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Kaiser Daily Global Health Policy Report

In The News

WHO Declares DRC Ebola Outbreak An International Emergency; Committee Cites Disease's Spread, Violence Against Health Workers, Delays In Funding As Reasons

Associated Press: Ebola outbreak in Congo declared a global health emergency
“The deadly Ebola outbreak in Congo is now an international health emergency, the World Health Organization announced Wednesday after a case was confirmed in a city of 2 million people…” (Cheng/Keaten, 7/17).

Devex: Breaking: WHO declares global public health emergency in DRC Ebola outbreak
“…Robert Steffen, chair of the emergency committee, cited several reasons for the decision, including the recent spread of the disease in the city of Goma, the recurrence of ‘intense transmission’ of the disease in Beni, and the assassination of the two Ebola workers over the weekend, which Steffen said demonstrates the continued risks responders face on the ground…” (Ravelo, 7/17).

The Guardian: DRC Ebola epidemic is international emergency, says WHO
“…Dr. Tedros Adhanom Ghebreyesus, the WHO director general, appealed on Wednesday for the international community to help with funds. WHO is working on a new plan to control the epidemic, he said, which would cost ‘hundred of millions’ of dollars. ‘It is time for the world to take notice and redouble our efforts. We need to work together in solidarity with the DRC to end this outbreak and build a better health system,’ said Tedros…” (Boseley, 7/17).

The Hill: WHO says Ebola is global emergency
“…The declaration is only the fifth time the WHO has labeled a viral outbreak a public health emergency of international concern [PHEIC]. Previously, the WHO has used the declaration to highlight the spread of swine flu in 2009, polio and the Ebola virus in 2014, and the Zika virus in 2016…” (Wilson, 7/17).

Los Angeles Times: Ebola outbreak in Congo is now a public health emergency, WHO declares
“…The international health agency had declined on three prior occasions to declare an international public health emergency, most recently in mid-June. … Experts worried the move could spark unintended economic and political consequences from other countries, including travel bans and trade freezes. Hostile reactions like these have worsened conditions during previous outbreaks, making it harder to get personnel and supplies into the hot zone…” (Baumgaertner, 7/17).

New York Times: Ebola Outbreak in Congo Is Declared a Global Health Emergency
“…The Congo outbreak began a year ago, with the first cases confirmed in August. As of Monday, the disease had infected 2,512 people and killed 1,676 of them. The virus has defied efforts to control its rampant spread in the northeastern part of the country, a conflict zone under unrelenting peril from warring militias…” (Grady, 7/17).

Quartz Africa: WHO has finally declared DR Congo’s Ebola crisis a global health emergency
“…In a statement for the declaration, WHO officials said the declaration should not be used by governments as a tool to hinder travel and trade in the affected regions. ‘It is important that the world follows these recommendations. It is also crucial that states do not use the PHEIC as an excuse to impose trade or travel restrictions, which would have a negative impact on the response and on the lives and livelihoods of people in the region,’ said professor Robert Steffen, chair of the Emergency Committee, in a statement” (Hadero, 7/17).

Reuters: Congolese Ebola victim may have entered Rwanda and Uganda — WHO
“A fishmonger who died this week of Ebola may have carried the virus from Congo into Rwanda as well as Uganda, the World Health Organization said, as health workers struggled to track down people she could have infected. … [T]he cases of the fishmonger and of a pastor who died this month after traveling to Goma, a city of 2 million and a gateway to other countries in the region, served to galvanize [the WHO emergency committee] into action…” (Miles et al., 7/18).

STAT: WHO declares Ebola outbreak an international health emergency
“…Mercy Corps, one of the NGOs working on the outbreak response, said it hoped the declaration of a PHEIC would translate into more support for the work that needs to be done in DRC. … The decision was applauded by some global health experts who have been frustrated by the fact it wasn’t taken earlier. ‘Almost all international legal and policy experts agree that the conditions for declaring a PHEIC were met long ago, so we are delighted to see that the emergency committee and the director general have finally come to this decision,’ said Rebecca Katz, director of the Center for Global Health Science and Security at Georgetown University…” (Branswell, 7/17).

Vox: The WHO finally declared a public health emergency over Ebola
“…For now, our collective focus should be on the DRC, said former U.S. ‘Ebola czar’ Ron Klain. The fact that this outbreak has been ‘spreading, unabated’ already should have been an international concern, he said in June, regardless of the official emergency designation. ‘What has been missing for some time is not a label, but rather, intensified international concern which is much needed and long overdue’…” (Belluz, 7/17).

Wall Street Journal: Ebola Epidemic in Congo Declared a Global Health Emergency
“…The committee on Wednesday expressed disappointment about delays in funding that have constrained the response. The WHO has received $112 million of funds pledged to help the effort, a spokeswoman said, but the outbreak has cost $233 million and the funding gap is expected to widen as the virus spreads…” (Bariyo, 7/17).

Washington Post: WHO declares Ebola in Congo to be emergency of ‘international concern’
“…U.S. officials have described as ‘arbitrary’ the WHO guidelines on declaring a public health emergency. … The fact that the CDC has already activated its own emergency operations center ‘speaks on its own,’ said J. Stephen Morrison, a senior vice president at the Center for Strategic and Inter­national Studies in Washington who has tracked the outbreak. ‘They see it as an emergency.’ But the United States’ presence on the ground is extremely limited, as CDC workers are barred from entering the zone of active infections, partly over security concerns stemming from clashes there…” (Bearak/Sun, 7/17).

Additional coverage of the WHO’s declaration of the DRC Ebola outbreak as a PHEIC, as well as history of this and other Ebola outbreaks, is available from Al Jazeera, Associated Press, Bloomberg, CIDRAP News, CNBC, CNN, Devex, Financial Times, Forbes, HealthDay News, Homeland Preparedness News, International Business Times, Nature, NBC News, New York Times, NPR (2), Reuters, SciDev.Net, Science, Science Speaks, TIME, U.N. Dispatch, UPI, and VOA News.

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Rep. Cummings, Sen. Murray Request Information From HHS Secretary Azar On Fetal Tissue Research Ban

The Hill: Democrats demand information from White House about fetal tissue research ban
“A pair of House and Senate Democrats are demanding answers from the Trump administration about its decision to ban the use of federal funds for research involving fetal tissue. In a Wednesday letter to Health and Human Services Secretary Alex Azar, House Oversight and Reform Committee Chairman Elijah Cummings (D-Md.) and Senate Health Committee ranking member Patty Murray (D-Wash.) asked for a host of internal documents and communications relating to the ban…” (Weixel, 7/17).

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3 Large Studies Examining Test-And-Treat Approach To HIV Prevention In Africa Show Mixed Results

New York Times: Intensive Anti-HIV Efforts Meet With Mixed Success in Africa
“Imagine that 90 percent of all people living with HIV were diagnosed and treated with drugs. Would that be sufficient to end the AIDS epidemic? Scientists tried to answer the question in three enormous studies published on Wednesday in the New England Journal of Medicine. … Results from three of the studies suggest that the strategy comes nowhere near bringing the rate of new infections with HIV, or incidence, down to zero. But all of the studies showed that incidence dropped by about 30 percent, and one found a decrease in HIV-related deaths. … One of the new studies, called Ya T’sie (a reference to teamwork in the Setswana language), focused on 15 pairs of villages in Botswana, while a second, called Search, examined 32 rural communities in Kenya and Uganda. The largest of the three studies, PopART, looked at 21 communities in Zambia and South Africa. Together, the studies cost more than $200 million and included nearly 1.5 million people…” (Mandavilli, 7/17).

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Donor-Funded Local Health Workers Help Decrease Malaria-Related Mortality In Myanmar

The Guardian: How Myanmar became an example to the world in the battle against malaria
“…Say Mu Phaw is one of thousands of [village health worker] volunteers across the country to have received training and supplies from foreign donors since political reforms began at the start of this decade, ushering in a flood of aid. Their efforts have helped save thousands of lives, and are fast turning Myanmar from a malaria black spot into a world leader in the fight to eliminate the disease. Across the country, almost 4,000 people died from malaria in 2010, according to World Health Organization (WHO) estimates. In 2017, the disease claimed just over 200 lives…” (Carroll, 7/18).

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New Way To Kill Disease-Carrying Mosquitoes Works On 2 Chinese Islands But Might Be Impractical For Larger Areas, Researchers Report

Associated Press: Scientists find new way to kill disease-carrying mosquitoes
“Scientists say they nearly eliminated disease-carrying mosquitoes on two islands in China using a new technique. The downside: It may not be practical for larger areas and may cost a lot of money. … For 18 weeks in 2016 and 2017, the team led by Zhiyong Xi at Michigan State University released [treated] male mosquitoes onto two small islands near Guangzhou, China, a region plagued by dengue fever. The number of female mosquitoes responsible for disease spread plummeted by 83% to 94% each year … No technique so far has had that kind of success, Xi said…” (Rehm, 7/17).

Newsweek: China: Scientists Released Millions of Infected, Sterilized Mosquitoes into Wild to Wipe Out Disease-Carrying Bugs
“…The approach involved two techniques: sterilizing female mosquitoes and spreading an infection among males. The findings were published in the journal Nature. … Other insects have been controlled by what are known as the sterile insect technique (SIT) and the incompatible insect technique, but these techniques haven’t been successfully used against mosquitoes…” (Gander, 7/17).

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North Korea Facing Increasing Rates Of Malnutrition, Disease Due To Poor Harvests, IFRC Warns

Reuters: Malnutrition, disease rising in North Korea: aid organization
“Rates of malnutrition and disease are increasing in North Korea as it faces a harvest that is half of what was expected, the International Federation of Red Cross and Red Crescent Societies (IFRC) said on Thursday. International aid agencies as well as North Korea state media have been warning that erratic weather with drought and floods, and a lack of access to resources could lead to a food crisis in a country under strict international sanctions over leader Kim Jong Un’s pursuit of nuclear weapons and ballistic missiles…” (Smith/Shin, 7/18).

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More News In Global Health

Fox News: Philippines declares national emergency after more than 100,000 people contract dengue fever (Dedaj, 7/17).

The Guardian: Babies in Nepal get quarter of calories from junk food, study finds (Boseley, 7/17).

The Guardian: Indonesian women suffering ‘epidemic’ of domestic violence, activists warn (Lamb, 7/17).

Inter Press Service: U.N. Report Shows Mixed Results in Meeting SDGs (Yang, 7/18).

New Humanitarian: Head to Head: Biometrics and Aid (7/17).

New Times: Rwanda to use technology to boost access to cervical cancer treatment (Kuteesa, 7/17).

Scientific American: Joseph Lange’s Campaign Against HIV (Mirsky, 7/17).

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Editorials and Opinions

Local Leaders, Frontline Workers Must Lead DRC Ebola Response

The Guardian: More of the same won’t solve Congo’s Ebola crisis — let locals lead
Susannah Mayhew, professor of health policy and systems at the London School of Hygiene & Tropical Medicine, and colleagues

“…On Wednesday, the World Health Organization (WHO) declared the [Ebola crisis in the Democratic Republic of the Congo (DRC)] a public health emergency of international concern. This raises the stakes and must lead to fundamental changes in the response. … [I]t is time for the WHO to step back and allow local leaders and frontline responders to lead the response. … Less emphasis must be put on the international response and more on local staff and community leaders. District authorities, traditional leaders, women’s groups, and even militia groups must be allowed to take the lead in shaping a culturally acceptable response to reduce hostility and improve access and outcomes. … Allowing local people to lead the response does not mean there is no role for the international humanitarian community. On the contrary, technical advice, response coordination, and an emphasis on human rights remain important contributions the international response can offer. But in DRC, … a ‘top-down’ approach is often seen as threatening, and needs to be avoided. … The affected population has to be patiently supported to find its own way. It also needs to be assigned a constructive role. … Above all, there is a need to trust in local common sense, once the nature of the epidemic and the infection risks it poses have been made clear…” (7/18).

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Opinion Piece Discusses George W. Bush's Impact On Africa Through PEPFAR

Financial Times: Why George W. Bush is Africa’s favorite U.S. president
David Pilling, Africa editor of the Financial Times

“…By some margin, the U.S. president most respected in Africa is one George W Bush. The main reason for Mr. Bush’s enduring popularity is a health initiative he personally championed with the unpromising acronym of PEPFAR. The President’s Emergency Plan for AIDS Relief, one of the biggest global health initiatives in history … Unlike some development assistance, PEPFAR has the virtue of having demonstrably worked. … Life expectancy around the continent, which dipped severely at the start of the AIDS epidemic, has bounced back strongly. So have economies once threatened with the devastation of losing large swaths of their working population. … [Today, t]he idea of aid is under attack, even in Africa itself. … In a 2016 speech, … [President Bush said,] ‘I believe … that spending less than two-tenths of 1 percent of our federal budget to save millions of lives is [in] the moral, the practical, and the national security interests of the United States.’ Millions of people with HIV who are living full and productive lives would agree” (7/17).

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U.S. Should Support Increased Investment In Global Fund

Idaho Statesman: Support for Global Fund imperative as U.S. tries to save lives from TB, malaria, AIDS
John Thompson, senior pastor of the Cornerstone Church in Boise, Idaho

“…Congress has the opportunity this year to make major progress against [AIDS, tuberculosis (TB), and malaria] in Thailand and beyond. We can step up the fight against AIDS, TB, and malaria with a modest increase to our previous commitments [to the Global Fund]. The U.S. can help the Global Fund reach its $14 billion fundraising goal for the next three years … This summer, [Senator Jim Risch (R-Idaho)] has the opportunity to support a modest increase for the Global Fund and showcase his leadership for humanitarian assistance as the chairman of the Senate Foreign Relations Committee. The Senate will soon consider a $1.56 billion annual U.S. contribution to the fund for fiscal years 2020-2022 in the State, Foreign Operations, and Related Programs 2020 funding bill. As Christians, we believe that supporting global health is not just smart and economical; it’s the right thing to do. … We know the Global Fund will lift up and save the lives of millions” (7/17).

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U.K. Should Increase Funding To, Lead On Global WASH Activities

The Telegraph: U.K. must spend more on water and sanitation to help lift everyone out of poverty
Tim Wainwright, chief executive of WaterAid

“…[U.K. overseas aid] fails to sufficiently prioritize one area that is an essential element in escaping poverty — providing clean water, decent sanitation, and good hygiene (WASH). Without these three basic human rights, escaping poverty is nearly impossible. Yet despite this, only two percent of [the U.K.] foreign aid budget is invested in ensuring everyone, everywhere has clean water and decent sanitation. … By increasing the amount spent on water and sanitation, health care facilities would be safer, hospital infections could be contained more effectively, and the millions of school days currently lost to illness restored. And it is those furthest behind and the most marginalized who would gain the most. … By increasing the funding available for [WASH] and [the U.K.’s Department for International Development (DFID)] using its considerable clout to encourage other actors to invest as well, the U.K. can regain its position as a leader. Without health, education, and WASH, human development is impossible. Good provision of all three paves the way to a future in which overseas development assistance is no longer needed. … If we act now and act with urgency and focus we have the greatest opportunity to change the situation and the most to gain. The U.K. can, and must, do better” (7/17).

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From the Global Health Policy Community

Pan-African Summit Communiqué Calls For Increased Domestic Resources For HIV, Health

UNAIDS: Pan-African Parliament calls for increased domestic resources for HIV and health in Africa
“A communiqué adopted at the High-Level Pan-African Summit on HIV and Health Financing has called for parliamentarians to ensure the right to health for all and for stronger advocacy to increase domestic resources for HIV and health. … Roger Nkodo Dang, the president of the Pan-African Parliament, highlighted the urgency of finding durable sources of financing to respond to HIV and to improve public health services in Africa. … Countries were also encouraged in the communiqué to further contribute to global solidarity in the upcoming replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria…” (7/15).

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Disease X Reflects Potential For Unexpected Pandemic Threats, Blog Post Says

American Council on Science and Health: Disease X: Which Plague Is Coming Next?
Lone Simonsen, professor, and Maarten Van Vijhe, post-doctoral researcher, both at Roskilde University, discuss the addition of Disease X to WHO’s list of priority diseases of concern for public health, writing, “While we don’t know what Disease X might be, it reflects the fact that a future pandemic threat may be unexpected. … Given the unknowns and the recent experience with unexpected novel pandemic threats … it is fitting that an unknown has been added to the list” (7/17).

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Chicago Council Blog Post Discusses Ways To Improve Policy-Making To Address Food, Water Insecurity

Chicago Council on Global Affairs’ “Global Food for Thought”: Next Generation 2019 — Recognizing the Role of Inclusive Policy-making in Food and Water Rights
Caroline Andridge, MA candidate at the University of Notre Dame, discusses ways to improve policy impact and cohesion to address water and food insecurity, writing, “Firstly, we must reframe food and water from commodities to human rights in and of themselves. … Secondly, policymakers must meaningfully include smallholder farmers in the decision-making process” (7/17).

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FHI 360 Post Discusses History, Global Health Community's Reaction To Results Of ECHO Trial

FHI 360’s “R&E Search for Evidence”: What is the global health community saying about the ECHO trial results?
Corey White, managing editor of R&E Search for Evidence and communications specialist in the Chief Science Office at FHI 360, discusses the history and results of the ECHO (Evidence for Contraceptive Options and HIV Outcomes) trial, which studied whether the birth control method Depo Provera, along with two other methods, increased women’s risk of contracting HIV. White also highlights the global health community’s reaction to the results (7/17).

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From the U.S. Government

USAID Administrator Provides Statement On WHO Designation Of Ebola As PHEIC

USAID: USAID Administrator Mark Green’s Statement on the Designation of Ebola as a Public Health Emergency of International Concern
“[On Wednesday], the World Health Organization (WHO) designated the outbreak of Ebola in the Democratic Republic of the Congo (DRC) as a Public Health Emergency of International Concern (PHEIC) under the International Health Regulations (2005). The U.S. Agency for International Development (USAID) applauds this decision, and will continue to scale up life-saving support to bring this outbreak to an end. This decision reinforces our call to strengthen the response to Ebola through improved leadership and coordination, enhanced community engagement, improved preparedness, and expanded vaccination in communities…” (7/17).

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U.S. Provides Additional 174,000 Mosquito Nets To Prevent Malaria In Laos

USAID: U.S. Provides 174,000 Additional Mosquito Nets to Prevent Malaria
“Continuing the United States deep support of the Lao health sector, U.S. Ambassador to Lao PDR Rena Bitter presented more than 174,000 additional mosquito nets to Mr. Khamphone Phoutthavong, deputy minister of health, at a ceremony in Vientiane on July 9. These mosquito nets will be distributed to families in rural areas of the southern province of Champasak, where the number of malaria cases remains high…” (7/17).

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