KFF Daily Global Health Policy Report

In The News

House Leaders Expect Bipartisan Support For Emergency Zika Funding; CDC Says New Funding Needed To Improve Prevention, Diagnostics

CQ News: Leftover Ebola Funds Can’t Be Used to Fight Zika, CDC Says
“Leftover money approved to respond to the Ebola virus outbreak in 2014 cannot be used to combat the emerging Zika virus because a majority of those dollars have already been committed, administration officials told Senate appropriators Thursday. Instead, Centers for Disease Control and Prevention Director Thomas Frieden suggested at a hearing that a fresh injection of cash is needed to fight Zika by enhancing mosquito control programs, stocking up on the supply of diagnostic tests, and funneling research toward development of a vaccine…” (Zanona, 2/11).

The Hill: Ryan: House will take bipartisan action on Zika funding
“Speaker Paul Ryan (R-Wis.) said Thursday that he expects bipartisan action to approve funds to fight the Zika virus. The White House is asking for $1.8 billion in emergency funding for programs including the creation of rapid response teams for local outbreaks of the virus and boosting vaccine research. Ryan said that lawmakers are still waiting for the formal submission of this request from the administration…” (Sullivan, 2/11).

The Hill: Overnight Healthcare: GOP leaders say Zika funding likely
“…House Minority Leader Nancy Pelosi (D-Calif.) on Thursday also expressed hope that the funding could pass in a bipartisan way, saying her ‘read from the Speaker is that [the issue] will be bipartisan, hopefully noncontroversial, as we go forward to meet the president’s request for Zika emergency funding’…” (Ferris/Sullivan, 2/11).

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Experts Say Zika Focus Must Remain On Disease's Consequences, Surveillance, Prevention

VOA News: Expert: Focus on Zika’s Consequences, Not Disease Itself
“… ‘The problem with the Zika virus is not the disease itself,’ Dr. Ronald Waldman told VOA’s ‘Straight Talk Africa’ on Wednesday. … Therefore, he said, the task ahead is to understand more about the consequences of the disease, notably microcephaly … ‘We are in an unfortunate situation with so many unknowns,’ said Josh Michaud of the Kaiser Family Foundation, a nonprofit organization focusing on national health issues. … Michaud said that in parts of the world where access to health care is limited, governments need to do a better job of surveillance, setting up studies to make sure the link between Zika infections and microcephaly is genuine…” (Diallo, 2/11).

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Debate Continues Over Contraception, Abortion Access For Women In Latin American Zika-Affected Nations

Associated Press: U.S. ships Zika test for pregnant women; Puerto Rico at risk
“The U.S. government is shipping Zika virus tests for pregnant women to health departments around the country, but it warns there could be temporary shortages, as travelers try to tell if they returned with an infection that could put a developing baby at risk. Health officials don’t expect widespread transmission of the mosquito-borne virus in the continental United States, but they said Thursday that Puerto Rico is especially vulnerable…” (Neergaard, 2/11).

The Guardian: ‘Zika-linked’ miscarriages pose jail risk for women in El Salvador, activists say
“Women’s rights activists fear that a suspected rise in miscarriages linked to the Zika epidemic could lead to a surge in criminal prosecutions of women for deliberate abortion or homicide under El Salvador’s draconian abortion law…” (Lakhani, 2/12).

The Guardian: El Salvador’s Zika crisis compounded by failings of state, violence, and machismo
“…[I]n El Salvador the challenge [of Zika] is exacerbated by tottering public institutions, high rates of sexual violence, inadequate sex education and a backdrop of violence and gang warfare which are undermining efforts to control the outbreak. … But women’s rights activists said that the controversial advice [for women to delay pregnancy for two years] failed to reflect the country’s entrenched culture of sexism which leaves many women — especially poor women — with little control over their bodies…” (Lakhani, 2/12).

International Business Times: South American pregnant women battle health and inequality issues with Zika virus outbreak
“…Human rights organizations around the world find the call to avoid getting pregnant an unfair solution to avoid passing on the infection to unborn children. … ‘Naïve’ and ‘irresponsible,’ as women’s rights activist and programs specialist for the Center for Reproductive Rights, Paula Avila-Guillen, called the recommendation…” (Hernandez, 2/12).

NPR: Chart: Access To Contraception And Abortion In Zika-Affected Countries
“…One thing is certain: The outbreak has sparked a public debate about issues of contraception and abortion. … [A Kaiser Family Foundation] chart uses data from the U.N. Population Division, which relies on surveys from the various countries. Josh Michaud, associate director of global health policy for the Kaiser Family Foundation, notes that the contraception statistic may ‘mask what are large disparities between rural and urban areas and across different income classes. Poor rural women have the least access to contraception’…” (Silver, 2/11).

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Brazil, University Of Texas Sign Agreement To Develop Zika Vaccine

Associated Press: Brazil, Texas state hospital reach deal on Zika vaccine
“Brazil has signed an agreement with a Texas research hospital to develop a vaccine against the Zika virus, the country’s health minister said Thursday, adding the goal is for the vaccine to be ready for clinical testing within 12 months…” (Goodman, 2/11).

BBC News: Zika virus: Brazil hopes to develop vaccine in ‘one year’
“…But two more years would be needed for any large-scale rollout, the health minister said…” (2/11).

Bloomberg Business: Brazil Partners With U.S. Scientists to Develop Zika Vaccine
“…The government will fund research by scientists in Brazil and at the University of Texas Medical Branch with $1.9 million over five years, the Health Ministry said in a statement…” (Edgerton/Santos, 2/11).

Wall Street Journal: Brazil, University of Texas to Work on Zika Vaccine
“…The governments of Brazil and the U.S. have already agreed to work together to develop a vaccine for Zika. Presidents Dilma Rousseff and Barack Obama spoke by telephone in late January and said they’ll broaden the cooperation on a vaccine for dengue fever to include Zika…” (Jelmayer/Lewis, 2/11).

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WHO Speculates On Timelines For Experimental Zika Vaccine, Conclusions On Possible Links To Microcephaly, Guillain-Barré Syndrome

Associated Press: WHO: possible Zika vaccines months away from broad trials
“The World Health Organization says possible Zika vaccines are at least 18 months away from large-scale trials. WHO assistant director-general for health systems and innovation Marie-Paule Kieny says the U.N. health agency’s response is ‘proceeding very quickly’ and 15 companies or groups have been identified as possible participants in the hunt for vaccines…” (2/12).

Reuters: WHO sees Zika link proven in weeks as U.S., India lead vaccine race
“Suspected links between the Zika virus and two neurological disorders, microcephaly in babies and Guillain-Barré syndrome, should be confirmed within weeks, the World Health Organization (WHO) said on Friday…” (Nebehay/Hirschler, 2/12).

Wall Street Journal: WHO Says Possible Zika Vaccines at Least 18 Months Away From Broad Trials
“..In remarks at a news conference, WHO’s assistant director-general for health systems and innovation Marie-Paule Kieny said ‘the landscape is evolving very rapidly and numbers change daily’…” (Blackstone/McKay, 2/12).

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Brazil Plans 'Mega-Operation' To Combat Mosquitoes; Scientists Continue To Investigate Potential Zika Complications

GlobalPost: Brazilian researchers find hundreds more microcephaly cases that predate Zika
“Researchers trying to pinpoint what’s causing birth defects in Brazil might have just hit a setback. A study in Brazil’s northeastern state of Paraiba, published Feb. 4 on the World Health Organization (WHO) website, found there were far more newborns with abnormally small heads than previously reported, and many of the babies were born before Zika apparently reached this country in 2014…” (Carless, 2/11).

The Guardian: Zika virus counterattack: Brazil’s big plan to combat threat not easing fears
“Amid rumors and panic over the Zika virus, the Brazilian government is preparing to launch a ‘mega-operation’ to eliminate potential mosquito breeding sites and to educate the public about its role in combating the spread of disease…” (Douglas, 2/11).

Reuters: Brazil probes three deaths with Zika links, aims for vaccine in a year
“Recent laboratory analyses identified Zika virus infections in three people who died in Brazil last year, the health ministry said on Thursday, although authorities could not confirm that Zika alone was responsible for their deaths…” (Cascione et al., 2/11).

Washington Post: Brazil says a third adult has died of Zika
“Brazil’s health ministry said Thursday that a 20-year-old woman infected with Zika has become the country’s third adult fatality linked to the virus, but scientists caution that they’re only beginning to identify Zika’s potential risks to human health…” (Phillips/Miroff, 2/11).

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Health Authorities Prepare For Possible Zika Outbreak On Mainland Africa

Reuters: Back to its roots: how Zika may threaten Africa
“…According to new data from Cape Verde’s health ministry, more than 7,000 cases of Zika have been recorded in the country since the beginning of the epidemic in October 2015 … Regional health officials told Reuters they were most worried about Zika being exported to Senegal or Guinea Bissau, which shares the same Portuguese heritage as Cape Verde. A regional meeting on Zika took place in Dakar on Feb. 9, with African and Western partners discussing preparations for possible imported cases, according to officials…” (Rodrigues/Hirschler, 2/11).

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Wall Street Journal Examines Traditional, Innovative, Controversial Mosquito-Control Measures

Wall Street Journal: Fighting the ‘Cockroach of Mosquitoes’
“Experts working to halt the spread of the Zika, dengue, and chikungunya viruses face a stubborn foe in the main mosquito that transmits them, and some of the many methods under consideration for fighting them are stirring controversy. The Aedes aegypti mosquito primarily responsible for spreading these diseases has been called ‘the cockroach of mosquitoes’…” (McKay et al., 2/11).

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News Outlets Examine Global Health, R&D Aspects Of President's FY17 Budget Request

The Atlantic: What Is the Point of Joe Biden’s Cancer ‘Moonshot’?
“No one doubts the sincerity of Vice President Joe Biden’s ‘cancer moonshot’ initiative. But is the plan even really a ‘moonshot’? … Whether Biden can really do as much to break down the barriers between academic disciplines, between different drug companies, between drug companies and researchers, and between all of them and the federal government, remains to be seen. But there’s something to be said for the approach…” (Graham, 2/11).

The Hill: Obama Proposes Less Money To Fight World’s Top Infectious Killer
“Less than two months after unveiling a plan to fight multidrug-resistant tuberculosis, President Barack Obama has proposed cutting the U.S. Agency for International Development’s funding to combat the world’s No. 1 infectious killer — by 19 percent. This will be the fourth budget in a row from the Obama administration that calls for a 19 percent cut to tuberculosis funding at USAID. In each of the previous years, Congress rejected that reduction…” (Weber, 2/11).

The Lancet: NIH hopes funding increases will continue
“The U.S. Congress recently approved the largest single increase in funding for the National Institutes of Health (NIH) in 12 years … But almost as soon as NIH supporters stopped cheering, they began to worry about next year’s budget, and the challenge of a new public health threat, Zika virus…” (Jaffe, 2/13).

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India Launches National Framework For Malaria Elimination

News outlets report on India’s launch of a National Framework for Malaria Elimination.

Financial Express: JP Nadda launches National Framework for Malaria Elimination
“JP Nadda, Union Minister for Health & Family Welfare (MoHFW), launched the National Framework for Malaria Elimination (NFME) 2016-2030 in New Delhi, which outlines India’s strategy for elimination of the disease by 2030…” (2/12).

International Business Times: Health Ministry launches framework to eliminate malaria by 2030
“… ‘This framework has been developed with a vision to eliminate malaria from the country and contribute to improved health and quality of life and alleviation of poverty,’ said Nadda, according to a statement released by the Health Ministry…” (Sharma, 2/12).

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Return On Investments In Childhood Vaccines Can Be High In LMICs, Study Shows

Quartz: A new study confirms that spending $1 on childhood vaccines can save $44 in future savings, in poor countries
“…This month in Health Affairs, a team of U.S. public health and data specialists calculated the costs and economic benefits associated with distributing childhood vaccines for diseases in 94 low- and middle-income countries. The study, supported by the Bill & Melinda Gates Foundation and advocacy group Gavi, the Vaccine Alliance, considered 10 different antigens, including measles, rubella, human papillomavirus, and rotavirus…” (Garza, 2/11).

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UNICEF, WHO Scale Up Response To Lassa Fever Outbreak In Benin

U.N. News Centre: U.N. agencies boost efforts to prevent further spread of Lassa fever in Benin
“Following the outbreak of Lassa fever in Benin, United Nations Children’s Fund (UNICEF) and World Health Organization (WHO) officials in the country are scaling up an emergency response to help prevent further spread of the disease. To date, there have been four confirmed and 52 suspected cases of the disease in Benin, resulting in 17 deaths — two of them health workers…” (2/11).

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Editorials and Opinions

Opinion Pieces Discuss Issues Surrounding Humanitarian Response To Syrian Conflict

Devex: Syria not just a humanitarian crisis, but a development one too
Paige Alexander, assistant administrator of the Bureau for the Middle East at USAID, and Thomas H. Staal, senior deputy assistant administrator at USAID

“…The U.S. government is leading the humanitarian response inside Syria — and even as we provide immediate, lifesaving humanitarian assistance, we are working to expand opportunities for adults to work and for youth to attend school. … The continuum from humanitarian relief programs to longer term development is crucially important … We are working to ensure that the humanitarian assistance we provide to Syrian refugees has benefits for the local economies in which they are living. … The crisis will soon enter its sixth year, and the need for lasting benefits beyond basic needs and essential services is paramount for any future rebuilding of Syria…” (2/11).

Foreign Policy: How Feeding Syrians Feeds the War
Brent Eng, independent analyst, and José Ciro Martínez, doctoral candidate in politics and Gates scholar at the University of Cambridge

“…The verdict is still out on USAID’s flour-to-bakeries program and other efforts like it. On the one hand, the availability of affordable bread in rebel territory reduces local dependence on the Syrian government and helps ensure that civilians do not flee to regime- or Islamic State-controlled parts of the country (or, importantly for Jordan and Turkey, to neighboring countries) to survive. In doing so, the program saves lives, alleviates suffering, and ensures a minimum level of social stability. On the other hand, without a well-defined, inclusive opposition group, it is unclear to whom civilian loyalties are being redirected. Although such forms of external assistance may be tactically astute in the short term, they will be politically meaningless if they do not come in the context of a cohesive strategy to end the Syrian conflict. By fostering a dangerous dependency on external assistance and further fragmenting the country’s welfare apparatus, they may even make the war and its aftermath worse…” (2/11).

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Opinion Pieces Discuss Potential Unintended Consequences Of Zika Response

Huffington Post: Zika and Rubella: Vaccine Lessons for Our Future
Robert Marion, chief of genetic medicine in the department of pediatrics at Albert Einstein College of Medicine and the Children’s Hospital at Montefiore Medical Center

“…The [MMR vaccine that helped curb rubella-related congenital abnormalities] was almost a miracle. But one person’s miracle can be another person’s calamity. In the 1990s, the prevalence of [autism spectrum disorders (ASDs)] soared. Although the dramatic rise in reported cases was almost certainly due to health care providers having become more sensitive to the symptoms and signs of the condition, this explanation was not acceptable to many parents. … I hope that as we enter the age of Zika, we can learn from our experience with rubella, that although the development of a vaccine to prevent the tragedy of [Zika-related birth defects] will prove life-saving, it’s almost inevitable that eventually, someone somewhere will blame this miraculous substance for causing one or another of the world’s ills. And when that happens, it’s imperative that we in the scientific community urge the public to reserve judgment until definitive proof can be found to either prove or disprove the claim…” (2/11).

The Hill: As we respond to Zika, don’t forgot about unintended consequences
Amanda D. Rodewald, director of conservation science at the Cornell Lab of Ornithology, professor in the department of natural resources at Cornell University, faculty fellow at Cornell University’s Atkinson Center for a Sustainable Future, and Robert F. Schumann faculty fellow

“…Advocates [in favor of using DDT in response to the Zika virus] exemplify a common reaction to urgent human need: acting quickly without careful consideration of the long-term consequences. … [A] careful review of strategies to reduce Zika risk is needed, and … several alternatives exist that may be more effective, without the weighty human health and ecological burdens of DDT. … Of course we cannot act with perfect knowledge; there will always be some errors and missteps. However, we must recognize that our health and well-being are inextricably linked to healthy, functioning ecosystems. We must acknowledge that rash decisions made with limited attention to the long-term are very likely to produce unintended and often undesirable outcomes” (2/12).

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Global Community Must Coordinate Efforts To Eradicate Polio

New England Journal of Medicine: A World Free of Polio — The Final Steps
Manish Patel, member of the Task Force for Global Health, and Walter Orenstein, associate director of the Emory Vaccine Center

“…[In the process of removing all oral polio vaccines (OPVs) over the long term, c]oordinated communication among global health organizations, countries, manufacturers, and funders is imperative … Successful synchronization also requires [Global Polio Eradication Initiative (GPEI)] leaders and countries to monitor the timely completion of preparatory steps both globally and within each country … Equally, if not more, important, however, will be the monitoring of outcomes of withdrawal of the vaccine in April 2016. … More preparation for the switch is required in the coming months, and for completing polio eradication in the coming years. … Capitalizing on the gains made to date should push overall polio eradication over the finish line and may pave the way for measles eradication and future global health initiatives” (2/11).

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From the Global Health Policy Community

U.S. Working To End FGM/C

Council on Foreign Relations’s “Women Around the World”: Three Ways the United States Is Working to End FGM/C
In this guest post, Cathy Russell, ambassador-at-large for global women’s issues at the U.S. Department of State, discusses findings from a recently released UNICEF report on female genital mutilation/cutting (FGM/C) and describes the U.S. response to end the practice (2/11).

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GHTC Blog Posts Discuss Global Health R&D Funding In President's FY17 Budget Request

Global Health Technologies Coalition’s “Breakthroughs”: Global health R&D in the President’s FY17 budget request
Courtney Carson, GHTC’s senior policy and advocacy associate, examines global health research and development (R&D) aspects of President Obama’s FY 2017 budget request (2/11).

Global Health Technologies Coalition’s “Breakthroughs”: Ebola funding boost hides ongoing decline in neglected disease R&D
In a guest post, Anna Doubell, analyst at Policy Cures, discusses findings from this year’s G-FINDER report on neglected disease R&D and suggests that Ebola R&D funding masked the decline in funding for non-Ebola neglected disease R&D. Doubell writes, “This year’s report, published in December, and the supporting data, released this week, highlight funding trends and gaps for R&D to develop new health technologies for neglected diseases, which can help governments, philanthropic organizations, and industry make informed decisions…” (2/11).

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Blog Posts Discuss Issues Surrounding Zika Response

Center for Global Health Policy’s “Science Speaks”: From French Polynesia, to Brazil, through the Americas and in Cape Verde, Zika highlights need for speed in health threat response
Antigone Barton, senior writer and editor of “Science Speaks,” discusses CDC Director Tom Frieden’s remarks at a House Foreign Affairs joint subcommittee hearing on the Zika outbreak, as well as an opinion piece published in the Journal of the American Medical Association written by Dan Lucey and Lawrence Gostin of Georgetown University Medical School and Law School, respectively, on the need for the WHO to convene a committee to examine and respond to future global health threats (2/11).

Health Affairs Blog: Why Are We Years Away From A Zika Vaccine?
Rob Lott, deputy editor for special content at Health Affairs, writes, “In the new and urgent fight against the Zika virus, most global health officials and policymakers are focused on immediate steps to curb the disease’s transmission. That’s important because the chances of developing a vaccine anytime soon are slim. To understand why, Health Affairs spoke with Aaron Kesselheim, an associate professor of medicine at Harvard Medical School…” In this podcast, Lott speaks with Kesselheim about the market forces that shape vaccine development and his research published in the February issue of Health Affairs (2/11).

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