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Kaiser Daily Global Health Policy Report

In The News

Trump Administration's FY 2020 Budget Request Calls For Cuts To Global Health, Including Bilateral HIV Spending, While Increasing Funding For Domestic HIV Efforts

Associated Press: The Latest: Hospital groups protest cuts in Trump budget
“President Donald Trump’s proposed government spending plan would cut funding for diplomacy and development by about 24 percent. But Congress has twice rejected the Trump administration’s attempts to slash the foreign affairs budget and is likely to do so again. … Anti-AIDS activists are condemning proposed cuts for worldwide efforts to fight the disease in President Donald Trump’s new budget request. Activists say the global cuts are at cross-purposes with the $291 million in additional spending that Trump has requested for an effort to virtually eliminate new HIV infections in the United States…” (3/11).

Devex: U.S. budget slashes global development funding, stresses burden sharing
“…In addition to the proposed cuts, the budget repeatedly mentions the need for other countries to share the burden for funding various global health and development priorities and pointed to aid being seen as a foreign policy tool: ‘The budget supports America’s reliable allies, but reflects a new approach toward countries that have taken unfair advantage of the United States’ generosity,’ the 150-page budget document reads…” (Saldinger, 3/12).

Foreign Policy: Despite Pompeo’s Call for ‘Swagger,’ Trump Slashes Diplomatic Budget
“…President Donald Trump’s fiscal year 2020 budget proposal, released on Monday, calls for a [24] percent cut for the international affairs budget. The budget proposal would hit international organizations hardest, imposing up to $1 billion in cuts for United Nations activities and slashing more than 30 percent in humanitarian assistance. It also appears to dismantle the State Department’s chief refugee protection bureau. … The proposal drew fierce backlash from Democratic lawmakers and some foreign policy experts, as well as a cadre of former top military commanders who argue continued cuts to diplomacy and foreign aid harm U.S. national security…” (Gramer/Lynch, 3/11).

Kaiser Health News: Trump’s Budget Offers $291M To Fight HIV In U.S. But Trims Overseas Efforts
“…[W]ithin the budget, the administration also proposed actions that could undermine efforts to control the virus’s spread, HIV experts and advocates said, including carving out funds from programs that aim to eradicate HIV in other parts of the world. Among those moves was a $1.35 billion cut in [bilateral HIV funding through] the President’s Emergency Plan for AIDS Relief (PEPFAR), according to an analysis by the Kaiser Family Foundation. [Kaiser Health News is an editorially independent program of the (Kaiser Family Foundation).] … The budget proposal is for the fiscal year beginning Oct. 1. Congress is not obligated to fulfill any of the requests in the budget proposal. The administration has asked for similar cuts to global HIV initiatives in the past without success…” (Rodriguez, 3/12).

Science: Trump once again requests deep cuts in U.S. science spending
“For the third year in a row, President Donald Trump’s administration has unveiled a budget request to Congress that calls for deep spending cuts at many federal science agencies, including a … cut for the National Institutes of Health (NIH) and a … cut for the National Science Foundation (NSF), while providing hefty increases for the military…” (3/11).

TIME: Trump’s Budget Asks for Nearly $300 Million to End the U.S. HIV Epidemic Within 10 Years
“President Donald Trump’s proposed 2020 budget includes nearly $300 million meant to ‘defeat the HIV/AIDS epidemic’ in the U.S. — even as it calls for a 12% reduction in total funding to the Department of Health and Human Services (HHS). During his February State of the Union address, Trump announced an ambitious plan to ‘eliminate the HIV epidemic in the United States within 10 years’…” (Ducharme, 3/11).

Wall Street Journal: Budget Proposal Adds Funding for Fighting HIV/AIDS in U.S., Cuts Contribution to Global Effort
“…HIV advocates had hoped that President Trump’s pledge in his State of the Union address to ‘defeat AIDS in America and beyond’ would translate into more money for U.S. programs that provide HIV prevention, testing, and treatment in developing countries. But his budget called for a 29% cut to the U.S.’s signature program, to $3.4 billion, for the U.S. President’s Emergency Plan for AIDS Relief. It also proposed a 29% cut to its fiscal 2020 contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria, a Geneva-based, international financing organization, and a $1 billion decrease in U.S. funding for the Global Fund over the next three years…” (McKay, 3/11).

Washington Post: Budget calls for deep cuts to foreign aid, especially for refugees and in humanitarian crises
“The Trump administration is proposing slashing the budget for the State Department and the United States Agency for International Development (USAID) by almost 24 percent, with particularly steep cuts to humanitarian aid, refugee assistance, and global health programs. The proposed 2020 budget would take three funds that collectively are funded by more than $9 billion and consolidate them into an International Humanitarian Assistance fund that would be allotted about $6 billion, a one-third drop. In addition, the administration proposes cutting global health programs from [$8.8 billion] this year to $6.3 billion next year, a cut of … 28 percent. … State Department officials defended the budget, saying the United States remains the world’s largest contributor to global health and humanitarian efforts. They said the State Department’s proposed budget reflects the desire to reward U.S. allies with similar goals and get other donors to be more generous…” (Morello, 3/11).

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NIAID Director Anthony Fauci Discusses Recent HIV Research Results In Hill.TV Interview

The Hill: Most recent HIV breakthrough is ‘not widely applicable’ to most patients, says expert
“The director of the National Institute of Allergy and Infectious Diseases told Hill.TV on Monday that a recent breakthrough that appeared to cure an HIV-positive patient is ‘not widely applicable’ to the majority of people living with the virus that causes AIDS…” (Manchester, 3/11).

The Hill: Expert says gene editing could be ‘promising’ path to HIV cure
“Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, on Monday told Hill.TV that gene editing could prove to be promising in curing more HIV patients after a recent breakthrough has appeared to provide only the second-known cure to an HIV-positive patient…” (Manchester, 3/11).

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WHO Releases 11-Year Global Influenza Plan, Saying Threat Of Pandemic Flu 'Ever-Present'

Deutsche Welle: Next flu pandemic ‘a matter of when, not if,’ says WHO
“The World Health Organization (WHO) on Monday outlined a global plan for fighting influenza and trying to prevent or slow any worldwide outbreak of the viral disease, warning that the danger of a pandemic was ‘ever-present’…” (Jones, 3/11).

Reuters: World must prepare for inevitable next flu pandemic, WHO says
“… ‘The threat of pandemic influenza is ever-present,’ Tedros Adhanom Ghebreyesus, the WHO’s director general, said in a statement. ‘We must be vigilant and prepared — the cost of a major influenza outbreak will far outweigh the price of prevention’…” (Kelland, 3/11).

U.N. News: U.N. unveils global influenza strategy to prevent ‘real’ threat of pandemic
“…The WHO’s 11-year plan focuses on the formulation of robust national programs and has three goals: reducing seasonal influenza, minimizing the risk of transmission from animals to humans, and limiting the impact of a pandemic. In addition, WHO is calling for better tools to prevent, detect, control, and treat influenza, such as more efficient vaccines and anti-viral drugs…” (3/11).

Additional coverage of the WHO’s flu plan is available from Fortune, The Telegraph, and VOA News.

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Already Struggling, Venezuela's Hospitals Heavily Impacted By Nationwide Power Outage

Reuters: Doctors pray for sick as blackout batters Venezuelan hospitals
“…Venezuela’s hospitals, already struggling with shortages of supplies and equipment amid an economic meltdown, entered crisis mode on Thursday when the South American nation’s power system went down. Public hospitals typically have generators to provide back-up electricity in the event of an outage, but doctors consulted by Reuters said they were either damaged or idled for lack of fuel…” (Armas, 3/11).

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U.N. Staff Members, Aid Workers Among 157 Killed In Ethiopian Airlines Flight 302 Crash

Devex: In Nairobi, aid community struggles in wake of ET302 crash
“In the United Nations’ Nairobi complex in Kenya, which houses several agencies, the mood has been subdued since the shocking news that 157 people were killed in the Ethiopian Airlines Flight 302 crash on Sunday morning. … At least 45 aid professionals and those working for international organizations are believed to have been on the flight, including nine from the African Union, seven from the World Food Programme, and six from the U.N. Office at Nairobi, or UNON…” (Sampathkumar, 3/12).

New York Times: Victims of Ethiopian Airlines Flight 302 Came From at Least 30 Nations
“…On Sunday, when Ethiopian Airlines Flight 302 plummeted to the ground shortly after takeoff, killing more than 150 people, the plane had a particularly high concentration of United Nations employees: At least 22 staff members died in the crash, a United Nations official said on Monday. The airline said the flight had passengers from at least 30 countries, some of whom were aid workers for other humanitarian organizations…” (Jacobs/Searcey, 3/10).

Wall Street Journal: U.N. Remembers Victims of Ethiopian Airlines Crash
“…Ten U.N. agencies lost employees on flight 302, which crashed shortly after takeoff from Addis Ababa en route to Nairobi, killing all 157 aboard. … The deaths of the aid workers — who included Europeans, Asians, and Africans — underscored the inherent risks faced by many U.N. personnel who travel the world for investigations that subject them to dangers from disease, terrorist attacks, and travel accidents…” (Fassihi/Legorano, 3/11).

Washington Post: ‘In deep grief’: Aid workers, U.N. staff, tourists among victims in Ethiopia plane crash
“…The Rome-based World Food Programme, which provides food assistance to millions of people across the world and in the Horn of Africa, lost seven employees. David Beasely, the agency’s executive director, said the loss was ‘devastating, heartbreaking. I don’t think there was a dry eye today in our team in Addis’…” (Schemm et al., 3/11).

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More News In Global Health

BBC News: Tunisian health minister resigns over 11 baby deaths (3/10).

CIDRAP News: New attack, case in high-risk village among latest Ebola perils (Schnirring, 3/11).

CIDRAP News: Sewage study highlights global antimicrobial resistance disparity (Dall, 3/11).

Dallas News: Ethiopians didn’t have a term for ‘stroke,’ so this Dallas doctor created one (Kuchment, 3/11).

Devex: What to expect from WTO’s 2019 Global Review of Aid for Trade (Cornish, 3/11).

GlobalPost/PRI: Blame game over aid leaves Syrian refugees stranded in desert ‘death’ camp (Carrié/Al Omar, 3/11).

The Guardian: Pathogens hitchhiking on plastics ‘could carry cholera from India to U.S.’ (McVeigh, 3/11).

The Guardian: Surge in chemical use ‘a threat to health and environment’ (Watts, 3/12).

Reuters: China lawmakers urge freeing up family planning as birth rates plunge (Stanway, 3/12).

Reuters: Deadly plague breaks out on Uganda-Congo border, WHO says (Miles, 3/12).

Science: Largest-ever HIV prevention study delivers sobering message (Cohen, 3/11).

U.S. News & World Report: Air Pollution Causes 8.8 Million Extra Deaths a Year (Trimble, 3/12).

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Editorials and Opinions

U.S. Should Take Leading Role In Addressing Ebola, Opinion Piece Says

Tribune Chronicle: U.S. should take lead in fight against Ebola
Editorial Board

“…Battling Ebola on its home turf in Africa presents various challenges. They include a dearth of decent health care facilities. … But African doctors and nurses, often with help from groups such as Doctors Without Borders, do the best they can. … Officials from the World Health Organization and the U.S. Centers for Disease Control and Prevention have been to the outbreak area, vowing — again — to stamp out Ebola. That seems unlikely. Nature, even in its most unpleasant aspects, is highly resistant to human efforts. Still, we have to try — and the United States should be taking a lead role. If Ebola is not at least contained, the threat of it spreading to other parts of the world is enormous. We Americans may not be so lucky the next time that happens” (3/12).

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Ending HIV/AIDS Epidemic Achievable By Diagnosing People With HIV, Providing Them With Treatment

Washington Post: Physicians cured a man of HIV. But that’s not our best shot at fighting AIDS.
Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases at NIH

“…For the second time in history, a man had been cured of HIV. Many considered this a breakthrough. But it is important to put this case and its predecessor into perspective. This cure is an exceedingly risky procedure, and while developing it into a safe and scalable treatment is a laudable goal, we must focus on using the tools we already have to end the HIV/AIDS epidemic. … The importance of the [bone marrow stem cell] transplants for the Berlin and London patients is not the potential for widespread use; it is most valuable as a road map for further research. … [A] more immediate issue is the gap in providing proven, lifesaving anti-HIV drugs to people who need them. … [I]f we could identify almost all people with HIV infection and get them on therapy, as well as provide PrEP to a high percentage of people at risk, we could end the HIV/AIDS epidemic. The Berlin and London patients give important insights for HIV researchers, and a cure for HIV is an aspiration we continue to pursue. But the end of the epidemic — the reduction of new HIV infections and HIV-related deaths to very low levels — is within our reach even without a cure. It is our ethical duty to use the tools we have already to stop this disease. Because that would be a real breakthrough” (3/11).

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National Public Health Institutions Vital To Outbreak Preparedness In Africa

Nature: How Africa can quell the next disease outbreaks
John N. Nkengasong, director of the Africa Centres for Disease Control and Prevention

“This week, African and global health experts and policymakers are gathering in Addis Ababa to discuss how to enable national public health institutions (NPHIs) to keep emerging and re-emerging infectious disease in check. At the top of the agenda must be empowering local leadership to act fast…. NPHIs are a health-security imperative in a changing Africa … And we have seen time and again that an outbreak in Africa is a global threat. … NPHIs should prioritize four broad areas. First, providing basic functions such as disease surveillance and coordinating emergency operations, even in remote areas. Second, creating lab networks that can quickly diagnose, track, and pinpoint the origin of emerging infections. Third, developing a workforce to collect, assess, share, and act on quality data … Fourth, developing a strong capacity for social scientists to engage with communities and change behaviors. … All this requires political leadership, financial commitment, partnerships, and innovation. … [N]o one doubts that this road map for pandemic preparedness requires unprecedented levels of political and financial engagement. … The health of the continent, and of the world, depends on all of us keeping our commitments” (3/11).

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Latin America Must Address Issue Of Obstetric Violence Against Women

New York Times: Latin America Claims to Love Its Mothers. Why Does It Abuse Them?
Vanessa Barbara, author

“…[Obstetric violence] refers to disrespectful, abusive, or neglectful treatment during pregnancy, childbirth, abortion, and the postpartum period. … In Latin America, reports of obstetric violence have been extensively documented. … The most common kinds of mistreatment are non-consensual procedures (including sterilization), non-evidence-based interventions like routine episiotomies, and physical, verbal, and sexual abuse. … Putting a name to the practice of obstetric violence is the first step toward standing up against it, and so, of course, doctors have begun fighting back. … It is disappointing to see that some doctors are more concerned with the way this semantic ‘aggression’ injures their prestige than with the concrete, horrendous reality of abuse that abounds against women in childbirth, not only in Latin America but elsewhere. It’s plain that they resent the limitations on their authority. But pregnancy is not an exception to the idea that a capable patient has the right to make informed decisions about her medical care. Health care providers should not ‘explain what will be done’ to pregnant women; they should honestly discuss our choices and respect our bodily autonomy. And choosing another term such as ‘disrespect during childbirth’ instead of ‘obstetric violence’ will not soften the atrocities often committed by caregivers in the name of ‘doctor knows best'” (3/11).

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From the Global Health Policy Community

Global Health Organizations Release Statements On President's FY 2020 Budget Request

Friends of the Global Fight Against AIDS, Tuberculosis and Malaria: A look at the impact of the President’s FY20 budget proposal
“The White House released its preliminary fiscal year 2020 budget request, proposing major cuts to global health spending, including … for the Global Fund to Fight AIDS, Tuberculosis and Malaria…” (3/11).

Friends of the Global Fight Against AIDS, Tuberculosis and Malaria: ‘This Budget Does Not Represent the U.S. Global Fund Replenishment Pledge’
“The White House released its preliminary fiscal year 2020 budget request [Monday], proposing major cuts to global health spending, including a … reduction compared to fiscal year 2019 appropriation levels to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and major cuts to bilateral global health programs…” (3/11).

Global Health Council: Global Health Council Rejects President’s Budget, Calls for Continued U.S Investments in Global Health and Development Programs
“…These proposed cuts undermine the leadership role the United States has played in global health and development, and could potentially roll back major milestones achieved in the field thus far. ‘The Trump administration continues to jeopardize the long-term impact that U.S. investments in foreign assistance and global health programs have had on millions of lives around the world,’ stated Loyce Pace, President and Executive Director of Global Health Council…” (3/12).

International Rescue Committee: Leading humanitarian, development, and global health organizations urge congress to reject cuts to foreign assistance
“Leading humanitarian, development, and global health organizations Bread for the World, CARE, Catholic Relief Services, Interaction, International Rescue Committee, Mercy Corps, ONE, Oxfam, PATH, Save the Children, and World Vision, are calling on Members of Congress to protect the International Affairs budget in Fiscal Year 2020 (FY20) despite the administration’s proposed … cuts. American leadership is critical in the face of daunting global challenges, from conflict to mass displacement, from food insecurity to global health crises…” (3/11).

Modernizing Foreign Assistance Network: Trump Administration Again Slashes Resources for Effective Development and Diplomacy
In a statement delivered on behalf of MFAN, Co-Chairs George Ingram, Lester Munson, and Tessie San Martin, write, “MFAN is alarmed for the third consecutive year by the Trump administration’s massive proposed cuts to the U.S. foreign affairs budget. … MFAN supports wise and strategic spending decisions, but unreasonable, drastic cuts harm the effectiveness and efficiency of our nation’s interests abroad. … MFAN will work with Congress to oppose these cuts, provide the necessary resources to ensure our security, and reaffirm U.S. global leadership, while furthering effectiveness and evidence-based reform” (3/12).

Save the Children: Save the Children Condemns President’s Proposed Deep Cuts to Foreign Aid for Third Consecutive Year
“Save the Children condemns the president’s third consecutive budget request seeking to make deep cuts to international development, diplomatic, and humanitarian assistance. The fiscal year (FY) 2020 budget request … if enacted, would have disastrous impacts on the health, education, and safety of children and families abroad. Cuts to these programs could mean more children going hungry, fewer children receiving quality education, more children at risk in fragile and conflict-affected states, and fewer opportunities for promoting global gender equality and empowering women and girls…” (3/11).

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

Center for Strategic & International Studies: Global Health Policy Center Monthly Update
In the March 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 past and upcoming events hosted by CSIS. The newsletter includes links to a commentary on the U.S. and international community’s need to address North Korea’s health and humanitarian situation; a podcast episode hosted by Nellie Bristol, senior fellow at the CSIS GHPC, who speaks with Senator Ayesha Raza Farooq of Pakistan about polio eradication in the country; and an upcoming CSIS event on maximizing U.S. global nutrition investments (March 2019).

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Bloomberg Philanthropies Works With Tanzania To Improve Maternal Health, Family Planning Services

Bloomberg Philanthropies: A Model for Preventing Maternal Deaths
Neena Prasad, director of Obesity Prevention and Maternal & Reproductive Health Programs at Bloomberg Philanthropies, discusses Bloomberg Philanthropies’ Maternal and Reproductive Health Program’s efforts to improve obstetric and family planning services in Tanzania by partnering with the Tanzanian government to make quality maternal health services accessible at the community level (3/8).

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From the U.S. Government

U.S. Department Of State, USAID Release Resources On FY 2020 Budget Request

U.S. Department of State: Briefing With Deputy Secretary of State John J. Sullivan, USAID Administrator Mark Green, and Experts on the President’s Fiscal Year 2020 Budget Request for the U.S. Department of State and USAID
This press briefing highlights remarks by Deputy Secretary of State John J. Sullivan, USAID Administrator Mark Green, and other experts on the FY 2020 budget request for the U.S. Department of State and USAID (3/11).

U.S. Department of State: State Department and U.S. Agency for International Development FY 2020 Budget Request
This fact sheet provides an overview of the proposed FY 2020 budget for the U.S. Department of State and USAID, including funding for international organizations, global health, humanitarian assistance, and diplomacy efforts (3/11).

USAID: Fiscal Year 2020 Development and Humanitarian Assistance Budget Request
This fact sheet provides an overview of the proposed FY 2020 budget for USAID, stating, “The President’s Fiscal Year (FY) 2020 Budget Request for USAID continues to advance our efforts to strengthen U.S. national security through strategic investments that promote the Journey to Self-Reliance. The Budget envisions the day when USAID’s development assistance is no longer needed…” (3/11).

U.S. Department of State’s “DipNote”: Department of State and USAID FY 2020 Budget Request: Protecting U.S. Citizens, Increasing American Prosperity, and Supporting Partners
This blog post highlights statements by U.S. Secretary of State Mike Pompeo and USAID Administrator Mark Green on the FY 2020 budget request for the U.S. Department of State and USAID (3/11).

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U.S. House Appropriations SFOPs Subcommittee Holds Public Witness Hearing On FY 2020 Budget

U.S. House Committee on Appropriations: Public Witness Hearing: State, Foreign Operations, and Related Programs
The U.S. House Committee on Appropriations Subcommittee on State, Foreign Operations, and Related Programs today is holding a public witness hearing on the FY 2020 budget, including 34 representatives of global health, humanitarian, education, and other organizations. This document contains links to the witnesses’ full statements and biographies, as well as a link to a live stream of the hearing (3/11).

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From the Kaiser Family Foundation

KFF Budget Summary Analyzes Global Health Aspects Of President's FY 2020 Budget Request

Kaiser Family Foundation: White House Releases FY20 Budget Request
This budget summary highlights global health-related aspects of the President’s FY20 Budget Request released on March 11. The request includes significant cuts to global health programs compared to FY19 enacted levels. The summary includes a table comparing the FY20 request with the FY19 request and enacted levels (3/11).

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