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Kaiser Daily Global Health Policy Report

In The News

DRC Health Minister Resigns After Country's New President Appoints Task Force To Manage Response; WHO Estimates Ebola Funding Needs To Triple Over Next 6 Months

Associated Press: Congo’s health minister quits over Ebola response changes
“Congo’s Health Minister Oly Ilunga resigned from his post Monday to protest the president’s decision to take over management of the response to the Ebola outbreak. ‘Following the president’s decision to manage the Ebola epidemic at his level, I handed in my resignation as Minister for Health,’ Ilunga wrote in a tweet…” (Mwanamilongo, 7/22).

Bloomberg: Ebola Funding Need to Triple as International Risk Escalates
“The Ebola emergency in the Democratic Republic of Congo will require about three times more money than currently provided, the United Nations agency leading the public health response said. The World Health Organization estimates $324 million is needed to fund its response and preparedness in the Africa region over the next six months. Additional funds will be required to support other functions outside the WHO’s remit to help stop transmission of the deadly hemorrhagic virus, the Geneva-based agency said in an email Tuesday…” (Gale, 7/23).

Devex: DRC health minister quits as new president takes over Ebola response
“…Ilunga made public Monday his two-page resignation letter addressed to President Félix Tshisekedi. In the letter, Ilunga raised issues with the president’s decision to hand over the responsibility of leading the Ebola response to a multisectoral team that directly reports to the president, a move made while Ilunga was away supervising the response in Goma…” (Jerving/Ravelo, 7/22).

Science: DRC health minister resigns over Ebola response
“…Tshisekedi’s administration announced on Saturday that direct supervision of the Ebola response was being placed with a team of experts under the direction of Jean Jacques Muyembe Tamfum, director general of the DRC’s National Institute for Biomedical Research (NIBR) and a microbiologist at the University of Kinshasa’s medical school. Tamfum has studied Ebola and responded to outbreaks for more than 40 years…” (Wadman, 7/22).

VOA News: DRC Health Minister Resigns After Being Dismissed as Head of Ebola Response
“…[In his resignation letter, Ilunga] said another flashpoint was outside pressure to introduce a new experimental vaccine. The country has deployed hundreds of thousands of doses of a vaccine by Merck, a German pharmaceutical company. The World Health Organization (WHO) and others have encouraged the DRC to use another vaccine by Johnson & Johnson, an American company. … It’s unclear if the new task force will change the DRC’s position on the second vaccine…” (7/22).

Additional coverage of the health minister’s resignation is available from Al Jazeera, BBC News, Bloomberg, CIDRAP News, Financial Times, and Reuters.

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WHO Recommends Antiretroviral Drug Dolutegravir As Preferred HIV Treatment, Including For Women Of Childbearing Age, Pregnant Women

U.N. News: U.N. health agency ‘strongly recommends’ dolutegravir antiretroviral medication to manage HIV
“Based on new evidence, the United Nations health agency on Monday announced it was recommending the use of the antiretroviral drug dolutegravir (DTG) — which, with other medication, treats HIV/AIDS — as the preferred first- and second-line treatment for all cases, including pregnant women and those who have the potential to give birth…” (6/22).

Additional coverage of the new recommendation is available from MedPage Today and The Telegraph.

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Multidrug-Resistant Malaria Spreading Quickly In Southeast Asia, Two Lancet Studies Conclude

NPR: Study: Malaria Drugs Are Failing At An ‘Alarming’ Rate In Southeast Asia
“Malaria drugs are failing at an ‘alarming’ rate in Southeast Asia as drug-resistant strains of the malaria parasite emerge. That’s the conclusion of researchers in two new reports — one based on a randomized trial and the other on a genetic study — that have just been released in the medical journal The Lancet. And there’s concern that this drug resistance could spread around the globe…” (Beaubien, 7/22).

Reuters: Multidrug-resistant malaria spreading in Southeast Asia: study
“A strain of malaria resistant to two key drugs has spread rapidly from Cambodia and has become dominant in Vietnam, Laos, and northern Thailand, with a ‘terrifying prospect’ that it could reach Africa, scientists warned on Monday…” (Kelland, 7/22).

Additional coverage of the studies is available from Al Jazeera, BBC News, The BMJ, The Guardian, and The Telegraph.

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New York Times Publishes Several Articles On Global Incidence Of, Efforts To Prevent Rabies

New York Times: Rabies Kills Tens of Thousands Yearly. Vaccinating Dogs Could Stop It.
“…Mission Rabies, which is part of Worldwide Veterinary Service and supported partly by Dogs Trust Worldwide, both nonprofits, has targeted Goa [in India] as a place to demonstrate the viability of its program to stop the spread of canine rabies. It spends about $300,000 a year and has vaccinated 100,000 dogs a year since 2017, about 50,000 a year before that. Deaths of people from rabies in Goa fell to zero last year from 15 in 2014, when the campaign started. There are none so far in 2019…” (Gorman, 7/22).

New York Times: Where Rabies Is Entrenched
“…Rabies, one expert has written, ‘became a neglected disease when it was eliminated from Europe and North America.’ The vast majority of the estimated 59,000 human deaths each year from rabies are in Africa and Asia, in countries with large populations of free-roaming dogs that provide a so-called reservoir for the virus…” (Gorman, 7/22).

New York Times: Five Things to Know About Rabies
“One of the world’s most studied and preventable diseases is still a deadly and common threat in much of the world…” (Gorman, 7/22).

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Global Warming Might Have Contributed To Drug-Resistant Fungus's Adaptation To Survive At Higher Temperatures, Researchers Say

NBC News: Deadly fungal infections may increase with global warming
“Scientists have a new theory about the origins of a dangerous, drug-resistant fungus that can strike the sickest patients in hospitals and other facilities that provide long-term care: global warming. The proposal, from researchers at Johns Hopkins Bloomberg School of Public Health, was published Tuesday in the journal mBio…” (Edwards, 7/23).

Newsweek: Scientists Who Studied Candida Auris Fungus Warn Global Warming May Lead to Diseases ‘We Don’t Even Know About Right Now’
“…Dr. Arturo Casadevall, chair in molecular microbiology and immunology at Johns Hopkins Bloomberg School of Public Health and co-author of the latest study published in the journal mBio explained to Newsweek that fungi can struggle to survive a mammal’s body temperature. His team believes Candida auris started infecting humans relatively recently because it adapted to higher ambient temperatures resulting from global warming, such that it was able to survive at human temperatures…” (Gander, 7/23).

STAT: The superbug Candida auris is giving rise to warnings — and big questions
“What’s known about the fungus Candida auris confounds the scientists who study it, the doctors who struggle to treat the persistent infections it causes, and the infection control teams that endeavor to clear it from hospital rooms after infected patients leave. But the list of what’s not known about this highly unusual fungus is longer still — and fascinating. Experts say there’s an urgent need for answers and for funding with which to generate them…” (Branswell, 7/23).

Washington Post: Deadly fungal disease may be linked to climate change, study suggests
“…Researchers have never been able to isolate the fungus from the natural environment or figure out how genetically distinct versions emerged independently at roughly the same time in India, South Africa, and South America. … Researchers cautioned that global-warming related changes in the environment alone do not explain the fungus’s emergence. ‘It’s an interesting theory, it’s a very good theory, but it needs to be proven,’ said Luis Ostrosky, an infectious disease researcher at UTHealth Houston’s McGovern Medical School. The widespread use of antifungal drugs and heavy use of fungicide on crops are among other theories for the emergence of the fungus, Ostrosky said…” (Sun, 7/23).

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More News In Global Health

Al Jazeera: The ‘vicious cycle’ driving teen pregnancy in El Salvador (Davies, 7/22).

The BMJ: Investing in global health will ‘improve our NHS,’ says England’s CMO (Hawkes, 7/22).

Devex: Maternal health: The next frontier for private sector engagement (7/22).

Devex: How to address HIV/AIDS stigma in health facilities to achieve UHC (Politzer, 7/22).

Devex: High cost of healthy food linked to stunting, new study finds (Welsh, 7/23).

Reuters: Death toll from India, Nepal, Bangladesh floods jumps to over 300 (Quadir/Varadhan, 7/22).

VICE: China to Start Human Testing for a Vaccine That Will Cure HIV (Pundir, 7/22).

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Editorials and Opinions

World Bank Must Be Held Accountable, Release Pandemic Emergency Financing Funds To Address Ebola, Opinion Piece Says

Foreign Policy: The World Bank Has the Money to Fight Ebola but Won’t Use It
Laurie Garrett, former senior fellow for global health at the Council on Foreign Relations

“…[T]he World Bank’s sentiments [on Ebola] have not been mirrored by its actions. Indeed, the bank has behaved reprehensibly. In 2014, in response to the tremendous financial shortfalls that delayed national and global responses to the West African Ebola epidemic, then World Bank President Jim Yong Kim publicly and repeatedly vowed that ‘never again’ would an epidemic be allowed to unfold for reason of lack of funds. He created a unique, and rather complicated, set of insurance and hedge funds inside the International Bank for Reconstruction and Development (IBRD) to be used to combat outbreaks. Dubbed the Pandemic Emergency Financing Facility, or PEF, the idea was to amass billions of dollars in insurance, bonds, and hedge funds that could be activated, based on unstated triggers, for use in fighting outbreaks. Investors were encouraged to put money into the various disease-specific funds, hedging against outbreaks. … Beyond the small sum of $20 million given two months ago, the PEF has not been activated for the Ebola epidemic. … WHO may declare a global emergency, but it will not have any impact on the World Bank’s decision to release money. … It is appalling that the bank has failed the people of Ituri and North Kivu, and placed the people of neighboring South Sudan, Uganda, Rwanda, and Burundi in harm’s way. It must be held accountable for its unconscionable refusal to release the PEF funds that are, by design, specifically meant to address precisely the sort of situation now unfolding in the Democratic Republic of the Congo” (7/22).

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Global Community Must Do More To Make Progress On Ending AIDS In Children, Youth

Devex: Opinion: Reigniting the global fight to end AIDS in children and youth
Chip Lyons, president and CEO at the Elizabeth Glaser Pediatric AIDS Foundation

“…Progress on ending AIDS in children and youth is stalling. … Gains made to date on behalf of children with HIV are precarious at best. … In the coming weeks, a new executive director of UNAIDS will be chosen to lead the agency in the global, regional, and national response to end the epidemic. … As agency leaders consider candidates, it is essential that they advance those who understand and prioritize the unique and often neglected agenda around ending AIDS in children and youth — or risk rolling back the tangible progress of recent years. … Our community must push for a global AIDS response that not only champions the needs of children and youth but also understands their inextricable link to the global goal of defeating the epidemic worldwide. We have raised the alarm, we have called for renewed urgency — but most importantly, we have made a promise to millions of children, women, and families and our work is not done until we succeed” (7/22).

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Strengthening National Health Systems Critical To Ensuring Global Health Security

Global Health NOW: Global Health Security Starts with Countries
Chikwe Ihekweazu, director general of the Nigeria Centre for Disease Control

“…Countries need to develop and scale up improved prevention, detection, and response to infectious disease threats. To do this, they need to build well-funded national public health institutes that incorporate surveillance and response to all infectious diseases. … [T]o build a sustainable and resilient public health institute, national governments must provide [a] majority of its funding. … While experts continue to call for action and collaboration in global health, we must remember that the pieces make the whole. The global health community is a collection of sovereign countries, professional groups, multilateral organizations, and civil society groups that ultimately have the collective responsibility for addressing the cross-border spread of infectious diseases. But the most important entity in this collection is the countries. Therefore, it is through developing and strengthening systems in countries that our goal for a safe and secure world can be achieved. … Clearly, there can be no global health security without national health security” (7/21).

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From the Global Health Policy Community

New Report Released At IAS 2019 Identifies Common Contributors To Success, Roadmap For Ending Global HIV Epidemic

Friends of the Global Fight Against AIDS, Tuberculosis and Malaria: The future of the HIV response
“For the first time, AIDS experts have brought together new assessments from six locations around the world that have made impressive progress fighting the epidemic, identifying the common contributors to success and providing a roadmap to ending the epidemic globally. In a new report released [Monday] at IAS 2019 and on EndAIDS.org, amfAR, AVAC, and Friends of the Global Fight Against AIDS, Tuberculosis and Malaria demonstrate how dramatic reductions in HIV incidence and mortality have been accomplished in six very different settings around the world: Thailand; Malawi; Rakai, Uganda; New South Wales, Australia; London, England; and San Francisco, United States. The report provides a graph for each location, illustrating declining HIV rates and deaths, as well as policy decisions that drove advances against the epidemic. The report also maps out the future, showing how the required policy, structural, and research advances can propel dramatic progress…” (7/22).

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UNAIDS Report Shows Slowing Pace Of Progress In Reducing New HIV Infections Among Children, Expanding Access To Treatment In Children, Adolescents, Pregnant Women

UNAIDS: UNAIDS calls on countries to accelerate efforts and close service gaps to end the AIDS epidemic among children and adolescents
“A new report released [Monday] at the 10th IAS Conference on HIV Science in Mexico City, Mexico, shows that the world is lagging behind in its commitment to end the AIDS epidemic among children and adolescents. The report, Start Free, Stay Free, AIDS Free, shows that the pace of progress in reducing new HIV infections among children and expanding access to treatment for children, adolescents, and pregnant women living with HIV has slowed significantly and that global targets set for 2018 have been missed, despite important gains being made in some countries…” (7/22).

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'Science Speaks' Provides Coverage Of IAS 2019 Conference In Mexico City

IDSA’s “Science Speaks”: IAS 2019: Preventing TB — the leading killer of people with HIV — remains tangential to global HIV responses (Aziz, 7/22).

IDSA’s “Science Speaks”: IAS 2019: With new data, WHO updates DTG guidelines including women in strong, preferred recommendation (Barton, 7/22).

IDSA’s “Science Speaks”: IAS 2019: Recency testing opens doors to faster, focused HIV responses, raises questions of community involvement (Barton, 7/22).

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From the Kaiser Family Foundation

KFF Brief Provides Summary Of Roundtable Discussion On Blended Finance For Global Health

Kaiser Family Foundation: Blended Finance for Global Health: Summary of a Policy Roundtable
In February 2019, the Kaiser Family Foundation held a policy roundtable with a group of stakeholders and experts on blended finance for global health. The discussion focused on the role of the U.S., the potential for and the challenges of blended finance for global health, and recommended next steps. This brief provides some background on blended finance and global health, as well as summarizes key points from the discussion (Michaud/Kates, 7/19).

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