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Kaiser Daily Global Health Policy Report

In The News

Trump To Highlight Plan To End Domestic HIV Transmissions By 2030 In SOTU Address, POLITICO Reports

POLITICO: Trump’s State of the Union pledge: Ending HIV transmissions by 2030
“President Donald Trump plans to use Tuesday night’s State of the Union address to promise an end to the HIV epidemic in America, four individuals with knowledge of the planned remarks told POLITICO. Under Trump’s 10-year strategy, health officials would target the U.S. communities with the most HIV infections and work to reduce transmissions by 2030. The strategy has been championed by top health officials, including HHS Secretary Alex Azar and CDC Director Robert Redfield. … HHS has pressed the White House to ensure the HIV strategy is highlighted on Tuesday night, said two individuals. The agency is also planning a broader rollout this week. … The Trump administration has had an at times fraught relationship with the HIV/AIDS community. … Trump also repeatedly sought to cut the President’s Emergency Plan for AIDS Relief, better known as PEPFAR … However, Trump in December 2018 signed an extension to the program that received bipartisan support…” (Diamond, 2/3).

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Mother Jones Examines Impact Of Mexico City Policy In South Africa

Mother Jones: Two Years Ago, the Trump Administration Limited Abortion Access Worldwide. These Powerful Images Reveal the Impact.
“…Two years ago last month, the Trump administration revived and expanded the Mexico City policy, also known commonly as the global gag rule. The policy blocks U.S. [global health] funds to any foreign nongovernmental organization that provides abortion-related services. In its past incarnations — all under Republican presidents, starting with Ronald Reagan — the rule only affected funding for sexual and reproductive health programs. But President Donald Trump has taken the unprecedented step of expanding the policy to cover almost all health care funding, which has created an uproar of confusion in countries like South Africa. In South Africa at least, conditions are made even worse by barriers — cultural and political — on the ground. … Several NGOs have expressed frustration that the South African government isn’t supporting them or helping them understand the new changes to the Mexico City policy, which now impact a wider array of women’s health providers than ever before…” (Todras-Whitehill, 2/2).

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U.S. Government Sending Humanitarian Aid To Venezuela

Wall Street Journal: Aid for Venezuela to Test Military’s Support for Maduro
“The U.S. government and Venezuela’s opposition are preparing humanitarian aid shipments for the crisis-stricken country, setting the stage for a showdown with authoritarian leader Nicolás Maduro as his military backers face rising international pressure. Over the weekend, USAID Administrator Mark Green posted images on Twitter of hundreds of boxes carrying food for malnourished Venezuelan children and bearing a U.S. flag being loaded on to pallets for delivery…” (Vyas/Castro, 2/3).

Additional coverage of the economic, political, and humanitarian crises in Venezuela is available from the Associated Press, BBC News, and TIME.

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U.N. Health Official Expresses Guarded Optimism As DRC Ebola Outbreak Reaches 6-Month Mark

Associated Press: As Ebola outbreak marks 6 months, health centers a concern
“The deadly Ebola outbreak in eastern Congo marked six months on Friday with officials noting a worrying number of confirmed cases linked to health centers. Such infections are seen as a major problem that highlights poor practices and the risk of spread among patients and workers. Combined with community resistance in an unstable, densely populated region that has never faced Ebola before, the task of containing the outbreak remains challenging…” (Petesch, 2/1).

CIDRAP News: Guarded optimism as DRC Ebola outbreak hits 6-month mark
“…Speaking at a media briefing in Geneva, Matshidiso Moeti, MD, the WHO’s regional director for Africa, praised the WHO staff on the ground and the leadership of the DRC’s health ministry. ‘We can clearly see the strategies that have been successful in controlling the outbreak in some of the affected areas, such as Mangina, Beni, Komanda, and Oicha, though we continue to face flareups in some of these areas and outbreaks in others’…” (Schnirring, 2/1).

U.N. News: Six months into DR Congo’s deadliest Ebola outbreak, top U.N. official praises ‘brave’ response effort
“…Insecurity remains one of the biggest obstacles stopping health workers from reaching those at risk in the vast country, in an area where more than 100 armed groups operate. … An additional obstacle to health workers is suspicion among communities. Despite the challenges, major advances are being made in tackling DRC’s worst Ebola outbreak, helped by a new therapy now being tested on patients with their consent…” (2/1).

Additional coverage of the DRC Ebola outbreak and response is available from Al Jazeera, Becker’s Hospital Review, Healio, and Washington Post.

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U.K. Aid Must Focus More On Reducing Extreme Poverty, Be Spent More Effectively, ONE Report Says

The Guardian: Billions of U.K. aid failing to reduce poverty, report finds
“Too much of Britain’s aid budget is being spent poorly by Whitehall departments on projects that fail the test of reducing poverty in the world’s poorest countries, a campaign group has said. The ONE Campaign — an advocacy organization set up by the U2 singer Bono — said the huge gulf in standards across government was undermining the battle to build public trust that taxpayers’ money was being well spent. … The campaign group’s new Real Aid Index said that only 5 percent of the £765m spent by the business, energy, and industrial strategy department (BEIS) and 16 percent of the £1.05bn spent by the Foreign Office (FCO) went to the countries that needed it most…” (Elliot, 2/4).

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Cancer Patients In Developing Countries Need Improved Access To Pain Relief, WHO Says On World Cancer Day

The Economist: Outdated drug policies leave millions of Africans in agony
“…In West Africa there are just 52 palliative-care centers such as hospices for about 360m people. Many of these do not have enough drugs. In Senegal the average patient who needs it gets 13mg of morphine a year, compared with 55,704mg in America. Across sub-Saharan Africa nine-tenths of cancer sufferers in moderate or severe pain die without the relief granted by opioids…” (1/31).

Reuters: Cancer patients in poor countries needlessly denied pain relief: WHO
“Cancer patients in developing nations are being denied basic pain relief, often because of excessive fears about opioid abuse, the World Health Organization (WHO) said on Thursday. … There are 18.1 million new cancer cases in the world every year and one in six deaths — about 9.6 million — are from the disease, the WHO said in a report for World Cancer Day on Feb. 4” (Nebehay, 1/31).

VOA News: Millions of Cancer Patients Suffer Needlessly From Pain
“…Great advances have been made in the treatment of cancer, but measures to relieve the horrific pain experienced by patients lag woefully behind. WHO hopes to remedy this with its new guidance on pain management…” (Schlein, 2/2).

Additional coverage of World Cancer Day is available from Deutsche Welle and Reuters.

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Health Policy Watch Reports On Issues Discussed At WHO Executive Board Meeting

Health Policy Watch: Draft Global Strategy On Health: Environment, Climate Change Hailed At WHO (Saez, 1/31).

Health Policy Watch: WHO Aims To Broaden Dialogue With Civil Society (Fletcher, 1/31).

Health Policy Watch: WHO Governance Questioned As It Adds World Health Assembly Agenda Item On Biodiversity (New, 2/1).

Health Policy Watch: WHO Board Resorts To Vote To Settle Israel Request To Remove Palestine Agenda Item (Saez, 2/1).

Health Policy Watch: Ending TB: Multi-Sectoral Collaboration Needed To Tackle Disease Of Poverty, Board Says (2/1).

Health Policy Watch: Including Gaming Disorder In Official WHO Classification Receives Civil Society Support (Branigan, 2/1).

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Devex Examines Former World Bank President Jim Kim's Legacy

Devex: As Jim Kim steps down, a tumultuous World Bank presidency comes to an end
“…In the wake of Kim’s abrupt resignation, Devex spoke with more than a dozen of his former colleagues, staff, and World Bank experts, about the legacy Kim leaves behind. Beneath the noise of a disruptive presidency, did Kim succeed in achieving what he initially set out to do? Many of them spoke to Devex on the condition of anonymity to preserve professional ties…” (Edwards, 2/4).

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More News In Global Health

Al Jazeera: Distrust of polio vaccine plagues Afghanistan (Birtley, 2/3).

Bloomberg Quint: Malaysia Asks WHO to Pull ‘Biased’ Report on Palm Oil Industry (Raghu, 2/3).

Devex: Traffic fatalities in Southeast Asia, Africa higher than reports say (Ravindran, 2/4).

Devex: Solar power sales help women avoid food insecurity in Yemen (Welsh, 2/4).

Mother Jones: Study: Emails Show How Coca-Cola Tried to Influence Global Health Policy (Sonde, 2/1).

New Yorker: “Reverse Innovation” Could Save Lives. Why Aren’t We Embracing It? (Vanderbilt, 2/4).

New York Times: Woman Killed by Fire in Menstruation Hut, as Nepal Fights a Tradition (Sharma/Schultz, 2/2).

New York Times: Greece, 10 Years Into Economic Crisis, Counts the Cost to Mental Health (Kitsantonis, 2/3).

New York Times: British Jury Delivers First Conviction for Female Genital Mutilation (Karasz/Schaverien, 2/1).

PRI: Rural women in India struggle to access contraception. These people are trying to change that (Green, 2/1).

Salon: New emails reveal CDC employees were doing the bidding of Coca-Cola (Karlis, 2/1).

STAT: American scientist played more active role in ‘CRISPR babies’ project than previously known (Qiu, 1/31).

Washington Post: An American hid his HIV status to survive in Singapore. Exposed, he allegedly punished thousands living with the virus (Stanley-Becker, 2/1).

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Editorials and Opinions

WHO Director General Should Reconvene Emergency Committee, Consider Declaring PHEIC For DRC Ebola Outbreak

The Lancet: Ebola in the Democratic Republic of the Congo: time to sound a global alert?
Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University, and colleagues

“…A storm of detrimental factors complicates [the Ebola outbreak in the Democratic Republic of the Congo (DRC)]: armed conflict, political instability, and mass displacement. WHO, the DRC Government, and non-governmental organization (NGO) partners have shown remarkable leadership but are badly stretched. The outbreak remains far from controlled, risking a long-term epidemic with regional, perhaps global, impacts. Faced with an evolving complex humanitarian crisis, and recent elections complete, WHO Director-General Tedros Adhanom Ghebreyesus should reconvene the Emergency Committee (EC) and consider declaring a Public Health Emergency of International Concern (PHEIC). … The EC should recommend proactive measures on health, diplomacy, security, and community engagement. … A PHEIC is a clarion call to galvanize high-level political, financial, and technical support. … WHO has shown leadership and operational endurance, working tirelessly to combat the DRC Ebola epidemic. But WHO and partners cannot succeed alone. We live at a political moment when international solutions to collective threats are increasingly hard to achieve. But WHO and the U.N. system will be called upon with ever-greater frequency in the future to manage complex humanitarian crises. We must plan for a future in which political violence and instability become the new abnormal” (2/4).

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West Can Make More Effort To Improve Health Systems In Developing Countries

New York Times: Giant Strides in World Health, but It Could Be So Much Better
Austin Frakt, director of the Partnered Evidence-Based Policy Resource Center at the V.A. Boston Healthcare System, associate professor with Boston University’s School of Public Health, and adjunct associate professor with the Harvard T.H. Chan School of Public Health; and Aaron E. Carroll, professor of pediatrics at Indiana University School of Medicine

“In so many domains, life is improving across the world. It doesn’t always feel that way. In surveys, Americans overwhelmingly believe that world poverty is getting worse or staying the same (it’s getting much better). And they tend to underestimate, by a wide margin, the percentages of children in the developing world who are receiving vaccines. Public health campaigns have been a big reason for major improvements, but urgent priorities remain. The biggest area of need is probably in infectious disease prevention and treatment. … Improving health care systems can be crucial. … [Peter Piot, a physician and director of the London School of Hygiene and Tropical Medicine,] said sustained action was needed ‘to tackle growing epidemics of obesity and diabetes.’ … [W]hat else can the West do to help? [Ashish Jha, a physician with the Harvard T.H. Chan School of Public Health and the director of the Harvard Global Health Institute,] said we could assist in funding the development of drugs and diagnostic tests for diseases threatening poorer countries to a greater extent than wealthier ones, such as tuberculosis. He said helping fund the expansion of health care workers was another worthy priority … A sense of hopelessness can sometimes weaken efforts to help the poor. The giant strides that have been made in recent years show things are far from hopeless, and point the way toward the possibility of more progress” (2/4).

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Ending Violence Against Women, Girls Vital To Achieving SDGs

Inter Press Service: Ending Violence Against Women & Girls in the Sahel: Crucial for Sustainable Development
Amina Mohammed, deputy secretary general of the United Nations

“…[I]t is important that we acknowledge the multiple forms of violence women and girls face, and the consequences they have for individuals, families, communities, and our shared agendas for development — the 2030 Agenda and the African Union’s Agenda 2063. … From early forced marriage to femicide, from trafficking to sexual harassment, from sexual violence to harmful traditional practices: violence in all its forms is a global impediment to sustainable development, peace, and prosperity. It prevents women from fully engaging in society, scars successive generations, and costs countries millions in health expenses, job days lost, and long-term impacts. The United Nations, together with partners, national governments and civil society, is leading efforts to end all forms of violence against women and girls by 2030. And we have existing efforts we can build on. … [W]e need to implement our global agenda on sustainable development — the 2030 Agenda — with urgency, and gender equality is at the very heart of this…” (2/1).

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From the Global Health Policy Community

'Science Speaks' Discusses Survey Highlighting Effects Of Mexico City Policy On PEFPAR Implementing Partners

IDSA’s “Science Speaks”: PEPFAR partners reveal HIV prevention service cuts from expanded “Mexico City Policy,” as organizations endorse act to end its restrictions
Antigone Barton, senior editor and writer at “Science Speaks,” discusses findings from an issue brief, produced by researchers from amfAR and the Johns Hopkins Bloomberg School of Public Health, on the effects of the expanded Mexico City policy on PEPFAR programming implemented by partner organizations (2/1).

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Pew Interviews BARDA Director On U.S. Efforts To Address Antibiotic Resistance

Pew Charitable Trust: Fight Against Superbugs Crucial to America’s Biodefense
This post features an interview with Rick Bright, director of the Biomedical Advanced Research and Development Authority (BARDA), which is part of the Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (ASPR), about the threat to U.S. national security posed by antibiotic-resistant bacteria and BARDA’s efforts to mitigate those risks (2/1).

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U.N. Secretary General Encourages More Action To End FGM, Uphold Rights Of Women, Girls

United Nations: Urging More Action to End Female Genital Mutilation, Secretary General Says Nearly 4 Million Girls at Risk Annually, in Message for International Observance
In a message for the International Day of Zero Tolerance for Female Genital Mutilation, observed annually on February 6, U.N. Secretary-General António Guterres says, “Female genital mutilation is an abhorrent human rights violation affecting women and girls around the world. … With strong political commitment, we are seeing positive change in several countries. However, if current trends persist, these advances will continue to be outpaced by rapid population growth where the practice is concentrated. On this Day of Zero Tolerance, I call for increased, concerted, and global action to end female genital mutilation and fully uphold the human rights of all women and girls” (2/1).

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FT Health Discusses Role Of Food Industry In Obesity, Malnutrition, Climate Change

FT Health: Is Big Food ripe for the Big Tobacco treatment?
The latest issue of the Financial Times’ weekly global health newsletter discusses the food industry’s role in obesity, undernutrition, and climate change, highlighting the recently released Lancet Commission report on the topic. The newsletter also provides a round-up of global health-related news stories (Dodd, 2/1).

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From the U.S. Government

NIH-Supported Scientists Develop New Tool To Count Cells In HIV Reservoirs

National Institutes of Health: NIH-Supported Scientists Develop Tool to Measure Success of HIV Cure Strategies
“Scientists funded by the National Institutes of Health have developed a new assay to accurately and easily count the cells that comprise the HIV reservoir, the stubborn obstacle to an HIV cure. This advance will enable researchers who are trying to eliminate the HIV reservoir to clearly understand whether their strategies are working…” (1/30).

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