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Kaiser Daily Global Health Policy Report

In The News

U.S. Senate, House To Consider Legislation Addressing Zika Research, Funding

CQ News: Zika Bill Could Dovetail With Broader Research Initiative
“Legislation that aims to speed the development and approval of a Zika virus vaccine could dovetail with ongoing efforts to spur biomedical innovation, according to the chairman of the Senate Health, Education, Labor and Pensions Committee. Lamar Alexander, R-Tenn., indicated Wednesday that a measure (S 2512) to make Zika vaccines eligible for priority reviews will be considered next month, when the panel marks up a slate of other bills intended to serve as a companion to House-passed 21st Century Cures legislation (HR 6)…” (Zanona, 2/24).

CQ HealthBeat: Pressing for Zika Response Funding; Senate Votes on FDA Nomination
“…The administration issued its formal $1.9 billion supplemental fiscal 2016 funding request on Monday. … The supplemental spending bill, despite GOP suggestions urging a reprogramming of existing funds tagged for the earlier Ebola virus response, will likely gain congressional approval. House Minority Whip Steny H. Hoyer suggested to reporters on Tuesday that Zika response funding could be combined with other emergency funding to address a water crisis in Flint, Michigan, and fiscal concerns of Puerto Rico. An advancing omnibus-style emergency bill could also attract a range of other pressing topics…” (Jenks, 2/24).

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Zika Outbreak Likely Will Worsen, WHO's Chan Warns, Calls For Better Coordination Of Prevention, Research Efforts

Reuters: Zika outbreak will worsen before it gets better, WHO head says
“The head of the World Health Organization warned Wednesday that the Zika outbreak would likely worsen before nations besieged by the mosquito-borne virus linked to thousands of birth defects in Brazil see relief. Director-General Margaret Chan made the comments at the end of her two-day visit to Brazil, the country at the epicenter of the Zika crisis…” (Eisenhammer, 2/24).

U.N. News Centre: In Brazil, U.N. health chief calls for better coordination in fight against Zika
“… ‘A coordinated international response is needed to improve surveillance, the detection of infections, congenital malformations, and neurological complications, to intensify the control of mosquito populations, and to expedite the development of diagnostic tests and vaccines to protect people at risk, especially during pregnancy,’ Dr. Chan said…” (2/24).

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Zika, Dengue Disproportionately Affecting Poorer Populations In Brazilian City

Washington Post: Zika exposes class differences in Brazil, where most victims are poor
“…Since last year, Zika has infected an estimated 1.5 million Brazilians, mostly in the hot, poor northeast. Though the virus arrived late to [Ribeirão Preto, a] city of 660,000, the local health department already suspects that 130 pregnant women may have caught it. The cases appear concentrated among lower-income residents. That trend is also evident with dengue — of the 1,557 cases since January, only 160 came from the well-to-do south side…” (Cuadros, 2/24).

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Researchers Examine Links Between Climate Change, Spread Of Diseases, Mosquitoes

The Atlantic: The Link Between Zika and Climate Change
“…[A]s the Zika epidemic continues to spread through Brazil, Central America, and now the United States, scientists will continue to wrestle with how environmental factors like climate change are affecting the creatures that spread infectious diseases…” (Mercer, 2/24).

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1 In 5 African Children Do Not Have Access To Vaccines, WHO Report Shows; Ministerial Conference Hails Meningitis A Vaccine Success

Agence France-Presse: One in five African children denied access to vaccines: report
“One in five children in Africa do not receive basic life-saving vaccines, despite the continent making great strides on immunization, the World Health Organization (WHO) said in a report Wednesday. The report noted a dramatic rise in child vaccination rates, from 57 percent in 2000 to 80 percent in 2014, but said more needed to be done to prevent the spread of diseases such as measles, rubella, and neonatal tetanus that have been virtually eradicated in some parts of the world but remain prevalent and deadly in Africa…” (Boulo, 2/24).

Ventures: #MCIA 16: African nations celebrate a 55 percent drop in child mortality rates due to immunization
“As the Ministerial Conference on Immunization in Africa commences … in Addis Ababa, Ethiopia, vaccine experts and officials representing 26 African countries from the ‘meningitis belt’ celebrate the introduction of MenAfriVac® and its achievements in the continent’s public health system. In five years, MenAfriVac, which is designed, developed, and produced for use in Africa, has nearly eliminated serogroup A meningococcal disease from the meningitis belt countries and is now being integrated into routine national immunization programs…” (Okoroafor, 2/24).

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Market Forces Negatively Affect Prospects For Increased Role Of Semi-Synthetic Artemisinin For Malaria Treatment

Nature: Synthetic biology’s first malaria drug meets market resistance
“When Paris-based pharmaceutical giant Sanofi started to sell malaria drugs made with the help of genetically engineered yeast in 2014, the move was hailed as a triumph for synthetic biology. … Yet Sanofi produced no ‘semi-synthetic’ artemisinin (SSA) at all in 2015, Nature has learned. And the company is now selling the manufacturing site in Garessio, Italy, where it made its SSA. That such celebrated drugmaking technology — developed with the help of US$64 million from the Bill & Melinda Gates Foundation — stands idle illustrates the complicated web of economic forces that affects the market for malaria drugs…” (Peplow, 2/23).

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2 U.S. Gynecologists Propose Female Genital 'Nicks' In Journal Article

NPR: Can A Bath Of Milk And Honey Replace Female Genital Mutilation?
“…This week, two American gynecologists published an article in the British Journal of Medical Ethics, proposing a ‘compromise solution’ that would permit minimal female genital ‘nicks’ that would ‘accommodate cultural beliefs while protecting the physical health of girls, but would proscribe those forms of [female genital alteration (FGA)] that are dangerous or that produce significant sexual or reproductive dysfunction.’ Are such nicks ‘a better way’? Dr. Githinji Gitahi doesn’t believe so. He’s a physician with a specialty in OB­-GYN and a leader in the group Amref Health Africa…” (Cole, 2/24).

Thomson Reuters Foundation: Female genital “nicks” should be legal — gynecologists
“…The gynecologists suggested that global attempts to stamp out FGM with legislation had failed and may by driving the practice underground. ‘We are not arguing that any procedure on the female genitalia is desirable,’ they said. ‘Rather, we only argue that certain procedures ought to be tolerated by liberal societies.’ They said the term ‘female genital mutilation’ should be replaced with the less emotive ‘female genital alteration’ (FGA) to avoid ‘demonising important cultural practices’…” (Batha, 2/22).

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Complications Challenge U.N. Food Drops In Syria, WFP Says

IRIN: First U.N. Syria airdrop lands in trouble
“Only a few hours after U.N. aid chief Stephen O’Brien told the U.N. Security Council that a 21-ton World Food Programme airdrop had successfully been made to the besieged Syrian city of Deir Ezzor Wednesday, the WFP said something had gone wrong and local activists said the aid was either damaged on landing or fell wide of its mark…” (Slemrod, 2/24).

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Looters Damage MSF Health Center In South Sudan, Threatening Health Care Access

Thomson Reuters Foundation: Looting of charity health center threatens medical care in South Sudan
“A health center operated by Médecins Sans Frontières (MSF) has been damaged by looters in South Sudan, threatening medical care for residents of the violence-torn region, the charity said on Wednesday…” (Malo, 2/24).

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New South African Obesity Research Center Aims To Shed Light On Growing Problem

The Guardian: Rising to the nutrition challenge: South Africa’s new obesity research center
“…[O]besity rates are on the rise [in South Africa], driven by increasingly sedentary lifestyles, a rise in disposable income and the popularity of cheap junk food. … But obesity has been somewhat overlooked as a health problem in the country, says Shane Norris, a health researcher at the University of the Witwatersrand in Johannesburg, and one of the brains behind the African Centre for Obesity Prevention (ACTION). The center launched in November last year to strengthen obesity research in South Africa and is one of the first of its kind on the continent…” (Nordling, 2/24).

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Editorials and Opinions

Opinion Pieces Discuss U.S., WHO Responses To Zika

The Hill: Zika, Ebola, other public health crises — we need a better plan
Sen. Bill Cassidy (R-La.)

“…The U.S. and our global partners should adopt a two-tiered preparedness strategy [for disease outbreaks]: proactive research and reactionary response. Predictive models of disease hotspots must be connected with travel patterns. This would allow public health officials to anticipate where the next outbreak will occur. Being able to anticipate this allows public health researchers to go to a community, do background data, and begin administering a vaccine if one is available. Ongoing funding — rather than episodic, emergency funding — is more efficient. If we operated under this two-tiered strategy, the current Zika crisis could have possibly been avoided…” (2/24).

Quartz: The WHO botched Ebola — but it’s winning praise for handling the terrifying Zika epidemic
Akshat Rathi, reporter for Quartz

“…[T]he WHO’s response to the [Zika] crisis has been remarkable. It shows how simple but crucial principles of crisis management can be applied at a massive scale. … The first principle of managing a crisis is to be prepared. … The second principle of managing a crisis is to communicate clearly. … The third principle of managing a crisis is to use resources well. … [I]t’s remarkable how fast a big bureaucracy like the WHO has turned itself around. Almost all the improvements in the WHO’s capacity for dealing with outbreaks were made in the few months between the tail-end of the Ebola epidemic and the explosive start of the Zika outbreak. … [I]t’s reassuring that there is now at least one global institution that can be trusted to respond effectively [to disease outbreaks]” (2/24).

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All Forms Of FGM Should Be Considered 'Child Abuse'

The Guardian: There’s no such thing as ‘mild’ FGM. It’s still child abuse
Celia Jeffreys, midwife and head of the National FGM Centre

“…[T]his week two American gynecologists have written in the British Journal of Medical Ethics arguing that some ‘mild’ forms of [female genital mutilation (FGM)] should be legalized to ‘allow families to uphold cultural and religious traditions while protecting girls from more dangerous forms of cutting.’ … FGM is child abuse, full stop. No matter if it’s pricking, nicking, or tucking any part of a girl’s genitalia against her will. Most survivors are scarred internally and externally by this harmful practice and have to learn to live with it for life. We’ve come a long way in our efforts to raise awareness of FGM. Let’s not go backwards by accepting some forms of this practice which is simply another form of violence against women and girls. It’s abuse, so let’s treat it as such — no ifs, no buts, and no exceptions” (2/24).

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HIV Services For Men, Not Only Women, Crucial To Ending AIDS Epidemic

The Conversation: Dying from a treatable disease: HIV and the men we neglect
Kathryn Dovel, Phd candidate, and Sara Yeatman, associate professor in the Department of Health and Behavioral Sciences, both at the University of Colorado Denver; and Susan Watkins, professor emerita in the Department of Sociology at the University of Pennsylvania

“…Unlike women, men are not targeted by HIV policies to ensure they are tested and treated. As a result, heterosexual men have become a marginalized group when it comes to HIV services. They are systematically disadvantaged in their access to care. … [T]o stem the tide of the HIV pandemic, men must be included. We are not advocating that there needs to be an equal number of health services for men. Instead, we propose that more must be done for men than is currently offered. The international community has done a great deal to keep women and their children alive through the AIDS epidemic. It should not continue to overlook their husbands and fathers. Dedicated male-friendly HIV services are needed. The alternative scenario is dismal. … Men’s use of health services can be improved — we have seen it happen for women” (2/22).

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From the Global Health Policy Community

Stop TB Partnership, Pharmaceutical Company Announce New Initiative To Help Developing Countries Access Drug For MDR-TB

Stop TB Partnership: Stop TB Partnership’s Global Drug Facility jumpstarts access to new drugs for multidrug-resistant tuberculosis with innovative public-private partnerships
“A new initiative to enable developing countries to access delamanid — one of two new life-saving drugs approved to combat multidrug-resistant (MDR) tuberculosis (TB) — [was on Wednesday] announced by the Stop TB Partnership and Otsuka, the drug’s manufacturer. The innovative public-private partnership will allow countries to access delamanid through the Stop TB Partnership’s Global Drug Facility, which already supports the USAID donation for bedaquiline — the other recently approved drug for MDR-TB, manufactured by Janssen…” (2/24).

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Ebola, Zika Epidemics Highlight Needed Shift To More Open, Speedy Science Publishing

BMJ Blogs: Liz Allen: How Ebola and Zika might help to open up science
Liz Allen, director of strategic initiatives at F1000 and a visiting senior research fellow at the Policy Institute at Kings’ College London, discusses how the Ebola and Zika epidemics could serve as “catalysts” to open and speed up science publishing, writing, “We should use the opportunity of a cross stakeholder call on data sharing to collaboratively rethink how new findings are shared generally … There may be many paths to publishing research in an open science future, but all should enable researchers (and funders) to make research findings and data … available for scrutiny at speed and not just in emergency situations” (2/24).

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'Science Speaks' Covers Issues Discussed At CROI 2016

The Center for Global Health Policy’s “Science Speaks” blog is covering a range of issues discussed at the Conference on Retroviruses and Opportunistic Infections (CROI), taking place this week in Boston.

Science Speaks”: CROI 2016: Scale of Ebola crisis led to knowledge, new questions, ongoing research, and need for unprecedented community health care delivery (Barton, 2/24).

Science Speaks”: CROI 2016: In the global epidemic of hepatitis C, millions await the cure (Lubinski, 2/24).

Science Speaks”: CROI 2016: HIV and TB link the Bronx and Tugela Ferry in a story of human rights and social justice (Barton, 2/23).

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