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Kaiser Daily Global Health Policy Report

In The News

U.S. Secretary Of State Tillerson Traveling To 5 African Nations This Week

The Hill: State Dept. details Tillerson’s multination African tour
“The State Department announced on Monday the details of Secretary of State Rex Tillerson’s first official trip to Africa. Tillerson, who leaves for the tour on Tuesday, will visit Chad, Djbouti, Ethiopia, Kenya, and Nigeria, as well as meet with the African Union Commission…” (Manchester, 3/5).

Reuters: Tillerson to make first trip to Africa as top U.S. diplomat
“…During his March 6-13 trip, Tillerson ‘plans to discuss ways we can work with our partners to counter terrorism, advance peace and security, promote good governance, and spur mutually beneficial trade and investment,’ the department said in a statement…” (Beech, 3/2).

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Vanguard Examines Impacts Of Mexico City Policy On Nigerian Women's Health

Vanguard: Trump’s Global Gag Rule: More cases of unsafe abortion imminent in Nigeria
“…One year after [U.S. President Trump’s] reinstatement of the [Mexico City] policy, access to contraceptive commodities and services, including provision of voluntary family planning information, education and services around sexual and gender-based violence like rape, female genital mutilation (FGM), early and forced marriage, amongst others, are adversely affected. … Nigerian experts generally describe the GGR as a restrictive, anti-choice policy. They agree that by blocking funding to the world’s largest NGO providers of modern contraception, the gag rule is worsening an already bad global contraceptive funding gap and undermining women’s ability to prevent unwanted pregnancy. … Many [Nigerian] states have no appreciably dedicated family planning or reproductive health financing, rather, they depend on major partners including USAID; the Department For International Development, DFID; United Nations Population Fund, UNFPA, among others. … [H]uge funding shortfalls are characteristic of the heavily donor-dependent National Family Planning and commodities procurement program. … Observers urge that the federal government needs to invest more in family planning services and contraceptive supplies…” (Ogundipe, 3/6).

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DFID Announces Stricter Standards For Aid Sector Accountability Following Sexual Abuse Scandals; U.K. Parliament Committee Opens Inquiry

Devex: U.K. aid chiefs agree safeguarding action plan as DFID uncovers new incidents
“Aid bosses who gathered in London on Monday have agreed a ‘shortlist’ of practical steps that aim to make the sector safer and more accountable following a series of sexual abuse scandals. The United Kingdom’s aid boss, Penny Mordaunt, also revealed that the Department for International Development’s review of 179 delivery partners has uncovered 80 previously unreported incidents of issues ‘broadly related to safeguarding’ at 26 organizations. DFID has ordered those organizations to now report the incidents to the Charity Commission, the U.K. charity regulator, with Mordaunt warning delegates at Monday’s ‘safeguarding summit’ that grantees will be cut off from funding unless they can live up to ‘tough and exacting’ new standards…” (Edwards/Anders, 3/6).

The Guardian: Child sex abuse claims among cases newly reported to charity watchdog
“…The [Charity Commission] said reporting of serious incidents across all charities had doubled since early February, after allegations of sexual misconduct by Oxfam workers following the 2010 earthquake in Haiti. … In a separate development on Monday, the [U.K. Parliament] International Development Committee announced an inquiry into sexual exploitation and sexual abuse in the aid sector. The new safeguarding standards announced by DFID include an assessment of codes of conduct, how organizations respond and handle incidents, and whether their risk management systems put beneficiaries first…” (McVeigh, 3/5).

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Gates Foundation To Invest $170M Over 4 Years To Improve Women's Economic Empowerment

Chronicle of Philanthropy: Gates Foundation Pours Another $170 Million Into Helping Women
“Over the next four years the Bill & Melinda Gates Foundation will steer $170 million to increase women’s economic might across the world, delivering on Melinda Gates’s longstanding goal to place a greater emphasis on women’s equality…” (Daniels, 3/5).

CNBC: Melinda Gates just announced a new $170 million plan to fund women’s equality around the world
“… ‘With a new focus on women’s economic empowerment, connecting women to markets, making sure they have access to financial services, and empowering them to help themselves, we aim to help tear down the barriers that keep half the world from leading a full life,’ Gates wrote in an op-ed for Quartz published Monday…” (Mejia, 3/5).

Devex: The Gates Foundation launches $170M gender strategy
“… ‘We’re aiming to invest this $170 million over four years to support four critical and integrated pillars on women’s economic empowerment,’ said Sarah Hendriks, director of gender equality at the Gates Foundation, who outlined the new strategy, which aims to transform how women participate in economies around the world…” (Cheney, 3/5).

Fast Company: Bill and Melinda Gates’ next big move? The economic empowerment of women
“…To spur change, the foundation will focus its money on ‘connecting women to markets, making sure they have access to financial services, and empowering them to help themselves’…” (3/5).

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Drop In Child Marriage In India Fuels Global Decline But More Must Be Done To Stop Practice, UNICEF Says

CNN: Child marriages on decline but 12 million girls still married every year
“Child marriages are declining, with the largest drop in South Asia, according to UNICEF. Ten years ago, a South Asian girl’s risk of getting married as a child was about 50 percent, but now that has fallen to about 30 percent. … ‘Any reduction is welcome news, but we’ve got a long way to go,’ said Anju Malhotra, UNICEF’s principal gender adviser…” (Park, 3/6).

Deutsche Welle: U.N.: Child marriage dropped significantly in previous decade
“Global advocacy efforts led to an estimated 25 million fewer child marriages since 2008 with South Asia seeing the largest decline in the practice, UNICEF said on Tuesday. But the agency warned that some 150 million girls are at risk of being married before their eighteenth birthday through to 2030 — the the U.N.’s target date for ending the practice — unless more is done…” (Pearson, 3/6).

Thomson Reuters Foundation: India’s child marriage numbers drop sharply, driving down global rate: UNICEF
“The proportion of girls getting married in India has nearly halved in a decade, the United Nations children’s agency UNICEF said on Tuesday, which has contributed significantly to a global decline in child marriage. … ‘India constitutes more than 20 percent of the world’s adolescent population and accounts for the highest number of child marriages in South Asia given its size and population,’ said Javier Aguilar, UNICEF’s chief of child protection…” (Srivastava, 3/5).

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More Countries Than Expected Used TRIPS Provisions To Improve Access To Medicines, Analysis Shows

STAT: Nearly 90 countries sidestepped patents to bring down drug prices, surpassing expectations
“In 2001, a modified World Trade Organization agreement ushered in a new era of access to medicines by giving countries the right to sidestep drug makers that charged unaffordable prices. … [A] new analysis finds that 89 countries made extensive use of the trade agreement provisions between 2001 and 2016, a fact that was not previously reported. In all, there were 176 instances involving medicines used to treat 14 different diseases, and 87 percent were implemented, according to the analysis, which was published in the Bulletin of the World Health Organization…” (Silverman, 3/5).

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Aid Convoy Reaches Eastern Ghouta; Some Trucks Return Full After Attacks Resume

Associated Press: Violence halts rare aid delivery to Syria’s Eastern Ghouta
“The first aid delivery in weeks to reach the besieged eastern suburbs of Damascus was cut short after Syrian government forces began shelling the area while aid workers were still inside, a local council said Tuesday, amid a renewed escalation in the government’s deadly aerial and ground campaign…” (Issa, 3/6).

New York Times: Aid Convoy Reaches Syria Town, but Fighting Forces Some Trucks to Return Full
“…By the time the convoy of 46 trucks sent by the United Nations, the International Red Cross, and the Syrian Arab Red Crescent reached the town of Douma around midday on Monday, government officials had already removed many of the medical supplies…” (Cumming-Bruce/Homsi, 3/5).

NPR: Aid Begins To Reach Besieged Syrian Region, As Civilian Deaths Continue
“…The blocked supplies are ‘desperately needed to save lives and reduce suffering,’ the World Health Organization told NPR via email. Eastern Ghouta, a rebel-held suburb of Damascus, has been bombarded for months, with airstrikes by the Syrian government and Russia accelerating sharply February…” (Domonoske, 3/5).

Reuters: Aid reaches Ghouta but retreats after shelling; Syria presses assault
“…The United Nations says 400,000 people are trapped inside the besieged enclave, and were already running out of food and medical supplies before the assault began with intense air strikes two weeks ago…” (McDowall et al., 3/5).

U.N. News: U.N. food relief agency and partners deliver much-needed aid to Syria’s East Ghouta
“…Marwa Awad, a [World Food Programme (WFP)] communications officer based in Damascus, said plans are under way for another humanitarian convoy to access Eastern Ghouta on Thursday…” (3/5).

VOA News: Aid Convoys Reach Syria’s Eastern Ghouta, but Retreat After Shelling
“…The Britain-based Syrian Observatory for Human Rights said at least 68 people were killed Monday in the latest attacks, even as the aid was arriving. That pushed the death toll to 760 in the last three weeks…” (Bredemeier, 3/5).

Washington Post: U.N. convoy begins aid distribution in Syria’s besieged Ghouta area amid shelling
“… ‘The convoy is a positive first step and will lessen the immediate suffering of some civilians in the Eastern Ghouta region,’ said the [International Committee of the Red Cross (ICRC)] Middle East director, Robert Mardini. ‘But one convoy, however big, will never be enough, given the dire conditions and shortages people are facing. Repeated and continuous humanitarian access is essential, and more must be granted in the coming period…” (Cunningham/Loveluck, 3/5).

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Johns Hopkins Report Examines WHO's Role In Mosul, As 'Provider Of Last Resorts'

Devex: Did WHO’s quest to save lives in Mosul battle get too close to the front lines?
“The term ‘provider of last resorts’ has been a point of discussion in the World Health Organization’s draft 13th program of work. In efforts to illustrate what it means, Director-General Tedros Adhanom Ghebreyesus has often made an example of the organization’s intervention in Mosul, Iraq, in 2017 … But a recent report by the Center for Humanitarian Health from the Johns Hopkins Bloomberg School of Public Health reveals the events that unfolded on the ground in Mosul — and the decisions that actors made — raised significant questions on the future of humanitarian response in today’s conflict settings…” (Ravelo, 3/6).

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IHME Researcher Discusses Precision Public Health, Sustainable Development In Devex Interview

Devex: These new maps point to the power of ‘precision public health’
“Last week, the Institute for Health Metrics and Evaluation published two studies revealing health and education disparities on the African continent. … In an email interview, Devex asked Simon Hay, director of the Local Burden of Disease Study at IHME at the University of Washington in Seattle, to explain the connection between precision public health and sustainable global development…” (Cheney, 3/6).

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More News In Global Health

The Guardian: ‘I was crying with unbearable pain’: study reveals extent of FGM in India (Cantera, 3/6).

The Guardian: ‘Lives will be lost’: Bangladesh rains promise further misery for Rohingya (Watt, 3/1).

HuffPost: Where Zika Came From (Martell, 3/6).

IRIN: Forgotten Ukrainians feel the bite of winter food cuts (Bociurkiw, 3/2).

New York Times: Yellow Fever Circles Brazil’s Huge Cities (Darlington/McNeil, 3/5).

Reuters: Malawi cholera death toll rises to 19, health ministry says (Phiri, 3/6).

Science: New ways to fight HIV and tuberculosis emerge at AIDS conference (Cohen, 3/5).

U.N. News: Some 19 million newborns at risk of brain damage every year due to iodine deficiency — U.N. (3/1).

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Editorials and Opinions

U.S. Should Do More To Address 'Slow-Motion Genocide' Of Rohingya

New York Times: I Saw a Genocide in Slow Motion
Nicholas Kristof, New York Times columnist

“…It is difficult to understand [the] denial of humanitarian access [to the Rohingya] as anything but an intentional policy of grinding down and driving out the Rohingya — one reason I see this as a slow-motion genocide. … Still, we can work with other countries to raise the cost of ethnic cleansing, and under international law we have an obligation to take steps to address genocide … A crucial first step is targeted sanctions against Myanmar leaders, as bipartisan legislation in both the House and the Senate proposes. … The U.S. government can also do more to name and shame the perpetrators, and to exert relentless pressure for humanitarian access. … [A]s Elie Wiesel, the great survivor of a different genocide, said in his Nobel Peace Prize acceptance speech, ‘Wherever men or women are persecuted because of their race, religion, or political views, that place must — at that moment — become the center of the universe.’…” (3/2).

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Continued Cooperation With U.N. Agencies Vital To Addressing U.S. Opioid Epidemic

The Hill: The U.S. and the U.N. can be allies in the global opioid fight
Jordie Hannum, executive director of the Better World Campaign

“…U.S. government collaboration with the right partners is key to combat the growing threat of opioids. … [T]ackling [the opioid] problem is not simply a matter of unlocking U.S. resources, it’s about continuing to support and partner with the United Nations, specifically agencies like the U.N. Office on Drugs and Crime (UNODC) and the World Health Organization. … Moving forward, Richard Baum — former acting director of the White House Office of National Drug Control Policy — recently noted that global cooperation is central to addressing the U.S. opioid epidemic. This means continued close cooperation with U.N. agencies like UNODC and the WHO; organizations on the front lines of the opioid battle and doing everything they can to help the U.S. defeat one of the deadliest enemies in a generation” (3/1).

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Women's Economic Empowerment Represents 'Promising Entry Point' For Gender Equality

Quartz: Melinda Gates: When money flows into the hands of women, everything changes
Melinda Gates, co-chair of the Bill & Melinda Gates Foundation

“…I am convinced that we’ll never reach our goals if we don’t also address the systematic way that women and girls are undervalued. With a new focus on women’s economic empowerment, connecting women to markets, making sure they have access to financial services, and empowering them to help themselves, we aim to help tear down the barriers that keep half the world from leading a full life. We’ll spend $170 million over the next four years to help women exercise their economic power, which the evidence suggests is among the most promising entry points for gender equality. Simply put, when money flows into the hands of women who have the authority to use it, everything changes. … Our role, as we see it, is to make targeted investments that give women the opportunity to write new rules. First, our new gender equality strategy will seek to link women to markets. … We also want more women to use digital bank accounts. … Finally, we’ll support self-help groups where women and girls teach one another about everything from launching a small business to raising healthy children — and reimagine their standing in society…” (3/5).

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Development Organizations Should Address Gender Equality Within Their Own Workplaces

Devex: Opinion: It’s time we walk the talk on gender equality. Here’s how.
Amanda Glassman, director of global health policy and a senior fellow at the Center for Global Development

“Women’s equality and empowerment is a driver of economic growth and development around the world, and development organizations routinely include and espouse this goal as part of their missions and activities. But if you peel back the curtain, there are serious questions about whether — behind the scenes — development organizations are living up to these values in the workplace. My colleagues … analyzed a random sample of 30 U.S. organizations (10 each from foundations, think tanks, and NGOs) that work on global development, and found that less than one-third of key/high-paid employees at the sampled think tanks are women, and that key/high-paid women appear to be paid less than key/high-paid men in all three of the sample groups. … The data is clear: There is more that we can all be doing, and it’s time to look inward. First, development aid organizations need better workplace policies. … Second, development organizations need to foster work environments that are safe spaces for women and people of all genders. … Finally, there’s the subtle stuff. It’s pointing out a problem when you see it … Cultural shift and leadership is essential to make policies effective…” (3/5).

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Effective Medical Tools, Strong Health Systems Vital To Preventing, Responding To Disease Outbreaks

BBC News: Lassa fever: The killer disease with no vaccine
Charlie Weller, head of vaccines at the Wellcome Trust

“…[T]he fight against Lassa — and other infectious diseases — is hampered by a lack of effective medical tools like diagnostic tests, treatments, and vaccines. It is likely that a vaccine could be found for Lassa — reducing the possibility of an outbreak becoming a global health emergency — but as with other epidemic diseases that mainly affect poorer countries, progress has stalled. … A new organization called CEPI (Coalition for Epidemic Preparedness Innovations) … hopes to accelerate vaccine production. Lassa is one of the diseases on its hit list and it’s hoped one or more promising vaccines will be ready for large-scale testing in the next five years. … But research alone isn’t enough. Stronger health systems are needed in the countries where epidemics are most likely to arise. This could mean building better health care facilities and training staff to recognize and respond to outbreaks. It will also mean working with communities to understand how to identify outbreaks at an early stage and prevent their spread” (3/5).

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Global Collaborative Approach Needed To Halt Cancer In Africa

Project Syndicate: The Cancer Threat to Africa’s Future
Danny A. Milner, Jr., chief medical officer of the American Society for Clinical Pathology

“…Just as the world united to help Africa beat infectious disease outbreaks, a similar collaborative approach is needed to halt the cancer crisis. … Building health-care systems that are capable of managing infectious diseases, while also providing quality cancer care, requires a significant investment in time, money, and expertise. Fortunately, Africa already has a head start. Past initiatives — like the Global Fund to Fight AIDS, Tuberculosis and Malaria, the U.S. President’s Emergency Plan for AIDS Relief, and the World Bank’s East Africa Public Health Laboratory Networking Project — have greatly expanded the continent’s medical infrastructure. National efforts are also strengthening pharmaceutical supply chains, improving medical training, and increasing the quality of diagnostic networks. Still, Africans cannot face down this threat alone. … [S]uccess depends on coordination among African governments, health-service providers, drug makers, and non-governmental organizations. … [G]eography should never be the deciding factor in patients’ fight to survive the disease. Cancer has been Africa’s silent killer for far too long, and the global health community must no longer remain quiet in the face of this crisis” (3/2).

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From the Global Health Policy Community

MFAN Community Reacts To President's Proposed FY 2019 Budget Cuts To State Department, USAID

MFAN: MFAN Community Rejects President’s Proposed FY19 Budget Cuts for State Department and USAID
Madeline Hartlieb, program associate at MFAN, highlights reactions from the MFAN network and Capitol Hill on the foreign affairs aspects of President Trump’s FY 2019 budget request (3/5).

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Brookings Article Examines Progress Made During MDG Era

Brookings Institution’s “Up Front”: Taking stock (once more) of the Millennium Development Goal era
John McArthur, senior fellow, and Krista Rasmussen, research analyst, both with the Global Economy and Development program at the Brookings Institution, discuss key findings from a recently published article that “assesses a cross section of key indicators to compare trends before and after the start of the Millennium Development Goals (MDGs) … Using a combination of empirical assessments, the article aims to determine which trajectories changed where, and to what scale of human consequence” (3/5).

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'Science Speaks' Reports On Findings Presented At 2018 Conference On Retroviruses And Opportunistic Infections

Antigone Barton, senior editor and writer of “Science Speaks,” reports on findings presented at the 25th Conference on Retroviruses and Opportunistic Infections.

IDSA’s “Science Speaks”: CROI 2018: Dr. Harold Jaffe looks back — for lessons to inform responses to the next infectious disease outbreak (Barton, 3/5).

IDSA’s “Science Speaks”: CROI 2018: HIV drug-resistance testing leads to “tremendous opportunity” to target, treatment, prevention, partner services (Barton, 3/5).

IDSA’s “Science Speaks”: CROI 2018: 25 years of HIV science see “precision prevention,” hopes for long-term remission, attention to TB, and more (Barton, 3/5).

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From the U.S. Government

MMWR Article Discusses Challenges Of, Progress Toward Polio Eradication In Nigeria

CDC’s “Morbidity and Mortality Weekly Report”: Progress Toward Poliomyelitis Eradication — Nigeria, January-December 2017
This article provides a summary of Nigeria’s challenges in and progress toward polio elimination. The authors note, “Sustained efforts to optimize surveillance and improve immunization coverage, especially among children in inaccessible areas, are needed” (Bolu et al., 3/2).

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MMWR Article Examines Human Rabies Cases, Treatment Among Pregnant, Breastfeeding Women In Vietnam From 2015-2016

CDC’s “Morbidity and Mortality Weekly Report”: Rabies Vaccine Hesitancy and Deaths Among Pregnant and Breastfeeding Women — Vietnam, 2015-2016
This article examines factors associated with human rabies among pregnant and breastfeeding women in Vietnam from 2015-2016. The findings “highlight the need for public health messaging about the safety and effectiveness of [postexposure prophylaxis (PEP)] in preventing rabies among all persons with exposures, including pregnant and breastfeeding women” (Nguyen et al., 3/2).

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