KFF Daily Global Health Policy Report

In The News

Obama Administration Says MERS-CoV Poses Public Health Threat

“The Obama administration on Tuesday designated a respiratory disease now found in the Middle East a threat to public health and national security,” The Hill’s “Healthwatch” blog reports (Wilson, 6/4). According to CIDRAP News, Department of Health and Human Services Secretary Kathleen Sebelius made the designation in a May 29 statement, saying the Middle East Respiratory Syndrome coronavirus (MERS-CoV) “poses ‘a significant potential for a public health emergency that has a significant potential to affect national security or the health and security of United States citizens living abroad'” (Roos, 6/4). The move allows the Food and Drug Administration (FDA) to quickly approve treatments and tests for the virus, which has infected at least 54 individuals since April 2012, according to the WHO, The Hill notes (6/4). “The statement does not mean that the United States faces a public health emergency with regard to MERS now, said Elleen Kane, a spokeswoman for the HHS Office of the Assistant Secretary for Preparedness and Response,” according to CIDRAP (6/4).

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House Republicans' Draft Agricultural Spending Bill Includes No Changes To Food Aid Reform

“House Republicans rolled out a $19.5 billion [draft] agriculture spending bill Tuesday that deals back-to-back blows to President Barack Obama’s reform agenda for food aid overseas and the financial markets at home,” Politico reports. “An estimated $1.15 billion is provided for the Food for Peace program, $284 million less than was enacted this spring and with none of the changes that Obama wanted to allow the purchase of more food overseas,” the news service writes, adding, “At the same time, the Commodity Futures Trading Commission is effectively frozen at its current operating budget of $195 million reflecting the March sequester.” The news service notes, “The House Appropriations Committee is expected to begin consideration of the 76-page measure this week, but no floor action is expected before the larger five-year farm bill later this month.”

According to Politico, “Obama’s goal has been to shift funding into the foreign aid budget with USAID assuming greater control and given authority to purchase more food overseas, rather than relying so much on American crops and U.S. flag vessels.” However, “[o]ne risk for the administration is that the fight will only invite more cuts by conservatives from the underlying program,” the news service writes, noting, “Almost half the House Republicans in the last Congress voted to kill funding entirely for Food for Peace” (Rogers, 6/4).

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Global Hunger, Malnutrition Costing World Trillions In Health Fees, FAO Report Says

“Global hunger, poor nutrition and obesity are costing the world trillions of dollars in health costs and lost productivity, according to a new report from the U.N. Food and Agriculture Organization (FAO),” VOA News reports (Baragona, 6/4). “In [the] hard-hitting report, the U.N. said the levels of malnutrition — which includes being overweight and obese as well as under-nourished — were ‘unacceptably high’ and called for a concerted global campaign to cut food waste,” The Independent writes, adding, “Malnutrition now costs the world $3.5 trillion — or $500 for every person — in health care and lost productivity,” according to the report (Bawden, 6/5). “The report notes that while some 870 million people were still hungry in 2010-2012, this is just a fraction of the billions of people whose health, well-being and lives are blighted by malnutrition,” the U.N. News Centre notes (6/4).

“Although some progress has been made in fighting hunger, a form of malnutrition, there is still ‘a long way ahead,’ FAO Executive Director Jose Graziano da Silva said in a statement to mark the release of the organization’s annual report,” according to the Thomson Reuters Foundation (Caspani, 6/4). The report “underlines the need to ensure all the institutions and people responsible for producing and processing food ‘align to support good nutrition,'” IRIN notes, adding, “The report also provides an overview of the linkages between agriculture, quality food, health and the economy, emphasizing that ‘agriculture and the entire food system … can contribute much more to the eradication of malnutrition'” (6/4).

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Smallholder Farmers Hold Key To Sustainable Agriculture, Report Says

“Given the right conditions and targeted support, small farmers can unleash a new and sustainable agricultural revolution, the United Nations environment agency and a partner agricultural development organization reported [on Tuesday] on the eve of World Environment Day,” the U.N. News Centre reports. The report (.pdf), titled “Smallholders, Food Security and the Environment,” was commissioned by the U.N. Environment Programme’s World Conservation Monitoring Centre (UNEP-WCMC) and the International Fund for Agricultural Development (IFAD), the news service notes. “The report makes it clear that investing in the agricultural sector offers the highest rate of return for those interested in overcoming poverty, [U.N. Under-Secretary-General and UNEP Executive Director Achim Steiner] said, and speeds progress towards reaching the eight anti-poverty targets known as the Millennium Development Goals (MDGs) and building a post-2015 sustainable agenda,” the news service continues (6/4). In an interview with Devex, Elwyn Grainger-Jones, climate and environment head of IFAD, “makes a case for the farmers and asks the international community to not ignore them in the discussions on climate change” (Morales, 6/4).

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Disease Outbreaks In Syria 'Inevitable,' WHO Warns

“Outbreaks of hepatitis, typhoid, cholera or dysentery are ‘inevitable’ in Syria and its neighbors this summer, while cases of measles and other infections are already growing because of the country’s broken health system and increasing numbers of displaced people, the [WHO] has warned,” The Guardian reports (Meikle, 6/4). “Almost 4.25 million Syrians who have had to leave their homes are living in overcrowded, unsanitary conditions, with concerns about the provision of safe drinking water and safe sanitation,” BBC News writes, adding, “According to the WHO, at least 35 percent of the country’s public hospitals are out of service, and in some areas, up to 70 percent of the health workforce has fled” (6/4). The “WHO statement added that diarrhea and hepatitis A cases had doubled since January 2013, and because the Syrian health service could not run any vaccination campaign, measles started spreading across the country,” World Bulletin notes (6/5). “Cases of acute watery diarrhea have also shot up by 172 percent, from 243 cases to 660” from early January to the second week of May, The Star adds (Yang, 6/4).

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NPR Features Stories Examining Drug-Resistant TB

NPR features several stories examining drug-resistant tuberculosis (TB) in Eastern Europe. On Monday’s “All Things Considered,” correspondent Jason Beaubien tells the story of a young couple from the Moldovan city of Balti. Both have been treated for drug-resistant TB, but the man, Pavel, “has extremely drug-resistant TB, or XDR-TB, a version of the infection that has become a growing problem around the world, particularly in India, Eastern Europe and Southern Africa,” NPR’s “Shots” blog writes (6/3). On Tuesday’s “Morning Edition,” Beaubien reports on the debate in Moldova “over whether infectious TB patients should be returned to sanitariums or be treated at home.” According to the transcript, Beaubien states, “Roughly 40 percent of tuberculosis cases in Moldova are now classified as multi-drug resistant, and MDR-TB can be extremely difficult to treat” (6/4). And on Tuesday’s “All Things Considered,” Beaubien continues his reporting from Moldova, discussing why TB is so rampant in Moldova and the challenges it creates. NPR’s “Shots” blog features portraits of TB patients (6/4).

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New York Times Examines Case Of Salvadoran Woman Who Sought Abortion

Highlighting the case of Beatriz, a woman in El Salvador who sought an abortion in “a challenge to one of the strongest anti-abortion laws in the world,” the New York Times examines whether “doctors in a country that bans abortion under any circumstances manage[d] to terminate the pregnancy without violating the law” when they performed “a caesarean section that ended her high-risk pregnancy after almost seven months of gestation.” According to the newspaper, “With no guidance on how to proceed in complicated cases or a clear definition of what constitutes an abortion, [doctors] say, the country’s strict penal code has left itself open to interpretation.” The New York Times notes, “At its root, some legal experts said, the case was largely a battle over words.” The news analysis examines measures doctors have taken in the past to skirt the law (Zabludovsky/Palumbo, 6/4).

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Editorials and Opinions

Voluntary Medical Male Circumcision A 'Critical Pillar' In Fight Against HIV/AIDS

In “the 12th blog in a series of blogs from the Office of the Global AIDS Coordinator in recognition of the 10th anniversary of PEPFAR,” Ambassador Eric Goosby, head of the U.S. State Department’s Office of Global Health Diplomacy and the U.S. Global AIDS Coordinator, writes in the Huffington Post’s “The Big Push” blog, “When it comes to HIV/AIDS, men have an extraordinary opportunity to reduce their risk of HIV infection by almost 60 percent by undergoing voluntary medical male circumcision (VMMC).” He continues, “This one-time health intervention has the potential to save millions of lives and billions of dollars in HIV/AIDS treatment costs,” noting, “Modeling studies predict that the benefits of male circumcision are likely to be most significant in populations with high prevalence of primarily heterosexually driven HIV and low rates of male circumcision.”

“PEPFAR supports male circumcision activities in 14 countries in Eastern and Southern Africa that fit these criteria and is working side-by-side with countries and other partners to plan and implement programs safely and efficiently,” Goosby continues. “On May 31, 2013, PrePex™ became the first adult medical male circumcision device to receive WHO prequalification as an alternative to conventional surgical circumcision,” he notes, writing, “Although PEPFAR will continue to implement surgical circumcision programs, we look forward to helping African ministries of health assess the acceptability and safety of PrePex™ in their local public health contexts.” He concludes, “All people must seize every opportunity to protect themselves and their communities from HIV/AIDS. VMMC is one critical pillar in this fight” (6/4).

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With Continued Support For PEPFAR, 10 Years After Creation, Global Community Can Defeat HIV/AIDS

“In 2003, an AIDS diagnosis in sub-Saharan Africa was a death sentence. Just 10 years later, with high-tech drugs, courageous political commitment and funding, AIDS patients — millions of them — receive treatment and live long, fulfilling lives,” Tom Hart, U.S. executive director of ONE, writes in the Huffington Post’s “Impact” blog. “That’s in large part thanks to legislation that was enacted 10 years ago,” he continues, noting, “On May 27, 2003, President George W. Bush signed into law [PEPFAR], the largest commitment of funds by any one nation in human history to combat a single disease.” He states, “In partnership with the Global Fund to Fight AIDS, Malaria and [Tuberculosis] — the multilateral financing mechanism set up around the same time — PEPFAR has transformed the fight against HIV/AIDS and changed the way we think about humanitarian assistance.”

“To the lasting credit of our nation, Members of Congress from both sides of the aisle have supported PEPFAR from the beginning,” Hart continues, adding, “Moreover, an impressive cross-section of Americans — conservatives, liberals, students, union members, business leaders, church officials and others — have joined organizations like the ONE Campaign to lend their support to American initiatives that fight global diseases like HIV/AIDS.” He writes, “In a world more interconnected than ever, they understand that helping to create healthier societies is not only the right thing to do morally, but contributes to America’s economic and national security interests.” He concludes, “With a continued dedication of resources and political will that builds on lessons learned from PEPFAR’s first 10 years, we can defeat HIV/AIDS once and for all” (6/4).

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Support For Food Aid Reform Should Be 'No Brainer'

“The president took a bold step forward earlier this year when he requested wide-ranging changes to our food aid program to make them more efficient and cost-effective,” Jim French, the lead agriculture organizer for Oxfam America, writes in The Hill’s “Congress Blog,” noting Reps. Ed Royce (R-Calif.) and Karen Bass (D-Calif.) last month in the House Foreign Affairs Committee “introduced the Food Aid Reform Act, H.R. 1983, which would authorize a long-term fix to our broken food aid program.” He continues, “The president and members of the House Foreign Affairs Committee have stepped up where the Agriculture committees have failed to act.”

“I am disappointed that the House Agriculture Committee failed to grab the opportunity of reform as they took up the farm bill,” French continues, adding, “And though the Senate farm bill, which is being debated on the Senate floor, is better, it does not go far enough.” He states, “With common-sense reforms, up to 17 million more people would receive life-saving assistance — at no additional cost to the taxpayer,” and writes, “Cutting the red tape would allow humanitarian organizations to have the flexibility to purchase food aid closer to where it’s needed for better prices.” French continues, “Support for changing the status quo should be a no-brainer when more than half of the taxpayer dollars that could be helping to feed people are siphoned away into the pockets of middlemen before one hungry child is fed” (6/4).

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Malnutrition Eradication Rightly At Top Of Development Agenda

“The world community has decided, at last, to get serious about nutrition. That is the big message coming from national leaders and nutrition experts who will participate in the ‘Nutrition for Growth’ meeting convened by the U.K. and Brazilian governments to be hosted by Prime Minister David Cameron in London on June 8,” Jose Graziano da Silva, director-general of the U.N. Food and Agriculture Organization (FAO), writes in a Thomson Reuters Foundation opinion piece. The meeting “has elevated the focus of world attention on nutrition and has mobilized actors from two vital sectors — business and science — who need to be brought more fully into public action,” he writes, adding, “Scientists and businesses can work with governments, civil society and the U.N., through the reformed Committee on World Food Security and the Scaling Up Nutrition Movement.” He concludes, “[T]he broad measures that have been proposed to end malnutrition also serve to end extreme poverty and to empower women” (6/3).

In an opinion piece in the Huffington Post’s “World” blog, da Silva says, “This year’s edition of FAO’s publication, ‘The State of Food and Agriculture: Food systems for better nutrition,’ gives us some answers” about how to eradicate malnutrition. He discusses the importance of investing in research to increase productivity; cutting food losses and waste; better organizing food systems; and being more responsive to the needs of women and children. He continues, “Food security and nutrition are now at the very top of the international sustainable development agenda. We must be bold and take the step of committing to the total eradication of hunger and malnutrition” (6/4).

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Learning From The Success Of African Leadership In AIDS Response

“The AIDS epidemic threatened to overcome Africa — but instead, Africa and the world have united to overcome AIDS, going farther than most ever thought possible,” UNAIDS Executive Director Michel Sidibé writes in the Huffington Post’s “The Big Push” blog. “Today fewer people are becoming newly infected with HIV, millions are receiving HIV treatment, fewer babies are becoming infected with HIV, and Africa is investing more than ever in the AIDS response — and in the continent’s future,” he states and provides statistics. “From civil society and faith-based organizations, to the private sector and government, the visionary leadership of many Africans has played a major role in this success,” he continues.

“From the 2001 Abuja Declaration and the 2005 Gaborone Declaration through to the 2012 African Union Roadmap on Shared Responsibility and Global Solidarity for AIDS, TB and Malaria Response in Africa, the African Union has long taken a strong stand in solidarity with the tens of millions of people in Africa affected by HIV,” Sidibé continues, adding, “African governments are also steadily decreasing their reliance on donor funding for these efforts.” He writes, “As we look to our future goals, African leadership can be the pathfinder to better global health,” adding, “In particular, there are five things that we have learned from the AIDS response” — “Put people at the center,” “[m]obilize culture and communities,” “[s]implify the architecture and strengthen accountability,” “[s]hare responsibility and stand in solidarity,” and “[e]levate health as a force for social transformation” (6/4).

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From the Global Health Policy Community

Proposed Food Aid Reform Needs Bipartisan Support

Noting “[t]he Obama administration’s FY14 budget request included a food aid reform proposal that the administration estimated would allow U.S. food aid to reach an additional two to four million people per year — for roughly what the United States spends now,” Beth Schwanke, senior associate for policy outreach at the Center for Global Development (CGD), writes in the CGD’s “Rethinking US Foreign Assistance Blog,” “As [my colleague Kim Elliott, a senior fellow at CGD,] previously put it, the administration’s proposal is welcome but still only ‘half a loaf’ of reform.” She continues, “But even the administration’s half reform appears to be too much in the face of strong pushback from maritime interests and some in the farm industry,” adding, “A champion for big reform in the Senate has yet to emerge but the optimist in me says that this kind of smart reform that eliminates enormous waste in the U.S. system is just calling out for a bipartisan push, even if not in the very near term” (6/4).

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Blog Examines Disagreement Over Food Aid Reform Among Aid Groups

“Food aid is shaping up to be one of the most hotly contended issues in the frequently hotly contended Farm Bill,” development blogger Tom Paulson writes in the Humanosphere blog. “[T]he Obama administration has proposed some major changes to food aid aimed at purchasing some of the food overseas and closer to the hunger crisis du jour,” Paulson writes, adding, “This is the approach taken by other donor countries doing food aid and is widely regarded by experts as cheaper (a better buy for the taxpayers), more efficient and, if adopted by the U.S., capable of feeding two to four million more hungry people per year for the same amount of money.” He discusses how two organizations involved with food aid, Oxfam and World Vision, disagree on the proposed changes. Paulson concludes, “[S]o far, mean politics appears to be winning over meaningful policy. The U.S. Senate [on Monday] largely ignored the Obama administration’s requests for food aid reform” (6/4).

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