KFF Daily Global Health Policy Report

In The News

Kerry Tours Syrian Refugee Camp In Jordan; U.N. Official Calls On Both Sides Of Conflict To Protect Children

“Secretary of State John Kerry helicoptered to the crowded refugee camp [in Zaatari, Jordan,] on Thursday to take stock of the humanitarian crisis caused by the bitter fighting in neighboring Syria and highlight the American efforts to provide aid,” the New York Times reports. “Troubled by a range of problems, the camp is just a small piece of a widening humanitarian crisis,” the newspaper states. “According to a senior State Department official, about 2.5 million Syrians are ‘internally displaced,’ an increase of one million since the beginning of the year,” and “[a]n additional 1.7 million Syrians have left the country, according to tabulations by the United Nations refugee agency, though the State Department official noted that the actual number could be higher,” the newspaper notes. “As he prepared to leave the camp, Mr. Kerry told reporters that his visit had highlighted the need to respond to the worsening situation in Syria,” the New York Times writes, adding, “Having provided $815 million in humanitarian assistance, the United States is the largest financial aid donor in the conflict.”

On Tuesday, U.N. High Commissioner for Refugees António Guterres “expressed growing alarm about the scope and severity of the crisis” when “he told the Security Council that the pace of Syrians’ fleeing the country was the worst since the Rwandan genocide in 1994,” the New York Times reports (Gordon, 7/18). At the conclusion of a tour of Syria, Jordan, Iraq, Turkey, and Lebanon, U.N. Special Representative of the Secretary-General for Children and Armed Conflict Leila Zerrougui “urged all parties to take urgent measures to protect children and civilians,” the U.N. News Centre notes. “Children will continue to suffer the consequences of the ongoing conflict in Syria unless an urgent political solution is found, [she] stressed …, citing reports of the use of children as combatants, the arbitrary arrest and detention of children, and the denial of education as schools continue to come under attack,” the news service writes (7/18). “A U.N. report, released in June, said both government forces and rebels have been using boys and girls as suicide bombers or human shields,” according to Al Jazeera (7/18).

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USAID Launches Program Aimed At Empowering, Educating Women In Afghanistan

USAID “is launching a program to educate, train and empower at least 75,000 women between the ages of 18 to 30 in Afghanistan,” the Associated Press/Huffington Post reports. “The goal of the five-year program is to strengthen women’s rights groups, boost female participation in the economy, increase the number of women in decision-making positions within the government and help women obtain business skills,” the news agency writes (7/18). USAID Administrator Rajiv Shah announced the program on Thursday “amid fears that gains in women’s rights and development made over the past decade will dissipate after the withdrawal of foreign combat troops next year,” the Washington Post states. Speaking at the U.S. Institute of Peace, Shah said, “Many people ask me and others what will happen to Afghanistan when we complete a military transition. … The answer is, it depends. This is a critical moment for Afghanistan and for our partnership in the region,” according to the newspaper. “Women have made large strides in Afghanistan over the past decade,” the newspaper writes, noting maternal mortality has decreased “from 1,600 per 100,000 births to 327, between 2000 and 2010, according to the World Bank,” and “[p]renatal health care coverage has increased from six percent to 39 percent, and institutional deliveries from seven percent to 43 percent” (DeYoung, 7/18).

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WHO Reports 6 More Cases Of MERS Virus In Saudi Arabia, UAE

“Six more people, most of them health care workers, have contracted the deadly MERS virus in Saudi Arabia and the United Arab Emirates, the [WHO] said Thursday,” Agence France-Presse reports (7/18). “The latest infections of four women and two men aged between 26 and 42 bring the global total to 88 cases, including 45 deaths, the United Nations agency said in a statement,” Reuters writes, adding, “Five of the six new cases were health workers and the other was a man who came in close contact with someone who had been infected with the disease, which is known as Middle East Respiratory Syndrome coronavirus, or MERS, WHO said” (7/18). “The report comes a day after a panel of experts assembled by the [WHO] concluded that the MERS situation is a serious concern but does not yet constitute an international public health emergency,” CIDRAP News notes (Roos, 7/18).

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Experts Meeting In Uganda Urge African Governments To Spend More, Train Caregivers On Mental Health Care

“African psychiatrists and mental health experts are determined to change what they all agree is the alarming condition of mental health care across the continent,” where “[c]aregivers are few and health facilities even fewer,” the Associated Press reports. “Experts are meeting in the Ugandan capital this week to press their governments to spend more on mental health care as well as train caregivers to treat patients with knowledge and compassion,” the news agency writes, adding, “Across Africa, researchers say, the mentally ill are getting poor or no care, and often are treated with the kind of stigma usually reserved for prisoners. The attitude toward mental illness is sometimes reinforced by ignorance about what causes it and how it should be treated, they say.” The AP notes, “The Peter C. Alderman Foundation, which underwrote the conference in Kampala, says it seeks to build ‘mental health capacity in post-conflict countries,’ especially by training caregivers and running clinics that treat thousands of patients each year.” The news agency writes, “The conference drew more than 500 participants, including scores of African students who hope to swell the ranks of a specialty that seldom attracts the attention of sub-Saharan Africa’s impoverished governments” (7/18).

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U.N. Allocates Additional $1.5M In Emergency Funds For Haiti's Cholera Response

“The United Nations emergency relief fund will allocate an additional $1.5 million to the cholera response in Haiti, at a time when cases are set to rise due to the rainy season,” the U.N. News Centre reports. “The latest allocation brings the total amount provided this year by the U.N. Central Emergency Response Fund (CERF) for emergency cholera response in Haiti to $4 million,” the news service notes. “According to OCHA, lack of funding has dramatically decreased capacity to respond to cholera in Haiti,” the news service writes, adding, “The number of humanitarian organizations engaged in the response has fallen to less than half of what it was in 2012, from 107 to 43, and there is a serious gap in coverage in the north where most new cases are being recorded.” Acting Humanitarian Coordinator for Haiti Sophie de Caen said, “The CERF contribution is greatly appreciated, but we cannot rely upon the CERF as a primary funding source. I urge donors to increase their support to these critical activities,” according to the U.N. News Centre (7/18).

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Devex Interviews President Of Foundation Promoting mHealth Model In India

“To promote development in India, [USAID] is increasingly pushing small-scale and low-cost innovation there,” Devex reports, adding, “One of these affordable solutions is Project Vikalp, an integrated family planning e-health care model by the U-Respect Foundation that aims to bring about high contraceptive prevalence rates among India’s populous rural communities” and one of “nine winners of this year’s Millennium Alliance Awards, co-funded by [USAID].” The news service interviews U-Respect Foundation President Arundhati Char about “her organization’s award-winning project, named after the Hindi term for ‘alternative.'” According to the interview transcript, Char reflects on what makes Project Vikalp different from other programs, examines “some overlooked development problems in India which could benefit from Project Vikalp,” and discusses whether “the advantages of mobile technology [have] been adequately exploited in India” (Morden, 7/18).

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Editorials and Opinions

In Debate Over Food Aid Reform, Congress Should Choose Efficiency Over Industry Interests

“This spring the White House proposed reforming the way the United States runs its overseas food aid, and it has led to a legislative turf battle in which some lawmakers are blaming North Carolina and other agricultural states for their own inaction,” Matthew Leatherman, a resident fellow at the International Affairs Council of North Carolina in Raleigh, writes in a News & Observer opinion piece. “On one side are Congress’ agriculture committees, which control this budget and are resisting change on the pretense of representing farmers,” he notes, adding, “On the other are foreign policy committees that stand to gain control and support the administration’s proposal, citing ‘good government’ reasons.” He provides an overview of the Food for Peace program, outlines the changes to the program proposed by the Obama administration, and states, “The real issue is that this reform would switch the budgeting prerogative for food aid from agriculture legislators to foreign policy legislators. In a body defined by the power of the purse, Congress’ committees will fight to control every inch of legislative turf.”

“The measured argument favors reform,” Leatherman continues, writing, “The benefit of Food for Peace is sustenance for those otherwise at risk of malnutrition or starvation, an objective at the heart of our humanitarian values and our interest in maintaining a leadership role. And its cost — $1.8 billion — is less than a 20th of one percent of the total 2014 federal budget plan.” However, he states, “A principle of our foreign policy is to assist U.S. industry with opening foreign markets,” and “[u]sing domestically grown food in this aid program falls within that spirit.” Leatherman concludes, “There’s a chance to get more foreign policy bang for the few bucks we spend on food aid. North Carolinians are sure to favor such efficiency, and the agriculture industry may turn out to be more receptive to change than it is credited. Seems those standing most in the way are Congress’ bickering insiders” (7/17).

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European Leaders Must Make Good On Commitments To Fight TB

“One third of the world’s population is infected with Mycobacterium tuberculosis, the bacterium that causes TB, and one tenth of these people will become sick from the illness during their lifetime,” WHO Regional Director for Europe Zsuzsanna Jakab writes in the Huffington Post’s “The Big Push” blog. “Today we are confronted with forms of TB that do not respond to conventional treatment, but can still be passed from person to person through breathing the same air,” she adds, noting, “The multidrug- and extensively drug-resistant (M/XDR) TB are becoming more widespread across the European region, particularly in eastern countries.” She continues, “We can no longer afford to be complacent and must take effective steps to screen and treat people with these new forms of the disease, to stop them spreading further,” and writes, “Global investment in fighting these forms of TB must focus on Europe, as over half of the countries in the world with the highest rates of MDR/XDR-TB are here.”

“In 2011, European governments acknowledged the threat, endorsing a five-year plan developed by WHO’s Office for Europe to diagnose 85 percent of MDR/XDR-TB cases, and successfully treat 75 percent of them by 2015,” an “ambitious” but “desperately needed” plan, Jakab continues. “Yet the goal still remains far off,” as “[o]nly one in three people with MDR/XDR-TB are currently being diagnosed, according to estimates, and half of patients are treated successfully,” she notes. “We need to invest in health systems that put the patient first, in the spirit of WHO’s new European Policy Framework, Health 2020,” she states, adding, “European leaders now have a unique opportunity to join international partners and renew their efforts to fight TB.” She concludes, “I call on European governments to make good on their commitment: provide funding now to avoid an epidemic that tomorrow will be hundreds of times more costly to tackle” (7/18).

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Providing Safe Meals To Children In India Presents Challenges

India’s cooked midday meal (CMDM) program, which has “reduced child hunger and increased school enrollment, particularly among less privileged social classes,” “is being viewed more critically this week, after meals tainted by pesticides killed 23 students and sickened many others at a school in Bihar state,” Washington Post foreign affairs blogger Max Fisher writes in the newspaper’s “World Views” blog. “In the backlash, some are pointing to a 2010 Indian government report on the program that, while generally positive, identified serious issues in the CMDM program, particularly with regards to hygiene and food quality,” he states, noting, “Schools in Bihar, as in a number of other regions, often lack proper cooking facilities, according to the report, which warned that this can lead to food safety and hygiene problems.”

Bihar’s CMDM program experienced rapid growth between 2000 and 2006, but, by 2010, the program was “the least likely to serve each child an adequately sized meal: 22 percent of the program’s beneficiaries said they were not getting enough food,” Fisher writes. “It’s not clear whether these strains on the program in Bihar exacerbated the health issues there or merely coincided with them,” he states, concluding, “But it’s clear from the Indian government report that, despite the program’s broader successes in feeding hundreds of thousands of children, many of whom might have otherwise gone hungry, feeding them in a way that is hygienic and safe remains a challenge — one not exclusive to Bihar state” (7/18).

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From the Global Health Policy Community

Blog Examines PEPFAR, Global Fund Collaboration In Haiti

“For the past decade, [PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria] have navigated uncharted waters,” Michael Johnson, Global Fund attaché to the permanent mission of the U.S. to the U.N. and other international organizations, writes in the AIDS.gov blog. He provides a brief overview of the partnership and collaboration between the two organizations. Noting his “current role as Global Fund attaché was created to facilitate this collaboration through identifying programmatic areas and opportunities for partnership between PEPFAR and the Global Fund, and enhancing communication among all stakeholders,” he states, “Haiti is a great example of how this collaboration can work in-country.” He discusses the groups’ work in the country and continues, “As we reflect on this, the 10-year anniversary of PEPFAR, it is remarkable what has been achieved in the fight against HIV/AIDS in Haiti and around the world. … Continued partnership between the Global Fund and PEPFAR will be key to maintaining and scaling up the fight” (7/18).

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CGD Blog Examines 'Power Africa' Initiative

“On a sub-continent where 600 million people don’t have regular access to electricity, an initiative that would bring electricity to 20 million households in six countries might feel like a drop in the proverbial unlit bucket, but it’s an exciting start — and one that could be amped up by the Electrify Africa Act of 2013,” Todd Moss, vice president for programs and a senior fellow at the Center for Global Development (CGD), and Beth Schwanke, senior associate for policy outreach at CGD, write in the center’s “Rethinking U.S. Foreign Assistance Blog” in a post examining President Obama’s Power Africa initiative announced on June 30 in Cape Town. But “beyond just cheering on the substance, here are the big process things we’ll be watching for to see if Power Africa is going to succeed or be just another showy announcement,” they state, and examine the following questions: “Who’s in charge?”; “Is this just a repackaging of existing projects [plus] new buzzwords?”; “How will the U.S. involve the African Development Bank and other [multilateral development banks (MDBs)]?”; and “Will the administration seize or buck the Electrify Africa Act?” (7/18).

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Blog Reports On Capitol Hill Briefing Examining Scientific Advancements In AIDS Response

The Center for Global Health Policy’s “Science Speaks” blog reports on a Capitol Hill briefing held Thursday, where physician researchers Myron Cohen of the University of North Carolina at Chapel Hill; Chris Beyrer of Johns Hopkins Bloomberg School of Public Health; Laura Guay of the Elizabeth Glaser Pediatric AIDS Foundation; and Renee Ridzon of Akeso Associates examined scientific advancements in the HIV/AIDS response. At the briefing, titled “Where are we in ending the AIDS epidemic? An update on the science,” the participants said it is important to provide proven treatment and prevention interventions “to all who need them,” according to the blog, which provides an overview of the discussion (Barton, 7/18).

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