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Kaiser Daily Global Health Policy Report

In The News

MERS Virus Not A 'Public Health Emergency,' WHO Emergency Committee Declares

“The Middle East Respiratory Syndrome coronavirus (MERS) is not a ‘public health emergency of international concern,’ the emergency committee of the [WHO] said on Wednesday,” Reuters reports (Nebehay, 7/17). “The committee felt that the ‘dramatic action’ of declaring an emergency would be disproportionate and might do more harm than good, said Keiji Fukuda, the WHO’s assistant director-general for health security and environment,” CIDRAP News writes, noting, “The panel’s recommendation was unanimous” (Roos, 7/17). “The decision followed the second meeting of the agency’s ’emergency committee’ of outside experts to assess the risks of the virus,” according to the New York Times (McNeil, 7/17).

“The so-called emergency committee of public health experts, which WHO established on July 5, met for the first time last week,” Science Insider notes, adding, “The 15-member panel was tasked with keeping a close eye on MERS and determining whether it posed risks serious enough to justify WHO recommending that governments limit travel or take other steps to prevent MERS from spreading” (Kupferschmidt, 7/17). “The previously unknown virus has infected at least 82 people and killed 45 since September, according to the WHO,” Bloomberg Businessweek reports, adding, “While most cases have been detected in [Saudi Arabia], infections in the U.K., France, Germany and Italy have sparked concern of a global outbreak like the epidemic of severe acute respiratory syndrome [SARS] in 2003” (Bennett, 7/17).

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U.N. Appeals For Additional $8.6B In 2013 For Humanitarian Aid

“Nearly $13 billion is needed this year — about a third of that amount for Syria and its neighboring countries — to provide aid to 73 million people, the top United Nations humanitarian official said” on Wednesday, the U.N. News Centre reports. “That’s an extra $8.6 billion to raise by the end of the year,” Under-Secretary-General for Humanitarian Affairs and U.N. Emergency Coordinator Valerie Amos said during the launch of the Office for the Coordination of Humanitarian Affairs’ (OCHA) mid-year humanitarian overview (.pdf), according to the news service. Amos “stressed that millions of people around the world desperately need help feeding their families, treating malnourished children and getting safe drinking water and other essential supplies,” the news service writes. “More than $5 billion has been provided for humanitarian organizations in 24 countries so far this year, Ms. Amos said,” the U.N. News Centre reports (7/17). The Guardian reports, “Turkey contributed more than $1 billion (£66 million) in humanitarian aid last year, making it the fourth-largest government donor, highlighting the role of new countries in the aid landscape.” The nation, “which also received official development assistance, ranked behind only the U.S. ($3.8 billion), the E.U. ($1.9 billion), and the U.K. ($1.2 billion), according to the Global Humanitarian Assistance Report 2013, released by Development Initiatives (DI), a research group,” according to the newspaper (Tran, 7/17).

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At Least 22 Children Die After Eating Contaminated Free School Lunch In India

Within hours of eating a free school lunch apparently contaminated with a deadly insecticide, at least 22 children were dead and dozens of others hospitalized in the northeastern Indian state of Bihar on Tuesday, the New York Times reports (Harris/Kumar, 7/17). “The focus of the investigation is on the oil used in the preparation of the meal,” Reuters writes, adding, “Doctors treating the children said they suspected the food had been contaminated with insecticide. Media reports said the oil may have been stored in an old pesticide container” (Banerji/Colvin, 7/18). “India’s midday meal scheme is one of the world’s biggest school nutrition programs,” covering 120 million children, the Associated Press notes. The free meal program is “part of an effort to address concerns about malnutrition, which the government says nearly half of all Indian children suffer from,” the news agency writes, adding, “Although there have been occasional complaints about the quality of the food served, or the lack of hygiene, the tragedy in Bihar appeared to be unprecedented for the massive food program” (Singh, 7/17).

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Humanitarian Groups Continue Assistance To North Korea Despite Sanctions, Report Says

“International humanitarian groups are continuing their assistance to North Korea despite sanctions imposed on the North for its nuclear test early this year, a report said Wednesday,” Yonhap News Agency reports. “North Korea was slapped with tougher U.N. sanctions earlier this year for conducting a satellite launch in December and a nuclear test in February, stoking concerns that the move may affect relief efforts there,” according to Yonhap, which adds, “The World Food Programme told Radio Free Asia earlier this week that a lack of donation has pushed it to scale down its food aid to North Korea by 85 percent,” and “[t]he U.N. food agency has halted operations in June at five of its 14 food factories in the North due to grain shortages” (7/17). “These sanctions risk tipping North Korea over the edge, especially if it is hit by further natural disasters, said Kim Hartzner, managing director of Mission East, a Danish provider of food aid to children that has operations in the country,” according to Reuters. “‘I am seriously concerned about the blockade. I’m seriously concerned about the consequences,’ Hartzner told Reuters late on Monday, adding that children, pregnant women and the elderly would suffer most from any disruptions to aid programs,” the news agency writes (Blanchard, 7/16).

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NPR Examines Global Rise Of Sickle Cell Anemia

NPR’s “Shots” blog and “Morning Edition” program examine the global rise of sickle cell anemia, noting, “[E]very year, hundreds of thousands of babies around the world are born with this inherited blood disorder. And the numbers are expected to climb.” According to the blog, “The number of sickle cell anemia cases is expected to increase about 30 percent globally by 2050, scientists said Tuesday in the journal PLOS Medicine. Countries in sub-Saharan Africa, where the disease is most common, will be the hardest hit.” The blog continues, “To get a handle on the global scale of the problem, [Fred Piel, an evolutionary biologist at the University of Oxford,] and his colleagues used population data and information about the frequency of the sickle cell gene within different populations” and “calculated how that number will change in the future.”

“The two countries hardest hit will be Nigeria and the Democratic Republic of Congo, Piel says,” according to “Shots,” which adds, “But other, less populous countries won’t be spared either. As more people from poorer countries migrate to developed countries, the cases of the disease will increase globally.” Though there is no cure for sickle cell anemia, “screening newborn babies, followed by vaccines and antibiotics, can prevent deadly complications, Piel says,” the blog writes, adding, “The [WHO] has long recognized the importance of sickle cell anemia as a global health issue. In 2006, the World Health Assembly called on countries to tackle the disease” (Chatterjee, 7/17).

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Editorials and Opinions

Women, Girls Should Be Central Part Of Post-2015 Global Development Agenda

Women and girls “make up half the population (and the majority of the poor), yet they’ve been neglected by the development community,” Melinda Gates, co-chair of the Bill & Melinda Gates Foundation, writes in a Foreign Policy opinion piece. “Moreover, advocates and experts have known for years that when women and girls have the power to make basic household decisions, they prioritize education, food, and health care — the stuff of broad-based economic and social development.” She states, “Unfortunately, this fact hasn’t always influenced the official development agenda,” adding, “Take the example of the eight Millennium Development Goals (MDGs), which have served as a charter for the development field since the U.N. adopted them in 2000.”

“The negative corollary to the success of the MDGs is that the priorities not enshrined in the world’s report card tend to get less attention,” Gates continues. “In some ways, that’s what happened to women and girls. … Which brings us back to the U.N. panel’s recommendations for what should replace the MDGs when they lapse in 2015,” she writes. “The proposed gender equity goal for post-2015 is much stronger than its predecessor. It includes targets for limiting gender-based violence and child marriage and for promoting property rights for women,” she states, noting “the panel’s recommendation that data on every single goal and target be broken out by gender.” She continues, “I know that disaggregating data sounds mundane,” and, “[a]s it stands right now, the world doesn’t have the ability to gather the necessary data or analyze it properly.” However, she adds, “There are still two years before the next-generation MDGs are signed, sealed, and delivered. I hope that when they are, the theory underlying the U.N. panel’s report — that women are not just a development constituency but a powerful source of development — is still at the heart of the agenda” (7/17).

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Senate Should Uphold Rights Of Disabled And Ratify U.N. Treaty

In December, the U.S. Senate failed to ratify a U.N. treaty defending the rights of people with disabilities by five votes, and negotiations are ongoing to arrange another vote, according to a New York Times editorial. “With the social-issue pandering of the 2012 campaign behind us, the treaty can be seen for what it is: a singular opportunity to apply the principles of the highly effective Americans With Disabilities Act to the world at large,” the editorial writes, noting 125 countries have ratified the treaty and President Obama signed it in 2009. “Contrary to critics, national sovereignty is in no way compromised in the treaty’s declaration that all people, regardless of ability, deserve to live in dignity, safety and equality under the law,” the editorial writes, continuing, “The whole point of the treaty is to encourage other nations to match the standards set by the United States in the Americans With Disabilities Act, approved by a bipartisan majority in 1990 and signed by President George H.W. Bush.” The New York Times concludes, “It would be ludicrous if the nation that has been in the forefront of upholding the rights of the disabled rejected a global treaty affirming those rights” (7/17).

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West Africa Should Use Human Rights Model To Improve Food Security

“When the Millennium Development Goals (MDGs) expire in 2015, governments are likely to set themselves a challenge no less ambitious than eradicating hunger and extreme poverty by 2030. West Africa has the potential to match this ambition and spearhead the global fight against hunger,” Olivier De Schutter, the U.N. special rapporteur on the right to food, writes in a Nigerian Tribune opinion piece. Though several countries in the region have made significant progress in reducing malnutrition, factors such as population growth and extreme weather events continue to threaten income and productivity, and “too little has been done to build the resilience — to climate shocks, to market uncertainties — that West African food systems urgently need,” he states. “What West African countries need are national and regional food security strategies that identify the objectives which all subsequent initiatives must serve,” he writes, adding, “The right to food, a human right protected under international law, can provide the compass that West African countries need to put them squarely on the path to ending hunger.” De Schutter describes several national-level initiatives based on the rights model (7/18).

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Africa's Progress Against 'Ancient Scourges' One Of Humanity's 'Great Achievements'

“We in journalism mostly focus on problems, but one of the remarkable changes in the developing world has been the decline of these ancient scourges,” including trachoma, leprosy and polio, Nicolas Kristof writes in his New York Times column. “When I first traveled through West Africa, as a student backpacker more than 30 years ago, I was haunted by the beggars disabled by blindness, leprosy and polio,” but traveling now “on my annual win-a-trip journey with a university student, Erin Luhmann of the University of Wisconsin, [we are] encountering a fundamentally improved landscape than the one I saw when I was her age,” Kristof says. He outlines some of the prevention and treatment advances made against trachoma, leprosy and polio, writing, “The progress goes far beyond these three ailments.” He notes “[t]he number of children dying worldwide before the age of five has plunged from 12 million in 1990 to 6.9 million in 2011” and, “[a]s the disease burden declines, the economy surges.” He continues, “Journalists and humanitarians understandably focus on unmet needs, and that can leave the impression that the story of global health is a depressing one of failure. In fact, it’s an inspiring story of progress.” Kristof adds, “We need to do more, especially against AIDS, malaria and tuberculosis, but one of the great achievements of humanity in recent decades has been the marginalization of ancient and dreaded diseases” (7/17).

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Community Conversations Key To Ending Practice Of Female Circumcision

“UNICEF estimates (.pdf) that between 70 million and 140 million girls and women globally are circumcised. The practice is widespread throughout Africa, and in some countries of Asia and the Middle East,” author and columnist Tina Rosenberg writes in the New York Times “Opinionator” blog. However, she notes, “In the last decade, many countries in Africa have seen a marked drop in the practice of cutting. This is thanks to organizations working all over the continent.” She highlights the work of some organizations, such as Kembatti Mentti Gezzima-Toppe (“Women Working Together”) in Ethiopia, and Tostan, “which works with local organizations in eight African countries.” She continues, “All of the successful methods have one thing in common — a factor that is also responsible for the success of the Positive Deviance strategy I wrote about in February: ‘You must allow the community to decide for themselves rather than condemning,’ [Bogaletch Gebre, an Ethiopian woman who was circumcised as a girl in Ethiopia and is an advocate against the practice,] said.”

“Changing the law is a step, but only one step. In many places where cutting is outlawed, it is widely practiced in secret,” Rosenberg notes. She discusses Gebre’s work with Kembatti Mentti Gezzima-Toppe, a core component of which is community conversation groups, and writes, “Community conversations are now spreading through Ethiopia in areas of all religions. Gebre said KMG was reaching six million people in southern Ethiopia. The conversations range more broadly than health and gender violence.” She continues, “In 2004, the Ethiopian government made community conversations a major piece of its HIV prevention strategy, and Gebre’s group became the first trainers, all over the country. … UNAIDS considers community conversations a keystone of that achievement” (7/17).

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From the Global Health Policy Community

USAID's Shah Discusses U.S. Partnership With Africa

The Center for Global Development recently hosted USAID Administrator Rajiv Shah for an hour-long discussion of the U.S. partnership with Africa, according to a summary of the video of the discussion. “Shah was just back from accompanying President Obama in Senegal, South Africa, and Tanzania,” and he “discussed the administration’s new commitments and USAID’s role in doubling electric power in Africa, working with young African leaders, boosting food security and global health, and attracting trade and investment to the continent,” the summary states (7/10).

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National Survey Shows Health Improvements In Haiti

“A newly released nationwide health survey of Haiti shows continuing positive trends on key health care indicators, in particular those of Haitian women and children,” Natalia Machuca, a USAID adviser on infectious disease in Latin America and the Caribbean, writes in the agency’s “IMPACTblog.” “The latest survey, undertaken by the Haitian Ministry of Public Health and Population, was conducted in 2012 and compares with the prior survey done in 2006,” she writes, adding, “It shows steady improvements among key indicators despite significant health challenges in Haiti due to the 2010 earthquake and cholera outbreak.” Machuca details some of the report’s findings (7/17).

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Blog Examines Abortion Laws In Latin America

“In light of the recent case of Beatriz, a 22-year-old Salvadoran woman and mother of a toddler, who, while suffering from lupus and kidney failure and carrying an anencephalic fetus, was denied the right to an abortion, it is relevant to discuss the restrictive abortion laws in Latin America and some of the reasons behind them,” Cora Fernandez Anderson, a Five College Andrew W. Mellon Postdoctoral Fellow in comparative reproductive politics, writes in the “RH Reality Check” blog. She discusses the policies of various countries, noting “Latin America is home to five of the seven countries in the world in which abortion is banned in all instances, even when the life of the woman is at risk.” She also examines the influence of the Catholic Church in the region (7/17).

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