Kaiser Daily Global Health Policy Report

In The News

Tensions Rise In Venezuela Over Humanitarian Aid From U.S., Russia; Health Care System Continues Collapse

Associated Press: Aid wars: U.S.-Russia vie to ease Venezuelan crisis
“Call it the aid wars. The Trump administration is accusing President Nicolas Maduro of starving Venezuelans by blocking tons of American-supplied humanitarian aid stored next door in Colombia. In Russia, the Kremlin sees the opposition’s plan to ram the aid across the border as a reckless pretext for ordering a U.S. military intervention. As tensions in Venezuela mount ahead of a Saturday showdown over humanitarian aid, both sides are digging in, highlighting how the South American nation’s crisis has become the latest fault line in a battle for global influence by the former Cold War adversaries…” (Goodman et al., 2/20).

The Guardian: ‘I came to Peru to survive’: Venezuelans migrating for HIV drugs
“…The Venezuelan Pharmaceutical Federation estimates AIDS-related deaths have more than doubled as a result of an 85 percent shortage of medicines in the country…” (Collyns, 2/21).

VOA News: Venezuela’s Health Care System Continues Downward Spiral
“U.N. and international health agencies say Venezuela’s health care crisis is causing a rise in infectious diseases and the re-emergence of illnesses such as malaria and tuberculosis, once considered vanquished. The World Health Organization (WHO) blames Venezuela’s complex political and socio-economic situation for the virtual collapse of the country’s health care system. It says the system is under stress because of a shortage of doctors and nurses who have left the country, as well as a lack of medical supplies and other factors…” (Schlein, 2/20).

Additional coverage of the humanitarian crisis in Venezuela is available from the New York Times, Outbreak News Today, Reuters, and Xinhua News.

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PolitiFact Wisconsin Examines Rep. Grothman's Statements On U.S. Tax Dollars Funding Abortions Abroad

PolitiFact Wisconsin: Grothman off-base with claim on U.S. tax dollars funding abortions abroad
“On Jan. 3, 2019, the House of Representatives — fresh under Democratic control — passed a bill in an effort to reopen government departments that were affected by the partial shutdown. Ultimately, that bill didn’t go anywhere, and the shutdown was resolved differently. But we wanted to return to that piece of legislation and a claim made by U.S. Rep. Glenn Grothman, R-Glenbeulah. … Is Grothman correct that a provision in the first bill passed by House Democrats would ‘allow the billions of dollars of aid we send to other countries to be used for abortions?’ … [H]ad the House Democrats been successful with their measure, and [undone] the new [Protecting Life in Global Health Assistance, also known as the Mexico City] policy, would it mean U.S. aid money could then go to fund abortions? No. Before the Mexico City policy, there was a budget amendment enacted in 1973 that states ‘no foreign assistance funds may be used to pay for the performance of abortion as a method of family planning or to motivate or coerce any person to practice abortions.’ The so-called ‘Helms Amendment’ … remains in place…” (Soellner, 2/19).

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Spending On Health Care Increasing Faster Than Rest Of Global Economy, Especially In LMICs, WHO Report Shows

U.N. News: Spending on health increase faster than rest of global economy, U.N. health agency says
“Spending on health is outpacing the rest of the global economy, particularly in low- and middle-income countries, the World Health Organization (WHO) said on Wednesday. According to the U.N. health agency, ‘countries are spending more on health, but people are still paying too much out of their own pockets.’ The agency’s new report on global health expenditure launched on Wednesday reveals that ‘spending on health is outpacing the rest of the global economy, accounting for 10 percent of global gross domestic product (GDP)’…” (2/20).

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Financial Times Examines Criticism Of, Support For World Bank's Pandemic Bonds

Financial Times: World Bank’s ‘pandemic bonds’ under scrutiny after failing to pay out on Ebola
“…[Two years ago, the World Bank] had just sold its first ‘pandemic bonds,’ raising $320m from private investors, in a deal designed to help developing nations facing a serious outbreak of infectious disease. … Just a year later, a severe attack of Ebola hit the Democratic Republic of Congo. So far it has claimed almost 500 lives and become the second-largest outbreak ever recorded, according to Médecins Sans Frontières. Yet the bonds have yet to pay out a penny…” (Allen, 2/20).

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Pregnant, Lactating Women, Infants In DRC To Be Offered Ebola Vaccine In Policy Reversal

STAT: Ebola vaccine will be provided to women who are pregnant, marking reversal in policy
“Women who are pregnant and lactating, as well as children under the age of one, will be offered access to an experimental Ebola vaccine in the Democratic Republic of the Congo, officials said Wednesday, marking the reversal of a controversial policy that had drawn fire from public health experts. The decision was made by a committee advising the Congolese Ministry of Health, but received the support of the World Health Organization. It followed an outcry over the exclusion of pregnant women from the vaccination program, with some experts calling the initial policy ‘indefensible’…” (Branswell, 2/20).

Additional coverage of the policy change and the DRC Ebola outbreak is available from CIDRAP News, The Telegraph, and Xinhua News.

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War, Economic Collapse Severely Impacting Yemen's Health Care System, Allowing Diseases To Spread

Reuters: Starving girl shows impact of Yemen war, economic collapse
“Displaced by war, starving, and living under a tree, 12-year-old Fatima Qoba weighed just 10kg when she was carried into a Yemeni malnutrition clinic. … Qoba’s slide into starvation is typical of what is happening in much of Yemen, where war and economic collapse have driven around 10 million people to the brink of famine, according to the United Nations…” (Barrington et al., 2/14).

U.N. News: Humanitarian crisis in Yemen remains the worst in the world, warns U.N.
“An estimated 24 million people — close to 80 percent of the population — need assistance and protection in Yemen, the U.N. warned on Thursday. With famine threatening hundreds of thousands of lives, humanitarian aid is increasingly becoming the only lifeline for millions across the country…” (2/14).

Xinhua News: Feature: Lethal swine flu spreads in war-torn Yemen amid collapse of health system
“…Plagued by cholera, malnutrition, diphtheria, and now swine flu, the Arab country is unable to cope with the most deadly epidemics as its four years of civil war has almost destroyed its health care system…” (al-Azaki, 2/17).

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U.N., Partners Appeal For $920M To Assist Rohingya Refugees In Bangladesh

U.N. News: U.N. and partners appeal for $920 million to meet ‘dire needs’ of Rohingya refugees
“With more than 745,000 Rohingya having fled violence in Myanmar to settle in Bangladesh, joining roughly 200,000 others already sheltering there, United Nations aid agencies and partners launched an appeal on Friday to help meet their ‘dire needs’…” (2/15).

VOA News: $920M U.N. Appeal Aims at Rohingya Humanitarian Crisis
“…The U.N. high commissioner for refugees, Filippo Grandi, said that in the coming weeks, work must be accelerated to protect the Rohingya from the ravages of the next monsoon season. … The U.N. said more than half of the funding would go for food, water, sanitation, and shelter. Other key sectors of the appeal include health, site management, and protection for children and survivors of sexual and gender-based violence…” (Schlein, 2/15).

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CARE Releases Report On 10 Most Underreported Humanitarian Crises Of 2018

Devex: Humanitarian crises where media is missing in action
“Media plays an important role in bringing attention to the most devastating disasters around the world. But in the eyes of media, not all crises are created equal. For the third year running, CARE has released its report on the 10 most underreported humanitarian crises of 2018. … Those in Africa dominate the list. … Outside Africa, the impact of category five Typhoon Mangkhut on Luzon Island in the Philippines last September was overshadowed by other disasters in the region … But the Haiti food crisis — created by frequent natural disasters, poverty, and political instability — was identified as the most underreported humanitarian crisis in 2018…” (Cornish, 2/21).

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Climate Change Impacting Global Health, Food Production, Insect Activity, Studies Show

Scientific American: Climate Change Is Having a Major Impact on Global Health
“…[C]limate change is making … extreme weather more common — and the effects will not be limited to the old and sick. Warming temperatures do not only threaten lives directly. They also cause billions of hours of lost labor, enhance conditions for the spread of infectious diseases, and reduce crop yields, according to a recent report. The report, published last December in The Lancet, represents the latest findings of The Lancet Countdown — a coalition of international research organizations collaborating with the World Health Organization and the World Meteorological Organization. The group tracks the health impacts of — and government responses to — climate change…” (Lewis, March 2019).

Scientific American: Warming Climate Implies More Flies — and Disease
“The incidence of foodborne illness could jump in a warming world, due to an increase in housefly activity…” (Intagliata, 2/20).

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Researchers Test Genetically Modified Mosquitoes In High-Security Italian Lab; Study Examines Ethics Of Pest Elimination

NPR: Scientists Release Controversial Genetically Modified Mosquitoes In High-Security Lab
“Scientists have launched a major new phase in the testing of a controversial genetically modified organism: a mosquito designed to quickly spread a genetic mutation lethal to its own species, NPR has learned. For the first time, researchers have begun large-scale releases of the engineered insects, into a high-security laboratory in Terni, Italy…” (Stein, 2/20).

Popular Mechanics: Scientists Are Testing a Way to Exterminate Mosquitoes for Good
“…The researchers plan to genetically modify mosquitoes using the new CRISPR gene-editing technology, infusing a handful of mosquito larvae with targeted genetic mutations. When these mutations are passed on to female mosquitoes — the ones that actually bite people and spread diseases — the mutation damages their reproductive organs and prevents them from drawing blood. The end result, if the genetic modifications work as intended, is that an entire generation of mosquitoes won’t be able to feed or breed. The genetic mutations will spread throughout the population and quickly cause the entire species to go extinct…” (Thompson, 2/20).

Scientific American: Should We Kill Off Disease-Causing Pests? Not So Fast
“…[A]nother new study, published in December in BioScience, calls for reexamining [the goal of tsetse fly eradication in Africa]. ‘The important ethical question remains: Is tsetse fly elimination morally appropriate?’ entomologist Jérémy Bouyer and his co-authors wrote. … For the authors, the main point is it is important to think through the ethical and practical implications rather than simply acting on the initial impulse to eradicate a pest…” (Conniff, 2/20).

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New WHO Expert Panel To Set Global Guidelines For Human Genome Editing

NPR: World Health Organization Forms Committee To Guide Editing Of Human Genes
“The World Health Organization [on February 14] announced the formation of an international committee aimed at establishing uniform guidelines for editing human DNA in ways that can be passed down to future generations. The 18-member committee ‘will examine the scientific, ethical, social, and legal challenges associated with human genome editing,’ according to the WHO announcement…” (Stein, 2/14).

Wall Street Journal: WHO Reacts to Chinese Gene-Edited Twins With Plan for Global Guidelines
“…Core to their work will be understanding how to promote transparency and accountability within the scientific community, as well as what risk assessments should made before sign-offs are granted on such experiments. The WHO first said it wanted to develop such standards two weeks after a Chinese scientist stunned the world in November by saying he produced twin girls who are resistant to HIV, the virus that causes AIDS, using a nascent gene-editing tool…” (Rana, 2/21).

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More News In Global Health

ABC: Poo and polio: How researchers are using one to find the other (Kearney, 2/21).

Agence France-Presse: Desperate measures: Pakistani women seek abortions as birth control (2/18).

BMJ: Lassa outbreak: WHO warns of unusually rapid spread in Nigeria (Dyer, 2/19).

Devex: New coalition harnesses ‘radical collaboration’ for community health (Cheney, 2/18).

The Guardian: Study of Brazil favela stricken by Zika shows dengue may protect against virus (Phillips, 2/18).

Nature: Faster, better, cheaper: the rise of CRISPR in disease detection (Maxmen, 2/19).

Popular Science: Children suffer more from air pollution, but our policies don’t reflect that (Wetsman, 2/20).

Quartz: An anti-vax religious group apologized for its role in a major measles outbreak in Japan (Steger, 2/21).

Reuters: ‘Two is enough,’ Egypt tells poor families as population booms (Masri, 2/20).

SciDev.Net: Rapid drug-resistant TB tests needed to cut deaths (Odhiambo, 2/20).

The Telegraph: New cholera tracking tool could provide more accurate picture of outbreaks (Newey, 2/20).

The Telegraph: Clamor for vaccines as measles outbreak kills nearly 1,000 children in Madagascar (Blomfield, 2/20).

The Telegraph: ‘Reborn’ typhoid vaccine to be introduced in Zimbabwe in a bid to halt drug resistance (Gulland, 2/19).

U.N. News: Biggest ever U.N. aid delivery in Syria provides relief to desperate civilians (2/15).

Xinhua News: Cambodia sees zero death from malaria for 1st time last year (2/20).

Xinhua News: Kenya urges Africa to reinforce surveillance on malaria drug resistance (2/15).

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Editorials and Opinions

Opinion Pieces Discuss Humanitarian Situation In Venezuela, Politicization Of Aid

NBC News: Trump’s Venezuela policy isn’t a case of right versus left. It’s a case of right versus wrong.
Brett Bruen, president at Global Situation Room, Inc.

“…[Venezuela’s Nicolas] Maduro callously refuses to acknowledge, let alone address the suffering of his people. If America allows him to stay the course, the consequences will be catastrophic. This isn’t just a political crisis. There is a humanitarian imperative to act. … The question for lawmakers should not be if, but how, we act. … So far, I give the Trump administration mixed, but passing, marks on their response to the crisis; many of the steps they have taken to pressure Maduro and the military — including the diplomatic, disaster response, and denial of funds — are the right ones. … There are, however, several areas of our Venezuela policy in which I differ with the administration. … Any one of us can disagree with Trump on some, or even most, of his policies. But, he is right that the people of Venezuela need our help now. We should continue to encourage a multilateral, multi-dimensional strategy that emphasizes aggressive diplomacy and disaster assistance. But, we cannot let partisanship or past problems prevent us from protecting those in danger, especially the hundreds of thousands of malnourished children. That would truly be an immoral legacy” (2/16).

IRIN: Why the Venezuelan opposition’s high-stakes aid gamble must pay off
Francisco Toro, founder of the Caracas Chronicles news site

“On top of longstanding concerns over chronic shortages of food and medicine reaching the country, there’s now real worry about the increasingly blatant politicization of aid, as the internationally backed opposition movement puts efforts to bring humanitarian supplies into the country at the center of its messaging strategy against the regime. … The larger problem is that when aid becomes this politicized, there’s no room left for a realistic assessment of Venezuela’s humanitarian needs. … The basic message here is that aid-as-politics turns out to be incompatible with aid-as-aid in the Venezuelan context. If [opposition leader Juan] Guaidó’s strategy pans out and delivers a knockout blow to the Maduro regime in the near future, paving the way for large-scale relief efforts under a new government, it will be hailed as a masterstroke. But if it fails and the Maduro clique manages to entrench itself in power, it could be remembered as the prelude to a catastrophe on a scale that the western hemisphere hasn’t seen in decades. What is clear is that the Venezuelan opposition — alongside powerful allies in the United States, Colombia, Brazil, and Europe — has chosen an exceptionally risky approach without a credible Plan B. For Venezuelans’ sake, we can only hope it works” (2/20).

The Conversation: Why Maduro is blocking Venezuela-bound humanitarian aid when so many people in his country need it
Morten Wendelbo, research fellow at the American University School of Public Affairs

“…Although there is no clear evidence of an ulterior motive, history does give Maduro reasons to be skeptical of U.S. intentions [in providing humanitarian aid]. … [H]umanitarian aid is rarely just about saving lives. In Venezuela, … the U.S.-supplied aid may have substantial political consequences. … The U.S. government generally considers aid and development assistance as part of their broader foreign policy. The State Department officially calls USAID an ‘important contributor to the objectives of the National Security Strategy of the United States.’ In other words, USAID’s work abroad is at least partially intended to safeguard American security and promote U.S. interests. … Even if the Trump administration has only the best of intentions, it may not be in Maduro’s interest to let the aid across any of his country’s borders. … To Maduro, it is no doubt clear that Guaidó stands to gain most from the humanitarian aid reaching Venezuelans because he can champion the aid as a success of his shadow government. … [T]he U.S., other nations, and aid organizations must take care to avoid letting their assistance get politicized while ensuring that humanitarian assistance actually reaches and benefits the thousands of Venezuelans who need it. Otherwise, these shipments could further destabilize the country, making Venezuelans in need of aid in the first place even worse off” (2/15).

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International Community Could Play Major Role In Bringing Peace To Yemen

The Guardian: Have world leaders really got the will to bring peace to Yemen?
Radhya al-Mutawakel, chair and co-founder of Mwatana Organization For Human Rights

“…The need to remind everyone that what we are witnessing [in Yemen] is manmade, and not a natural disaster, is constant. … Since 2014, my organization, Mwatana for Human Rights, has documented hundreds of incidents where lives have been lost or violated and civilian infrastructure has been damaged or destroyed … What is really sad about the violations in Yemen is that they are preventable. They occur because the parties don’t care. The total lack of accountability, not only to their own but also to the outside world, empowers them to feel as though they can do whatever they want. The last U.N. Resolution on Yemen was adopted by the Security Council in December; it too suggested that the way to maintain peace is through accountability on all sides. … States should not just act as humanitarian organizations, as they have the ability to do so much more. Yemen can be a success story. It offers a chance for the international community to demonstrate that, by working together, it can end a disaster anywhere in the world. If we lose this opportunity, the conflict will not only continue but is likely to get worse…” (2/16).

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Earning Trust Among Locals Critical To Preventing Ebola Outbreaks

IRIN: First Person: To stop Ebola, ask the rebels to help
Jean-Christophe Shako, Ebola response coordinator in Butembo in the Democratic Republic of Congo

“…Since [the Ebola] outbreak erupted in [DRC’s] North Kivu province last August, health teams knew they would face big challenges. The virus had resurfaced in a densely populated, heavily traveled urban region where about 100 armed groups operate, restricting the response. The risk of rapid geographic spread was very high. … As the Ebola response coordinator in Butembo, my role was to organize surveillance activities to find these contacts as quickly as possible — that means before they start showing symptoms, become contagious, and spread the virus. Very early on in this outbreak we got an indication of just how hard this was going to be. … Finding people who don’t want to be found is not an easy task. … Earning trust during such a deadly outbreak is always hard. … [R]espect, compassion, and humility can go a long way — even saving your life and the life of an entire community” (2/20).

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Government, Civil Society Must Work Together To Expand Immunization Coverage In India

Project Syndicate: Taking Vaccines the Last Mile
Radhika Batra, medical doctor and founder and president of Every Infant Matters

“…India has a strong health care system. And in 1985, the government established the Universal Immunization Plan — a much-acclaimed program that aims to provide at least 85 percent coverage. Yet, according to UNICEF, India’s national average for immunization stands at just 62 percent, with little progress having been made in recent years. … While expanding immunization coverage is undoubtedly challenging, there is no excuse not to be making steady progress with low-cost, scalable, and sustainable solutions. To take top-down immunization schemes to the doorsteps of the disadvantaged, governments and civil society must work together to establish and expand efficient last-mile channels for vaccine delivery, accounting for barriers ranging from lack of awareness to out-of-pocket cost. … Persistent gaps in vaccination coverage must be addressed on a war-like footing. … If not, we shall continue to lose innocent lives and mothers will mourn loud and long…” (2/15).

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From the Global Health Policy Community

U.N. Dispatch Discusses Impacts Of U.S. FY 2019 Budget On U.N.

U.N. Dispatch: Here is How the U.N. Is Impacted By The Budget Deal Between President Trump and Congress
Mark Leon Goldberg, editor of U.N. Dispatch, discusses the potential impacts of the U.S. FY 2019 budget on foreign policy and the U.N., noting that while U.N. peacekeeping activities were “underfunded,” the U.N. regular budget was “properly funded” (2/20).

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Lancet Global Health March 2019 Issue Available Online

The Lancet Global Health: March 2019
The most recent issue of The Lancet Global Health provides articles on various global health topics including an editorial on cancer treatment, commentaries on the importance of the measles vaccination and upstream approaches to global health training, and an article on the role of research and research funding in developing high-quality health systems (March 2019).

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From the U.S. Government

USAID Fact Sheets Provide Overview Of U.S. Global Health Efforts In Liberia

USAID: Global Health Security Agenda Program
This fact sheet provides an overview of the Global Health Security Agenda (GHSA) and its efforts in Liberia, noting, “In Liberia, GHSA supports a multi-sector coordination mechanism for sampling and testing animals; builds capacity of animal health professionals for risk-based epidemiology and response; and implements behavior change communications to influence risky behaviors” (2/19).

USAID: Health Commodity Logistics Management
This fact sheet provides an overview of USAID’s efforts to help strengthen the management of Liberia’s Health Commodity Logistics Management System through technical assistance, noting, “USAID’s assistance is focused on improving commodity forecasting, ordering, storage, distribution, and monitoring of medicines and other health commodities” (2/19).

USAID: Strengthening M-Hero in Liberia Activity
This fact sheet provides an overview of USAID’s m-health efforts “to address the communication and information sharing gaps between health officials and frontline health workers” during the Ebola outbreak in Liberia (2/19).

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From the Kaiser Family Foundation

KFF Updates Primer On U.S. Congressional Engagement In Global Health

Kaiser Family Foundation: The U.S. Congress and Global Health: A Primer
This primer provides an overview of congressional engagement in global health. It examines the structure of Congress and its role and key activities in global health. It then illustrates these by examining two global health examples: the creation and evolution of PEPFAR and the 2014/2015 Ebola outbreak in West Africa (Moss/Kates, 2/20).

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