KFF Daily Global Health Policy Report

In The News

PEPFAR Reauthorization 'Rests With Congress,' OGAC Official Says

Speaking at a briefing on Tuesday at the Center for Strategic and International Studies (CSIS) in Washington, D.C., Deputy Global AIDS Coordinator Julia Martin said “[t]he decision about whether to reauthorize [PEPFAR] ‘rests with Congress. … Whether we move in that direction is yet to be fully determined but PEPFAR will continue at the will of Congress,'” CQ HealthBeat reports. “Many advocates assume that lawmakers are preoccupied with other international priorities and will not focus on PEPFAR enough to move a bill,” the news service writes, adding, “Even without a reauthorization, the program can continue.” The briefing, co-sponsored by CSIS and the Kaiser Family Foundation, focused on the Institute of Medicine’s (IOM) Evaluation of PEPFAR, which was released in February, the news service notes. “Martin said at the briefing that federal officials can move forward with IOM recommendations without the need for legislation,” CQ HealthBeat writes (Adams, 4/30). According to the event’s webpage, J. Stephen Morrison, CSIS vice president and director of the CSIS Global Health Policy Center, moderated the panel, which included Martin; Chris Collins, vice president and director of public policy at amfAR, the Foundation for AIDS Research; Jennifer Kates, vice president and director of global health and HIV policy at the Kaiser Family Foundation; and Kimberly Scott, senior program officer at the Institute of Medicine (4/30).

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U.S. Global AIDS Coordinator Goosby To Visit India This Week

Ambassador Eric Goosby, head of the U.S. State Department’s Office of Global Health Diplomacy and the U.S. Global AIDS Coordinator, “is travelling to India this week to recognize the successful health partnership between the two countries, an official statement said,” the Press Trust of India/Business Standard reports. “During his India trip from May 1 to 4, Goosby will meet with key government officials in the health sector, development partners, donor agencies, non-government organizations, and academic institutions to see first-hand the important work being done to fight HIV/AIDS in India,” the news service notes (5/1).

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U.S. Proposes Talks Aimed At Improving Food Security At Upcoming WTO Meeting

“The United States said on Tuesday it was prepared to examine how agricultural policy reform could boost global food security as part of a package of commitments at the World Trade Organization’s [WTO] upcoming meeting in December,” Reuters reports. “‘The United States agrees with India and other proponents that enhancing food security in developing countries is indeed an important issue for this body to address,’ U.S. Ambassador to the WTO Michael Punke said in Geneva, according to a text of his remarks released in Washington,” the news agency writes (Palmer, 4/30). “The U.S. Trade Representative [USTR], which has been pressing for freer trade in food in hopes of boosting U.S. exports, said it could agree that food security is a valid issue to be dealt with under the World Trade Organization talks,” Agence France-Presse notes.

“The issue, which had put especially the United States and India at loggerheads, has threatened to stymie the negotiations toward even a limited new WTO pact targeted for December’s WTO ministerial meeting in Bali,” according to AFP, which adds, “The USTR said that Washington would agree to the launch in Bali of a ‘work program’ to examine in detail the trade-related issues of food security.” The news service writes, “The U.S. said the program would cover security-related public stocks of food, price-setting, and the role of markets, public subsidies, export controls, and other issues” (4/30). “The proposed food security work program should look at how food security could be enhanced by ‘further liberalization in agriculture trade, reductions in trade-distorting domestic support, elimination of export restrictions, improved transparency, and efficient distribution systems,’ [Punke] said,” Reuters states (4/30).

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The Guardian Examines New Reports On Nutrition Spending

The Guardian examines two new reports on nutrition spending. “Ambitions to eradicate world hunger will not be realized if aid for basic nutrition remains at only 0.4 percent of total official development assistance (ODA), according to the research group Development Initiatives (DI),” the newspaper writes. “Even though nutrition aid is rising, it remains far below what is needed, the DI report says,” The Guardian notes, adding, “The World Bank estimated in 2010 that an increase of $10.3 billion in annual resources would end undernutrition. But since these estimates, basic ODA for nutrition has increased by only $139 million (£90 million), according to DI.” The newspaper continues, “The research group acknowledges, however, the difficulty in identifying aid for nutrition,” as “[p]rograms in health, agriculture or education can have an important impact on nutrition, but the nutrition components are hard to identify and measure.”

“A separate report from the Overseas Development Institute (ODI) think tank stressed the importance of smallholder agriculture in improving food security and reducing undernutrition,” according to The Guardian. “The report said empowering female farmers through legislation on rights and education, promoting home gardens and small-scale livestock rearing, and complementary programs in health, water and sanitation would improve the lives of smallholder farmers,” the newspaper writes. “Steve Wiggins, co-author of the report, emphasized the importance of the public sector,” the newspaper notes (Tran, 5/1).

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UNICEF, Partners Step Up Measles Immunization Campaign In Middle East; U.K. Provides Funding For WFP Work In Region

UNICEF and its partners “have stepped up vaccination campaigns in Syria, Jordan, Lebanon, Iraq and Turkey amid measles outbreaks in a region already struggling to provide humanitarian assistance to millions of people affected by ongoing conflict in Syria,” the U.N. News Centre reports (4/30). According to VOA News, UNICEF “reports hundreds of cases of measles have broken out among children in [the five countries] over the past year.” UNICEF spokesperson Marixie Mercado said, “[T]hese outbreaks have been contained thus far in Syria and across the region. In large part, also because of an immunization campaign last year that reached 1.3 million children with measles vaccination and 1.5 million children with polio vaccination,” the news agency notes. However, she added, “[T]he concern is very real. These are conditions that are conducive to the spread of disease and things are not getting any better for the Syrians either inside of the country or outside,” according to VOA. Mercado said security concerns are hindering the reach of health care workers, but “[d]espite such setbacks, she says health workers are continuing their campaign to vaccinate hundreds of thousands of Syrian children against measles throughout the region,” the news service writes (Schlein, 4/30).

“Meanwhile, the U.N. World Food Programme (WFP) [on Tuesday] welcomed a generous contribution of around $43 million from the United Kingdom that will help provide much-needed food assistance to tens of thousands of Syrians both inside and outside their country,” the U.N. News Centre reports. “The agency will also use the funds to issue food vouchers to thousands of Syrian refugees who are either sheltering in camps in Turkey or as urban refugees in Lebanon,” the news service adds, noting, “The agency must raise $19 million each week to provide food assistance to 2.5 million hungry people inside Syria and more than one million refugees in neighboring countries” (4/30).

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Grand Challenges Canada Funds Innovative Ideas To Solve Global Health Problems

“Grand Challenges Canada just announced grants of $100,000 for 102 imaginative new ideas to tackle health problems in resource-poor countries,” Inter Press Service reports, noting, “Of these, 59 grants went to researchers in 13 low- and middle-income nations worldwide.” IPS continues, “Although the 102 ideas are selected through a peer-review process, at this early point they aren’t much more than inspired ideas. … If any of these raw ideas prove effective, the innovators will be eligible for an additional Grand Challenges Canada scale-up funding of up to $1 million.” The news service highlights some of the ideas, including “a test strip you touch with your tongue to see if you have a deadly disease,” “a mobile phone game to prevent HIV,” and a sanitation system that turns “untreated human waste from slums … into marketable products” (Leahy, 4/30).

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Editorials and Opinions

Opinion Pieces Address Global Vaccine Summit

Project Syndicate last week published two opinion pieces addressing the Global Vaccine Summit, held in Abu Dhabi from April 24-25, which was hosted by His Highness General Sheikh Mohamed bin Zayed bin Sultan Al Nahyan, Crown Prince of Abu Dhabi, in partnership with U.N. Secretary-General Ban Ki-moon and Bill Gates, co-chair of the Bill & Melinda Gates Foundation. The following is a summary of those pieces.

  • Desmond Tutu: “The vaccine summit builds on a commitment last year by nearly 200 countries to eradicate polio, develop new and improved vaccines at affordable prices, and deliver them to every child by 2020,” the Archbishop Emeritus of Cape Town and a Nobel Peace Prize laureate writes. He recounts his personal experience with polio as a child, discusses progress in the global effort to stamp out the disease, and continues, “Ending polio will be a key milestone on the path to realizing this vision. And the summit in Abu Dhabi has provided a clear plan to get there by 2018 — a strategy that complements other efforts to raise immunization coverage for diseases such as measles, pneumonia, and rotavirus.” He adds, “Strengthening routine immunization will protect our gains against polio and enable us to reach the most vulnerable children in the hardest-to-reach and most underserved communities. … We must do it. And when we succeed, it will be a triumph for humanity” (4/24).
  • Ban Ki-moon and Bill Gates: “Along with Mohamed bin Zayed bin Sultan Al Nahyan, Crown Prince of Abu Dhabi, we attach great importance to the world’s first global summit, being held this week in Abu Dhabi, aimed at ensuring that all children have access to the full benefits of vaccines,” the U.N. Secretary General and Gates write. They discuss the benefits and cost-effectiveness of vaccination and state, “Yet more than 22 million children lack access to the basic vaccines that people in high-income countries take for granted.” They note, “Raising global immunization coverage will speed progress toward the [Millennium Development Goals (MDGs)] and generate momentum toward a successful post-2015 development agenda,” and they highlight the vision of “the Decade of Vaccines” — “a world free from vaccine-preventable diseases, with the full benefits of immunization reaching all people, regardless of who they are or where they live.” They write, “Over the next 1,000 days and beyond, our progress will be measured by what we have done to improve the lives of the poorest and most vulnerable members of the human family” (4/23).

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Editorial, Opinion Piece Address Emergence Of H7N9 Bird Flu Strain In China

The following is a summary of an editorial and an opinion piece addressing the emergence of a new strain of bird flu — H7N9 — in China.

  • Boston Globe: “[W]ith the rise in China of a new bird flu called H7N9, which has killed 23 people and infected over 120 more, and with one case now confirmed outside the Chinese mainland, Asian countries are also bracing for the potential outbreak of a highly lethal virus,” the editorial states. “Global health depends on China being as forthcoming with information as possible, so that other nations can take appropriate precautions,” the newspaper writes, adding, “By all accounts, including that of the World Health Organization, the Chinese government and state media have been more open about the spread and genetic makeup of the disease [than the country was during the SARS epidemic a decade ago], encouraging citizens to share information.” The editorial concludes, “China owes the rest of the world a full account of its efforts to isolate patients and ensure that infected people don’t spread the virus beyond its borders” (5/1).
  • Scott Gottlieb, Forbes: “We have grappled with deadly pockets of potent flu outbreaks before. But this one has characteristics that make it different,” Gottlieb, a physician and fellow at the American Enterprise Institute, writes, adding, “There’s a greater risk that this strain could acquire the ability to spread more easily from person to person.” He provides statistics about the spread of the virus so far and asks, “So are we ready to battle a pandemic strain of bird flu if this new virus picks up the capacity to more efficiently spread from person to person?” He continues, “For the most part, our strategy for preparing for pandemic flu focuses on the development of vaccines,” but “there’s good reason to believe this may not be enough. What we really need are potent antiviral medicines with broad activity against many different strains of pandemic virus” (4/30).

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To Reach 'FP2020' Goal, Targets Must Be Re-Examined

Participants at the 2012 London Family Planning Summit “pledged $2.6 billion dollars in additional funding to achieve a worthy goal: provide 120 million new women who have ‘unmet need’ with family planning products and services by 2020 in 69 of the world’s poorest countries,” a movement dubbed “FP2020,” Christopher Purdy, executive vice president of DKT International, writes in the Huffington Post’s “Global Motherhood” blog. However, he says “an analysis of available data on a country-by-country basis suggests that a majority of the women with unmet need for family planning are in the world’s middle-income countries.” Purdy describes his data analysis, stating, “Given that significant unmet need continues to exist in middle-income countries, it seems fair to assume that we will be hard-pressed to reach 120 million new women unless we invest in these countries.” He concludes, “Allocation of human and financial resources is underway but needs to be aligned with the realities of where the greatest chance for success can be achieved. It would appear that some re-orientation may be required to avoid falling short of FP2020’s ambitious target seven years from now” (4/30).

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From the Global Health Policy Community

Blog Examines Drug Donation Programs, Big Pharma's Role In Public Health Agenda

“Drug donations, reinvestment of profits in developing countries and a more flexible approach to intellectual property have all signaled a more collaborative approach from industry with the likes of GlaxoSmithKline, Sanofi, Johnson & Johnson and Merck all performing well in the 2012 Access to Medicine Initiative,” Adam Robert Green, senior reporter with the Financial Times’ “This is Africa,” writes in the Royal African Society’s “African Arguments” blog. “But while talk of a new era of friendship is appealing (not least to the companies), there are still unresolved debates about the role that companies play in shaping the public health agenda in developing countries. Even the most seemingly charitable acts have come under scrutiny,” he writes, noting some programs raise questions of sustainability, prioritization, and cost effectiveness. “No one should expect Big Pharma to act as a charity — for one thing, such behavior will be superficial and unsustainable,” he writes, adding, “The challenge is to establish where ‘corporate citizenship’ stops and the bottom line starts” (4/29).

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MSF, GAVI Alliance Vaccine Discussion Shows Complications In Global Health Programs

Writing in the American Public Health Association International Health Section’s “IH-Blog,” Jessica Keralis, IH Communications Committee chair, highlights three recently released advocacy videos by Médecins Sans Frontières (MSF) discussing child vaccines and a subsequent conversation between MSF and the GAVI Alliance over vaccine pricing. “The last video … talks about how qualified governments are allowed to access GAVI’s low vaccine prices, but [non-governmental organizations (NGOs)] are not given access to them,” Keralis writes, and she includes MSF and GAVI statements responding to the video’s request to allow NGO access. “We often talk about issues of coordination (or lack thereof) and collaboration between different aid groups and funding organizations in the wake of natural disasters and humanitarian crises,” she writes, adding, “It is interesting to see this kind of friction between different groups who are trying to do exactly that because of how complicated it can actually be” (4/29).

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PLOS 'Q&A' Blog Post Highlights PLOS Medicine Series

In the latest installment of the PLOS “Speaking of Medicine” blog’s Q&A series, Pamela Collins, director of the Office for Research on Disparities and Global Mental Health at the National Institute of Mental Health (NIMH) and “the corresponding author of a series of Policy Forum articles in PLOS Medicine that provides a global perspective on integrating mental health,” answers questions “about some of the topics discussed in the new series, which will be published in PLOS Medicine weekly for the next five weeks, starting with the publication [on Tuesday] of a Policy Forum article discussing integration in research, policy, and practice.” According to the Q&A, Collins discusses “[w]hy the integration of mental health care is so important,” her “main motivations for initiating the series,” and “the main barriers to moving this field forward,” among other topics (4/30).

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May 2013 Issue Of WHO Bulletin Available Online

The May issue of the WHO Bulletin features an editorial examining policy coherence for improved medical innovation and access, a public health news roundup, several research papers on maternal and child health, and a review of 12-month antiretroviral therapy outcomes in low- and middle-income countries, among other articles (May 2013).

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