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Kaiser Daily Global Health Policy Report

In The News

Senate Approves Modest Changes To U.S. Food Aid Program In Farm Bill

“The Senate on Monday voted to make modest changes to the way international food aid is delivered, a much scaled-back version of an overhaul proposed by President Barack Obama earlier this year,” the Associated Press reports. “Senators adopted an amendment by voice vote to a wide-ranging farm bill Monday that would slightly boost dollars to buy locally-grown food close to needy areas abroad,” the news agency writes (Jalonick, 6/3). The approved amendment would “allocate only $60 million a year for the purchase of food aid under the Food for Peace program in or near the country for which it is destined,” Reuters notes, adding, “This was an increase of only $20 million” from the $40 million included in the bill (Abbott, 6/3).

The amendment, sponsored by Sen. Mike Johanns (R-Neb.) and Sen. Chris Coons (D-Del.), would represent a small portion of the FY 2014 total of $1.8 billion proposed by the Obama administration for U.S. food aid programs (.pdf), the AP notes. “The Obama administration in April proposed shifting almost half of the international food aid money to more flexible accounts that allow for cash purchases abroad, saying such a move would be more efficient,” according to the news agency. However, “that proposal has so far fallen flat in Congress, where farm-state lawmakers who oversee agriculture spending and the farm bill have been reluctant to shift money away from American farmers,” the AP writes, adding, “Aid groups that supported the changes praised the amendment but said they would like to see more significant overhaul” (6/3).

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E.U., UNICEF To Provide $59M To Nigeria For Health, Water Initiatives

The European Union (E.U.) and UNICEF have agreed to provide 44.75 million euros ($59 million) to Nigeria for water and health projects, Bloomberg reports. Maternal and child health programs in two northern states will receive 40 million euros over four years, with the remaining 14.75 million euros going to water and sanitation programs in three states, the news service notes. “At least 1.5 million children and 380,000 pregnant women will benefit annually from the health project in Adamawa and Kebbi while about 80 percent of rural dwellers in Plateau, Ekiti and Adamawa will get improved water supplies and sanitation,” Bloomberg writes, adding, “The E.U. from 2012 to 2017 plans to invest about 200 million euros to improve water and sanitation in the West African country, according to [a] statement” from the E.U. delegation to Nigeria (Bala-Gbogbo, 6/3).

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Salvadoran Woman Denied Abortion To Terminate Dangerous Pregnancy Delivers Via Caesarean Section

“An ill Salvadoran woman who had asked the courts for — and been denied — an abortion during a high-risk pregnancy delivered her 27-week-old fetus by caesarean section on Monday, the Associated Press reported,” according to the New York Times. “For months, doctors had warned the woman, Beatriz, who has lupus and related illnesses, that as the pregnancy progressed, she could become seriously ill or even die,” the newspaper notes, adding, “The fetus, they said, had anencephaly, a birth defect where parts of the brain and skull are missing, and almost no chance of survival.”

“In a 4-to-1 ruling last Wednesday, the country’s Supreme Court denied an appeal from Beatriz, citing the country’s legal ‘absolute impediment to authorize the practice of abortion,'” the New York Times writes (Zabludovsky, 6/3). “The health ministry stepped in late last week after the ruling and said it would allow the c-section because the pregnancy was already at 26 weeks and the country’s strict abortion laws were no longer applicable,” The Guardian notes (6/4). “El Salvador banned all types of abortion in 1999,” according to BBC News, which adds, “The sentence for doctors and women violating that ban is 50 years in prison” (6/4). “Beatriz’s case has convulsed the region, which is known for having some of the world’s most stringent abortion laws, particularly Chile, El Salvador and Nicaragua, which have bans on the procedure,” the New York Times writes (6/3).

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Polio Virus Found In Sewage Sample From Israel

“The polio virus has been found in a sewage sample from Israel for the first time since 2002, the [WHO] announced on Monday,” the New York Times reports, noting no new cases have been identified in Israel or in Gaza or the West Bank. “The sample was from Rahat, a city in the Negev Desert near the Egyptian border that has 53,000 residents, primarily Bedouins,” the newspaper writes, adding, “There has not been a case of polio in Israel since 1988. The virus was last found in sewage samples in 1991 and 2002.” The New York Times continues, “Because most Israelis and Palestinians are routinely immunized against polio, it is unlikely the virus will spread further, said Dr. Bruce Aylward, director of the WHO’s polio campaign” (McNeil, 6/3).

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South African Researcher To Head UNAIDS Panel On Science Strategy

“South African epidemiologist and University of KwaZulu-Natal Professor Salim Adbool Karim has been named the chair of the newly established UNAIDS Scientific Expert Panel,” Times Live reports (Child, 6/4). “The panel which he will head up is tasked with providing strategic advice on the relevance of new research and findings and how they can be rapidly implemented to prevent new HIV infections and improve the lives of people living with HIV,” the U.N. News Centre notes, adding, “The other members will be announced in the coming weeks” (6/3). The panel also will advise UNAIDS on “gaps and strategic needs in AIDS research and on how UNAIDS can adjust its policies to address these needs and shape the AIDS response,” according to an UNAIDS press release. “As part of its new mandate the panel will convene international scientific consultations on behalf of UNAIDS, the first of which is already underway in Durban, South Africa,” the press release states, noting this first meeting is titled, “Scientific advances from the ‘Mississippi baby‘: Implications for public health programs on mother to child transmission of HIV” (6/3).

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Editorials and Opinions

Through Partnerships, 'Incredible Strides' Can Be Made Against Health, Development Challenges

“Over last week, I traveled across Southeast Asia, delivering clean water as part of Procter & Gamble’s Clinton Global Initiative (CGI) commitment in Myanmar, attending the Women Deliver conference in Kuala Lumpur and ending my trip in Cambodia, where I saw how the Clinton Health Access Initiative (CHAI) is working with the government to fight HIV/AIDS and improve health care delivery at the national level through better supply chain management and at the local level in different hospital and clinic settings,” Chelsea Clinton, board member of the William J. Clinton Foundation, writes in the Huffington Post’s “The Big Push” blog. She provides details of her trip, noting, “While I was in Myanmar, P&G announced a new partnership with USAID to improve maternal and child health in Myanmar and provide 200 million more liters of clean drinking water over the next two years, furthering its CGI commitment.”

“It is these types of innovations and partnerships that will continue to save millions of lives and fundamentally change health care in developing countries,” Clinton writes. For example, “Cambodia is uniquely placed to be one of the first countries to eliminate new pediatric HIV infections, and through collaborative partnerships, I have no doubt Cambodia will be able to reach its goal,” she writes. Clinton discusses one such partnership and outlines three ultimate goals of Cambodia Strategy 3.0. She concludes, “From reducing the prevalence of HIV/AIDS to providing clean drinking water to rural communities, these programs are examples of how, when corporations, [non-governmental organizations (NGOs)], governments, and people work together, incredible strides can be made to challenges that were once thought intractable” (6/3).

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International Community Must Close Gaps In Cervical Cancer Prevention, Screening, Treatment

“Girls and women in the developing world are losing the fight against cervical cancer because we have failed to close deadly gaps in prevention, screening and treatment that could spare their lives and end this disease,” John Seffrin, CEO of the American Cancer Society, and Sally Grooms Cowal, senior vice president and chief liaison officer at PSI, write in a Forbes opinion piece published as “part of a special edition of Impact – PSI’s global health magazine — and … produced in partnership with Women Deliver and the Skoll World Forum on Social Entrepreneurship.” They continue, “The control of cervical cancer is at a global tipping point with the advent of the human papillomavirus (HPV) vaccine.”

“But we must accelerate adoption of the HPV vaccine, improve access to resource-appropriate cervical cancer screenings, and increase global resources for and attention to cervical cancer prevention and treatment,” Seffrin and Grooms Cowal write. “With proven, cost-effective interventions at hand and a recent commitment to wider accessibility of the HPV vaccine … [w]e have an unprecedented opportunity — and a moral obligation — to change the course of cervical cancer and [non-communicable diseases (NCDs)],” they write, concluding, “But we must ensure they are a priority at the global policy level, with investments and action reflecting these diseases’ tremendous impact on society, health and the economy” (5/30).

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Pakistan's New Government Should Aim To Eradicate Polio

“When Pakistan’s new government is sworn in on Wednesday it has a historic opportunity” — “to eradicate polio from Pakistan, one of three countries where the crippling disease remains endemic,” Sania Nishtar, a federal minister in the government of Pakistan, writes in the Wall Street Journal’s “India Real Time” blog. “But they must overcome critical challenges to succeed,” including “providing security to health workers, … reaching children from marginalized groups,” and dispelling “deep-seated opposition among some religious leaders who are able to persuade parents not to vaccinate their children against the disease,” she continues.

“I became the government’s federal cabinet minister and the lead for health in the interim government two months ago and have been working to keep up the fight against polio in the country,” Nishtar writes. “Most notably, we have reinstated the federal level ministry of health that was abolished in 2010 when all health powers went to the four provincial governments,” she states. Nishtar outlines several important steps in the fight against polio, including continuing a national health system restructuring, prioritizing the implementation of clean water and sanitation projects, and “winning support among the hierarchy of clerics through the ministry of religious affairs.” She concludes, “By making polio history the new government will build a legacy that permeates across our health system. They will also honor our brave health workers who have given their lives in the battle to purge the country of this disease” (6/4).

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Issue Of AIDS Orphans In Asia Must Be Addressed Through Policy, Community-Based Responses

“The great number of AIDS orphans in Asia is one of the most serious consequences of the HIV/AIDS epidemic today,” César Chelala, an international public health consultant, writes in an Epoch Times opinion piece. “Although proportionally the number of AIDS orphans in Asia is much lower than in sub-Saharan Africa, in absolute numbers there are more orphans due to AIDS in Asia than in Africa,” he states, noting, “Children orphaned because of their parents’ death by AIDS are likely to be malnourished and unschooled, and are at greater risk of becoming HIV-infected themselves.” He continues, “Orphans due to HIV/AIDS are part of a much larger problem, since countries that have high rates of AIDS orphans also have a high number of children directly affected by the epidemic, and who are often just as vulnerable.”

“It is necessary to develop major educational campaigns to make adults more aware of the danger of the infection, not only to themselves, but also the risks it poses to their children,” Chelala continues, adding, “Orphan children’s special needs should also be addressed through community-based responses and by increasing the capacity of local orphanages.” He concludes, “It is critical not only to plan new government policies including legal, education, and labor frameworks, but also to create the conditions so that these policies will be implemented” (5/31).

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From the Global Health Policy Community

USAID's Shah, Others Discuss Food Security In Google+ Hangout

Writing in the ONE blog, Malaka Gharib, ONE’s social editor, describes a June 3 Google+ Hangout that included USAID Administrator Raj Shah, “ONE’s U.S. Executive Director Tom Hart and a group of ONE members and agriculture policy experts from Feed the Future, GAIN, Thousand Days and Future Fortified.” She writes, “One of the highlights of the Hangout was hearing Administrator Shah talk about how global food security is in fact in America’s best interest.” Shah said, “We know that this [nutrition] is an issue that touches on the economic prospects of countries that will be our trading partners in the future, it touches on our national security in places ranging from Afghanistan to Somalia, where far too many children die of core underlying malnutrition, and most importantly, we know it just touches on our moral consciousness because we cannot live in 2013 knowing that hundreds of millions of children go hungry and that that hunger prevents them from learning in school, from fighting disease, from surviving a simple bout of diarrhea or pneumonia and of building a better future for themselves.” Gharib provides a link to a video of the chat (6/3).

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Reflecting On Women Deliver Conference

“I’ve just returned from an inspiring and thought-provoking week in Kuala Lumpur, Malaysia, where leaders and advocates from 149 countries gathered for the Women Deliver 2013 conference,” Robert Clay, deputy assistant to the administrator for USAID’s global health bureau, writes in USAID’s “IMPACTblog.” He continues, “Over the past decade, we’ve seen wonderful success in reductions of maternal and child deaths and improved access to family planning. But despite all the good we have done, millions around the globe still do not receive the reproductive, maternal, newborn, and child health services they need.” He concludes, “After a week of renewed commitments, sharing lessons learned, and listening to those pioneering the way forward on women’s health and rights, I feel inspired to do my part in leading USAID to achieve our global health goals and improve women’s and girl’s health and rights across the globe” (6/3).

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Integrating Maternal, Neonatal, Child Care Is 'Most Promising' Strategy

Writing in the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog, France Donnay, senior program officer for maternal, neonatal and child health on the family health team at the Bill & Melinda Gates Foundation; Gary Darmstadt, who heads the foundation’s Family Health Division; and Ann Starrs, co-founder and president of Family Care International, discuss a study (.pdf) published in a special issue of the Journal of Maternal-Fetal and Neonatal Medicine that “looked at more than 150 [maternal and newborn health] interventions, assessing them for impact on both maternal and neonatal outcomes.” The study “grouped the interventions into ‘packages of care’ that can be effectively delivered at each of the key levels of care: community, health center, and hospital,” they write, continuing, “Most importantly, the findings send a clear message: that greater integration of maternal and newborn care — and, more broadly, of services across the reproductive, maternal, newborn, and child health (RMNCH) continuum of care — is one of our most promising strategies for strengthening efforts to save women’s and children’s lives” (6/3).

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