KFF Daily Global Health Policy Report

In The News

Lawmakers Continue Debate Over U.S. Food Aid Policy

“Lawmakers attempted Wednesday to push along an ongoing effort to modernize U.S. international food aid policy amid mounting bipartisan support for the use of more locally grown food products over the long-standing practice of shipping U.S.-grown commodities,” Inter Press Service reports. “The Food Aid Reform Act, introduced by House Foreign Affairs Chairman Representative Ed Royce [R-Calif.] and Africa Subcommittee Ranking Member Representative Karen Bass [D-Calif.], would eliminate previous requirements that food assistance be grown in the United States and transported on U.S.-flagged ships,” the news service notes, adding, “According to Royce, who spoke Wednesday in a conference of the House Committee on Foreign Affairs, 50 percent of the U.S. food aid budget is currently spent on shipping costs.” IPS continues, “Throughout Wednesday’s congressional discussions, experts highlighted the consequences of this food chain, particularly in war zones or emergency situations” (Hargis, 6/12).

“The hearing today with [former U.S. Secretary of Agriculture Dan Glickman] and [former USAID Administrator Andrew Natsios] obviously builds support with their endorsement of the initiative,” Royce said after the hearing, adding, “We will take some of the suggestions [by the witnesses], incorporate them [into the bill] and that would be an underlying vehicle potentially for achieving reforms,” according to The Hill’s “Global Affairs” blog (Pecquet, 6/12). Natsios “argued before the committee that the current program must be made more flexible,” Talk Radio News Service notes (Dingbaum, 6/12). “Currently, the Food Aid Reform Act is a separate bill, but many observers assume that it will probably be tied into the House Farm Bill eventually,” Inter Press Service writes. In related news, the Senate on Monday “overwhelmingly passed a massive, five-year bill that covers much of U.S. agriculture and food-related policy and known as the Farm Bill,” the news service notes (6/12). “The bill, which finances programs as diverse as crop insurance for farmers, food assistance for low-income families and foreign food aid, passed with overwhelming bipartisan support, 66 to 27,” the New York Times writes. The bill “left in place the decades-old international food aid program,” but “increased spending for buying food abroad to $60 million from $40 million,” the newspaper notes (Nixon, 6/10).

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WTO's TRIPS Council Grants Extension To World's Poorest Nations

“The globe’s poorest nations have won an eight-year extension of a waiver on intellectual property rules, but still need to hold talks on the vexed issue of pharmaceutical patents, World Trade Organization [WTO] officials said Tuesday,” Agence France-Presse/GlobalPost reports. “A session of the 159-nation WTO’s TRIPS Council — standing for trade-related aspects of intellectual property rights — ruled that the waiver for 34 countries can now run until July 1, 2021,” the news service writes, noting, “The TRIPS agreement, in force since 1995, requires WTO member states to legislate and enforce minimum standards for the protection of intellectual property in order to boost confidence in global commerce” (6/11).

“The extension of the agreement giving the world’s least developed countries exemption from implementing the full standards of patent protection observed by wealthy countries means impoverished countries will, for the time being, preserve access to generic antiretroviral drugs essential to fighting HIV effectively in some of the hardest-hit countries,” the Center for Global Health Policy’s “Science Speaks” blog states (Barton, 6/11). “The decision comes as WTO members continue to work feverishly toward concluding a set of deliverables in time for their upcoming ministerial conference at year’s end in Bali, Indonesia,” according to an article in the International Centre for Trade and Sustainable Development’s “Bridges Weekly Trade News Digest,” which adds, “While many have warned in recent months that preparations for Bali are not moving at the necessary pace, the success of this extension effort has been welcomed by some as a sign that members can still negotiate constructively” (6/13).

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Daily Antiretroviral Dose Reduces Risk Of HIV Infection Among IDUs, Study Shows

“A daily dose of powerful anti-HIV medicine helped cut the risk of infection with the AIDS virus by 49 percent in intravenous drug users [IDUs] in a Bangkok study that showed for the first time such a preventive step can work in this high-risk population,” Reuters reports (Steenhuysen, 6/13). “Earlier clinical trials showed that the therapy can sharply reduce the risk of HIV transmission from mother to child, and in gay and bisexual men and heterosexuals,” the New York Times writes (McNeil, 6/12). “The research by the CDC and the Thailand government was published online Wednesday by the journal Lancet,” the Associated Press notes, adding, “Based on the findings, the CDC recommended that doctors consider prescribing [the antiretroviral] tenofovir to those who inject drugs” (Stobbe, 6/12).

The researchers “recruited 2,411 volunteers who were attending drug-treatment clinics in Bangkok,” according to Agence France-Presse. At the end of four years, an “average reduction in infection risk of 48.9 percent [was seen] among tenofovir takers. But it rose to more than 70 percent among those who adhered most closely to the daily pill-taking,” AFP writes, noting, “The probe found no evidence of viral resistance nor of any serious side effects from taking tenofovir” (6/12). “Previous studies have shown [the prevention method, called pre-exposure prophylaxis, or PrEP,] can help reduce the risk of HIV infection by 44 percent in gay and bisexual men, and by as much as 75 percent in heterosexual couples in which one member is infected,” Bloomberg Businessweek adds (Bennett, 6/12). According to Jonathan Mermin, director of the CDC’s Division of HIV/AIDS Prevention, “[q]uestions to be addressed include how willing uninfected people would be to take a daily pill outside the confines of a clinical trial, how the cost would be covered and where they should get it — a primary-care clinic, a clinic specializing in HIV treatment or another setting,” the Wall Street Journal writes (McKay, 6/12).

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British PM Cameron Lists Major Issues To Be Addressed At G8 Summit

Noting “Britain is hosting this year’s G8 summit, which gets underway next week (June 17-18) in Northern Ireland,” VOA News reports, “Prime Minister David Cameron has listed the major issues he wants leaders to tackle when they gather at the Lough Erne resort.” The news service notes G8 Research Center Director John Kirton said, “David Cameron said back in November last year that he wanted his summit to focus on trade, tax and transparency. And since then, rising up on the agenda has been another T — terrorism — and then of course the escalating war in Syria.” “Even before it starts, Kirton says the summit is shaping up to be one of ‘significant success,'” VOA writes, adding, “For example, this month’s London summit on malnutrition saw governments and business pledge an additional four billion dollars over the next seven years” (DeCapua, 6/12).

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FAO Reports 38 Countries Have Met Part Of MDG Goal On Hunger

“Amid the 1,000 days of action for the eight anti-poverty targets known as the Millennium Development Goals (MDGs), 38 countries have met part of the first MDG which calls on Member States to halve by 2015 the proportion of people who suffer from hunger,” according to a report from the U.N. Food and Agriculture Organization (FAO), the U.N. News Centre reports. “These countries are leading the way to a better future. They are proof that with strong political will, coordination and cooperation, it is possible to achieve rapid and lasting reductions in hunger,” FAO Director-General José Graziano da Silva said, according to the news service (6/12). “He also urged all countries to keep up the momentum and aim for the complete eradication of hunger,” New Europe reports, noting, “Even though globally hunger has declined over the past decade, 870 million people are still undernourished and millions of others suffer the consequences of vitamin and mineral deficiencies, including child stunting” (Gaydazhieva, 6/12).

“The countries that met the anti-hunger aspect of the first MDG include Algeria; Angola; Bangladesh; Benin; Brazil; Cambodia; Cameroon; Chile; Dominican Republic; Fiji; Honduras; Indonesia; Jordan; Malawi; Maldives; Niger; Nigeria; Panama; Togo; Uruguay,” the U.N. News Centre notes. In addition, 18 countries met “the more stringent World Food Summit Goal of reducing by half the absolute number of undernourished people between 1990-1992 and 2010-2012,” including “Armenia, Azerbaijan, Cuba, Djibouti, Georgia, Ghana, Guyana, Kuwait, Kyrgyzstan, Nicaragua, Peru, Saint Vincent and the Grenadines, Samoa, Sao Tome and Principe, Thailand, Turkmenistan, Venezuela and Vietnam,” according to the news service (6/12).

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Some Eastern European, Central Asian Countries Working To Improve Harm Reduction Programs

“As former presidents, senior diplomats and experts meet in the Lithuanian capital to discuss a litany of rights abuses, lethal epidemics and social destruction caused by repressive drug policies in Eastern Europe and Central Asia, pockets of hope for drug reform are emerging across the region,” Inter Press Service reports. “Delegates at the International Harm Reduction Conference in Vilnius Jun. 9-12 … repeatedly heard how state drug policy across the region remains widely rooted in repression and criminalization, compounding public health problems and having no effect on reducing drug use,” the news service writes, adding, “But what also emerged from the conference was the success of harm reduction efforts in some countries and surprising reform plans in others.” IPS describes initiatives in Georgia, Kazakhstan, and Ukraine that are working to expand harm reduction programs and reform laws that hinder their implementation (Stracansky, 6/11).

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People Of CAR Remain Cut Off From Health Services 2 Months After Rebel Coup

“Rebels and bandits in Central African Republic (CAR) have ransacked clinics and forced medical staff to flee, leaving tens of thousands of children at risk as the rainy season approaches, an international health charity has warned,” Thomson Reuters Foundation reports. “Two thirds of CAR’s population — 3.2 million people — remains cut off from health services more than two months after rebels seized control of the chronically unstable country in a March 24 coup,” the news service notes. “Arvind Das, country director at aid group Merlin, said thousands of children were dying as a result of the insecurity because their families could not get medical help and did not have enough food,” the news service notes, adding, “He said around 300,000 people were displaced in the southeast where many people had spent months hiding in the bush. Malnutrition, measles and malaria are major concerns.”

“Das said they were particularly worried that more people would fall sick with malaria in the coming weeks because of the higher risk of infection during the rainy season which lasts until July/August,” the news service writes (Batha, 6/12). “More than 15,000 people living with HIV in [CAR] had their life-prolonging antiretroviral (ARV) treatment interrupted as a result of the instability before, during and after the 24 March coup by the Séléka rebel group,” IRIN notes, adding non-governmental organizations (NGOs) “are now struggling to ensure these people resume their regimens to reduce the risk of illness, drug resistance and death.” The news service writes, “Interrupting HIV treatment can have dangerous consequences, including speeding up progression to AIDS and drug resistance, which requires patients to be placed on more expensive second- and third-line therapies” (6/12).

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Uganda Experiencing HIV Treatment, Testing Kit Stock Outs, IRIN Reports

“Uganda has run out of most antiretroviral drugs (ARVs), HIV testing kits, drugs to treat opportunistic infections and several crucial diagnostic tools for HIV care, according to a recent Ministry of Health stock status report [.pdf],” IRIN reports. The report, posted on May 27, “listed the status of medical supplies as of May 1” and “reported that central stocks of a number of first- and second-line ARVs, pediatric ARV formulations and HIV test kits were either out or below the minimum stock levels in country’s three government warehouses — National Medical Stores (NMS), Joint Medical Stores (JMS) and Medical Access Uganda Limited (MAUL),” the news service writes. “The ministry noted that a number for of requests had been sent to partners — including [PEPFAR], the Global Fund to Fight AIDS, Tuberculosis and Malaria, and pharmaceutical giant Pfizer — to boost stocks,” IRIN notes. “The current shortage is only the latest in a list of supply-chain problems that have caused similar stock-outs of drugs and condoms in the past,” the news service writes, adding, “Activists say continued mismanagement of the distribution chain is harming the country’s HIV response” (6/12).

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SciDev.Net Interviews Economist Sachs On Post-2015 Development Agenda

“With less than 1,000 days until the U.N.’s Millennium Development Goals (MDGs) expire,” SciDev.Net interviews economist Jeffrey Sachs, special adviser to U.N. Secretary-General Ban Ki-moon and director of the Earth Institute, about the post-2015 development agenda. According to the interview transcript, Sachs “tells SciDev.Net what the road to 2015 will look like” and “highlights the scientific and technological changes that have occurred since the MDGs were created, how these will alter development activities and what steps are needed to maximize the benefit of these advances” (Piotrowski, 6/12).

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Editorials and Opinions

Senate's Failure To Approve Changes To Food Aid Program Keeps 'Harmful System In Place'

On Monday, “the U.S. Senate voted 66-27 to approve a ‘Farm Bill’ that leaves food aid policy stuck in the 1950s …, a decision that will unnecessarily keep an estimated four million people from receiving American food aid while harmfully distorting local markets,” freelance journalist Mike Miesen writes in a PolicyMic opinion piece. “[U]nder the bill, food aid policy would be basically unchanged, leaving a sclerotic, inefficient system intact,” he says. “It didn’t have to be this way,” he writes, noting the Obama administration’s proposed changes to the food aid program contained in its FY 2014 budget request. Meisen argues that changes under the proposal would allow an estimated four million to 10 million more people to benefit from food aid for the same cost, and the proposal would lessen the impact “that outside supply has on the local market.” He mentions two senators’ explanations of opposition to the changes, and he concludes, “It’s ‘just politics,’ in other words. Unfortunately, ‘just politics’ is keeping a sclerotic, inefficient, and harmful system in place that fails to assist millions of people and succeeds in distorting local markets” (6/12).

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Opinion Pieces Address Malnutrition Ahead Of G8 Summit

The following is a summary of opinion pieces addressing the issue of malnutrition ahead of the G8 summit taking place in London next week.

  • David Nabarro, Inter Press Service: “In recent years many leaders have made commitments to tackle food insecurity and malnutrition. The intensity of focus and action has mushroomed in 2013 and in June it is higher than ever before,” Nabarro, special representative of the U.N. secretary-general for food security and nutrition, writes. He highlights a number of recent publications, initiatives and meetings addressing the issue of nutrition and continues, “As the deadline for the Millennium Development Goals nears, the international community is considering the post-2015 development agenda and sustainable development goals. Though negotiations are still underway, there is growing support among governments and other stakeholders for food security and good nutrition for all people to be one of the goals.” He concludes, “It will not be easy, and progress may not be linear, but we have an unprecedented opportunity to eliminate one of humanity’s most ancient scourges” (6/11).
  • Raj Patel, The Guardian’s Poverty Matters Blog: “Over centuries, modern agriculture has bred the nutrients out of our food. The G8 will next week try to go one further — within a generation, they want to squeeze the politics out of hunger,” Patel, an author who will speak at the World Development Movement’s activist conference, “Not the G8,” in Leeds on Saturday, writes, adding, “If they succeed, they’ll have licensed an army of development technicians who’ll be free of democracy, accountability or history.” He continues, “It’s not easy to take a complex question — one that needs democratic debate, mechanisms of accountability, and principles of justice — and convince people that it’s a purely technical matter. But business and governments have been doing their best to ‘nutritionize’ development.” Patel adds, “The vision offered by G8 leaders will be one in which business needs to be free to ‘modernize’ agriculture, particularly in Africa, by being able to buy land, sell chemicals, [and] privatize genetic material” (6/12).
  • Sarah Degnan Kambou, The Guardian’s Poverty Matters Blog: “A discussion on ending hunger must take into account factors that affect women’s ability to produce, process and prepare food for their families. We must make sure that ending all forms of violence against girls and women is a priority as the international community looks beyond the 2015 Millennium Development Goals,” Kambou, president of the International Center for Research on Women (ICRW), writes. ICRW “is delighted to see that the U.N. High-Level Panel’s report last week outlined the need for a stand-alone goal to achieve gender equality and empower women and girls,” she states, adding, “This year’s G8 declaration on preventing sexual violence in conflict is a remarkable first step towards that end.” She continues, “I urge the G8 leaders meeting in County Fermanagh on June 17 and 18 to follow the U.K.’s lead by making comprehensive commitments to the cause across different international platforms” (6/13).

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From the Global Health Policy Community

WHO Report Examines Global Nutrition Policies

The WHO has released a new report (.pdf), titled “Global nutrition policy review: What does it take to scale up nutrition action?,” which “is based on a questionnaire survey conducted during 2009-2010, in which 119 WHO Member States and four territories participated,” according to the report’s webpage. The review “analyzed the information on whether the countries have nutrition policies and programs and if so, what topics the policies cover, how they are being implemented, what the implementation coverage is, who the stakeholders are, what coordination mechanism exists, and how the monitoring and evaluation are being implemented,” the website states, adding, “Most countries that responded to the review had policies and programs that are addressing key nutrition issues, such as undernutrition, infant and young child feeding, vitamin and mineral malnutrition, and obesity and diet-related [non-communicable diseases (NCDs)]. The review nevertheless identified a number of gaps in the design, content and implementation of these policies and programs” (June 2013).

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Global Hidden Hunger Indices, Maps Aim To Inform Policy, Advocacy

Writing in a PLOS One article published on June 12, researchers from Australia, India, Switzerland and the U.S. present “indices and maps of global hidden hunger to help prioritize program assistance, and to serve as an evidence-based global advocacy tool,” according to the abstract. “A number of countries in sub-Saharan Africa, as well as India and Afghanistan, had an alarmingly high level of hidden hunger, with stunting, iron deficiency anemia, and vitamin A deficiency all being highly prevalent,” the researchers write in the abstract, adding, “The current indices and maps provide crucial data to optimize the prioritization of program assistance addressing global multiple micronutrient deficiencies. Moreover, the indices and maps serve as a useful advocacy tool in the call for increased commitments to scale up effective nutrition interventions” (6/12).

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