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Kaiser Daily Global Health Policy Report

In The News

WHO Announces Plan To Restructure Under 4 Primary Pillars To Reach 'Triple Billion' Targets

Devex: New WHO structure revealed
“The World Health Organization has revamped its senior management structure. The revamp, laid out in an internal memo sent to staff and seen by Devex, includes the creation of new positions and divisions which will help WHO achieve its triple billion targets in its new five-year strategic plan…” (Ravelo, 3/6).

New York Times: WHO Chief Plans to Reorganize a Vast Bureaucracy
“…The announcement, made in a lengthy and mostly cheerful speech delivered jointly by the organization’s director general, Tedros Adhanom Ghebreyesus, and the directors of the agency’s six regional offices, aims to serve the WHO’s new targets: to get affordable health care to the world’s poorest one billion people; to better protect them against epidemics; and to help them enjoy better health, including protection from noncommunicable diseases like cancer. But it was unclear how the plan, as announced, would increase efficiency…” (McNeil, 3/6).

Reuters: WHO chief unveils reforms, with more science, apps and an academy
“…Alongside this ambition to cast a huge global net, there will be a new chief scientist role, reflecting the WHO’s determination to be ahead of the curve on frontier technologies such as gene editing, and to ensure its member countries are first to benefit from research and innovation. A new chief of antimicrobial resistance will tackle what Tedros told staff was ‘one of the most urgent health threats of our time.’ The agency will also focus more on ‘digital health,’ using text messages to spread messages about vaccination and smartphone applications to help people manage and monitor their health…” (Miles, 3/6).

U.N. News: Ramped-up emergency preparedness, part of ‘changing the DNA’ of the U.N.’s health agency
“…To provide new learning opportunities for staff and public health professionals around the world, a state-of-the-art WHO Academy has also been proposed to create a more dynamic, diverse workforce. Other measures include a streamlined recruitment process to cut hiring time in half; more management training; new opportunities for national professional officers, and previously announced improvements in conditions for interns…” (3/6).

Xinhua News: WHO’s historic reform centers on universal health coverage, health emergencies
“… ‘The changes we are announcing today are about so much more than new structures, they’re about changing the DNA of the organization to deliver a measurable impact in the lives of the people we serve,’ said WHO Director-General Dr. Tedros Adhanom Ghebreyesus. … According to the WHO chief, the WHO’s new corporate structure will be based on four pillars: the Programs pillar to support the UHC, the Emergencies pillar to respond to health crises, the External Relations and Governance pillar to target resource mobilization and communications, and the Business Operations pillar to focus on delivery of key corporate functions…” (3/7).

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Violence, Mistrust Continue To Hamper DRC Ebola Outbreak Response As Number Of Cases Surpasses 900

Associated Press: Response to Ebola in Congo hampered by violence, says group
“Health workers battling Ebola in eastern Congo are facing ‘a climate of deepening community mistrust’ nearly seven months after the outbreak began, Doctors Without Borders warned Thursday…” (Larson, 3/7).

BBC News: Ebola in the DR Congo warzone
“Violence by militia groups has made treating the worst Ebola outbreak in the history of the Democratic Republic of Congo even harder. Anne Soy joined teams in the east of the country to see their challenges and successes” (Inwood, 3/7).

CIDRAP News: Ebola total tops 900 in DRC, with 7 new cases today
“[Wednesday] the Democratic Republic of the Congo’s (DRC) ministry of health confirmed there are now officially 907 cases of Ebola in an 8-month long outbreak in the country’s North Kivu and Ituri provinces, reflecting 10 new cases in two days…” (Soucheray, 3/6).

Xinhua News: U.N. provides funding to regional logistics base for Ebola response
“The U.N. relief agency said Wednesday it has released 50 million shillings (500,000 U.S. dollars) to support the creation of a regional common logistics services staging area in Uganda to strengthen Ebola readiness and response in the region…” (3/6).

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MSF, CEPI Exchange Comments Regarding Access To CEPI-Supported Vaccines

CIDRAP News: MSF questions affordable access to CEPI-supported vaccines
“Doctors Without Borders (MSF) [Tuesday] sent an open letter to the Coalition for Epidemic Preparedness and Innovations (CEPI) expressing concerns about recent revisions to its equitable access policy that it says weakens guarantees that countries can buy vaccines developed with CEPI support at an affordable price. In a statement [Wednesday], CEPI said its commitment to access hasn’t changed, but the earlier draft of the policy was overly prescriptive and has been a barrier to potential partners…” (Schnirring, 3/6).

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Vox Examines Cases For Upstream, Downstream Solutions To Development, Philanthropy's Role

Vox: The case for “Band-Aid” philanthropy
“…Here’s the argument: Most problems like poverty, disease, hunger, and war won’t be permanently fixed by homeless shelters, private donations, or other small-scale projects. We need bigger changes to the system to really solve them. That’s true as far as it goes. But it’s a short leap from concluding that shelters and bednets to prevent malaria are just ‘Band-Aids’ to concluding that philanthropists should stop wasting their time on the ‘Band-Aid’ solutions in front of them, and should instead focus their energy on big bets that might, if they pan out, solve the problem entirely. In the spring edition of the Stanford Social Innovation Review, David Callahan, the founder of Inside Philanthropy, pushes back on that view, and points out some of the tragic consequences of its newfound popularity…” (Piper, 3/6).

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Media Outlets Continue Coverage Of ‘London Patient,’ Possible Third Patient, HIV Research Implications

Los Angeles Times: Two patients with HIV are in remission. How many more will follow them? (Healy, 3/6).

New Scientist: A third person may have become HIV-free after a bone marrow transplant (Wilson, 3/5).

Reuters: World’s second man cleared of AIDS virus invigorates quest for cure (Kelland/Steenhuysen, 3/6).

San Francisco Chronicle: Second man cured of HIV sparks hope that millions more could eventually benefit (Allday, 3/6).

Slate: What’s a Cure, Anyway? (Palus, 3/6).

The Telegraph: Gene editing could end HIV, scientists hope, after second patient is ‘cured’ using rare mutation (Knapton, 3/6).

VOA News: A Cure for HIV Is Possible (Pearson, 3/6).

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11M People In North Korea Malnourished, Without Access To Health Care, Clean Water; 1 In 5 Children Stunted, U.N. Report Says

Associated Press: U.N.: 11 million North Koreans need food and kids are stunted
“An estimated 11 million people in North Korea — over 43 percent of the population — are undernourished and ‘chronic food insecurity and malnutrition is widespread,’ according to a U.N. report issued Wednesday. The report by Tapan Mishra, the head of the U.N. office in North Korea, said that ‘widespread undernutrition threatens an entire generation of children, with one in five children stunted due to chronic undernutrition.’ With only limited health care and a lack of access to clean water and sanitation, ‘children are also at risk of dying from curable diseases,’ the report added…” (Lederer, 3/6).

U.N. News: Nearly four million North Koreans in urgent need, as food production slumps by almost 10 percent
“The U.N. is calling for some $120 million to provide life-saving humanitarian aid, desperately needed by 3.8 million North Koreans, as it releases its 2019 Needs and Priorities Plan for the country. Women, children, the elderly, and people with disabilities are prioritized in the plan: 90 percent of nutritional aid, and 92 percent of health assistance, go to children under five years old and women. … Overall, some 11 million people in the country are not getting enough nutritious food, clean drinking water, or access to basic services like health and sanitation…” (3/6).

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More News In Global Health

Devex: In the era of #AidToo, global health is short on sexual harassment policies (Ravelo, 3/7).

Devex: Achieving UHC in Africa requires support for most vulnerable, experts say (Roby, 3/7).

IRIN: Q&A: How churches are leading the way in helping migrants with HIV (Dupraz-Dobias, 3/7).

NBC News: This African nation is now the ‘most dangerous place in the world for children’ (Romo et al., 3/6).

Reuters: Bayer launches combination insecticide to fight resistance malaria (3/6).

U.N. News: Without tackling ‘gross inequalities’ major issues will go unsolved, warns U.N. rights chief Bachelet (3/6).

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Editorials and Opinions

Opinion Pieces Discuss Issues Around Anti-Vaccination Movement, Threat To Global Health

Foreign Policy: The World’s Many Measles Conspiracies Are All the Same
Laurie Garrett, former senior fellow for global health at the Council on Foreign Relations

“…Vaccination isn’t just an individual choice; it’s a social contract entered into by the public and its government. … When governments fail to fulfill their side of the social contract, not providing vaccines to the population in an appropriate and affordable manner, outbreaks soon follow. … Most vaccine refusal worldwide goes hand in hand with public distrust in government. … But the global anti-vaccination movement that predominantly confronts public health advocates today is dominated by highly educated, typically well-heeled individuals … The anti-vaccination movement is, at its heart, based on privilege. … Unfortunately, there is no simple recipe for cooking up bonds of trust amid a broken social contract. Public health leaders and pediatricians are hard-pressed to counter anti-vaccination messaging that is tied to larger political, religious, and cultural divisions and suspicions. Once the obligations of herd immunity are cast aside, the individual trumps the needs of the community. And once the one is more important than the us or all, it’s very hard to reverse that equation” (3/6).

New York Times: This Is the Truth About Vaccines
Brett P. Giroir, assistant secretary for Health and Human Services; Robert R. Redfield, director of the Centers for Disease Control and Prevention; and Jerome M. Adams, U.S. surgeon general

“Vaccinations save lives, protect our children, and are one of our greatest public health achievements. … But misinformation about vaccines is still widely reported, so we feel it is crucial to state clearly and unambiguously: Vaccines do not cause autism and they do not contain toxic chemicals. … Unfortunately, many more communities are at risk for outbreaks because of areas with low vaccine coverage. … We cannot be complacent. The recent measles outbreaks are a reminder that diseases that we might have thought had become rare in the United States are still infecting unvaccinated people, sometimes with dire consequences: Children with measles can develop fatal complications. These diseases should be seen only in history books — not in our emergency rooms. We are committed to countering the misinformation that fuels anti-vaccine sentiment among parents and legislators who are earnestly trying to protect their children and the public. Science that sits on the shelf has no value. We must take advantage of the lifesaving tools we have to protect our nation’s most vulnerable. Our children, and our children’s children, have the opportunity to grow up in a world that is free from polio, measles, and other vaccine-preventable diseases. We must work together to make this a reality” (3/6).

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Building Trust Among Communities Vital To Containing Ebola, Other Outbreaks

New England Journal of Medicine: An Epidemic of Suspicion — Ebola and Violence in the DRC
Vinh-Kim Nguyen, medical team leader at Médecins Sans Frontières in the Democratic Republic of Congo (DRC)

“…Ebola is worsening despite medical progress because trust is breaking down. Medical innovations need social traction to deliver results. … Since 2014, anthropologists have pointed out that resistance to Ebola control efforts reveals ongoing, legitimate concerns about the conduct of interventions, respectful treatment of local populations, and resource distribution. Yet we have not learned how to alleviate distrust or establish mechanisms for recognizing and addressing underlying anxieties and actual injustices. The mistrust of authority in the DRC also reflects a growing global mistrust of experts and science. Vaccine refusals are a growing problem worldwide, and they have already resulted in measles epidemics in the United States and France and in outbreaks elsewhere. Mistrust of public health authorities may thus be the new norm, and smoldering epidemics merely a symptom. State-of-the-art medical interventions won’t be enough without serious efforts to rebuild trust, informed by social science rather than pious liturgies. Displays of armed force feed a vicious cycle of mistrust, infection, and violence. If we continue down that path, those seemingly fantastical dystopian outbreak movies, with their heavily armed global health forces and rebelling populations, may not be so far from reality in the near future” (3/6).

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Data, New Technology, Strategic Decision-Making Key To Achieving UHC In Africa

AllAfrica: Africa: Three Promising Pathways to Universal Health Coverage in Africa
Jean Kagubare, deputy director of Global Primary Health Care at the Bill & Melinda Gates Foundation

“…[T]here is no better return on investment than strengthening primary health care, the backbone of all great health systems. But how do we do that? While every country’s path to universal health coverage will look different, I am excited about three key approaches: using data to guide improvements, leveraging new technologies to expand access to care, and making better decisions about where to spend resources. … As countries across the continent increasingly commit to Health for All, the next step is identifying the reforms that will help get there. Improving primary health care systems through better data, technology, and strategic purchasing is the smartest way forward. We all have a role to play in translating rhetoric into results and transforming health on the continent. Let’s get to work” (3/4).

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Multisectoral Collaboration Critical To Addressing Women's, Children's, Adolescent Health Globally

Devex: Opinion: Business as usual won’t work for maternal and child health
Helga Fogstad, executive director of the Partnership for Maternal, Newborn & Child Health

“…The widespread health inequality that disproportionately affects women, children, and adolescents in remote areas, communities affected by poverty, patriarchal cultures, and humanitarian settings screams loud and clear that the status quo needs to be broken. … [F]ocusing on solutions to improve the health and well-being of women, children, and adolescents is one of the greatest investments we can make, contributing to not only social development but also economic growth. … As the world’s largest multistakeholder alliance for women’s, children’s, and adolescent health and well-being, [the Partnership for Maternal, Newborn & Child Health (PMNCH)] has the strength of over 1,000 partner organizations. … If it were not for PMNCH partners, child and maternal mortality in [low- and middle-income countries (LMICs)] would still be drastically high. The collective efforts by PMNCH’s partners during the years of the MDGs led to 50 percent reduction in child and maternal mortality in these countries. It is now time to build upon the gains accomplished during the MDG era and strive for more multisectoral collaborations to address health challenges in a comprehensive and integrated manner. Business as usual is not enough and will no longer work” (3/6).

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From the Global Health Policy Community

Wellcome Pledges £2M To Support Vaccine Research, Ebola Response In DRC

Wellcome: Wellcome pledges new funds to tackle Ebola outbreak — but more is needed to prevent catastrophe
“Wellcome is making £2 million available to the World Health Organization (WHO) and the government of the Democratic Republic of Congo (DRC), to support vaccine research as part of the emergency response to the Ebola outbreak there. The pledge comes after the WHO Director-General, Dr. Tedros Adhanom Ghebreyesus, called on donors to continue funding the response to the Ebola outbreak…” (3/6).

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Conflict Driving Forced Displacement, Threatening Communities Across Sahel, Public Health Officials Say

U.N. Office for the Coordination of Humanitarian Affairs: Persistent Needs in Sahel, Conflict Driving Massive Displacement
“Top United Nations and non-governmental aid officials [on Wednesday] sounded the alarm over rising conflict and insecurity that have accelerated forced displacement across the Sahel, where millions of people are still reeling from the effects of last year’s food and nutrition crisis…” (3/6).

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From the U.S. Government

Ebola Survivors In Liberia Have Higher Prevalence Of Certain Health Issues Compared To Control Group, Study Shows

NIH: Study finds Ebola survivors in Liberia face ongoing health issues
“Survivors of Ebola virus disease (EVD) in Liberia had a higher prevalence of certain health issues — including uveitis (eye redness and pain), abdominal, chest, neurologic, and musculoskeletal abnormalities upon physical exam — when compared to a control group of household and community members who did not have a history of EVD, according to findings from an ongoing study published in the New England Journal of Medicine. However, even participants in the control group experienced a relatively high burden of health issues overall…” (3/6).

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NIH-Supported Analysis Shows Elevated Mortality Among People With HIV Who Have TB Diagnosis In Latin America

NIH: Tuberculosis diagnosis in people with HIV increases risk of death within 10 years
“Among people with HIV in Latin America, those diagnosed with tuberculosis (TB) at an initial clinic visit were about twice as likely to die within 10 years as people not initially diagnosed with TB, according to findings from a large observational study. This increased risk persisted despite the availability of TB treatment and mirrored patterns seen previously in HIV-negative populations, according to research supported by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health…” (3/6).

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