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Kaiser Daily Global Health Policy Report

In The News

Tillerson's Ouster As Secretary Of State Highlights Conflicting Messages Of Trump Administration's Global Health Policies, Funding Decisions

Washington Post: The Health 202: Tillerson’s rhetoric didn’t match reality on global health
“As Rex Tillerson exits the State Department, he leaves behind a confusing trail of mixed messages about whether the Trump administration wants to support or undermine U.S. funding for global health. … Trump and Tillerson’s rhetoric did at times sounded quite positive toward funding major global health initiatives. … But the picture looks different when you consider Trump’s budget requests. … ‘There was this rhetorical support, but the proposed cuts were so significant there seemed to be a disconnect,’ said Jen Kates, director of global health and HIV policy at the Kaiser Family Foundation. … There is one way global health programs appeared to be sheltered from the staffing upheaval in Foggy Bottom. Experts say Tillerson left in place or brought on top administrators with strong backgrounds in global health, including Deborah Birx, who oversees PEPFAR, and Mark Green, head of USAID. But, as with many other areas of Trump’s administration, it’s often hard to figure out the direction or priorities for top Trump appointees. That is how many global health experts said they’ll remember Tillerson…” (Cunningham, 3/14).

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Trump Administration Highlights Success Of Global Health Security Agenda; Concern Remains Over Adequacy Of Funding For Efforts

New York Times: White House Hails Success of Disease-Fighting Program, and Plans Deep Cuts
“…The National Security Council released a report on Monday trumpeting the achievements of the multinational Global Health Security Agenda, which helps low-income countries halt epidemics before they cross borders. The report ‘clearly shows how the investments made by taxpayers to improve global health security are paying dividends,’ White House officials said in the announcement. But the United States is set to dramatically shrink its contributions to the initiative, a point that the report omitted. … Over all, Mr. Trump’s February budget proposal offered the CDC, the United States Agency for International Development, and the Defense Department’s health security programs about the same funding those agencies received between 2006 and the Ebola crisis, ‘objectively inadequate for the agencies’ activities’ since the outbreak, said Jennifer Kates, who studies global health policy at the Kaiser Family Foundation. … At a health security panel on Monday, Dr. Anne Schuchat, the acting director of the CDC, said, ‘The administration, CDC, the partners across government, and the private sector are very keen for us to not lose the progress.’ She added, ‘It’s a few years ago, but people remember Ebola’…” (Baumgaertner, 3/13).

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Development Experts Express Mixed Views On Mike Pompeo's Nomination As Secretary Of State; Cabinet Shakeup Forces Congress To Cancel Budget Hearing, Shuffle Spring Schedule

Devex: Pompeo’s nomination carries risks, opportunity for U.S. development efforts
“On Tuesday, United States President Donald Trump announced — via tweet — that he is replacing Rex Tillerson as secretary of state. Central Intelligence Agency Director Mike Pompeo is the president’s nominee to take over leadership of America’s foreign affairs agencies. For a U.S. development community that has been largely disappointed by Tillerson’s tenure and approach, Pompeo’s rise represents both opportunity and risk. On one hand, aid experts who spoke to Devex welcomed the potential to see foreign affairs agencies led by someone with the ear of the president and who knows how to get things done in Washington. On the other hand, some expressed reservations that Pompeo will accelerate U.S. foreign aid’s ongoing drift towards harder-line policies and a security-first agenda. Nearly all of them agreed that replacing Tillerson with Pompeo will amount to a major leadership change with significant implications for the U.S. development community…” (Igoe, 3/14).

Reuters: Out in Africa? Tillerson trip leaves hosts nonplussed
“From the outset, Rex Tillerson’s first trip to Africa looked half-hearted and token, but with the hindsight knowledge that the U.S. Secretary of State was fired just two days in, his African hosts must be wondering why they bothered. … [T]he revelation from a senior White House official that Trump told Tillerson he was out of a job just two days into the six-day jaunt leaves little room for doubt about the Trump White House’s attitude towards the continent. Given its increasing reliance for aid and trade on China, its main commercial partner, and a recent diplomatic push led by Russian foreign minister Sergei Lavrov, the slight is likely to have real consequences for Washington’s status on the continent of a billion people…” (Cropley et al., 3/14).

Roll Call: Tillerson Termination Adds New Priorities to Senate Calendar
“…The Senate is scheduled to be in recess the last week of March and the first week of April for Passover and Easter. The next break would be the first week in May. Trump’s personnel moves mean that two of the six session weeks over the next two months could easily be consumed with the senior national security nominations. … Tillerson had been scheduled to testify Thursday before the Foreign Relations panel on the fiscal 2019 budget request as well as his reorganization plans, but that hearing was [cancelled]…” (Lesniewski, 3/14).

Wall Street Journal: ‘Rex, Eat the Salad’: Inside the Awkward Relationship Between Rex Tillerson and Donald Trump
“…A promise from Mr. Trump during the transition that Mr. Tillerson could pick his own staff almost immediately fell through. Nor was Mr. Tillerson a central part of the decision-making process on the White House’s original proposed travel ban or on expanding the so-called ‘Mexico City policy,’ … officials said. It was all a sharp change for an executive who was used to calling the shots at Exxon…” (Bender/Schwartz, 3/13).

Washington Post: Pompeo will face a host of foreign policy challenges if confirmed as secretary of state
“President Trump has chosen a new secretary of state, untested in diplomacy but more attuned to the president’s views and way of conducting foreign policy, at a time when the United States is facing an array of delicate and potentially dangerous national security challenges. Seeking what he called ‘a different mind-set, a different thinking,’ Trump said Tuesday that he was replacing the reserved and cautious Rex Tillerson with CIA Director Mike Pompeo, a former House of Representatives firebrand with strong ‘America First’ and hard-line Republican credentials…” (DeYoung/Hudson, 3/13).

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North Korea Objects To Global Fund's Closing Of Grants For TB, Malaria, Calls For Reconsideration

NK News: North Korea calls on Global Fund to reconsider termination of grants
“North Korean Vice Minister of Public Health Kim Hyong Hun has urged the Global Fund to reconsider its recent decision to end grants for the treatment of tuberculosis and malaria in the DPRK, state media reported on Tuesday. According to the Korean Central News Agency (KCNA), Kim sent a letter to Peter Sands — the executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria — on March 10…” (Macdonald, 3/13).

Xinhua News: DPRK urges Global Fund not to stop grants on humanitarian grounds
“…The vice minister said the decision could not be seen as anything else but ‘the outcome of the pressure of some hostile forces,’ adding that the decision was made without any prior discussion with other international agencies operating in the DPRK. The agency’s decision was timed with the U.S. announcement of keeping ‘maximum pressure’ on the DPRK, Kim said” (3/13).

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Experts Laud India PM's Plan To Eradicate TB By 2025 But Say More Must Be Done Worldwide To Reduce Disease's Burden

HuffPost: India’s Prime Minister Pledges Massive Push To Fight World’s Top Infectious Killer
“India’s Prime Minister Narendra Modi announced the country’s plan to eradicate tuberculosis by 2025, a bold move that global health experts hailed as game-changing in the fight against tuberculosis. The goal is a starkly ambitious one, striving to eliminate the scourge five years before already bold World Health Organization goals. … Health experts applauded Modi’s leadership in taking ownership of the country’s disease burden but stressed it was the first step in what should be a worldwide endeavor…” (Weber, 3/14).

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China's Proposed Government Restructuring Creates New Foreign Aid Agency, Streamlines Health, Environment Authority

Quartz: China just got one step closer to ending its family planning policies
“Over the years few things have symbolized China’s heavy-handedness quite like the one-child policy it implemented in 1979. But in a sign of change, this week Beijing announced the end of the commission charged with implementing such policies. The move comes amid a broad reshuffling of ministries and agencies taking place during this year’s Two Sessions meeting of the National People’s Congress, a two-week event ending March 20. A newly formed National Health Commission will oversee the family planning policy, which as of 2016 allows for two kids…” (Huang, 3/14).

Reuters: China says new agency will improve foreign aid coordination
“China plans to set up an international development cooperation agency to better coordinate foreign aid and promote its ‘Belt and Road’ initiative, State Councillor Wang Yong said on Tuesday. The new agency will be responsible for forming policies on foreign aid, as well as granting aid and overseeing its implementation, according to a parliamentary document released earlier in the day…” (Blanchard/Shepherd, 3/12).

Science: China’s government shake-up could have big payoffs for public health, environment
“China today unveiled a sweeping revamp of its bureaucracy that is expected to reap benefits for public health, the environment, and combatting climate change — while raising questions about the management of basic research. … Tobacco control has long been under the purview of the industry ministry, which also manages China’s hugely profitable tobacco monopoly. As part of the overhaul, the health ministry would assume responsibility for cutting smoking…” (Normile, 3/13).

The Times: China seeks to extend its reach with new office for foreign aid
“China is to set up a foreign aid and overseas infrastructure development department in an effort to extend its global influence. In what will be seen as an attempt to compete with the United States, China said that the office was designed to make its aid and overseas spending more efficient and was part of reforms designed to strengthen the Communist Party’s rule and reflect President Xi’s policy priorities…” (Tang, 3/13).

Washington Post: China sets up new foreign aid agency to better project influence abroad
“…The establishment of a new international development cooperation agency came as part of the biggest shake-up of the government’s structure in two decades. … The new agency will draft foreign aid policies, grant aid, and supervise projects. … China provides few details of its aid program, but said it sent more than half of its foreign aid of more than $14 billion between 2010 and 2012 to Africa. … China likes to boast that its finance in Africa does not come with political strings attached…” (Denyer et al., 3/13).

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More News In Global Health

The Guardian: ‘Immoral sentence’: Salvadoran woman jailed for stillbirth set free after 14 years (Ford, 3/13).

Reuters: Namibia records first listeria case after it kills 180 in S. Africa (Nyaungwa, 3/13).

Scientific American: Pakistan Is Racing to Combat the World’s First Extensively Drug-Resistant Typhoid Outbreak (Ahmad, 3/14).

VOA News: Cholera Outbreak Sparks Blame Game in Malawi (Masina, 3/13).

Xinhua News: HIV prevalence rise to 13.2 pct in Mozambique (3/13).

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Editorials and Opinions

U.N. High-Level Meeting On TB 'Historic Opportunity' To Accelerate Global Efforts To End Disease

Thomson Reuters Foundation: A historic chance to end tuberculosis
Lucica Ditiu, executive director of the Stop TB Partnership, and Peter Sands, executive director of the Global Fund

“…[W]e need to get our act together [on TB] now. India’s Prime Minister Narendra Modi will be guest of honor at this week’s Delhi TB Summit in India, where WHO and Stop TB Partnership will launch a joint initiative aimed at finding four million missing people with TB. The initiative will be built on a Global Fund program with Stop TB, WHO, and partners, which will contribute to finding an additional 1.5 million people with TB in 13 countries by 2020. We hope such efforts will ignite concrete political leadership and action on the ground to end TB. … The U.N. High-Level Meeting on TB is a historic opportunity to ensure TB gets on the agenda of the heads of states and governments, and that we get different sectors engaged and accelerate our efforts to put the world on course to ending TB. We should start by changing the status quo to move toward a comprehensive standard of care for TB. We must also seek new sources of financing; more efficient case finding, diagnosis, and treatment; put people with TB at the center of the response; help countries move toward universal health systems; increase research for TB; and ensure that human rights and equity are protected…” (3/13).

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Using Different Investment Packages, Global Community Can End Hunger, Achieve Multiple SDGs

Thomson Reuters Foundation: The multibillion dollar question: How much will it cost to end hunger and undernutrition?
Shenggen Fan, director general at the International Food Policy Research Institute (IFPRI)

“…Multiple approaches exist to end hunger and reduce undernutrition through different investment packages, specific targets, measures, and policy pathways, leading to a wide range of costs: Estimates range from $7 billion to $265 billion per year. This may sound like a lot, but research shows the costs are far outstripped by potential benefits in terms of boost to the global productivity and GDP. … Ending hunger and malnutrition has significant benefits that include increased productivity and better health, more peaceful and stable communities and households, and improved educational attainment. … Ending hunger and malnutrition is a moral imperative, and … can bring about the end of other major problems in global development, and usher in numerous social and economic benefits to the world. By boosting investments, we can better strive to end hunger and malnutrition and achieve many of the interconnected SDGs…” (3/14).

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From the Global Health Policy Community

WHO Renews Call For Protection Of Health Workers, Access To Besieged Populations Across Syria

WHO: Seven years of Syria’s health tragedy
“After seven years of conflict in Syria, WHO has renewed its call for the protection of health workers and for immediate access to besieged populations. Attacks on the health sector have continued at an alarming level in the past year. … WHO is committed to ensuring that people across Syria have access to essential, life-saving health care…” (3/14).

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Egypt Eliminates Lymphatic Filariasis

WHO: Egypt: first country in Eastern Mediterranean region to eliminate lymphatic filariasis
“Egypt becomes the first country in the Eastern Mediterranean Region of the World Health Organization (WHO) and the latest in the world to eliminate lymphatic filariasis (LF) as a public health problem. … The country joins 10 others, already validated by WHO as achieving this criteria…” (3/12).

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Numbers-Driven Malaria Interventions Must Take Into Account Community Experiences, TEDx Speaker Says

Tropical Health Matters: Malaria by the numbers: are the statistics real or are they a barrier to community involvement?
Bill Brieger, professor at the Johns Hopkins Bloomberg School of Public Health, highlights remarks made at the recent Johns Hopkins University TEDx event by JHU Bloomberg School of Public Health student George Mwinnyaa about his experience with malaria interventions in Ghana. Mwinnyaa said, “The numbers that drive interventions can be meaningless to the community people they represent unless we engage the community and learn how our interventions can really help them” (3/12).

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New Registry Aims To Track, Better Understand Uganda's Community Health Workforce

IntraHealth International: Uganda Takes Major Steps to Professionalize Community Health Workforce
This post discusses the Uganda Ministry of Health’s use of a new registry developed using IntraHealth International’s open source iHRIS software to track community health workers and provide “health officials with the data they need to understand the size and scope of the existing community health workforce and to integrate these workers into the health system, while accounting for their contributions to health outcomes” (3/11).

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From the U.S. Government

Acting CDC Director Highlights U.S. Commitment To Global Health Security Agenda

CDC’s “Our Global Voices”: Global Health Security Agenda Programs Protect Americans from Infectious Disease Threats
Anne Schuchat, acting director of the CDC, discusses the U.S. commitment to the Global Health Security Agenda (GHSA), highlighting CDC’s efforts to prevent, detect, and respond to infectious disease threats. Schuchat also discusses the launch of a new U.S. government report on the impact of U.S. investments in global health security (3/13).

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USAID, Partners Work To Change Gender Norms, Increase Male Involvement To Improve Food Security, Child Nutrition In Zimbabwe

U.S. Department of State’s “DipNote”: A Man Among Men
Themba Nduna, nutrition adviser at USAID/Zimbabwe’s Office of Humanitarian Assistance and Resilience, discusses USAID’s work on changing gender norms to improve food security and child nutrition in Zimbabwe (3/13).

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