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Kaiser Daily Global Health Policy Report

In The News

Obama Administration Seeks $200M Boost For President's Malaria Initiative In FY17

Media sources discuss the Obama administration’s request for a funding increase for the President’s Malaria Initiative.

Devex: What can $200M buy in the fight to eradicate malaria?
“U.S. President Barack Obama delighted malaria fighters with his State of the Union pledge to ask the Congress for more money to help end the disease. Now the administration has released its budget request — and more details about what it will do with an extra $200 million. The additional funding would bring the President’s Malaria Initiative budget to $874 million for the next fiscal year, roughly a 30 percent increase over fiscal 2016. So what can $200 million buy you?…” (Igoe, 2/23).

Wall Street Journal: Obama Administration Plans to Expand Malaria Effort by $200 Million
“…The boost in funding for the President’s Malaria Initiative — which must be approved by Congress for fiscal 2017 — would expand malaria prevention and control services to 332 million people in West and Central Africa, or 92 percent of those at risk there, officials said. The money would also be used to help two countries eliminate malaria: Zambia, where the national government and multiple international organizations have developed a strong program, and Cambodia, an epicenter of emerging resistance by malaria-carrying parasites to antimalarial drugs…” (McKay, 2/22).

White House Blog: Mosquitoes and Malaria: Taking a Big Step Against a Small but Deadly Foe
Shaun Donovan, director of the Office of Management and Budget, writes, “…From our ongoing efforts to combat the Zika virus (which is also transmitted by mosquitoes), to joining our African partners in defeating Ebola, to fighting HIV/AIDS, promoting global health and global health security has been a cornerstone of President Obama’s foreign policy. And — in partnership with other governments, donors, multilateral organizations, and the broader public health community — we’ve come closer than ever to banishing the scourge of malaria from the planet…” (2/22).

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President Obama Requests Nearly $2B For Emergency Zika Funding, Works With Governors On Virus Response

CQ News: White House Strengthens Ties With Governors on Zika Response
“With health experts warning that the Zika virus could spread to the United States this summer, the White House announced it will partner with the National Governors Association in responding to the mosquito-borne disease. Zika was one of the first topics discussed when President Barack Obama met with governors in Washington, D.C., on Monday, according to an NGA official who was present. The goal of the new partnership is to coordinate the federal, state and local response and prevention efforts…” (Zanona, 2/22).

The Hill: White House presses GOP for nearly $2B to fight Zika virus
“The Obama administration on Monday redoubled its call for nearly $2 billion in emergency funding to fight the Zika virus, rejecting the GOP’s idea the government should use leftover Ebola money to fight the new virus. President Obama’s budget chief, Shaun Donovan, told House Republicans in a letter that federal health and security officials still have big plans for the millions of dollars slated to fight Ebola, which he said is ‘still a threat’…” (Ferris, 2/22).

The Hill: CDC launches key study of Zika virus amid funding battle
“Federal health officials are launching a large-scale study to determine whether the Zika virus is the cause of hundreds, and possibly thousands, of birth defects in Brazil. … The impacts of the CDC’s first-of-its-kind study could impact the ongoing funding battle between the White House and GOP leadership about whether to devote new funding to fighting and studying the virus…” (Ferris, 2/22).

Reuters: White House presses Congress for emergency funds for Zika
“… ‘The magnitude of the Zika outbreak primarily requires new resources to ensure it is adequately addressed,’ White House budget director Shaun Donovan said in a letter to Republican Representative Hal Rogers, head of the House Appropriations Committee. The White House also would like permission from Congress to put unused Ebola money toward Zika projects to ‘give us the flexibility to respond to Zika needs beyond what we have so far identified,’ Donovan said in the letter…” (Rampton/Cowan, 2/22).

Washington Post: Obama asks Congress for $1.9 billion to combat spread of Zika virus
“… ‘This request supports the necessary steps to fortify our domestic health system, detect and respond to any potential Zika outbreaks at home, and to limit the spread in other countries,’ Obama wrote in a letter to House Speaker Paul D. Ryan (R-Wis.)…” (Dennis, 2/22).

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Bill, Melinda Gates Address Energy, Climate Change, Gender Equality, Other Issues In Foundation's 2016 Annual Letter, Interviews

News outlets report on the release of the Bill & Melinda Gates Foundation’s 2016 Annual Letter, which focuses on energy, climate change, gender equality, and other development issues.

Bloomberg Business: Bill Gates Q&A on Climate Change: ‘We Need a Miracle’
“All we need is an energy miracle. No pressure, kids. So came the call from Bill Gates on Monday evening with the release of his annual letter. It tackles heady subjects with the billionaire’s usual optimistically sober tone. Unlike letters past, Gates aimed this year’s missive at teenagers instead of adults, arguing they’re our best shot at solving the world’s energy crisis…” (Vance, 2/22).

Business Insider Australia: The Bill Gates Interview: An energy miracle is coming, and it’s going to change the world
“…The head of the Bill & Melinda Gates Foundation spoke about how to make an energy miracle happen, the stakes of climate change, and what the role of the world’s billionaires is in all of this…” (Baer, 2/22).

Reuters: Bill Gates says Zika response better than for Ebola
“The Bill & Melinda Gates Foundation has turned its attention to the Zika virus outbreak, and its founders said the response to the crisis, which may be linked to devastating birth defects in South America, has been better than for the 2014 Ebola outbreak in Africa. ‘We got deeply involved in Ebola, and we’re already getting deeply involved in Zika,’ said Melinda Gates in an interview ahead of release of the foundation’s annual letter on Monday…” (Berkrot, 2/23).

USA TODAY: Bill Gates’ superpower: More (and cheaper) energy
“…After focusing nearly two decades and prodigious resources on a range of often vexing global issues, Gates says he remains optimistic about the state of the world. ‘Because the news lens is more on the setbacks than the gradual improvements, I think the world at large has not seen where a combination of innovation and generosity is actually having this huge positive effect,’ he says. ‘I wouldn’t enjoy the foundation work if I wasn’t seeing a lot of progress on all the things that we work on’…” (della Cava, 2/23).

WIRED: Bill Gates Talks Climate Peril and Election 2016 (Oh, and Beyoncé)
“…This year, the issue most on his mind is climate change, and on hers, improving the lives of women. These are the kinds of world-scale issues that attract the couple every year; what’s different in 2016 is their decision to address this year’s letter to high school students. But it’s not surprising when you think about it: today’s teens will be dealing with these issues longer than the rest of us. WIRED recently talked to Gates about the letter…” (Alba, 2/22).

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Vaginal Ring Containing Antiretroviral Reduced HIV Incidence By About 30% Among African Women In 2 Studies

News outlets report on two HIV prevention studies presented Monday at the Conference on Retroviruses and Opportunistic Infections (CROI) in Boston

Agence France-Presse: Vaginal ring cuts HIV risk by nearly one-third: studies
“A monthly vaginal ring that contains an antiretroviral drug has been shown to cut the risk of HIV infection in women by nearly one-third, according to two international studies Monday…” (Sheridan, 2/22).

Associated Press: Study finds anti-AIDS vaginal ring partially protects women
“…The ring proved safe although the protection was modest, reducing overall HIV infection by less than a third. Surprisingly, the ring worked far better in women 25 and older, leaving researchers wondering if the youngest women, who got little to no benefit, simply didn’t use the device properly…” (Neergaard, 2/22).

New York Times: Vaginal Ring With Drug Lowers HIV Rates in African Women
“…But researchers said that the device was still a major advance and that the results were the most promising to date in HIV prevention for African women. They said they would press ahead to get the ring approved and widely distributed as quickly as possible…” (Grady, 2/22).

Reuters Health: Drug-coated ring cuts HIV risk by more than half in some women
“…Results of the study, known as ASPIRE, were presented Monday at the Conference on Retroviruses and Opportunistic Infections in Boston. Results were also published online in the New England Journal of Medicine. Findings from a second test of the device, known as The Ring Study, were also to be presented; it found a 37 percent reduction in women over 21, according to a news release from the International Partnership for Microbicides (IPM), the nonprofit organization that developed the ring…” (Emery, 2/22).

Science: Drug-laced vaginal ring succeeds against HIV — sometimes
“…The ring, a silicon band that releases an experimental antiretroviral called dapivirine, was tested in South Africa, Malawi, Uganda, and Zimbabwe among 18- to 45-year-olds. The ASPIRE trial found 27 percent efficacy overall, while the second trial — called The Ring Study — found a 31 percent efficacy. But the ring didn’t do nearly as much for women aged 18 to 21, conferring a mere 15 percent protection in The Ring Study and had none whatsoever in the ASPIRE trial. In women over 21, however, efficacy hit 56 percent in ASPIRE; The Ring Study showed 37 percent protection in the older group…” (Cohen, 2/22).

USA TODAY: Study: Vaginal ring reduces HIV infection in women
“…Researchers have been eager to give women a way to reduce their risk of HIV. Many women, especially those in developing countries with the highest HIV rates, are unable to persuade men to use condoms, said Zeda Rosenberg, founding chief executive officer of the International Partnership for Microbicides…” (Szabo, 2/22).

U.S. News & World Report: Vaginal Ring May Help Prevent HIV Transmission
“… ‘Women need a discreet, long-acting form of HIV prevention that they control and want to use,’ said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, which funded the clinical trials…” (Leonard, 2/22).

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Cuba Calls On Individuals, 9K Army Troops To Help Prevent Zika-Carrying Mosquitoes

Reuters: Cuba deploys 9,000 troops in effort to ward off Zika virus
“President Raul Castro called on all Cubans to help eradicate the mosquitoes that carry the Zika virus on Monday and ordered 9,000 army troops to help stave off the disease. Cuba has yet to detect a case of Zika, but the outbreak is affecting large parts of Latin America and the Caribbean…” (Frank, 2/22).

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Extent Of Venezuela's Zika Outbreak Unknown, AP Reports

Associated Press: Venezuela takes on Zika amid shortages, information blackout
“This is what the Zika outbreak looks like in Venezuela, a country whose medical system has teetered for months on the brink of collapse: There’s a lack of bug spray to prevent mosquito bites, scant contraceptives to avert pregnancies, little medicine to treat Zika-linked maladies. There has been no effective public health campaign to inform the public about the disease — and nobody really knows how many infections there have been…” (Sanchez, 2/22).

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PRI Series Examines Various Aspects Of Zika Outbreak In Latin America

PRI published two articles as part of its #HerPlanet series on the Zika virus.

PRI: The budget for the Rio Olympics is 16 times higher than the budget to combat the Zika virus
“…For the Olympics in Rio, the Brazilian government has allocated $9.7 billion from both public and private sectors, which is 16 times more than the allocation for Aedes [mosquito] prevention. … The campaign to combat Zika has received about $475 million so far in 2016. The government has added another about $125 million — or about $600 million total…” (Kuang, 2/22).

PRI: These mosquitoes could be a weapon against Zika
“There’s a room at the University of São Paulo with between 10,000 and 15,000 mosquitoes in it. If you’re very quiet, you can hear them buzzing. This is where mosquito researcher Margareth Capurro is trying to figure out the best strategy to reduce the type of mosquito, Aedes aegypyti, that carries Zika and other dangerous viruses…” (Beeler, 2/22).

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Syrian Government Forces Deliberately Target Hospitals, U.N. Report Says

New York Times: U.N. Finds ‘Deliberate’ Destruction of Hospitals in Syria
“First, the government soldiers made sure no food could get into rebel-held towns. Then, government planes bombed what health centers remained in those towns, making sure that those who got sick from hunger had no medical care to save them. That is the harrowing picture painted by the latest report of the United Nations Commission of Inquiry on the war in Syria…” (Sengupta, 2/22).

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1.5M Somalis Lose Health Care Access Amid Donor Funding Cuts, Aid Agencies Say

Thomson Reuters Foundation: Aid cuts trigger health crisis in Somalia, say relief agencies
“Some 1.5 million Somalis have lost access to health care over the last two years as around 10 hospitals have closed or cut back their services due to aid shortages, relief agencies said on Monday. … Donor funding for health care has fallen by nearly two-thirds to $29 million in 2015 from $72 million in 2011, they said, citing United Nations data…” (Migiro, 2/22).

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Ethiopia Facing Serious Food Insecurity Due To El Niño

Washington Post: History repeats itself in Ethiopia
“Ethiopia is in the grip of a devastating drought sparked by the worst El Niño in a generation, and aid agencies warn that food aid could run out as soon as May. Unlike in the past, the government and aid groups have kept food shipments flowing to areas ravaged by drought in recent months. But they need more money, at a time when international donors are distracted by a string of humanitarian disasters around the world…” (Schemm, 2/22).

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Editorials and Opinions

Young People Have Power To Solve World's Energy, Gender Equality Challenges

CNN: Bill and Melinda Gates: What superpower do you wish you had?
Bill and Melinda Gates, co-chairs of the Bill & Melinda Gates Foundation

“…[F]or billions of families around the world, the challenges of energy and time are very different from ours — and these challenges have a huge impact on their ability to realize their potential. … Without access to energy, the poor are stuck in the dark, denied all of the economic, social and health benefits that come with power. So if we really want to help the world’s poorest families, we need to find a way to get them access to energy they can afford. And we need to do it in a way that doesn’t make climate change worse, because the poor are more vulnerable to extreme weather and other climate impacts than anyone else. … The more than one billion people without energy spend a significant portion of their time collecting wood and water for the basics of life: heating and cleaning their homes and cooking their food. Almost invariably, that grueling and time-consuming labor is done by women and girls. … This heavy and unequal burden is unfair. It’s also a serious obstacle to progress, because women are so busy meeting basic needs that they can’t invest in the future by doing paid work, going to school, or visiting the doctor regularly. … We’d love to play a role in inspiring young people to help shift those norms…” (2/23).

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Opinion Pieces Discuss Various Aspects Of Zika Response

The Lancet Infectious Diseases: Zika virus in the dock
Editorial Board

“…At the moment, the causal link between Zika virus and microcephaly is speculative. The position taken by WHO on the reported microcephaly cases will help to guarantee accurate investigations based on standardized parameters, to promote case-control studies, and to accelerate development of diagnostic tests, potential vaccines, and therapies for Zika virus infection. The precautionary approach taken by WHO and national governments is sensible. Care of pregnant women who might be at risk is essential, as is providing adequate access to birth control. Nevertheless, at this stage caution should be exerted by the media in linking Zika virus to the microcephaly cases to avoid unjustified fears, and investigations on alternative causes of microcephaly should continue in parallel with studies on Zika virus” (March 2016).

Baltimore Sun: The low-tech approach to Zika
David Bishai and Clive Shiff, both professors at the Johns Hopkins Bloomberg School of Public Health

“…Getting more Maryland public health departments accredited would ensure that they earn the public’s trust and get us ready to take on whatever our coming health challenges may be. … Accreditation builds strength at collecting health data and communicating it to the public in a way that engages everyone and builds the trust ready to take decisive action on a community’s leading health threats. … Accreditation builds the excellence that builds the trust that makes it politically possible for public health to lead the efforts that make us healthy. … Sure, a vaccine [for Zika virus] would be nice. But history shows that controlling epidemics is possible though low-tech means when we work together and trust each other…” (2/22).

The Hill: Zika virus: Why emergency funding is necessary, and why it shouldn’t be
Jeff Schlegelmilch, deputy director, and Irwin Redlener, director, both at the National Center for Disaster Preparedness at Columbia University’s Earth Institute

“…Disease investigation, developing trainings and risk communication strategies, as well as some degree of controlling mosquito populations should already be part of the public health preparedness toolkit and staffed by an adequate number of professionals. These capabilities are required in nearly every response and should already be funded. But they are not, and so we need all of the categorical funding we can get, including [the president’s proposed $1.9 billion] emergency appropriation for the Zika outbreak. Unfortunately, this recurring cycle of emergency funding for each new event is necessary because we continue to fail to learn the lessons of prior events, and to make real investments that will reduce the cost of emergency funding and the frequency in which we need it. Responding to disasters is exciting and politically attractive, preventing them is not. As a consequence it costs us more to repeat the same mistakes, and more lives are at risk because it is easier [to] fund and provide leadership for emergency response than emergency preparedness” (2/23).

Huffington Post: Rousseff Launches a National Mobilization Against Zika
Paulo Sotero, director of the Brazil Institute at the Woodrow Wilson International Center for Scholars

“…It is uncertain … whether a high profile offensive to contain Zika virus will help the president [of Brazil, Dilma Rousseff,] regain the political credibility she needs to govern and start moving the country away from its unhealthy current path. … The complexity of the epidemic and the government’s poor crisis management record suggest the challenge posed by Zika and microcephaly is one more uphill battle for the president. … Providing the resources public health officials and researchers need to conduct their work is key to ensure the continuity of their efforts to understand and contain the spread of the virus … In the toxic political environment prevailing in Brazil, however, it would be naïve to underestimate the negative implications of attempts by the government or the opposition to use the Zika virus crisis to score political points…” (2/22).

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Global Health Initiatives, Practitioners Must Collaborate On TB 'From Prevention To Cure'

Devex: Working to close the TB diagnostics and treatment gap
Wim Parys, head of research and development at Janssen’s global public health group, and Claudia Denkinger, head of the tuberculosis and hepatitis program at FIND

“…[H]ow can it be that TB remains one of the world’s biggest health threats, ranking as the number one cause of death from infectious disease worldwide? First, efforts to eliminate TB are being thwarted by the alarming spread of multidrug-resistant TB … Secondly … it is the poorest areas of the world that typically bear the brunt of the burden. … It is essential that global health initiatives and practitioners — those with expertise in diagnosis and treatment — collaborate and deliver a truly sustainable and scalable impact among underserved populations battling TB and MDR-TB. We fully embrace the post-2015 TB agenda, which has a new ambition to reduce TB deaths by 95 percent by 2035 and cut new cases by 90 percent. To achieve these ambitious goals it is imperative that global health and development practitioners collaborate to modernize and scale up TB diagnosis and care, to deliver a continuum of access from prevention to cure” (2/22).

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Health Care Workers Attend To Mothers, Newborns Even In Face Of Ebola Threat

The Guardian: Sierra Leone: we save lives of women in childbirth — while fighting Ebola
Benjamin Black, obstetrician and gynecologist for Médecins Sans Frontières

“…When Ebola first visited in 2014 no one knew what to expect. Paranoia was rife, and the death toll soared. At our previous hospital we tried to withstand the force of the disease and find ways to keep going but ultimately it was stronger than us. Closing the maternal and child health project back then was a painful decision, but the safest one, given the uncontrolled situation. That experience kept many of us returning during the outbreak, and pushing for the need to create a project that could withstand another. That objective was now being tested less than a week after opening. … When the official announcement [of a new Ebola case in January 2016] finally came it was no surprise. I had assumed our fledgling project would suffer and that new staff would not come to work, but I was wrong. Everyone came, and the team has stood taller and stronger than I would have ever dared to expect. … We have seen what Ebola can do, and we are working to prevent it disrupting the vital services we are supporting the hospital to provide…” (2/23).

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From the Global Health Policy Community

Zika Outbreak Highlights Importance Of Access To Sexual, Reproductive Health Care In Latin America

PLOS “Translational Global Health”: Let’s talk about sex: Why the Zika outbreak is really about reproductive rights for Latin American women
Sarah Borg, a junior medical doctor and intern in the reproductive health and research department at the WHO, discusses how the “Zika outbreak has highlighted a dire need for comprehensive sexual and reproductive health care for all Latin Americans,” including access to contraception and abortion services (2/22).

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Vaginal Ring Could Protect Women Against HIV, Studies Suggest

USAID’s “IMPACTblog”: Innovative HIV-Prevention Product for Women Could Be New Tool in the Fight for an AIDS-Free Gen
Elizabeth Russell, senior adviser for biomedical prevention technologies in the research division of USAID’s Office of HIV/AIDS, discusses the results and implications of the ASPIRE trial and The Ring Study that tested an antiretroviral vaginal ring for HIV prevention, writing, “This is the first time that two large clinical trials have yielded statistically significant results in finding that a [vaginal ring] can protect against HIV infection. However, we must recognize that these results are only the starting point for further research…” (2/22).

Center for Global Health Policy’s “Science Speaks”: CROI 2016: Vaginal microbicide ring protects against HIV some of the time, among women who use it, some of the time…
Antigone Barton, senior writer and editor at “Science Speaks,” discusses results from the two vaginal ring studies, which researchers presented on Monday at the Conference on Retroviruses and Opportunistic Infections (CROI) in Boston (2/22).

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Meningitis A Vaccine Helping African Nations Pursue Disease's Elimination

PATH Blog: Celebrating in Africa: the end of the reign of meningitis
Steve Davis, president and CEO of PATH, discusses progress against meningitis A in Africa, saying the bacterial infection has been nearly eliminated with the development and widespread use of the MenAfriVac vaccine (2/22).

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