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Kaiser Daily Global Health Policy Report

In The News

Senate Subcommittee Approves FY14 State And Foreign Operations Appropriations Bill

The Senate Subcommittee on the Department of State, Foreign Operations, and Related Programs of the Senate Committee on Appropriations on Tuesday approved a $50.6 billion FY 2014 State and Foreign Operations Appropriations bill, which includes funding for global health programs at USAID and the State Department, The Hill’s “On The Money” blog reports. The total amount “is $10 billion more than the House is proposing” in a bill approved Friday by the House State-Foreign Operations Appropriations Subcommittee, the blog notes (Wasson, 7/23). “According to a summary released by the subcommittee, funding through the Senate appropriations bill for PEPFAR at the State Department, which supports bilateral programs and the Global Fund to Fight AIDS, Tuberculosis and Malaria, is at the same level as both the president’s request and the related House appropriations bill,” Kaiser Family Foundation’s “Policy Tracker” notes. “Funding in the bill for tuberculosis, neglected tropical diseases (NTDs), pandemic influenza, and polio are above the president’s request,” the “Policy Tracker” states, adding, “Total funding for family planning and reproductive health (FP/RH) programs in the bill, which includes $40 million for UNFPA, is above both the president’s request and the House appropriations bill” (7/23). The Center for Global Health Policy’s “Science Speaks” blog also discusses the bill’s approval (Aziz, 7/23). The Hill blog notes the bill “will come before the full Senate Appropriations Committee on Thursday” (7/23).

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African Governments Fall Short On Health Spending Pledges, WHO Data Show

“Twelve years after African governments pledged in the Abuja Declaration to allocate at least 15 percent of their annual budgets to health care by 2015, just six countries have met this goal,” IRIN reports. “Liberia, Madagascar, Malawi, Rwanda, Togo and Zambia have met the target, and five other countries are spending at least 13 percent of their annual budgets on health, according to data compiled by the [WHO],” the news service writes, noting, “While on aggregate spending on health has increased — up to 10.6 percent from 8.8 — about a quarter of African Union (A.U.) member-states have regressed and are now spending less on health than they were in 2001, adds the WHO data.” The news service adds, “At present, funding for health care remains short of requirements and is very unevenly spread across countries,” noting, “According to UNAIDS, an additional $31 billion per year will be needed to meet the continent’s 15 percent health funding targets.”

Noting the A.U. last week “held another special summit on HIV/AIDS, tuberculosis (TB) and malaria in Abuja, Nigeria, dubbed Abuja +12, which provided an opportunity for African governments and other stakeholders to review progress made and to discuss what should be done to ensure health funding targets are met before 2015,” the news service continues, “According to [a joint A.U.-UNAIDS report launched at the summit], there is an economic case to be made for further investment in health care: For every year that life expectancy rises across the continent, it argues, GDP will increase by four percent.” IRIN provides quotes from UNAIDS Executive Director Michel Sidibé, Ghanaian President John Dramani Mahama, Liberian President Ellen Johnson-Sirleaf and A.U. Commissioner of Social Affairs Mustapha Sidiki Kaloko (7/23). In a related article, Nigeria’s “Daily Trust” interviews Babatunde Osotimehin, executive director of the United Nations Population Fund (UNFPA), “on the need [to] increase budgetary allocation for health, as dependence on external funding according to him introduces a sense of insecurity” (7/23).

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U.N.'s ECOSOC Addresses HIV/AIDS, NCDs, Science And Technology For Development

“The United Nations Economic and Social Council (ECOSOC) [on Monday] took action on reports pertaining to HIV/AIDS, non-communicable diseases (NCDs), and science and technology for development,” Intellectual Property Watch reports, detailing the actions taken pertaining to each at the current ECOSOC session. According to the news service, “the Council took note of [a] report [.pdf] of the executive director of UNAIDS and adopted a resolution urging UNAIDS to continue supporting and fully implementing the 2011 Political Declaration on HIV and AIDS”; “reached a decision to request the secretary-general to establish the U.N. Interagency Task Force on the Prevention and Control of Non-Communicable Diseases (NCDs)”; and adopted three recommendations “contained in the report of the Commission on Science and Technology for Development” (Ngo, 7/23).

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Pregnant Women In Sub-Saharan Africa Not Receiving Recommended Malaria Prevention Treatment, Study Says

“[D]espite relatively high attendance at clinics for expectant mothers and their newborns throughout sub-Saharan Africa, statistics show that just a little over 21 percent of women are receiving intermittent preventive treatment in pregnancy, or IPT, and fewer than 40 percent of them are being given protective bed nets,” VOA News reports. For the past 20 years the WHO “has recommended that pregnant women in areas with high rates of malaria receive insecticide-treated bed nets and periodic doses of a cheap drug to prevent the disease.” According to Jenny Hill of the Liverpool School of Tropical Medicine, program manager for a research partnership called the Malaria and Pregnancy Consortium, “an analysis of 99 studies” — published in the journal PLOS Medicine on Tuesday — “found a number of barriers to malaria prevention, including unclear policy and guidance from government ministers and health care officials and, at the clinical level, lack of clean water, drug shortages and confusion about procedures for administering IPT.”

Noting the WHO “recommends that expectant women receive IPT during regular visits to prenatal clinics, usually around four times in the course of a pregnancy,” VOA writes, “Free intermittent preventive treatment [during] pregnancy is the policy in 37 countries across the region, according to Hill. Yet, investigators found prenatal clinics, known as ANCs, posed economic obstacles that discouraged women from coming back” (Berman, 7/23). According to the journal’s “Speaking of Medicine” blog, “The barriers identified in this study may be helpful as a checklist for use by country malaria programs and policymakers to identify factors that influence the uptake of these interventions in their specific location or context” (7/23).

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Vietnam Facing Funding Challenges As Donors Pull Back

Devex examines how Vietnam, now considered a middle-income country, is facing the challenge of securing funding for its HIV/AIDS programs, as donors begin to “either reduc[e] their aid footprints or cu[t] altogether their bilateral ties.” The news service writes, “On the ground, implementing partners from civil society and non-profit circles are forging new bonds with corporations, other big non-profits and private foundations to secure future funding. Some are even relying on special assistance from their headquarters to continue their operations.” However, “declining funding does not mean donors are abandoning Vietnam. As their funding is expected to dry up in the coming years, donors are now trying to help the Vietnam government to lead the fight against the global scourge,” according to Devex, which discusses funding from the U.S., U.K., Australia, the Netherlands, and the Global Fund to Fight AIDS, Tuberculosis and Malaria (Morales, 7/23).

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Editorials and Opinions

Access To Comprehensive Reproductive Health Services Necessary To Reach AIDS-Free Generation

In a Huffington Post “Global Motherhood” opinion piece, Ambassador Eric Goosby, head of the U.S. State Department’s Office of Global Health Diplomacy and the U.S. global AIDS coordinator, and UNAIDS Executive Director Michel Sidibé discuss progress (.pdf) made on the “Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive” (Global Plan). “During the first three years of implementing the Global Plan, we have seen a tremendous increase in the percentage of women in the priority countries receiving [antiretroviral therapy (ART)] for their own health as part of [prevention of mother-to-child transmission (PMTCT)] programs,” they write, noting, “Another important achievement of the Global Plan has been the adoption of task-shifting policies allowing nurses to initiate ART for eligible pregnant women.”

“However, here too there is more work to be done. For example, the Global Plan calls for programs to help all women improve their overall reproductive wellbeing, including avoiding unintended pregnancies,” Goosby and Sidibé state, noting data on maternal mortality. “The PEPFAR Blueprint: Creating an AIDS-free Generation [.pdf] reflects a strong focus on women, girls and gender equality,” and “UNAIDS continues to champion efforts to address the persistent gender inequalities and human rights violations that put women and girls at a greater risk of HIV,” they write. “Collectively, we will continue to press forward toward the overall goal of reducing the number of women and girls acquiring HIV infection and ensuring all people living with HIV who are eligible for ART have access to it,” the authors write, concluding, “Women and girls — whether or not they are mothers — need access to comprehensive reproductive health services, including HIV prevention, treatment and care if we are to truly create an AIDS-free generation” (7/23).

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Women Want Access To Family Planning

“As CEO of WomanCare Global, a non-profit supply chain for reproductive care products, I’ve talked to thousands of women from almost every continent,” Saundra Pelletier writes in the Huffington Post’s “Global Motherhood” blog. “What women, and specifically mothers, want is astonishingly simple: to provide a better life for their children,” she states, adding, “They also know they can provide a better quality of life by taking control of their family planning and in turn, make the choice to empower their future.” She notes, “Families who have access to contraceptives tend to be healthier, wealthier and better educated,” and she writes, “With broad access to contraceptives, we could decrease … maternal deaths and … deaths of children under five.”

“More than 200 million women worldwide want to avoid pregnancy but don’t have access to contraceptives,” Pelletier continues. “WomanCare Global is combating these problems directly through a sustainable supply chain,” she states, adding, “We believe women everywhere should have access to real choice: a full range of quality family planning methods that work for every woman’s life stage and unique circumstance.” She describes the “hybrid for-profit/non-profit model” employed by the organization and concludes, “While a supply chain doesn’t sound glamorous, it’s a critical building block to improve the health, education and well-being of mothers, children and entire societies. If you want to improve the world, start by providing women with what they want” (7/23).

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From the Global Health Policy Community

USAID Working To Improve Public Health In India

Writing in the White House Blog, Jill Biden, wife of Vice President Joe Biden, discusses a recent trip to India and how the USAID Health and Urban Poor (HUP) Program is working in settlements near the Taj Mahal to improve health infrastructure, connect residents with health services and track mothers and their children by name. “The partnership between USAID and the government of India to improve the lives of the residents of the settlement was impressive to witness,” she writes, adding, “After traveling to Africa, nutrition advancement has been an area of interest to me and I am proud that USAID has decided to partner with the Indian government to help end malnutrition.” The post includes a video discussing several of the programs (7/23).

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Essay Examines Access Issues Surrounding Medicines For NCDs In Developing Countries

In an essay published in PLOS Medicine, Thomas Bollyky, a senior fellow for global health, economics and development at the Council on Foreign Relations (CFR), examines “new controversy [emerging] over patented medicines [for non-communicable diseases (NCDs)] and their affordability in developing countries.” He notes, “India, China, and other middle-income countries have taken measures to circumvent patents on medicines for diabetes, cancer, and cardiovascular and chronic respiratory illnesses — the [NCDs] increasing most rapidly in low- and middle-income countries,” and he writes, “Addressing this latest treatment-access crisis will require another transformation in global health [similar to that which took place surrounding HIV/AIDS], this time focusing on NCDs, low-cost interventions, and patient-centered strategies” (7/23).

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Partnerships Under MPP Key To Lowering Antiretroviral Therapy Costs

The ONE blog features an interview with Esteban Burrone, head of policy for the Medicines Patent Pool, who discusses how antiretroviral drugs used to treat HIV became less expensive over the past decade, allowing for millions more people living with the virus to receive treatment. Burrone says partnerships with pharmaceutical companies have been key in reducing the cost of treatment, and he adds, “Our focus is now on drugs under development and second- and third-line medicines, which patients need when they develop resistance” (7/23).

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Global Health Experts Examine Key Strategies To Tackle Drug Resistant Malaria

In a post in The Guardian’s “Global Development Professionals Network,” global health experts weigh in on “key strategies to tackle drug-resistant malaria.” The blog provides commentary from Tamara Bugembe, a pediatric registrar at the Bamenda Regional Hospital in Bamenda, Cameroon; Jörg Möhrle, head of translational medicine at Medicines for Malaria Venture in Geneva; Kefas Mugittu, director and senior consultant for Muvek Development Solutions Ltd. in Dar es Salaam, Tanzania; Prudence Hamade, a senior technical adviser for the Malaria Consortium in London; Georgina Humphreys, a researcher with the World Wide Antimalarial Resistance Network (WWarn) in Oxford; Sanjeev Krishna, a professor of molecular parasitology and medicine at St George’s, University of London; Angus Spiers, deputy director for the malaria and child survival department at Population Services International (PSI) in Washington, D.C.; Colin James Sutherland, a reader in parasitology at the London School of Hygiene & Tropical Medicine; and Jasson Urbach, director of Africa Fighting Malaria in Durban, South Africa (Young, 7/23).

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