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Kaiser Daily Global Health Policy Report

In The News

U.S. House Rejects President Obama's Request For $1.8B In Zika Emergency Funding, Citing Unused Ebola Money

CQ News: House Appropriators Push Administration to Use Ebola Funds for Zika
“House Republican appropriators told the Obama administration Thursday that they prefer to tap unused Ebola funding to fight the emerging Zika virus — an idea Obama administration officials had resisted, but are now signaling a willingness to partially accept. Congress would have to send President Barack Obama legislation allowing any transfers. An administration official said Thursday evening that Obama is open to shifting only the amount of unobligated Ebola funds that have not yet been planned to be used for important activities…” (Zanona, 2/18).

The Hill: House rejects Obama’s request for $1.8 billion to fight Zika
“The head of the House Appropriations Committee on Thursday turned down the Obama administration’s request for emergency funding to fight the Zika virus, citing a pool of funding leftover from the Ebola virus. Federal health officials had requested $1.8 billion to combat the Zika virus both in the U.S. and abroad. … The GOP’s response to Obama’s funding request is likely to draw fire from Democrats, who have said that Ebola funding should be used to shore up public health systems that would prevent another Ebola-like health scare…” (Ferris, 2/18).

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Zika Will Have Moderate Economic Impact In LAC, World Bank Says, Makes $150M Available Immediately

News outlets report on the World Bank’s initial projections for Zika’s impact in Latin America and the Caribbean, as well as an announcement the bank would make $150 million available immediately.

Associated Press: World Bank sees modest economic drag from Zika
“The spread of Zika will have a modest drag on economies in Latin America, with tourism-dependent Caribbean nations most at risk, the World Bank said Thursday. It made $150 million immediately available to help fight the virus…” (Goodman, 2/18).

The Hill: World Bank: Zika to cost at least $3.5B
“The World Bank on Thursday warned that the spread of the Zika virus across Latin America and the Caribbean is expected to cost those regions about $3.5 billion in forgone economic output…” (Ferris, 2/18).

Wall Street Journal: World Bank Calculates Zika’s Economic Cost in Latin America
“…The figure represents only 0.06 percent of gross domestic product of the region’s countries, but those that are most highly dependent on tourism could experience losses of more than one percent of GDP, according to the bank…” (Lewis/Magalhaes, 2/18).

Washington Post: World Bank announces $150 million to fight Zika outbreak
“…The [$150 million in] funding, being made available immediately, comes after extensive consultations with governments in the region, the bank said in a statement. The bank said it could provide additional financing if needed…” (Dennis/Sun, 2/18).

Washington Times: World Bank extends $150 million for Zika fight
“… ‘Our analysis underscores the importance of urgent action to halt the spread of the Zika virus and to protect the health and well-being of people in the affected countries,’ bank President Jim Yong Kim said. ‘The World Bank Group stands ready to support the countries affected by this health crisis and to provide additional support if needed’…” (Howell, 2/18).

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Pope Francis Suggests Contraception Acceptable In Zika-Hit Nations, Says Abortion 'Absolute Evil'

Associated Press: Pope suggests contraception can be condoned in Zika crisis
“Pope Francis has suggested women threatened with the Zika virus could use artificial contraception, saying ‘avoiding pregnancy is not an absolute evil’ in light of the global epidemic…” (Winfield, 2/19).

The Guardian: Pope suggests contraception can be condoned in Zika crisis
“…However he reiterated the church’s staunch opposition to abortion, saying it was a crime and ‘absolute evil’…” (Sherwood, 2/18).

International Business Times: Pope Francis and Zika: Women Threatened By Virus Could Use Birth Control, Pontiff Says
“…Even if the pope condones the use of birth control, people in the region may not have access to it. In 2015, clinics in the Dominican Republic, El Salvador, Guatemala, Haiti, and Honduras ran out of contraceptives, a recent report by the Kaiser Family Foundation found…” (Whitman, 2/18).

New York Times: Francis Says Contraception Can Be Used to Slow Zika
“…The careful positioning of the pope on the use of contraception reflects how the emergence of Zika, which was officially identified in Brazil less than a year ago, is forcing a wide array of political and religious institutions to respond to the virus’s rapid spread to more than 20 countries…” (Romero/Yardley, 2/18).

Wall Street Journal: Pope Francis Says Contraception Can Be Acceptable in Regions Hit by Zika Virus
“…[The pope’s comments] also could resonate in Africa, where AIDS still kills an estimated 1.1 million people a year. The use of condoms to help prevent its transmission has long been a flashpoint between the Catholic Church and health workers…” (Rocca, 2/18).

Washington Post: Pope: Contraceptives could be morally permissible in avoiding spread of Zika
“…Theologians disagreed about whether the outspoken pontiff had said something new. Popes in the past have spoken of exceptions to the ban on artificial contraception, but the debate Thursday centered on the context…” (Borstein et al., 2/18).

ABC News: Pope Francis Says Contraception May Be ‘Lesser of Two Evils’ During Zika Virus Outbreak (Mohney/Moran, 2/18).

Agence France-Presse: Pope Francis on Zika: abortion a crime, contraception a lesser evil (2/18).

The Atlantic: The Pope Takes on Contraception and the Zika Virus (Green, 2/18).

The Hill: Pope suggests people can use contraception to avoid Zika virus (Sullivan, 2/18).

Reuters: Zika crisis pressures Vatican to soften contraception stance (Eisenhammer, 2/18).

USA TODAY: Pope suggests contraception can be condoned in Zika crisis (Bacon, 2/18).

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WHO Calls For Use Of, Access To Contraception For Women In Zika-Affected Nations

New York Times: WHO Recommends Contraception in Countries With Zika Virus
“The World Health Organization issued a strong call on Thursday for the use of contraception in countries with the Zika virus, and said that women who had unprotected sex and feared infection should have access to emergency contraception, a recommendation that may not sit well with the Roman Catholic Church…” (Tavernise, 2/18).

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Obama Administration Officials Concerned Over Zika In Puerto Rico, Given Territory's Limited Health Care Infrastructure, Medicaid Funding

Wall Street Journal: Obama Administration Pushes Steps to Aid Puerto Rico With Zika Virus
“Obama administration officials are increasingly worried about Puerto Rico’s ability to handle a projected influx of Zika virus cases, given the territory’s struggling health care infrastructure and limits on federal Medicaid funding. … In addition to its health care infrastructure, Puerto Rico is challenged by a debt crisis that has left its government unable to repay obligations. It has more than $70 billion in debt. … ‘It’s a triple whammy,’ said Diane Rowland, executive vice president at the Kaiser Family Foundation. ‘They have a low-income population, limited health care infrastructure, and capped Medicaid. It’s a trifecta. It highlights what happens in an emerging health emergency’…” (Armour, 2/18).

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Researchers Continue To Search For Answers On Zika's Short-, Long-Term Effects

Austin American-Statesman: Health officials scramble to fill research gaps on Zika virus
“Health authorities say they are learning every day about Zika but still have wide knowledge gaps, including whether other types of mosquitoes or animals can be infected and spread the virus and whether pregnant women who catch it but have no symptoms might still have a baby with birth defects…” (Roser, 2/17).

MedPage Today: Zika Found in Amniotic Fluid
“Zika virus was found in amniotic fluid from two pregnant women in Brazil whose fetuses were microcephalic, strengthening the possible link between the virus and birth defects, researchers said. … In an online forum, [NIAID Director Anthony Fauci] told reporters that it will take ‘careful case-control studies’ to pin down whether Zika infection causes microcephaly. Those studies, he said, are already being initiated in Brazil…” (Smith, 2/18).

New York Times: Zika May Increase Risk of Mental Illness, Researchers Say
“…[R]eproductive health experts are warning that microcephaly may be only the most obvious consequence of the spread of the Zika virus. Even infants who appear normal at birth may be at higher risk for mental illnesses later in life if their mothers were infected during pregnancy, many researchers fear…” (McNeil, 2/18).

Reuters: Experts question assumption that Zika sickens just 1 out of 5
“Since the beginning of the Zika outbreak in Brazil that is now spreading rapidly in the Americas, public health authorities have cited a statistic that only about one in five people infected by the virus develops any symptoms. Experts, however, are now questioning whether this standard assumption understates the actual percentage who become ill, saying the finding was made nearly a decade ago in a vastly different setting: a sparsely populated island in Micronesia…” (Prada, 2/18).

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U.S., Brazilian Researchers Discuss Research Agendas For Zika Virus

Global Health NOW: Zika: Defining a Research Agenda
“…To clarify what is known and unknown about the virus and define a research agenda, the Johns Hopkins Bloomberg School of Public Health (JHSPH) gathered global experts Wednesday to share pieces of the puzzle from their various areas of expertise…” (2/17).

Reuters: U.S., Brazil researchers join forces to battle Zika virus
“Top U.S. and Brazilian medical experts met on Thursday to launch a research partnership to find a vaccine against the Zika virus that has spread rapidly through the Americas since it first appeared in the hemisphere last year…” (Boadle, 2/18).

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U.S. Homeland Security Ends Ebola Screening For Passengers Arriving From West Africa

The Hill: Homeland Security Department ends enhanced Ebola screening
“Thursday is the last day of enhanced screening for Ebola of travelers returning from West Africa. The Department of Homeland Security made the announcement on Thursday, citing the Centers for Disease Control and Prevention declaring West Africa Ebola-free…” (Sullivan, 2/18).

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Devex Examines Potential Development Priorities In Cuba, Including Food Security

Devex: Cuba’s development priorities in the new landscape
“…With Obama revealing Thursday that he is set to visit the Caribbean island nation in March as part of a broader trip to Latin America, is Cuba finally on a steady course away from isolation? What are the impacts for the global development community and how can aid actors ensure that transitioning to a market-based economy will not exacerbate inequality in the country? … Despite Cuba’s success in fighting hunger, food security remains a major concern in the country’s poorest regions. That is likely to be the key area in which international cooperation is expected to focus in the future, in addition to climate change and disaster risk reduction…” (Pasquini, 2/19).

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Food Air Drops To Begin In Syria, U.N. Says Following International Agreement

New York Times: Agreement Clears the Way for Airdrops of Humanitarian Aid in Syria
“Most of the Russian and American aircraft traversing Syria have been warplanes firing missiles and dropping bombs. But under an international agreement to aid Syrians trapped in the fighting, Russian planes will soon be dropping food in an operation partly financed by the United States…” (Cumming-Bruce/Sengupta, 2/18).

Reuters: U.N. aims to air drop food to IS-besieged city in eastern Syria
“The United Nations plans to make its first air drops of food and other aid in Syria, to Deir al-Zor, an eastern city of 200,000 besieged by Islamic State militants, the chair of a U.N. humanitarian task force said on Thursday…” (2/18).

Reuters: U.N. Syria envoy says wants to ‘work on’ expanding aid air drops
“U.N. Syria envoy Staffan de Mistura said on Thursday the United Nations wanted to ‘work on’ the idea of air drops of aid to besieged Syrians in different areas of the country…” (2/18).

U.N. News Centre: Syria: humanitarian air drops ‘very concrete proposal,’ says U.N. envoy
“…He added that the main goal is getting to ‘all of the millions in hard to reach areas,’ including Aleppo, where the U.N. Office for the Coordination of Humanitarian Affairs (OCHA) [Thursday] reported that intense fighting continues, including through aerial bombardments…” (2/18).

VOA News: U.N. Set to Air-drop Food to Syrian Area Held by IS
“…The United Nations has repeatedly called for all parties in Syria to allow unhindered humanitarian access. U.N. officials estimate 13.5 million people in Syria need humanitarian assistance. Another 4.6 million Syrians have fled the country as refugees since early 2011…” (2/18).

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Ukraine's Health System Reform Stalls; UNICEF Calls For Humanitarian Access To Country's Children Who Need Psychological Support

The Lancet: Ukraine’s beleaguered health system awaits reform
“Disillusioned doctors in Ukraine are warning that the country’s health care system is crumbling because of a severe lack of investment as reforms to the sector stall…” (Holt, 2/20).

New York Times: Ukraine: UNICEF Warns of Conflict’s Toll on Children
“More than 500,000 children in eastern Ukraine have been ‘deeply affected’ by the trauma of living through the violent conflict between government forces and insurgents that began two years ago, the United Nations Children’s Fund, UNICEF, said in a report issued Thursday, and many need psychological and social support…” (Gladstone, 2/18).

U.N. News Centre: Two years on, Ukraine conflict affects over half a million children — UNICEF
“… ‘Two years of violence, shelling, and fear have left an indelible mark on thousands of children in eastern Ukraine,’ Giovanna Barberis, a UNICEF representative in the eastern European nation, said in a press release…” (2/19).

VOA News: UNICEF Calls for Access to 500,000 Children in Eastern Ukraine
“…UNICEF is calling on both sides in the Ukraine conflict to ensure unhindered humanitarian access to the children in need. The agency says it has already been working to provide children in the affected areas with psychosocial support, education, hygiene supplies, vaccines and information on landmines and other wartime hazards” (2/19).

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Continuing Conflict Exacerbates Health, Humanitarian Crises In Yemen

The Lancet: Yemen’s neglected health and humanitarian crisis
“Despite the easing of a naval blockade, Yemen still faces severe shortages of medicines, water, and fuel amid ongoing coalition airstrikes across the country…” (Burki, 2/20).

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Microbiome Influences Nutrition, Growth Status, Studies Show; Better Understanding Could Lead To New Therapies, Food Supplements

Agence France-Presse: Some gut microbes protect against malnutrition’s harms
“Certain gut microbes may encourage normal growth in children who suffer from chronic malnutrition, and could lead to a therapy for millions of underfed kids worldwide, researchers said Thursday…” (2/18).

The Atlantic: How Microbes Make Malnutrition Worse
“…Together, these studies illustrate the big themes in microbiome research: how influential our microscopic companions are; how much potential there is for improving our health by manipulating them; and how carefully we must proceed in doing so” (Yong, 2/18).

Washington Post: Could the right bacteria help save children from malnutrition?
“A trio of new studies suggest that the bacteria living in children’s guts could play a vital role in protecting them from malnutrition — the leading cause of death before age five — and in allowing them to benefit from consuming breast milk. Scientists haven’t yet found a microbial quick-fix to save undernourished kids, but their work could lead to more effective treatments…” (Feltman, 2/19).

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Editorials and Opinions

WHO Emergency Committee On Zika Explains Decision For Declaring Public Health Emergency Of International Concern

The Lancet: Zika virus and microcephaly: why is this situation a PHEIC?
David L. Heymann, head and senior fellow at the Chatham House Center on Global Health Security and professor of infectious disease epidemiology at the London School of Hygiene & Tropical Medicine, and colleagues, all members of the WHO Emergency Committee on Zika virus

“…Representatives from four countries (Brazil, El Salvador, France, and the USA) that have had either outbreaks or importations of Zika virus, and a group of arbovirus specialists, took part in the meeting. … [W]e were able to discern as a committee, and then agree unanimously in an initial poll, that the clusters of microcephaly and neurological disorders, and their possible association with the Zika virus, constituted a PHEIC. … The first recommendation of the PHEIC was to call for standardised and enhanced surveillance of microcephaly in areas of known Zika virus transmission. … Our second recommendation under the PHEIC is for increased research into the etiology of confirmed clusters of microcephaly and neurological disorders to determine whether there is a causative link to Zika virus, other factors, and cofactors. … After our discussion on the PHEIC, there was unanimous agreement to make recommendations for precautionary measures to prevent arboviral infection. … The Director-General declared the Ebola outbreaks a PHEIC because of what science knew about the Ebola virus from many years of research during outbreaks in the past, whereas she declared the current PHEIC because of what is not known about the current increase in reported clusters of microcephaly and other disorders, and how this might relate to concurrent Zika outbreaks…” (2/20).

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Linking Health, Education Critical To Reducing HIV Among Adolescent Girls, Young Women

Huffington Post: Education and Health: Keys to Reducing HIV among Adolescent Girls and Young Women
Mark Dybul, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria

“…Hard work by global partners in health succeeded in halting and reversing the spread of HIV worldwide. But adolescent girls and young women have not seen the same progress. … If adolescent girls and young women get the education and access to care to protect themselves, we can beat back HIV in all sectors of the population — including amongst adolescent girls and young women. Through innovative new programs, this is starting to happen. … [One] new approach combines innovative measures that improve health by removing barriers to education among girls, supporting access to sexual and reproductive services, addressing gender-based violence, and improving the well being of girls and their families. To break the interconnected factors of disease, inequality, and poverty, countries and development partners must invest in programs that link health and education…” (2/18).

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Universal Access To Vaccines Achievable, Essential For Children To Live Healthy Lives

Ethiopian Herald: Africa: Now Is the Time to Reach Every Child with Life-Saving Vaccines
Matshidiso Moeti, WHO regional director for Africa, and Ala Alwan, WHO regional director for the Eastern Mediterranean

“Africa has an incredible opportunity to provide a better life for each and every child, and we know exactly how to seize it — provide universal access to immunization across the continent to protect them from vaccine preventable diseases. … Unfortunately, far too many children in Africa still miss out on essential immunization services. … To galvanize action, the World Health Organization’s offices for Africa and the Eastern Mediterranean, in conjunction with the African Union and other partners, are hosting the first-ever Ministerial Conference on Immunization in Africa, in Addis Ababa from February 24-25, 2016. … The benefits of immunization for Africa have never been clearer, and universal access to immunization is an achievable goal. We look forward to convening leaders from across sectors and countries … to take bold action to ensure that every African child receives the vaccines he or she needs to live a healthy and productive life…” (2/19).

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U.N. SG's World Humanitarian Summit Report Should Have Included More On Health Issues

The Lancet: An ambitious agenda for humanity
Editorial Board

“…Last week, Ban Ki-moon released his report for the [World Humanitarian Summit that will take place in Istanbul in late May] — One Humanity: Shared Responsibility — which presents his vision for humanitarian reform. … [M]ore could have been specifically included on health. For example, non-communicable diseases (NCDs) in conflict-affected populations are a serious, neglected health concern. NCDs, and the substantial funds needed for their treatment, should have been acknowledged. The report could have also recognized the opportunity of using the skills and training of refugee doctors and nurses who are often not allowed to provide services in their own refugee communities. However, despite these shortcomings, one, overarching issue is clear: the current response to health and humanitarian crises has substantial failings. … Ban Ki-moon’s initiative is an ambitious attempt to address the situation. Its realization will depend on how seriously countries believe in, value, and are willing to act on the concept of collective responsibility…” (2/20).

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Essays Discuss Impact Of AIDS Epidemic On Global Health

The Conversation: AIDS global health series
The following two essays are part of a series written by Lawrence O. Gostin, professor of global health and director of the O’Neill Institute at Georgetown University.

The Conversation: The scientific journey of AIDS from despair to cautious hope
“…The very success of the AIDS movement has sparked a debate about the ethical allocation of scarce resources. … It requires agonizing decisions on how to allocate life-saving interventions. Who should receive treatment when all cannot access it? Should priority go to research, prevention, or treatment? And, ultimately, should AIDS receive a higher priority than other health threats? These are life-and-death questions for millions of people, and there is no consensus on the right answers…” (2/17).

The Conversation: How AIDS brought global health to the world political stage
“…Unquestionably, the AIDS movement has had dramatic success, which has redounded to the benefit of global health. … AIDS brought global health to the world political stage, raising consciousness about security, trade, intellectual property, and human need. In short, AIDS forever changed the way we think about health, culture, and politics” (2/18).

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From the Global Health Policy Community

U.S. Officials Discuss Challenges Of, Responses To Zika Virus

Humanosphere: Lessons from mishandling Ebola crisis evident in Zika response
Humanosphere reporter Tom Murphy discusses statements CDC Director Tom Frieden and Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), made during a media briefing where they discussed the U.S. response to Zika virus, compared the situation to the Ebola outbreak, and called for health systems strengthening (2/18).

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CSIS Report Discusses U.S. Role In Transitioning Polio Eradication Assets In Ethiopia

Center for Strategic & International Studies’ “Global Health Policy Center”: Bolstering Public Health Capacities through Global Polio Eradication
The summary of this report by Nellie Bristol, senior fellow, and Chris Millard, research associate and program manager, both at the CSIS Global Health Policy Center, states, “U.S.-funded global polio eradication assets provide valuable health services support in Ethiopia’s hard-to-reach border regions. The assets, including laboratory strengthening, health worker training, and vaccine cold chain support, contribute toward both countries’ health goals, including improved immunization coverage and disease surveillance capacities. The U.S. government should be a proactive partner as the Ethiopian government begins making hard choices about which assets should be continued and how they should be paid for” (2/17).

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Gates Foundation Calls For Proposals To Improve Malaria Surveillance, Data Availability

Bill & Melinda Gates Foundation’s “Impatient Optimists”: Challenge: help apply advances in information communication technology to malaria elimination
Erin Stuckey, program officer and global health fellow on the malaria team at the Bill & Melinda Gates Foundation, discusses the importance of accurate surveillance data in malaria elimination efforts and describes the foundation’s call for proposals on “innovative solutions for improving data availability and use in decision-making for malaria elimination” (2/18).

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'Science Speaks' Discusses Findings From Investigation Into Cambodian HIV Outbreak

Center for Global Health Policy’s “Science Speaks”: Cambodia HIV cluster highlights medical injection issues
Antigone Barton, senior writer and editor of “Science Speaks,” discusses an investigation published in the CDC’s Morbidity and Mortality Weekly Report examining a cluster of HIV infections in the Cambodian village of Roka, where most people were infected through injections using shared needles. The case shows “the explosive outbreak potential when HIV is introduced into settings where contaminated needles are shared,” Barton writes (2/18).

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