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Kaiser Daily Global Health Policy Report

In The News

Secretary Of State Pompeo Announces Expansion Of Mexico City Policy, Enforcement Of Siljander Amendment

The Guardian: Trump expands global gag rule that blocks U.S. aid for abortion groups
“The Trump administration has expanded its ban on [global health] funding for groups that conduct abortions or advocate abortion rights, known as the global gag rule [or Mexico City policy] … The extension of the policy announced by [Secretary of State Mike] Pompeo would not only cut funding to foreign non-governmental organizations directly involved in abortions or abortion rights advocacy, but also those who fund or support [with non-U.S. money] other groups which provide or discuss abortion…” (Borger, 3/26).

New York Times: U.S. Expands Anti-Abortion Policies With New Overseas Funding Rules
“The Trump administration will withhold [global health] funding from foreign nongovernmental organizations that give [non-U.S.] money to foreign groups that perform abortions, Secretary of State Mike Pompeo said on Tuesday. … Mr. Pompeo also said the government was ‘fully enforcing’ a law that prohibits groups from using United States aid to lobby on abortion issues. ‘We will enforce a strict prohibition on backdoor funding schemes and end-runs around our policy,’ Mr. Pompeo said. ‘American taxpayer dollars will not be used to underwrite abortions.’ The move builds on a 2017 announcement by the Trump administration that it was reinstating and expanding the so-called Mexico City policy. … In his announcement, Mr. Pompeo said American officials had become aware that a group under the Organization of American States had engaged in abortion rights advocacy. … The United States would reduce funding to the organization as punishment, Mr. Pompeo added…” (Wong, 3/26).

POLITICO: Trump beefs up funding ban aimed at abortion providers overseas
“…Jen Kates, director of global health policy for the Kaiser Family Foundation, said that her organization was still reviewing … Pompeo’s announcement… The Trump administration’s earlier expansion of the Mexico City policy already has affected a ‘significant amount of funding and a large number of NGOs,’ she said…” (Toosi/Diamond, 3/26).

Wall Street Journal: Trump Administration Expands Global Anti-Abortion Policy
“…The Trump administration expanded the policy to cover billions in federal funding for the President’s Emergency Plan for AIDS Relief, known as PEPFAR, as well as global health-assistance funding from other agencies. However, Mr. Pompeo said some organizations have attempted to get around the U.S. policy by providing [non-U.S.] funds to other organizations that promote or perform abortions. He said ‘further refinements’ would prevent organizations from violating the spirit of the presidential directive…” (McBride, 3/26).

Washington Post: Pompeo cuts OAS funds over advocacy of legal abortion
“…Groups that provide health care said the expansion in Trump’s executive order [reinstating the Mexico City policy] imperils care for women and children, especially in rural areas where there are few alternative providers. They say that leads to more pregnancies, including unwanted ones that end in unsafe abortions. Pompeo dismissed that argument as ‘just wrong’ and said the contention they were setting up conditions for more abortions was ‘perverse on its face.’ Several antiabortion groups have campaigned for funding cuts to the OAS over the abortion rights advocacy practiced by some of its subgroups…” (Morello, 3/26).

Additional coverage of the Trump administration’s announcement is available from Agence France-Presse, Al Jazeera, Breitbart, BuzzFeed.News, CBS News, CNN, Deutsche Welle, Fox News, The Hill, NBC News, New York Intelligencer, Reuters, Rewire.News, Science Speaks, and TIME.

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Humanitarian Groups Working In North Korea Challenged By U.S., U.N. Sanctions

VOA News: Humanitarian Groups Say Sanctions Impede Aid to North Koreans
“Humanitarian groups are continuing to face complications, including funding shortfalls, when delivering aid to North Korea as the U.S. maintains its ‘maximum pressure’ sanctions campaign on the country. The United Nations granted sanctions exemption to five humanitarian organizations earlier this month, raising the total number of groups that can deliver aid to North Korea to 21. Humanitarian agencies said sanctions placed on North Korea have created complications for aid groups that need to secure funds and deliver assistance to the country…” (Lee, 3/26).

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Washington Post Examines Patent Rights Of HIV Prevention Drug Developed By U.S. Government, Made By Gilead

Washington Post: An HIV treatment cost taxpayers millions. The government patented it. But a pharma giant is making billions.
“…[Researchers’] work — almost fully funded by U.S. taxpayers — created a new use for an older prescription drug called Truvada: preventing HIV infection. But the U.S. government, which patented the treatment in 2015, is not receiving a penny for that use of the drug from Gilead Sciences, ­Truvada’s maker, which earned $3 billion in Truvada sales last year. Gilead argues that the government’s patents for Truvada for PrEP, as the prevention treatment is called, are invalid. And the government has failed to reach a deal for royalties or other concessions from the company… The extraordinary standoff between the CDC and a drug company over patent rights raises a big question for the Trump administration: How aggressively should the government attempt to enforce its patents against an industry partner? … Activists want the government to take a more aggressive stance against Gilead. Their complaints are part of a broader wave of anger over drug companies reaping hefty financial rewards by capitalizing on taxpayer-funded research…” (Rowland, 3/26).

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Number Of DRC Ebola Cases Continues To Grow Amid Violence, Mistrust; Aid Agencies Reconsider Outbreak Response Tactics

CIDRAP News: Ebola sickens 6 more in DR Congo
“The Democratic Republic of the Congo (DRC) saw no let-up in the steady pace of Ebola cases [Tuesday], with the health ministry reporting six more cases. In other developments, Oxfam, one of the nongovernmental agencies working in the region, weighed in on ongoing challenges in the outbreak, and the World Health Organization (WHO) African regional office provided a snapshot of events in its weekly update…” (Schnirring, 3/26).

Devex: ‘Chanjo’? Ebola warnings puzzle communities in Goma
“The availability of an experimental vaccine is seen as a game changer in the ongoing Ebola outbreak in the Democratic Republic of the Congo. But some residents in the North Kivu province capital city of Goma, in particular women over 35 years old, aren’t so sure. … The findings are part of a new report by [Translators without Borders] that surveyed 216 residents of Goma and engaged 75 others in a group discussion to assess whether the information provided by aid organizations on Ebola prevention is understood…” (Ravelo, 3/27).

Homeland Preparedness News: More than 1,000 cases reported in ongoing Ebola outbreak in eastern Democratic Republic of Congo
“An outbreak of Ebola that has raged through the eastern Democratic Republic of Congo (DRC) since last August has now passed more than 1,000 cases, making it the second largest outbreak ever recorded…” (Galford, 3/26).

New Humanitarian: As Congo Ebola cases pass 1,000, growing calls to listen to locals when responding
“…[I]nternational aid groups are reconsidering the way they respond after a string of attacks by armed assailants on health centers. … The attacks were a ‘wake-up call and need to be a game-changer for us,’ Joanne Liu, international president of [Médecins Sans Frontières (MSF)], told The New Humanitarian on the sidelines of a press conference in Geneva earlier this month. ‘We (need to) take the time to reflect and ask: how did we get there, what did we get wrong, how are we going to change,’ Liu said…” (Dupraz-Dobias, 3/26).

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Mozambique Confirms First Cholera Cases In Wake Of Cyclone Idai; U.N. Chief Warns Storm Represents 'Alarm Bell' On Climate Change

Associated Press: 1st cholera cases confirmed in Mozambique’s cyclone-hit city
“The first cases of cholera have been confirmed in the cyclone-ravaged city of Beira, Mozambican authorities announced on Wednesday, raising the stakes in an already desperate fight to help hundreds of thousands of people sheltering in increasingly squalid conditions. The five cholera cases were confirmed in Munhava, one of the poorest neighborhoods in the hard-hit port city, the national director of medical assistance, Ussene Isse, told reporters…” (Ntshangase, 3/27).

Reuters: Destructive Cyclone Idai rings ‘alarm bell’ on climate change: U.N. chief
“Cyclone Idai’s deadly hit has left some 1.85 million people in need of assistance in Mozambique in a catastrophe that United Nations chief António Guterres said on Tuesday rang ‘yet another alarm bell’ about climate change. Guterres described Idai, which flattened homes and caused massive flooding after slamming into Mozambique near the port of Beira on March 14, as ‘an uncommonly fierce and prolonged storm’…” (Rumney/Eisenhammer, 3/26).

Additional coverage of the damage from and response to Cyclone Idai is available from Associated Press, New York Times, NPR, Reuters, and VOA News (2).

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Nigerian, International Response To Lassa Outbreak Provides Model For Partnership Response To Emerging Diseases

Quartz Africa: How a Nigerian genome team contained a Lassa fever outbreak with international partners
“Lassa fever first flared across Nigeria in February 2018, 1,081 cases reported in just six weeks, according to the Nigeria Centre for Disease Control; 57 people, including four health care workers, died. … The fear for scientists and health professionals at the time was that the virus had mutated into a deadlier strain, perhaps one that can be passed through the air, like the flu. Such a change could be catastrophic. … Years of partnership and preparation between the African Center of Excellence for Genomics of Infectious Disease (ACEGID), the Irrua Specialist Teaching Hospital in southern Nigeria, and the Cambridge, Massachusetts-based Broad Institute ensured the [Lassa] samples were rapidly sequenced in Nigeria by local labs. This response, marked by cooperation and in-country capability, may be the model for the years ahead, as scientists from both Broad in the U.S. and Nigeria believe the chances are high of emerging virus outbreaks occurring more frequently…” (Zarley, 3/27).

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Ethical Investing Can Play Larger Role In Fight Against Antimicrobial Resistance, England Chief Medical Officer Says

The Telegraph: Ethical investments could help in fight against superbugs, says chief medical officer
“Investors are being urged to put their money into companies that are developing new antibiotics and vaccines as a way of curbing the rise of superbugs. Dame Sally Davies, chief medical officer for England and a key figure in the global fight against superbugs, told a conference on antimicrobial resistance (AMR) that ethical investment was one way of tackling the problem…” (Gulland, 3/26).

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More News In Global Health

Associated Press: U.N. Officials: 13 Million in Congo Need Aid in Major Increase (Lederer, 3/25).

Devex: Q&A: Henrietta Fore on driving change at legacy institutions (Kumar, 3/27).

PBS NewsHour: Can new medications shift the battle against drug-resistant TB? (Hellerman/Tobias, 3/26).

U.N. News: 10 million Yemenis ‘one step away from famine,’ U.N. food relief agency calls for ‘unhindered access’ to frontline regions (3/26).

VOA News: Drought in Kenya’s Northwest Leaves Thousands Near Starvation (Ombuor, 3/26).

Xinhua News: Somalia begins polio immunization drive for children under 5 (3/26).

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Editorials and Opinions

Opinion Piece Discusses Expanded Mexico City Policy's Potential Impact On Health Care

Los Angeles Times: No, Pompeo, a global gag rule doesn’t protect ‘the least amongst us.’ It hurts the poor
Carla Hall, editorial board member for the Los Angeles Times

“It’s astonishing that Secretary of State Michael R. Pompeo, who announced an expansion of the so-called global gag rule that prevents U.S. [global health] aid from going to foreign health care providers if they also provide or offer guidance on abortions, said his administration ‘protects the least amongst us.’ That’s absolutely the reverse of what this administration is doing overseas (and at home) when it gives providers of desperately needed health care a Hobson’s choice: either stop performing abortions and abortion counseling, or stop receiving vital U.S. aid. And, by the way, none of these organizations is using U.S. aid money to fund abortions. That is already against the law. The global gag rule (also known as the ‘Mexico City policy’) is an attempt to control what providers do with their other funds. The further expansion of the gag rule stops [foreign] nongovernmental organizations that receive foreign aid [for global health] from funding [with non-U.S. money] other groups that provide or offer counsel on abortion…” (3/26).

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Poverty-Stricken Countries At Greatest Risk Of Climate Change Impacts

Washington Post: Mozambique isn’t alone. Rising sea levels threaten millions in the developing world.
Mami Mizutori, head of the U.N. Office for Disaster Risk Reduction

“The devastation of one of Mozambique’s largest cities, Beira, by Cyclone Idai, which claimed hundreds of lives, is stark evidence that the countries which contribute least to climate change are the ones being affected by it the most. … Beira is not alone. There are thousands of cities and towns across the developing world where the sea is encroaching little by little. … That threat adds another layer to preexisting risks that stem from rapid urbanization, the rise of slums in vulnerable locations, the absence of resilient infrastructure, failures in planning, and the destruction of protective ecosystems … But the greatest risk driver of them all are the extreme levels of poverty that still afflict countries such as Mozambique and cripples their capacity to adapt to climate change. What Beira tells us is that climate change is creating new obstacles to achieving the Sustainable Development Goals, including the eradication of poverty and hunger. New climate risks are emerging, and their full significance is yet to be fully grasped. … The push for progress on reducing greenhouse gas emissions must be pursued with unshakable resolve, but it must be accompanied by an equally strong push for investment in resilient infrastructure in the poorest places on Earth, where adaptation to climate change is now a matter of life or death” (3/26).

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As Humanitarian Situation Continues To Deteriorate In Yemen, 'Lasting Peaceful Solution' Must Be Found

Thomson Reuters Foundation: Yemen: where worst nightmares have become a reality
Najat Elhamri, head of the Middle East and Eastern Europe region at Islamic Relief Worldwide

“…[F]ears are now rising that we could be on the brink of a fresh cholera epidemic [in Yemen.] … [Last month, the] conditions [in Hodeidah, Sanaa, and Aden] were so poor that there was no isolation center to treat cholera cases and sometimes more than five people were sharing two beds between themselves. Those with infectious diseases such as cholera were not being properly isolated, and conditions were almost begging the germs to jump from body to body, ravaging those already frail from malnutrition and other diseases that are not being properly treated due to a chronic lack of medicine and medical supplies. Premature babies were particularly at risk, in incubators with no ventilation and no adequate medical care. … Islamic Relief is doing what it can to help, providing food to over two million people every month and supporting health clinics and hospitals and running feeding centers to help severely malnourished mothers and babies. But it is no mean feat. Aid workers themselves are falling prey to this conflict. … Access for aid agencies must urgently improve. But what’s really needed in Yemen is a lasting peaceful solution. … All parties to the conflict must put people first and stop this brutal war, before it is too late” (3/26).

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From the Global Health Policy Community

New Report Surveys Global Development Leaders On Changing Sector

Brookings Institution’s “Future Development”: How global development leaders think their field is changing
George Ingram, senior fellow for Global Economy and Development at Brookings, and Kristin M. Lord, president and CEO of IREX and former Brookings fellow, discuss three key findings from a new report surveying 93 global development leaders on how they see the sector changing, “what they forecast in the near and mid-term future, and how their own organizations are adapting.” The authors highlight several issues, including funding for development, the proliferation of new actors in the development field, and the challenge of a rapidly changing landscape (3/26).

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Podcast Episode Discusses Need For Global Solution To Malnutrition

Food Tank’s “Food Talk”: Malnutrition: A Global Problem That Requires a Global Solution
In this podcast episode, Dani Nierenberg, host of “Food Talk,” speaks with Lawrence Haddad, executive director of the Global Alliance for Improved Nutrition (GAIN), “about the urgency for nutrition advocacy in global food production” (3/27).

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Bloomberg Philanthropies Experts Discuss Central Role Of Data In Tobacco Control Initiative, Challenges Of Program Implementation

Health Affairs Blog: How Evidence Has Fueled Bloomberg Philanthropies’ Work In Tobacco Control
Kelly Henning, public health program lead at Bloomberg Philanthropies, and Jennifer Ellis, director of the Bloomberg Data for Health Initiative, discuss the central role data has played in helping Bloomberg Philanthropies approach its tobacco control work and highlight challenges the Bloomberg Initiative to Reduce Tobacco Use has faced (3/26).

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From the U.S. Government

U.S. Announces More Than $61M In Additional Humanitarian Assistance For Afghan Refugees

USAID: United States Announces Additional Humanitarian Assistance for Afghans Affected by Conflict, Drought, and Other Natural Disasters
“The United States announced more than $61 million in additional humanitarian assistance to meet the needs of vulnerable communities, displaced persons, and returning refugees across Afghanistan, as well as Afghan refugees in the region. … This new funding will provide emergency food assistance, nutrition services, hygiene kits, safe drinking water, access to latrines, and protection for people in the most affected regions of Afghanistan, including Afghan refugees who face the challenge of reintegrating into Afghan communities…” (3/26)

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