KFF Daily Global Health Policy Report

In The News

China Changes Coronavirus Case Diagnosis Criteria In Hubei Province

AP: China reports spike in virus cases with new way of counting
“China on Thursday reported a sharp spike in deaths and infections from a new virus after the hardest-hit province of Hubei applied a new classification system that broadens the scope of diagnoses for the outbreak, which has spread to more than 20 countries. … The new diagnostic approach came on the same day that Hubei and its stricken capital, Wuhan, replaced their top officials in an apparent response to public criticism of how authorities have handled the epidemic. … The total now includes more than 13,000 cases of ‘clinical diagnosis’ in Hubei, which appears to include those based on a doctors’ analysis combined with lung imaging, as opposed to waiting for laboratory test results…” (Wang, 2/13).

NPR: A Change In How 1 Chinese Province Reports Coronavirus Adds Thousands Of Cases
“China’s Hubei province expanded its criteria for identifying new coronavirus infections on Thursday, causing a dramatic spike in reported cases at the epicenter of the disease, as Beijing moved to purge provincial party officials amid criticism of their handling of the epidemic. Hubei, where the majority of the world’s infections have been concentrated, added a new category of ‘clinical cases’ to its reporting. Now, patients will be included who exhibit all the symptoms of COVID-19, the disease caused by the coronavirus — including fever, cough, and shortness of breath — but have either not been tested or tested negative for the virus itself. The change, likely a response to the scarcity of test kits and questions about their reliability, caused a ninefold increase in new reported cases in the province…” (Feng/Neuman, 2/13).

Reuters: Coronavirus diagnosis method not changed in other Chinese provinces, regions: Shanghai health commission
“The methodology for coronavirus diagnosis has not changed in other provinces apart from Hubei, and not in municipalities such as the city of Shanghai, a Shanghai Health Commission spokeswoman said on Thursday…” (Zhang/Goh, 2/13).

Additional coverage of the broader case definition and case counts is available from BBC, NBC News, New York Times, and Reuters (2)(3)(4).

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Devex Examines Potential Role For NGOs If Coronavirus Outbreak Hits Africa

Devex: What NGOs need to do if coronavirus reaches Africa
“As the outbreak of the novel coronavirus taxes the health system in China, there is growing anxiety about the potential dire consequences of the virus on countries with weaker health systems. The fears are particularly heightened across the African continent, where NGOs are expecting to play a key role in trying to contain the spread. ‘I have a great concern that if this virus makes it to a weaker health system, it will create havoc,’ said Dr. Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, during a press conference Tuesday. There are currently no confirmed cases of the new coronavirus — officially named COVID-19 — in Africa. With the help of WHO, at-risk African countries have scrambled to enhance airport screenings for passengers with symptoms and increase capacity to test for the virus — originally only two laboratories on the continent had that capability. If there is an outbreak in Africa, NGOs expect to help in areas such as patient care, support to governments, community sensitization, hygiene promotion, and contact tracing…” (Jerving, 2/13).

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Media Outlets Discuss Coronavirus Death Rate, Severity, Transmission

Los Angeles Times: How deadly is the new coronavirus? Scientists race to find the answer
“Of all the questions scientists hope to answer about the new coronavirus sweeping across the globe, the most pressing is this: How deadly is it? The only way to know is to figure out how many people have been infected — and that’s the real challenge. More than 60,000 infections have been confirmed, but experts are certain there are at least tens of thousands more. Some cases haven’t been counted because patients didn’t have biological samples sent to a lab. Some never saw a doctor, and others had such mild symptoms that they didn’t even know they were sick. Without a true picture of the total number of cases, it’s impossible to calculate a fatality rate. That’s why scores of epidemiologists and mathematicians are working to solve one of the most complex modeling problems of their time…” (Baumgaertner, 2/12).

MedPage Today: No Coronavirus Vertical Transmission in Early Study
“Findings from nine late-stage pregnancies in which the mother was infected with the novel coronavirus suggest ‘vertical transmission’ — passing infection from mother to infant in utero — does not occur. In nine pregnant women with laboratory-confirmed COVID-19 pneumonia (the new name for the novel coronavirus infection sweeping China), samples from their infants, including amniotic fluid, cord blood, and a neonatal throat swab, tested negative for the virus, reported Yuanzhen Zhang, PhD, of Wuhan University in China, and colleagues, writing in The Lancet…” (Walker, 2/12).

Washington Post: Most coronavirus cases are mild, complicating the response
“The coronavirus has killed more than 1,300 people, brought a huge swath of central China to a standstill, and rattled millions around the globe with hints of a pandemic seen in Hollywood fantasies. But the virus’s destructive potential has overshadowed one encouraging aspect of this outbreak: So far, about 82 percent of the cases — including all 14 in the United States — have been mild, with symptoms that require little or no medical intervention. And that proportion may be an undercount. Health authorities managing the outbreak are trying to understand what that critical fact portends. Are the 60,000 sick people tallied so far just a portion of a vast reservoir of uncounted victims, some of whom may be spreading the disease? And do the mild illnesses reveal characteristics of the virus itself — something that could be useful in crafting a more effective response?…” (Bernstein/Johnson, 2/12).

Additional coverage on these topics is available from Al Jazeera and STAT.

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Media Outlets Report On E.U., WHO Coronavirus Responses, Other Aspects Of Outbreak

ABC News: EU ministers hold emergency talks on COVID-19 virus (Petrequin, 2/13).

CBS San Francisco: ‘Infodemic’: World Health Officials Aim To Fight Rising Misinformation About Coronavirus (Ramirez, 2/12).

KHN: To Fight Chinese Outbreak, Doctors Deploy Drugs Targeting HIV, Malaria And Ebola (Heredia Rodriguez, 2/13).

Scientific American: Here’s How Computer Models Simulate the Future Spread of New Coronavirus (Hsu, 2/13).

Wall Street Journal: The World Health Organization Draws Flak for Coronavirus Response (Page/McKay, 2/12).

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CDC Officials Discuss Likelihood Of More Coronavirus Cases In U.S., Response Measures

CNBC: Top CDC official says U.S. should prepare for coronavirus ‘to take a foothold’
“The Centers for Disease Control and Prevention said Wednesday it is preparing for the new coronavirus, which has killed at least 1,115 and sickened more than 45,000 worldwide, to ‘take a foothold in the U.S.’ ‘At some point, we are likely to see community spread in the U.S. or in other countries,’ Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, told reporters on a conference call. ‘This will trigger a change in our response strategy.’ Health officials had confirmed 13 U.S. cases of the virus, now named COVID-19, short for Corona Virus Disease…” (Lovelace, 2/12).

STAT: CDC director: More person-to-person coronavirus infections in U.S. likely, but containment still possible
“Health officials believe there is still opportunity to prevent widespread transmission of the coronavirus in the United States, the director of the Centers for Disease Control and Prevention said Wednesday, even as he warned that more human-to-human transmission here is likely. ‘We’re still going to see new cases. We’re probably going to see human-to-human transmission within the United States,’ Dr. Robert Redfield said in an interview with STAT. He added that ‘at some point in time it is highly probable that we’ll have to transition to mitigation’ as a public health strategy, using ‘social distancing measures’ — for example, closure of certain public facilities — and other techniques to try to limit the number of people who become infected…” (Branswell, 2/12).

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Trump Administration Proposes To Cut PEPFAR Funding, Reduce U.S. Contribution To Global Fund

Washington Blade: Trump’s budget seeks increased HIV funds — but housing, global programs cut
“With a declared goal of beating HIV/AIDS in the United States by 2030, President Trump this week in his $4.8 trillion budget request for fiscal year 2021 proposed major increases in HIV/AIDS funds, but global programs … face steep cuts. … [D]espite $716 million proposed to beat HIV in a PrEP-centric ‘Ending the HIV Epidemic’ initiative, the budget seeks to cut … funding for PEPFAR and reduce the U.S. commitment to the Global Fund to Fight AIDS, Tuberculous & Malaria…” (Johnson, 2/12).

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U.S. Pledges To Commit $1.16B To Gavi For FY2020-2023, Subject To Congressional Appropriations

Becker’s Hospital Review: U.S. commits $1.16B to international vaccination effort
“[Subject to Congressional appropriations, the] U.S. is pledging $1.16 billion over the next three years to a global health partnership aiming to immunize 300 million children by 2025. … The $1.16 billion that the U.S. has committed includes $290 million in the fiscal year 2021 budget released Feb. 10…” (Vaidya, 2/12).

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W-GDP Marks 1 Year Anniversary With Announcements On Future Activities, Management

Devex: W-GDP marks year 1 with efforts to set down roots
“The Women’s Global Development and Prosperity Initiative, or W-GDP, marked its one-year anniversary Wednesday with a set of announcements and research outlining how it will be managed moving forward and what it has achieved thus far. … The State Department will take the lead role in coordinating W-GDP, which has until now been run out of the White House. … The U.S. Agency for International Development will apparently continue to manage the W-GDP fund, which was launched last year…” (Saldinger, 2/13).

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WHO Emergency Committee Upholds PHEIC Designation For DRC Ebola Outbreak

U.N. News: DR Congo Ebola outbreak still an international public health concern
“The World Health Organization (WHO) convened its Emergency Committee which reaffirmed that the risk [of Ebola] remains high at the national and regional levels, but low globally. ‘It was the unanimous view of the Committee that this event still constitutes a public health emergency of international concern (PHEIC)’, the U.N. agency said in a statement. The Committee was concerned that withdrawing the PHEIC now might have adverse consequences for the response efforts through diminishing focus’…” (2/12).

Additional coverage of the WHO Emergency Committee’s decision is available from Al Jazeera, UPI, and Xinhua.

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U.N. Secretary-General Says 250M Children Living In Conflict-Affected Areas, Urges For 'Concrete Action' To Prioritize Protection Of Children

AP: U.N. chief: 250 million children in conflict-affected nations
“Some 250 million children live in countries affected by conflict, Secretary-General Antonio Guterres told the U.N. Security Council on Wednesday. And he said 2018 saw more than 12,000 children killed or injured as a result of those conflicts, the highest number since 1996. … The secretary-general urged all countries to take ‘concrete actions’ to make the protection of children affected by conflict a priority…” (Lederer, 2/13).

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U.N. To Support African Governments' Efforts To Expand Access To Reproductive Health Services

Xinhua: U.N. pledges support for reproductive health agenda in Africa
“The United Nations will support African governments to expand access to quality and affordable reproductive health services for disadvantaged groups like women and girls living in urban slums, officials said on Wednesday…” (2/12).

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More News In Global Health

Devex: To deliver tech solutions in delivery rooms, donors look to distribution (Cheney, 2/13).

Outbreak News Today: Africa: CDC issues travel notice for 15 countries due to polio outbreaks (2/12).

Washington Blade: Transgender Hondurans with HIV face uncertain future (Lavers, 2/12).

Washington Post: Guatemala lawmakers OK controversial NGO regulations (Pérez, 2/12).

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Editorials and Opinions

Strong Health Systems, Responsive Governance Critical To Outbreak Preparedness, Opinion Piece Says

The Atlantic: Coronavirus Is Spreading Because Humans Are Healthier
Thomas J. Bollyky, director of the global health program at the Council on Foreign Relations

“…[S]hoe-leather public health and basic medical care — not miracle drugs — are generally what stop outbreaks of emerging infections like severe-acute respiratory syndrome and the Ebola virus. … Humanity’s progress against infectious diseases is neither free nor irreversible. …  If the latest outbreak spreads to poorer nations in Africa or South America, it will become a pandemic, difficult for even the most prepared nations to control. This particular outbreak may have been hard to predict in advance, but the threat that a novel virus would pose to fast-urbanizing nations with underdeveloped health systems was not. Only investment in health care systems, responsive governance, and the international architecture needed to prevent, detect, and respond to future outbreaks can prepare the world for threats like COVID-19. The historic improvements in global health over the last several decades are an opportunity, not a guarantee” (2/12).

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Health Equity, Investments In R&D Critical To Achieving SDGs

Devex: Opinion: Fighting for global health with ‘one-two punch’ of innovation and access
Jamie Bay Nishi, director of the Global Health Technologies Coalition

“…To reach the [Sustainable Development Goals (SDGs)], we must do two things at once: Reach everyone with the solutions we have, while increasing research investments to find the solutions we don’t. … [W]hile expanding access to existing interventions is essential to health equity, it’s also important that global health advocates give equal attention to the need for greater investments in R&D. … The fact is that today, we don’t yet have the tools we need to achieve the health-related ambitions enshrined in the SDGs. But they are clearly within reach — if we continue to invest in R&D while working to ensure breakthroughs emerging from what many consider to be a golden age for biomedical innovation are available to all” (2/13).

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From the Global Health Policy Community

Global Health Council Urges Congress To Reject Proposed Cuts To Global Health In Trump Administration's FY2021 Budget Request

Global Health Council: Global Health Council Calls for Increased U.S. Investment in Global Health and International Development Programs
“The Trump Administration released its proposed budget for Fiscal Year (FY) 2021 [on Monday], which contains a … decrease in the international affairs budget, including a 34% cut to global health programs at the U.S. Agency for International Development (USAID) and Department of State. Cuts were also proposed for programs that support global health … at the Department of Health and Human Services, and its Centers for Disease Control and Prevention (CDC). These proposed cuts will drastically undermine the leadership role the United States plays in global health, decrease the likelihood of progress at the country level, and limits our capacity to fight pandemics today or tomorrow. … As it has previously, Global Health Council calls on Congress to reject the President’s budget as presented and further urges the continued funding of global health and international development programs across federal government accounts…” (2/10).

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CFR Experts Discuss Potential Impact Of Novel Coronavirus On International Cooperation

Lawfare: No Nation Can Fight Coronavirus on Its Own
Thomas Bollyky, director, and Samantha Kiernan, research associate, both at the global health program at the Council on Foreign Relations (CFR), discuss the role of pandemics in international cooperation, writing, “Microbes have continued to inspire episodes of cooperation among even bitter rivals. … Perhaps a pandemic of novel coronavirus, if it occurs, would be a sufficiently frightening antagonist to force international cooperation, even at a moment that otherwise has proved inhospitable to global governance” (2/12).

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Global Health Security Index Highlights Countries Best Prepared For Health Emergencies

World Economic Forum: These are the countries best prepared for health emergencies
David Elliott, senior writer for Formative Content at the World Economic Forum, discusses findings from the Global Health Security Index, a report that assesses countries’ ability to prevent, detect, and respond to health emergencies. Elliott notes, “The 195-country study finds national health security to be ‘fundamentally weak’ around the world. No nation is fully prepared to handle an epidemic or pandemic, it says. … Stronger, unified responses to these threats … will be of vital importance” (2/12).

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Population Foundation Of India Executive Director Discusses Calls For A 'Two-Child Norm' In Country, Argues For Increased Investments In Women, Girls

Think Global Health: Human Development is the Best Contraceptive — Why India Does Not Need a Two-Child Norm
Poonam Muttreja, executive director of the Population Foundation of India (PFI) argues against calls for the introduction of a ‘two-child norm’ in India in order to curb population growth. Muttreja writes, “The key to harnessing the potential of India’s population lies not in a two-child norm but in enhancing the capabilities of young people and expanding the freedoms enjoyed by girls and women. In the ultimate analysis, human development is the best contraceptive” (2/11).

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Aidspan Publishes New Issue Of 'Global Fund Observer'

Aidspan: Global Fund Observer
Aidspan, an independent watchdog of the Global Fund to Fight AIDS, Tuberculosis and Malaria, has published Issue 373 of the ‘Global Fund Observer.’ The newsletter features an article on the Global Fund’s first-ever allocation of funding to Venezuela to address malaria; a report on the nature of civil society and community engagement in the Global Fund’s country dialogue process in Asia-Pacific; and an analysis that finds that the Global Fund finances the majority of insecticide-treated nets for malaria globally (2/12).

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From the U.S. Government

NIAID Perspective Outlines Recent Progress In Improved TB Diagnostics, Prevention, Treatment

NIH: Recent advances in addressing tuberculosis give hope for future
“In September 2018, the National Institute of Allergy and Infectious Diseases (NIAID), part of the NIH, issued its Strategic Plan for Tuberculosis Research, which outlined research priorities to reduce and ultimately end the burden of tuberculosis (TB). … Now, a new ‘Perspective‘ in The Journal of Infectious Diseases by NIAID Director Anthony S. Fauci, M.D., and other Institute officials summarizes recent progress in improved TB diagnostics, therapeutic regimens, and prevention approaches that made 2019 a ‘banner year’ for TB research…” (2/11).

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