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Kaiser Daily Global Health Policy Report

In The News

Global Fund Seeks To Raise $14B For Sixth Replenishment Cycle

Devex: Global Fund wants to raise $14B for next 3 years
“The Global Fund to Fight AIDS, Tuberculosis and Malaria hopes to raise $14 billion for its sixth replenishment cycle, but with budget deficits facing some of its largest donors, questions hover on whether the multilateral health partnership will be able to raise the full amount. In an interview with Global Fund Executive Director Peter Sands on Thursday — a day before French President Emmanuel Macron announced the bank’s investment case and formally kicked off [the] Global Fund’s fundraising for its 2020-2022 budget cycle — he told Devex how the fund is in ‘constant dialogue’ with the United States, its largest donor, and continues to receive strong bipartisan support in Congress…” (Ravelo, 1/11).

Reuters: Fund battling AIDS, TB and malaria seeks $14 bln to invigorate fight
“…Announcing a fundraising target for the next three-year cycle, Peter Sands, director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, said the money could help save 16 million lives, halving deaths from the three diseases. It would also be used to build stronger health systems in poor countries ill-equipped to handle existing outbreaks and unable to cope with potential new epidemics. ‘New threats mean there is no middle ground,’ Sands said in a statement. ‘We need to … protect and build on the gains we have made, or we will see those achievements eroded, infections and deaths resurge, and the prospect of ending the epidemics disappear’…” (Kelland, 1/11).

Additional coverage of the Global Fund’s next replenishment cycle is available from the Irish Times and The Telegraph.

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U.S. State Department Eases Some Restrictions On Humanitarian Aid Shipments, Travel To North Korea

Foreign Policy: U.S. to Ease Limits on Humanitarian Aid to North Korea
“The U.S. State Department has decided to ease some of its most stringent restrictions on humanitarian assistance to North Korea, lifting travel restrictions on American aid workers and loosening its block on humanitarian supplies destined for the country, according to several diplomats and relief workers. The decision — which was communicated to humanitarian aid organizations on Wednesday by Stephen Biegun, the U.S. senior envoy for North Korea — follows claims by United Nations and private relief agencies in recent months that the U.S. policy was undermining their efforts to run life-saving relief operations. Those include programs designed to combat infectious diseases, such as cholera and drug-resistant tuberculosis…” (Lynch, 1/11).

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N.Y. Times Examines North Korea's Suspected Biological Weapons Activities, Lack Of U.S. Attention

New York Times: North Korea’s Less-Known Military Threat: Biological Weapons
“Pound for pound, the deadliest arms of all time are not nuclear but biological. … Even so, the Trump administration has given scant attention to North Korea’s pursuit of living weapons — a threat that analysts describe as more immediate than its nuclear arms, which Pyongyang and Washington have been discussing for more than six months. According to an analysis issued by the Middlebury Institute of International Studies at Monterey last month, North Korea is collaborating with foreign researchers to learn biotechnology skills and build machinery. As a result, the country’s capabilities are increasing rapidly…” (Baumgaertner/Broad, 1/15).

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DRC Ebola Outbreak Grows Amid Concerns Over Election Anxiety, Misinformation

CIDRAP News: DRC Ebola total climbs to 644 led by spike in Katwa cases
“In daily updates [since Thursday], the Democratic Republic of the Congo (DRC) health ministry reported 19 more Ebola cases in five locations, though most were from Katwa, one of the latest outbreak hot spots. In other Ebola developments, an American health worker who may have been exposed to Ebola in the DRC was released from monitoring after remaining symptom-free, and another security incident was reported, affecting responders working in Ituri province…” (Schnirring, 1/14).

Reuters: Public mistrust after Congo election raises Ebola epidemic anxiety
“Global health teams battling the world’s second largest Ebola epidemic in Democratic Republic of Congo fear an election dispute may deepen public mistrust and allow the epidemic to run out of control. … ‘When you have political instability, public health always suffers,’ said Jeremy Farrar, an infectious disease expert who recently visited east Congo with a World Health Organization leadership team. Without public trust, he said, the Congo epidemic could kill many hundreds more people…” (Kelland, 1/14).

Science: Fighting Ebola is hard. In Congo, fake news makes it harder
“The Ebola epidemic in the Democratic Republic of the Congo (DRC) is providing a natural experiment in fighting fake news. Occurring in a conflict zone, amid a controversial presidential election, the epidemic has proved to be fertile ground for conspiracy theories and political manipulation, which can hamper efforts to treat patients and fight the virus’s spread. Public health workers have mounted an unprecedented effort to counter misinformation, saying the success or failure of the Ebola response may pivot on who controls the narrative…” (Spinney, 1/14).

Additional coverage of the DRC Ebola outbreak and response is available from The Express, The Hill, VOA News, and Xinhua News.

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FRANCE 24, PBS NewsHour Examine Malaria Treatments, Drug Resistance

FRANCE 24: The malaria business: Big pharma vs natural medicine
“A medicinal plant called Artemisia annua (or sweet wormwood) has been used in China to treat malaria for 2,000 years and is still grown by farmers in Africa. But it’s not approved by the World Health Organization and remains banned in a number of countries, including France. Malaria claims almost half a million lives each year and Africa is worst affected. In recent years, the mosquitoes that spread the disease have become increasingly resistant to insecticide. FRANCE 24 brings you an in-depth investigation into the debate between those for and against this natural anti-malaria remedy, which appears as a threat to large pharmaceutical laboratories…” (Crutzen, 1/11).

PBS NewsHour: Fighting malaria in the remote reaches of Cambodia
“Malaria causes nearly half a million deaths worldwide every year. Ninety percent of them are in sub-Saharan Africa, where poor infrastructure limits delivery of drugs. But now there is worry that those drugs are losing effectiveness as disease strains become resistant. Special correspondent Fred de Sam Lazaro reports from Cambodia, where scientists are researching and tracking new outbreaks…” (de Sam Lazaro, 1/11).

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Nepal's Local Governments Take Steps To Enforce Ban On 'Period Huts'

The Guardian: Destroy ‘period huts’ or forget state support: Nepal moves to end practice
“…The withdrawal of state support services is one of the penalties being brought into force as the country tries to tackle chhaupadi, which was banned by the supreme court in 2005 and criminalized by the government last year. Forcing a menstruating women into a ‘period hut’ is now punishable with three months in prison and a 3,000 rupee (£33) fine. Reports nonetheless emerge each year of women dying in huts from snake bites, smoke inhalation, or fire. The practice has also been linked to death and illness among mothers and newborn babies. … But local authorities in some of Nepal’s more remote regions, particularly in the west of the country, where the practice is still common, are determined to act…” (Adhikari, 1/14).

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Devex Examines Collaborative Philanthropy Trend, Including Recent Grant Announcements From Co-Impact

Devex: How big grants can pave the way to more investment
“Co-Impact, a collaborative of funders focused on systems change, announced its first grants on Tuesday. The grants, which total $80 million, are aimed at improving health, rethinking education, and increasing opportunity for people in South Asia, Africa, and Latin America. Co-Impact is part of a growing trend of collaborative philanthropy, which can combine smaller gifts into larger bets, and help social enterprises access the resources they need to drive global health and international development outcomes at scale…” (Cheney, 1/15).

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More News In Global Health

Al Jazeera: World Food Programme cuts aid for Palestinians (1/13).

Associated Press: Bare-handed surgeries as Zimbabwe’s health system collapses (Mutsaka, 1/12).

Devex: How polio campaigners won €55M for their fight (Hargrave, 1/14).

Inter Press Service: Shedding Light on Forced Child Pregnancy and Motherhood in Latin America (Jara, 1/14).

NPR: Human Trafficking Reaches ‘Horrific’ New Heights, Declares U.N. Report (Cole, 1/14).

Reuters: Indonesia seeks to reassure HIV patients over drug supplies (Da Costa et al., 1/13).

SciDev.Net: Açaí fruit can transmit Chagas disease (de Oliveira Andrade, 1/11).

STAT: Science with borders: A debate over genetic sequences and national rights threatens to inhibit research (Branswell, 1/14).

TIME: Chinese Police Opened an Investigation Into Reports of Expired Polio Vaccinations (Meixler, 1/14).

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Editorials and Opinions

U.S. Congress Should Support Global HER Act, Permanently Repeal Mexico City Policy

New York Times: Letter to the Editor: To Guarantee Women’s Rights
Melvine P. Ouyo, student at the Kennedy School of Government at Harvard and provider at Family Health Options Kenya

“…Every day, young women … face inaccessible health care, domestic violence, delayed decision-making that leads to dangerous abortions, unintended pregnancy, and criminal prosecution. And as if these series of abuses aren’t atrocious enough, women who do survive life-threatening abortions and miscarriages are increasingly being criminalized, from Guatemala to Indiana. We must urge Congress to support the Global Health, Empowerment and Rights Act, which would permanently repeal the global gag rule and protect the health of women across the world. Lives and livelihoods depend on it” (1/10).

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Budget, Strategy Reforms At USAID Critical To Helping Countries Achieve Self-Reliance

Devex: Opinion: The toll of budget dysfunction on U.S. development leadership
Susan Reichle, president and chief executive officer at the International Youth Foundation

“…From shutdowns to delays, to other inefficiencies, the impact of a broken budget process takes an enormous toll on [America’s] ability to exert influence around the world. … Our counterparts on the ground question whether the U.S. government is a reliable partner and not surprisingly, it feeds into negative rhetoric about the lack of U.S leadership. Even when this government shutdown ends, budget paralysis will continue unless reforms are undertaken. … [USAID] Administrator Green has proposed bringing greater alignment between budget and strategy, which will not only lead to increased policy coherence, but it will help fulfill the vision of country self-reliance. This proposal, as well as other reforms, are now with Congress and deserve immediate approval. … America’s development leadership not only projects our unique values but is also clearly in our national interest … However, without reforms — including a more optimally structured USAID, a planning process free from endless clearances, and increased flexibility from Congress — American interests abroad and our partner countries’ development trajectories will suffer” (1/14).

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International Community Must Prioritize Maternal, Women's Health In Efforts To Achieve UHC

Devex: Opinion: We must keep maternal health front and center of the UHC conversation
Joyce Banda, former president of Malawi; Bineta Diop, African Union special envoy on women, peace, and security; Mary-Ann Etiebet, lead and executive director at MSD for Mothers; Pape Amadou Gaye, president and CEO at IntraHealth; Edna Adan Ismail, director and founder of the Edna Adan Maternity Hospital and former foreign minister of Somaliland; and Mariam Claeson, director of the Global Financing Facility

“…We must seize all available opportunities to accelerate progress for women’s health as we push forward on the broader global goal of universal health coverage. As leading advocates, we surfaced a few ideas on how to do this — a set of guiding principles and priorities based on our different experiences and lessons learned on the ground through our maternal health initiatives: Define basic maternity and newborn care, and ensure underserved populations are aware of this foundational health care right. … Remember that change begins at the grassroots level, working within existing social structures. … Recognize the need for more trained frontline health care workers with the capacity and support to improve access to quality care. … Engage the local private health sector as an important partner in addressing access and quality issues. … Use pay for performance and other innovative financing approaches. … Strengthen accountability. … Look outside the health system for answers. … An important starting point, and the key to all of this is to enable decision-making that is informed and responsive to local needs. And for this, we must invest in data. … By ensuring access to quality care for women — not just during pregnancy and childbirth but across their life course — we can promote the health, well-being, security, and future prosperity of their children, families, communities, and countries. This ‘mom effect’ is why we must keep maternal health front and center of the UHC conversation” (1/11).

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Interests Of Pregnant, Lactating Women Must Be Considered In Lassa Fever Vaccine Development

STAT: As the world prepares to fight Lassa fever, the interests of pregnant women must be part of the planning
Ruth A. Karron, director of the Center for Immunization Research and director of the Johns Hopkins Vaccine Initiative; Carleigh Krubiner, policy fellow at the Center for Global Development; and Ruth R. Faden, founder of the Johns Hopkins Berman Institute of Bioethics

“…As plans are being made now to advance the important work necessary to combat Lassa fever, it is essential that the interests of women who are pregnant or lactating and their infants are addressed from the very outset. [The Coalition for Epidemic Preparedness and Innovation (CEPI)] has paved the way, not only by prioritizing Lassa fever vaccine development but by underscoring the importance of conducting research specific to pregnancy and considering how best to move [the Pregnancy Research Ethics for Vaccines, Epidemics, and New Technologies (PREVENT)] recommendations forward. Developing a Lassa fever vaccine that can be offered to pregnant women will be an important double win for global health. It will not only help ensure that pregnant women and their infants are protected against a deadly disease, but will also provide a model for future development of vaccines for use in epidemics” (1/15).

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From the Global Health Policy Community

Organizations, Blog React To Global Fund Call For $14B In Replenishment Funds

Friends of the Global Fight Against AIDS, Tuberculosis and Malaria: The Global Fund Announces Funding Request to Cut AIDS, TB and Malaria Deaths in Half by 2023 (1/11).

Malaria No More: To Save More Lives From Preventable And Treatable Diseases, The Global Fund Seeks $14 Billion For Programs Between 2020-2022 (1/14).

ONE: We have a chance to save 16 million lives (Rhodes, 1/11).

U.N. Dispatch: Global Fund Replenishment Means Funding the Fight Against AIDS, Tuberculosis and Malaria (Goldberg, 1/11).

UNAIDS: UNAIDS calls for a fully funded Global Fund to Fight AIDS, Tuberculosis and Malaria (Barton-Knott, 1/14).

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Rutgers, LSE Experts Say Mexico City Policy 'Has Unintended Effects'

London School of Economics’ U.S. Centre: Trump’s reinstatement and expansion of the global gag rule has harmful effects for women, men, and children
In this blog post, Yana van der Meulen Rodgers, professor at Rutgers University and faculty director of the Center for Women and Work; Ernestina Coast, professor of health and international development in the Department of International Development at LSE; and Nicky Armstrong, communications and events assistant for both the Global Health Initiative and the Latin America and Caribbean Centre at the LSE, discuss President Trump’s reinstatement and expansion of the Mexico City policy, writing, “Evidence suggests that the [policy] — renamed by the Trump administration as ‘Protecting Life in Global Health Assistance’ — does not achieve its objectives in most countries that receive U.S. foreign aid. Instead, it appears that the policy is counterproductive, places lives at risk, and has unintended effects…” (1/11).

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WHO Highlights 10 Priority Global Health Issues For 2019

WHO: Ten threats to global health in 2019
“…2019 sees the start of the World Health Organization’s new five-year strategic plan — the 13th General Programme of Work. This plan focuses on a triple billion target: ensuring one billion more people benefit from access to universal health coverage, one billion more people are protected from health emergencies, and one billion more people enjoy better health and well-being. Reaching this goal will require addressing the threats to health from a variety of angles. Here are 10 of the issues that will demand attention from WHO and health partners in 2019…” (January 2019).

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Report Examines Funding, R&D, Challenges Of Developing, Deploying Vaccines For Emerging Infectious Diseases

GlobalData: Vaccines for Emerging Infectious Diseases: Funding, R&D, and Global Partnership Strategies
“Emerging infectious diseases (EIDs) are characterized by unpredictable incidence and clinical patterns that pose unique challenges for vaccine development. As outbreaks of Ebola virus, Zika virus, and other EIDs have occurred in the past decade, drug developers and global health organizations are turning to novel funding and clinical trial paradigms to improve epidemic preparedness. This report covers current and future challenges for the development and deployment of vaccines for EIDs, focusing on vaccine platform technology and research, funding mechanisms, and collaborative global partnerships…” (December 2018).

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FT Health Features Interview With IAVI President/CEO

FT Health: Key moment for the NHS
The latest issue of the Financial Times’ weekly global health newsletter features an interview with Mark Feinberg, president and CEO of the International AIDS Vaccine Initiative, on the organization’s priorities, the potential of an HIV vaccine, and concerns about vaccine skepticism. The newsletter also provides a round-up of global health-related news stories (Dodd/Jack, 1/11).

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From the U.S. Government

NIH Officials Discuss Scientific Evidence Establishing HIV Undetectable=Untransmittable Concept

NIH: The science is clear: with HIV, undetectable equals untransmittable
“In recent years, an overwhelming body of clinical evidence has firmly established the HIV Undetectable = Untransmittable (U=U) concept as scientifically sound, say officials from the National Institutes of Health. … In [a] new commentary, NIAID Director Anthony S. Fauci, M.D., and colleagues summarize results from large clinical trials and cohort studies validating U=U. The landmark NIH-funded HPTN 052 clinical trial showed that no linked HIV transmissions occurred among HIV serodifferent heterosexual couples when the partner living with HIV had a durably suppressed viral load…” (1/10).

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