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Kaiser Daily Global Health Policy Report

In The News

U.N. Envoy Says Eastern Europe's Criminal Prosecution Of IDUs Hinders HIV Fight

“The U.N. envoy for AIDS in Eastern Europe on Tuesday denounced the region, and Russia in particular, for its increasingly harsh criminal prosecution of drug [users], at a conference to curb the spread of HIV,” Agence France-Presse/France 24 reports. Michel Kazatchkine, the U.N. special envoy for HIV/AIDS in Eastern Europe and Central Asia, “spoke to AFP on the sidelines of the International Harm Reduction Conference in Vilnius, which is backed by the Elton John AIDS Foundation and is spotlighting health among intravenous drug users,” the news agency writes.

“Kazatchkine said opiate substitution therapy is illegal in Russia and needle exchange programs are almost nonexistent,” and he “denounced the justice system’s harshness, fuelled by ‘social, cultural, religious and now economic factors,'” AFP states. “According to the U.N. agency UNAIDS, Eastern and Central Europe has the fastest-growing HIV epidemic of any region in the world, with injecting drug use accounting for around three-quarters of new cases,” and “[i]n Russia, some 1.5 million people are living with HIV compared to some 100,000 a decade ago,” the news agency writes, noting, “The conference is taking place in the Lithuanian capital to focus on Central and Eastern Europe and Central Asia, an HIV hotspot with more than 3.7 million injecting drug users [IDUs], almost a quarter of the worldwide tally” (6/11).

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The Atlantic Examines China's Role In Counterfeit Medicines, Medical Aid In Africa

Noting “[a] small but growing body of evidence partly faults China for the massive upswing in counterfeit medications in Africa,” The Atlantic examines whether “the Chinese pharmaceutical industry [can] overcome its reputation for producing bogus medicine.” The magazine describes China’s role in the discovery of artemisinin and the resulting artemisinin combination therapies, or ACTs, used to treat malaria, as well as the country’s role in manufacturing and distributing counterfeit anti-malaria drugs. “Until now, the deadly risk of fake medications flooding Africa has been under-studied and under-reported,” The Atlantic writes, adding, “The Wellcome Trust and others estimate that one-third of malaria drugs in Uganda, including ACTs and all others, may be fake or substandard.” The magazine also examines China’s role in health care in East Africa, writing, “A primary trouble with China’s medical aid on the continent is that it has not been subject to independent oversight.” The Atlantic continues, “The deadliest problem remains counterfeiting and fakes, risking lives and threatening to kill China’s potential for real medical aid in Africa” (McLaughlin, 6/11).

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Haiti Faces Food Shortages As Hurricane Season Begins, WFP Says

“Poverty-stricken Haiti faces a new crisis amid fears of a poor harvest as hurricane season looms in the Caribbean nation, the World Food Programme [WFP] warned Tuesday,” Agence France-Presse/GlobalPost reports. “Launching an appeal for $17.2 million, Elisabeth Byrs, spokeswoman for the U.N. food agency, said 1.5 million people in Haiti currently relied on food aid to survive,” and “[a] further 6.7 million people in the nation of 10.2 million struggle to feed themselves on a daily basis, she said,” according to AFP (6/11). “Before the hurricane season, which runs from June to November, the [WFP] had pre-positioned emergency supplies to cover the needs of 300,000 people for two days with ready-to-use food and for four weeks with staple food rations,” the U.N. News Centre writes, adding, “The agency also had established agreements with 15 partners and had begun emergency distribution to 200,000 beneficiaries through schools in the worst-affected communities.” The news service continues, “However, Ms. Byrs noted that WFP urgently needs $17.2 million in funding to meet these needs, and added that the agency is currently facing a shortfall of $1.5 million to cover emergency preparedness” (6/11).

The Associated Press/Huffington Post reports on hunger in Haiti, writing, “Three years after an earthquake killed hundreds of thousands and international donors promised to help Haiti ‘build back better,’ hunger is worse than ever. Despite billions of dollars from around the world pledged toward rebuilding efforts, the country’s food problems underscore just how vulnerable its 10 million people remain.” The news agency focuses on how food insecurity is affecting the country’s children. “Child malnutrition rates have been high for years,” the AP writes, adding, “The [WFP] reports that nearly a quarter of Haiti’s children suffer from malnutrition, though the figure is higher in places such as Guatemala and the Sahel region in Africa” (Daniel/Luxama, 6/10).

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Berlin Hosts International Policies Against Hunger Conference

“Berlin is once again host to the international conference ‘Policies against Hunger,'” a Press TV video report notes. “International conferences like ‘Policies Against Hunger’ work on applying and developing guidelines that will contribute towards food security and reducing world hunger, one of the U.N. Millennium Development Goals, the news service states (Barragan, 6/12). The 10th annual conference is taking place from June 10-12, according to the event’s webpage (June 2012). “The conference aims at developing strategies for action and recommendations for policymakers, civil society, academia and the private sector,” the U.N. Committee on World Food Security notes (6/11).

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Bill Gates Offers To Assist Pakistan In Health Sector

Bill Gates, co-chair of the Bill & Melinda Gates Foundation, “has offered to assist Pakistan [with its] health sector in a letter to Prime Minister Nawaz Sharif, the PM office said Tuesday,” News Pakistan reports (Khan, 6/11). “Gates promised to extend financial and technical assistance to the government of Pakistan as far as possible,” Dawn.com writes, adding, “Gates congratulated [Sharif] on assumption of his office, and expressed the confidence that the new government in Pakistan [will place] special emphasis on the immunization and eradication of fatal diseases including polio” (6/11). “Gates said that we must not allow the recent attacks on polio workers to undermine the great work being done in Pakistan. The safety of health workers and the police officers who protect them is critical to the success of eradication efforts, he continued,” according to the Associated Press of Pakistan (6/11). “President Asif Ali Zardari Tuesday said that polio eradication remained a high national priority and efforts in this regard which had been institutionalized at policy and field level would continue unabated as there was a complete ownership of the program by all the political parties as well as from the civil society,” the news service writes in a separate article (6/11).

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Singapore, Thailand Face Worsening Dengue Outbreaks

“As weekly dengue fever infections surge to a record, Singaporean health officials are stepping up efforts to beat back a tropical disease outbreak that could become the city-state’s worst ever,” the Wall Street Journal’s “Southeast Asia Real Time” blog reports. More than 9,400 people have been infected so far this year, with two deaths recorded, and an all-time high of 820 cases reported in the week ending on June 8, the blog notes. “In the next one to two months, the [National Environment Agency] will add 300 more officers to its vector-control team, which currently comprises 850 people dedicated to killing mosquitoes and clearing breeding spots,” according to the blog (Wong, 6/11). In 2005, during the worst dengue outbreak on record for Singapore, approximately 14,000 people were infected and 25 died, Xinhua reports (Yang, 6/11).

In related news, Thailand could be experiencing its worst-ever dengue outbreak, “[w]ith more than 40 deaths and almost 40,000 cases of dengue fever reported in Thailand so far this year,” IRIN reports. “‘About 25 years ago we had a dengue outbreak of around 170,000 cases,’ Pornthep Siriwanarangsun, the director of Thailand’s Department of Disease Control, told IRIN,” adding, “This year, we expect 150,000 to 200,000 cases,” according to the news service. “There is still no vaccine for dengue, a mosquito-borne disease,” the news service notes and describes efforts by health officials to curb dengue’s spread in the country (6/12).

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Editorials and Opinions

International Community Must Advance Human Rights By Ensuring Access To Health Programs For Most Vulnerable

“No entire country, or entire population, is at the same risk of contracting infectious diseases. Many diseases disproportionately affect the groups of people who get left behind, because they are criminalized and at the margins of society,” Mark Dybul, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, writes in the Huffington Post’s “The Big Push” blog. “By better identifying and locating those at greatest risk of becoming infected because of where they live or who they are, some scientists now argue that we can dramatically improve our ability to control the spread of these diseases,” he notes, adding, “In the case of HIV and tuberculosis, that means reaching those who are most vulnerable: women and girls, sex workers, people who use drugs, men who have sex with men, transgender people, people in prison and migrants.”

“That has big implications for human rights,” Dybul continues, noting, “Since the Global Fund began in 2002, it has been committed to advancing human rights in the fight against AIDS, TB and malaria.” He states, “To reach the most vulnerable people, to keep them in health programs once they start, and to make sure they get appropriate services, greater engagement is needed by partners in civil society including community- and faith-based groups that meet people where they are.” He concludes, “We have an historic opportunity to break down the barriers that divide us and come together to bring HIV, TB and malaria under control. We must rise to the challenge of advancing human rights or we cannot advance evidence-based public health” (6/11).

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'Tax Justice' Is 'Crucial' In Fight Against Hunger

“On one hand, ending hunger involves getting agriculture and nutrition policies right. But it is also about social justice, good governance, and the broader set of conditions within which targeted food strategies can work durably and for the poorest,” Olivier De Schutter, U.N. special rapporteur on the right to food, writes in The Guardian’s “Poverty Matters Blog.” He continues, “The U.K. presidency of the G8 has a chance to tackle this side of the hunger coin in a week’s time, when G8 leaders convene at Lough Erne on June 17 for a two-day meeting that will address the flagship issues of tax, trade and transparency.”

“In terms of tackling hunger, nothing is more crucial in financial or symbolic terms than tax justice,” De Schutter writes, describing the importance of developing countries collecting taxes and the private sector “pay[ing] a fair share of tax.” He continues, “Aid flows continue to be vitally important, but can never compensate the loss of tax revenue.” He adds, “The G8 can make a difference on hunger. The hunger and tax agendas must be brought together. The relatively simpler part has been done, in the shape of fresh aid commitments at the nutrition for growth summit. Now, in Lough Erne, the G8 must treat tax injustice as the driver of hunger and poverty that it is, urgently initiating a new era of tax transparency” (6/12).

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Japan's Global Health Efforts Provide Model For Fighting Disease, But Sustained Funding Needed

“In the days leading up to this year’s G8 summit, we look to members of the G8 to follow through on their commitments from past meetings — particularly as they relate to improvements to global health and welfare,” Tsutomu Takeuchi, a professor emeritus at Keio University, and Alvaro Arzú Irigoyen, president of Guatemala from 1996-2000 and current mayor of Guatemala City and a neglected tropical disease (NTD) special envoy for the Global Network for Neglected Tropical Diseases, write in the Huffington Post’s “The Big Push” blog. “Tackling diseases like malaria, tuberculosis, HIV/AIDS, as well as neglected tropical diseases (NTDs) is not only critical to the G8’s work to improve global health, but also to reduce poverty and inequality,” they continue. “To see the benefits of sustained commitment to international development through G8 leadership, we can look to Japan’s efforts to control infectious disease at the global level,” they state, and provide an overview of these efforts.

“Along with Japan, the United States and United Kingdom among others have been great advocates and sponsors of the important task of improving global health and preventing infectious disease. But there are more actions that all G8 members should take,” Takeuchi and Irigoyen write and provide examples of those actions. “As we can see from successes in Japan, and in Latin America and the Caribbean, stopping infectious disease is a goal we can achieve within a matter of years, not a generation or lifetime,” they state, adding, “But this can only be possible with the continued support from Japan and other members of the G8.” They conclude, “Eliminating these diseases as public health threats by the end of the decade will require new commitments as well as sustained investments from existing partners and countries fighting these diseases” (6/11).

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From the Global Health Policy Community

G8 Accountability Report Should Focus More On NTD Treatment

“Last Friday, the G8 Lough Erne Accountability Report [.pdf] was released by the U.K. government in the lead-up to the G8 summit happening at the end of this week,” the Global Network for Neglected Tropical Diseases’ “End the Neglect” blog writes, adding, “We are pleased to see that the G8’s past commitments on [neglected tropical diseases (NTDs)] were specifically mentioned and evaluated, although the report is not completely candid about the lack of progress being made by many of the G8 countries in this area.” The blog discusses the report, saying, “NTD treatment was mostly overlooked.” The blog adds, “A focused and coordinated effort by the world’s leaders is critical to seeing the end of these diseases by 2020” (Gunderson, 6/11).

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Examining Role Of Behavioral Economics In Global Health

“Leveraging better health outcomes is difficult without addressing the behavioral roots of health problems: around half of the world’s disability-adjusted life years are lost due to behavioral factors such as physical inactivity, high blood pressure, malnutrition and smoking,” Amanda Glassman, director of global health policy and senior fellow at the Center for Global Development (CGD), and Denizhan Duran, a research assistant with the global health policy team at the center, write in CGD’s “Global Health Policy” blog. They continue, “[I]nsights from the work of behavioral economists can be mobilized to enhance the effectiveness of behavior change programs, and not only in marginal ways,” and describe the work of Alison Buttenheim from the University of Pennsylvania’s Center for Health Incentives and Behavioral Economics (CHIBE). They conclude, “It is clear that behavioral economics will keep on informing development policy: USAID recently hosted a summit on leveraging behavior change to reduce child mortality, and the World Bank’s World Development Report in 2015 is set to focus on the behavioral and social foundations of economic development, where health will most likely be featured prominently” (6/11).

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Reflecting On The Role Of Health Workers In Improving Women's Health Globally

In a post in IntraHealth’s “Global Health Blog,” Rebecca Kohler, senior vice president of corporate strategy and development for IntraHealth, reflects on the Women Deliver conference, noting she “attended the conference to hear what the international community is saying about the roles health workers play in achieving this global imperative.” She asks whether “health workers [are] delivering for women,” highlighting the role of midwives in women’s health and noting “there is still much to do to ensure that all health workers can deliver for women.” She examines whether the international community is “delivering for health workers,” and writes, “[U]nfortunately, the answer is, ‘Not really.'” She highlights “a technical brief presented by the Barcelona-based firm Integrare” to support this claim and concludes, “Clearly, there is still need for the global community and all of us to advocate for increased attention, collective action, and resources for health workers, be they clinical officers, midwives, anesthesiologists, or community health workers” (6/10).

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