KFF Daily Global Health Policy Report

In The News

President Obama Optimistic About Zika Vaccine Research At White House Precision Medicine Initiative Summit; HHS Secretary Discusses Funding On Capitol Hill

CQ HealthBeat: More Burwell Budget Testimony; White House Summit Promotes Precision Medicine
“…Health and Human Services Secretary Sylvia Mathews Burwell return[ed] to Capitol Hill [Thursday] to defend her department’s fiscal 2017 budget proposal. The House Appropriations panel responsible for the annual Labor-HHS spending bill will also likely hear an appeal for immediate action on current year supplemental appropriations funding a Zika virus response effort…” (2/25).

The Hill: Obama strikes optimistic tone in fight against Zika
“President Obama on Thursday expressed confidence about the nation’s ability to beat the Zika virus, striking a more optimistic tone than some of his own federal researchers. ‘We actually think there’s a promising pathway for diagnostics and vaccines on this,’ Obama said in a packed White House auditorium. ‘It’s not a real complicated virus, apparently.’ The main challenge ahead, Obama said, is how to ‘figure out a production cycle that makes sense’…” (Ferris, 2/25).

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More Than 100 Democratic U.S. Representatives Urge Expansion Of Women's Access To Health Care Services Amid Zika Outbreak

Framington Patch: Rep. Clark Urges More Women’s Health Resources In Wake of Zika Outbreak
“Congresswoman Katherine Clark is leading an effort in the U.S. House to bolster funding for women’s health care and family planning services in response to the Zika virus. … Joined by 105 of her Democratic colleagues, Clark’s letter to Republican leadership urged that any ‘response to the Zika virus must include a robust and focused effort on expanding access to women’s health care services’…” (Petroni, 2/26).

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American Public Closely Following Zika Outbreak, Kaiser Family Foundation Poll Shows

Media outlets report on a Kaiser Family Foundation poll that examined the public’s views on changing the U.S. health system and included some questions on the Zika outbreak.

Becker’s Hospital Review: Kaiser poll: American public closely following Flint, Zika news and getting good information overall
“The American public is following a number of health care- and infection-related issues in the news closely, and they mostly have a good grasp on the facts, according to a Kaiser Family Foundation survey. Of respondents, 28 percent attested to very closely following the news regarding the lead poisoning crisis in Flint, Mich., with 35 percent saying they were following it fairly closely. The next most-followed story was the Zika virus outbreak, with 20 percent of respondents reporting following it very closely and 37 percent following it fairly closely…” (Green, 2/25).

Huffington Post: The Latest On Zika Virus
“…Three-fourths say that they know it is passed via mosquito bite, more than half know it can also be sexually transmitted, and seven in 10 know it can’t be spread just by shaking someone’s hands. Six in 10 [respondents] also know that there are cases of Zika virus in the U.S., and that the disease may be linked to birth defects. Finally, 43 percent of respondents said they were ‘very’ or ‘somewhat’ worried that the U.S. will have a large number of Zika virus cases in the next year…” (Almendrala, 2/25).

POLITICO: What to expect at the White House today
“…Interestingly, the public seems more informed on Zika — and less terrified — than they were on Ebola 18 months ago. Three-quarters of respondents understood that Zika could be transmitted by mosquito bites, and just 28 percent said they were worried that they or a family member would be infected. In contrast, many Americans in October 2014 were confused by Ebola transmission, and nearly half of respondents believed that they or a family member would be infected by it…” (Diamond, 2/25).

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Some Brazilian Experts Question Zika, Microcephaly Link; Outbreak Spurs Sanitation, Mosquito-Control Efforts

Associated Press: Some experts contend Brazil is exaggerating Zika crisis
“Often drowned out by the dire warnings and fear surrounding Zika, some medical professionals are saying that Brazil and international health officials have prematurely declared a link between the virus and what appears to be a surge in birth defects. A few even argue that the Brazilian government is being irresponsible, given that a connection hasn’t been scientifically proven between the mosquito-borne virus and the birth defect known as microcephaly, which causes infants to be born with abnormally small heads…” (Barchfield/Prengaman, 2/25).

Inter Press Service: Zika Epidemic Offers Sanitation a Chance in Brazil
“Three decades of dengue fever epidemic did not manage to awaken a sense of urgency in Brazil regarding the need for improving and expanding basic sanitation. But the recent surge in cases of microcephaly in newborns, associated with the Zika virus, apparently has…” (Osava, 2/26).

USA TODAY: Go on patrol with ‘Zika police’ in Rio de Janeiro
“…In the middle-class neighborhood of Maracana, where the opening and closing ceremony of the Olympics will be held in August, a tiny man carrying a clipboard and a container of anti-larvae powder is flanked by four soldiers in military uniform. These are the ‘Zika police,’ as they have come to be known by locals, one of many health inspection squads roaming Brazil’s towns and cities, going door to door to try to raise education against a virus that is causing domestic and international alarm…” (Rogers/Pelit, 2/25).

USA TODAY: Brazilians dispute link between Zika virus, birth defects
“International health experts and the Brazilian government have declared ‘war’ on the Zika virus, but as the condition threatens to spread globally another battle is being waged. Medical and public opinion in Brazil, where the Zika outbreak took its most worrisome turn when being linked to severe birth defects, is fiercely split on the issue, leading to confusion and fear…” (Rogers/Pelit, 2/25).

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Case Report Shows Possible Link Between Zika, More Severe Birth Defects

News outlets discuss the findings of a report published in PLOS Neglected Tropical Diseases on severe birth defects and a possible link to Zika virus.

CIDRAP News: Case hints at other severe birth defects tied to Zika
“The suspected link between Zika virus and congenital complications in newborns grew stronger [Thursday] with the report of several severe birth defects in a stillborn Brazilian baby infected with the virus…” (Schnirring, 2/25).

Reuters: Zika infection may cause stillbirth, loss of brain tissue: report
“…The study showed the baby’s brain was absent, a condition known as hydranencephaly. Instead of tissue, the brain cavities were filled with fluid. The baby also had abnormal pools of fluid in other parts of its body. The case, published in the journal PLOS Neglected Tropical Diseases, is the first to link Zika virus with damage to fetal tissues outside the central nervous system…” (Steenhuysen, 2/25).

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Health Experts Call For Action Against Dengue, Citing Sanofi Pasteur's Vaccine

Business Insider: Another worrisome problem is afflicting many of the same places where Zika is spreading
“…There’s a commercial vaccine that’s now available for dengue, but it still isn’t available to everyone who needs it. In December, the company developing it, global pharmaceutical giant Sanofi, got approval to distribute its dengue vaccine in some of the areas that need it the most. Sanofi is also one of many companies hot on the trail of a possible Zika vaccine. Business Insider spoke with Sanofi’s Chief Scientific Officer, Dr. Gary Nabel, about why the road ahead is so challenging…” (Ramsey, 2/25).

Thomson Reuters Foundation: Health experts press for urgent, integrated approach to tackle dengue
“Health experts called on Thursday for urgent action to tackle the ‘global dengue pandemic,’ and said the number of cases was expected to spike in some countries this year, partly because of the El Niño weather phenomenon. … One impetus for the call to action is Sanofi Pasteur’s new Dengvaxia vaccine that has received approval in Mexico, Brazil, El Salvador, and the Philippines, said Dr. In-Kyu Yoon, director of the Dengue Vaccine Initiative (DVI), adding that other vaccines were in the development pipeline…” (Tang, 2/25).

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Many Ebola Survivors Experience Long-Term Risks, Complications, Researchers Report

The Guardian: Ebola survivors face long-term neurological problems, researchers find
“Ebola survivors are continuing to suffer from neurological problems more than six months after infection, according to the early results of a new study. The findings from research undertaken by U.S. neurologists in Liberia appear to confirm suspicions that there are serious long-term effects of Ebola virus disease. They have been made public days after Pauline Cafferkey, the nurse who contracted Ebola while working as a volunteer in Sierra Leone, was admitted for the third time to the infectious diseases unit of the Royal Free Hospital…” (Boseley, 2/25).

Science: New reports highlight long-term risks from Ebola infection, limits of ZMapp
“…At a meeting in Boston [Tuesday], researchers presented new evidence that the Ebola epidemic in West Africa has had long-term effects on many survivors, including joint pain, neurological problems, and eye damage. They also found that many men harbor RNA from the virus in their semen after they recover and for far longer than imagined — which suggests that fresh outbreaks caused by sexual transmission are still a threat — and that many people may well have had Ebola without realizing it. Scientists also presented disappointing results from a clinical trial of what was once considered the most promising Ebola treatment: an antibody cocktail called ZMapp. The study, started late in the epidemic, enrolled far fewer people than researchers had planned, and it failed to provide statistically significant results…” (Cohen, 2/24).

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Some Medical Workers Fear Syrian Hospitals Being Deliberately Bombed

New York Times: As Bombs Hit Syrian Hospitals, Medical Workers Fear They Are the Target
“…[M]any Syrian medical workers in insurgent-held areas and human rights groups believe medical facilities are not just being hit by stray bombs or indiscriminate attacks, but have long been deliberately targeted by the Syrian government and its Russian allies. It is a measure of the deep mistrust that gravely challenges prospects for a truce set to begin Saturday…” (Barnard, 2/25).

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Food Aid Needed In South Sudan To Avoid Famine, U.N. Says

Frontline: When Food Shortage Becomes Famine
“…[Peter] Luak and his family are among the more than 2.8 million people in South Sudan — nearly a quarter of the country’s population — who are currently facing food shortages and need urgent assistance according to the United Nations. The U.N. is now warning of a looming famine…” (Hopkins, 2/25).

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Global Trachoma Mapping Project Atlas Will Help Achieve Disease Elimination

The Economist: Now is the time to say “goodbye”
“…The [Global Trachoma Mapping Project] atlas’s publication brings encouraging news. Malawi, Nigeria, Tanzania, and Uganda had much lower levels of trachoma than expected. Laos and Cambodia, unsurveyed since the 1960s, turned out to be virtually free of it. And, for those places that are infected, the full force of antibiotic-distribution and face-washing education programs can now be brought to bear. The World Health Organization aspires to eliminate trachoma as a public health risk by 2020, leaving only sporadic cases that local doctors can clear up. That sounds ambitious. But knowing where to concentrate fire certainly helps” (2/27).

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GSK's HIV Unit, ViiV Healthcare, Helping Spur Growth In Company

Financial Times: HIV unit emerges as ‘critical’ driver of GSK growth
“It is only a year since GlaxoSmithKline was considering a spin-off of its HIV unit as a way to unlock value for disgruntled shareholders. The option was rejected and now the business, known as ViiV Healthcare, is playing an increasingly important role in efforts to return the U.K. drugmaker to growth…” (Ward, 2/25).

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Editorials and Opinions

Opinion Pieces Discuss Various Issues Surrounding Zika Outbreak

Quartz: What Africa’s fight against HIV can teach Latin America about Zika
Celine Gounder, internist, infectious diseases and public health specialist, and medical journalist

“…[Intrauterine devices (IUDs)] and hormonal implants are the most reliable form of reversible contraception, with failure rates of less than one percent. They’re also long-lasting … Latin American countries and nonprofits should move quickly to scale up access to the contraceptives we know to be most effective and long-lasting. … [W]e should make expanding access to effective, long-lasting contraception an immediate priority. This will buy us time as the global medical community works to prevent Zika infections in pregnancy” (2/25).

The Guardian: Tackling Zika in Brazil: ‘There is fear among the people I meet’
Rozana Ribeiro, nurse at Brazil’s Red Cross

“…Following an appeal by the health ministry, I’ve spent the last two months alongside other Red Cross volunteers going door to door with pamphlets to raise awareness about Zika. We talk to people about how to prevent the conditions that allow mosquitoes to thrive and how to avoid getting bitten. There is fear among the people I meet on their doorsteps. The women are especially concerned; they are scared because the number of cases of people with the Zika virus has risen so fast. In fact, the problem is much bigger and the reality much worse than what is being reported by the media. … Why has the virus spread so fast? It’s down to a combination of factors, including a lack of action by the authorities and not enough awareness of the causes or knowledge about how to prevent it…” (2/26).

Marie Claire: Two Powerhouse Politicians on What the Fight Against Zika Really Needs
Rep. Debbie Wasserman Schultz (D-Fla.), chair of the Democratic National Committee, and Rep. Norma Torres (D-Calif.)

“…In an effort to reduce the incidence of [microcephaly], some governments have encouraged women to avoid or delay getting pregnant. … According to a recent report from the Kaiser Family Foundation, five Western Hemisphere countries with active Zika transmission — Guyana, Haiti, Bolivia, Suriname, and Guatemala — have Contraceptive Prevalence Rates … at or below 50 percent. Other countries with active Zika transmission, including the Dominican Republic, El Salvador, and Honduras, struggle with a lack of access to contraception. … As women members of Congress, and staunch advocates for a woman’s right to make her own health care decisions, we urge the global community to join us in calling for improved access to family planning resources, including education and contraception. Women and men facing the risk of Zika infection need the resources and information to make voluntary, informed choices on family planning — not anti-women’s health policies that leave them without viable options” (2/24).

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Resilient Partnerships Critical To End Malaria In Southeast Asia

Huffington Post: A Partnership to End Malaria in the Mekong
Mark Dybul, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria

“…The Global Fund partnership is backing a smart regional initiative with a US$100 million grant to tackle artemisinin resistance in Myanmar, Thailand, Viet Nam, Laos, and Cambodia, with a special focus on mobile populations such as farming communities and seasonal agricultural workers. The Regional Artemisinin-resistance Initiative (RAI) has galvanized strong political commitment from East Asian leaders to achieve the goal of a malaria-free Asia Pacific by 2030. Countries are now saying that to end this devastating disease, control is not enough, and that to stamp out malaria we need to work together, with deeper cross border collaboration and regional data sharing. … Our ability to succeed will ultimately depend on the resilience of our partnerships. RAI is a terrific example of working together, in an interconnected world, to end this malaria” (2/25).

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New Drugs, Investment In Education Can Help Prevent HIV Among Women In Africa

New York Times: Helping Women in Africa Avoid HIV
Editorial Board

“…The results of two major studies in Africa that were released Monday show that a new device could help protect women against HIV. It is a flexible ring a woman inserts into her vagina, where it slowly releases an antiretroviral drug. … Of course, new drugs and devices can only help so much. Poverty, a lack of education, … and social and cultural customs … all contribute to women’s high infection rates. Investing in educating and empowering women in Africa and elsewhere in the developing world must remain an important part of the fight against this disease” (2/26).

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African Governments Continue To Address, Make Progress On Gender Challenges

Huffington Post (World Bank) Closing the Gender Gap: Lessons from Africa
Makhtar Diop, vice president for Africa at the World Bank; Awa Marie Coll-Seck, Senegal’s minister of health and social action; and Cristina Duarte, minister of finance, planning, and public administration in Cabo Verde

“…[G]overnments, researchers, and many others in Africa have set about generating evidence to determine what works and what does not work to address the many gender challenges that are preventing them from making even greater progress. … The fact that we are seeing a proliferation of such rigorous evidence on measures to address gender issues in Africa gives us great hope. Firstly, it signifies that we have moved well beyond the tendency to include gender in development policy as a well-meaning token, and can now systematically develop rigorously tested solutions that work in practice. Secondly, it gives Africa the rare opportunity to lead the global policy dialogue on gender and speak for itself, by its own actions, rather than being spoken about, and prescribed to, by others” (2/25).

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Global Community Must Commit To Supporting National Deworming Programs

Devex: Deworming: Now more than ever, a best buy for development
Grace Hollister, global director of Evidence Action’s Deworm the World Initiative, and Priya Jha, director of Evidence Action’s work in India

“…[D]eworming children is considered a ‘best buy’ in development, with a very high rate of return to society. A growing number of countries with high worm prevalence — Kenya, Ghana, Rwanda, Ethiopia, Nicaragua, South Africa, and the Philippines — have begun national school-based deworming programs where all at-risk children regularly receive deworming treatment. India is by far the largest addition to this global movement. … The World Health Organization and global community are clear on what we need to achieve: Eliminate morbidity due to parasitic worms in children by 2020. … Political commitment to national programs in highly endemic countries is growing but the technical capacity in many countries is still low, and within countries there is often insufficient coordination among government agencies, donors, and nongovernmental organizations. Other high-burden countries need to join the fight against worms. … Together, we can deworm the world” (2/25).

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Senegal's Integration Of Family Planning Into Health System Contributes To Country's Overall Progress

Devex: 5 reasons Senegal is ahead of its neighbors on family planning and HIV
Pape Amadou Gaye, president and CEO of IntraHealth International

“…Countries that embrace family planning and build it into their health systems enjoy not only greater health, but greater gender equality and economic prosperity. And Senegal has made this a priority. … Here are a few reasons the country is ahead of the curve in its region: Early, decisive action on HIV — and Ebola … Country ownership and investment … Robust national plan … Creative health workforce management … Powerful system for managing contraceptive supplies … Senegal’s success comes not only from making commitments but from following them up with implementation plans, working efficiently with its partners (including NGOs), investing and coordinating resources, and doing the day-to-day work necessary to stay on track — precisely the kind of hard work that will help individual countries reach their health targets and achieve the Sustainable Development Goals” (2/25).

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From the Global Health Policy Community

Ministers Sign Declaration To Close Immunization Gap By 2020 At First-Ever Ministerial Conference On Immunization In Africa

WHO: Ministers pledge to improve access to vaccines at first-ever Ministerial Conference on Immunization in Africa
“…At a landmark Ministerial Conference on Immunization in Africa held from 24-25 February, in Addis Ababa, Ethiopia the ministers signed a declaration to promote the use of vaccines to protect people of all ages against vaccine-preventable diseases and to close the immunization gap by 2020. The conference, which was hosted by the World Health Organization (WHO) Regional Offices for Africa (AFRO) and the Eastern Mediterranean (EMRO) in conjunction with the African Union Commission (AUC), was the first-ever ministerial-level gathering with a singular focus on ensuring that children across the continent can get access to life-saving vaccines…” (2/25).

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Religious Leaders Play Important Role In Efforts To End FGM/C

U.S. Department of State’s “DipNote”: The Role of Religious Leaders in the Global Effort to End FGM/C
Arsalan Suleman, acting U.S. special envoy to the Organization of Islamic Cooperation (OIC), discusses the importance of engaging community leaders, including religious leaders, in efforts to end female genital mutilation and cutting (FGM/C). He highlights an event held at the U.N. on February 8 to commemorate the International Day of Zero Tolerance to FGM/C, co-convened by the OIC and the U.S. Department of State (2/25).

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Community Health Workers Vital To Achieving SDGs

USAID’s “IMPACTblog”: More Community Health Workers Needed for a Healthier World
Katie Taylor, child and maternal survival coordinator and deputy assistant administrator in the Bureau for Global Health at USAID, discusses the role of community health workers in strengthening global maternal and child health. She highlights the Community Health Framework, which provides a “common language” for and approaches to community health work (2/25).

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Mother-To-Child HIV Prevention Program Shows Promising Results In Malawi

CDC’s “Our Global Voices”: Malawi’s Approach to Treating Pregnant Women With HIV Shows Success
Sundeep Gupta, CDC country director for Malawi, and Beth Tippett Barr, CDC country director in Zimbabwe, discuss the results of a study examining national outcome results for the Option B+ initiative to prevent mother-to-child HIV transmission in Malawi. Gupta presented the results Tuesday at the Conference on Retroviruses and Opportunistic Infections in Boston (2/25).

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