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Kaiser Daily Global Health Policy Report

In The News

IRIN Examines Impact Of U.S. Government Shutdown On Foreign Aid Operations

IRIN: What effect did the U.S. shutdown have on foreign aid?
“Humanitarian groups say the record 35-day halt to the funding of routine government activity stopped short of causing massive disruptions: NGOs including Save the Children and Mercy Corps, as well as the U.N.’s World Food Programme, said the shutdown hadn’t impacted their operations. It was a slightly different story at USAID. The U.S. government agency responsible for administering civilian foreign aid and development assistance reported that as of January 23 (two days before the shutdown ended) just over half of non-contractor ‘direct hire employees’ (1,706 out of 3,311) had been furloughed, meaning they were instructed not to report for work, nor were they working remotely. Though proportionally fewer staff were furloughed overseas, the cash freeze appeared to be felt most strongly on humanitarian and diplomatic operations outside the United States… During the shutdown, the U.S. government said it would provide $20 million in humanitarian aid for Venezuela, but its aid delivery department was hampered by the government shutdown…” (Oakford, 1/31).

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Media Outlets Report On U.S. Aid Cuts To Palestinians

Reuters: USAID assistance in the West Bank and Gaza has ceased: U.S. official
“The U.S. Agency for International Development (USAID) has ceased all assistance to Palestinians in the occupied West Bank and Gaza, a U.S. official said on Friday. The decision was linked to a Jan. 31 deadline set by new U.S. legislation under which foreign aid recipients would be more exposed to anti-terrorism lawsuits. The deadline also sees the end of about $60 million in U.S. aid for the Palestinian security forces, whose cooperation with Israeli forces helps maintain relative quiet in the West Bank…” (Farrell/Lubell, 2/1).

World Politics Review: Despair Sets in Among Vulnerable Palestinians Hit by U.S. Aid Cuts
“Last year, the United States curtailed its humanitarian aid to the Palestinian territories by cutting hundreds of millions of dollars in direct development assistance and funding to the United Nations. That has exacerbated a humanitarian crisis, with aid organizations on the ground reporting that they are no longer able to provide critical food aid to vulnerable households in Gaza and the West Bank. Lana Abu-Hijleh is the local director for one such aid group, Global Communities, based in the West Bank. In an interview with WPR, she discusses the impact of U.S. aid cuts on food security and the difficult situation facing Palestinians who previously relied on American assistance…” (1/31).

Additional coverage is available from The Hill.

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Mother Jones Examines Global Impacts Of Trump Administration's Expanded Mexico City Policy

Mother Jones: New Data Shows How the U.S. Ban on Global Funds for Abortion Spectacularly Backfires
“…When President Donald Trump signed an executive order to reinstate the memorandum [commonly] known as the global gag rule [also known as the Mexico City policy] in January 2017, its effects were … felt by people … who serve communities in some of the world’s poorest provinces. Proponents said the [Mexico City] policy, first pushed by anti-abortion activists during the Reagan administration, would reduce the number of abortions in developing countries. The ban has been dismantled by every Democratic president, and reinstated by every Republican, since. But research published in November shows that, in some countries, the global gag rule backfires spectacularly. … Human Rights Watch reports that the policy now affects funding to programs addressing the prevention and treatment of tuberculosis and malaria, and even to water, sanitation, and hygiene initiatives. In particular, efforts to stem HIV infection have been severely impacted. … In Washington, D.C., the president’s expansion [of the policy] has inspired a push to repeal the global gag rule for good…” (Furneaux, 1/31).

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Efforts To Control DRC Ebola Outbreak Show Signs Of Progress, But Challenges Remain As Cases Continue To Grow

Associated Press/Washington Post: AP Explains: Why Congo’s Ebola outbreak still going strong
“The Ebola outbreak in eastern Congo, the second deadliest in history, marks six months on Friday and is moving toward the major border city of Goma, a development that would greatly complicate any hope of stopping the virus’ spread in the unstable region. This may be the most challenging Ebola outbreak ever. Health workers face the threat of attack from rebel groups and resistance from frightened communities. A highly mobile population produced two scares in the past week alone: The discovery of an infected, wide-ranging young trader led to vaccinations in a new, third province near the South Sudan border. And two contacts of Ebola victims slipped away and were found in the capital of neighboring Uganda — free of the virus. And yet this outbreak has seen a number of advances, including the widespread use of an experimental Ebola vaccine and a clinical trial of experimental treatments…” (Anna, 2/1).

Axios: There are tools to fight Ebola — but first people need to trust them
“Despite having more tools to combat Ebola than ever before, the disease continues to spread to new parts of the Democratic Republic of the Congo — partly as a result of continued lack of trust from the public, according to several experts from Doctors without Borders (MSF). … They said the combination of the security situation, nasty disease and community distrust amounts to a ‘very frustrating’ situation. … The treatment trials have also been hampered by the security situation, Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, told Axios. … But, the ring vaccination appears to be helping, although no one is 100% sure since it’s not part of a randomized trial, Fauci tells Axios…” (O’Reilly, 1/31).

CIDRAP News: Over 70,000 vaccinated against Ebola as outbreak marches on
“More than 70,000 people in the Democratic Republic of the Congo (DRC) have now been vaccinated with VSV-EBOV, Merck’s unlicensed Ebola vaccine, according to today’s update from DRC health officials. … Though experts have called the campaign a success, the outbreak shows no signs of slowing. [Yesterday], the DRC confirmed 7 new cases, bringing the total number to 759, including 468 deaths…” (Soucheray, 1/31).

STAT: Top WHO official sees progress in grueling fight against Ebola outbreak
“Six months after the ongoing Ebola outbreak in the Democratic Republic of the Congo began, efforts to stop spread of the disease are producing signs of progress, a senior World Health Organization official told STAT on Thursday. Transmission has either been halted or significantly reduced in a number of the areas where the disease has spread, said Dr. Mike Ryan, assistant director of the WHO’s emergency preparedness and response program…” (Branswell, 2/1).

VOA News: U.S. Researchers Looking For Long Lasting Ebola Vaccine
“The World Health Organization reports that more than 700 people have been sickened with Ebola in the Democratic Republic of Congo. And now, neighboring countries of South Sudan and Rwanda are bracing for the virus to spread. But, half a world away, U.S. researchers are hoping to develop a new, long-lasting vaccine against Ebola. VOA’s Carol Pearson has more…” (Pearson, 1/31).

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Venezuela's Humanitarian Crisis, Health System Collapse Contributing To Disease Reemergence, Threat Of Spread

The Telegraph: Crisis in Venezuela threatens neighboring countries as infectious diseases return
“Venezuela’s economic ruin poses a health threat to the Americas and potentially beyond, as diseases like measles and diphtheria re-emerge and spread to neighboring countries, academics have warned. The country’s meltdown has been so profound its health system resembles that of a war-shattered state and people are no longer vaccinated for common infectious diseases. A paper in the journal Emerging Infectious Diseases says there are parallels with the return of polio in Syria and diphtheria in Yemen, after those countries descended into violent chaos…” (Farmer, 1/31).

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Displaced Children Dying Due To Cold; Supplies Running Low At Syrian Refugee Camp, WHO Says

CBS News: 29 children and babies reportedly die while families seek safety during Syria’s winter
“At least 29 newborns and children have reportedly died over the past two months while heading to a Syrian refugee camp or not long after getting there, the World Health Organization (WHO) said Thursday. Most of them died from hypothermia as they joined tens of thousands of people seeking safety during Syria’s winter…” (Baldwin, 1/31).

The Guardian: Children and babies die as temperatures plummet in Syria
“…Many have walked or traveled in open trucks for days in bitterly cold weather to reach al-Hol, the main camp for displaced people, only to spend several nights in the facility’s open-air reception areas without tents, blankets, or heating. ‘The situation in the camp is now critical,’ the WHO warned in a statement. ‘The authorities are overwhelmed and struggling to cope with the sheer numbers of people. Many new arrivals are malnourished and exhausted following years of deprivation living under the control of the Islamic State of Iraq and the Levant.’… Humanitarian access to the camp in al-Hasakah governorate, and to surrounding roads, has been hampered by bureaucratic obstacles and security constraints…” (Ratcliffe, 1/31).

New York Times: 29 Syrian Children Die During Freezing Escape From the Islamic State
“…Almost a third of the displaced people are younger than five, [WHO] said. … Shortages are everywhere — of tents, latrines, medical care, and sanitation facilities — leaving thousands of people who have already endured years living under Islamic State rule and a miserable march to the camp to spend several nights there without any shelter or even blankets…” (Yee, 1/31).

Additional coverage of the situation in Syria and the WHO statement is available from NPR, U.N. News, and Xinhua.

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Devex Examines Development Community's Role In Transforming Global Food System

Devex: What role for development actors in global food system overhaul?
“Scientists have charted an ambitious new plan to transform the global food system by 2050 with the twin goals of making it sustainable while delivering healthy diets to everyone in the world. To succeed, the development community will need to join governments, businesses, and consumers in translating the plan into reality. Though the role of development actors goes largely unaddressed in the report from the EAT-Lancet Commission — a joint project of the food system-focused nonprofit and the medical journal — theirs will be critical to translating the panel’s framework into granular actions…” (Green, 1/31).

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Devex Examines Growing Impact Investing Sector, Role Of NGOs

Devex: Nonprofits are carving their own impact investing niche
“The average number of employees working full-time on impact investing for international NGOs has nearly doubled since 2016, according to a new report that polled 45 charities. The change is reflective of a growing impact investing sector — one attracting more dollars and more INGO attention than ever before. … What sets nonprofits apart and establishes them as important actors in the impact investing ecosystem is that they are driven by impact, not financial returns, INGO leaders told Devex…” (Saldinger, 2/1).

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WHO Calls For Increased Efforts To Prevent Cervical Cancer

VOA News: WHO: Cervical Cancer Preventable, Can Be Eliminated
“Ahead of World Cancer Day (February 4), the World Health Organization (WHO) is calling for accelerated action to eliminate cervical cancer, a preventable disease that kills more than 300,000 women every year. Cervical cancer ranks among leading causes of death for women worldwide. Nine in 10 deaths occur in poor and middle-income countries. The disease is caused by the human papillomavirus and is transmitted through sexual contact…” (Schlein, 1/31).

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More News In Global Health

CNBC Africa: Here’s how we can cure the physician shortage in Africa — Expert (1/31).

The Economist: A newly revived vaccine may deal a death blow to typhoid fever (1/31).

Global Health NOW: Is the World Ready for Climate Change Refugees? (Devadason, 1/31).

The Lancet Infectious Diseases: Vaccine-derived poliovirus cases exceed wild types (Burki, 2/1).

The Lancet: Health agenda close to absent in Nigeria’s election campaign (Adepoju, 2/2).

The Lancet: Scientific conflict and big food companies (Boseley, 2/2).

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Editorials and Opinions

U.S. Should Continue Providing Aid To Palestinians, Opinion Piece Says

NPR: Opinion: Here’s Why U.S. Aid To Palestinians Needs To Continue
Dana Stroul, senior fellow at the Washington Institute for Near East Policy, and Daniel B. Shapiro, visiting fellow at the Institute for National Security Studies in Tel Aviv

“Is U.S. assistance to the Palestinians an indulgence we can do without? Will its elimination leave Israelis, Palestinians, and U.S. interests better off? Unless Congress and the Trump administration act quickly, we are about to find out. … [F]unding for Palestinian assistance programs has always flowed with bipartisan support because it was determined to reinforce Israel’s security and provide a measure of U.S. leverage and influence. … Walking away from ongoing USAID projects in the West Bank and Gaza — unfinished roads, incomplete water projects, and piecemeal humanitarian and education programs — is a total waste of U.S. taxpayer dollars. Such visible reminders of U.S. abandonment will also inflame local sentiment against the United States. Congress should authorize and explicitly appropriate funds to complete these projects, following a thorough review of the status of U.S. programs in the West Bank and Gaza. … Members of Congress naturally seek Israel’s views on the security and economic consequences of completely shutting down U.S. assistance programs to the Palestinians. But during the Trump administration, the answers have been murky. After Israel’s election in April, Congress should urgently seek a clear picture of the new government’s views, as members continue to vote on this much-debated set of issues” (1/31).

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Vaccine Hesitancy Represents Threat To Global Health

USA Today: Today’s skepticism of vaccines could be as big of a health threat as HIV
Amesh A. Adalja, senior scholar at the Johns Hopkins Center for Health Security

“It might come as a surprise that vaccine hesitancy appears on the World Health Organization’s 2019 list of the top health threats, which include HIV, pandemic influenza, and antimicrobial resistance, among others. Surely, vaccine hesitancy — a voluntarily chosen human behavior — cannot be in the same category as HIV … However, if one thinks about the full context of vaccine hesitancy and what it represents, the WHO’s inclusion of this outrageous phenomenon is completely justified. … The WHO’s top-10 list also includes noncommunicable diseases … A chief reason that noncommunicable disease is a problem at all is because people are no longer dying from infectious diseases and are, hence, living long enough to develop these noncommunicable diseases. The control of infectious diseases, largely due to vaccination along with sanitation and antimicrobial therapy, gives humans the ‘luxury’ of dying from diseases of adulthood. … Today when a new vaccine is developed … it is greeted with derision and is the subject of conspiracy theories that even presidential candidates spread. … If [vaccine hesitancy] continues to spread unchallenged, it will be a willful, self-inflicted threat to human life” (2/1).

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Multi-Sectoral, Focused Approach Critical To Preventing Drug-Resistant Malaria From Spreading

Scientific American: We Need to Stop Drug-Resistant Malaria at Its Source, Right Now
Colin Ohrt, founding director of Consortium for Health Action

“Global investments in malaria control and elimination are now at risk of being rapidly reversed. … Despite large investments and recent success in driving down overall rates of malaria, high levels of resistance to nearly all antimalarial drugs are now widespread in Cambodia, the main source of drug-resistant strains previously. … Incurable malaria spreading from this region is a real and present threat that must be stopped. … We call on all stakeholders — specifically, the Bill & Melinda Gates Foundation, the Global Fund, the [President’s] Malaria Initiative, the World Health Organization and importantly, the U.S. Army and U.S. Navy — to urgently take corrective action to address this critical challenge. If the few key organizations could commit to effectively implementing a straightforward multi-sectoral approach, the WHO’s goal of eliminating multidrug-resistant falciparum malaria from Southeast Asia near the 2020 target can be achieved. The alternative — continued poor quality implementation, wasteful spending, and investigator-oriented research — will mean that the nearly incurable and still evolving parasites will reach Africa, with the potential to start the next global pandemic” (1/31).

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Sexual, Reproductive Health, Rights Integral To Achieving UHC

Devex: Opinion: SRHR puts the ‘universal’ in universal health coverage
Susan Papp, managing director of policy and advocacy at Women Deliver

“…If the world’s leaders really want to get serious about achieving [universal health coverage (UHC)] and truly providing health for all, then investing in a more comprehensive approach to [sexual and reproductive health and rights (SRHR)] is nonnegotiable. We need to develop aligned and concerted advocacy at three levels. First, at the global level, we must raise our collective voices to help ensure that SRHR in UHC is on the agenda at influential meetings that guide the adoption of UHC principles and service packages … Second, in-country advocates must directly engage with governments to foster political will and commitment to SRHR in UHC. … Third, we should mobilize at the point-of-care and community level to track and spotlight how integrated UHC programming is working for accountability purposes. … At all levels, advocates and health professionals can play a powerful role to ensure that SRHR, gender equality, and human rights are not shortchanged in UHC conversations, and that strong, comprehensive UHC policy trumps political expediency. This will take vigilance, but advocates must be united and strong behind a common evidence-based position that there is no UHC without SRHR” (2/1).

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From the Global Health Policy Community

Borgen Magazine Articles Highlight Passage Of U.S. Global Development, Health-Related Legislation

Borgen Magazine: Global Food Security Reauthorization Act Passed
Emily Triolet, writer at Borgen Magazine, discusses the passage of the Global Food Security Reauthorization Act and its role in addressing global hunger and poverty (1/30).

Borgen Magazine: 5 Major Anti-Poverty Bills Passed in 2018
John Chapman, journalist intern at Borgen Magazine, highlights five bills passed by Congress in 2018, including the BUILD Act, PEPFAR Extension Act, African Growth and Opportunity (AGOA) and MCA Modernization Act, Protecting Girls Access to Education in Vulnerable Settings Act, and Global Food Security Reauthorization Act. Chapman writes, “Thanks to the bipartisan effort of American legislators, young women around the world will gain access to education, new investments in emerging markets are being made possible, those suffering from HIV and AIDS will continue to receive life-saving medical care, and global hunger is one step closer to becoming a problem of the past. … The progress made by the five major anti-poverty bills passed in 2018 is cause for celebration, but millions of people around the world are depending on continued momentum going through 2019” (1/31).

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amfAR Releases Issue Brief Discussing Implications Of MCP For PEPFAR Implementers

amfAR: The Effect of the Expanded Mexico City Policy on HIV/AIDS Programming: Evidence from the PEPFAR Implementing Partners Survey
This new issue brief examines the implications of President Trump’s reinstatement and expansion of the Mexico City Policy (MCP) for PEPFAR’s implementing partners (IPs). According to the issue brief’s overview, “While the [expanded MCP’s (EMCP)] impact on PEPFAR IPs is not yet known, previous iterations of the MCP prompted service reductions and clinic closures among family planning providers. In order to understand if and how PEPFAR IPs may be affected, amfAR, in collaboration with Johns Hopkins University, launched a confidential electronic survey and key-informant interviews with PEPFAR IPs to document any changes in organizational operations and service delivery prompted by the EMCP” (1/31).

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Health Expert Examines U.K.'s 5-Year Plan For Addressing Antimicrobial Resistance

American Council on Science and Health: The U.K. Plan: Tackling Antimicrobial Resistance
David Shlaes, member of the American Council on Science and Health Scientific Advisory Panel and president of Anti-Infectives Consulting, LLC, discusses the U.K.’s recently released five-year plan for addressing antimicrobial resistance, particularly the plan’s approach to addressing the “global failure to incentivize the development of new antimicrobials and alternative treatments.” Shlaes writes, “In their five-year plan, the U.K. seems to be saying that they will ‘test’ a model based on ‘value’ of a new medicine to the health care of the nation. The first question is, how can one test an incentive that will surely not be an incentive since it will be unlikely to provide for global value to health care. The second question is, how will they determine ‘value.’ And finally, where will the money come from? … Given the current urgency, I strongly believe that our default position for 2019 is to provide a market entry reward … Other approaches, such as the one being undertaken by the U.K., will take too much time but could inform the market entry reward at a later time” (1/31).

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February 2019 Issue Of WHO Bulletin Available Online

WHO: Bulletin of the World Health Organization
The February 2019 WHO Bulletin focuses on prevention and control of noncommunicable diseases (NCDs) and features articles on the challenges and threats to NCD control, actions needed to prevent NCDs and improve mental health, and research on implementing national NCD action plans in Bhutan, Cambodia, Indonesia, Philippines, Sri Lanka, Thailand, and Vietnam (February 2019).

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CFR Releases Latest World101 Module On Global Health Challenges, Threats

Council on Foreign Relations: Global Health
The Council on Foreign Relations released its latest World101 installment on global health challenges and threats. The module includes videos, charts, timelines, and articles on global health-related topics (1/31).

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From the U.S. Government

CDC Journal Article Examines Resurgence Of Vaccine-Preventable Diseases In Venezuela, Potential Spread To Surrounding Region

CDC’s “Emerging Infectious Diseases”: Resurgence of Vaccine-Preventable Diseases in Venezuela as a Regional Public Health Threat in the Americas
Alberto E. Paniz-Mondolfi, infectious diseases pathologist and clinician at the IDB Biomedical Research Institute, Venezuelan Science Incubator, and Laboratory of Cell Signaling and Parasite Biochemistry (IDEA), and colleagues examine the resurgence of vaccine-preventable diseases in Venezuela and the potential spread throughout the region. The authors write, “In this article, we discuss the ongoing epidemics of measles and diphtheria in Venezuela and their disproportionate impact on indigenous populations. We also discuss the potential for reemergence of poliomyelitis and conclude that action to halt the spread of vaccine-preventable diseases within Venezuela is a matter of urgency for the country and the region. We further provide specific recommendations for addressing this crisis” (April 2019).

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From the Kaiser Family Foundation

KFF Updates Fact Sheets On TB, MCH Efforts

Kaiser Family Foundation: The U.S. Government and Global Tuberculosis Efforts
This updated fact sheet explains the U.S. government’s role in addressing global TB, including the history of U.S. involvement and funding trends (1/31).

Kaiser Family Foundation: The U.S. Government and Global Maternal & Child Health Efforts
This updated fact sheet examines global maternal and child health efforts and the U.S. government’s history of support for these efforts, including funding (1/31).

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KFF Updates Fact Sheet On U.S. Relationship With Gavi, the Vaccine Alliance

Kaiser Family Foundation: The U.S. & Gavi, the Vaccine Alliance
This updated fact sheet examines Gavi, the Vaccine Alliance (also known as Gavi), an independent, public-private partnership and multilateral funding mechanism that aims to increase access to immunization in poor countries, and explores the role the U.S. government plays in supporting the partnership (1/31).

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KFF Updates Fact Sheet on Millennium Challenge Corporation's Engagement In Global Health

Kaiser Family Foundation: The Millennium Challenge Corporation (MCC) and Global Health
This fact sheet describes the functions, governance, funding, and approach of the Millennium Challenge Corporation (MCC), with a particular focus on MCC’s engagement in global health (1/30).

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