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Kaiser Daily Global Health Policy Report

In The News

Maintaining Momentum In Global Immunization Efforts Critical For Child Survival, Panel Speakers Say

“With less than 1,000 days left to meet the United Nations’ goal to cut child mortality 67 percent by 2015, there is cause to be optimistic, said global health experts Tuesday at a webinar hosted by the Kaiser Family Foundation,” GlobalPost’s “Pulse” blog reports. The event, titled “Getting to Zero: Saving Children’s Lives with Vaccines,” included leaders from USAID, the GAVI Alliance, Save the Children and the Center for Global Development, the blog notes. “Panelists lauded efforts to supply low-income countries with vaccines, but expressed concern that a shortage of trained health workers might be keeping children from benefiting,” the blog writes. In addition, while “[m]ost of the gains have been made by high-income and … low-income countries, … without outside help, middle-income countries aren’t progressing, they said,” according to the blog. “Pulse” quotes panelists Ariel Pablos-Mendez, USAID’s assistant administrator for global health; GAVI CEO Seth Berkley; Save the Children President and CEO Carolyn Miles; and Amanda Glassman, director of global health policy for the Center for Global Development (Stuart, 6/19). A webcast of the panel discussion, moderated by Josh Michaud, associate director of global health policy at the Kaiser Family Foundation, is available online (6/19).

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House Rejects Amendment To Farm Bill That Would Have Allowed U.S. Food Aid Reform

“Members of the House on Wednesday voted down a proposal to radically reform U.S. food aid by allowing aid recipients to buy non-U.S. farm commodities,” The Hill’s “Global Affairs” blog reports. The House rejected the Farm Bill amendment, proposed by House Foreign Affairs Committee Chair Ed Royce (R-Calif.) and Rep. Eliot Engel (D-N.Y.), in a 203-220 vote, with both parties “dramatically divided on the proposal,” the blog notes. The proposal “would have allowed up to 45 percent of funds in the Food for Peace program to be used for aid other than U.S. commodities,” according to the blog (Kasperowicz, 6/19).

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MERS Virus Easily Transmitted In Health Care Environments, Study Says

“The new Middle East coronavirus that has killed 38 people after emerging late last year is a serious risk in hospitals because it is easily transmitted in health care environments, infectious disease experts said on Wednesday,” Reuters reports. “In a study published in the New England Journal of Medicine, the researchers said the Middle East respiratory syndrome (MERS) was not only easily transmitted from patient to patient, but also from the transfer of sick patients to other hospitals,” the news service writes (Kelland, 6/19). “The report was prepared by a large international team with members from Saudi Arabia, Canada, the United Kingdom, and the United States,” CIDRAP News notes (Roos, 6/19). The “international team of doctors who investigated nearly two dozen cases in eastern Saudi Arabia found the new coronavirus has some striking similarities to SARS,” the Associated Press writes (Cheng, 6/19). “The incubation period of the virus — the time between exposure and development of symptoms — was similar to SARS, about five days,” according to the Washington Post (Kim, 6/19).

However, “[w]hile [MERS] belongs to the same family of viruses as the one responsible for SARS, it appears far less transmissible than the earlier pathogen, the WHO has said,” Bloomberg Businessweek writes (Bennett/Carey, 6/19). “The SARS virus is thought to have originated with bats, and scientists suspected that the same might be true of MERS, and that people might have contracted it from eating dates that had been contaminated by bats,” the New York Times notes. “But so far, no bats or any other animals have been found to be infected, according to Dr. Alimuddin I. Zumla, an author of the study and a professor of infectious diseases and international health at University College London Medical School,” the newspaper adds (Grady, 6/19). “Globally, [MERS] has sickened 64 people and killed 38 since September, 32 of which have been in Saudi Arabia, according to the [WHO],” Bloomberg Businessweek notes in a separate article (Bennett, 6/19). “Eleven cases of the virus have been detected in France, Germany, Italy and the U.K. among people who traveled to the Middle East, or who have had contact with someone who has, suggesting that more imported cases can be expected,” according to the report, the news service notes in another article (Bennett, 6/19).

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World's Poorest Children Twice As Likely To Contract Malaria As Least Poor Children

“The poorest children in the world’s most impoverished communities are twice as likely to contract malaria as the least poor, according to a new study published in the Lancet medical journal Wednesday,” VOA News reports. “Researchers say the study, led by Britain’s Durham University and the London School of Hygiene and Tropical Medicine, suggests that alleviating poverty could protect children from malaria,” the news agency continues (Hennessy, 6/19). The researchers conducted “a systematic review and meta-analysis to assess whether the risk of malaria in children aged 0-15 years is associated with socioeconomic status,” according to the study abstract (Tusting et al., 6/19). The researchers concluded, “That malaria control remains largely the preoccupation of the health sector alone is a failing of both those who work in health and those who work in international development. The disease severely compromises socioeconomic development, and its control and elimination would improve economic prosperity worldwide,” Medical News Today notes (Fitzgerald, 6/20).

In an accompanying Lancet opinion piece, Jürg Utzinger of the Swiss Tropical and Public Health Institute and Marcel Tanner of the University of Basal write, “We agree with the conclusions of Tusting and colleagues and are convinced that investments that support socioeconomic development in malarious settings will prove an effective and sustainable intervention against not only malaria, but also a host of other poverty-related diseases, including the neglected tropical diseases. Such action requires innovative multi-disease, multi-intervention, cross-sectoral collaboration, coupled with further longitudinal intervention studies” (6/19).

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Foreign Policy Examines Challenges To Fighting Leishmaniasis In Syria

Foreign Policy examines the spread of cutaneous leishmaniasis, a parasitic infection that “is carried by sand flies and causes painful lesions that can become secondarily infected, often resulting in disfigurement,” throughout war-torn Syria and neighboring countries. “According to the WHO, which has set up an early-warning system to monitor the disease in all 14 of Syria’s governorates, 1,047 cases of cutaneous leishmaniasis” — also known as the “Aleppo evil” or the “Aleppo boil” – “were reported between April 14 and May 18 of this year,” the magazine writes, adding, “The majority of those cases occurred in Aleppo, where the disease was endemic prior to the crisis, but an increasing number have cropped up among internally displaced people in Syria’s Tartus governorate, where the disease was previously unreported.” In addition, “[t]housands of additional cases have been reported in bordering countries in the last year,” Foreign Policy states. The magazine notes challenges to collecting data on the disease due to “movement of Syrians inside the country and within neighboring countries” and highlights challenges to treatment and prevention efforts, such as interrupted insecticide spraying campaigns, deteriorating sanitation conditions, and drug shortages (Banco, 6/19).

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Financial Times Publishes Special Report On Sustainable Health Care

The Financial Times on Wednesday published a special report titled, “Sustainable Healthcare 2013.” Among others, the report includes an article examining the “need to put prevention before cure” to combat non-communicable diseases; an article examining alternative approaches to dealing with addiction and resulting health issues; and an article examining how India’s “weak health system” is threatening the country’s development (Kazmin, 6/19).

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Editorials and Opinions

U.S. Food Aid Reform Critical To Keep Program Efficient, Effective

“There has never been a greater need for a comprehensive and sustainable approach to tackling hunger and malnutrition. And in a tough budget climate, we must maximize the effect of our aid dollars. Impact is about efficiency, effectiveness and commitment,” Helene Gayle, president and CEO of CARE USA, writes in a CQ Roll Call opinion piece. “Our food aid system is outdated and constrained by decades-old policies that require commodities to be purchased in the United States and shipped overseas — even when food is available nearer the crisis,” she notes, adding, “President Barack Obama’s food aid reform proposal is timely and essential” because “[t]he more flexible plan enables the United States to reach as many as four million more people every year — faster and without increased spending.”

“Food aid reform is a critical component of an efficient approach to tackling hunger and malnutrition, but we also need an effective approach,” Gayle continues, adding, “That means addressing emergency food and nutrition needs and hungry families’ long-term ability to grow their own food and raise their own incomes.” She notes, “Nutrition is a smart and effective investment — for every $1 invested in reducing undernutrition, we see a $30 return on investment in terms of increased health, schooling and productivity. That’s effective” (6/19).

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Thanks To Germany's Leadership, Global Fund Closer To Reaching Ambitious Goals

“When Germany and other wealthy nations came together to create the Global Fund [to Fight AIDS, Tuberculosis and Malaria] a decade ago, AIDS, tuberculosis and malaria were leading causes of death in developing countries and a major source of poverty,” Melinda Gates, co-chair of the Bill & Melinda Gates Foundation, writes in the Huffington Post’s “The Big Push” blog. “But world leaders recognized that they could make dramatic gains against these three diseases by expanding the delivery of a few low-cost, lifesaving tools to those who needed them,” she states, noting the Global Fund has played a “key role” in decreasing the cost of HIV treatment, in introducing a diagnostic test that can detect TB infection in less than two hours, and “in reducing Malaria in Africa by 33 percent.” However, “that is not enough,” she continues, adding, “I am confident that Germany will continue to be a leader in the global fight against AIDS, TB and malaria. … Thanks to Germany, we are getting closer to the $5 billion annual target that the Global Fund needs to reach its ambitious goals.” She concludes, “This is certainly a significant investment, but it is one that will pay back many times over” (6/19).

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India's National Food Security Bill Will Not Promote Nutrition

“After decades of sponsoring an ineffective child nutrition program, [India’s] Union government is on the verge of launching a National Food Security Bill (NFSB), which undermines India’s fight against malnutrition,” a LiveMint editorial states. “Despite giant strides in reducing both hunger and poverty over the past two decades, India has struggled to rein in malnutrition,” the editorial says, adding, “Three key factors explain this paradox.” The editorial continues, “First, India’s lopsided food policy has made cereals widely available at the cost of other foods”; “Second, the low social status of women makes them ill-nourished and results in an extraordinarily high proportion of low birth weights, raising the risks of both childhood stunting and adult obesity”; and, “Third, open defecation and high population density create a perfect storm for infectious diseases to thrive, inhibiting children’s ability to absorb nutrients.”

“We need a radical overhaul of our community outreach programs to meet the needs of the very young, pay close attention to gender-friendly policies and women’s health, invest in preventive public health services such as clean water and sanitation, provide farm incentives to promote food diversity, and launch an effective nutrition education campaign to fight the burden of malnutrition,” the editorial states. Noting the NFSB would spend four times the amount of money annually recommended by The Lancet to fight global undernutrition, the editorial concludes that the initiative will not provide “any significant nutritional return … [because t]he only return from NFSB will be political” (6/19).

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Time To Ramp Up HPV Vaccination Efforts

The CDC on Wednesday “released some really good news — the prevalence of types of human papillomavirus (HPV) that commonly cause cervical cancer in women has dropped about half in girls aged 14-19 [in the U.S.] since 2006, when the vaccination program started,” CDC Director Tom Frieden writes in the Huffington Post’s “Global Motherhood” blog. “Results of the study, published in the Journal of Infectious Diseases, are striking and should be a wake-up call to our nation to make sure adolescent and teenage girls are vaccinated against HPV,” he writes, noting, “Only one third of 13- to 17-year-old girls in the United States have received the HPV vaccine as recommended.” He adds, “In fact, countries such as Rwanda have vaccinated a higher percentage of females than we have in the U.S.” Frieden continues, “Our low vaccination rates represent 50,000 preventable tragedies — 50,000 girls alive today who will develop cervical cancer that would have been prevented if we had reached 80 percent vaccination rates,” concluding, “It’s time for health care providers, health departments and parents to move swiftly and act now protect the next generation of women against cervical cancer by increasing HPV vaccination rates” (6/19).

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From the Global Health Policy Community

State Department To Host Google+ Hangout On 10th Anniversary Of PEPFAR Featuring Ambassador Goosby

On June 20 at 2:00 p.m. EDT, the State Department will host a Google+ Hangout with Ambassador Eric Goosby, head of the U.S. State Department’s Office of Global Health Diplomacy and the U.S. global AIDS coordinator, on HIV/AIDS and the 10th anniversary of PEPFAR, the State Department reports on its webpage. According to the agency, attendees will include Washington Post op-ed columnist Michael Gerson; Linda Gail Bekker, deputy director of the University of Cape Town’s Desmond Tutu HIV Centre at the Institute of Infectious Disease and Molecular Medicine and chief operating officer of the Desmond Tutu HIV Foundation; Tatu Msangi, nursing officer in charge at the Kilimanjaro Christian Medical Center (KCMC) and an HIV-positive woman; and Jen Kates, vice president and director of global health and HIV policy at the Kaiser Family Foundation. Those interested in attending are invited to “[s]ubmit questions now on Google+ and follow the conversation on Twitter using the hashtag #AIDSFreeGen,” according to the event information, which notes the conversation can be seen live on Google+ and YouTube (6/19).

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Report Examines Civil Society's Role In Sustaining Public Health, Transitioning To Country Ownership Model

This week, amfAR, The Foundation for AIDS Research; the USAID-funded Health Policy Project; International Planned Parenthood Federation Africa Region; and Planned Parenthood Global, released a new report (.pdf) based on a consultation held in late 2012 and that included civil society leaders from 20 countries, according to an email alert. The consultation, titled “Advancing Country Ownership: Civil Society’s Role in Sustaining Public Health,” “sought to identify priorities and models for ensuring civil society engagement in health decision-making — and to identify some key principles around country ownership of health programming and policymaking,” the alert notes (6/19). “The organizations invited a diverse array of stakeholders to (1) consider the implications for civil society’s role in the ongoing transition of development aid programs to a country ownership model, and (2) discuss ways in which civil society might participate as a partner in the country ownership paradigm, thus maximizing its potential as the representative for populations disadvantaged by poverty, marginalized due to stigmatization, or vulnerable to discrimination,” the report summary states, noting the report “builds upon those conversations and incorporates additional research” (June 2013).

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Blog Examines Partnership Between U.S., India To Develop Oral Vaccine Against Rotavirus

In a guest post in the Global Health Technologies Coalition’s “Breakthroughs” blog, “John Boslego, director of PATH’s Vaccine Development Global Program, writes about an innovative partnership between the United States and India to develop an oral vaccine against rotavirus diarrhea,” according to the blog. Since the vaccine “originated from an attenuated (weakened) strain of rotavirus that was isolated from an Indian child at the All India Institute of Medical Sciences in New Delhi in the mid-1980s … partners in the vaccine’s development have included DBT, Bharat Biotech, the [NIH], the [CDC], Stanford University School of Medicine, and PATH,” he notes, adding, “With the development costs shared by several partners, Bharat Biotech was able to commit to a price of $1.00 per dose for ROTAVAC®. As such, Bharat Biotech plans to register the vaccine for use in India first. If licensed by the Indian regulatory authority, the vaccine will be a more affordable alternative to the rotavirus vaccines already on the market” (6/19).

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