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Kaiser Daily Global Health Policy Report

In The News

Trump Administration Releases Global Health Security Strategy

Press Trust of India/Business Standard: U.S. unveils strategy to detect and respond to health security threats globally
“The U.S. government has come up with a first-of-its-kind strategy to prevent, detect, and respond to threats from infectious diseases occurring naturally or accidentally, in an effort to help improve the world’s ability to stop and contain deadly outbreaks before they spread between countries. The Global Health Security Strategy, unveiled on Thursday, defines the actions the administration will take by adopting a whole-of-government approach to health security and leveraging the strengths of different federal departments, agencies, and funding streams, the White House said…” (5/10).

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U.S. House Appropriators Draft FY20 SFOPs Spending Bill, Including Repeal Of Expanded Mexico City Policy

Roll Call: House works to end Trump’s suspension of aid to Central America
“House appropriators are trying to end a divisive suspension of foreign aid to Central America made by President Donald Trump, one of many provisions in a spending bill that would counter administration policy on a range of international issues. The draft fiscal 2020 State-Foreign Operations spending bill released Thursday would also provide more money to reproductive health programs and international agencies. The State-Foreign Operations Appropriations Subcommittee is scheduled to mark up the measure on Friday. … The legislation would repeal the Trump administration’s expanded Mexico City policy, which prohibits any U.S. global health assistance funds from going directly or indirectly to [foreign] nongovernmental organizations that provide abortions, abortion counseling, or referrals. Additionally, the bill would bar any funding from prior fiscal years from being used to carry out the Mexico City policy and would end a prohibition on funding for the United Nations Population Fund…” (Oswald, 5/9).

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Reps. Engel, McCaul Introduce Bipartisan Legislation To Prevent Reprogramming Of Foreign Assistance To Central America

Devex: New House bill would prevent reprogramming of Central America funds
“Democratic Rep. Eliot Engel and Republican Rep. Michael McCaul on Thursday introduced legislation that authorizes $577 million in foreign assistance to Central America to address the root causes of migration and prohibits those funds from being reprogrammed, rescinded, or transferred. … Engel and McCaul are the chairman and ranking minority member of the House Foreign Affairs Committee, and both have been outspoken about the aid cutoff. They were visiting USAID programs in El Salvador on a bipartisan congressional delegation trip when they learned [President Trump] had decided to stop U.S. assistance to the Northern Triangle, and both have said that cutting off funds that are targeted at addressing the root causes of migration is counterproductive…” (Welsh, 5/10).

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DRC Ebola Outbreak Could Spread If Violence Continues, WHO Warns; Paul Allen Foundation Calls For Greater Effort To End Outbreak

Associated Press: WHO warns Ebola could spread elsewhere if attacks don’t stop
“The World Health Organization warned Friday that it may not be possible to contain Ebola to the two affected provinces in eastern Congo if violent attacks on health teams continue. The ominous statement comes amid escalating violence nine months after the outbreak began, crippling efforts to identify suspected cases in the community and vaccinate those most at risk…” (Larson, 5/10).

Devex: Paul Allen Foundation: It’s up to all of us to stop the Ebola crisis in DRC
“The Paul G. Allen Family Foundation is calling on both governments and private funders to step up and support Ebola response efforts in the Democratic Republic of the Congo, where deaths have now reached over 1,000. ‘The world needed to pay a bit more attention to this outbreak,’ said Paul Keating, senior director of philanthropy at Vulcan Inc., a private company established by the late Microsoft co-founder to oversee his business and philanthropic works…” (Ravelo, 5/10).

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Taiwan's Continued Exclusion From World Health Assembly Threatens Global Health Security, Foreign Minister Says

The Telegraph: Taiwan at greater risks of pandemics after WHO exclusion, says foreign minister
“…This week the WHO, a United Nations agency, declined to invite Taiwan for the third consecutive year to an annual meeting of its decision-making body, the World Health Assembly (WHA), because of objections from Beijing. In a Telegraph interview, Joseph Wu, the Taiwanese foreign minister, warned that Taipei’s exclusion from the world health summit and from dozens of WHO technical expert meetings created loopholes in global health security networks that could quicken the spread of pandemics in Taiwan, Asia, and beyond…” (Smith, 5/9).

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Drug-Resistant TB Could Cost World Economy $20B Annually, Needs To Be Treated As Public Health Emergency, Report Says

The Telegraph: Warning over global failure to act on deaths from drug-resistant TB
“The spiraling number of deaths from drug-resistant tuberculosis (DR-TB) is set to cost the world economy nearly $20 billion annually. A report from the Economist Intelligence Unit warned that despite the fact that DR-TB is a huge global health threat, the fight against the disease lags behind others in terms of both money and attention. In low- and middle-income countries, where 97 percent of the TB cases took place in 2018, there was an estimated $3.5 billion shortfall in the total $10 billion budget required to address the disease. … The EIU and Johnson & Johnson report called for the disease to be treated as a public health emergency and said $9 billion was needed to develop new drugs, diagnostics, and vaccines…” (Wallen, 5/9).

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Gilead Announces Generic Version Of Truvada Available In 2020, Will Donate Drug Used For PrEP To 200K U.S. Patients

NBC News: Generic HIV prevention drug coming in 2020, Gilead says
“Gilead Sciences announced Wednesday that a generic version of Truvada will be available in September 2020, one year earlier than expected. … While a month’s supply of generic Truvada is available in countries around the world for as little as $70, in the United States a month’s supply sells for $1,600 to $2,000, and activists have mounted a pressure campaign to force Gilead to make the drug more widely available in order to curb the global HIV epidemic…” (Fitzsimons, 5/8).

New York Times: Gilead Will Donate Truvada to U.S. for HIV Prevention
“Gilead Sciences, maker of Truvada, the only drug approved to prevent infection with HIV, will donate enough of the drug to supply 200,000 patients annually for up to 11 years, federal health officials announced on Thursday. … Gilead appears to be following a pattern set in 2001 by other drug companies. While millions of Africans died of AIDS because their drugs cost as much as $20,000 a year, drug makers refused to cut their overall prices. But the companies did offer to donate limited amounts of HIV medications — all while pressuring the United States and European governments to make sure that generic drugs made in India were kept out of the market. The tactic ultimately failed, and Indian companies now supply almost all of Africa’s HIV drugs. In Africa, generic Truvada is sold for about $60 a year. … Gilead will donate Truvada until [the generic] Descovy is approved for HIV prevention, then switch patients to the new drug… (McNeil, 5/9).

Additional coverage of Gilead’s announcements is available from The Hill and Washington Post.

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Mexican Official Resigns Post At National HIV/AIDS Agency Over Drug Shortages

Thomson Reuters Foundation: Mexican official resigns as HIV drug shortage sparks outcry
“A top Mexican health official said on Thursday that he had resigned amid growing anger over drug shortages that have left hundreds of HIV patients without life-saving medicines. Carlos Magis confirmed to the Thomson Reuters Foundation via text message local media reports that he had quit his job as director of comprehensive care at the national HIV/AIDS agency, Censida, but declined to give further details…” (Lopez, 5/9).

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NEJM Study, Commentary Address Knowledge Gaps For Nipah Virus, Call For Greater Epidemic Preparedness

CIDRAP News: Study highlights caregiver risk, respiratory role in Nipah
A new study based on 14 years of Nipah virus infections in Bangladesh — the country hit hardest by the disease — revealed an elevated risk to caregivers, the role of respiratory secretions, and other new clues about what fuels transmission among humans, findings that could help control future outbreaks. An international group of researchers published its findings [Thursday] in the New England Journal of Medicine. Nipah virus, a paramyxovirus spread by bats found throughout South and Southeast Asia, is one of nine World Health Organization (WHO) priority diseases for research and development. … In an accompanying commentary in the same journal, Jeremy Farrar, MD, PhD, director of the Wellcome Trust, said Bangladesh has experienced a Nipah virus outbreak every year since 2001, but large gaps remain in understanding the virus, including how it crossed to India in 2018 to trigger an outbreak in Kerala. Alluding to the WHO research priority list, which includes a yet-unknown ‘disease X,’ he said Nipah virus was disease X until 20 years ago, and to better prepare for future epidemics, the world needs to expect them…” (Schnirring, 5/9).

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More News In Global Health

Devex: Rory Stewart: What to expect from DFID’s new leader (Edwards, 5/10).

Homeland Preparedness News: Scientists combat the use of Ebola as a bioweapon, advance treatments (Adrien, 5/9).

Thomson Reuters Foundation: Measles threatens all of Chad as children go unvaccinated (Peyton, 5/9).

U.N. News: ‘Abhorrent’ ambulance attack in Libyan capital imperils life-saving work, warns U.N. (5/9).

U.N. News: New SDG Advocates sign up for ‘peace, prosperity, people’ and planet, on the road to 2030 (5/9).

Washington Post: Some of the world’s most polluted cities are in India, and New Delhi is one of them. This is what life’s like there (Dickerman/Mejlvang, 5/10).

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Editorials and Opinions

Global Community Must Reevaluate Thinking Around, Approach To Addressing NCDs

The Lancet: Offline: Time to radically rethink non-communicable diseases
Richard Horton, editor-in-chief of The Lancet

“…[G]lobal health actions, although necessary, are not sufficient to achieve human health and wellbeing. Unless global health leaders reinterpret, resituate, and reactivate their advocacy and practice in the context of an urgent planetary emergency, their well-intentioned words will be wasted. Perhaps the best example of this misplaced thinking is to be found in the strategies to prevent and control non-communicable diseases (NCDs) — a global movement that is dangerously off course. … [A]ny political action to attack NCDs demands equal attention to the connected crises of climate change and nutrition. There is, therefore, a compelling case for a wholesale reappraisal of global health’s approach to NCDs. … Applying a syndemic approach [– the Lancet Commission on the Global Syndemic of Obesity, Undernutrition, and Climate Change defined a syndemic as a ‘synergy of epidemics’ or components that ‘co-occur in time and place, interact with each other to produce complex sequelae, and share common underlying societal drivers’ –] indeed opens new opportunities for accelerating action to advance health. But it is no panacea. … The unsolved paradox is that policies that would produce the greatest health impact receive the least attention. Why? Here is the alarming truth: our economies are incentivized to earn vast private wealth by increasing public risks for NCDs. Until that truth is accepted and addressed, NCDs will remain part of an unchecked planetary emergency” (5/11).

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To Advance Human Health, WHO Should Incorporate Insight From Behavioral Research Into Its Policy Initiatives

Scientific American: The World Health Organization Needs to Put Human Behavior at the Center of Its Initiatives
Saad B. Omer, William H. Foege chair in global health and professor of global health, epidemiology, and pediatrics at Emory University, and Robb Butler, social scientist at the School of Global Health at the University of Copenhagen

“…While behavioral tools have been used for health promotion for several decades, they are inconsistently included in global health policy-making. Fortunately, there are a few models for incorporating insights from behavioral research into large-scale policy initiatives. One approach, used by many governments and some multi-lateral institutions, is establishing so called ‘nudge units.’ These units use lessons from behavioral economics and psychology to inform public policy … This … is precisely the right time for establishing a nudge unit at WHO. … As heath ministers and global health leaders prepare to convene at the World Health Assembly in Geneva this month, the WHO would be well-advised to reflect. The WHO was established to advance human health — and human behavior is a core determinant of human health and wellbeing. Now is the time for this fact to [be] fully accommodated in its structure and programs” (5/9).

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Predictive Modeling System Could Help Prevent Zoonotic Diseases

The Conversation: How humans interact with the changing environment is affecting the spread of infectious disease
Konstans Wells, research lecturer in ecology and global change biology at Swansea University, and Nicholas J. Clark, postdoctoral fellow in disease ecology at the University of Queensland

“Some of the world’s most notorious infections … come from zoonotic diseases. These illnesses are caused by pathogens … which can be passed from animals to humans. But … [w]e don’t yet fully understand how pathogens ‘shift’ between different host species and cause epidemics — and research is starting to show that the changing environment could be a factor. … Studies have found that the environments around us — including different habitats as well as climate conditions — provide new opportunities for humans to pick up different pathogens from wildlife. … Implementing a system [that predicts when and where pathogens will be exposed to new host species] could help track the reemergence of diseases that are under control in humans and domestic animals, but still present in wildlife. It could also increase awareness of the large diversity of poorly studied pathogens which have unpredictable zoonotic capacity. … [B]y preempting global disease spread we can start to understand their origins and hopefully predict their movements” (5/9).

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From the Global Health Policy Community

Inactivated Polio Vaccine Now Introduced In All Countries Worldwide

Gavi, the Vaccine Alliance: Inactivated polio vaccine now introduced worldwide
“After the introduction of inactivated polio vaccine (IPV) into Zimbabwe and Mongolia’s routine immunization programs with Gavi’s support, every country worldwide, including all 73 Gavi-supported countries, have now introduced the vaccine which protects children against the disease…” (5/9).

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MEASURE Evaluation Report Examines Ways To Strategically Approach Nutrition In Context Of HIV, TB Programming

IDSA’s “Science Speaks”: Thinking strategically about nutrition supports disease responses and more
In a guest post, Heather B. Davis, NACS portfolio program manager, and Emily A. Bobrow, senior technical specialist for evaluation and learning, both at MEASURE Evaluation at the University of North Carolina at Chapel Hill, discuss key issues from a recently released MEASURE Evaluation report on ways to think strategically about nutrition, especially in the context of HIV and TB. The authors write, “Given the landscape of siloed funding focused on particular diseases (especially HIV and TB), this publication takes an important step back to consider the overall health of a client and delineates specific nutrition-related concerns that arise when considering HIV and TB programming…” (5/9).

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From the U.S. Government

White House Releases Global Health Security Strategy

White House: President Donald J. Trump is Protecting the Homeland and the World from Global Health Security Threats
This fact sheet provides a summary of the Trump administration’s recently released Global Health Security Strategy, which “defines the actions the Administration will take to prevent, detect, and respond to infectious disease threats,” including through “strengthening global health security capacities” and “increasing international support” (5/9).

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