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Kaiser Daily Global Health Policy Report

In The News

News Outlets Examine Reach Of Expanded Mexico City Policy, Reactions From Advocates

Boston Globe: Seeing hope in Trump, local anti-abortion advocates head to D.C. rally
“…Just days into President Trump’s administration, the anti-abortion movement has logged progress on two of its four top agenda items, on expanding protections against government funding for abortions both in the United States and overseas. For the first time, a presidential administration will be represented at the [annual March for Life]; in addition to remarks from presidential aide Kellyanne Conway, a longtime abortion opponent, the crowd will hear from Vice President Mike Pence himself…” (Ebbert, 1/27).

CBS News: The “Mexico City Policy”: Why does it matter?
“First established in 1984 by the Reagan administration during an international conference in Mexico City, (hence the name), the ‘Mexico City policy’ denies money to international nongovernmental organizations (NGOs) that ‘perform or actively promote abortion as a method of family planning.’ The policy has been a political football ever since, having been revoked or reinstated by each subsequent administration along party lines for the past 32 years…” (Shaffir, 1/27).

Los Angeles Times: Abortion rates went up in some countries the last time ‘global gag rule’ was in effect
“…One of President Trump’s first acts in office [last] week was to bring back the ban, but the effect might not be what was intended. When the policy was last in effect, abortion rates increased in some sub-Saharan African nations, researchers found. … ‘Attempts to stop abortion through restrictive laws — or by withholding family planning aid — will never work, because they do not eliminate women’s need for abortion,’ Marjorie Newman-Williams, who directs Marie Stopes International’s international operations, said in a statement. ‘This policy only exacerbates the already significant challenge of ensuring that people in the developing world who want to time and space their children can obtain the contraception they need to do so.’ Some abortion opponents, however, take issue with the argument that the policy denies women access to family planning services. ‘The money is there,’ said Carol Tobias, president of the National Right to Life Committee in Washington. ‘It will just go to organizations that agree to limit their abortion activities’…” (Zavis/Dixon, 1/28).

Vox: How the global gag rule will hurt women and families, explained by 2 experts on the ground
“…Under Trump, however, about 15 times more funding will be impacted by the gag rule. That will affect not just contraception access and abortion rates but also maternal health care, HIV/AIDS testing and treatment, and Zika virus prevention and treatment. Millions of poor women will lose birth control access, and thousands will die from unsafe abortion or from avoidable pregnancy complications. Vox spoke separately with two overseas health care providers about the situation on the ground in their countries: Lalaina Razafinirinasoa, country director of Marie Stopes Madagascar, and Marta Royo, executive director of the Profamilia network of family planning clinics in Colombia…” (Crockett, 1/27).

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Facebook COO, LeanIn.Org Founder Sheryl Sandberg Speaks Out Against Trump Administration's Expanded Mexico City Policy

The Hill: Sheryl Sandberg blasts Trump’s revival of ban on abortion funding
“Facebook executive Sheryl Sandberg is blasting President Trump’s decision to revive a ban on foreign aid to overseas health providers who give abortion counseling or provide abortions. Sandberg took to Facebook Thursday evening to share an article from the New York Times about her support for the Global Health Empowerment and Rights Act, saying the reinstated ban ‘could have terrible consequences for women and families around the world’…” (Firozi, 1/27).

Washington Post: Sheryl Sandberg was quiet about the Women’s March. Now she’s sounding off about a Trump policy.
“…In her post Thursday, Sandberg cited her own career experience. ‘I started my career working at the World Bank on health care in India,’ she wrote. ‘I saw firsthand how clinics funded by foreign aid are often the only source of health care for women.’ Sandberg’s post followed a critical column published Thursday in the Silicon Valley publication Pando that questioned why she had not spoken out more against Trump or about the Women’s March. ‘Since November, I’ve heard one phrase uttered over and over by senior women in the Valley: “Why isn’t Sheryl saying anything about this?”‘ wrote the site’s founder, Sarah Lacy, in the sharply worded essay…” (McGregor, 1/27).

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Dutch Government Invests $10.7M In 'She Decides' Fundraising Initiative To Fill Gap Created By U.S.'s Mexico City Policy

Associated Press: ‘She Decides’: Dutch put millions into birth control fund
“The Dutch government announced Saturday it’s putting 10 million euros ($10.7 million) into an international fund it has launched to finance access to birth control, abortion, and sex education for women in developing nations after President Donald Trump [reinstated and expanded the Mexico City policy on January 23]. Lilianne Ploumen, the minister for foreign trade and development cooperation, said she was making the initial contribution and launched the fund — ‘She Decides – Global Fundraising Initiative’ — with a website…” (1/28).

Reuters: Dutch commit $10 million to replace lost U.S. abortion funding
“…The Netherlands, which has some of the world’s most liberal laws on reproductive health, said [last] week the fund would seek donations from other governments, charities, and companies, as well as individuals. … Lilianne Ploumen, Dutch minister for international development cooperation, said she was confident after early discussions that fundraising would go a long way toward plugging the gap…” (van den Berg, 1/28).

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Trump's Executive Order Banning Immigrants From Some Nations Will Impact Public Health In Syria, Doctors Without Borders U.S. Head Says

The Atlantic: What Trump’s Executive Order Means for the Syrian Health Crisis
“The U.S. took in 12,486 Syrian refugees in 2016, a tiny fraction of the 11 million Syrians who have fled their homes since the war there started in 2011. Now, with the signing of President Trump’s executive order, that number will be brought to zero — indefinitely. This means the U.S. is effectively shutting out a group of people who are suffering from one of the worst humanitarian and public health crises in recent memory. … For a closer look at the crisis and how Trump’s order will affect it, I spoke with Jason Cone, executive director of Doctors Without Borders — U.S…” (Khazan, 1/29).

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News Outlets Examine Potential Impacts Of U.S. Cuts To Funding For UNFPA, Other International Organizations; Administration Signals No Action 'At This Time'

Devex: Why Trump’s draft executive order to slash U.N. funding should be treated seriously, though with caution
“A U.S. presidential executive order targeting the United Nations and other international organizations could inflict a major blow to global development and humanitarian operations, slashing American funding by at least 40 percent. But the full extent of the draft measure’s potential harm — for now, at least — remains difficult to gauge, experts say. The order began circulating Wednesday in various media outlets and quickly spread, even as it remained in draft form. It calls for a conditional review of U.S. foreign funding, including a ‘special review of funding’ for the U.N. Population Fund and development aid that ‘oppose, more than support, policies across the United Nations’…” (Lieberman, 1/27).

The Guardian: Trump policy changes would leave lives of millions in balance, agencies warn
“…The U.N. Population Fund and Save the Children are among international organizations braced for Trump to sign leaked executive orders that would have a major impact on funding to the U.N. and support for U.S. refugee resettlement programs. One of the leaked orders directly targets any U.N. agency involved in programs that support or fund abortion as a method of family planning. The UNFPA does not directly support or fund abortion, but does take the view that it should be safe in states where it is legal. The organization estimates that the loss of funding for even one year would prevent the delivery of sexual and reproductive health and gender-based violence services to nine million people in humanitarian settings…” (Hodal, 1/27).

Reuters: No U.S. review of treaties, U.N. funding at this time: admin official
“The Trump administration will not issue executive orders calling for a review of international treaties and U.S. funding of the United Nations and other international bodies ‘at this time,’ a senior U.S. administration official said on Friday. The Trump administration was preparing executive orders that would review U.S. funding of the United Nations and other international organizations and certain forms of multilateral treaties, the New York Times reported on Wednesday…” (Wroughton/Nichols, 1/27).

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Scientists Voice Concern Over Role In Diplomatic, International Relations Under Trump Administration

Nature: Trump agenda threatens U.S. legacy of science diplomacy
“…U.S. President Donald Trump has a deep bench of scientific and technical expertise to tap across multiple government agencies — but it is not clear that he will use it. Science diplomats are watching warily to see whether the volatile new president will draw on the best available evidence when setting foreign policy. So far, his isolationist tendencies are winning: Trump is reportedly considering whether to pull the United States back from international organizations such as the United Nations. … ‘Everybody’s worried that we won’t be in the room any more as a voice of reason advocating for evidence-based decision-making, for bringing the best and brightest to the table no matter where they come from or who they are,’ says Frances Colón, who until last week was the deputy science adviser at the U.S. Department of State. For decades, scientists have had a key role in informing U.S. foreign policy, primarily through the State department…” (Witze, 1/27).

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During Press Conferences, WHO Director General Candidates Discuss Agency's Funding Challenges, Transparency

Devex: WHO nominees talk deprioritization, Trump
“With member states of the World Health Organization divided over a proposed 10 percent contribution increase and an expected funding cut to the United Nations by the Trump administration, the next director general will have to quickly decide which programs to cut or place at the bottom of the health agency’s priority list. The three nominees vying to become the next director general of the organization — David Nabarro, Sania Nishtar, and Tedros Adhanom Ghebreyesus — are well aware of the organization’s budget constraints, but they exercised caution when asked to identify which programs they envision deprioritizing if they become director general…” (Ravelo, 1/27).

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WHO Executive Board Considers Adding Several Organizations Into Official Relations; Some Groups Raise Concerns Over Gates Foundation Trust's Investments

International Property Watch: Is Gates Foundation, WHO’s Biggest Private Funder, Ineligible To Join WHO?
“As the World Health Organization Board prepares to consider candidate institutions to be admitted into official relations with the U.N. agency, some health and public interest groups are raising alarm at what they see as a seeming lack of safeguard against conflicts of interest. Particular concern has been raised over admitting the Bill & Melinda Gates Foundation as an observer because of the Foundation trust’s investments in business ventures such as Coca-Cola, which they see as contrary to health goals. But the Gates Foundation, which is the biggest private donor of the WHO, said the trust is a separate entity from the foundation, and refutes any conflicts of interest…” (Saez, 1/29).

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Financial Times Examines Progress Of London Declaration, Concerns Of NTD Researchers Over New Political, Global Health Leaders

Financial Times: Will war on neglected diseases hit target?
“Five years ago [Sunday], the heads of some of the world’s largest pharmaceutical groups gathered in London with leading health experts, donors, and governments to commit to an unusual medicines program. In the London Declaration, they pledged to work together rather than compete in an innovative program, and to donate rather than charge for supplying large volumes of drugs. … The impact since has been significant. Yet some are nervous that progress may stall given a shift in global priorities and funding under new political and health leaders, and the challenges of tackling the diseases themselves…” (Jack, 1/29).

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Editorials and Opinions

Opinion Pieces Discuss Potential Impact Of Mexico City Policy On Women's Health Worldwide

Huffington Post: The Mexico City Policy does not Actually Consider Women’s Health
Joel Lamstein, president and CEO of John Snow Inc. (JSI) & World Education, and Merce Gasco, senior technical adviser at JSI Research & Training Institute

“…The Mexico City policy has nothing to do with public health; it is purely political. … Forcing organizations to forgo U.S. government funding for a broad array of health services if an organization even wants to mention abortion as an option, ensures that this policy will have a detrimental effect on women’s health — and adolescent, child, newborn, and prenatal health, as well. As a public health consulting firm, JSI is well aware that international evidence clearly shows that legal restrictions do not reduce the number of abortions. Instead, they actually increase the number of risky procedures because women resort to illegal and unsafe service providers. … If the U.S. government wants to reduce the number of abortions performed, it should support policies that support women, e.g., family planning. Until that happens, poor, undereducated women with fewer options will continue to be the ones who suffer most. And rates of abortion will not drop” (1/27).

STAT: Trump’s global gag rule silences doctors and midwives and harms their patients
Catharine Taylor, vice president for health programs at Management Sciences for Health

“…The global gag rule … steps right between a woman and her doctor, nurse, or midwife, preventing these frontline health providers from telling their patients about the full, legal range of health options available to them. … Under the Trump version of the global gag rule, millions of women in some of the poorest places in the world will lose access to affordable, high-quality, comprehensive reproductive health care, and will be less able to make informed health choices. … The U.S. investment in global health will be much less effective. Global health experts know that access to family planning and accurate, comprehensive health information saves lives. By restricting that access, the global gag rule does the opposite, harming the well-being and resiliency of families, communities, nations, and economies. Organizations should not be disqualified from participating in U.S.-funded health projects because they use their own funds to provide the accurate, comprehensive health information that their patients need, and services that are legal in their own countries. If they are, it is women who will pay the price” (1/27).

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WHO Should Elect Ethiopia's Former Health, Foreign Affairs Minister, Tedros Adhanom Ghebreyesus, As Next WHO Director General

Devex: Opinion: The election that matters for the health of the world
Prashant Yadav, senior fellow at the William Davidson Institute at the University of Michigan and visiting scholar at the Harvard Medical School, and Akash Goel, physician and journalist

“…In the current context of what the WHO needs the most, Tedros Adhanom Ghebreyesus, former health and foreign affairs minister of Ethiopia, is the most qualified [candidate] for the role [of director general]. … Tedros’ suitability for director general rests [on] is his irrefutable ability to create and build efficient and sustainable health systems, the linchpin of health care delivery. … This election may well represent a watershed moment in the architecture of global health governance. The WHO urgently needs a leader to repair its deficit in finances and credibility. Fractured and under-resourced health systems are in need of fortification to not only project those within their own borders but also to build resilience against the rise of transnational threats to public health. Tedros is the candidate to do both, and it would be in all of our best interest to elect him” (1/27).

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Strengthening Epidemic Preparedness, Response Critical To Preventing Future Pandemics

Financial Times: Missing links: urgent action is needed to prevent future pandemics
Steve Davis, president and CEO of PATH

“…Improving epidemic preparedness and prevention should be one of our most urgent priorities. … Effective pandemic preparedness will depend on our ability to connect innovations, starting with research and development and extending all the way to the logistic capabilities critical to delivering supplies to those who need them. … In addition, to respond to outbreaks quickly we need to improve local surveillance capabilities, laboratory capacity, diagnostic tools, and health information systems. … Ebola, Zika, and yellow fever are a resounding wake-up call for a world that has been reluctant to make the investments needed to prevent a future disease outbreak from becoming a global catastrophe like the 1918 flu epidemic. A pandemic on that scale today would claim hundreds of millions of lives and create unimaginable economic and social disruption. To ensure that the next outbreak of yellow fever — or flu, or some other as yet-unknown pathogen — never causes that kind of devastation, we need to strengthen every link of the chain of epidemic preparedness and response. And we need to do it now” (1/27).

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From the Global Health Policy Community

Rewire Examines Vice President Mike Pence's Comments On Abortion At March For Life

Rewire: Pence Says Science Supports Anti-Choice Policies — It Doesn’t
Ally Boguhn, political and campaigns editor at Rewire, discusses Vice President Mike Pence’s remarks at Friday’s March for Life in Washington, D.C., on science and abortion, writing, “Vice President Mike Pence claimed that the ‘steady advance of science’ was aiding the anti-choice crusade … Pence lauded President Donald Trump’s move to reinstate the anti-choice ‘global gag rule’ restriction, also known as the ‘Mexico City policy,’ as proof that the administration is ‘in the promise-keeping business.’ … Pence promised the anti-choice marchers that the Trump administration would ‘work with Congress to end taxpayer funding for abortion and abortion providers, and we will devote those resources to health-care services for women across America.’ The Hyde Amendment already ensures that federal funding does not go to abortion care.” (1/27).

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Foreign Assistance, Development, Diplomacy Critical To U.S. National Security, Sen. Graham Says

U.S. Global Leadership Coalition: GOP Senator: U.S. Foreign Assistance Vital to National Security
Megan Rabbitt, communications manager at USGLC, discusses Sen. Lindsey Graham’s (R-S.C.) interview with John Dickerson on CBS’ Face the Nation about the importance of investing in “civilian-led tools of foreign policy” to ensure U.S. national security, writing, “The Senator maintained that in order to keep America safe, strong, and secure the U.S. needs to leverage the powers of foreign assistance, development, and diplomacy alongside the strength of our military” (1/27).

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USGLC Blog Post Outlines 3 Reasons Trump Administration Should Incorporate Africa Into Foreign Policy Strategy

U.S. Global Leadership Coalition: 3 Reasons Why the New Administration Should Focus on Africa
Sean Hansen, government relations and policy associate at USGLC, outlines three reasons why the Trump administration should incorporate Africa into its foreign policy strategy, including bipartisan support, growing new markets, and promoting stability (1/27).

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U.N. Ruling On Access To Abortion In Ireland Serves As 'Roadmap' For Other Countries

Rewire: How a U.N. Committee’s Ruling on Abortion in Ireland Holds Countries Accountable
Jamie J. Hagen, a doctoral student at the University of Massachusetts Boston, explores how a case in Ireland in which a woman appealed to the U.N. arguing that being denied access to a safe and affordable abortion was a violation of her human rights, “has created a roadmap for advocates to call out the prohibition and criminalization of abortion by any country as a violation of human rights. … Advocates in other countries, including the United States and Poland, have sought to protect access to abortion as a human right in different ways through the Human Rights Committee. They have used the U.N. committee periodic review of whether or not the International Covenant on Civil and Political Rights is being upheld within a nation as a forum for addressing violations to reproductive health care. However, the reach of the human rights norms established by the U.N. depends on the willingness of a particular country to work within the bounds of established international human rights frameworks…” (1/27).

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