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Kaiser Daily Global Health Policy Report

In The News

Obama, Bush Appear Together In Tanzania; First Ladies Discuss Women's Health At Conference

President Barack Obama concluded his weeklong Africa tour on Tuesday, “with an unusual double act with his predecessor George W. Bush,” Agence France-Presse/France 24 reports (7/2). At “a brief, silent appearance together at a monument to victims of the 1998 embassy bombing” in Dar es Salaam, Obama and Bush “found common ground … honoring the victims of a terrorist attack in an unprecedented chance encounter a world away from home,” the Associated Press writes. “While the two U.S. leaders didn’t say anything publicly, their wives engaged in a … joint appearance at a summit on African women,” the news service notes (Pickler/Pace, 7/2). U.S. First Lady Michelle Obama “helped Laura Bush open a summit of the wives of African leaders, saying Africa was ‘at the hub of global development,'” according to Reuters, which adds, “The summit aims to promote women’s well-being on the continent.” The news service writes, “The unusual Obama-Bush combination spotlights U.S. interest in the continent and the importance of Africa to the legacy of the president and his predecessor” (Felsenthal, 7/2).

After arriving on Monday in Dar es Salaam, Obama “announced a new venture, dubbed ‘Trade Africa,’ that aims to increase the flow of goods between the U.S. and sub-Saharan Africa,” the AP reports in a separate article (Pace, 7/1). In another article, the AP notes, “Obama praised Bush’s funding for AIDS treatment in particular during a news conference with President Jakaya Kikwete, shortly after his arrival” (Pickler/Pace, 7/1). But “even as he praised the work” of Bush, “Obama defended his administration’s efforts in Africa on Monday,” according to The Hill (Parnes, 7/1). “Obama disputed a Washington Post story Monday that [discussed] funding for programs to fight HIV/AIDS in Africa,” the Washington Post notes, adding, “The program is treating four times as many people as it did when it began in 2003, Obama said, and it has reduced costs considerably.” Obama “said his administration has shifted some of the savings to other global health initiatives, including tuberculosis and malaria alleviation,” the newspaper adds, noting he “emphasized that Bush deserves ‘enormous credit’ for PEPFAR, which has saved millions of lives” (Nakamura, 7/1). ABC News provides video footage of Obama speaking at the press conference on Monday (7/1). The White House provides a fact sheet on U.S. global health investment and partnerships in Africa on its webpage (6/30).

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IAS 2013 Attendees Address Issues Surrounding Treatment Access, Including Stigma, Trade Agreements

On Sunday at the opening of the 7th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2013) in Kuala Lumpur, Malaysia, IAS 2013 International Chair and IAS President Françoise Barré-Sinoussi said, “[S]tigma and discrimination are still amongst the key barriers” to people living with HIV receiving early treatment, Agence France-Presse/Fox News reports. “Many Asian countries experienced concentrated epidemics, and there is an immense need to address key affected populations, which are still left behind in many countries,” she said, according to the news agency. “Adeeba Kamarulzaman, AIDS researcher at Malaysia’s Universiti Malaya, said those affected by the disease and needing help included gay men, sex workers and transgendered people,” AFP writes, noting, “Michel Kazatchkine, the U.N.’s special envoy for HIV/AIDS in Eastern Europe and Central Asia, said the region should also decriminalize drug use, making it easier for users to get clean needles and other help to prevent infections with HIV” (6/30). According to an IAS 2013 press release (.pdf), the issue of stigma and punitive laws was discussed at the plenary session on Tuesday (7/2).

Also on Tuesday at the conference, Médecins Sans Frontières (MSF) “warned … that rising intellectual property rights are blocking the generic production of newer drugs to treat HIV and are keeping them out of reach for developing countries,” the Associated Press reports (7/2). “The price of first- and second-line antiretrovirals (ARVs) to treat HIV are falling because of increased competition among generic producers, but newer ARVs continue to be priced astronomically high, according to the annual report ‘Untangling the Web of ARV Price Reductions,'” which was released at the conference, according to an MSF Access Campaign press release (7/2). “Patents keep them priced beyond reach. We need to watch carefully as newer, better medicines reach the market in the coming years, as these are the drugs that we’ll quickly be needing to roll out. The price question is far from resolved,” Jennifer Cohn, medical director at MSF’s Access Campaign, said, Agence France-Presse/France 24 reports (7/2). The group “urged the United States and 11 other countries negotiating a Trans-Pacific Partnership not to sign the free-trade pact … warn[ing] that the pact will increase intellectual property rights across Asia and the Americas, expanding monopoly protection for medicines and threatening cheap access to drugs,” the AP notes (7/2).

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UNAIDS, Lancet Commission Addresses AIDS Response, Global Health Issues

“Strategic challenges for the future of the AIDS response and global health were discussed at the first meeting of the UNAIDS and Lancet Commission: From AIDS to Sustainable Health, which was held in Lilongwe, Malawi, from June 28-29, 2013,” a UNAIDS press release reports. “Three main issues were debated during the two days: the need to harness shifting global and domestic resource flows for health; trade, innovation and commodity security; and the democratization of global health,” according to the press release (7/1). The commission comprises more than 30 commissioners from around the world, and the summit drew together dignitaries including Malawi President Joyce Banda, Gabon First Lady Sylvia Bongo Ondimba, Rwanda First Lady Jeanette Kagame, and former Botswana President Festus Mogae, according to the Malawi News Agency (6/29).

At the summit’s opening on Friday, UNAIDS Executive Director Michel Sidibé applauded Malawi’s efforts in addressing HIV/AIDS, a separate MNA article notes (6/29). Banda said, “Let’s openly discuss HIV and AIDS issues to end stigma and discrimination,” Agence France-Presse reports (6/30). The commission will hold its next meeting “in Brazil in 2014, hosted by the former President of Brazil and UNAIDS and Lancet Commissioner President Luiz Inacio Lula da Silva,” the UNAIDS press release notes (7/1). In related news, the Programme Coordinating Board of UNAIDS on Monday at its 32nd meeting “announced its commitment to lay the foundations to end the AIDS epidemic” and “added that this commitment included realizing UNAIDS vision of zero new HIV infections, zero discrimination and zero-AIDS related deaths,” according to a separate UNAIDS press release (7/1).

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U.N.-Organized Meeting On Food Security In Africa Held In Addis Ababa

“More than 150 representatives of civil society, the private sector and the farming industry met over the weekend in Addis Ababa, Ethiopia, to establish partnerships to guarantee food security in Africa during a United Nations-organized meeting,” the U.N. News Centre reports. “We hope that this meeting will help us to coordinate and mobilize further our common efforts to promote food security,” U.N. Food and Agriculture Organization (FAO) Director-General Jose Graziano da Silva said on Saturday at the meeting, the news service writes, adding, “Graziano da Silva said that increasing food production is not enough to end hunger because the main cause of food insecurity is insufficient access to the resources needed to produce food or to income to buy it” (7/1). “Subsistence agriculture must be abolished if African countries want to eradicate hunger by 2025, the former president of Brazil, Luiz Inácio Lula da Silva, told [the meeting] on Sunday,” according to The Guardian. “In a rousing speech to open [the conference], Lula said Africa could end hunger if there was enough political will to embed the needs of poor people in national policy,” the newspaper writes.

“The conference was convened by the FAO, the New Partnership for Africa’s Development and the Lula Institute under the banner Toward African renaissance: renewed partnership for a unified approach to end hunger in Africa by 2025,” The Guardian notes. The meeting ended “on Monday with a declaration apparently designed to get greater political commitment to improve agricultural productivity and address underlying social factors that contribute to poor nutrition, such as lack of access to health care and credit,” the newspaper writes. “The declaration will reaffirm government commitments, including the 2003 Maputo declaration, and encourage more partnerships between governments, the private sector and civil society,” and “[i]t includes reducing the need for food aid within 10 years, eliminating stunting among children under five, doubling productivity of staple crops within five to 10 years, and contributing to the African trust fund for food security, launched at an FAO conference in Brazzaville last year,” The Guardian states (Ford, 7/1).

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Anti-Smoking Policies Could Prevent Millions Of Premature Deaths, WHO Study Says

“Anti-smoking measures including higher taxes on tobacco products, bans on adverts and controls on lighting up in public places could prevent tens of millions of premature deaths across the world, researchers said on Monday,” Reuters reports. “Similar steps taken by Turkey, Romania and 39 other countries between 2007 and 2010 were already saving lives, the independent study published by the [WHO] said,” the news service adds (Nebehay, 7/1). “Scientists looked at the effects of six anti-smoking policies introduced in 41 countries … between 2007 and 2010,” the Press Association/Huffington Post U.K.’s “Lifestyle” blog writes, noting, “Projections of the number of premature deaths the measures were likely to prevent by 2050 produced a figure of 7.4 million” (7/1). “Douglas Bettcher, director of the department of non-communicable diseases at the [WHO], added that wider implementation of these anti-smoking measures would allow the prevention of millions more smoking-related deaths,” according to HealthDay News/U.S. News & World Report (7/1).

The policies examined include “monitoring tobacco use, protecting people from tobacco smoke, warning about the dangers of tobacco, enforcing bans on tobacco advertising, promotion and sponsorship, and raising tobacco taxes,” the Australian Associated Press adds (7/1). “The report found that raising tobacco taxes and enforcing smoking-related air quality controls (such as public smoking bans) were the most effective anti-smoking measures by far,” according to Think Progress (Mukherjee, 7/1). “Increasing taxes on cigarettes to 75 percent of their price in 14 regions had the biggest impact, which was greater than legal smoking bans,” the Associated Press/Herald Sun notes, adding, “Tax rises prevented 3.5 million smoking-related deaths while ‘smoke-free air laws’ in 20 of the countries studied averted 2.5 million” (7/2).

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HIV, Syphilis Prevalence Rose 'Significantly' Among MSM In Bangkok From 2005-2011, Study Shows

“Cases of HIV and syphilis among gay men in Bangkok are on the rise, according to data released by U.S. and Thai health authorities” and published in the Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report on Friday, Agence France-Presse reports. According to the report, syphilis prevalence “among gay men more than doubled from five percent in 2005 to 12.5 percent in 2011,” and “the annual prevalence of HIV also rose ‘significantly,’ from 24.5 percent in 2005 to 29.4 percent in 2011 among men who have sex with men (MSM),” the news agency writes. “The data came from the Silom Community Clinic, located in a central Bangkok hospital and near entertainment venues for gay men,” and “may not be representative of the wider gay population in Thailand, the study noted,” AFP states. HIV prevalence among MSM in Thailand was about 17 percent in 2003 but is now around 30 percent, according to the study, the news agency notes. “[T]he data underscore ‘the urgent need for preventive interventions to reduce the spread of HIV and [sexually transmitted infections (STI)] in this population,’ the study said,” AFP writes (6/29). An article in The Guardian’s “Global Development Professionals Network” blog examines different programs addressing the issue (Parry, 7/1).

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Editorials and Opinions

Obama Administration's Power Africa Initiative Represents A 'Strategic And Moral Advance'

“Before his current trip, President Obama’s Africa strategy was known for inattention at the highest level,” columnist Michael Gerson writes in a Washington Post opinion piece, continuing, “This is one of those rare cases, however, in which the reality has often been better than the rhetoric (or lack of it).” Gerson outlines some of the Obama administration’s accomplishments related to Africa, stating that the administration “has pushed for greater transparency” in foreign aid; “has renewed an emphasis on agricultural productivity through its Feed the Future initiative”; and “[i]n a difficult fiscal environment, it has fought to preserve overall aid budgets (though the recent cuts to PEPFAR … have been disturbing).” Despite these developments, “Obama has lacked a creative, signature initiative of his own,” but the announcement of a new U.S.-funded program, Power Africa, “aimed at doubling access to electricity across the continent — could be a major strategic and moral advance,” he writes.

Gerson discusses the electrical supply challenges in Africa, including the impact on health. He writes that it is difficult “for clinics to store vaccines or blood without reliable refrigeration, or for municipalities to run the pumps necessary for clean water and sanitation. Women and girls have an especially hard time of it: carrying firewood for long distances on their heads or backs, cooking with stoves that produce toxic fumes, giving birth in health facilities without lighting.” He continues, “Energy poverty is not merely economic; it is expressed in deforestation, respiratory illness, and maternal and child mortality” (7/1).

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International Cooperation, Action Necessary To End Violence Against Women

Noting several different U.N. actions taken recently condemning violence against women, including a U.N. Security Council resolution adopted last week “devoted to the issue of sexual violence in armed conflict,” Lakshmi Puri, acting head of U.N. Women and U.N. assistant secretary general, writes in The Guardian’s “Poverty Matters Blog” that these “recent policy gains indicate progress.” She continues, “Now, inspiring words must be turned into action by investing in female empowerment and leadership as the most effective strategy to end violence against women.” Puri adds, “Only greater equality between the sexes will turn the tide to prevent and end violence against women and girls.” She says national governments and “multilateral and regional entities, including U.N. Women,” must cooperate “to empower women and girls and put an end to the atrocities.” In addition, “it requires strong efforts by civil society organizations and the global women’s movement to remind both national governments and international organizations that words are not enough, that a few actions are not enough, that we must aim high and maintain progress,” she concludes (7/2).

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Volunteerism Can Be 'An Integral Part Of Universal Health Coverage'

“Expanding volunteerism is one part of the solution to help improve global health investments and ensure equitable access to health,” Matthias Schmale, under-secretary general at the International Federation of Red Cross and Red Crescent Societies, writes in The Guardian’s “Global Development Professionals Network” blog. “But there is often vocal criticism of volunteerism, so it is important to be clear not just about the benefits but also about the contexts in which working with volunteers produces the best results,” he writes. “When done successfully, volunteerism can help a country achieve its development targets,” he states, noting, “A recent study published in the Lancet medical journal showed that health education by volunteers contributed to improvements in maternal and child health in Malawi.” Schmale provides examples of volunteer-based health programs in Afghanistan and the Philippines. “Volunteers are best motivated when they see that their contribution improves the health of their family and community, which can be an incentive more powerful than money,” he writes, concluding, “The government, private sector and civil society partners must work together to fund and promote volunteerism as an integral part of universal health coverage” (7/1).

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From the Global Health Policy Community

ONE Blog Reflects On Obama's Africa Trip

Writing in the ONE blog, Erin Hohlfelder, who specializes in infectious diseases, maternal and child health, and global health financing mechanisms for ONE, reflects on the second leg of President Obama’s Africa trip, during which he traveled from Senegal to South Africa. “We were glad that President Obama selected South Africa for a health site visit, because the country presents such a unique case study full of progress achieved and big challenges ahead,” she writes. “Through a fact sheet, the administration quietly committed an additional $10 million to support South Africa’s ongoing efforts to expand medical male circumcision services,” Hohlfelder notes. She briefly criticizes the administration, writing, “While many other African countries receive more Global Fund [to Fight AIDS, Tuberculosis and Malaria] support than South Africa, it seemed like a real missed opportunity for the U.S. to barely name check the Global Fund at a moment when all eyes were watching Obama and the media was poised to write about global health” (7/1).

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Blog Discusses President Obama's Global Development Council

Writing in the Center for Global Development’s (CGD) “Rethinking U.S. Foreign Assistance Blog,” Sarah Jane Staats, director of CGD’s Rethinking U.S. Foreign Assistance Program, provides a timeline of operations for President Obama’s Global Development Council. Staats says “[i]t was created in Obama’s 2010 U.S. global development policy directive to offer high-level, independent advice to the president on development policy, including through active engagement across and outside the U.S. government,” but she notes the council has yet to meet. She writes that “the delay in getting the council up and running exposes three risks in execution” — staff support inside the administration, missed opportunities to utilize the advisory group, and a lack of visibility across and outside the government — and provides “three ideas that might help” — “[a]n executive secretariat, not just an executive director”; the use of a “plus one” model “in which an agency principal appoints a plus one to support him or her during White House and interagency meetings and do a lot of the work”; and filling the four remaining open spots “with members who would bring additional expertise and political affiliation” (7/1).

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AIDS.gov Blog Provides Highlights Of IAS 2013 Conference

The AIDS.gov blog provides video interviews with Carl Dieffenbach, director of the Division of AIDS at the National Institute of Allergy and Infectious Diseases (NIAID), who discusses issues covered at the ongoing 7th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2013) in Kuala Lumpur, Malaysia. AIDS.gov Director Miguel Gomez writes, “[W]e invite you to check back regularly to hear about the exciting new developments in research from the largest scientific conference on HIV/AIDS.” Interviews from the first and second days of the conference are available, and other video highlights from IAS 2013 are available on YouTube (7/2).

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Blog Examines Pros, Cons Of New Alliance For Food Security And Nutrition

A post in the SOS Children’s Villages blog discusses the “pros and cons” of the G8’s New Alliance for Food Security and Nutrition. The post examines arguments for and against the initiative, put forth by various non-governmental organizations. “It is too early to tell whether the New Alliance will prove successful in its aims and the signed-up African governments are therefore taking a gamble with their involvement. But given the desperate need for better harvests and increased food security in their nations, clearly they believe it’s a bet worth taking,” the post concludes (Luffman, 7/1).

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