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Kaiser Daily Global Health Policy Report

In The News

U.K. International Development Secretary Encourages WHO To Declare DRC Ebola Outbreak As Public Health Emergency; Some Aid Groups Call For 'Reset' In Response

Devex: Ebola responders call for a ‘reset’ in the response. What does that mean?
“Nearly one year after an Ebola outbreak was declared in the Democratic Republic of Congo, more than 1,600 people have died and the disease has spread to a case across the border in Uganda. Aid agencies are increasingly calling for a ‘reset’ in the response. … What exactly needs to change? Different organizations involved in the response point to some common issues that need to be resolved: better coordination, clarification of roles, and concretization of community engagement. Some also called for more dialogue, among responders…” (Ravelo, 7/8).

The Guardian: Declare Ebola outbreak in DRC an emergency, says U.K.’s Rory Stewart
“The year-long Ebola outbreak in the Democratic Republic of the Congo is on the edge of spiraling out of control and the World Health Organization should declare it an international emergency, Rory Stewart, the U.K.’s international development secretary, has said. Stewart is on a two-day visit to the DRC visiting emergency health centers and victims of the disease to assess the issues hampering efforts to bring the epidemic under permanent control. … The WHO has refused three times to declare the outbreak a global health emergency, largely for technical reasons. Stewart said: ‘I would politely, bearing in mind I have no formal locus in this, encourage them to declare this is a global health emergency, and partly because it will make it easier to raise the extra cash’…” (Wintour, 7/7).

New Humanitarian: Hunger, measles, cholera, and conflict: Ebola not the only killer ravaging Congo
“As the Democratic Republic of Congo grapples with the second deadliest Ebola outbreak in history, aid groups say a host of other emergencies — from renewed conflict and mass displacement to health epidemics like measles and cholera — are being neglected despite mounting humanitarian needs. On 19 June, the World Health Organization issued an appeal to international donors to assist with a $54 million funding shortfall in the Ebola response, but aid workers have told the New Humanitarian that the funding picture for the other emergencies is just as — if not more — bleak…” (Acland, 7/3).

Additional coverage of the Ebola outbreak and response in DRC, as well as preventive measures being taken in neighboring countries, is available from CBC News, CBS News, CIDRAP News, The Lancet, PRI, Reuters, VOA News (2), and Xinhua News (2).

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Devex Examines USAID's New Private Sector Engagement Policy

Devex: USAID’s private sector engagement policy takes shape
“The U.S. Agency for International Development launched a new private sector engagement policy late last year, and since then the agency has been staffing up and drafting plans as it works to implement greater engagement with companies across its geographies and sectors. There hasn’t been a big push to create new partnerships — though there have been a few announcements. Much of the work in recent months has been on changing USAID’s systems, operations, and culture in line with the policy, said Sarah Glass, acting director of USAID’s Center for Transformational Partnerships…” (Saldinger, 7/4).

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FDA Advisory Panel Split On Recommending New TB Treatment For Approval

Devex: Will a new TB treatment be available soon?
“Experts advising the U.S. Food and Drug Administration on marketed and investigational drugs for infectious diseases and disorders were divided on whether the regulatory agency should approve a new drug as part of a proposed combination therapy for highly resistant tuberculosis. The majority of the independent experts — 14 out of 18 — advising the regulatory agency voted favorably last month. But the remaining four found insufficient evidence on efficacy and safety of the TB Alliance’s oral anti-TB drug pretomanid when used in combination with bedaquiline and linezolid, or BPaL. … If the U.S. FDA approves the drug, the TB Alliance and its pharmaceutical partner, Mylan, will have permission to market the drug in the U.S…” (Ravelo, 7/5).

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Estimated Number Of People Living With Latent Multidrug-Resistant TB Threatens Elimination Goals, Study Warns

The Telegraph: ‘Worryingly high’ number of people infected with latent form of drug-resistant TB
“More than 19 million people around the globe are infected with one of the most complex forms of dormant tuberculosis, threatening efforts to control the fatal disease, researchers have warned. In the first study to estimate the number of people living with latent multi-drug resistant tuberculosis (MDR-TB), published in Lancet Infectious Diseases, experts found that three people in every 1,000 carry the hard-to-treat bacteria — a ‘worryingly high’ figure that ‘threatens elimination goals’…” (Newey, 7/4).

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G7 Development Ministers Do Not Include Spending, Outcome Targets For Sahel Region's Health, Education In Summit Communiqué

Devex: G7 development ministers resist setting targets for Sahel
“A meeting of G7 development ministers and their counterparts from north-central Africa has stopped short of setting targets for health and education spending and outcomes in the Sahel, prompting NGOs to decry a lack of commitment weeks out from the G7 leaders’ summit in Biarritz, France. … The French government, which is hosting this year’s G7 summit from August 24-26, had not responded to a request for comment at the time of publication. However, a French official, who requested anonymity, said it is for the [World Bank’s International Development Association (IDA)] board of governors, not G7 members, to set spending targets…” (Chadwick, 7/5).

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Chinese Researchers Using Mass Drug Administration In Kenya In Attempt To Eliminate Malaria

The Atlantic: China Is Leading the Next Step in Fighting Malaria in Africa
“…As Western donors garner headlines for funding expensive, experimental malaria interventions, Chinese researchers are undertaking a far more tested approach. Called mass drug administration, or MDA, it involves giving antimalarial pills to every man, woman, and child in a given area all at once. Rather than kill off the world’s mosquitoes, which spread the disease by drawing blood from infected people, the thinking goes, why not simply wipe out malaria among humans? If successful, the effort would ease the disease’s burden on Kenya’s health system and economy…” (Kushner, 7/4).

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More Suspected Cholera Cases Reported In Yemen So Far In 2019 Than All Of Last Year, Save The Children Warns

The Independent: Yemen cholera outbreak hits over 200,000 children in 2019, charities warn
“Hundreds of thousands of children have been infected with suspected cholera in Yemen in the first six months of 2019 and the death toll is set to soar as the rainy season begins, aid groups warn. There have been 440,000 suspected cholera cases reported in the civil war hit nation in 2019, already eclipsing the total of the previous year, the charity Save the Children said…” (Matthews-King, 7/7).

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More News In Global Health

Devex: It’s the end of ‘easy solutions’ in global health, Peter Piot says (Cheney, 7/8).

Devex: Q&A: Bringing women’s rights into the finance discussion (Donback, 7/8).

Devex: In quest for UHC, Kenya faces pharmacy regulation battles (Langat, 7/5).

The Economist: Attack of the superbugs: July 2041 (7/6).

The Economist: Armed with smartphones, Colombians are taking on the local mozzies (7/4).

The Economist: Pakistan is trying new tactics to eliminate polio (7/4).

The Guardian: How Ifrah Ahmed, the girl from Mogadishu, took her FGM story to the world (Ferguson, 7/7).

Health Policy Watch: “Delinkage” Of Medicines R&D From Patent Incentives Stirs Debate at Human Rights Council (Fletcher, 7/4).

Health Policy Watch: Dr. Tedros Calls For Investment In Nurses, Highlights WHA 2020 Focus On Nurses & Midwives (Branigan, 7/2).

NPR: Good News About Democracy: It’s Good For Your Health (Lamber, 7/4).

PRI: Burkina Faso is fighting malaria — with genetically modified mosquitoes (7/4).

Reuters: Botswana seeks to overturn ruling that legalized gay sex (Benza, 7/6).

STAT: Glaxo’s ViiV Healthcare tussles with Kazakhstan over an AIDS drug (Silverman, 7/5).

The Telegraph: Rabies fear stalks Pakistan as hospitals run short of lifesaving vaccine (Farmer, 7/4).

The Telegraph: More than 700 children confirmed HIV positive in Pakistan disease outbreak (Farmer, 7/4).

Xinhua News: Fighting in E. Ukraine threatens safe water supply for millions of people: UNICEF (7/4).

Xinhua News: Spotlight: Tobacco-related illnesses kill 15,000 in Cambodia per year: U.N.-led study (Sovan, 7/4).

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Editorials and Opinions

U.S. Should Prioritize WASH Efforts To Respond To DRC's Ebola Outbreak

Fox News: Bill Frist: Lessons not learned in Congo’s Ebola outbreak
Bill H. Frist, former U.S. Senate majority leader and chair of the executive board of Cressey & Company

“…Preventing and containing disease outbreaks — and delivering adequate health care — is impossible with no clean water, no soap, and no toilets. … While there is no doubt that the [Democratic Republic of the Congo’s (DRC)] Ebola outbreak has grown increasingly complex, the global health community must focus attention on not just the immediate problem, but the foundational weaknesses that cripple the prevention and containment of a range of potential pandemic diseases … [I]mproved hygiene is the most powerful and cost-effective way to prevent and contain illnesses, protect vulnerable newborns and the immune-suppressed, prevent person-to-person transmission, avoid antibiotic resistance, and stop global pandemics. … From health security to economic security, it’s in our nation’s best interest to elevate this issue and augment these efforts. … The U.S. Agency for International Development must continue to elevate the fundamental importance of WASH in its overall work (in accordance with the 2017 Global Water Strategy) and adopt an agency-wide policy that WASH be made available in every health care facility in which the agency is active. … The Centers for Disease Control and Prevention must ensure that WASH in health care facilities is integrated into its existing programs related to pandemic disease preparation, prevention, and control. … [The outbreak in the DRC] should be a harsh reminder that pandemics know no borders and investing in prevention is the best cure” (7/6).

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When Mexico City Policy In Place, Abortion Rates Increase In Sub-Saharan Africa, Study Authors Write

CNN: The unintended consequences of U.S. global abortion policy
Nina Brooks, PhD candidate in environment and resources at Stanford University; Eran Bendavid, associate professor of medicine at Stanford University; and Grant Miller, associate professor of medicine at Stanford University, director of the Stanford King Center on Global Development, and non-resident fellow at the Center for Global Development

“…Our findings published in the Lancet Global Health … suggest that a major U.S. global abortion policy [– the Mexico City policy –] has striking, important, and unintended consequences in sub-Saharan Africa. … What we find is a stark, quantitative pattern that shows when the policy is in place, contraceptive use decreases by 13.5%, pregnancies increase by 12%, and importantly, abortions increase by 40% in countries most reliant on U.S. funding compared to when the policy is inactive. … While it may at first seem surprising that the Mexico City policy increases abortions, this pattern of results makes sense. Because many of [the affected] organizations are important providers of contraceptives and family planning across Africa, when the policy is active, the supply of these services falls — and the rest of what we find then flows from this: less contraceptive use, more pregnancies, and more abortion. Given that many abortions are performed under unsafe circumstances, our analysis likely underestimates the full harm of the policy. … Regardless of one’s political leaning or values, an increase in abortion seems to be an unintended consequence of the Mexico City policy. There may be little agreement on alternatives to the policy, but not increasing abortion on a large scale, even unwittingly, could potentially be a common goal. And the data shows that the Mexico City policy does not achieve that” (7/3).

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Trump Administration's Nominee For U.S. Representative To U.N. In Geneva Controversial Because Of Views On Abortion

The Guardian: Trump’s pick for U.S. representative to the U.N. is a dangerous anti-abortion fanatic
Bergen Cooper, director of policy research, and Beirne Roose-Snyder, director for public policy, both at the Center for Health and Gender Equity

“During a fiery hearing with the Senate Foreign Relations Committee last month, Andrew Bremberg, President Trump’s controversial nominee for U.S. representative to the United Nations office in Geneva, declared that victims of rape and sexual violence should not be allowed to terminate their pregnancies. Bremberg pledged that, if confirmed, he would vote against any U.N. resolution outlining fundamental rights for survivors of sexual violence if they include abortion. Bremberg also took credit for driving the Trump administration’s massive expansion of the global gag rule, or ‘Mexico City policy’ … To be clear, Bremberg is taking credit for cutting off access to life-saving HIV prevention, treatment, and care; cervical cancer screening; voluntary male medical circumcision; and gender-based violence screening. … Unlike previous iterations, Trump’s global gag rule targets nearly all global health assistance funds, and has already cut funding [to certain foreign NGOs that did not certify the Mexico City policy] for programs targeting issues such as HIV/AIDS, maternal and child health, malaria, tuberculosis, family planning and reproductive health, nutrition, non-communicable diseases, water, sanitation and hygiene at the household and community levels, and the Zika virus. … Given all that we know about Trump’s contributions to the global gag rule, it’s clear that matters will only get worse with Andrew Bremberg in charge…” (7/5).

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G20 Summit Was 'Disappointing' On Global Health Commitments

The Lancet: G20 Osaka: when will global health commitments be realized?
Editorial Board

“The Group of 20 (G20) Summit took place on June 28 and 29 in Osaka, Japan, amid escalating tensions over trade, climate change, and even the value of liberalism. With the dominant focus on the economy and global trade, … health discussions failed to make the mainstream media headlines. Indeed, progression on health was disappointing. … On health, the G20 Osaka Summit recognized that ‘global health … is essential as a basis for sustainable growth of the global economy,’ and noted ‘the importance of sustainable health financing towards UHC.’ However, the first Joint Session of the G20 Finance and Health Ministers as part of the G20 Osaka Summit was also a disappointment, with no formal outcome document, and with health ministers simply capitulating to the constraints set by finance ministers. … In the words of Dr. Tedros, WHO’s director general, who was invited to G20 Osaka: ‘Health is a political choice. As @g20org leaders, you have a unique opportunity to make that choice for a better world.’ The G20 Osaka Summit could best be described as building momentum on past global health commitments. The Health Ministers’ Meeting on Oct 19-20, 2019, in Okayama and the G20 Summit in Saudi Arabia are the next milestones. Progress on the Declaration commitments must now be demonstrated” (7/6).

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From the Global Health Policy Community

DRC Rolls Out Phase 2 Of Largest-Ever Oral Vaccination Campaign Against Cholera

World Health Organization: More than a million people to be vaccinated in phase 2 of a huge cholera vaccination campaign in the Democratic Republic of the Congo
“Phase 2 of the biggest ever oral vaccination campaign against cholera is scheduled to take place from 3-8 July 2019 in 15 health districts in the four central provinces of the Democratic Republic of the Congo (DRC) — Kasaï, Kasaï Oriental, Lomami, [and] Sankuru. … ‘This cholera vaccination campaign marks the intensification of our response in the DRC,’ said Dr. Matshidiso Moeti, WHO regional director for Africa. ‘WHO and our partners are working with national authorities to rollout the vaccine, which comes in addition to multiple interventions introduced since the beginning of the cholera epidemic, including sanitation and water quality control in the affected areas, many of which have little access to a safe water supply.’…” (7/3).

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Food, Agriculture Must Play Vital Role In Reaching SDGs, FAO Director General Says

Food and Agriculture Organization of the U.N.: Food and agriculture must play a vital part in reaching a sustainable future
“There is a growing realization that food and agriculture must play a vital part in reaching the Sustainable Development Goals and that in this context, FAO provides a neutral forum to address global issues of transboundary dimensions, the U.N. agency’s director general, José Graziano da Silva, said … He made the remarks to representatives of member states at the closing of the 41st session of the FAO Conference…” (6/28).

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From the U.S. Government

CDC GHSA Côte d'Ivoire Program Director Discusses Country's First Joint External Evaluation To Assess Health Security

CDC’s “Our Global Voices”: The Joint External Evaluation (JEE) Process: Assessing health security in Côte d’Ivoire
Serigne Ndiaye, CDC’s Global Health Security Agenda (GHSA) program director for Côte d’Ivoire, discusses the country’s first joint external evaluation (JEE) to develop a plan to strengthen the country’s capacity to prevent, detect, and respond to public health threats, writing, “Côte d’Ivoire used recommendations from the JEE to drive decisions and actions that can help shape our work around health security, especially in surveillance, laboratory, emergency response, and workforce development” (7/5).

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USAID Releases Resource Describing History Of Agency's Involvement With Nutrition

USAID: Nourishing Lives and Building the Future: The History of Nutrition at USAID
“For more than 50 years, USAID has worked to address the devastating effects of malnutrition, continually learning and adapting our response to ever-evolving nutrition needs and understanding. This resource describes the agency’s investments and contributions to global progress to improve nutrition, achieved through close collaboration with implementing partners, host countries, civil society, the private sector, researchers, and other key stakeholders…” (7/26).

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