“…And several reports have found that immigrants make up a substantial portion of the health care workforce, including in the United States. … ‘Rather than being a burden, migrants are more likely to bolster services by providing medical care, teaching children, caring for older people, and supporting understaffed services,’ The Lancet, which sponsored the report with University College London, said in a statement…” (Fox, 12/5).

Additional coverage of UCL-Lancet report on migration and health is available from Forbes, HuffPost, and NPR.

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Ebola Spreads To Major City In Eastern Congo; Health Workers Respond To Outbreak Amid War Zone

Associated Press: Ebola spreads to major Congo city as vaccines a concern
“The second-largest Ebola outbreak in history has spread to a major city in eastern Congo, as health experts worry whether the stock of an experimental vaccine will stand up to the demands of an epidemic with no end in sight. Butembo, with more than one million residents, is now reporting cases of the deadly hemorrhagic fever. That complicates Ebola containment work already challenged by rebel attacks elsewhere that have made tracking the virus almost impossible in some isolated villages…” (Petesch/Anna, 12/7).

Washington Post: ‘Like a horror film’: The efforts to contain Ebola in a war zone
“…This is the first Ebola outbreak during which health workers have had to regularly don bulletproof helmets and vests. To reach at least 20 percent of Ebola-affected areas, health workers need armed police or U.N. escorts, said Michel Yao, WHO’s response coordinator in Beni. The U.S. government withdrew its only personnel in the region in late August and has no plans to redeploy them. The WHO has 300 specialists from around the world in North Kivu. Those on the ground describe a chaotic effort to either negotiate with or simply avoid the region’s various militias…” (Bearak, 12/7).

Additional coverage of the Ebola outbreak in Congo is available from Becker’s Hospital Review, CIDRAP News, and VOA News.

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Yemen Peace Talks Begin; U.N. Agencies Issue Warnings On Child Malnutrition

NPR: Yemen Peace Talks Begin In Sweden, As Humanitarian Crisis Deepens
“For the first time in more than two years the Yemeni government and Houthi rebels are holding peace talks, with half of Yemen’s population facing starvation as a result of the civil war. … The civil war in Yemen, which began more than three years ago, has been devastating, with millions of people facing famine. Millions have also been displaced, and thousands of civilians have been killed. Yemen is home to the world’s worst cholera outbreak, and hunger is a growing problem. The U.N. estimates that a child under five dies in Yemen every 10 minutes. … On Wednesday, UNICEF issued a grim update on the fate of children in Yemen…” (Domonoske, 12/6).

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More News In Global Health

The BMJ: Health gains make actions to curb climate change cost neutral, says WHO (Limb, 12/6).

CIDRAP News: Guidance seeks to increase outbreak vaccines in pregnant women (Schnirring, 12/6).

Devex: Outlook remains bleak for South Sudan food crisis (Root, 12/7).

Devex: WHO launches ‘Twitter-like’ platform for NCDs (Ravelo, 12/7).

The Economist: Progress on eradicating polio has stalled (12/6).

Financial Times: E.U. warns of bioterror and disease risk as vaccination rates fall (Peel, 12/6).

The Lancet: WHO keeps polio on the international health emergency list (Zarocostas, 12/8).

The Lancet: Boosting quality diagnostics could give Africa better health (Makoni, 12/8).

The Lancet: The U.K. reaches UNAIDS 90-90-90 targets (Kirby, 12/8).

The Lancet: FRONTLINE: a new treatment facility for Ebola virus disease (Devi, 12/8).

New York Times: Irish Lawmakers Vote to Allow Abortion, Part of Landmark Liberal Shift (O’Loughlin, 12/6).

SciDev.Net: Country-owned strategies launched to fight malaria (Adepoju, 12/6).

Washington Post: Bad air kills more than a million Indians a year, study says (Slater, 12/7).

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Editorials and Opinions

Opinion Pieces Discuss Humanitarian Crisis In Yemen, Need For International Action To End War

New York Times: U.S. Tax Dollars Help to Starve Children
Nicholas Kristof, New York Times columnist

“…Both the Obama and Trump administrations have supported the Saudi war in Yemen with a military partnership, arms sales, intelligence sharing, and until recently air-to-air refueling. The United States is thus complicit in what some human rights experts believe are war crimes. The bottom line: Our tax dollars are going to starve children. … What is most infuriating is that the hunger is caused not by drought or extreme weather, but by cynical and failed policies in Riyadh and Washington. The starvation does not seem to be an accidental byproduct of war, but rather a weapon in it. … But in Yemen the most common war casualties are children … who suffer malnutrition. … The war and lack of health care facilities have also led to outbreaks of deadly diseases like diphtheria and cholera. Half of the country’s clinics and hospitals are closed. … To avert a catastrophe in Yemen, the world needs to provide more humanitarian aid. But above all, the war has to end. … One step to a solution: Congress should suspend arms sales to Saudi Arabia so long as the Saudis continue the war…” (12/7).

CNN: U.N. humanitarian chief: It’s not too late to save Yemen from apocalypse
Mark Lowcock, U.N. under-secretary general for humanitarian affairs and emergency relief coordinator

“…Yemen’s crisis is entirely man-made. It will not be solved by Mother Nature. But we can stave off the looming apocalypse if we take action now. Here is the U.N.’s five-point plan. First, we need an immediate ceasefire to protect people but also the essential infrastructure without which a great famine is guaranteed. … Second, the U.N.’s humanitarian response plan for 2019 has to be fully funded. … Third, urgent and ongoing measures are needed to stabilize the economy. … Fourth, work needs to start now on recovery and rebuilding, including for the key state institutions. … And fifth, the parties attending the talks set to begin in Sweden — convened by Martin Griffiths, the U.N. special envoy for Yemen — need to stay until they have agreed to the first meaningful actions towards peace. Rebuilding the battered economy and creating jobs and livelihoods to a point where Yemen can sustain itself will be the work of decades. But piecing back together Yemen’s fractured society and overcoming the anger and grievances the war has amplified will take generations. None of this is going to get better until it stops getting worse. Better get on with it before it is too late” (12/6).

Washington Post: Yemen’s looming famine has been a long time coming
Peter Salisbury, consultant analyst at the International Crisis Group and senior consulting fellow with the Chatham House Middle East and North Africa Program

“Analysts have long argued that, if left unchecked, Yemen’s political, economic, and fiscal crises were all but certain to cause a massive, debilitating famine. As Yemen barrels toward this worst-case scenario, what is most disturbing is that there is no indication the trend will be stopped, even when people start dying in unprecedented numbers. … Unless a planned assault on the Red Sea port of Hodeida is prevented and the war ended, says Mark Lowcock, the United Nations humanitarian chief, a ‘great big famine’ will follow soon, and Yemen will endure what Lowcock believes will be the worst humanitarian disaster in our lifetime. … Calls for peace talks unaccompanied by concrete action and debates on the [U.S.] Senate floor are likely to be too little, too late — if they amount to anything at all. … When the famine comes, the United States will not be alone in its culpability. Yemen represents a long-term failure of the international system and the U.N. Security Council in particular. As the country slips into unimaginable, desperate hunger, it’s important to understand that what is happening was utterly, tragically predictable. The people who should have known knew. They just had other priorities” (12/5).

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Multidisciplinary, Multisectoral, Coordinated Action Critical To Address AMR

Devex: Opinion: It takes a coalition to defeat antimicrobial resistance
Mohan Joshi, GHSA/AMR technical lead for the USAID-funded Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program implemented by Management Sciences for Health

“…How can countries even begin to tackle the interrelated objectives of improving antimicrobial stewardship, awareness, and surveillance, as well as preventing and controlling infections? A key initial step is to form a national multidisciplinary, multisectoral coalition of all [antimicrobial resistance (AMR)]-related stakeholders. These diverse groups can simultaneously tackle complex issues that need action on a number of fronts. As well as obvious government stakeholders, coalitions need to include the private sector, consumer and faith-based groups, and civil society organizations. … Coalitions need to extend beyond the human health sector to the veterinary, agricultural, and environmental sectors. … Lastly, we need to educate patients and the public, from mass media messaging to the doctor’s office. … Gathering these often disparate groups can be challenging and requires strong leadership and advocacy. But it is only by coordinated action that we’ll be able to provide the united front we need to defeat AMR” (12/6).

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From the Global Health Policy Community

Development Experts Discuss Opportunities For BUILD Act To Set 'Gold Standard' For Transparency

Modernizing Foreign Assistance Network: Setting the Gold Standard for Transparency: The Opportunity for the New U.S. Development Finance Agency
Sally Paxton, U.S. representative for Publish What You Fund, and George Ingram, senior fellow at the Brookings Institution and co-chair at MFAN, discuss the Better Utilization of Investments Leading to Development Act (BUILD Act), which was signed into law on October 5, 2018, and the new U.S. International Development Finance Corporation (USIDFC) created under the legislation. They write, “There are lots of questions to answer and details to be addressed to ensure that the potential of this new initiative is best poised to meet the challenges of effectively using both its development mandate and its resources. … We want to call attention to one specific provision of the BUILD Act. As part of the transparency goals that underpin U.S. foreign assistance strategy, the law requires that the DFC publish its data at the project not country level. Although this is the norm globally for traditional aid, it is not common for [development finance institutions (DFIs)]. … Informed by the significant benefits of comparable, comprehensive, and accessible data and smart policy decisions, the USIDFC can be positioned to set the transparency gold standard…” (12/6).

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Aid Organizations Discuss Food, Humanitarian Crisis In Yemen, Response Efforts

International Rescue Committee: New nutrition analysis confirms children are being starved in Yemen
“A new integrated food security and classification (IPC) report shows that 240,000 Yemeni civilians are living in famine condition and 9.8 million are on the brink of famine, a shocking increase of 42 percent … since 2017. About two million children under the age of five are severely malnourished in Houthi-controlled areas, and as many as 400,000 children could starve if assistance cannot be distributed to them…” (12/6).

Oxfam America: Struggle to survive near-famine conditions in Yemen
This post discusses the humanitarian crisis in Yemen, including the threat of malnutrition and cholera, and provides an overview of Oxfam America’s response, including WASH efforts, job training, and advocating for peace (12/6).

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Report Of 3rd WHO Stakeholders Meeting On Sleeping Sickness Elimination Examines Progress, Challenges

PLOS Neglected Tropical Diseases: The elimination of human African trypanosomiasis is in sight: Report from the third WHO stakeholders meeting on elimination of gambiense human African trypanosomiasis
Michael P. Barrett, member of the Wellcome Centre for Molecular Parasitology and professor at the Institute of Infection, Immunity, and Inflammation at the University of Glasgow, discusses outcomes from the third WHO meeting of stakeholders on the elimination of gambiense human African trypanosomiasis (HAT), otherwise known as sleeping sickness, and examines the progress made and remaining challenges of eliminating the disease (12/6).

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