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Kaiser Daily Global Health Policy Report

In The News

Presidential Candidate Clinton Admonishes Congress For Not Moving On Emergency Zika Funding Before Recess

The Hill: Clinton: Congress must approve Zika funding
“Democratic presidential candidate Hillary Clinton is slamming Congress for ignoring a request from President Obama for $1.8 billion to fight the Zika virus. ‘The president asked for this funding over a month ago, but on Saturday, Congress will begin a two-week break without having allocated one penny,’ Clinton wrote in a Medium post Friday…” (Hellmann, 3/19).

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Rep. Pelosi Urges U.S. House Action On Zika Supplemental Spending Bill; Senate Approves Measure Making Experimental Zika Vaccines Eligible For FDA Priority Review

CQ HealthBeat: Zika Supplemental Pressure; House Budget Waits
“…House budget planners have developed a fiscal 2017 budget resolution but a vote on the measure has been deferred until next month (listen to CQ podcast on delay details). A separate fiscal 2016 supplemental spending bill seeking funds for a Zika virus awaits development by House appropriators. Democrats on Thursday reminded Republican leaders about the bill, but all three possible elements are disputed. GOP appropriators are looking to allow past Ebola virus funding covering more — and possibly offering a faster response option — of the $1.9 billion administration request for Zika virus response funding … Prior to leaving for a spring break, the Senate quietly approved a measure (S 2512) making a Zika virus vaccine eligible for an FDA priority review process…” (Jenks, 3/18).

Roll Call: Pelosi Urges Emergency Spending as Appropriations Markups Near
“House Minority Leader Nancy Pelosi on Thursday called on the House to bring a supplemental appropriations bill to the floor before adjourning for the spring recess, calling the emerging threat of the Zika virus, opioid abuse, and the water crisis in Flint, Mich., ’emergencies’ that deserve urgent attention…” (Mejdrich/Lesniewski, 3/18).

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FDA Approves Faster Zika Virus Test; Scientists Examining Ways To Control Mosquito Populations

The Hill: CDC takes key step toward Zika test
“The Food and Drug Administration has given preliminary approval for the first test that can confirm a diagnosis of the Zika virus without multiple tests. The faster test, created by the Centers for Disease Control and Prevention (CDC), was approved for emergency use on Thursday…” (Ferris, 3/18).

Reuters: WHO backs trials of bacteria, genetic modification to fight Zika mosquitoes
“The World Health Organization (WHO) called on Friday for pilot projects to test two experimental ways to curb Zika-carrying mosquitoes, including testing the release of genetically modified insects and bacteria that stop their eggs hatching…” (Kelland, 3/18).

Washington Post: This lab is ground zero in the U.S. fight against Zika
“…Behind an unmarked gated entrance in this working-class neighborhood of San Juan, [Puerto Rico,] scientists from the Centers for Disease Control and Prevention have only one focus: to stop Zika’s spread. About 100 virologists, biologists, entomologists, and more are working here, including dozens brought from CDC sites in Colorado and Georgia. They’re racing to develop tests for faster and more accurate diagnosis of infection and killing Aedes aegypti mosquitoes by the hundreds to determine what chemicals are most effective…” (Sun, 3/20).

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G7 Nations Considering Creation Of Liaison Entity To Coordinate International Disease Outbreak Responses, Sources Say

Japan Times: G7 to consider creating new body to coordinate efforts to combat infectious diseases
“The Group of Seven major industrialized countries are considering creating an organization that will serve as a liaison in international efforts to combat infectious diseases, according to informed sources. The body will ensure the coordination of international agencies, governments, and private entities so that they can respond quickly and efficiently to outbreaks of infectious diseases such as Ebola and Zika that cross national borders, the sources said on Saturday…” (3/20).

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WHO Sends Emergency Response Team To Guinea After Ebola Resurfaces; At Least 4 Dead

Agence France-Presse: Ebola clinic reopens in Guinea after virus resurfaces
“A medical charity said Friday it had reopened its specialist Ebola clinic in southern Guinea to treat an infected woman and her child after the virus killed at least two of their relatives…” (3/18).

Associated Press: WHO sends specialists in response to Guinea Ebola flare-up
“The World Health Organization deployed specialists to southeast Guinea on Friday after two new Ebola cases were confirmed…” (3/18).

Reuters: Fourth person dies of Ebola in latest flare up in Guinea
“A fourth person has died of Ebola in Guinea in the latest flare up of an epidemic that has killed more than 11,300 people in that country, Sierra Leone, and Liberia since 2013 but now claims few victims…” (Samb/Bigg, 3/19).

U.N. News Centre: Ebola: U.N. health agency sends specialists to help contain flare-up in Guinea
“…Guinea’s National Emergency Response Centre is convening a meeting today to further coordinate a rapid response to contain the flare-up, the World Health Organization (WHO) said in a press release…” (3/18).

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Strong El Niño Increasing Risk Of Malnutrition, Disease Worldwide

New York Times: El Niño Upsets Seasons and Upends Lives Worldwide
“In rural villages in Africa and Asia, and in urban neighborhoods in South America, millions of lives have been disrupted by weather linked to the strongest El Niño in a generation. … The World Health Organization has estimated that worldwide, El Niño-related weather is putting 60 million people at increased risk of malnutrition, water- and mosquito-borne diseases, and other illnesses…” (Fountain, 3/19).

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Ethiopia Prime Minister Calls For Additional Food Aid For Drought-Affected Country

Associated Press: Ethiopia leader calls for more foreign food aid amid drought
“Ethiopia’s leader on Thursday urged the international community to donate more toward emergency food aid for millions of people amid a drought. Ethiopia ‘should not be neglected by any means despite all the other crises that are going on elsewhere in the world,’ Prime Minister Hailemariam Desalegn told the Associated Press in an interview…” (Meseret, 3/17).

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WHO Suspends Approval Of TB Products From India's Svizera Labs, Supplier Of Generic Drugs To 70 Nations

International Business Times: WHO Suspends Tuberculosis Drugs From Major Indian Supplier
“The World Health Organization (WHO) reportedly suspended its approval of all tuberculosis products made at India’s Svizera Labs citing unreliable manufacturing standards and quality management. The company is one of the largest suppliers of generic TB medicines to more than 70 countries, according to its website…” (Kondalamahanty, 3/19).

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Chinese Authorities Investigating Vaccine Stocks After Improper Storage, Sales Discovered

New York Times: China Says It Found Ring Said to Sell Improperly Stored Vaccines
“The police in China said they had uncovered a criminal ring suspected of selling improperly stored vaccines in dozens of provinces beginning in 2010. After the arrest of a former doctor and her daughter in Shandong Province, in eastern China, the police said they were searching for 300 suspects across the country…” (Ramzy, 3/21).

Reuters: China vows crackdown on fake vaccines amid scandal
“…The drug regulator in Shandong, the province at the heart of the scandal, said on Monday it would work with police forces and the health ministry to inspect vaccine stocks to ascertain where 570 million yuan ($88 million) worth of vaccines had ended up. The case, which involves vaccines against meningitis, rabies, and other illnesses, underlines the challenge the world’s second-largest drug market faces to regulate its fragmented supply chain, even as Beijing looks to support home-grown firms…” (Jourdan, 3/21).

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Haiti's Cholera Death Toll Could Be Much Higher Than Official Count, MSF Study Suggests

New York Times: Cholera Deaths in Haiti Could Far Exceed Official Count
“Deaths from the cholera epidemic that ravaged Haiti after the 2010 earthquake could be much higher than the 9,200 officially tallied so far because of underreporting during the initial outbreak, a new study suggests. The study, by Doctors Without Borders, found that incomplete surveillance and data collection, overwhelmed health clinics, the rapid spread of the disease, and cholera’s ability to kill quickly contributed to what appears to have been a drastic understating of the death toll…” (Gladstone, 3/18).

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Shackling Of Mental Health Patients Still Occurs In Indonesia Despite Ban, Report Says

The Guardian: ‘Living in hell’: mentally ill people in Indonesia chained and confined
“Almost 40 years after Indonesia banned the practice of shackling people with mental health conditions, nearly 19,000 are still living in chains, or are locked up in institutions where they are vulnerable to abuse, according to a new report from Human Rights Watch (HRW)…” (Jones, 3/20).

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Editorials and Opinions

Editorial, Opinion Pieces Discuss Zika Outbreak Response

Washington Post: Swatting the Zika carriers
Editorial Board

“…[T]he age of genetic engineering has brought new possibilities: The tiny building blocks of life can be manipulated to impede the disease. So far, laboratory trials have shown that genetic material can be altered to suppress mosquito populations or make them less likely to ferry disease. More recent science has suggested that a mosquito gene ‘drive’ could be created that would pass down to generations of mosquitoes the characteristic of resisting a disease such as malaria. This technique has enormous implications for entire ecosystems, and research ought to be carried out with the utmost care. It may not be the answer to this epidemic, but it is important to explore. Would the world be worse off if Aedes aegypti were genetically altered, now and forever? A lot of human babies might have a better chance to be born healthy” (3/18).

Medium: The time to take action against Zika is now
Hillary Clinton, 2016 presidential candidate and former U.S. secretary of state

“…There is a lot we need to do [to stop Zika], and fast. First and foremost, Congress should meet President Obama’s request for $1.8 billion in emergency appropriations to fight Zika. … Congress needs to provide the funds to fight Zika now. Here’s where that money should go: developing a rapid diagnostic test for Zika; developing a vaccine; and developing treatment. We need to increase our research into the connection between Zika and microcephaly. And we need to step up mosquito control and abatement, and make sure the public knows how to protect themselves and their kids. … There are smart, achievable things we could be doing right now, and there’s no time to waste. So we need Congress to act. We need citizens to demand action…” (3/18).

The Hill: Zika coming our way: Points for Catholics to consider
Jon O’Brien, president of Catholics for Choice

“…Only affirmative support of contraception on behalf of the Vatican can turn the tide on these institutional blockages to contraception access and help ensure women can get contraception during the Zika crisis and beyond. That means overturning the Humanae Vitae encyclical’s ban on contraception and a positive assertion by the pope of contraceptive use as part of a healthy relationship. … [I]nstead of cheerleading [Pope] Francis’ inadequate response to the Zika crisis, we should take a step back and consider what women really need. They don’t need favors; they need justice from Pope Francis. They do not need a half-hearted, on-the-fly endorsement of contraception in limited situations. They need sustained access to appropriate contraception and abortion services…” (3/18).

USA TODAY: Public health ‘monster spray’ won’t stop Zika: Column
Puneet Opal, neurologist at Northwestern University Feinberg School of Medicine and director of the Physician-Scientist Training Program, and Ameet R. Kini, director of hematopathology and flow cytometry at Loyola University Chicago Stritch School of Medicine

“…How should we deal with [misperceptions] of risk? Some feel it is acceptable to respond to risks with seemingly irrational actions — if those actions calm public fears. After all, while our fears may be irrational, they are still real. … [S]uch attempts to contain fear are misguided and even dangerous. First, health care is mostly a zero-sum game, with limited resources. Excessive attention to a small risk will take away resources from larger risks. Doctors and nurses would waste valuable time preparing and training for improbable scenarios, instead of preventing and treating diseases that are real threats. Second, draconian measures such as quarantining asymptomatic, low-risk health care workers could result in the loss of crucial expertise — a perilous measure. Finally, far from calming fears, a disproportionate public response could backfire, exaggerating the public’s sense of danger” (3/20).

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U.N. Must Promote Harm Reduction As HIV Prevention Strategy Among Drug Users

The Guardian: To end HIV in drug users, stop chasing the dream of a drug-free world
Susie McLean, senior adviser on drug use and HIV for the International HIV/AIDS Alliance

“…The evidence for the effectiveness of harm reduction interventions — reducing the negative consequences of drug use rather than focusing solely on reducing drug use — is described by UNAIDS as irrefutable and all relevant U.N. agencies now endorse a harm reduction approach to HIV and drug use. … Yet in Vienna last week, references to harm reduction, needle and syringe programs, and opioid substitution therapy (OST) were contested. The policy process has been widely criticized, and the negotiations heavily influenced by countries including Russia who are vetoing harm reduction in favor of a bald restatement of the decades-old illusion of a drug-free world. … [I]t’s unbelievable that U.N. member states are likely to recommit to another ineffective and dangerous policy on drugs when it is put before them in New York next month, at the first U.N. General Assembly special session on drugs. While this strange corner of the U.N. system in Vienna continues to promote the fantasy of a drug-free world, we will continue to urge states to commit to two words: harm reduction” (3/21).

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Global Disease Prevention Must Focus On Macrobiome, Environment

New Yorker: The Bugs That Live On Us and Around Us
Amanda Schaffer, New Yorker contributor

“…If every disease is the result, in some way, of political and scientific choices, then why don’t we make better choices? Of course, the factors that drive outbreaks — poor infrastructure, changes in land use, more frequent contact among wild and domestic animals and people — can be addressed. But doing so requires political will and sustained attention. … Recently, the international community and the U.S. have taken some steps toward faster detection and response to emerging disease, chastened in part by Ebola. But it remains to be seen whether these efforts will be sustained. ‘The history of U.S. funding is so episodic and memory is so short, it’s hard not to be pessimistic,’ Josh Michaud, the associate director for global health policy at the Kaiser Family Foundation, told me. … [I]n 2015, Americans purchased over 10 billion dollars of probiotics, many of them with unproven benefits. At some point, perhaps our obsessive focus on the microbiome will be matched by attention to the macrobiome and environment around us. But that may only happen when specific business interests are threatened and demand change…” (3/18).

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To Address NCDs In Developing Nations, International Community Can Leverage Existing Health Infrastructures Used To Treat, Prevent Infectious Diseases

Washington Post: If we really cared about saving lives in poor countries, we wouldn’t focus only on AIDS
David J. Heller, internist and global health researcher

“…We need to start paying attention [to noncommunicable diseases]. … Fortunately, there are proven, cost-effective ways for the United States and the global development community to respond. And we don’t have to reinvent the wheel; we can leverage the infrastructure we’ve already put in place to take on diseases such as AIDS and malaria. For example, over the past two decades, HIV treatment centers have sprung up across Africa, Asia, and Latin America. Treating and preventing HIV at those clinics involves educating communities about healthy lifestyles, testing seemingly healthy people for a silent killer, offering medications to control a chronic condition, and using blood tests to measure progress. This playbook is essentially identical to the way to fight high blood pressure, diabetes, and other non-communicable diseases. … Non-communicable diseases are the health issue of our time, both in developing countries and in the United States. We have the infrastructure and the playbook we need to address these problems” (3/18).

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From the Global Health Policy Community

U.N. Agencies, World Bank Commit To Global Strategy For Women's, Children's, Adolescents' Health

UNAIDS: Harnessing the collective strengths of the U.N. system to reach every woman, child, and adolescent
“…The U.N. Secretary-General’s Global Strategy for Women’s, Children’s, and Adolescents’ Health sets out a plan to give every woman, child, and adolescent the opportunity to not only survive, but to thrive and transform his or her community. Implementing the Global Strategy and achieving the [Sustainable Development Goal (SDG)] targets requires an unprecedented level of alignment and coordination amongst each and every one of us working in the field of [reproductive, maternal, newborn, child, and adolescent health (RMNCAH)]. On behalf of the six organizations responsible for promoting and implementing the global health agenda across the U.N. system, UNAIDS, UNFPA, UNICEF, U.N. Women, WHO, and the World Bank Group, we, the undersigned, stand united in our commitment to operationalize the Global Strategy…” (3/18).

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