KFF Daily Global Health Policy Report

In The News

As DRC Ebola Outbreak Grows, Congress Hears Testimony On Response, IMF Signals Readiness, WHO Makes Vaccination Plan

CIDRAP News: Beni Ebola activity tops first wave as outbreak grows by 8 cases
“A second wave of Ebola activity in the Democratic Republic of the Congo (DRC) city of Beni has now topped its first wave, and the area has become a source of spread to other areas, the World Health Organization (WHO) said in its weekly snapshot of outbreak activity [Thursday]. … The current wave of infections in Beni has involved more cases and is now longer than the initial wave in that region, early in the outbreak, which began almost a year ago…” (Schnirring, 7/25).

Homeland Preparedness News: Ebola outbreak in DRC requires coordinated response to contain disease, witnesses tell Congress
“…During a hearing titled, ‘Confronting Ebola: Addressing a 21st Century Global Health Crisis,’ witnesses discussed the continuing outbreak before the Senate Foreign Relations Subcommittee on Africa and Global Health Policy. The increasing number of deaths in the Democratic Republic of Congo (DRC) are concerning, the panel said, but largely contained. The hearing came one week after the World Health Organization (WHO) declared the Ebola outbreak a Public Health Emergency of International Concern…” (Carey, 7/25).

Reuters: IMF says ready to aid Congo in Ebola crisis if needed
“The International Monetary Fund said on Wednesday it had ample scope to provide financial support to Congo if it needs help dealing with an Ebola outbreak that has been declared an international health emergency…” (Shalal, 7/25).

Reuters: Deployment of second Ebola vaccine would not be quick fix, experts warn
“The resignation of Congo’s health minister in the midst of the country’s worst Ebola outbreak could clear the way for a second experimental vaccine to be deployed. But the new shot would likely take months to win the trust of frightened locals and show results, health officials say…” (Mahamba et al., 7/25).

STAT: WHO, preparing for the worst, makes plans for reduced doses of Ebola vaccine
“The World Health Organization is drawing up plans to use reduced doses of Ebola vaccine in the Democratic Republic of the Congo in the event that supplies in the long-running outbreak run short, according to the head of the WHO’s health emergencies programs…” (Branswell, 7/26).

Additional coverage of the DRC Ebola outbreak and response is available from Agence France-Presse, Associated Press (2), The Lancet, Los Angeles Times, PRI, Washington Post, and Xinhua News.

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Senate Committee Approves Nomination Of Kelly Craft As U.S. Ambassador To U.N.

POLITICO: Senate panel endorses Craft as U.N. envoy
“The Senate Foreign Relations Committee [on Thursday] approved the nomination of Kelly Craft to be the nation’s top diplomat at the U.N., days after new details about the extent of her travels away from her post in Canada were revealed. … Senate Majority Leader Mitch McConnell, who recommended Craft for the U.N. post, is expected to quickly shepherd her nomination to a vote by the full Senate…” (Gardner, 7/25).

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U.S. Implements Sanctions On Venezuelan Elites Accused Of Running Corruption Scheme Diverting Funds From Nation's Food Program

New York Times: U.S. Sanctions Venezuelan Elites for Alleged Food Corruption Scheme
“United States officials have accused President Nicolás Maduro of Venezuela of a corruption scheme in which his officials, family members, and business partners made off with large sums of money meant to feed the country’s starving population. The allegations appeared Thursday in a new round of sanctions targeting three stepsons of Mr. Maduro and a Colombian business partner of theirs named Alex Saab, among others. American officials said that for years the men had used shell companies and no-bid contracts to siphon off government money, largely from Venezuela’s state-run food program, for their own profit. … A Trump administration official said the sanctions would not stop food or medicine from being sent to Venezuela to ease shortages during the [country’s economic] crisis…” (Casey/Jakes, 7/25).

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New U.K. International Development Secretary Sharma States Support For U.K. Aid Budget

The Telegraph: New development secretary Alok Sharma signals he will protect U.K. aid budget
“New international development secretary Alok Sharma has signaled that he is committed to sticking with the U.K.’s contribution to foreign aid. In a statement published on the day of his appointment to the Cabinet, Mr. Sharma said he would work to deliver Brexit and ‘make sure U.K. aid is tackling global challenges’ including climate change, disease, and humanitarian disasters…” (Gulland/Newey, 7/25).

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WHO Guideline Group To Review Recommendations For Depo-Provera For Use By Women At Risk Of HIV

The BMJ: Depo-Provera: WHO set to review guidance on use by women at high HIV risk
“A World Health Organization guideline development group will convene next week (29-31 July) to review recommendations for the use of contraceptive methods by women at high risk of contracting HIV. The group will review the status of the three monthly injectable contraceptive Depo-Provera, using new evidence from a randomized clinical trial published in The Lancet last month…” (Iacobucci, 7/25).

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More News In Global Health

Agence France-Presse: Honduran hospitals overrun by dengue fever epidemic (Leiva, 7/25).

Associated Press: U.N.: International failure in face of escalating Syria crisis (7/26).

Devex: 4 years later, is it any easier to track the SDGs? (Lieberman, 7/26).

Devex: Is Uganda Africa’s role model when it comes to tackling hepatitis B? (7/26).

The Lancet: Northern Ireland likely to legalize abortion (Burki, 7/27).

The Telegraph: Remote town becomes first in Nepal to end practice of isolating women during periods (Wallen, 7/24).

Thomson Reuters Foundation: Act now to avert disaster in drought-hit East Africa, aid agencies say (Bhalla, 7/25).

U.N. News: New President of top U.N. economic and social body to push for development financing, fundamental freedoms ‘for all’ (7/25).

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Editorials and Opinions

Ebola Response In DRC Must Involve Building Trust With Affected Communities, Ensuring Local Engagement, Focusing On Strengthening Health Systems

STAT: The real public health emergency of international concern: the DRC
Seth Berkley, CEO of Gavi, the Vaccine Alliance

“…[T]he response [to the Ebola outbreak in the Democratic Republic of the Congo (DRC)] will need to go beyond the immediate Ebola crisis and address much deeper long-term issues that have plagued the region … Because in truth it is not just Ebola, but more broadly the situation in the DRC itself, that represents a public health emergency, and one that really should be of international concern. … [P]ublic health in the DRC is in a state of emergency. … [I]t is … important that part of the response involves building trust within the affected communities, to ensure that efforts are not perceived by locals as being undertaken merely to protect others, and then leaving once the job is done. This can be achieved by ensuring there is local engagement and leadership in the response, and by making sure that in addition to tackling the virus there is as much focus on strengthening health systems in affected areas and building strong and sustainable primary health care to address the broader health issues these communities face. … By working through this sort of government-led initiative and with the support of President Tshisekedi, it may [be] possible to begin to rebuild trust and halt the epidemic, while reducing outbreaks of other infectious disease and improving disease surveillance at the same time. If we are to stop this epidemic and prevent future ones from spiraling out of control, then we need to recognize that this Ebola outbreak should not be viewed in isolation, but must be seen as a symptom of a deeper public health crisis” (7/25).

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Opinion Piece Outlines 5 Priorities For DFID's New Leader

Devex: Opinion: 5 priorities for Alok Sharma, DFID’s new leader
Fergus Drake, chief executive of Crown Agents

“…The appointment of Alok Sharma as the fifth secretary of state for international development in just four years marks yet another new era to which the aid community in the United Kingdom must brace itself and adjust. So as Sharma takes his seat, rolls up his sleeves, and gets his feet under his desk, here are five pressing priorities that we hope will be at the top of his in-tray: 1. Double down on climate change … 2. Reboost the [Sustainable Development Goals (SDGs)] …3. Prioritize the Africa Investment Summit … 4. Protect aid dollars post-Brexit … 5. Make a stand in the Spending Review … [T]he U.K. needs to be prepared and properly equipped to play a leading role on the global stage. A confident and innovative [Department for International Development (DFID)] supported by a world class U.K. development sector has a key role to play in navigating existential challenges from climate change to migration and pandemics. It is only through a strong and well-resourced aid sector, aligned across Whitehall and working with global business that ambitions will be realized for a safer and fairer world — which is inextricably linked to the U.K.’s own national interests” (7/25).

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Addressing Poverty Critical To Advancing Global Health, Lancet Editor In Chief Says

The Lancet: Offline: Global health’s indifference to poverty must end
Richard Horton, editor-in-chief of The Lancet

“…[B]eating poverty remains a prerequisite for flourishing and sustainable lives. Disappointingly, global health and its leaders have judged poverty to be yesterday’s idea. … Poverty is not only a curse for the poorest nations in the world. There is endemic poverty in supposedly rich countries too. … And one must not forget that poverty in rich and poor nations alike is gendered. Women lose more life-years to poverty than men. Ending poverty must return as a political objective for global health. Health professionals are uniquely placed to draw attention to the acute personal consequences of poverty. We can be powerful advocates for action. … Poverty consumes lives, eroding mental resources, diminishing cognitive capacities, and destroying life possibilities. Universal health will never be achieved unless and until poverty is eradicated. How tragic that our global health leaders have forgotten this lesson” (7/27).

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Public-Private Approaches Critical To Achieving UHC, Opinion Piece Says

CapX: We cannot achieve universal health coverage without the private sector
Jeffrey L. Sturchio, CEO at Rabin Martin and co-editor of The Road to Universal Health Coverage: Innovation, Equity and the New Health Economy, and Harald Nusser, head of Novartis Social Business and contributor to The Road to Universal Health Coverage

“…[H]ow countries should go about achieving [universal health coverage (UHC)] — defined as all people having convenient access to quality health services and commodities without the risk of suffering financial harm as a result of illness — is a matter of intense debate. Unfortunately, the discussion has largely ignored one crucial subject: the role the private sector can play in delivering health care for all. … In most lower-income countries, 30-80% of health services are delivered through the private sector. A winning strategy for governments is to identify what’s working well in the delivery of health care in their countries, and then to build on those successes. In many cases this will mean developing or strengthening partnerships between both the public health system and the private sector. … Such public-private approaches also include partnerships with faith-based organizations that have long been a critical source of health care in low-income countries. … Developing the partnerships necessary to achieve UHC requires sustained engagement from political leaders who are willing to be creative, put new ways of working in practice, and listen to and respond to the needs of citizens…” (7/25).

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Adopting Inclusive Approach, Finding Common Ground Could Help Advance Sexual Reproductive Health, Rights, Achieve SDGs

The Lancet: Sexual and reproductive health and rights and population policies: from “either/or” to “both/and”
Carmen Barroso, member of the WHO Gender and Rights Technical Advisory Group, and Steven W. Sinding, director of the International Planned Parenthood Federation from 2002-2006

“…We identify population growth and sustainable development, people and the planet, and reproductive and sexual rights as the three most important issues facing the field today and propose responses. These three issues once seemed irreconcilable, but the application of comprehensive analysis and on-the-ground experience to ‘either/or’ dilemmas of global development have led, and can continue to lead, to the discovery of ‘both/and’ solutions. Sexual and reproductive health and rights (SRHR) remain at best a second-tier priority in the U.N. 2030 Agenda for Sustainable Development Goals (SDGs). We believe that the adoption of ‘both/and’ approaches will enhance the health and dignity of individuals and help to achieve most of the SDGs. … Lessons can be learnt from the past about how human rights, women’s rights, reproductive rights, and sexual rights evolved from somewhat separate issues into a powerful common agenda. … [T]he past successes in resolving differences and finding common ground offer important lessons for new and emerging leaders, if we are to make real progress in SRHR and achieving the SDGs. To overcome conservative resistance to SRHR, alliances with advocates of other SDGs need to be built. We believe that the lessons learned from these three central debates during the 20th century have laid the basis for what should be broad agreement in the 21st century on how to implement the global consensus of Agenda 2030” (7/20).

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From the Global Health Policy Community

Brookings Releases Commissioned Report Of 8 Briefs On U.S. Global Development In Preparation For 2020 Election Discussions

Brookings Institution: 2020 and beyond: Maintaining the bipartisan narrative on U.S. global development
“Over the past 15 years, a strong bipartisan consensus — especially in the U.S. Congress — has emerged to advance and support U.S. leadership on global development as a key pillar of U.S. foreign policy. 2020 presidential and congressional candidates are taking the field and looking for themes that will galvanize their campaigns in 2019. … The 16th Brookings Blum Roundtable will consider what narrative and practical proposals will not only maintain current levels of U.S. development leadership and investments, which have remained static in recent years, but respond appropriately to rising global challenges. Ahead of the roundtable, Brookings commissioned eight briefs to set the scene for discussion… 1. What does 2020 mean for foreign aid? … 2. A call for a transformative agenda for women for 2020 and beyond … 3. The global education challenge … 4. Generation Unlimited … 5. The climate crisis, migration, and refugees … 6. Implementing a fragility strategy … 7. International development cooperation in the age of U.S.-China strategic rivalry … 8. An open letter to the candidates…” (7/25).

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CFR Expert Discusses CoC Report Card On International Cooperation, Prospects For Global Health

Council on Foreign Relations: Apathy Continues to Plague Global Health
Terrence Mullan, assistant director for international institutions and global governance at the Council on Foreign Relations, discusses the Council of Councils (CoC) Report Card on International Cooperation, which evaluates efforts to address the world’s most pressing global challenges. Mullan provides a summary of the report card’s results for 2018, opportunities for 2019, and recommendations moving forward and writes, “For now, it appears that in a world awash in troubles, nothing less than catastrophe will spur policymakers to forceful action on global health. Unfortunately, with countless health crises already simmering, concerted action could come too late to prevent local crises from becoming global emergencies” (7/25).

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Sabin-Aspen Vaccine Science & Policy Group Release Report Calling For Urgent, Coordinated Effort To Develop Universal Influenza Vaccine

Aspen Institute: Sabin Vaccine Institute and The Aspen Institute Release Report Calling for Bold, New, and Coordinated Commitments to Making Universal Influenza Vaccines a Reality
“A new report released [Thursday] by the Sabin-Aspen Vaccine Science & Policy Group, a joint initiative of the Sabin Vaccine Institute and the Aspen Institute, calls for an urgent, coordinated effort to amplify and focus resources on the long-sought, but overdue achievement of a universal influenza vaccine (UIV). … Designed to close the critical gaps in the organization, funding, and infrastructure of vaccine science and development, the report includes three ‘big ideas’ to transform and accelerate the development of a UIV. Assessments of the current challenges and opportunities within the vaccine research and development ecosystem are detailed in the four background papers that frame the key findings of the report…” (7/25).

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WHO Calls On Countries To Scale-Up Investments To Eliminate Hepatitis

World Health Organization: WHO urges countries to invest in eliminating hepatitis
“Ahead of World Hepatitis Day (28 July), WHO calls on countries to take advantage of recent reductions in the costs of diagnosing and treating viral hepatitis and scale up investments in disease elimination. A new study by WHO, published today in Lancet Global Health, has found that investing US$6bn per year in eliminating hepatitis in 67 low- and middle-income countries would avert 4.5 million premature deaths by 2030, and more than 26 million deaths beyond that target date. … By investing in diagnostic tests and medicines for treating hepatitis B and C now, countries can save lives and reduce costs related to long-term care of cirrhosis and liver cancer that result from untreated hepatitis…” (7/26).

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From the U.S. Government

USAID Administrator Green, World Bank President Malpass Meet To Discuss DRC Ebola Outbreak

USAID: USAID Administrator Mark Green’s Meeting With World Bank President David Malpass
In a statement, USAID Spokesperson Tom Babington notes USAID Administrator Mark Green met with World Bank President David Malpass on July 25 “to discuss the outbreak of Ebola in the Democratic Republic of the Congo (DRC).” Babington continues, “Administrator Green and President Malpass also affirmed their shared commitment to ending this outbreak as soon as possible and discussed the World Bank’s role in responding to the crisis…” (7/25).

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USAID Announces 5-Year, $300M Award To Improve Prevention, Detection, Treatment Of TB In USAID Priority Countries

USAID: USAID Announces $300 Million Commitment in the Fight Against Tuberculosis
“The U.S. Agency for International Development (USAID) is pleased to announce a five-year, $300 million award, the TB Implementation Framework Agreement (TIFA), to improve the prevention, detection, and treatment of tuberculosis (TB). The lead partner in the cooperative agreement for the TIFA effort is John Snow, Inc., Research and Training Institute. A key component of the TB Accelerator initiative USAID Administrator Mark Green announced at the United Nations General Assembly (UNGA) High-Level Meeting (HLM) on TB in September of 2018, the TIFA will work to increase local ownership, financing, and accountability by creating partnerships with host-government entities in 24 USAID TB priority countries to empower them to implement locally generated, context-specific solutions…” (7/24).

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U.S. Government Provides Additional $4.7M To Zimbabwe For Cyclone Idai Recovery

U.S. Embassy in Zimbabwe: United States provides additional US$4.7 million in response to Cyclone Idai
“The United States Government has provided an additional US$4.7 million to assist thousands of Zimbabweans living in Chimanimani and Chipinge districts to recover and rebuild their lives following Cyclone Idai. With this additional funding, the United States Agency for International Development (USAID) will work with seven partners including CARE, Catholic Relief Services, the International Organization for Migration, International Rescue Committee, Mercy Corps, the United Nations Office for the Coordination of Humanitarian Affairs, and World Vision to provide affected families with access to clean water and hygiene supplies, shelter and settlement support, and agricultural early recovery services…” (7/25).

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World Hepatitis Day Calls For Increased Investments In Efforts To Eliminate Disease

CDC’s “Morbidity and Mortality Weekly Report”: World Hepatitis Day — July 28, 2019
This entry in the CDC’s MMWR discusses World Hepatitis Day, recognized annually on July 28. “The theme of this year’s World Hepatitis Day is ‘Invest in Eliminating Hepatitis,’ underscoring the need to increase commitment for hepatitis response. In 2015, an estimated 257 million persons were living with hepatitis B and 71 million with hepatitis C worldwide,” the article states (7/26).

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