KFF Daily Global Health Policy Report

In The News

White House Official Says Regulations Clarifying Mexico City Policy Memorandum Forthcoming; Rules May Differ Significantly From Than Previous Versions

BuzzFeed News: The White House Has Finally Said More About What Its Global Anti-Abortion Rule Means
“A White House official on Thursday clarified a new policy that renews abortion-related restrictions on global health funding, suggesting that the new version [of the Mexico City policy] may be even more restrictive than previously understood. … The previous version of the policy exempted hospitals or clinics that don’t offer abortion. It also carved out an exemption that allowed health facilities to treat women with complications from illegal or unsafe abortions without putting the facilities’ U.S. funding at risk. White House Deputy Press Secretary Sarah Sanders said the Trump administration has not decided on similar exemptions yet. ‘The [George W.] Bush regulations implementing this policy excluded hospitals,’ she wrote in an email responding to questions on the policy from BuzzFeed News. ‘We will be issuing regulations as well, and may very well address the issue of hospitals there.’ Sanders’ statement is significant. It’s the first time a Trump administration official has suggested that hospitals may have to agree to the so-called gag rule as a condition to receive global health assistance. It’s also the administration’s first clear indication that it may depart from the ground rules laid out last time the policy was enacted. But the clarification also raises more questions. The Bush-era ground rules stipulated that the policy applied to ‘foreign nongovernmental organizations’ and that foreign governments were specifically exempted. Trump’s language omits the word ‘nongovernmental,’ and Sanders didn’t mention exemptions for foreign governments. She did not reply on Thursday to an email requesting more details…” (Moore/Nocera, 1/26).

Vox: Trump’s global abortion gag rule goes much further than any previous administration
“…Traditionally, the gag rule, when in place, has banned all international nongovernmental organizations (NGOs) that receive USAID family planning funding from mentioning abortion to patients, as well as curtailed their ability to use outside funding to provide abortions. Now, with the Trump administration’s change, experts say the gag rule will apply to 15 times more funding than it used to. According to the Kaiser Family Foundation, a nonprofit organization focused on health issues, the policy will now apply to aid money coming not just from the U.S. Agency for International Development (USAID), as before, but also from the Centers for Disease Control and Prevention (CDC), the Department of Health and Human Services, [and] the National Institutes of Health (NIH) … The global health world is reeling, and it’s still unclear how this will all play out. But the implications could potentially be enormous…” (Wildman, 1/26).

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Health Advocates, Providers Concerned Over Impacts Of Expanded Mexico City Policy

Christian Post: President Trump’s Global Gag Rule Affects Fight to End the Spread of HIV/AIDS
“With United States President Donald Trump reinstating the global gag rule, a lot of advocates are worried about its imminent repercussion not only in preventing abortion but also on the ongoing fight against the HIV/AIDS epidemic…” (Dumaroag, 1/26).

The Economist: A policy intended to cut abortions is likely to do just the opposite
“…Previously, the Mexico City policy applied only to aid for family planning programs … Mr. Trump’s version covers all global health aid … Nobody knows how many NGOs will shun money under the new rules. The casualties may include the foot soldiers in America’s global campaign against HIV/AIDS, which has beaten back the disease in Africa. (George W. Bush made an exception for HIV/AIDS when he resurrected the Mexico City rules.) Supporters of the policy see it as pro-life. Sadly, the probable outcome may be just the opposite” (1/28).

The Guardian: ‘Global gag rule’: stop playing politics with women’s lives, MSF tells Trump
“Médecins Sans Frontières has told the Trump administration to stop ‘playing politics’ with women’s rights and other global health efforts after the new U.S. president reintroduced a policy likely to affect millions of women and girls around the world. … MSF is not directly affected by the gag rule since it relies on donations rather than U.S. government funds to provide its services. Nonetheless, the organization pointed out that it treats women and girls with abortion-related complications daily…” (Hodal et al., 1/26).

The Guardian: ‘Global gag rule’ jeopardizes future of Asia health initiatives, campaigners say
“Women’s health advocates across Asia have said Donald Trump’s decision to reinstate and beef up the ‘global gag rule’ will result in hundreds of thousands of unwanted pregnancies and imperil programs aimed at improving sanitation, treating AIDS, and protecting LGBT activists. Health providers and advocacy groups in Delhi, Phnom Penh, Jakarta, and beyond have been holding emergency meetings since Tuesday’s announcement that U.S. aid funding was now contingent on organizations abandoning their abortion advocacy work, services, or information…” (Safi/Hodal, 1/26).

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Belgium Joins Netherlands In International Funding Plan For Birth Control, Abortion, Sex Education

Associated Press: Belgians, Dutch join in opposing Trump’s anti-abortion plans
“Belgium is joining the Netherlands in backing the creation of an international fund to finance access to birth control, abortion, and sex education for women in developing countries in an attempt to make up for U.S. President Donald Trump’s ban on U.S. funding. Alexander De Croo, Belgium’s minister for foreign trade and development, says he is fully behind the initiative of his Dutch counterpart to set up an international fund for safe abortions. De Croo says Wednesday that ‘this decision of the White House has an immediate impact on the lives of millions of girls and women in developing nations’…” (Casert, 1/25).

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British Lawmakers Urge U.K. Development Secretary To Take Action In Support Of Women's, Girls' Health In Light Of Mexico City Policy

BuzzFeed News: Labour MPs Add To Calls For Britain To Step In After Trump’s “Global Gag” Rule
“A chorus of MPs and charities have called on the development secretary, Priti Patel, to offer more support to women’s organizations that work to improve women’s reproductive rights, after Donald Trump blocked their funding. [Wednesday] BuzzFeed News revealed that the Tory MP Sarah Wollaston had written to Patel to request action, while The Guardian later reported that six Labour MPs had written asking Britain to follow the Netherlands in forming an overseas fund…” (Le Conte, 1/26).

The Guardian: Labour MPs urge Priti Patel to stand against Trump’s ‘global gag’ rule
“…The group [of six Labour MPs] — Stephen Doughty, Stella Creasy, Gareth Thomas, Stephen Twigg, Luciana Berger, and Anna Turley — praise Patel for championing the work of the Department for International Development (DfID) for women and girls in developing countries. They say it has focused on access to education, health services, family planning, better nutrition, and water and sanitation. ‘The department has been at the global forefront in helping poor women to lead healthy and productive lives, and to increase voice, choice and control for girls and women,’ they add, warning that Trump’s decision could undermine DfID’s work. They highlight the Dutch plans for a fund to help projects providing access to birth control, abortion, and women’s education…” (Asthana, 1/27).

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WFP Hopes U.S. Aid To Organization Continues Under Trump Administration, Executive Director Says

Agence France-Presse/Rappler: U.N. food agency hopes for continued U.S. funding
“The head of the World Food Programme (WFP) said she was hopeful of continued U.S. funding for the organization, despite reports that Washington was mulling heavy cuts in financial support. Foreign Policy magazine reported on Thursday, January 26, it had seen an executive order from President Donald Trump’s administration that proposed cuts of 40 percent in voluntary U.S. funding for U.N. agencies, including the WFP and UNICEF. … [WFP Executive Director Ertharin] Cousin told AFP late on Thursday: ‘The U.S. has been the largest donor to WFP for over 50 years. Our hope is that this organization, which serves humanity around the globe and ensures that children don’t go hungry, that has benefited from support on the Republican as well as the Democratic side of the house, can continue to depend upon receiving the financial assistance that’s necessary’…” (1/27).

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MSF Criticizes U.S. Army's Decision To Grant Sanofi Exclusive Rights To Experimental Zika Vaccine

Devex: Zika vaccine could be delayed, unaffordable after U.S. Army grants exclusive rights to pharma company
“The U.S. Army’s plan to grant exclusive rights to a promising Zika vaccine to a major pharmaceutical company has raised questions about whether that threatens its future affordability and availability to people in developing countries. … The humanitarian aid organization Médecins Sans Frontières has criticized the Army’s decision to grant Sanofi the patent license, which will give the company an exclusive right to make, use, and sell the vaccine for 20 years, as well as 12 years of marketing and data exclusivity even after the patent has expired. … MSF wants the U.S. Army to consider granting an ‘open nonexclusive’ patent license instead, opening up the technology to other pharmaceutical companies for testing and development…” (Edwards, 1/27).

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Final 3 WHO DG Candidates Discuss Qualifications During Press Briefing

NPR: Finalists For Top WHO Spot Say Why They’d Be Good At The Job
“The World Health Organization’s next director general will inherit an ailing institution with funding problems — and a bad reputation for how it’s handled global health emergencies. The three finalists for the top spot are Tedros Adhanom Ghebreyesus, David Nabarro, and Sania Nishtar. WHO’s Executive Board selected them [Wednesday] from a group of six candidates. On Thursday, they introduced themselves in a press briefing from WHO’s headquarters in Geneva. … Here’s a brief snapshot of what each finalist had to say…” (Gharib, 1/26).

ScienceInsider: Meet the three people who hope to lead WHO in the Trump era
“…From now until the election in May, the [candidates] and their countries will campaign in the media and lobby furiously behind the scenes to get as many of WHO’s 194 member states as possible on their side. The outcome will depend in part on what happens on the international stage in the months ahead, says Ilona Kickbusch, an independent global health consultant based in Brienz, Switzerland. What influence will Brexit negotiations have on European support for U.K. candidate Nabarro? If U.K. Prime Minister Theresa May draws closer to U.S. President Donald Trump, will that hurt Nabarro’s chances? Which candidate will be able to convince member states to give WHO more money, not less? ‘This is the first time that world politics will play such a big role’ in WHO’s election, Kickbusch says…” (Kupferschmidt, 1/26).

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Devex Offers Lessons For Development Sector Working With USAID Based On Australian Experience

Devex: Lessons for aid in the Trump era, from Australia
“…For the development sector working with USAID, looking to Australia can provide insights into how to plan and prepare for the changes ahead. 1. Budget cuts mean all programs will be under review. … 2. Foreign aid becomes a diplomatic tool. … 3. Expertise and knowledge could disappear. … 4. Aid will take a regional refocus. … 5. Aid for trade will move up the priority list. … 6. Expect less transparency. … From the experiences of Australia, Devex has three tips for how to be ahead of the game. 1. Demonstrate how a program benefits Trump’s priorities. … 2. Programs should be sustainable. … 3. Prepare for the worst and hope for the best…” (Cornish, 1/26).

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Editorials and Opinions

Editorial, Opinion Piece Discuss Potential Impacts, Implementation Of Mexico City Policy

New York Times: Mr. Trump’s ‘Gag Rule’ Will Harm Global Health
Editorial Board

“…Mr. Trump’s memorandum … would apply the policy to ‘global health assistance furnished by all departments or agencies.’ Although reproductive health groups are still studying the memorandum, this language would appear to apply to any international health funding … used to fight malaria, HIV, Zika, Ebola, and many other global health threats. This would seem to go well beyond family planning aid from the [U.S.] Agency for International Development and the State Department, to also include money from all American governmental agencies and departments. … President Trump’s decision [to reinstate the Mexico City policy] will limit health organizations’ ability to fight disease and promote reproductive health, and other governments will have to pitch in to help. On Wednesday, the Dutch government announced plans to establish an international fund to help fill the gap left by the reinstatement of the policy, paying for contraception, abortion, and education for women. [Rep. Nita Lowey (D-N.Y.) and Sen. Jeanne Shaheen (D-N.H.)] have introduced bills that would permanently repeal the Mexico City policy. Neither, regrettably, is likely to pass” (1/26).

The Hill: A new global gag rule: The trouble with governing by executive order
Mark J. Rozell, dean of the Schar School of Policy and Government at George Mason University

“…[I]t is appropriate to ask whether [an executive order] is the most appropriate way to create policy. … These constant shifts in policy are the result of presidents taking direct action unconstrained by other policymaking forces that likely would have facilitated greater policy continuity. The lack of policy continuity of course has had consequences for the intended beneficiaries of U.S. aid programs, not to mention the utter confusion caused for international aid organizations that have been spun back and forth over shifting policies from one administration to the next. In fairness, Trump is following a now long established pattern of unilateral presidential action in the first days of an administration to decide an issue that should be addressed through the normal process of legislative deliberation and negotiation with the president. No one expected differently. … The trouble is, what Trump does today by executive order will eventually be reversed. Rule by executive order only ensures temporary accomplishments” (1/26).

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Policymakers Should Heed Role Of Law In Improving Global Health

The Lancet: Law: an underused tool to improve health and wellbeing for all
Editorial Board

“One of the most potent tools to advance health and wellbeing and enshrine the right to health in local, regional, national, and international policies has not yet gained sufficient attention in global health discussions. A new report, released on Jan. 16, Advancing the right to health: The vital role of law, aims to fill this gap. The report … tackles this vast topic in three parts: advancing the right to health through law reform; the process of public health law reform; and priorities for public health law reform. … [T]hree areas in the chapter about the process of public health law reform deserve special attention and further thought. … First, awareness of barriers and counterforces is crucial to success, and implementation is likely to be in a stepwise fashion. … Second, the role of civil society, patients’ advocacy groups, and other non-governmental organizations is important in the process of reform. … Third … is the power of the law to facilitate intersectoral action. … However, the report misses an important opportunity by not recognizing the existing and non-existing legal frameworks for adolescents and the consequences. … Nevertheless, this is an important report, and law, especially through an intersectoral lens, could provide big successes in achieving healthier populations in the future. All involved in policymaking need to take heed” (1/28).

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From the Global Health Policy Community

Latest Global Fund Results Show Supported Programs Making Progress Against HIV, TB, Malaria

Global Fund to Fight AIDS, Tuberculosis and Malaria: New Global Fund Results Show Further Progress Against HIV, TB and Malaria
“Latest results show that programs supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria have achieved significant increases in the number of people receiving treatment for HIV, diagnosis and treatment for TB, and having an insecticide-treated net to prevent malaria. The new results, highlighting cumulative progress by programs supported by the Global Fund since 2002, show that the number of people currently on antiretroviral therapy increased 8.5 percent to 10 million. New smear-positive TB cases detected and treated rose by 9.4 percent to more than 16.6 million. Over 713 million insecticide-treated nets were distributed to help families protect themselves from malaria, an increase of 8.1 percent. The results are based on data from the first half of 2016…” (1/26).

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CGD Podcast Discusses How Investments In Women, Family Planning Work To Improve 'America-First Strategy,' Developing Countries' Economies

Center for Global Development’s “CGD Podcast”: Empowering Women Can Make America Great — Podcast with Amanda Glassman, Mayra Buvinic, and Charles Kenny
In this podcast, Rajesh Mirchandani, vice president of communications and policy outreach, speaks with Amanda Glassman, chief operating officer and senior fellow at CGD, and Mayra Buvinic and Charles Kenny, co-directors of CGD’s gender program and senior fellows at CGD, about how “the evidence that engaging and empowering women — both at home and overseas — makes good sense, especially in an America-First strategy.” They discuss the implications of the expanded Mexico City policy and how “providing access to family planning for women in developing countries helps to empower women and strengthen those countries’ economies — and that’s good for America’s economy” (1/26).

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Global Dispatches Podcast Examines History, Potential Impact Of Expanded Mexico City Policy

Global Dispatches Podcast: Trump Just Re-Instated the “Global Gag Rule.” Here’s what that means.
In this podcast Mark Leon Goldberg, editor of the U.N. Dispatch and host of the Global Dispatches Podcast, speaks with Seema Jalan, executive director of the Universal Access Project and Policy, Women and Population at the U.N. Foundation, about the history of the Mexico City policy, its impact on women’s lives globally, and the potential implications of its expansion to U.S. global health assistance (1/26).

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CGD, U.N. Dispatch Examine Potential Implications Of Draft Executive Order To Reduce U.S. Funding To International Organizations, U.N.

Center for Global Development’s “U.S. Development Policy/Views from the Center”: Cutting U.N. Funding Will Cost the U.S.
After the New York Times reported that the Trump administration is considering a new executive order titled “Auditing and Reducing the U.S. Funding of International Organizations,” Charles Kenny, senior fellow at CGD, discusses the potential implications of cutting U.S. funding to the U.N., writing, “The United Nations is a flawed organization but it is still effective, comparatively cheap, and an irreplaceable tool of U.S. foreign policy. Cutting funding to some of its most cost-effective elements would be a loss to American leadership, values, and security” (1/26).

U.N. Dispatch: A Draft Executive Order Takes Aim at the U.N. Here’s What’s Wrong With It
Mark Leon Goldberg, managing editor of U.N. Dispatch, discusses various issues with the draft executive order to reduce U.S. funding to international organizations. “The larger point, though, is that the U.N. is not an adversary of the USA. Rather, it was created (by Americans!) to help share the burden of maintaining global peace and security. To be sure, sometimes other countries use the platform of the United Nations to advance issues that the United States disagrees with, but that is no reason to undermine the operations of the U.N. around the world,” he writes (1/26).

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From KFF

Kaiser Family Foundation Releases Updated Primer On U.S. Engagement In Global Health

Kaiser Family Foundation: The U.S. Government Engagement in Global Health: A Primer
This updated primer provides a comprehensive overview of the U.S. government’s engagement in global health issues. Specifically, the document includes information about global health challenges; provides a brief history of the evolving response of the U.S. government and other stakeholders; describes the U.S. agencies and programs involved in global health and the federal budget supporting these efforts; and explores how the U.S. engages with multilateral institutions and international partners (1/27).

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Kaiser Family Foundation Updates Fact Sheet On Key U.S. Government Officials In Global Health

Kaiser Family Foundation: Key Global Health Positions and Officials in the U.S. Government
This updated fact sheet lists U.S. government positions and officials related to global health operations, including links to agencies and officials’ profiles, when available (1/26).

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