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Kaiser Daily Global Health Policy Report

In The News

WHO Committee Again Declines To Declare International Public Health Emergency After Ebola Jumps Border From DRC To Uganda; Agency Calls For More Robust Funding From Global Community

CIDRAP News: WHO experts again say Ebola not global health emergency
“A World Health Organization (WHO) emergency committee convened in the wake of imported Ebola cases in Uganda said [Friday] that the situation still doesn’t warrant a public health emergency of international concern (PHEIC), but they did express serious worries about the threat to the Democratic Republic of the Congo (DRC) and its neighbors and over a lack of funds…” (Schnirring, 6/14).

Devex: Merck to make more Ebola vaccine, WHO declines to declare global emergency
“Merck announced it would produce an estimated 450,000 additional doses of experimental Ebola vaccine, just after the first cross-border case was confirmed to have spread to Uganda from the Democratic Republic of Congo. But the World Health Organization declined on Friday to declare the outbreak a global emergency…” (Ravelo, 6/14).

The Guardian: WHO calls for more funds to fight DRC Ebola outbreak
“…Dr. Preben Aavitsland, the acting chair of the emergency committee, said they were extremely worried about the ongoing outbreak and its spread and especially concerned that the world had not yet come up with the money needed to fight it. ‘The committee is deeply disappointed that WHO and the affected countries have not received the funding and resources needed for this outbreak,’ he said. ‘The international community must step up funding and support for the strengthening of preparedness and response in the DRC and the neighboring countries’…” (Boseley, 6/14).

Science: WHO unexpectedly declines, again, to call Ebola outbreak a global emergency
“…Many infectious disease experts and public officials had expected, and called for, WHO to declare a PHEIC when Ebola broke out of the DRC. ‘I’m baffled and deeply troubled by this decision,’ Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University in Washington, D.C., tells ScienceInsider. ‘The status quo is no longer tenable. It is time to sound a global alert’…” (Kupferschmidt, 6/14).

STAT: After Ebola spills into Uganda, WHO decides against emergency declaration
“…The WHO said the response has been hampered by a lack of funding; the agency currently has a $54 million funding gap for this work. Efforts to prepare neighboring countries for cross-border spread, for instance, has not proceeded at the pace it ought to because funding for the work isn’t there, said Dr. Mike Ryan, executive director of the WHO’s emergencies program, which is leading the response in conjunction with the DRC ministry of health…” (Branswell, 6/14).

Wall Street Journal: WHO Declines to Declare Ebola a Global Emergency in Congo
“…Speaking by phone in a press conference from Congo, where he is viewing and holding discussions about Ebola response efforts, WHO Director-General Tedros Adhanom Ghebreyesus said he accepted the committee’s decision, while noting that the outbreak is an emergency for those affected by it. He urged international funders to help WHO fill an immediate gap of $54 million needed to fund response efforts through July. WHO also said it would need more funding for the months to come. ‘We need the international community to step up its financial commitment to end the outbreak,’ he said…” (McKay/Bariyo, 6/14).

Additional coverage of the WHO emergency committee’s decision, the Ebola outbreak in DRC and Uganda, and related news is available from Agence France-Presse, Al Jazeera (2), Associated Press (2) (3), BBC News, Becker’s Hospital Review, CNN, Deutsche Welle, Forbes, The Hill, Los Angeles Times, NBC News, New York Times, NPR, Reuters (2), Science Speaks, The Telegraph, VOA News, Vox, Washington Post, and Xinhua News.

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U.S. Sen. Rubio Calls For Interagency Cooperation To Implement Administration's New U.S. Strategy On Women, Peace, Security

Devex: Lawmakers question who will implement U.S. Women, Peace, and Security Strategy
“Legislators and advocates welcome the Trump administration’s new U.S. Strategy on Women, Peace, and Security, but warn that it must extend beyond words into real action from agencies involved in U.S. national security operations. … [Sen. Marco] Rubio, a Republican from Florida, said that because so many agencies — including the U.S. Agency for International Development, Department of State, and Department of Defense — are involved in meetings regarding U.S. strategy in conflict countries, there needs to be a clear interagency coordination process that ensures involving women in peace processes and conflict resolution is a priority. … By 2023, the strategy aims to improve women’s empowerment and equality by supporting the preparation and ‘meaningful participation’ of women in decision-making processes related to conflict; protecting women and girls’ human rights, access to humanitarian aid, and safeguarding against violence and abuse; ‘adjusting’ U.S. international programs to improve outcomes in equality of women; and encouraging partner governments to increase capacity to improve the meaningful participation of women in peace and security processes…” (Welsh, 6/14).

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Georgetown University Professor Matthew Kavanagh Discusses USAID's 'Journey To Self-Reliance' Strategy In Devex Interview

Devex: Q&A: Why ‘self-reliance’ is the wrong goal for U.S. aid
“Since his first day in office, U.S. Agency for International Development Administrator Mark Green has repeatedly emphasized his belief that the purpose of foreign assistance should be ending its need to exist. In practical terms, that has translated into a new policy framework at USAID that focuses on a ‘journey to self-reliance’ — the idea being that U.S. assistance should focus on helping countries along that journey, measured by new indicators the agency released last year. … Last month, Matthew Kavanagh, a professor at Georgetown University, tweeted, ‘”The Journey to Self Reliance” as a concept for development shows such a remarkable lack of historical understanding, context, and self-reflection I just kindof cant deal.’ Given that Green’s tenure and policy vision has garnered mostly positive reviews in the U.S. development community, Devex reached out to Kavanagh to hear more about why he takes issue with the self-reliance framework…” (Igoe, 6/17).

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Some Poor Countries Pay Up To 30 Times More For Basic Medicines Than Others, CGD Study Shows

Financial Times: Poor countries pay up to 30 times more for medicines
“…The Washington-based Center for Global Development examined billions of dollars in spending by developing countries, concluding that low- and middle-income countries were paying 20 or 30 times more for medicines such as omeprazole, for heartburn, or paracetamol, a common pain reliever. Pharmaceutical and health care markets ‘don’t work for the poorest countries, especially in South Asia and Africa,’ said Kalipso Chalkidou, one of the report’s authors. The study uncovered a stark disparity in the proportion of poorer countries’ use of unbranded generic drugs, usually the least expensive option…” (Neville/Dodd, 6/16).

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Nearly 7M People In South Sudan Face Acute Food Shortages, With More Than 20K Close To Famine, U.N. Agencies Warn

Agence France-Presse: S. Sudan sees record hunger levels, despite peace deal
“A record number of almost seven million people are facing severe hunger in South Sudan, despite a peace agreement which has largely stopped fighting after more than five years of war, U.N. agencies warned Friday…” (6/14).

U.N. News: South Sudanese facing famine in all but name, warns U.N. food agency
“Record numbers in South Sudan — some seven million people — face acute food shortages, while more than 20,000 are close to famine, the World Food Programme (WFP) warned on Friday. The warning, which follows years of violent unrest and vicious rights abuses linked to mass displacement, food shortages, and disease outbreaks, coincides with the release of updated data on hunger levels in the country…” (6/14).

Xinhua News: Record number of people facing critical food lack in South Sudan: U.N. agencies
“…[T]he Integrated Food Security Phase Classification (IPC) update [was] released on Friday by the government of South Sudan in collaboration with the Food and Agriculture Organization (FAO) of the United Nations, the United Nations Children’s Fund (UNICEF), and the World Food Programme (WFP)…” (6/15).

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UNHCR Steps Up Response In Peru As Record Number Of Venezuelans Cross Border

Reuters: As Peru tightens its border, desperate Venezuelans cling to asylum lifeline
“Thousands of Venezuelans crossed into Peru despite a crackdown on migrants without passports or visas meant to stem the flood of immigration from their crisis-stricken nation, as many lacking those documents filed asylum requests instead. … Regina de la Portilla, a UNHCR spokeswoman in Peru, said she was unaware of any Venezuelans seeking asylum who were barred from entering Peru. She said that most Venezuelans leaving their homeland in mass should be considered refugees, given the acute humanitarian crisis…” (Taj, 6/16).

U.N. News: Record number of Venezuelans arrive in Peru: U.N. steps up response
“The U.N. refugee agency, UNHCR, has sent extra teams this week to the border between Peru and Ecuador to support the authorities, as an unprecedented number of Venezuelan refugees and migrants — over 15,000 — have entered Peru this week. … Peruvian authorities, UNHCR, and its partners, including over a dozen NGOs at the border, are working around the clock on the ground to process the arrivals, providing humanitarian assistance, medical care, information, [and] legal support to refugees and migrants on both sides of the border…” (6/16).

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Australia To Launch 20-Year Strategy To Counter Antimicrobial Resistance

The Australian: Government crackdown on abuse of antibiotics
“Doctors could be prevented from prescribing repeats of antibiotics as authorities consider radical plans to contain the dangerous spread of superbugs through hospita­ls, aged-care homes and the wider community. With limited progress so far on containing the threat, health ­professionals have been put on ­notice that government intervention is now likely — and may extend to the fields of agriculture and environment…” (Parnell, 6/17).

Xinhua News: Australia to launch 20-year plan to counter rise of superbugs
“…The new strategy is the result of a review of Australia’s five-year antimicrobial resistance strategy, which found that the problem of superbugs has grown so great that a 20-year plan is needed. … Once approved by bureaucrats, the 20-year plan will go to the Council of Australian Governments (COAG) before it is implemented…” (6/17).

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Almost 100 Children In India Dead Of Acute Encephalitis Syndrome; Researchers Believe Several Factors Contribute

Washington Post: A mysterious sickness has killed nearly 100 children in India. Could litchi fruit be the cause?
“…Nearly 100 children have died this month in India from an illness that impairs the functioning of the brain and sends the level of glucose in the blood plummeting. The deaths have occurred in and around the city of Muzaffarpur in the northern state of Bihar, one of the poorest regions in India. The illness strikes the area each summer, but in recent years the death toll has been less than 20. … About 100 more remain in hospitals. The deaths represent the worst toll since 2014, according to figures provided by a state health official. Doctors describe the illness as Acute Encephalitis Syndrome, or AES, which is characterized by the rapid onset of fever combined with disorientation and seizures. … [Researchers] posited that the illness might only occur with a combination of factors, for instance when a poorly nourished child eats a large number of litchis and then misses an evening meal. They also pointed to the limitations on local hospitals in providing critical care to such patients, which likely contributes to the death toll…” (Slater/Dutta, 6/17).

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More News In Global Health

Agence France-Presse: In Afghanistan, conspiracy theories fuel polio outbreak (6/14).

Agence France-Presse: Indian doctors to go on strike over workplace assaults (6/14).

The Guardian: ‘I’ll never have another child’: the mothers failed by Mexico’s hospitals (Lakhani, 6/17).

Health Policy Watch: New Resource Gateway Launched On Innovation & Access To Medicines (Fletcher, 6/14).

Health Policy Watch: New Drug Transparency Observatory Launched In France (Branigan, 6/13).

Health Policy Watch: The Global Malaria Response: Extending The Reach Of Primary Health Care, Expanding Coverage Towards UHC (Branigan, 6/12).

Health Policy Watch: Interview With Seth Berkley, CEO Of Gavi, The Vaccine Alliance (New, 6/11).

New Humanitarian: A loan, not a gift: Merging business and aid in Afghanistan (Glinski, 6/17).

NPR: Countries Are Ranked On Everything From Health To Happiness. What’s The Point? (Gharib, 6/14).

U.N. News: Yemen: maternal and newborn health ‘on the brink of total collapse,’ UNICEF alerts (6/14).

Xinhua News: Dengue fever cases double 5-year average from Jan. to June in Thailand (6/15).

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Editorials and Opinions

Editorial, Opinion Piece Discuss Need To Control Ebola Outbreak In DRC

Financial Times: Ebola outbreak demands more urgent attention
Editorial Board

“The World Health Organization has for a third time declined to declare the Ebola outbreak in the Democratic Republic of Congo, which in the past week worryingly crept over the border into Uganda, a public health emergency — for technical reasons that may be correct. Such a declaration could have triggered unhelpful actions, such as suspension of flights to Congo or the closure of borders with neighboring countries. Making the impoverished central African country a pariah would probably not help anyone. … Three things are needed now to bring the [Ebola] crisis [in the Democratic Republic of the Congo (DRC)] under control. The first is money. … Second, plentiful supplies of vaccines are needed. … The third requirement is the hardest of all. Eastern Congo needs peace. … The root cause of the violence is the poverty that stalks much of Congo. If something cannot be done to tackle that, then even if this epidemic is brought under control, sooner or later Ebola will be back” (6/17).

The Conversation: Ebola outbreak spreads to Uganda — it should never have happened
Sterghios Moschos, associate professor in cellular and molecular sciences at Northumbria University

“…[T]he latest [Ebola] outbreak brings a new set of challenges. There have been armed attacks against health care workers and treatment centers have been firebombed. Affected regions are in a war zone and local people have a deep distrust of the DRC government and Western health care volunteers. … Even though neighboring countries have been preparing for the risk of the disease spilling into their territories, [six patients in Uganda, who had fled a DRC Ebola virus isolation center close to the Ugandan border,] still made it through border crossings unnoticed. … Symptom screening should have picked … these cases up, but checking people for things such as fever is neither foolproof nor effective. Yet a fast, reliable, and affordable test for the virus called QuRapID is available, which could restrict international transmission via illegal border crossings. … The likelihood that some health care staff involved will contract the disease is low as they are among the 4,700 Ugandan health care workers vaccinated for Ebola virus. But vaccine stocks are running low. The race is on to restock the vaccine, engage the local population, and trace the contacts of suspected cases to prevent further spread” (6/13).

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Bans On Skin-Bleaching Agents Likely Not Effective As Long As Skin-Lightening Industry Continues 'Colorist Advertising'

Washington Post: Dangerous skin bleaching has become a public health crisis. Corporate marketing lies behind it.
Ramya M. Vijaya, professor of economics at Stockton University

“In the past several years, multinational corporations have heavily marketed the idea that lighter skin leads to more prosperity. As a result, dangerous skin bleaching has become a public health crisis, according to the World Health Organization (WHO). In response, the East African Legislative Assembly (EALA) recently passed a resolution recommending a regional ban on cosmetics with hydroquinone, a skin-bleaching agent — a ban that looks likely to pass. … Despite these warnings and bans, the skin-whitening industry has experienced phenomenal growth in parts of Asia and Africa in recent years. … This new global marketing has created a segmentation or a split in the industry. While multinational brands target the middle class and link skin tones to economic success, low-income, working-class consumers who are priced out of the higher-end branded products have sought out cheaper, local products with harmful bleaching agents such as hydroquinone. … Bans on bleaching agents in individual countries or regions are likely to be ineffective as long as multinational corporations continue to aggressively market globalized, whiteness-based notions of beauty and social mobility. … Without coordinated global effort against multinationals’ colorist advertising, including social media and other consumer activism, bans alone are likely to remain ineffective” (6/15).

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From the Global Health Policy Community

Doctors For Choice U.K. Communications Officer Discusses Abortion As Political Issue

BMJ Opinion: In light of the wider attacks on reproductive rights worldwide, Hunt’s views cannot be ignored
Sonia Adesara, communications officer for Doctors for Choice U.K., GP trainee, and current National Medical Director’s clinical fellow, discusses abortion as a political issue. She writes, “Jeremy Hunt, who is one of the candidates to be our next prime minister [in the U.K.], publicly stated that he is in favor of restricting women’s access to abortion. … Playing political football with women’s rights is nothing new, but given the global attacks on reproductive rights, it is deeply concerning. As clinicians, we have a duty to speak out when politicians advocate policies that are detrimental to women’s rights, health, and wellbeing” (6/14).

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Understanding Women's Health Challenges Essential To Achieving SDGs, AFOG President Says

International Federation of Gynecology and Obstetrics: African Perspectives At Women Deliver
Anne Kihara, president of the African Federation of Obstetrics and Gynecology (AFOG), highlights discussions on women’s health challenges in Africa at the recent 2019 Women Deliver conference, writing, “The theme of ‘WD2019’ spoke to power, progress, and change towards attainment of the 2030 Agenda for Sustainable Development … We must provide social accountability and accelerated action towards gender equality in this generation, so that the promise of the SDGs can be actualized, and that means really understanding the scale of the challenge” (6/11).

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FHI 360 Research Expert Discusses Importance Of Quality Testing Health Commodities

FHI 360’s “R&E Search for Evidence”: We need to test medical devices and not just medicines to achieve global health goals
David Jenkins, associate director of research for FHI 360’s Product Quality and Compliance Laboratory, discusses the importance of testing medical devices, and not only pharmaceuticals, to achieve global health goals. Jenkins highlights a study in which 10 different condom brands in the Dominican Republic were tested, noting, “To appropriately safeguard the public and prevent circulation of poor-quality products in the market it is imperative to move away from singular or siloed approaches that focus only on pharmaceuticals. Expanding quality assurance approaches to comprehensively address all health commodities — like medical devices and condoms — can better prevent, diagnose, and treat public health concerns” (6/14).

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From the U.S. Government

USAID Administrator Meets With Health Care Workers, Community Leaders, NGOs In DRC

USAID: USAID Administrator Mark Green’s Visit To The Democratic Republic Of The Congo
USAID Spokesperson Tom Babington discusses USAID Administrator Mark Green’s recent visit to the Democratic Republic of the Congo (DRC), noting, “The administrator met with health care workers at an Ebola Treatment Unit in Katwa, community and local leaders at the Emergency Operations Center (EOC) in Butembo, and representatives from the NGO community. In response to Ebola in the DRC, USAID funds activities to bring the outbreak under control. … We will continue to work closely with our partners to see what else can be done to support the health workers and communities affected by this outbreak” (6/15).

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