KFF Daily Global Health Policy Report

In The News

Republican, Democratic Lawmakers Will Not Accept Trump Administration's FY 2020 Humanitarian Aid Budget Proposal

Roll Call: Lawmakers from both parties resist humanitarian and refugee aid changes
“Democratic and Republican lawmakers say they are determined to block a White House budget proposal that would gut the State Department’s refugee operations and slash overall humanitarian aid levels. President Donald Trump’s [fiscal year] 2020 budget request proposes consolidating three separate humanitarian assistance accounts operated by the State Department and U.S. Agency for International Development. The new umbrella account would be managed by USAID and, in theory, have more flexibility to respond to rapidly evolving global crises. … While longtime humanitarian assistance practitioners say the proposal has some merits, they do not trust the Trump administration’s ultimate intentions and thus oppose it. That’s because the White House is seeking to cut the overall humanitarian funding for fiscal 2020…” (Oswald, 3/22).

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USAID Chief Innovation Officer Alexis Bonnell Discusses Integration Across Agency In Devex Interview

Devex: Q&A: USAID’s chief innovation officer on whole-of-agency integration
“As the United States Agency for International Development undergoes an internal reorganization, innovation will be integrated across more of its programs. ‘Innovation is prioritized in USAID’s structural reorganization as a key area that needs whole-of-agency attention and integration,’ said Alexis Bonnell, chief innovation officer at USAID. … Nearly six months into her new role as chief innovation officer, which sits administratively within the [U.S. Global Development Lab] but also serves the agency, she spoke with Devex about the future of innovation at USAID…” (Cheney, 3/25).

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More Prevention, Treatment, Funding Efforts Needed To End TB, Experts Say On World Day

Devex: Building tuberculosis awareness in low-risk countries
“…While World TB Day, celebrated on March 24, came with a range of new announcements including a new report from [the] Lancet Commission on tuberculosis, which provides a framework for delivering on the political commitments made by heads of state and government in October last year at the United Nations High-Level Meeting on TB, there still remains an important challenge: more funding…” (Cornish, 3/25).

Homeland Preparedness News: The Lancet Commission on Tuberculosis seeks to eliminate disease by 2045
“Within a few decades, The Lancet medical journal’s Commission on Tuberculosis (TB) believes that the disease could be eliminated if proper funding, increased research, and greater accountability mechanisms are provided…” (Galford, 3/22).

SciDev.Net: TB ‘can be eradicated’ with funding push
“Global health organizations have issued a call to action for World Tuberculosis Day, with experts saying the deadly disease can only be eradicated if research funding is ramped up. … Declines in TB mortality are failing to keep pace with those from other infectious diseases such as HIV and malaria and the world is not on track to meet U.N. and WHO targets, according to a report in The Lancet medical journal…” (Douglas, 3/23).

U.N. News: It’s ‘time to #EndTB,’ says U.N. on World Tuberculosis Day
“Tuberculosis, or TB, is not only the world’s top infectious killer, it is also the leading cause of deaths among people with HIV and a major cause of antimicrobial resistance-related deaths, the United Nations health agency said on Sunday, World Tuberculosis Day. … Since 2000, global efforts to combat this preventable and curable disease have saved an estimated 54 million lives and reduced the TB mortality rate by 42 percent. ‘The theme of this year’s World TB Day is: It’s time to end TB,’ said Tedros Adhanom Ghebreyesus, WHO director general, leading the global call to ‘Find. Treat. All. #EndTB’…” (3/24).

Xinhua News: Mixed progress towards reducing TB deaths of people living with HIV: UNAIDS
“Five countries have already met and 18 more are on track to meet the U.N. target of reducing tuberculosis (TB) deaths among people living with HIV by 75 percent by 2020, the Joint United Nations Program on HIV/AIDS (UNAIDS) said in a report published here on Friday. However, most countries are lagging behind and risk missing the target completely, according to the report…” (3/22).

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WHO Meeting Develops Vision, Strategy Prototype For Post-2020 Vaccine Action

Health Policy Watch: WHO Stakeholders Meet To Establish A “Different Approach” For Post-2020 Vaccine Strategy
“The World Health Organization and global partners wrapped up a meeting [March 21] to develop a vision and strategy prototype for the post-2020 decade of action on vaccines and immunizations. This new plan of action for 2021-2030 will take a different approach that is more ‘bottom up’ and collaborative in engaging countries and other stakeholders to tackle emerging immunization challenges, including recent measles and diphtheria outbreaks and growing ‘vaccine hesitancy’ across WHO regions. The 3-day meeting, entitled ‘Co-creating the Future of Vaccines and Immunization,’ took place in Geneva [last] week from 19-21 March, and marked a key milestone in the development of a unified vision and plan for 2021-2030 that will guide WHO’s work on vaccines and immunization…” (Branigan, 3/21).

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WHO Reaffirms Commitment To Ending DRC Ebola Outbreak As Number Of Cases Surpasses 1K

CNN: More than 1,000 Ebola cases reported in outbreak
“The deadly Ebola outbreak in the Democratic Republic of Congo has surpassed 1,000 cases, according to the country’s health ministry. The number of confirmed cases stands at 1,009, of which 944 are confirmed and 65 probable, in an outbreak that started in August. The death toll is at 629 — 564 are confirmed from Ebola and 65 probable. … ‘We use words like “cases” and “containment” to be scientific, but behind every number is a person, a family and a community that is suffering,’ said Dr. Tedros Adhanom Ghebreyesus, WHO director general in a statement Saturday. ‘This outbreak has gone on far too long’…” (Park, 3/25).

The Hill: Ebola outbreak hits 1,000 cases
“…Health officials say the rising case count comes as they struggle to make inroads with communities that are not used to dealing with Ebola, or even with aid workers hoping to help. Those officials have been frustrated in recent weeks as the epicenter of the outbreak moved south from the town of Beni to the cities of Butembo and Katwa…” (Wilson, 3/24).

Additional coverage of the DRC Ebola outbreak and response is available from Spiegel Online, TIME, and VOA News.

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Threat Of Disease Spread Rises In Cyclone-Hit Southern Africa; Idai Heavily Impacting Children, UNICEF Says

Agence France-Presse: Disease fears mount for Africa cyclone survivors
“Disease is threatening to aggravate the already dire conditions facing millions of survivors following the powerful tropical cyclone which ravaged southern Africa 10 days ago, officials warned on Sunday…” (3/24).

The Telegraph: Disease stalks cyclone disaster zone as the world scrambles to fly more help in
“…The U.N. and the International Red Cross said humanitarian efforts were struggling to keep pace with the scale of the disaster and warned many more deaths were likely in the days and weeks ahead…” (Catueira/Blomfield, 3/22).

U.N. News: Cyclone Idai: UNICEF warns of ‘race against time’ to protect children, prevent spread of disease in flood-ravaged Mozambique
“… ‘We are in a race against time to help and protect children in the disaster-ravaged areas of Mozambique,’ UNICEF Executive Director Henrietta Fore said at the end of a visit to Beira, one of the areas worst affected by Cyclone Idai. According to initial government estimates, 1.8 million people across the country, including 900,000 children, have been affected by the cyclone which slammed into the country last week. However, many areas are still not accessible and UNICEF and partners on the ground know that the final numbers will be much higher…” (3/23).

Additional coverage of the impacts of Cyclone Idai is available from Al Jazeera, Deutsche Welle, The Guardian, New Humanitarian, Reuters (2), TIME, U.N. News, VOA News (2), and Washington Post.

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Taliban Leaders Hindering Polio Fight, Bill Gates Says, Urges Afghanistan, Pakistan To Continue Efforts

Reuters: Bill Gates urges Afghanistan and Pakistan to ‘get to zero’ in polio fight
“Local Afghan Taliban leaders are hindering global efforts to end polio, but Afghanistan and Pakistan must continue their fight to ‘get to zero’ cases, the philanthropist Bill Gates said on Monday. In a telephone interview with Reuters, Gates was optimistic about the global plan to eradicate the paralyzing viral disease, but said Afghanistan’s conflict and power struggles hamper progress…” (Kelland, 3/25).

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PRI Examines Access To Abortion In Argentina

PRI: Legal abortions remain elusive in Argentina, especially for the most vulnerable
“…[A]bortion-rights advocates say it’s all too common for women in Argentina to be denied access to legal abortions. Abortion is banned here except in the case of rape, incest or if a woman’s life is in danger. On Saturday, several anti-abortion gatherings [were] held in Argentina for its National Day of the Unborn Child…” (Herrera, 3/22).

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More News In Global Health

Al Jazeera: 10 years and 9 kilos: Child starvation takes its toll in Yemen (Gupta, 3/22).

Devex: Q&A: Why the world needs science and partnerships to tackle TB (3/22).

The Guardian: ‘The country could fall apart’: drought and despair in Afghanistan (Ratcliffe, 3/25).

The Guardian: The drugs don’t work: what happens after antibiotics? (Franklin-Wallis, 3/24).

Los Angeles Times: Philippine measles outbreak fed by distrust of vaccines — rooted in vaccination scandal (McLaughlin, 3/22).

U.N. News: U.N. conference agrees better ways for Global South countries to work together on sustainable development (3/22).

U.N. News: Hunger, displacement and disease: 4.3 million people remain in dire need of aid in Chad (3/22).

VOA News: India, Southeast Asia to Mark Five Years of Being Polio-free (Schlein, 3/23).

Vox: The new, confusing Zika travel advice, explained (Belluz, 3/22).

Xinhua News: Uganda scales up tuberculosis diagnosis, treatment to reduce incidence (3/23).

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Editorials and Opinions

Opinion Pieces Discuss Efforts Needed To End TB

Medium: No ribbons, no marches, no Santana
David Bryden, TB advocacy officer at RESULTS

“…A new organization is trying to end the ignorance about TB and bring it out of the shadows. It is called We Are TB, led by TB survivors themselves, who volunteer their time to raise awareness and call for action. These former patients and family members, drawn from a variety of backgrounds and from all over the U.S., are speaking out in their communities about their experience, to break down myths and provide accurate information. … [This] week, a small group of members of We Are TB will come to Capitol Hill to lobby Congress about the need for more federal support for TB programs in the U.S. and around the world, including the need for much greater spending to develop a vaccine for TB, more reliable diagnostics, and faster-acting treatments. … If we are serious about ending this disease, we must lend our voice … so … World TB Day becomes a day for everyone to remember” (3/22).

STAT: Ending tuberculosis: we can get there with a new roadmap
Robert W. Eisinger, special assistant for scientific projects in the Office of the Director at the National Institute of Allergy and Infectious Diseases (NIAID), and Anthony S. Fauci, director of the NIAID

“…The Lancet Commission has set the goal of achieving a TB-free world within a generation. That will require an intense and concentrated effort at all levels: local, regional, national, and global. … By strengthening collaborative efforts among partners in communities, academia, industry, government, and public health, we can move from an aspirational goal to realistic advances that ameliorate the devastating suffering and economic costs of TB. The pathway to ending TB — a disease that is preventable, treatable, and curable — is clear. But the time to act is now” (3/24).

The Conversation: Major battles have been won against TB. But the war isn’t over
Bavesh Kana, head of the Centre of Excellence for Biomedical TB Research at the University of the Witwatersrand

“…All nations, especially TB endemic countries, need to take up the call for action laid out in the U.N. declaration. But the world won’t simply treat its way out of the epidemic with antibiotics. Interrupting transmission, developing a vaccine, protecting vulnerable populations, developing new diagnostics and better treatment regimens are all required for controlling the epidemic. Innovative and cost-effective diagnostic and case finding approaches are desperately needed to strengthen health care systems together with more investment in research and development. Finally, we all need to advocate for more resources and better patient support. TB is everyone’s problem — not just the poor and forgotten” (3/20).

STAT: India should heed a teenager’s historic fight for lifesaving tuberculosis treatment
Stephen Lewis, co-director of AIDS-Free World, and Jennifer J. Furin, lecturer on global health and social medicine at Harvard Medical School

“…India has … proclaimed that it will eliminate TB by 2025. But the government continues to erect needless bureaucratic barriers between desperately ill individuals with drug-resistant TB and the medications that could restore their health. Fewer than 1,500 patients in India, just over one percent of those with drug-resistant TB, are receiving bedaquiline. … Sadly, it isn’t alone in withholding bedaquiline to those who need it: Nigeria, Ukraine, Indonesia, and Latin American countries [are] doing the same thing. … India and other governments [should be called upon] to provide the same humane, effective treatment to their citizens trapped in mortal struggles with drug-resistant TB that is saving lives elsewhere in the world” (3/24).

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Abortion Matters Should Be Determined At National, Local Level, Not 'International Right' Under U.N. Documents, Opinion Piece Says

The Hill: No, abortion is not an international right, so the left should stop pushing it
Shea Garrison, vice president of international affairs at Concerned Women for America and affiliated faculty and policy fellow at George Mason University Schar School of Policy and Government

“The Commission on the Status of Women (CSW 63) came to an end [last] week at the United Nations in New York City. News reports warn that the U.S. seeks to decrease the rights of women and girls by taking away an international ‘right’ to abortion in U.N. resolutions. … [T]his information is inaccurate and misleading. … Promoted through the term ‘sexual reproductive health’ (SRH), legalized abortion is neither an international right, nor does it effectively support the goals of health, prosperity, and advancement of women and girls. … [C]ontrary to claims of abortion advocates, legalized abortion is not an international right but under the sovereignty of U.N. member states. The [Cairo 1994 International Conference on Population and Development (ICPD)] Programme of Action clearly states that any changes related to abortion are determined ‘at the national or local level according to the national legislative process,’ adding that ‘governments should take the appropriate steps to help women avoid abortion, which in no case should be promoted as a method of family planning.’ … Even so, western organizations widely promote legalized abortion at the U.N. and especially as an integral part of maternal health and decreasing maternal mortality … U.N. development aid should focus on what women really need to combat the majority of maternal deaths — like skilled birth attendants, antibiotics, blood banking, and uterotonics…” (3/23).

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African Investments In Health Critical To Continent's Economic Future

CNN: President Kagame and Bill Gates: Every vaccine is a shot of adrenaline into the heart of the African economy
Paul Kagame, president of Rwanda, and Bill Gates, co-chair of the Bill & Melinda Gates Foundation

“…The link between health and economic growth is clear. … For example, over the past two decades, every dollar spent on essential medicines in Africa has generated $20 more in social and economic benefits. … [Africa’s] future depends on making even bigger and smarter investments in health. … [T]he case for foreign aid is much easier to make if the rest of the world knows Africa is investing in its own health, too. Going forward, the international community will call upon Africa to contribute an increasing share of … funding for the health programs that make such a difference in the lives of citizens. This is as it should be. In 2001, African Union member states pledged to dedicate at least 15 percent of their annual budgets to public health. Today, while only three A.U. member states have met this target, the situation is changing. Between 2000-15, 29 member states increased total health spending. Earlier this month, the African Union resolved to establish a domestic health financing tracker to monitor progress. Better data will help us see what is working, what isn’t — and how we can all work together to achieve more. All of us have a role to play in making good on our promises to improve health on the continent. Africa’s future depends on it” (3/22).

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Building Trust Critical To Controlling DRC Ebola Outbreak

Nature: Building trust is essential to combat the Ebola outbreak
Editorial Board

“…Central to [the] problem [of the Ebola outbreak in the Democratic Republic of the Congo (DRC)] is a lack of trust. … Researchers should consider the reasons for such skepticism, so that they can help to reduce it — because, without trust, the tools they’ve developed to fight the disease will not contain this emergency. … [M]embers of the international research community can do more. They can help to sound the alarm, and can highlight the broader problems to colleagues, health officials, and world leaders. Specifically, researchers can pressure politicians in wealthier countries to step up funding for the efforts of the World Health Organization (WHO) and their national partners in North Kivu. … Researchers can also play a part in strengthening the DRC’s biomedical and health institutions, helping to build communities’ trust in the nation’s health system. … The DRC outbreak could continue for another year. In that time, the virus could spread through porous borders into fragile nations such as Rwanda, Uganda, South Sudan, and the Central African Republic. The opportunity to act is now” (3/22).

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From the Global Health Policy Community

Organizations Recognize World TB Day, Release Blog Posts, Resources On TB

BMJ Opinion: The U.N.’s Political Declaration on the fight against Tuberculosis must be operationalized to rapid effect
Poonam Khetrapal Singh, regional director for WHO South-East Asia, discusses the importance of streamlining financing and global investment in TB (3/24).

Friends of the Global Fight Against AIDS, Tuberculosis and Malaria: MDR-TB: A Major Global Health Threat
This post discusses the threat of multidrug-resistant TB (MDR-TB) globally, noting that the issue “demands additional funding and attention from U.S. leaders” (3/22).

Global Fund to Fight AIDS, Tuberculosis and Malaria’s “Voices”: In Rural India, High-tech Vans Find “Missing” TB Patients
This post discusses the use of vans equipped with diagnostic tools to find “missing,” otherwise known as undiagnosed, untreated, or unreported, TB patients in India (3/21).

Global Fund to Fight AIDS, Tuberculosis and Malaria’s “Voices”: Q&A: The Hunt for TB’s “Missing Millions”
This post features an interview with Eliud Wandwalo, senior disease coordinator for TB at the Global Fund, on the importance of finding missing TB patients and the Global Fund’s efforts to ensure these patients are identified and put on treatment (3/21).

Institute of Development Studies: It’s time to address the intersection of poverty and masculinity to End TB
Bertie Squire, professor at Liverpool School of Tropical Medicine, discusses the burden of TB among men and boys, writing, “Men are disproportionately affected by TB. More men than women are diagnosed and die from TB globally, and more men than women have undetected TB. Yet while strategies to tackle the disease have become more gender-sensitive, they tend to focus on women and girls and not men and boys. Without the inclusion of men and boys, as well as a greater recognition of how gender and poverty intersect to prevent diagnosis and treatment of TB, efforts to end this deadly disease will be hindered” (3/22).

Médecins Sans Frontières: World TB Day: Treating the untreatable
This post discusses a patent challenge in India, which aims to block Johnson & Johnson (J&J) from extending its patent on the TB drug bedaquiline. The post notes, “If this new patent is granted, J&J’s monopoly on bedaquiline would be extended from 2023 to 2027, keeping cheaper generic versions of the drug off the market for an additional four years. … MSF supports the patent challenge and is calling on J&J to stop attempts to extend its monopoly on a lifesaving drug with the potential to improve cure rates for patients battling [drug-resistant TB (DR-TB)] in India and around the world. We are also urging J&J to cut the price of bedaquiline to $1 a day so that many more lives can be saved” (3/22).

PLOS Blog’s “Speaking of Medicine”: Progress in Peril: Stagnant Funding Could Lengthen the TB Elimination Timeline
In recognition of World TB Day, Jay Achar, tuberculosis/HIV program and research adviser within the Manson Unit of Médecins Sans Frontières, “explains how despite encouraging innovation in the fight to eradicate TB, progress could be stalled if TB actors become complacent” (3/22).

PLOS: PLOS Special Collection launch: Shaping novel TB treatments
“To commemorate World TB Day, a Special Collection has been released by PLOS Medicine containing a series of articles that articulate the essential new steps in clinical research that will pave the way for the development of tomorrow’s optimal treatment for all forms of tuberculosis. … The series is the outcome of a technical consultation organized by WHO … to identify and outline, through expert consensus, the optimal characteristics of clinical trial designs to inform policy guidance for the development of new TB regimens…” (3/22).

World Health Organization: Drug resistant strains could become the dominant form of TB in Europe: it’s time to end TB
“If the current situation continues, the majority of tuberculosis (TB) patients in the next generation could be suffering from drug resistant forms of the disease. The latest WHO/European Centre for Disease Prevention and Control (ECDC) report, ‘Tuberculosis surveillance and monitoring in Europe 2019 (2017 data),’ shows that the European Region is struggling to make sufficient progress to finally end TB…” (3/22).

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Latest Issue Of FT Health Guest-Curated By England's Chief Medical Officer Sally Davies

FT Health: The power of genomics
The latest issue of the Financial Times’ weekly global health newsletter was guest-curated by Professor Dame Sally Davies, chief medical officer for England and chief medical adviser to the U.K. government, who discusses the success of the U.K.’s 100,000 Genomes Project, as well as the threat of antimicrobial resistance. The newsletter also features an interview by Davies with Jon Symonds, HSBC’s deputy group chairman and Genomics England chair, as well as a round-up of global health-related news stories (3/22).

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From the U.S. Government

USAID Administrator Recognizes World TB Day In Statement, At Event

USAID: Statement from USAID Administrator Mark Green on World Tuberculosis (TB) Day
“…Since 2014, the U.S. Agency for International Development (USAID) has provided treatment to more than 13 million people, including more than 300,000 who were suffering from MDR-TB. Our partners have achieved nearly a 50 percent reduction in TB-related deaths across priority countries, and saved more than 54 million lives in the process. As the largest bilateral donor for TB, since 2000, USAID has funded programming in 23 countries, and aided more than 30 additional countries through grants from the Global Fund to Fight AIDS, TB, and Malaria (to which the United States contributes one-third of the overall financing)…” (3/22).

USAID: U.S. Agency for International Development Administrator Mark Green’s Remarks at USAID’s World TB Day Event
“…I am proud to say that USAID has been a leader in the global fight against TB, and we will continue to be. Since 2000, we have seen nearly a 50 percent reduction in TB-related deaths; more than 54 million lives have been saved, and that is something for us to celebrate. However, while many gains have been achieved, I think we all know that we have much to do. … In order to confront and to conquer these challenges, USAID launched the Global TB Accelerator to End Tuberculosis…” (3/21).

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U.S. Government Agencies Share Messages On World Water Day
U.S. Department of State’s “DipNote”: Celebrating World Water Day
“…On March 22, the U.S. Department of State and USAID, as well as U.S. Embassies and Consulates around the world shared World Water Day messages and highlighted actions they were taking to support this international day on their social media accounts. Here are a few highlights…” (3/22).

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From KFF

KFF Updates Fact Sheet On U.S. Government's Role In Addressing Global TB

Kaiser Family Foundation: The U.S. Government and Global Tuberculosis Efforts
Updated to coincide with World TB Day, this fact sheet explains the U.S. government’s role in addressing the global tuberculosis (TB) epidemic, including the history of U.S. involvement and funding trends (3/25).

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