KFF Daily Global Health Policy Report

In The News

Expanded Mexico City Policy Hindering Access To Health Care For Some Women In Africa, Asia, Report Says

Devex: Two years in, report finds ‘global gag rule’ cuts access to health care
“More than two years after the Trump administration’s implementation of the expanded ‘global gag rule,’ the impacts of the U.S. policy are increasingly clear: the regulations are cutting access to all health services, according to a new report from the International Women’s Health Coalition. The Mexico City policy — which states that foreign NGOs that receive any U.S. global health funding are prohibited from engaging in abortion-related activities, including providing counseling or education — had an instant chilling effect on those organizations, forced to choose between providing abortion-related services and receiving U.S. global health funding…” (Lieberman, 6/5).

The Guardian: Trump’s anti-abortion global gag rule threatening women’s lives, report says
“…The ‘Crisis in Care’ report from the International Women’s Health Coalition outlines the two-year impact of the Trump administration’s ‘global gag rule’ … The rule applies to an organization’s non-U.S. funded activities too… The new report, built on 118 interviews with community health organizations in Nigeria, Kenya, South Africa, and Nepal, portrays an international health community grappling with confusion over the gag rule’s implementation, increased stigmatization of reproductive health services, and a ripple effect that is closing or fragmenting critical health services…” (Horton, 6/5).

Thomson Reuters Foundation: U.S. global abortion policy causing deaths, researchers say
“…The research, which looked at the policy’s impact in Kenya, Nepal, Nigeria, and South Africa, was released at Women Deliver, a global conference on gender equality held every three years. … Beyond the impact on the availability of safe abortions, the rule has forced the closing of clinics and outreach programs that provide an array of health care services, the report said. … A spokeswoman for the U.S. Agency for International Development (USAID), which administers aid, said the government was making sure it did not fund groups that ‘perform or actively promote abortion as a method of family planning.’ Most of the groups that receive U.S. government [global health] aid have agreed to the policy’s conditions, she said. ‘The United States remains committed to helping women and their children thrive, particularly in countries where the need is greatest,’ the USAID spokeswoman said…” (Wulfhorst, 6/5).

Additional coverage of the report is available from Al Jazeera, The Independent, and VICE.

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Trump Administration Restricts Federal Research Involving Fetal Tissue, Ends UCSF Project Using Tissue To Test HIV Treatments

Associated Press: Trump halts fetal tissue research by government scientists
“The Trump administration said Wednesday that it is ending medical research by government scientists that uses human fetal tissue. The Health and Human Services Department said in a statement that government-funded research by universities that involves fetal tissue can continue for now, subject to additional scrutiny — although it also ended one major university project that used the tissue to test HIV treatments. That school — University of California, San Francisco — called the decision ‘politically motivated.’ Administration officials said the federal policy changes will not affect privately funded research…” (Alonso-Zaldivar/Neergaard, 6/5).

Washington Post: New restriction on fetal tissue research ‘was the president’s decision’
“…The determination to tighten federal support for an ideologically polarizing aspect of medical research was made by President Trump himself, a White House spokesman confirmed. ‘This was the president’s decision,’ said spokesman Judd Deere, calling it ‘another important policy … to protect the dignity of human life.’ The change represents … a major disappointment to scientists who say the tissue collected from elective abortions has been instrumental to unlocking the secrets of diseases that range from AIDS to cancers to Zika, as well as to developing vaccines and treatments for illnesses such as Parkinson’s disease…” (Goldstein, 6/5).

Additional coverage of the administration’s actions is available from Los Angeles Times, New York Times, POLITICO, San Francisco Business Times, Science, and STAT.

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U.S. Congress Sends Pandemics And All-Hazards Preparedness Bill, Including BARDA Reauthorization, To Trump For Approval

Healio: Congress takes step to support BARDA’s mission of pandemic preparedness
“Congress recently passed the Pandemics and All-Hazards Preparedness and Advancing Innovation Act, or PAHPAI, which will allow the Biomedical Advanced Research and Development Authority, or BARDA, to strengthen the country’s preparedness against a variety of global disease threats. The passage of PAHPAI reauthorizes certain programs, such as BARDA, under the Public Health Service Act and the Federal Food, Drug and Cosmetic Act…” (6/5).

Homeland Preparedness News: Pandemic and all-hazards preparedness, response bill heads to Trump following House approval
“[The bill] now heads to President Donald Trump’s desk for his signature to make it law. S. 1379, sponsored by U.S. Sen. Richard Burr (R-N.C.) on May 8, will strengthen the nation’s health security strategy, improve preparedness and response, bolster the country’s emergency response workforce, prioritize a threat-based approach, and increase communication in medical countermeasure advanced research and development, among numerous other provisions contained in the sweeping legislation…” (Riley, 6/4).

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Ebola Vaccine Expected To Run Out, CDC Director Warns; Ebola Lab Robbed In Beni, DRC Officials Say

CIDRAP News: New violence in Beni, DRC, as Ebola lab targeted
“Thieves robbed an Ebola lab in Komanda yesterday, taking laptops and a GeneXpert device used to test virus samples, the Democratic Republic of Congo’s (DRC’s) ministry of health said in [Tuesday’s] daily report. … The DRC said response efforts are still under way in Beni, despite the chaos…” (Soucheray, 6/5).

Devex: CDC director expects to run out of Ebola vaccine
“The director of the Centers for Disease Control and Prevention predicts that responders in the Democratic Republic of the Congo will exhaust the current supply of the Ebola virus vaccine before the pharmaceutical company manufacturing them can produce more. Robert Redfield, director at CDC, relayed that warning to U.S. lawmakers on Tuesday, just as new reports indicated the number of Ebola virus cases in eastern DRC has climbed past 2,000. While the Ebola vaccine has been helpful in this unprecedentedly difficult response effort, regulatory delays have stalled production of new vaccine stocks, Redfield said in a U.S. House of Representatives hearing…” (Igoe, 6/6).

Additional coverage of the DRC Ebola outbreak and response is available from The BMJ, Quartz Africa, and Thomson Reuters Foundation.

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World Leaders, Global Community Should Prioritize Ending FGM, Advocates Say At Women Deliver

Thomson Reuters Foundation: World leaders urged to make female circumcision a priority like HIV
“Tackling female genital mutilation (FGM) should be made a global priority like HIV/AIDS, according to campaigners concerned about growing evidence that the abusive practice was more widespread than thought. … Some 200 million girls and women are impacted by FGM worldwide, according to U.N. data, but some activists said this was a ‘massive underestimate’ as it ignored the true geographic spread of FGM and omitted children and older women. … British anti-FGM charity Orchid estimated global funding for FGM was about $200 million for the period 2018 to 2021. HIV by comparison — which affects about 37 million people — attracted $20 billion in funding in 2017. … Campaigners called for data collection to be ramped up in order to fully assess the global scale of FGM and better target efforts to end it…” (Batha, 6/5).

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U.N. To Allocate $45M From Emergency Response Fund For Food, Humanitarian Aid To Somalia Amid Drought, Official Says

Associated Press: U.N.: 2 million Somalis could die of starvation amid drought
“A United Nations emergency relief coordinator says more than 2 million men, women, and children could die of starvation in Somalia by summer’s end if international aid is not sent quickly to the drought-stricken African country. U.N. Undersecretary-General Mark Lowcock says about $700 million is needed after a rainless season that has killed both livestock and crops…” (6/5).

New York Times: U.N. Aid Chief Warns of Looming ‘Horror’ as Somalia Again Faces Famine
“…The official, Mark Lowcock, under secretary general and emergency relief coordinator at the United Nations, said that he had allocated $45 million from its emergency relief fund to help purchase food and other assistance for people of the region, and that many of them could face a serious food crisis by September. He called the allocation one of the biggest ever made from the fund…” (Gladstone, 6/5).

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More News In Global Health

CBS News: Air pollution kills 100,000 Indian children every year, study says (6/5).

Devex: To close gap in unpaid care work, a new call to action asks men to do more (Rogers, 6/5).

Miami Herald: Venezuela doctors fear country is at risk of deadly epidemic outbreak (Freisler, 5/29).

Quartz Africa: A battle with TB inspired his smart medicine dispenser, now it’s won Africa’s top engineering prize (Asiedu, 6/5).

Reuters: U.S. finds American guilty in Singapore HIV data leak case (Aravindan, 6/5).

VOA News: WFP: Growing Violence Destroys Vital Crops, Farmland in NW Syria (Schlein, 6/4).

VOA News: WHO: Fighting Air Pollution Key to Living Longer (Schlein, 6/5).

Vox: Vaccines that don’t need refrigeration could save a ton of lives (Piper, 6/5).

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Editorials and Opinions

U.S. Should Increase Global Health Investments To Continue To Support Africa's Health Advances

Devex: Opinion: The U.S. must continue to support Africa’s advances in health
Charles Holmes, co-director at the Center for Global Health Practice and Impact and visiting associate professor of medicine at Georgetown University; Susan C. Kim, executive director of the Center for Global Health Practice and Impact and assistant professor in the Department of Medicine at Georgetown University Medical Center; and Mark Dybul, co-director of the Center for Global Health Practice and Impact, professor in the Department of Medicine at Georgetown University Medical Center, and chair and fellow with the Joep Lange Institute

“…U.S. investments have helped catalyze domestic resource mobilization for health by governments, communities, and partners throughout the African continent. … As African leaders advance their commitments to fund some of the world’s most pressing health challenges, the United States should meet that ambition with robust commitments of our own. We are entering an era where African leadership will increasingly define and lead the efforts in global health security, migration, and broader improvements in health that will further stimulate a virtuous cycle of development. This is not the time to back away from U.S. support, as the current administration has suggested. … Rather, it is the time to double down on the great health successes that have been achieved and the diplomatic, security, and economic benefits the U.S. has received by increasing our funding for the upcoming Global Fund and Gavi replenishments and for PEPFAR and other bilateral global health programs…” (6/5).

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Breastfeeding Critical To Children's Health; Women Need Social Support To Breastfeed

New York Times: Where a Miracle Substance Called Breast Milk Saves Lives
Mia Armstrong, 2019 graduate of Arizona State University and winner of Nicholas Kristof’s 2019 ‘win-a-trip’ contest

“…The lives of 823,000 children younger than five could be saved annually if we scaled up breastfeeding to near universal levels, according to estimates published in The Lancet breastfeeding series from 2016. Specifically, breastfeeding is linked with decreases in diarrhea, middle ear infections, and respiratory infections and increases in IQ and nutrition. … The good news is that these are lives we know how to save: Babies should start breastfeeding within an hour of birth, breastfeed exclusively for the first six months of life without any other food or liquid, and then continue breastfeeding with complementary food until they are at least two years old, according to the World Health Organization. … But when we frame breastfeeding as solely a woman’s responsibility, as the 2016 Lancet series notes, we are also ‘ignoring the role of society in its support and protection.’ Though the challenges look different depending on where you are, as a society we’ve erected barriers all around the world to make it harder for women to give their children the breast milk they need in the way they need it. In the United States, these barriers may involve workplace rules hostile to breastfeeding or hospitals that unnecessarily separate infants from mothers, whereas in [other countries], they may involve misinformation surrounding when to introduce water or lack of access to healthy complimentary food. … [T]o breastfeed, [women] may just need more support…” (6/5).

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From the Global Health Policy Community

PAI, WaterAid Release Report On Impact Of Mexico City Policy On WASH Sector

PAI: How the Expanded Global Gag Rule Affects Water, Sanitation and Hygiene
This report, coauthored by WaterAid and PAI, discusses the ways in which the expanded Mexico City policy affects Water, Sanitation and Hygiene (WASH) efforts, noting, “WASH programs have an unusual funding structure within the U.S. government, in that funding is split across multiple accounts and agencies — some which are subject to [the policy] and some which are not.” This report provides an overview of how the policy might affect the WASH sector (6/4).

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Global Fund Posts Discuss Efforts To Support Young Women, Girls To End HIV/AIDS

Global Fund to Fight AIDS, Tuberculosis and Malaria’s “VOICES”: Silence Is Bad for Women’s Health
Linda Mafu, head of political and civil society advocacy at the Global Fund, discusses the role of social movements, like the #MeToo movement, in advocating against sexual violence and ending HIV/AIDS. Mafu notes, “We will only end HIV if we achieve a massive reduction in infection rates among adolescent girls and young women. We will only reduce those infections if we end sexual violence and other forms of gender inequalities. … We’ve known for decades that shame, taboo, and simple embarrassment have hindered the fight against HIV. Sexual violence magnifies all of those very human responses. The result has been silence, and a preventable epidemic has claimed millions of lives. But when women claim their stories and their voices, they claim their power. When societies call out for equality and dignity for all, they lay the foundation for health and well-being. To truly deliver for women, we must all become silence breakers.” This post was originally published in the Hill Times Canada (6/5).

Global Fund to Fight AIDS, Tuberculosis and Malaria’s “VOICES”: “We Are the Ones Who Are Going to End HIV”
In this post, HER Voice ambassadors explore answers to the question, “What is the global health community missing in its effort to support young women and girls to end HIV?” (6/5).

Global Fund to Fight AIDS, Tuberculosis and Malaria’s “VOICES”: Conquering HIV Again
This post discusses the experience of a woman in South Africa living with HIV and her efforts to educate her teenage daughter about the virus and ways to prevent it (6/3).

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CSIS Releases June 2019 Issue Of Global Health Policy Center Monthly Newsletter

Center for Strategic & International Studies: Global Health Policy Center Monthly Newsletter: June 2019
In the June 2019 CSIS Global Health Policy Center Newsletter, J. Stephen Morrison, senior vice president of CSIS and director of the CSIS Global Health Policy Center (GHPC), highlights recent publications, podcasts, and events hosted by CSIS. These include a commentary by GHPC Senior Fellow Nellie Bristol on the need for Gavi, the Vaccine Alliance and the Global Polio Eradication Initiative (GPEI) to collaborate more fully on polio eradication; a podcast episode in which Morrison speaks with Christopher Murray, director of the Institute for Health Metrics and Evaluation (IHME), about global diet-related issues and evaluating global eating habits and food systems; and a recent event highlighting U.S. efforts to end HIV/AIDS in the U.S. by 2030 (June 2019).

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Organizations Recognize World Environment Day, Highlighting Air Pollution

U.N. Environment: On World Environment Day, world turns spotlight on air pollution
“Governments, industry, communities, and individuals around the world [on Wednesday] commemorated World Environment Day, the United Nations’ biggest annual event for positive environmental action, encouraging worldwide awareness and commitment to protect our planet. This year’s celebrations, held under the theme ‘Beat Air Pollution,’ called upon people to explore renewable energy and green technologies, and improve air quality in cities and regions across the world…” (6/5).

U.N. Environment: Nine governments join BreatheLife on World Environment Day, commit to action on air pollution
“The BreatheLife campaign is proud to announce that nine new governments have joined its ranks, making fresh commitments to demonstrate their dedication to bring air quality to safe levels by 2030 and collaborate on the clean air solutions that will help us get there faster. Bogota (Colombia), Lalitpur and Kathmandu (Nepal), Honduras, Bogor City (Indonesia), the Republic of Moldova, Monaco, Montevideo (Uruguay), and Mexico bring the number of cities, regions, and countries in the BreatheLife Newtwork to 63, representing 271.4 million citizens around the world…” (6/5).

UNICEF: Only 6 percent of children in Africa live in areas where air pollution is reliably measured at the ground-level
“Only 6 percent of children in Africa live in areas where air pollution is reliably measured at ground-level, leaving half a billion children across the continent living in areas with no reliable means of measuring air quality, according to a new UNICEF report released on World Environment Day…” (6/4).

World Economic Forum: 5 ways to #BeatAirPollution
Emma Charlton, senior writer at Formative Content, highlights five areas in which the international community can take action against air pollution: automobiles, food, waste, energy, and advocacy (6/5).

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