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Kaiser Daily Global Health Policy Report

In The News

U.S. Congress Passes FY18 Omnibus Spending Bill, Rejecting Deep Cuts To U.S. Foreign Assistance

Devex: Congress again rejects steep cuts to U.S. foreign assistance in new budget
“Congress released a budget on Wednesday night that largely maintained U.S. foreign aid funding at fiscal year 2017 levels, and once again rejected the steep cuts proposed by the Trump administration…” (Saldinger, 3/22).

Washington Post: In late-night drama, Senate passes $1.3 trillion spending bill, averting government shutdown
“Congress cleared a sweeping $1.3 trillion spending bill early Friday and sent it to President Trump for his signature, staving off a government shutdown with less than 24 hours to spare. … The Senate passed the 2,232-page spending bill 65-32, about 12 hours after the House had also approved the legislation on a similarly wide bipartisan vote of 256-to-167…” (Werner et al., 3/23).

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U.S. Lawmakers Question USAID's Green Over Proposed Cuts To Agency, Mexico City Policy Implementation

Devex: Lawmakers question USAID administrator on budget request
“Federal lawmakers questioned United States Agency for International Development Administrator Mark Green Wednesday about how he could carry out the agency’s mission with the administration’s proposed budget cuts and pushed him on issues ranging from humanitarian crises to girls education to democracy building. Green was testifying at a House Foreign Affairs Committee hearing about the administration’s proposed fiscal year 2019 budget … Later on Wednesday, Congress unveiled its budget agreement for fiscal year 2018, which includes more modest cuts to foreign aid funding. … [Green] was pressed on the impacts of the reinstatement of the ‘global gag rule,’ and asked about issues of sexual harassment and assault plaguing the aid industry by some members of Congress. At the end of the year, the State Department and USAID will put out a more detailed report about the impacts of the Mexico City policy, adding that the budget request for fiscal year 2019 had $302 million requested from family planning [and reproductive health], funds that weren’t requested in fiscal year 2018, Green said’…” (Saldinger, 3/22).

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Media Outlets Continue To Examine New CDC Director's Background

The Atlantic: Trump’s Pick For CDC Director Is Experienced But Controversial
“On the face of it, veteran virologist Robert Redfield seems like a good pick to lead the agency, but decades-old disputes are shadowing his appointment…” (Yong, 3/22).

Vox: The new CDC director was once accused of research misconduct
“…Unlike previous CDC directors, the HIV researcher has no experience at the helm of a public health agency. … Throughout his career, he has focused on research and health care for people with chronic viral infections and infectious diseases, in particular HIV. He also served in the military and founded the Department of Retroviral Research within the military’s HIV Research Program. … While some have said this training may help Redfield respond to infectious disease outbreaks, others in the science community question the integrity of 66-year-old’s track record — and worry about the discriminatory and religious overtones of some of the health policies he’s championed during his long career…” (Belluz, 3/22).

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USAID Adviser Calls U.S. 'Pro-Life Country' During U.N. CSW Outcome Document Negotiations

The Independent: Trump official says U.S. is ‘pro-life country’ at closed-door U.N. meeting
“An official appointed by President Donald Trump said during a closed-door United Nations meeting that the ‘U.S. is a pro-life country,’ despite the fact both the law and public opinion support a woman’s right to access legal and safe abortion. Bethany Kozma, a senior adviser in the office of Gender Equality and Women’s Empowerment for [the] U.S. Agency for International Development (USAID), made the statement while countries negotiated the final document of the ongoing, annual women’s rights conference. … As part of the negotiations on the roughly 70-page outcome document, issued every year at the end of the conference, Ms. Kozma and the U.S. delegation also called for deleting any mention of the phrase ‘modern contraceptives’ and replacing it with the phrase ‘family planning’…” (Sampathkumar, 3/22).

Newsweek: Trump Sends Anti-Trans Pro-Lifer Bethany Kozma to Women’s Rights Conference at the U.N.
“The Trump administration has reportedly sent a delegate who once called trans children ‘gender confused’ and described the U.S. as a ‘pro-life nation’ to a United Nations meeting being held to promote gender equality. … Bethany Kozma attended [the U.N. Commission on the Status of Women (CSW)] as the senior adviser for the Office of Gender Equality and Women’s Empowerment at the U.S. Agency for International Development … The Department of State, CSW organizers U.N. Women, and the Agency for International Development did not immediately respond to a request to confirm Kozma’s attendance and the statements she made…” (Gander, 3/22).

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U.K. International Development Secretary Highlights New Fund To Spur Innovation In Health Care Delivery To War Zones

Daily Telegraph: Targeting of hospitals in Syria is ‘unparalleled brutality,’ Penny Mordaunt says
“…Penny Mordaunt, the international development secretary, has launched an £11 million fund to try and find innovative ways to deliver health care in war zones. Medical supplies have become a target in what she described as a ‘blatant breach of international humanitarian law.’ … ‘The aid sector needs to innovate if it is to continue delivering life-saving assistance in the most difficult situations imaginable. That’s why last month we launched a new fund with USAID to find new technology solutions and innovations to save lives in conflict zones. I urge any business or group with a bold idea to apply[,’ Mordaunt said]…” (Dixon, 3/21).

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Conflict, Climate Contribute To Deteriorating Food Security Trends, Report Shows

Devex: Record-high food insecurity trends set to worsen in 2018
“Protracted conflicts and climate shocks have led to a record breaking 124 million people, across 51 countries, now facing food insecurity or worse conditions, according to the Food Security Information Network’s annual report on food crises…” (Lieberman, 3/23).

U.N. News: Drought and conflict leave millions more hungry in 2017 — U.N.-backed report
“…Presented by the U.N. Food and Agriculture Organization (FAO), the U.N. World Food Programme (WFP), and the European Union at a briefing Thursday, the Global Report on Food Crises finds that food emergencies are increasingly determined by complex causes such as conflict, extreme climatic shocks, and high prices of staple food — often acting at the same time…” (3/22).

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On World Water Day, Focus Shifts To Systems; New Partnerships Launched To Reach Water-Related Goals

Devex: Why you should care about ‘systems’ in WASH
“The story has become all too familiar. Volunteers or organizations enter a village, build new infrastructure, and when it fails, they are nowhere to be seen. … The case has become an infamous example of why aid interventions sometimes fail, but it is just one of a number of examples of good intentions with poor outcomes in the water, sanitation, and hygiene, or WASH, sector. It is also an example of the need to shift the focus from gadgets to systems…” (Cheney, 3/22).

Inter Press Service: A Whole New Decade for Water
“As old and new challenges continue to threaten its access, the U.N. has dedicated the next decade in order to protect a crucial but fragile natural resource: water. On World Water Day, the U.N. launched the ‘International Decade for Action: Water for Sustainable Development’ which aims to mobilize implementation and cooperation on water issues as it relates to sustainable development. Already, many are hopeful that the initiative will boost international commitment…” (Yakupitiyage, 3/22).

Inter Press Service: Working Together Is Key to Meeting Water Targets by 2030
“…The Global Water Partnership (GWP), an international network created in 1996 to promote integrated water resources management (IWRM), calls for working and thinking together as a key to fulfilling SDG number 6, of the 17 goals that make up the Agenda, agreed in 2015 by the world’s governments within the framework of the United Nations. To this end, on Mar. 20 it launched the campaign ‘Act on SDG 6’ at the Australian Embassy in Brasilia, during an event emphasizing the importance of multi-stakeholder partnerships to promote water security, in the context of the Eighth World Water Forum, hosted by Brasilia Mar. 18-23…” (Osava, 3/22).

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Bill Gates Calls On Nigeria To Spend More On Social Infrastructure, Including Access To Vaccines, Maternal Health Care

Business Day: Bill Gates calls for innovative funding to sustain vaccine financing in Nigeria
“Bill Gates, the chairman of Bill & Melinda Gates Foundation, has called for innovative funding to enable the Nigerian government to sustain health programs and policies that assist vaccine financing in Nigeria. Bill Gates made the disclosure during a courtesy call on Nigeria’s Minister of Financing, Kemi Adeosun, as he seeks further support for his pet project on health projects and vaccine financing supports…” (Edeh, 3/22).

Reuters: Nigeria needs to boost social spending to sustain growth: Gates
“Nigeria needs to boost investment in social infrastructure to lift its population out of poverty and achieve a higher income status, billionaire Microsoft co-founder Bill Gates told Reuters on Thursday. Gates said in an interview that his Bill & Melinda Gates Foundation has committed $1.6 billion so far in Nigeria to fund pilot projects targeted at health care, agriculture, and financial inclusion, its biggest investment in Africa. But the government needs to boost spending…” (Ohuocha, 3/23).

Vanguard: Nigeria one of the most dangerous places to give birth — Bill Gates
“Chairman, Bill & Melinda Foundation, Bill Gates, has said that Nigeria is one of the most dangerous places in the world to give birth with the fourth worst maternal mortality rate in the world ahead of only Sierra Leone, Central African Republic, and Chad. … According to him, ‘The most important choice you can make is to maximize your greatest resource, the Nigerian people. Nigeria will thrive when every Nigerian is able to thrive’…” (Agbakwuru, 3/22).

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More News In Global Health

Christian Science Monitor: For doctor in Congo’s overlooked conflict, ‘crisis fatigue’ isn’t an option (Brown, 3/22).

Devex: More bad news: Does the media really impact how the aid sector works? (Anders, 3/22).

Devex: Q&A: What does 2018 hold for the fight against TB? (Pallares, 3/23).

The Guardian: Paraguayan rape victim, 14, dies giving birth (Carneri, 3/22).

The Lancet: Commitments to an end to tuberculosis renewed in India (Sharma, 3/24).

New York Times: Fearing New Outbreaks, Brazil Will Vaccinate Country Against Yellow Fever (Darlington, 3/20).

NPR: The U.N. Set 17 Goals To Make The World A Better Place. How’s It Doing? (Lu, 3/22).

SciDev.Net: Antibiotics resistance in Africa needs urgent attention (Ogodo, 3/22).

U.N. News: Hailing African free trade agreement, Guterres says U.N. ready to support continent’s ‘leap into history’ (3/22).

VOA News: Nearly 8 Million Ethiopians Need Emergency Food, Water (Schlein, 3/22).

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Editorials and Opinions

Ahead Of World TB Day, Opinion Pieces Discuss Efforts To End Global Epidemic

Inter Press Service: Ending TB Epidemic Among Youth: Key to Achieving SDGs
David Bryden, TB advocacy officer at RESULTS Educational Fund

“…Tuberculosis (TB) … poses a major risk for young people in countries with high prevalence of TB, and schools are among the places where they are most likely to catch it. … Urgent action is needed … First, active steps must be taken to find and provide person-centered treatment to everyone with active TB disease, including in school settings … Second, … we must rapidly identify anyone who has been in contact with people with active TB and provide a course of preventive antibiotic treatment. … Third, improving ventilation and reducing overcrowding in school settings … is critically important. … Fourth, we must raise TB awareness … Finally, governments must do more to establish adolescent-accessible health services, to meet the special needs of this group, including their vulnerability to TB infection and disease, as well as to other risks such as HIV…” (3/22).

The Lancet: Addressing social determinants to end tuberculosis
Tom Wingfield, clinical lecturer in infectious diseases at the Institute of Infection and Global Health at the University of Liverpool, and colleagues

“…Despite renewed interest in addressing the social determinants of tuberculosis, there remains a stark global disparity in disease burden and access to care. Low-income and middle-income countries (LMICs) bear the highest tuberculosis burden and people with tuberculosis are often vulnerable and impoverished. Conversely, in high-income countries, improvements in living conditions, increased social expenditure per person, and strategies to address the social determinants of health have been associated with decreased tuberculosis prevalence. WHO’s 2015 End TB Strategy acknowledges the need to reduce inequalities in tuberculosis prevention and care, including through provision of social protection and poverty alleviation for households affected by tuberculosis. … To end tuberculosis, medicines must be integrated with socioeconomic interventions that fight poverty” (3/24).

The Lancet: The Lancet Commission on tuberculosis: building a tuberculosis-free world
Eric Goosby, U.N. secretary general’s special envoy on tuberculosis and member of the Gilead Health Policy Advisory Board, and colleagues

“…The U.N.’s High-Level Meeting on Tuberculosis … represents a unique opportunity to secure a commitment from heads of state and governments for a coordinated global response to end the epidemic. The Lancet Commission on tuberculosis aims to identify decisive global and country-specific actions necessary to ensure the success of that response. These recommendations will address the following priorities. First and foremost, the global community needs to pivot to bold new strategies to address the tremendous burden of disease. … Second, creating an enabling environment is essential to successfully ending tuberculosis. … Third, investing in research and development must be a global priority. … Finally, countries need to dedicate substantial resources to implement strategies to end tuberculosis. … [E]nding tuberculosis is possible with better science, improved health systems, increased and sustainable financing, and renewed political will…” (3/24).

The Hill: Rise in tuberculosis highlights broader global health security concerns
Jennifer Nuzzo and Diane Meyer, faculty at the Johns Hopkins Center for Health Security​ at the Johns Hopkins Bloomberg School of Public Health and members of the Outbreak Observatory project team

“Global health leaders are paying close attention to the recent resurgence of tuberculosis (TB) in Venezuela, recognizing that the rise of a deadly infectious disease anywhere in the world is of international concern. Unfortunately, … support among policymakers about the importance of investing globally to prevent infectious diseases is trending in the wrong direction. This outbreak is the latest reminder of the urgent need for governments to boost funding for initiatives that bolster the front lines of epidemic prevention and response. … If countries are not well equipped to control routine infectious diseases, they will likely be unable to adequately contain epidemic threats such as pandemic influenza, Zika, or Ebola. … Efforts to strengthen public health capacities to improve TB control could not only help to decrease the global burden of TB, but also strengthen global health security more broadly…” (3/22).

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Opinion Pieces Recognize World Water Day

CNN: NFL player: What I saw in Honduras gives me hope for the global clean water crisis
Kelvin Beachum Jr., offensive lineman with the New York Jets and celebrity ambassador for World Vision

“…Access to clean water should be a basic human right. … Due to bad economics or poor infrastructure, millions of people, most of them children, die from diseases associated with inadequate water supply, sanitation, and hygiene. Water scarcity, poor water quality, and inadequate sanitation negatively impact food security, livelihood choices, and educational opportunities for poor families across the world. The need for clean water access is urgent…” (3/22).

The Hill: Water has experienced a decade of bipartisan success
John Oldfield, principal at Global Water 2020

“…As we [approached] World Water Day, [which took place on March 22,] I am reminded of how much we have accomplished in just over a decade. … Going forward, Congress will have opportunities to steward additional, targeted funding to help increase access to sustainable safe drinking water and sanitation across the developing world; get ahead of water-accelerated conflicts; and prevent the next famines and water-related infectious diseases. Congress would be smart to encourage the administration to implement the new Global Water Strategy as not just a whole-of-government exercise, but a whole-of-America exercise, increasing the important roles of civic groups like Rotary International, U.S. universities, faith-based organizations, and the many nonprofits in the health and development sectors. … [T]he U.S. government and private sector have an opportunity to build on over a dozen years of bipartisan progress and significantly accelerate progress on one of the most fundamental needs we face: Global water security” (3/20).

Fox News: World Water Day: We can solve the global water crisis — Here’s how
Richard Stearns, president of World Vision U.S.

“…The global water crisis is beatable. And it’s actually the perfect time to invest in solutions to water scarcity. … And I can tell you where you’ll find your best bet: Rwanda … Rwanda is likely to be the first sub-Saharan African country to achieve one of the biggest, most audacious goals for a developing country: universal access to clean water. … I’m convinced that Rwanda is where we will see history happen. We will witness victory over the scourge of water scarcity in the nation — not just in my lifetime, but in the next few years. That’s why I’m making it personal. In my last year as World Vision president I’m committed to raising $30 million to finish the job — to provide water to everyone throughout World Vision’s project areas. It’s a goal that aligns perfectly with Rwanda’s national strategy…” (3/22).

Thomson Reuters Foundation: The next great water crisis may be under our feet
Karen G. Villholth, principal researcher with the International Water Management Institute (IWMI) and CGIAR Research Program on Water, Land and Ecosystems (WLE) and coordinator of the Global Groundwater Initiative GRIPP

“…Key to avoiding the worst of a crisis is sound water governance, particularly as it relates to groundwater. If, with little foresight, we deplete or destroy our groundwater resources due to governance structures that do not explicitly aim to sustain it, societies may be undermined. … Politicians, governments, businesses, farmers, and the public need to engage in this now. Groundwater cannot be governed solely by a top-down approach. We need our leaders — and society at large — to take seriously the governance of our degrading, but crucial ‘last frontier’ natural water resource. If we fail to consider this urgently, the world can expect a future of serious groundwater-fed crises” (3/21).

Inter Press Service: Why You Should Care About the Water Crisis
Tim Wainwright, chief executive of WaterAid U.K.

“…[P]olitical will and financing are critical in addressing the water crisis. … This summer, world leaders will convene at the U.N. to review the progress made on [Sustainable Development] Global Goal 6; to deliver water and decent toilets to everyone, everywhere by 2030. In this, however, the world is dramatically far behind. At the current pace, global access to clean water will happen only by 2066 and global access to decent toilets not until the next century. … If we don’t achieve the water goal, other global goals for progress in education, nutrition, health, equality, and stability will most certainly fail too. Ending extreme poverty is impossible without universal access to clean water and decent toilets…” (3/21).

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Governments Must Use 'Research, Not Misconceptions' To Inform Abortion-Related Policies

The Lancet: Abortion: access and safety worldwide
Editorial Board

“…Abortion has become the subject of a highly politicized debate and of the worst kind of value signaling from those in positions of power, who are often protected from the consequences of their policies by gender, geography, and economics. The burden of unintended pregnancies falls hardest on the most vulnerable women. Reducing the stigma, minimizing the social and economic consequences of unintended pregnancies, improving access to highly effective modern contraception, and ensuring legal and safe abortions would generate tangible improvements to health. Those with real motivation to protect and support women and children should look to research, not misconceptions, to inform decision making” (3/24).

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WHO Should Repeal Policy On Plain Packaging Of Tobacco Products

Forbes: Unbranding Economic Freedom: The WHO And The Case Of Plain Packaging
Lorenzo Montanari, director of international programs and affairs for Americans for Tax Reform and executive director of Property Rights Alliance

“…The [plain packaging] policy [on tobacco products] is a direct attack on economic freedom and should never have gone into practice. … A new international coalition of 62 organizations sent a letter to the WHO Director-General Dr. Tedros Ghebreyesus to demand the organization to stop infringing on [intellectual property (IP)] rights with plain packaging policies. … It’s time for the WHO to rethink this plain packaging policy. Other countries have been able to reduce smoking prevalence without experimenting with this extreme measure. … Given the extraordinary costs for a policy that consistently returns dismal results, the WHO really has no choice but to repeal plain packaging. Instead it should protect IP rights and provide alternative solutions that actually work to reduce smoking prevalence” (3/22).

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Stronger Regulations On Antibiotic Prescriptions, Political Will Critical To Addressing Global AMR Challenge

Project Syndicate: India’s War on Antimicrobial Resistance
Abdul Ghafur, coordinator of the Chennai Declaration

“…Uneven and unregulated antibiotic usage is one of the most important reasons behind the [antimicrobial resistance (AMR)] crisis. … Stronger regulations of antibiotics prescriptions … could help to mitigate resistance. Yet such rules alone will not be enough … Inequalities in access to medicine, excessive use, and poor sanitation services complicate the problem further. And when farmers use antibiotics to speed the growth of chickens and other livestock, drug-resistant germs find new ways to enter the environment. … Clearly, guidelines are an important first step in addressing the global AMR challenge. But governments, medical associations, and hospitals must also commit to tackling the antibiotic crisis together. That is what the health care community in India is doing. In 2012, India’s medical societies adopted the Chennai Declaration, a set of national recommendations to promote antibiotic stewardship. … [H]ealth care communities in advanced economies must find the political will to reduce unnecessary antibiotic use by people, and in agriculture…” (3/22).

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From the Global Health Policy Community

PSI CEO Discusses Global Health Aspects Of, Lessons From Trump Administration's FY19 Budget Proposal

PSI’s “Impact”: What Trump’s ‘Groundhog Budget’ Reminds Us About Global Health Trends
Karl Hofmann, president and CEO of PSI, discusses the Trump administration’s FY19 budget proposal and compares it to the administration’s FY18 proposal. Hofmann writes, “Here are three Trump-era trends we shouldn’t ignore. 1. The global South will cover more of its health expenditures; the North and global institutions will cover less. … 2. We better listen to youth when thinking about their contraceptive needs. … 3. New technologies can effectively put more care and control directly in health consumers’ hands, even in the least developed parts of the world — but regulatory and funding hurdles need to be overcome…” (3/22).

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USAID Using, Improving Evaluation Systems To Inform Programming

MFAN: What USAID is Doing to Learn from Evidence
Melissa Patsalides, director of USAID’s Office of Learning, Evaluation and Research in the Bureau for Policy, Planning and Learning, discusses the agency’s “approaches to, and emphasis on, evaluation” and outlines several ways “USAID has made great strides in improving evaluation quality and use of evaluation findings to inform decisions and improve programs” (3/22).

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Blog Posts Discuss World TB Day, Progress In Disease Detection, Treatment

ACTION: On World TB Day, health advocates call on global leaders to commit to ending the disease
“ACTION global health advocacy partnership is observing World Tuberculosis (TB) Day with new calls on world leaders to prioritize ending the disease. … After years of being overlooked, TB is finally becoming a political priority on the world stage…” (3/22).

Friends of the Global Fight: On World TB Day, innovating to fight the world’s most deadly infectious disease
Berk Ehrmantraut, communications intern at Friends of the Global Fight, discusses ways the Global Fund to Fight AIDS, Tuberculosis and Malaria is addressing TB detection and treatment, writing, “[F]inding innovative ways to identify missing cases is an opportunity to make huge gains in the TB fight. Fortunately, the Global Fund is focused on tackling this very issue. … They are pursuing this goal through the TB Catalytic Investment initiative…” (3/22).

R&E SEARCH for EVIDENCE: Recent research contributes to ending TB
Corey White, managing editor of R&E SEARCH for EVIDENCE, writes that effectively addressing TB “can include things like transporting viable patient samples to the testing laboratory, using appropriate medications in proper doses, or developing shorter treatment regimens,” and he “highlight[s] three innovative research papers that address these sometimes overlooked issues within resource-limited settings” (3/22).

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From the U.S. Government

CDC's MMWR Recognizes World TB Day, Efforts To End TB In U.S.

CDC’s “Morbidity and Mortality Weekly Report”: World TB Day — March 24, 2018
This post recognizes World TB Day, which takes place annually on March 24, and highlights the CDC’s efforts to end TB in the U.S. (3/23).

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Vaccine Development Innovations Could Improve Public Health Response To Future Disease Outbreaks

NIH: NIH scientists say advanced vaccines could limit future outbreaks
“Novel vaccine technologies are critical to improving the public health response to infectious disease threats that continually emerge and re-emerge, according to scientists at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. In a perspective in the Journal of the American Medical Association, the experts highlight innovations that could significantly shorten the typical decades-long vaccine development timeline…” (3/22).

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