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Kaiser Daily Global Health Policy Report

In The News

U.N. Commission On Status Of Women Concludes; U.S. Delegation Draws Criticism From Some Advocates

Devex: U.S. ‘regressive’ stance at CSW dominates U.N.’s largest meeting on women
“United Nations member states wrapped the annual Commission on the Status of Women meeting last week with a set of conclusions that fell short of the agreement many civil society advocates were hoping would include strong language on human rights and sexual and reproductive health. The negotiations around the document — a tool civil society policy experts and activists bring back home to lobby for the rights of women and girls — drew late into Friday, the final day of the two-week event. For the second year in a row, the United States delegation was cast as one of the most aggressive — and regressive — players at the table…” (Lieberman, 3/27).

Devex: Top takeaways from the U.N.’s largest women’s rights gathering
“…Devex has been reporting from the CSW at the U.N. Headquarters and across Manhattan for the past two weeks, covering some of the many events headlined by more than 500 organizations. Here are some of the major takeaways…” (Lieberman, 3/24).

U.N. News: U.N. Commission delivers a blueprint to ensure the rights and development of rural women and girls
“The United Nations’ largest annual gathering on gender equality and women’s rights wrapped up Friday in New York with the strong commitment by its member states to achieving gender equality and the empowerment of rural women and girls. … These include ensuring their adequate living standards with equal access to land and productive assets, ending poverty, enhancing their food security and nutrition, decent work, infrastructure and technology, education and health, including their sexual and reproductive health and reproductive rights, and ending all forms of violence and harmful practices…” (3/24).

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U.K. Labour Outlines Opposition Party's Strategy For International Development Policies

Devex: U.K. Labour Party pledges to end PPPs in inequality-focused aid strategy
“On Monday, the United Kingdom’s Labour Party aid head Kate Osamor launched the opposition party’s strategy for overhauling international development policy. Osamor pledged a double-barrel mandate of poverty and inequality reduction if elected — in contrast to the current government’s focus mainly on poverty reduction — with a greater focus on local delivery partners, women-led initiatives, and reforming the global tax system. Questions were also raised among aid observers about suggestions that humanitarian funding could be redirected toward prevention…” (Anders, 3/27).

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Antibiotic Use Rose 65% Globally Between 2000-2015; Increase Driven By Economic Growth In LMICs, Study Shows

CBS News: Global use of antibiotics soars as resistance crisis worsens
“In recent years, antibiotic resistance has risen to dangerously high levels in all parts of the world. Yet despite this growing health crisis, new research shows worldwide use of antibiotics skyrocketed between 2000 and 2015, largely driven by dramatic increases in low-income and middle-income countries [LMICs]…” (Welch, 3/26).

CIDRAP News: Global antibiotic use rises, fueled by economic growth
“…The study, published [Monday] in the Proceedings of the National Academy of Sciences, found that overall global antibiotic use rose by 65 percent from 2000 through 2015, while the antibiotic consumption rate increased by 39 percent. Over that period, antibiotic consumption in LMICs more than doubled, with some LMICs having consumption rates that surpassed those of high-income countries (HICs). The increase was correlated with growth in per capita gross domestic product (GDP)…” (Dall, 3/26).

The Guardian: Calls to rein in antibiotic use after study shows 65% increase worldwide
“…Of particular concern, the report states, is the steep rise in global use of antibiotics of last resort, such as colistin, a drug that has been reintroduced despite being all but abandoned in the 1970s because of its toxicity. Colistin has been used to treat infections that cannot be shifted with other drugs, but in the past decade bacteria with colistin-resistant genes spread around the world after they emerged in a Chinese pig in the mid-2000s…” (Sample, 3/26).

NPR: Surge In Antibiotics Is A Boon For Superbugs
“…Antibiotic use more than doubled in India between the year 2000 and 2015. It was up 79 percent in China and 65 percent in Pakistan. Some of that increase was due to population growth but it wasn’t just that. Overall sales were up. So the report makes it clear that the average person in India, China, or Pakistan is taking far more antibiotics now than they were a decade and half ago…” (Beaubien, 3/26).

TIME: People Around the World Are Using Far More Antibiotics. Here’s Why
“…Antibiotic use in high-income countries declined slightly, the researchers note, though more judicious use of the medicines is still encouraged for countries like the United States. In the U.S., a third of antibiotics prescribed are unnecessary” (Sifferlin, 3/26).

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90% Of People With Hepatitis B Unaware Of Infection; More Diagnosis, Treatment, Prevention Efforts Needed Globally, Study Says

The Guardian: Scientists warn 90% of hepatitis B sufferers remain unaware of silent killer
“About 300 million people worldwide are living with hepatitis B, yet the majority of cases remain undiagnosed or untreated, researchers have found. According to a study published on Monday in the Lancet Gastroenterology & Hepatology journal, roughly 90 percent of people infected by the virus, which is incurable but manageable, are unaware they have it. … The study’s authors warn that global efforts aimed at eradicating the hepatitis B virus (HBV) by 2030 are unlikely to be met unless countries rapidly improve access to screening and treatment…” (Hodal, 3/27).

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Governments Should Address Increasing Teen Pregnancy Rates In East Asia-Pacific Region, Report Says

The Guardian: Rising teenage pregnancy rates in East Asia-Pacific spark health warning
“Teenage pregnancy — the biggest killer of girls and women aged 15 to 19 in the world — is growing in the East Asia-Pacific region, the only place where the rate is climbing. A new report from Plan International, Half a Billion Reasons, has called on governments to develop specific aid and development policies to improve the lives of the world’s 500 million adolescent girls — an ‘invisible’ cohort whose uplift could boost economies, reduce domestic violence, and improve health and education…” (Doherty, 3/26).

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More Funding, Efficient Uses Needed To Reach NCD Goals In Africa, Experts Say

Devex: The funding dilemma for noncommunicable diseases in Africa
“The disease burden on the African continent is shifting from infectious diseases, such as HIV and tuberculosis, to noncommunicable diseases, such as cancer, diabetes, and cardiovascular disease. … While more funding is needed, money alone won’t be enough to reach the U.N. goal [of cutting the cases of premature mortality from NCDs by a third by 2030]. Getting more value out of each dollar spent on NCDs is key to financing efforts to manage the diseases moving forward, said panelists at the ‘Building Solutions to Patient Challenges in Non-Communicable Diseases’ conference in Nairobi…” (Jerving, 3/27).

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WFP Director Discusses Links Between Food Security, Migrant Crises In AP Interview

Associated Press: AP Interview: U.N. food agency boss warns of migrant crisis
“…David Beasley, executive director of the World Food Programme, said many of the militants who fled Syria amid the collapse of the Islamic State group’s self-described caliphate had ended up in the greater Sahel region, a belt of semi-arid land spanning east-west across Africa and home to 500 million people. … He said he has warned European leaders that they could face a far larger migrant crisis from the Sahel than the Syrian conflict generated if they do not help provide the region with food and stability…” (McGuirk, 3/26).

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More Than 25% Of Indian TB Patients Resistant To At Least One Drug, National Survey Shows

Economic Times: World TB Day: Over 25% TB patients in India are resistant to at least one anti-TB drug
“More than a quarter of tuberculosis patients in India are resistant to at least one commonly used drug to treat the disease, stated a new national survey conducted to understand the prevalence of drug-resistance among TB patients in the country. The survey reported high treatment failure and death rates of multi-drug resistant TB patients than the global level. The study, which places particular focus on multi-drug resistant TB among both new and previously treated patients, stated that a high number of MDR-TB patients were resistant to a class of antibiotics known as fluoroquinolone…” (Raghavan, 3/24).

The Hindu: A fourth of Indian TB patients are drug resistant
“…Among the 4,958 patients on whom drug susceptibility testing (DST) was conducted (necessary to find out if a person has drug-resistant TB), 28% had resistance to one or the other anti-TB drug, while 6.19% had multi-drug resistant (MDR) TB. … While this is the largest study of its kind, the survey does not reveal the national burden of DR-TB as it does not include data from patients being treated in the private sector…” (Krishnan, 3/25).

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More News In Global Health

BBC News: A day in the life of India’s ‘tuberculosis warrior’ (3/24).

CNN: Bill Gates tells Nigerian leaders to ‘face facts’ so they can make progress (McKenzie/Swails, 3/26).

Devex: Beyond wells and hand pumps: The next phase in the fight for clean water (Edwards, 3/27).

Forbes: Where Political And Economic Instability Is Making Tuberculosis A Growing Public Health Threat (Stone, 3/26).

Miami Herald: A measles outbreak in ailing Venezuela is threatening Colombia and Brazil (Wyss, 3/26).

U.N. News: U.N. renews push for political solution as Yemen marks three years of all-out conflict (3/26).

U.N. News: Papua New Guinea: A month after deadly quake, U.N. on the ground delivering life-saving aid (3/26).

Xinhua News: Namibia on track to reach HIV epidemic control mark (3/27).

Xinhua News: Zambia resolves to sponsor resolution on cholera elimination at global health meeting (3/27).

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Editorials and Opinions

Opinion Pieces Discuss Global Efforts Needed To End TB Epidemic

The Conversation: Why community and not confinement will end TB
Eric Friedman and Drew Aiken, both researchers at Georgetown University

“…Without a response to TB based in human rights — including moving rapidly to community-based care and improving the conditions in prisons — we believe that progress will remain fatally slow. … To end TB as a public health threat by 2030, … countries should urgently change their laws and their practices to conform to both the right to health care and the most effective public health practices. That means ensuring everyone has access to comprehensive quality health services and ensuring everyone the nutrition, adequate housing, and other underlying determinants of health to which all people are entitled. … [C]ountries must unite to end the era where confinement and punitive measures are routinely used as a response to TB. Instead, they should establish a new era, one marked by community-based care, informed by evidence and human rights-based approaches” (3/23).

STAT: World leaders have the power to end TB. They must seize the moment
Eric Goosby, U.N. secretary general’s special envoy on TB, and Michel Kazatchkine, special adviser to UNAIDS for Eastern Europe and Central Asia

“….As we mark World TB Day and eagerly await a U.N. meeting on TB in September, we must work to sustain this commitment and build upon it to truly achieve a TB-free world. … Ending TB requires political will. Specifically, the global community must unite around efforts to develop better tools to diagnose TB and get to the ‘forgotten’ four million who have not been detected; build upon what we know works to prevent, detect, and treat TB; and enact universal health coverage that will help reduce the number of deaths due to TB and other infectious and noncommunicable diseases. Ending TB also means addressing the growing threat of multidrug-resistant TB (MDR-TB). … We must not miss this historic opportunity. Let’s seize the moment and end TB once and for all” (3/27).

Project Syndicate: The Neglected Solution to the TB Crisis
Joanne Liu, international president of Médecins Sans Frontières, and Paul Farmer, co-founder of Partners in Health, professor at Harvard Medical School, and chief of the Division of Global Health Equity at Brigham and Women’s Hospital

“…This September, the United Nations will host its first high-level meeting on the TB crisis. U.N. member states should use the occasion to pledge a radical increase in funding for TB programs around the world, and to overhaul an R&D model that has proved unfit for purpose. … Specifically, what we need are simpler, quicker, and cheaper ways to test and treat TB, especially in remote and impoverished settings. We need better tools to prevent infections in the first place, and to kill latent infections before they kill us. And, of course, we need a robust pipeline of drugs to ward off TB and its resistant forms. … A U.N. meeting is a golden opportunity to make progress. … [I]t is a chance finally to elevate TB to the World Health Organization-designated status of a ‘public health emergency of international concern,’ as was done in wake of the Ebola and Zika outbreaks…” (3/26).

The Conversation: How to help people with tuberculosis avoid the medical poverty trap
Tom Wingfield, NIHR academic clinical lecturer and LIV-TB collaboration lead at the University of Liverpool

“…A more holistic approach to TB control is needed that addresses not just the disease but also the person who has the disease and the circumstances in which they live. In its 2015 End TB Strategy, the World Health Organization (WHO), for the first time in the modern era of TB control, called for social support and poverty alleviation strategies for people with TB to reduce the hidden costs of treatment, reduce stigma, empower patients, and increase TB prevention, the number cured, and their overall well-being. … Helping households affected by TB to avoid the medical poverty trap, and providing them with moral support and hope, can enhance TB care and prevention. Without it, we won’t achieve the End TB Strategy goal of eliminating the disease by 2050, and millions more vulnerable households … could continue to suffer an entirely avoidable downward spiral of poverty and ill health” (3/22).

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BUILD Act Should Address Rule Of Law Conditions In Target Countries To Ensure Successful, Sustainable Investments

The Hill: BUILD Act needs a stronger rule of law foundation
Hilarie Bass, president of the American Bar Association and co-president of Greenberg Traurig

“…The ‘Better Utilization of Investments Leading to Development Act of 2018,’ or ‘BUILD Act,’ introduced in Congress in late February, has bipartisan support in Congress and fans among development advocates and the private sector alike. … Unfortunately, the draft legislation fails adequately to address the rule of law conditions that make for a healthy investment and sustainable development climate. … Consideration of the quality of governance in countries targeted for investment should be more than a mere suggestion in the law. … [The act’s] success will require development of standards for governance in countries targeted for investment and support for coordinated programs of technical assistance to lay the rule of law foundation on which private sector investment can flourish” (3/26).

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Lessons Learned From Pakistan's Final Push To Eliminate Polio Could Be Applied To Other Infectious Diseases

The Conversation: Inching closer to a world without polio
Christine Crudo Blackburn, postdoctoral research fellow at the Scowcroft Institute of International Affairs at the Bush School of Government and Public Service at Texas A&M University; and Morten Wendelbo, lecturer at the Bush School of Government and Public Service and Texas A&M University Libraries and research fellow at the Scowcroft Institute of International Affairs

“…Today, only three countries continue to see regular cases [of polio]: Pakistan, Nigeria, and Afghanistan. Of these, Pakistan is closest to becoming polio-free thanks to its persistent, innovative vaccination campaign programs. But its poor security, weak health system, and lack of proper sanitation work against this effort. The lessons infectious disease preparedness and response researchers like us are learning in Pakistan, during what’s hopefully a final push against polio, will also apply elsewhere, as public health experts work to wipe out other infectious diseases around the world. … It is likely that a world without polio may not be too far off in the future — and then infectious disease researchers can make use of the lessons learned in Pakistan as they move the fight to other diseases elsewhere around the world” (3/23).

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Rwanda's National Eye Care Program Could Serve As Blueprint For Other Countries

Devex: Opinion: 6 challenges and innovations to deliver eye care for all
Tony Hulton, chief executive at Vision for a Nation

“…New models are urgently needed to meet [the] global health and development challenge [of poor vision]. In 2012, we launched a highly innovative collaboration with Rwanda’s Ministry of Health. … Vision for a Nation Foundation rigorously analyzed these efforts and designed its program to address the six following specific weaknesses or problems. 1. Limited capacity at primary health care level. … 2. Limited technical training for primary eye care … 3. Lack of follow-up training or supervision … 4. Insufficient focus on providing glasses … 5. Low uptake of eye care services … 6. Low sustainability. … Crucially, together with the Ministry of Health, we have integrated the new local eye care service into the country’s national health system. … Rwanda demonstrates how a national eye care program can be rapidly built and sustained in a low-income country, and provides a blueprint that we hope many other countries will follow…” (3/26).

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New Project Aims To Reduce Maternal Mortality, Improve Newborn Health In Mozambique

The Conversation: New research partnership makes childbirth safer in Mozambique
Nazeem Muhajarine, professor at the Department of Community Health and Epidemiology and director of the Saskatchewan Population Health and Evaluation Research Unit at the University of Saskatchewan

“As the world awakens to deep injustices for women globally, an ambitious project led by University of Saskatchewan researchers in Mozambique is striving to reset the course — reducing maternal mortality and improving newborn health by empowering women and girls. … [T]he project … will increase access to health care services, increase management and leadership capacity in the health care system, and provide professional education for health practitioners. The project will also build infrastructure such as maternal clinics and waiting homes, provide much-needed ambulances and medical equipment, and increase the use of research-based information in decision-making. … [T]hrough concerted efforts and well-placed resources we can eliminate gender-based disparities, of which maternal mortality is one. To do so would be a great achievement for gender equity and reflect a shared commitment to a human rights framework for health” (3/25).

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From the Global Health Policy Community

More Than 160 Members Of U.S. Congress Sign Letter Supporting PEPFAR, Global Fund FY19 Funding

Friends of the Global Fight: 162 Members of Congress call for robust Global Fund and PEPFAR funding in FY 2019
“On March 16, U.S. House Representatives Barbara Lee (D-Calif.) and Ileana Ros-Lehtinen (R-Fla.) sent a letter to Chairman Hal Rogers (R-Ky.) and Ranking Member Nita Lowey (D-N.Y.) of the House Appropriations Subcommittee on State Foreign Operations, and Related Programs (SFOPS). The letter calls for continued, robust funding in FY 2019 for two incredibly successful humanitarian assistance programs — the President’s Emergency Plan for AIDS Relief and the Global Fund to Fight AIDS, TB and Malaria. Friends of the Global Fight worked with several other members of the Global AIDS Policy Partnership to successfully increase the number of Representatives’ signatures on the letter from the previous year. This year’s letter included 162 House Members, and more than doubled last year’s number of Republican signatures (from eight to 17)” (3/26).

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PLOS Blog Post Assesses Potential 'Yelp-Like Web-Based System' To Enhance Accountability Among NGOs

PLOS Blogs’ “Global Health”: How to Stop the Next Oxfam Scandal — A Yelp for International Aid?
Abraar Karan, resident physician at the Brigham and Women’s Hospital and Harvard Medical School; Lauren Taylor, author and doctoral candidate at Harvard Business School; and Nir Eyal, associate professor of global health and population at the Harvard T.H. Chan School of Public Health, discuss the potential development of a “Yelp-like web-based system’ to help hold NGOs accountable in light of the recent Oxfam scandal. The authors write, “Such a Yelp-like web-based system would be fraught with hard choices and implementation barriers. We do not purport to have ready answers but are eager to stimulate discussion about how it could develop and enhance accountability effectively. Recent revelations indicate the critical need to capture and catalogue wrongs done to the communities that global aid seeks to help” (3/23).

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World Bank Post Discusses Key Achievements Of, Remaining Challenges For TB Efforts

World Bank’s “Investing in Health”: Tuberculosis: new hope for an ancient disease
Miriam Schneidman, a lead health specialist in the Africa Region of the World Bank, discusses the global tuberculosis (TB) epidemic, including key achievements thus far and challenges moving forward. Schneidman also notes India’s new goal to end TB by 2025 and the upcoming U.N. High-Level Meeting on TB in September (3/23).

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IAS Releases 2018 Annual Letter

International AIDS Society: AIDS Is (Still) Political
In the organization’s annual letter, IAS addresses the role of politics in HIV/AIDS efforts and explores the following questions, “Who are we ending AIDS for? … Why is prevention falling behind? … How should donor nations support the response to HIV in low- and middle-income countries outside of Southern and Eastern Africa? … How ready are we, as the HIV community, to embrace other approaches to managing the epidemic?” (3/26).

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From the U.S. Government

State Department Blog Post Discusses Research On Genetic Larvicide For Mosquitoes, Use As Tool To Prevent Zika, Other Diseases

U.S. Department of State’s “DipNote”: Targeting Mosquito Genetics to Combat Zika
Avery White, program analyst in USAID’s Center for Accelerating Innovation and Impact who helps manage the Fighting Ebola and Combating Zika and Future Threats Grand Challenges, discusses the research of Molly Duman Scheel, a professor at Indiana University developing environmentally safe larvicides for mosquitoes. White writes, “A grant from USAID’s Combating Zika and Future Threats Grand Challenge in 2016 is enabling Scheel and her team to move the larvicide testing from the lab to the field. She was one of 26 awardees who received USAID investment to accelerate innovative approaches to fight the Zika outbreak and strengthen the world’s ability to prevent, detect, and respond to future infectious disease outbreaks” (3/26).

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