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Kaiser Daily Global Health Policy Report

In The News

Independent Panel Criticizes WHO's Ebola Response, Calls For Changes

News outlets discuss a new report from the Ebola Interim Assessment Panel and the WHO’s response.

Christian Science Monitor: Report slams WHO for slow Ebola response
“A new report released by a panel of experts examined the World Health Organization’s response to the Ebola outbreak in West Africa and criticized the organization for letting political considerations sway its decision-making…” (Maza, 7/7).

CIDRAP News: WHO independent panel calls out Ebola response flaws
“An independent committee appointed to review how the World Health Organization (WHO) performed during West Africa’s Ebola outbreak found several management and cultural problems that slowed the response, but it also said flaws in the International Health Regulations (IHRs) posed tough obstacles…” (Schnirring, 7/7).

Devex: Panel pushes for WHO center for health emergencies
“The World Health Organization should establish a single, unified WHO Center for Health Emergency Preparedness and Response — but not with Director-General Margaret Chan at the helm. In its final report, launched Tuesday, July 7, the panel tasked to review WHO’s early response to the Ebola crisis asked the leadership of the U.N. health agency to establish an independent board to oversee the center, which it deemed needed ‘new organizational structures and procedures’…” (Ravelo, 7/7).

Frontline: Report: Ebola Outbreak Exposed ‘Organizational Failings’ at WHO
“…The report also called for a $100 million contingency fund that would allow the WHO to respond to health emergencies more quickly. The report supported the idea of increasing the WHO’s operational capacity to deal with health emergencies, instead of handing over the emergency response portion of a health crisis to another U.N. agency altogether…” (Boghani, 7/7).

International Business Times: Ebola Outbreak Not Over, World Health Organization Warns Amid Criticism That It Failed To Stop Deadly Epidemic
“The Ebola outbreak that sparked a global panic has for the most part receded from headlines, but the threat is far from over, the World Health Organization cautioned Tuesday. The outbreak, which began in West Africa in the spring of 2014, ‘continues to constitute a public health emergency of international concern,’ the organization said, a warning only heightened by the scathing conclusions, also released Tuesday, of a panel assessing the organization’s own response to the crisis as woefully inadequate…” (Whitman, 7/7).

Los Angeles Times: Changes urged at World Health Organization after bungled Ebola response
“…The WHO welcomed the panel’s findings. In a statement Tuesday, it said it was already moving forward on some of the recommendations, including the development of a global workforce that can be deployed in a health emergency and the establishment of a contingency fund to ensure that resources are available for the initial response. Others will be discussed at a meeting in August…” (Zavis, 7/7).

New York Times: Panel Calls WHO Unfit to Handle a Crisis Like Ebola
“…The report urged the agency’s regional and country representatives to be independent and ready to speak out against recalcitrant governments that do not take sufficient action on their own. And it faulted donor countries for stripping the agency’s funding, urging them to contribute immediately to a ‘contingency fund’ designed to respond to disease outbreaks…” (Sengupta, 7/7).

PBS NewsHour: WHO’s 21-step program to better tackle Ebola-level health crises
“…The same panel of health specialists released a preliminary report in May that said the world body was ‘slow’ in its response to the Ebola outbreak. The panel said in both reports that the WHO should continue to coordinate the international response to health emergencies because it would only complicate matters to put another entity in charge…” (Epatko, 7/7).

POLITICO: WHO gets failing grade for Ebola response
“…Experts urged major changes to the organization and its main governing framework, the 2005 International Health Regulations, including building a Center for Emergency Preparedness and Response, overseen by an independent board. It also called for an overhaul of the group’s contribution policy, suggesting a $100 million contingency fund filled by voluntary contributions…” (Kim, 7/7).

Reuters: Experts call for immediate WHO reform after Ebola exposes failings
“…The 2005 International Health Regulations were reviewed and changes recommended in 2011 after the 2009/2010 H1N1 flu pandemic, the panel said, but many countries have not acted on that review — a failure that made the Ebola response even worse. ‘Had the recommendations for revision made in 2011 by the Review Committee in relation to Pandemic (H1N1) 2009 been implemented, the global community would have been in a far better position to face the Ebola crisis,’ the report said…” (Kelland, 7/7).

ScienceInsider: Updated: Independent group pans WHO’s response to Ebola
“…The report also criticizes WHO for taking too long to coordinate the response to the outbreak and for failing to mobilize community leaders, particularly women, early on. It took too long to prioritize culturally sensitive messages to ensure support from the stricken populations, the report says…” (Kupferschmidt, 7/7).

U.N. News Centre: After missteps on Ebola, WHO must re-establish itself as ‘guardian of global public health’ — review panel
“…On WHO’s role and cooperation with the wider health and humanitarian systems, the panel concluded that during the Ebola crisis, the engagement of the wider humanitarian system came very late in the response. ‘The Panel was surprised that many donors, governments, the United Nations, and international non-governmental organizations understood only either the health emergency or the humanitarian system,’ it said…” (7/7).

Washington Post: Panel slams WHO Ebola response, calls for new center for health emergencies
“…The experts — led by Dame Barbara Stocking, president of a college in Britain and former chief executive of the charity Oxfam — called for the WHO to establish a new division with new staff and a new director that would coordinate emergency preparation, coordination, and response. That was one of the only bright spots in the report for the WHO…” (Cha, 7/7).

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Proposed SDGs Overly Ambitious With Too Many Goals, Targets, Critics Say

NPR: How To Eliminate Extreme Poverty In 169 Not-So-Easy Steps
“…But many of the people who work to end poverty fear the list [of Sustainable Development Goals’ targets] has gotten out of control. By prioritizing so many issues, do you risk prioritizing none? ‘You do risk a real dilution of focus and energy and resources,’ says Mark Suzman, who oversees global policy advocacy for the Bill & Melinda Gates Foundation. ‘The worst case scenario is we might actually see some regression in some key areas where we have had so much momentum’…” (Aizenman, 7/7).

Thomson Reuters Foundation: New U.N. development goals will drive nations ‘nuts’: Indian economist
“[Bibek Debroy, an] Indian economist and member of a key government panel which formulates policy on social issues slammed the United Nations’ new development goals on Tuesday, saying that having so many goals and targets would drive governments ‘nuts’…” (Bhalla, 7/7).

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Study Examines How To Effectively Implement HIV Prevention Tools In Real-World Settings

Nature: How to beat HIV
“…Here in Kenya’s Nyanza Province, which has the country’s highest rate of HIV infection, this community is part of a groundbreaking study designed to explain a troubling conundrum. Interventions to prevent HIV transmission that work in trial settings — such as rapid on-the-spot HIV tests coupled with effective treatments — often fail to make as much of a dent in the epidemic as they should. … The growing consensus, however, is that the tools needed to stamp out HIV already exist if they could just be used in the right way…” (Hayden, 7/7).

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U.N., Aid Agencies Express Concern Over Yemen's Deteriorating Humanitarian Situation

Agence France-Presse: Aden’s overwhelmed hospitals turn into hospices
“Overwhelmed by hundreds of sick and wounded each day, hospitals in Yemen’s second city Aden have been reduced to hospices lacking medicines and space as the country’s bloodshed rages on…” (Al-Haidari, 7/7).

Thomson Reuters Foundation: ‘Real risk’ of famine in Yemen as death toll passes 3,000
“Conflict-ridden Yemen, where more than 3,000 people have been killed and one million displaced since war broke out in March, is at risk of famine, aid chiefs said on Tuesday, the day after the conflict’s highest one-day death toll was recorded. The situation is ‘clearly deteriorating by the day,’ said Antoine Grand, head of the International Committee of the Red Cross (ICRC) in Yemen, with food shortages making famine a ‘real risk,’ and electricity and fuel increasingly scarce…” (D’Urso, 7/7).

U.N. News Centre: Yemen: amid ‘massive’ humanitarian crisis, U.N. reports civilian death toll now exceeds 1,500
“The United Nations human rights office is among several key U.N. entities voicing deep concern over the worsening human rights and humanitarian situation in Yemen that has more than 1,500 civilians dead, 3,600 injured, and one million displaced in three months of violence…” (7/7).

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Advocates Urge Sierra Leone To Ban FGM After Nation Ratifies International Women's Rights Treaty

Thomson Reuters Foundation: Sierra Leone urged to ban FGM after backing women’s rights treaty
“Sierra Leone’s decision to back an international treaty on the rights of women in Africa could lead to a new law banning female genital mutilation (FGM) in a country where the practice is rife, campaigners said on Tuesday. The Ebola-hit country last week became one of the last West African nations to ratify the Maputo Protocol, which addresses a range of issues including FGM, violence against women, child and forced marriage, and women’s economic empowerment…” (Guilbert, 7/8).

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Drought In North Korea Threatens WASH Access, Children's Health, UNICEF Says

Reuters: Drought puts N.Korean children’s lives at risk — UNICEF
“A severe drought in North Korea is putting the lives of children at risk and many are in serious danger of disease and malnutrition, the U.N. children’s agency said on Wednesday. UNICEF said in a statement that there had been a sharp increase in cases of diarrhea among children in drought-affected areas, as access to safe drinking water and sanitation was severely compromised…” (Kim, 7/8).

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Malnutrition, Stunting Could Worsen Among Nepal's Children Following 2 Earthquakes

Thomson Reuters Foundation: Quake-hit Nepal gears up to tackle stunting in children
“…A 2011 government study showed that more than 40 percent of Nepal’s under-five-year-olds were stunted, showing that the country’s child malnutrition rate was one of the world’s highest. Experts say the two quakes, which killed 8,895 people and destroyed half a million houses, could make things worse as survivors have inadequate food, water, shelter, health care, and sanitation…” (Sharma, 7/7).

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South Sudan Cholera Death Toll Reaches 32; Educating Children Could Stem Outbreak, UNICEF Representative Says

Thomson Reuters Foundation: Cholera kills 32 in South Sudan, education key to stemming outbreak — U.N.
“A cholera outbreak in war-torn South Sudan has killed at least 32 people, a fifth of them children under five, and schools have a major role to play in stemming the spread of the disease, the United Nations said on Tuesday. … ‘One of the most powerful ways we can respond to this outbreak is by equipping schoolchildren with the information and tools they need to protect themselves and their families,’ [Jonathan Veitch, UNICEF representative in South Sudan, said]…” (Guilbert, 7/7).

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Eliminating Cholera In Haiti Continues To Prove Challenging

Mosaic Science: Why can’t we stop cholera in Haiti?
“…Cholera, it is often said, is a symptom of poverty. Cholera loves chaos. Haiti, home to both chaos and poverty, is a place where cholera thrives. … In the National Plan to Eliminate Cholera, the country’s sanitation is described as ‘practically non-existent’…” (George, 7/7).

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Editorials and Opinions

Opinion Pieces Discuss Various Aspects Of SDG Adoption, Implementation, Funding

Devex: With sights set firmly on SDGs, let’s push for wider adoption of best practices
Albina du Boisrouvray, founder and president emerita of FXB

“…Wider knowledge sharing in the humanitarian community is a must, if we want to speed up the process of lifting millions of people from extreme poverty. There is no time to waste in helping large organizations do a better job of learning from smaller, more nimble NGOs. Yet large government programs continue to function in a clustered fashion. The result is that the biggest sums of money available to fight poverty are sometimes spent the least effectively. The good news is we may have reached the ‘tipping point’ in the fight against poverty. … With our sights set firmly on the targets of the sustainable development goals, let’s get to work pushing for the faster, wider adoption of the best practices developed by NGOs. If we succeed, we stand a real chance of tipping the scales in the fight against extreme poverty around the globe” (7/7).

The Guardian: New development goals need to be ambitious, actionable, and accountable
Jonathan Glennie, director of policy and research at Save the Children

“…I am broadly an SDG fan, because I hope it will do something similar [to the broad vision of the Universal Declaration of Human Rights]. Having said that, there is no doubt that it is actions that matter, not just words. We need to set the SDG negotiators, and the governments they work for, a ‘triple A challenge’: the SDG agenda needs to be ambitious, actionable, and accountable. Ambition will not be a problem. It is the other two As we need to work on. … The SDG agenda is … visionary and inspiring. As the long process of drawing up the next set of global goals reaches its final straight, its ambition is assured. It is time to turn our attention to action and accountability in the hope of giving the whole process a triple A rating” (7/8).

Inter Press Service: Opinion: SDGs, FfD and Every Single Dollar in the World
Paul Ladd, UNDP director for the post-2015 team, and Pedro Conceicao, UNDP chief of profession of strategic policy

“…One of the most-asked questions is: How much will it cost us to achieve the Sustainable Development Goals (SDGs)? … So the answer to the question ‘How much money will it take to achieve the new SDGs?’ is … drum-roll … every single dollar in the world. … For instance, advancing gender equality would directly advance the SDGs and generate economic benefits. … Donors should indeed meet their 0.7 percent commitments and make much faster progress on their commitments on improving how aid is done. … [I]f the [Financing for Development (FfD) Conference] in Addis Ababa, scheduled to take place next week, only focuses on mobilizing more money and doesn’t do something about improving how that money is spent, then we will have missed the point, and will certainly miss the grand targets we have set for ourselves. This is why every dollar counts” (7/7).

Nature: Policy: Development goals should enable decision-making
Keith Shepherd, leader of the science domain on land health decisions at the World Agroforestry Centre, and co-authors

“…Target-setting is trendy among aid and development organizations as well as in multilateral agreements for accountability, impact and value for money. We contend that target-setting is flawed, costly and could have little — or even negative — impact. … We advocate a different approach. Governments and the development community need to embrace decision-analysis concepts and tools that have been used for decades in mining, oil, cybersecurity, insurance, environmental policy and drug development. Our call to adopt this approach is based on five principles. Replace targets with measures of investment return. … Model intervention decisions. … Integrate expert knowledge. … Include uncertainty in predictive models. … Measure the most informative variables. … We call on the delegates of the Financing for Development conference in Addis Ababa to establish a task force to explore our approach…” (7/8).

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Next U.N. Secretary General Should Be Qualified Woman Who Can Lead On Food Security

Huffington Post: The Next U.N. Secretary General: An Experienced Woman to Foster Global Food Security
Dan Glickman, former congressman and secretary of agriculture

“…The future of [the U.N.’s Zero Hunger Challenge], and of humanitarian responses to food-related crises generally, should be on world leaders’ minds in choosing a new U.N. secretary general to replace Ban Ki-moon when he steps down at the end of next year. It is imperative that someone with a strong commitment to the U.N.’s focus on development and food security, as well as an established track record of leadership in this field, be selected. In my judgment it would also be a big step forward if they chose a woman. … [T]he time is ripe for a woman possessing the credentials, leadership, and management skills to head the United Nations and ensure that food security remains a top priority for the U.N. and the international community…” (7/7).

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Increased Spending Necessary To End AIDS Epidemic

Nature: The HIV epidemic can be stopped
Editorial Board

“As scientists prepare to meet in Vancouver, Canada, for the annual meeting of the International AIDS Society (IAS) on 19-22 July, many argue that the end of the AIDS epidemic could be in sight. A mass of convincing data, they say, shows that the universal roll-out of antiretroviral treatment provides a means to stop HIV — but only if the world acts fast. … Getting there will take a massive financial investment — as much as US$36 billion annually, compared with current investment of $19 billion per year. That represents as much as 2.1 percent of the gross domestic product of some affected nations. Coaxing forth that level of investment in an age of austerity will be difficult. But, by modelling the economic gains of people remaining healthy and productive members of society, [a UNAIDS-Lancet] commission estimates that countries with large HIV burdens will benefit from their increased spending…” (7/7).

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Higher Tobacco Taxes Should Be More Widely Implemented

Project Syndicate: Taxing Tobacco
Oleg Chestnov, assistant director general of the WHO noncommunicable diseases and mental health program, and Tim Evans, senior director of health, nutrition, and population global practice at the World Bank Group

“…According to the latest WHO Report on the Global Tobacco Epidemic, levying taxes on tobacco is one of the cheapest and most effective measures to prevent death and suffering. Unfortunately, it is a tool that few countries are using. … According to a WHO report, only 33 countries levy sufficiently high taxes on tobacco, amounting to at least 75 percent of the retail price of cigarettes. This means that only one in 10 people worldwide benefits from this measure. … Governments have made tremendous progress in the fight against the tobacco epidemic … but many could be doing much more if they were willing to raise taxes on tobacco. Our organizations, the WHO and the World Bank Group, believe that it is a moral and economic imperative to support every possible measure of tobacco control. Taxes on tobacco — the least expensive, least implemented, and most effective tool in the fight to reduce the use of this deadly product — should not be left unimplemented…” (7/7).

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Fresh Food Supply Chains Can Learn From Recent Vaccine Supply Chain Innovations

The Guardian: Why transporting vegetables is not so different from delivering vaccines
Bruce Y. Lee, director of the Global Obesity Prevention Center at Johns Hopkins

“…Until agricultural supply chains for low-income countries are improved, fresh fruits and vegetables may have little chance against their hardier and less healthy [processed food] competitors. So what can be done to help transport fruit and vegetables around the world? Until the past few years, vaccines have faced a similar problem. … These realizations led to much greater focus on — and more resources being committed to — evaluating and improving vaccine supply chains. … The advancement of vaccines has taught us that creating a smooth path is crucial in delivering a healthy product — especially within the developing world. Fresh fruit and vegetables currently face a much more difficult path and have many more requirements than highly processed foods. But better understanding and facilitating this could well play a major role in improving health and wellbeing across the world” (7/8).

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Climate Change, Taboos Surrounding Food Contribute To Malnutrition In Mali

POLITICO Magazine: Eat Not This Fish
Anna Badkhen, author

“…What we choose to include in our diet and what we disallow describes a story, a history. Like the Fulani catfish ban, food taboos can be maps tracing our very specific connections to the Pleistocene forefathers on the African savannah, ritual expressions of our cultural identities. … Food taboos are also borders meant to keep things away — poor health, evil eye, outsiders, loneliness. Malnutrition, on the other hand, is a void, an opening. It weakens the body, invites illness, death. But what happens when an ancient rite meets a new, modern problem: a rapidly drying continent? In an analysis it published this winter, the USAID Office of Food for Peace cites ‘lack of knowledge of proper nutrition’ and ‘taboos in some ethnic groups that discourage the consumption of eggs or meat’ as major causes of malnutrition in Mali. … In [Malian pastoralist Oumarou Diakayaté’s] mind, by refusing catfish he preserves the integrity of his milking hands, the future of his family: Like any diet, a food taboo is a mechanism of control. But, of course, he preserves nothing…” (7/7).

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From the Global Health Policy Community

Health Aid Disbursement Generally Cost-Effective But Not Always Optimal, Study Shows

Health Affairs: Health Aid Is Allocated Efficiently, But Not Optimally: Insights From A Review Of Cost-Effectiveness Studies
Eran Bendavid, assistant professor in the Department of Medicine at Stanford University, and colleagues “reviewed the literature for cost-effectiveness of interventions targeting five disease categories: HIV; malaria; tuberculosis; noncommunicable diseases; and maternal, newborn, and child health. We measured the alignment between health aid and cost-effectiveness, and we examined the possibility of better alignment by simulating health aid reallocation. … We conclude that health aid is generally aligned with cost-effectiveness considerations, but in some countries this alignment could be improved” (July 2015).

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Tobacco Taxation Can Reduce Smoking, Raise Public Revenues But Remains Underutilized Public Health Tool

Bill & Melinda Gates Foundation’s “Impatient Optimists”: Tobacco Tax: A Win-win Measure for Public Health
Jean Paullin, program officer for the tobacco initiative at the Gates Foundation, and Amy Jerrett, associate program officer with the program advocacy and communications team at the foundation, discuss the WHO’s recently released “Report on the Global Tobacco Epidemic-2015, which highlights the important work in countries around the world to implement tobacco control policy,” and they highlight tobacco taxation as an underutilized prevention tool that can reduce smoking and raise public revenues (7/7).

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ONE White Paper Examines Accountability Lessons From Ebola Epidemic

ONE Blog: When losing track means losing lives: A new analysis by ONE about the Ebola crisis
Erin Hohlfelder, ONE’s policy director for global health, describes the organization’s new white paper, When Losing Track Means Losing Lives: Accountability Lessons From The Ebola Crisis. She writes the report is “our attempt to summarize what we learned from creating and updating our own Ebola tracker, as well as what we learned from other partners’ tracking efforts. We’re publishing it this week because world leaders are meeting at the United Nations on July 9th and 10th to discuss long-term recovery efforts from Ebola, and we think improving transparency and accountability are essential parts of their long-term thinking…” (7/7).

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Policymakers Need Better Data On CHWs To Show Their Value

IntraHealth International’s “Vital”: Why We Need Data on Frontline Health Workers
In an interview, Kate Tulenko, vice president of health systems innovation at IntraHealth International, says, “Better data on [community health workers (CHWs)] would help demonstrate their impact and cost-effectiveness, especially in medically underserved communities. There are still many policymakers who are skeptical of the value of CHWs. If we can demonstrate their value, we can get CHWs added as a formal member of the health team, with proper support supervision, a career ladder, and a salary…” (7/7).

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