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Kaiser Daily Global Health Policy Report

In The News

Effective Anti-Tobacco Measures Cover 2.3B People Worldwide, WHO Report Shows

“A new WHO Report on the Global Tobacco Epidemic 2013 shows hundreds of millions of non-smokers are less likely to start smoking because of national anti-tobacco campaigns that are reaching three billion people worldwide,” VOA News reports (Schlein, 7/10). “Anti-smoking measures including complete bans on tobacco advertising, promotion and sponsorship across the world have benefited nearly 700 million people since 2007,” according to the report, which “showed that up to date, 24 countries have introduced complete bans and 100 more countries are close to a complete ban, but 67 countries currently do not ban any tobacco advertising, promotion and sponsorship activities or have a ban that excludes advertising in national broadcast and print media,” Xinhua writes (7/10). The Bloomberg Philanthropies-funded report “shows that 2.3 billion people are covered by at least one effective tobacco control measure, an increase from the one billion covered in 2008,” a Bloomberg Philanthropies press release states.

“While progress is being made, the report also shows that two-thirds of the world is not yet protected by a single MPOWER [Monitoring tobacco use and prevention policies; Protecting people from tobacco smoke with smoke-free air legislation; Offering help to quit tobacco use; Warning about the dangers of tobacco with pack labels and mass media, Enforcing bans on tobacco advertising, promotion and sponsorship; and Raising taxes on tobacco] policy, indicating that there is more work to be done to save millions more lives,” the press release notes (7/10). According to a WHO press release, “the report notes to achieve the globally agreed target of a 30 percent reduction of tobacco use by 2025, more countries have to implement comprehensive tobacco control programs.” WHO Director-General Margaret Chan said, “If we do not close ranks and ban tobacco advertising, promotion and sponsorship, adolescents and young adults will continue to be lured into tobacco consumption by an ever-more aggressive tobacco industry,” the press release notes (7/10).

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Former South African Deputy President Appointed Head Of U.N. Women

“The United Nations named former South African Deputy President Phumzile Mlambo-Ngcuka to head the gender equality body U.N. Women on Wednesday, after former Chilean president Michelle Bachelet stepped down to pursue another presidential bid,” Reuters reports (Nichols, 7/10). “Announcing the decision at the U.N. midday press conference, a spokesman for the U.N. general secretary, Ban Ki-moon, said: ‘Phumzile Mlambo-Ngcuka brings to this position a wealth of experience in advocating for women’s issues with a combination of strategic leadership, consensus building and hands-on management experience,'” The Guardian writes, noting, “She is expected to take up her position at U.N. Women in August” (Ford, 7/10). “She was the first woman to hold the position of deputy president of South Africa from 2005 to 2008, and has also served as deputy minister in the Department of Trade and Industry, minister of Minerals and Energy, and briefly as acting minister of Arts, Culture, Science and Technology,” according to the U.N. News Centre, which adds, “Among her many activities, Ms. Mlambo-Ngcuka established Umlambo Foundation in 2008 to provide support to schools in impoverished areas in South Africa through mentorship and coaching for teachers and in Malawi through school improvements with local partners” (7/10).

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Group Representing Haitian Cholera Victims Reacts To Ban's Recent Letter To U.S. Lawmakers

Thomson Reuters Foundation examines the reaction of lawyers with the Institute for Justice and Democracy in Haiti (IJDH) to a letter U.N. Secretary-General Ban Ki-moon sent to U.S. lawmakers last week, responding to a May 30 letter signed by 19 members of the U.S. House of Representatives. The IJDH has “led an effort to claim compensation on behalf of 5,000 cholera victims and their families since the outbreak began in late 2010,” the news service writes, noting, “The group filed claims in November 2011 against the U.N., demanding hundreds of millions of dollars in compensation for cholera victims and a public apology.” According to the news service, IJDH head Brian Concannon “said the U.N. has refused to consider resolving the cholera victims’ claims outside of court, meet with victims or their lawyers, and set up a claims commission as required by its own treaty.” Reuters notes, “The U.N. has said it is committed to tackling cholera in Haiti and the neighboring Dominican Republic … through a $2.2 billion donor aid program known as the Hispaniola Initiative over the next 10 years, but critics say the amount is insufficient.” According to the news service, “Rights group IJDH says it will take the case against the U.N. to courts in Haiti, the U.S., or Europe” (Moloney, 7/10).

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Huffington Post Live Looks At Public Health Crisis In Syria

Huffington Post Live features an interview with two doctors and a nurse, representing several of dozens of American doctors who “are traveling to Syria doing their part to help treat a public health crisis in the midst of a civil war,” HuffPo Live correspondent Ahmed Shihab-Eldin states. Shihab-Eldin says “70 percent of Syria’s medical professionals have fled the country” and “many Syrians have not had any medical care or medicine available for more than two years, and those treating the injured are short of everything — IV fluids, antibiotics, painkillers, surgical supplies, electricity, ambulances, and even the very fuel needed to operate generators to keep the lights on.” Lara Setrakian, co-founder and executive editor of Syria Deeply, co-hosts the segment, which is part of Syria Deeply’s “Syria ER” feature. The news service provides links to other articles on Syria’s public health crisis (7/10).

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Egypt Facing Food Security Concerns, FAO Report Says

“Civil unrest and dwindling foreign exchange reserves raise serious food security concerns in Egypt, the United Nations’ food agency said in a report on Thursday,” Reuters reports. Grain import requirements for 2013-2014 will remain the same as this year in Egypt, the world’s largest wheat importer, because of a growing population and despite a predicted good harvest, the U.N. Food and Agriculture Organization said in its Crop Prospects and Food Situation report, the news agency notes. However, the report “warned … that declining foreign exchange reserves may result in increased restrictions on transactions by Egypt’s Central Bank, thus curtailing the imports,” the news agency writes (Hornby, 7/11). “Two and a half years of political turmoil have caused a deep economic crisis in Egypt, scaring away investors and tourists, draining foreign currency reserves and making it difficult to maintain imports of food and fuel,” Reuters/Firstpost reports. “Earlier this week a report issued by a U.S. Department of Agriculture (USDA) attaché in Egypt said domestic wheat stocks would last through October at current consumption levels. It gave no estimate for when foreign wheat would run out,” the news agency notes (7/11).

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Taliban Ban On Vaccines In Pakistan Affecting Children's Health

Inter Press Service examines how Taliban control is threatening the lives of children in Pakistan’s Federally Administered Tribal Areas (FATA), writing, “[T]he Taliban have imposed a complete ban on all vaccines against preventable childhood diseases, including polio — sometimes referred to simply as ‘infantile paralysis’ due to its crippling effects on a child’s nervous system — measles, diphtheria, hepatitis, meningitis, pertussis, influenza and pneumonia.” The news service continues, “Children in all seven agencies of FATA have been the worst affected by the ban on the oral polio vaccination (OPV), which the Taliban have described as a ploy by the United States to render the Muslim population infertile. Over 160,000 children in North Waziristan and 157,000 children in South Waziristan are now at risk of contracting deadly ailments.” The news service describes the effects of the ban, how health care officials are working to educate and vaccinate residents, and how “interventions by clerics are crucial to correcting the misconception that OPV is ‘anti-Islamic.'” Polio remains endemic in Pakistan, Afghanistan and Nigeria, IPS notes (Yusufzai, 7/11).

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India Out Of Pediatric TB Medicines, HIV Testing Kits, MSF Warns

“India’s public health system has run out of life-saving tuberculosis medicines for children and critical testing kits for AIDS patients, causing an outcry among patient groups who warn that the shortages could cost lives and worsen problems of drug resistance,” the Financial Times reports. “Leena Menghaney, Médecins Sans Frontières [MSF] project manager for the campaign for access to essential medicines, said frontline treatment centers in many parts of India were without the TB drugs and AIDS testing kits they needed,” the newspaper writes, adding, “A health ministry spokesman said he was not authorized to comment on the shortages” and “[o]ther senior ministry officials did not return phone calls.” The Financial Times writes, “Experts say health ministry officials apparently failed to ensure timely orders for the supplies, placing many lives at risk,” noting, “Delhi has now placed an emergency order for the pediatric TB medications, which it hopes to have by the end of the month” (Kazmin, 7/10).

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VOA News Interviews Gates Foundation's Senior Program Officer For TB

VOA News interviews Peter Small, senior program officer for tuberculosis (TB) at the Bill & Melinda Gates Foundation, about recent research developments and the global TB response. VOA writes, “Small … “Small says streamlining approval of effective drug regimens allows those who are infected to receive treatment sooner. But drugs are not the ultimate solution when addressing TB.” Small said, “I think the Holy Grail remains a vaccine. … We do need a vaccine to finish the job,” according to VOA. “As the world awaits a vaccine, research continues on new drugs that could be effective against multidrug-resistant and extensively drug-resistant types of TB,” the news service writes, adding, “Treating the millions of children and adults infected with TB may seem daunting,” but “the fact that the TB mortality rate has decreased 41 percent since 1990 gives hope for future progress and elimination of the disease” (Martin, 7/10).

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Editorials and Opinions

Opinion Pieces Address Global Family Planning, Reproductive Health Goals

World Population Day is recognized on July 11, as well as the one-year anniversary of the London Family Planning Summit. The following opinion pieces discuss issues surrounding global family planning and reproductive health.

  • Joy Lawn, Huffington Post U.K.’s “Impact” blog: “World Population Day on July 11 is a time for us all to focus on adolescent pregnancies and take action. This matters because of the impact on girls, the impact on their babies, and the impact on development and the economy,” Lawn, director of the Centre for Maternal, Reproductive, Adolescent & Child Health at the London School of Hygiene & Tropical Medicine, writes. “There are three key gaps to close,” she states, including “[g]aps in action, intentionally refocusing service provision to be adolescent friendly and funding these programs”; “[g]aps in knowledge on how best to reach adolescents, especially if not in school”; and “[g]aps in data contributing to invisibility, especially regarding collection of data with the right age groups split out, and a notable lack of data for reproductive health service use amongst unmarried girls and for abortion and for violence.” She concludes, “As well as leadership by country governments all around the world to protect and provide for a healthy adolescence, we need academics and civil society to be more innovative in closing these gaps … so that we can work towards a day when every pregnancy is wanted, every birth is safe, and the potential of every girl is fulfilled” (7/11).
  • Julia Bunting, The Guardian’s Poverty Matters Blog: “[M]eeting the need for contraceptives for all women in the developing world would cost $8.1 billion annually — double the current level of expenditure. But the impact of this additional investment would be incredible,” Bunting, programs and technical director at the International Planned Parenthood Federation, writes. She discusses the outcomes of the London Family Planning Summit and the potential impact of the FP2020 initiative. “Access to contraception must be seen as part of wider efforts on health and equity,” she writes, adding, “That means addressing early and forced marriages, preventing early pregnancy, increasing access to safe abortion, ending female genital mutilation, discrimination and sexual violence, improving maternal health, reducing HIV transmission, and increasing participation in education.” She continues, “Improving women’s and children’s health and wellbeing is central to creating more prosperous families, communities and nations,” concluding, “If we achieve the summit goal of enabling an additional 120 million women in the poorest countries to have access to contraception by 2020, it would be an achievement all of us in this field would be proud of” (7/11).

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Food For Peace Program Still Necessary

In 1954, President Dwight Eisenhower signed Public Law 480, now known as Food for Peace, a program that since has “saved millions of lives,” author William Lambers writes in a post The Hill’s “Congress Blog.” The program “was started because there was so much food in the United States, it made sense to avoid costly storage and move it overseas where there were hungry people,” he writes, noting, “Food for Peace was a way to continue the amazing humanitarianism of the United States so demonstrated following World War I and II when we fought famine in dozens of countries” and “was a continuation of the Marshall Plan which rebuilt Europe after World War II.” He continues, “Congress has a responsibility to maintain solid funding for Food for Peace because as George Marshall once said, ‘Hunger and insecurity are the worst enemies of peace,'” adding, “When reforms are needed to the program, Congress needs to add these to improve the efficiency.” He states, “Supporting small farmers in developing countries is key to the future,” and concludes, “Food for Peace has changed the lives of millions of people and is the best of what America has to offer. Let’s … plan for the future. Food for Peace is still needed today as much as ever” (7/10).

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New York Times Columnist, 'Win-A-Trip' Student Reflect On Breastfeeding In Mali

New York Times columnist Nicholas Kristof is in Mali for his annual win-a-trip journey, during which he travels with a university student to report on global poverty issues. The following is a summary of an opinion piece from Kristof and an “On the Ground” blog post from Erin Luhmann, this year’s winner, on their experience in a nomadic settlement just outside the city of Mopti, Mali, where they witnessed the treatment of a malnourished infant.

  • Nicholas Kristof: “Can you name a miracle food that is universally available, free and can save children’s lives and maybe even make them smarter?” Kristoff asks, and writes, “There really is such a substance, now routinely squandered, that global health experts believe could save more than 800,000 lives annually” — breast milk. “The latest nutritional survey from The Lancet estimates that suboptimal breastfeeding claims the lives of 804,000 children annually,” he notes, adding, “In some parts of the world, a problem has been predatory marketing by formula manufacturers, but, in the poorest countries, the main concern is that moms delay breastfeeding for a day or two after birth and then give babies water or food in the first six months.” He concludes, “[M]aybe in our sophistication we’ve overlooked a way to ease childhood malnutrition that is sustainable, scalable, free — and so straightforward that all hungry newborns cry for it” (7/10).
  • Erin Luhmann: “It seems counterintuitive that a mother would not be able to properly breastfeed her newborn. Yet this is a challenge that women continue to face in many parts of the world — including the United States,” Luhmann writes, and describes her experience of witnessing the treatment of a malnourished infant “[b]y simply correcting the way [the mother] held her baby to her breast.” She continues, “But I wonder if mental health issues like postpartum depression might also be playing a role in cases like this. Mental health may not top donor agendas, but it seems to me that the compounding stress of malnutrition and poverty could take a hidden toll on young mothers” (7/10).

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From the Global Health Policy Community

Ambassador Goosby Reflects On PEPFAR Expenditure Analysis Initiative

“In 2009, PEPFAR began to pilot the Expenditure Analysis Initiative, tracking expenditures for PEPFAR programs to provide rigorous financial monitoring. This analysis provides detailed annual data on expenditures by program area, cost category, and region,” Ambassador Eric Goosby, head of the U.S. State Department’s Office of Global Health Diplomacy and the U.S. global AIDS coordinator, writes in the PEPFAR.gov blog. “The Expenditure Analysis Initiative, currently being rolled out PEPFAR-wide, illustrates how the information collected will help direct our programs to stretch each dollar further through smart investments,” he states, adding, “To truly maximize program impact and find additional efficiencies, we need to work with partner governments as well as with multilateral and bilateral organizations to generate a complete picture of all resources currently supporting national AIDS responses. To this end, PEPFAR is actively engaged with the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Bank, UNAIDS, and other partners on harmonizing expenditure categories across donor and national accounting systems” (7/10).

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CSIS Authors Discuss Global Health Opportunities In Obama's Second Term

The Center for Strategic & International Studies (CSIS) Global Health Policy Center’s “Smart Global Health” blog presents videos of interviews with authors of the April 2013 CSIS report (.pdf) titled, “The Changing Landscape of Global Health Diplomacy.” The report presents an analysis of “the opportunities for global health diplomacy in Barack Obama’s second term,” according to the blog. “Taken together, the studies show that the world of global health diplomacy is quite dynamic at the moment, with new partners setting trends while traditional actors are reconfiguring their views and practices,” the blog states, adding, “As the Obama administration moves into a second term, there are numerous opportunities for U.S. diplomats to coordinate on global health goals with middle-income countries such as Brazil, Chile, Mexico, and South Korea; to learn more about how Russia and China continue to build their outreach and assistance capacities; and to strengthen existing relationships with Canada, Japan, and Europe to shore up support and innovation in the global commitment to public health” (7/9).

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ONE Blog Reflects On Feed The Future Results, Limitations

“ONE agriculture expert David Hong and Stephanie Hanson of One Acre Fund report on Feed the Future from Iringa, Tanzania,” in a post in the ONE blog, writing that the program “is the U.S. government’s most cost-effective way to fight poverty and spur economic growth.” They highlight some results Feed the Future has “produced for farmers and rural communities,” examine the program’s limitations, and state, “Smallholder farmers have incredible potential to increase their yields and help feed the world. But programs like Feed the Future need taxpayer funds to provide the support that millions of farmers and their families need to turn their farms into sustainable businesses.” They conclude, “Agriculture development is the most efficient way to deploy taxpayer dollars to reduce global poverty. Let’s ensure the new Feed the Future report galvanizes continued U.S. investment in agriculture” (7/10).

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'2013 Pipeline Report' Examines Priorities For Moving Research To Reality

The Center for Global Health Policy’s “Science Speaks” blog highlights the “2013 Pipeline Report” from the Treatment Action Group and HIV-iBase, which “is a call to leaders of global health, government and research to commit to and coordinate efforts that will expedite access to effective diagnostic, treatment and biomedical prevention tools, and make sure they address the conditions of the places where they are most urgently needed,” the blog writes. The blog summarizes the report’s “seven priorities to ‘speed up the pipeline’ of screening, treatment, cure, and prevention tools from conception to access” (Barton, 7/10).

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