Kaiser Daily Global Health Policy Report

In The News

Trump Administration Again Omits Reproductive Rights From U.S. State Department's Human Rights Reports

CNN: U.S. human rights report notes Khashoggi killing, avoids mention of Saudi prince
“The State Department’s human rights report for 2018 released Wednesday … makes it explicitly clear that a country’s rights record will not be a determining factor guiding U.S. diplomacy. ‘The policy of this administration is to engage with other governments, regardless of their record, if doing so will further U.S. interests,’ Secretary of State Mike Pompeo states in the preface. … As in 2017, the report has a drastically reduced emphasis on sexual and reproductive rights, though it notes the treatment of LBGT communities…” (Gaouette/Hansler, 3/13).

Los Angeles Times: Annual U.S. human rights report condemns Khashoggi killing but avoids assigning blame
“…For the second year, the State Department report did not mention reproductive rights for women as a fundamental human right. [Michael Kozak, a senior State Department official who oversaw writing the human rights report,] said the term was omitted…” (Wilkinson, 3/13).

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Human Activities Harming Global Environment, Threatening Health, Causing Premature Deaths Worldwide; Actions Must Be Scaled Up Quickly, U.N. Report Says

CNN: The ‘ecological foundations of society’ are in peril, a massive U.N. report warns
“Human activities are degrading the global environment at a pace that could endanger the ‘ecological foundations of society’ and human health, according to a landmark United Nations report released Wednesday. The authors say that with unprecedented action on a global scale — including drastically cutting carbon emissions, improving water management, and reducing pollution — humans can achieve a future with less poverty and hunger while preserving the environment. But our window for action is closing fast…” (Kann, 3/13).

Thomson Reuters Foundation: U.N. warns of millions of premature deaths by 2050 due to environmental damage
“…Seen as the most comprehensive and rigorous assessment on the state of the environment, the U.N.’s Global Environment Outlook said human health was in ‘dire straits’ due to unsustainable development and poor environmental protection. Air pollution from vehicles and industry as well as burning fuels such as wood, coal, and kerosene for cooking, heating, and lighting was resulting in around 7 million deaths annually, said the report — costing around $5 trillion in welfare losses. Water quality has worsened due to increased organic and chemical pollutants such as plastic, pathogens, heavy metals, and pesticides. Almost 1.5 million people die annually due to diseases related to drinking pathogen-polluted water, it said…” (Bhalla, 3/13).

U.N. News: Humanity ‘at a crossroads’ as damage to planet poses growing risk to health, U.N. environment agency warns
“…Unless environmental protections are drastically scaled up, the report says, there could be millions of premature deaths by the middle of this century, with pollutants in freshwater systems becoming a major cause of death by 2050. … On a more optimistic note, the report makes clear that the science, technology, and financing exists to move towards a more sustainable global economy, and ensure that the worst-case scenario is avoided, but political leaders, together with much of the public and private sector, is still wedded to outdated, polluting models of production and development…” (3/13).

Washington Post: Millions could die prematurely without ‘unprecedented’ action to clean air and water, a new U.N. report warns
“…Whether political leaders and policymakers will decide to heed the warnings is another question. President Trump pulled the United States out of the Paris agreement on climate change, and his nominee to replace Nikki Haley as U.S. ambassador to the United Nations, Kelly Knight Craft, is on record as saying she believes ‘both sides’ of the climate change debate” (Tamkin, 3/13).

Additional coverage of the U.N. report is available from the Associated Press, Deutsche Welle, The Hill, USA TODAY, and Xinhua News (2).

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Democratic Systems Of Government Help Improve Public Health More Than Autocracies, Study Shows

Bloomberg: Democracies Top Dictatorships for Public Health, New Study Finds
“People lived longer in countries that became democracies from 1970 to 2015, and that system of government played a bigger role in public health than economic performance, according to a report published in The Lancet. The report, published Wednesday, found that democratic governance is associated with declines in ‘cardiovascular disease mortality and road deaths, as well as increases in government health spending,’ boosting life expectancy by an average of three percent after 10 years…” (Tanzi, 3/13).

U.S. News & World Report: Democracy Tied to Improving Health, Study Finds
“…The research focused on low- and middle-income countries and may change how policymakers approach improving the health of their nation’s citizens. ‘The results of this study suggest that elections and the health of the people are increasingly inseparable,’ Thomas Bollyky, director of the global health program at the Council on Foreign Relations and who led the research, said in a prepared statement. The study was carried out by six researchers at four institutions: the Council on Foreign Relations, Stanford University’s School of Medicine, the Institute for Health Metrics and Evaluation (IHME) — all in the U.S. — and Bilkent University in Turkey…” (Radu, 3/13).

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Shorter Treatment Regimen For Drug-Resistant TB As Effective As Standard 2-Year Course, Study Shows

Health-e News: Shorter cure for resistant TB
“Drug-resistant tuberculosis (TB) can be cured in less than half the time, cutting costs and improving the chances that patients will complete the grueling treatment, according to a study published in the New England Journal of Medicine. Published on Wednesday night, the much-anticipated final results of the trial known as STREAM found that a nine- to 11-month treatment course is just as effective as the previous standard of 20 to 24 months of drugs in curing patients with multi-drug resistant TB (MDR-TB). This follows the December 2018 World Health Organization (WHO) recommendation for this shortened regimen, which, until now, was based on ‘very low certainty in the evidence’…” (Green, 3/14).

Additional coverage of the study results is available from Agence France-Presse and The Telegraph.

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International Group Of Scientists Call For Moratorium On DNA Editing In Human Sperm, Eggs, Embryos

Wall Street Journal: Scientists Call for Moratorium to Block Gene-Edited Babies
“An international group of researchers, including some inventors of the popular gene-editing tool CRISPR, called for a world-wide moratorium on editing DNA in human sperm, eggs, and embryos to prevent births of genetically modified babies. The group of 18 scientists said in a paper published Wednesday in the journal Nature that a moratorium would prevent irresponsible use of the technology before it causes irreversible changes, especially after a researcher in China announced last November he produced the first genetically modified babies…” (Marcus, 3/13).

Additional coverage of the call for a moratorium is available from the Financial Times, Nature, NPR, STAT, Vox, and Washington Post.

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Medicine, Equipment Shortages Causing Patient Deaths In Zimbabwe, Doctors Say

The Guardian: Doctors in Zimbabwe ‘sending patients away to die’ as drug shortages bite
“A doctors’ strike in Zimbabwe entered its second day on Wednesday with health workers claiming patients in the biggest state hospital are dying due to a lack of drugs and medical supplies. Dozens of doctors picketed outside Parirenyatwa hospital demanding improvements and claiming government promises to improve the health service had come to nothing…” (3/14).

Reuters: Zimbabwe doctors say patients dying due to drug, equipment shortages
“…The southern African nation is acutely short of dollars, the currency it has used since in 2009, causing price spikes and shortages of basic goods, medicines, and fuel. … The doctors said [Health Minister Obediah Moyo] had told them the government would speed up the purchase of equipment and other medical supplies…” (Bulawayo/Dzirutwe, 3/13).

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Human Rights Expert Urges U.N. To Take 'Immediate Action' To Compensate Kosovo Lead Poisoning Victims

Associated Press: Expert urges U.N. remedies for lead poisoning victims
“A human rights expert on Wednesday urged the United Nations to take ‘immediate action’ to provide justice and remedies to displaced minority communities in Kosovo who were sheltered on lead-contaminated wasteland. … Forced from their homes in Mitrovica, in northern Kosovo, after the 1998-99 war, some 600 members of the Roma, Ashkali, and Egyptian communities were housed by the U.N. between 1999 and 2013 on land known to have been contaminated by lead from a nearby mine. Several children and adults have died and many have experienced health problems, including seizures, kidney disease, various physical and mental disabilities, and memory loss. … In 2016, a U.N. human rights advisory panel recommended compensation payments to 138 members of the three communities and an apology for failing to comply with human rights standards…” (Semini, 3/13).

New York Times: U.N. Is Rebuked by Own Expert for Neglecting Kosovo Poisoning Victims
“…[The United Nations Interim Administration Mission in Kosovo, known as Unmik,] took action to protect United Nations peacekeepers from exposure to lead waste in 2000 but did not take action on behalf of the Roma families in the camps until 2006, [Baskut Tuncak, a United Nations expert monitoring cases relating to hazardous substances,] said Wednesday. … A year after the panel’s report, António Guterres, the United Nations secretary general, expressed his ‘profound regret’ for the suffering the families endured, but stopped short of apologizing or offering compensation. In response to the panel’s criticism, the United Nations said it would create a trust fund for projects to help the Roma and other people who lived in the camps. But it did not allocate any money and said only that it would call for contributions from international donors, expressing the hope that it would raise $5 million. The fund was established in 2017 and never received any donor contributions, Mr. Tuncak said…” (Cumming-Bruce, 3/13).

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More News In Global Health

CIDRAP News: DRC reports 2 new Ebola cases; study notes seroprevalence in region (Schnirring, 3/13).

CIDRAP News: MERS-CoV infects 2 more in Saudi Arabia, 102 this year (Schnirring, 3/12).

The Guardian: Fake drugs kill more than 250,000 children a year, doctors warn (Sample, 3/11).

Nature: Nearly half of global childhood cancer cases go undiagnosed (Oakes, 3/13).

New York Times: A Flurry of Ideas to Reverse China’s Declining Birthrate, but Will Beijing Listen? (Myers et al., 3/13).

Quartz: China is staring down a very expensive heart disease problem (Purdy, 3/13).

Reuters: Botswana court to hear case against criminalization of gay sex (Benza, 3/14).

U.N. News: Around 260,000 children in DR Congo’s Kasai region suffering severe acute malnutrition (3/13).

U.N. News: Syrians still living on ‘razor edge’ as U.N. launches $8.8 billion dollar appeal (3/13).

Washington Post: Measles cases are surging worldwide. In some European schools, that means banning unvaccinated children (Noack, 3/13).

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Editorials and Opinions

U.S. Should Continue To Prioritize Global HIV/AIDS Efforts In Budget

Fox News: Trump’s budget continues HIV/AIDS fight, but cuts to Bush program won’t help
Marc Siegel, professor of medicine and medical director of Doctor Radio at NYU Langone Medical Center and Fox News medical analyst

“…President Donald Trump’s proposed budget requests a $1.35 billion cut to [bilateral HIV efforts]. This is wrong. PEPFAR has done a lot of good in the world, and controlling and stamping out HIV globally should remain a top health priority. … But when it comes to fighting HIV in America, the Trump administration’s budget is quite useful. … Stamping out HIV/AIDS will require a multi-faceted approach. Genetic research, global outreach and education, continuation of PEPFAR to fifty countries and more, and expanded services and treatments here at home — especially to underserved patients with a lower socioeconomic status. An HIV-free future … now looks possible, provided that the U.S. continues its great commitment to fighting it here and around the world” (3/13).

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Funding, Action, Accountability 'Pivotal' To Achieving U.N. Political Declaration On TB, Ending Epidemic

The Lancet Global Health: After the UNGA High-Level Meeting on Tuberculosis — what next and how?
Suvanand Sahu, deputy executive director at the Stop TB Partnership; Lucica Ditiu, executive director at the Stop TB Partnership; and Alimuddin Zumla, professor at the Division of Infection and Immunity at the Center for Clinical Microbiology at University College London

“…Three critical components — funding, action, and accountability — will be pivotal to the success of the initiatives of the UNGA High-Level Meeting on Tuberculosis [held last September]. First and foremost, is for U.N. member states to make available the resources needed. … Second, rapid action by countries, donors, and stakeholders is required for scaling up tuberculosis care and prevention as well as fast-tracking research into the development of new diagnostics, drugs, and vaccines. … Third, a specific independent monitoring and accountability mechanism was absent from the political declaration [agreed to at the high-level meeting] and is essential to hold world leaders, national governments, and stakeholders accountable to the commitments made. … The [political declaration on TB] calls for a progress report in 2020 and a comprehensive review by heads of state and governments at a high-level meeting in 2023. These will provide opportunities to hold world leaders accountable for contributing resources, progress, and successes and failures to meet targets. Close collaboration among all stakeholders, including governments of tuberculosis-endemic countries, specialized agencies of the U.N., U.N. regional commissions, the Stop TB Partnership, WHO, UNITAID, the Global Fund, tuberculosis advocates, researchers, community leaders, patient groups, donors, and grant-awarding bodies, will be essential to the implementation and achievement of the political declaration on tuberculosis, and to ending the tuberculosis epidemic” (3/12).

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Simulations Have Opportunity To Play Important Role In Pandemic Preparedness

Wired: When it Comes to Disease, Why Wait for a Pandemic to Respond?
Andres Colubri, computational researcher at Sabeti Lab; Todd Brown, award-winning teacher; and Pardis C. Sabeti, professor at Harvard University and the Harvard T.H. Chan School of Public Health, the Broad Institute of MIT and Harvard, and the Howard Hughes Medical Institute

“…Advances in diagnostics, vaccines, and therapeutics hold great promise in preventing and responding to epidemics. Simulations…, however, have an important role in education, preparedness, and data generation. … Simulations provide a means of emotional and behavioral preparation, offering opportunities to reflect on how decision-making processes can be disrupted by conflicts of interest, chaos, and fear. … Ultimately simulations make clear, as in real life, that preparation and cooperation are essential elements for a successful response to outbreaks. And they increase our empathy, allowing us to see first-hand how challenging it might be to be a scientist fighting disease, a health care worker taking care of patients, or a government official planning and executing an effective response to an emergency situation. Why wait for a pandemic to learn such important lessons?” (3/13).

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From the Global Health Policy Community

Organizations Release Statements On President's FY 2020 Budget Proposal For HIV, Infectious Diseases Spending

Health GAP: Trump Budget Proposes Largest Ever Cuts to Global HIV Programs
“Just one month ago, President Trump promised during the State of the Union address to defeat HIV in the U.S. and beyond. But the president’s budget proposal … would wipe out years of progress in the effort to end the AIDS pandemic. … At the level of cuts proposed, PEPFAR and the Global Fund would interrupt the provision of life-saving treatment for people living with HIV and scale back essential HIV prevention programs. … [Congress] must consider the president’s budget dead on arrival … and appropriate the necessary increases to address the global AIDS crisis…” (3/11).

HIV Medicine Association: Administration Budget Proposal Takes Steps Towards Ending Epidemic, Undermined by Concurrent Cuts
“The White House budget proposal for 2020 recommends increases to the domestic HIV programs at the U.S. Centers for Disease Control and Prevention, the Health Resources and Services Administration, and Indian Health Services that will be essential to keeping the administration’s promise of ending our nation’s HIV epidemic in the next decade. Deep cuts planned in the same proposal however, to the Medicaid program, to the National Institutes of Health, and U.S.-led global HIV responses, counter those increases and would gravely compromise efforts to eliminate new infections here, and, as the president said in his State of the Union Address ‘everywhere.’ … Deep cuts to the President’s Emergency Plan for AIDS Relief and to the U.S. contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria would gravely weaken American leadership of HIV responses and reverse progress in reducing new HIV infections worldwide…” (3/12).

Infectious Diseases Society of America: White House Budget Plan Shows Some Investment but Inadequate Commitment to Sustained Public Health Responses
“The president’s fiscal year 2020 budget proposal released Monday is responsive to some of our nation’s most urgent public health challenges. The proposal, however, also neglects, and even deeply undermines critically needed investments in both immediate and long-term responses to infectious disease threats. … These [proposed] cuts would come at a time when ending the worldwide public health threat of these leading infectious disease killers is within sight. These proposed cuts stand at odds with the administration’s stated goal to ‘end HIV here and everywhere’…” (3/12).

Treatment Action Group: Treatment Action Group Statement on the President’s Fiscal Year 2020 Budget Proposal
“Treatment Action Group (TAG) opposes the President’s FY 2020 budget proposal… TAG welcomes additional investments in HIV prevention and treatment towards eliminating HIV in the U.S. However, the federal budget’s [proposed funding cuts to] equally important areas across domestic and global health programs, social services, and research raises tremendous doubt about the administration’s commitment to end HIV. We are also concerned about the fate of related epidemics such as hepatitis C (HCV) and tuberculosis (TB)…” (March 2019).

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Organizations Discuss Absence Of Women's Reproductive Health, Rights From U.S. State Department's 2018 Human Rights Reports

Human Rights Watch: U.S. Again Cuts Women from State Department’s Human Rights Reports
Amanda Klasing, senior researcher at the Women’s Rights Division of HRW, and Elisa Epstein, advocacy coordinator at HRW, discuss the omission of analyses on women’s reproductive health and rights in the U.S. Department of State’s 2018 Human Rights Reports. The authors write, “Congress can and should serve as a check on the administration’s … policies. … The Reproductive Rights are Human Rights Act … would ensure that reproductive rights are included in State Department reports. Congress mandated that the State Department release these annual reports, and Congress can mandate that they include women’s rights around reproductive health…” (3/13).

International Women’s Health Coalition: State Department Human Rights Reports Conceal Abuses of Reproductive Rights
“The International Women’s Health Coalition (IWHC) condemns the absence of reproductive rights in the State Department’s annual Human Rights Reports, released [Wednesday]. … The lack of reporting on reproductive rights obscures numerous violations of women’s fundamental right to bodily autonomy. … Removing critical sections, such as those relating to sexual and reproductive health, undermines the validity of the reports and damages U.S. authority on human rights issues…” (3/13).

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Among People Who Inject Drugs, HIV Incidence Not Declining, 99% Do Not Have Access To Adequate Harm Reduction Services, UNAIDS Report Says

UNAIDS: Promises to improve health outcomes for people who inject drugs remain unfulfilled as 99 percent do not have adequate access to HIV and harm reduction services
“A report released [Wednesday] by UNAIDS shows that despite a decline in new HIV infections globally, HIV incidence is not declining among people who inject drugs … The report also shows that 99 percent of people who inject drugs live in countries that do not provide adequate harm reduction service coverage…” (3/13).

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CDC Foundation Podcast Interviews Gates Foundation CEO Sue Desmond-Hellmann

CDC Foundation’s “Contagious Conversations”: Philanthropy, Optimism and Taking Risks
In this podcast episode, Claire Stinson, senior communications officer at the CDC Foundation, speaks with Sue Desmond-Hellmann, CEO of the Bill & Melinda Gates Foundation, about her career path, advice for aspiring leaders and innovators, and “vision for a world where every person has the opportunity to live a healthy, productive life” (March 2019).

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From the U.S. Government

U.S. Senate Appropriations Subcommittee Holds Hearing On Ebola, Other Emerging Health Threats

U.S. Senate Committee on Appropriations: Subcommittee Hearing: Review of the Ebola outbreak in the Democratic Republic of the Congo and Other Emerging Health Threats
The U.S. Senate Committee on Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies today held a public hearing addressing the Ebola outbreak in the Democratic Republic of the Congo and other emerging health threats. Witnesses included Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health (NIH); Robert Kadlec, assistant secretary for preparedness and response at the U.S. Department of Health and Human Services; Robert R. Redfield, director of the U.S. Centers for Disease Control and Prevention; and R.T. Ziemer, acting assistant administrator of the Bureau for Democracy, Conflict, and Humanitarian Assistance at the NIH (3/14).

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New PEPFAR-Supported Household Survey In Nigeria Measures HIV Prevalence, Viral Load Suppression In Country, Reveals Disparities Between Women, Men

PEPFAR: Large National Survey Shows Smaller HIV Epidemic in Nigeria Than Once Thought and Highlights Key Gaps Toward Reaching HIV Epidemic Control
“The Government of Nigeria released new data today from the Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS), one of the largest population-based HIV/AIDS household surveys ever conducted. The NAIIS directly measured HIV prevalence and viral load suppression and was primarily funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). According to the NAIIS results, the HIV prevalence in Nigeria is lower than previously thought, allowing the country to focus on providing services to the areas of greatest need to control the HIV epidemic…” (3/14).

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