Kaiser Daily Global Health Policy Report

In The News

House Appropriations Subcommittee Approves $56.4B SFOPs Spending Bill

Devex: U.S. House aid budget bill pushes back against Trump administration policies
“A bill approved Friday would increase U.S. foreign aid funding by 3.9% from fiscal year 2019, and reject the Trump administration’s proposed cuts. The U.S. House of Representatives appropriations subcommittee charged with the state and foreign affairs budget approved the bill, which also seeks to address a number of issues that have not been at the center of the last few budget cycles: climate change, reproductive health, and limitations on how the administration can redirect funds. … At the heart of the partisan concerns mentioned is the inclusion in the budget bill of the Global HER Act, which aims to permanently repeal the ‘global gag rule’ [otherwise known as the Mexico City policy.] The bill also prohibits current and previous funds from being used to implement the Mexico City policy and reinstates funding to the U.N. Population Fund. Unless provisions permanently overturning the Mexico City policy are taken out, the bill has no hope of becoming law, [ranking member of the subcommittee Representative Hal Rogers, from Kentucky,] said…” (Saldinger, 5/13).

The Hill: House panel defies Trump, approves $56B foreign ops spending bill
“A House subcommittee on Friday advanced a $56.4 billion spending bill for the State Department and foreign operations, rejecting President Trump’s proposed budget … ‘It rejects the administration’s unacceptable, irresponsible fiscal year 2020 requests and reaffirms strong support for reproductive health, climate change, and multilateral assistance,” [Rep. Nita Lowey (D-N.Y.), who chairs both the subcommittee and the full Appropriations Committee, said in a statement]. The full House Appropriations Committee is expected to take up the bill as soon as [this] week. … The bill adds funding to the State Department, USAID, Peace Corps, President’s Emergency Plan for AIDS Relief, and humanitarian assistance, among other programs…” (Elis, 5/10).

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Global Press Journal Publishes Additional Stories In 'Reproductive Health Around The World' Series, Including Those Focused On U.S. Policy

Global Press Journal: What is the Mexico City Policy? (5/12).

Global Press Journal: When the U.S. Pulls the Funding Plug, How Do Reproductive Health Providers Proceed? (Kandel et al., 5/12).

Global Press Journal: Mexico City’s Shelters Provide Care to Pregnant Women Traveling North (García, 5/8).

Global Press Journal: High in the Himalaya, Family Planning Services Inaccessible to Nomadic Women (Bashir/Maqbool, 5/6).

Global Press Journal: Options for Reproductive Health Are Limited for Women in IDP Camps in DRC (Saambili, 5/5).

Global Press Journal: Support Networks ‘Invaluable’ for Mexican Women Seeking Illegal Abortions (Revilla, 5/1).

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More Than 100 Civil Society Groups Issue Open Letter Stating Concerns Over Several Developed Countries' Stance On WHA Transparency Draft Resolution

Health Policy Watch: Several Developed Countries Want To “Derail” Transparency Resolution — Civil Society Groups Say
“More than 100 civil society organizations and health experts signed on to an open letter [Thursday] calling out Germany, Sweden, Denmark, the U.K., and Australia, along with Austria and the United States, as wanting to ‘derail’ and ‘weaken’ the transparency resolution on drug prices and R&D costs. These countries, along with Spain, Hungary, Poland, and Brazil, proposed changes to the draft resolution at [last] week’s informal consultation of member states at the World Health Organization in Geneva, in the lead-up to the 72nd annual World Health Assembly (WHA) from 20-28 May, where the resolution will be discussed…” (Branigan, 5/10).

Additional coverage of the informal consultation is available from Health Policy Watch.

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IRC President David Milliband Praises Work Of DFID In Telegraph Interview

The Telegraph: DFID has given U.K. global ‘clout,’ says David Miliband
“Former foreign secretary David Miliband has praised successive Conservative governments for not ‘trashing’ a Labour innovation: the Department for International Development. In an interview with The Telegraph, Mr. Miliband, now president of U.S. NGO International Rescue Committee, was asked whether he feared a merger between DFID and the Foreign Office, as has been touted by some Conservatives. … Mr. Miliband was talking to The Telegraph from Goma in the Democratic Republic of Congo, where he was visiting staff responding to the Ebola epidemic currently raging in the North Kivu region of the country…” (Gulland, 5/10).

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Global Fund Executive Director Discusses Efforts To Improve Countries' 'Absorption' Rates For Spending Grant Money In Devex Interview

Devex: How the Global Fund helped countries spend its grants faster
“In recent years, the Global Fund to Fight AIDS, Tuberculosis and Malaria has cracked down on countries that don’t spend grants fast enough — and while it has struggled with the issue of ‘absorption’ rates in the past, countries are now on track to meet its targets. With its efforts proving effective, it is intending to continue them through the next funding cycle. Global Fund Executive Director Peter Sands spoke to Devex about the work that was involved in encouraging countries to spend grant funds within the three-year window…” (Jerving, 5/10).

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DRC Ebola Outbreak Treatment, Prevention Efforts Hindered By Violence, Increasing Risk Of Disease Spread, WHO Warns

VOA News: Ebola Outbreak Could Spiral Beyond DRC, WHO Warns
“Armed attacks, misinformation, and a growing funding gap continue to impede the response to the Ebola outbreak in northeastern Democratic Republic of Congo, with the World Health Organization warning that the situation could spiral out of control. Insecurity leaves response teams ‘unable to perform robust surveillance nor deliver much needed treatment and immunizations,’ the WHO reported Friday in its latest update on the outbreak confirmed last August. The health organization warned that ‘without commitment from all groups to cease these attacks, it is unlikely that this EVD [Ebola virus disease] outbreak can remain successfully contained in North Kivu and Ituri provinces.’ The disease could spill into other parts of the country and across the borders of neighboring Uganda, Rwanda, and South Sudan, the health organization suggested…” (Guensburg et al., 5/10).

Additional coverage of the DRC Ebola outbreak and containment efforts is available from Agence France-Presse, Al Jazeera, CIDRAP News, Financial Times, NPR, and Thomson Reuters Foundation.

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Multiple NGOs Suspend Operations In War-Torn Syria; Government Forces Attack Hospital In Alleged Misuse Of U.N.-Supplied Coordinates

Al Jazeera: Syria’s war: NGOs suspend aid to embattled Idlib province
“U.N.-linked aid groups have suspended activities in parts of violence-plagued northwestern Syria, where escalating bombardments by the government and Russia are jeopardizing the safety of humanitarian workers…” (5/11).

Fox News: Syrian hospitals bombed by Assad, Russian troops after coordinates were shared with the U.N.
“Over the past two weeks, Syrian and Russian warplanes have hammered the last remaining rebel-held bastion in the country’s north — killing dozens and prompting almost 200,000 people to flee. Not only is the renewed offensive raising red flags that a final showdown might be underway in the long-running civil war, but that government forces may have misused data provided to them by the United Nations to gain an advantage and target hospitals…” (McKay, 5/11).

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News Outlets Examine Challenges, Setbacks In Efforts To Eliminate Polio From Pakistan

The Telegraph: Arson, panic and anti-vaxxers: The vaccination scare which threatens the global war on polio
“…The hysteria of April 22 [– when a mob ransacked and burned a clinic in Pakistan over rumors about polio vaccine –] marked a worrying setback for a campaign which had been on the cusp of eradicating what was once a worldwide scourge, but has faltered. … [A]fter years of declining cases, 2018 saw an increase and monitors last year admitted the final global push for eradication appeared to have stalled. With 13 cases now detected so far in Pakistan this year, the 2019 tally in that country has already surpassed last year…” (Farmer, 5/10).

Washington Post: Pakistan had all but eliminated polio. Then things went badly wrong.
“…Since [April 22], the anti-polio drive has been suspended until July while officials scramble to regroup. Half a dozen vaccinators or their guards have been killed, and new cases of children with numb or paralyzed limbs are being reported every week, setting back years of effort to eliminate the virus, health workers say…” (Khan/Constable, 5/10).

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Taliban Attack On Aid Groups Working In Afghanistan Deadliest Among In-Country NGOs In More Than 1 Year

New York Times: Taliban Train Sights on Aid Groups, an Ominous Turn in Afghanistan
“A Taliban attack on two aid organizations last week, the deadliest episode in a recent surge of violence against humanitarian workers in Afghanistan, is a signal to many that as peace talks falter, the insurgents are lashing out against so-called soft targets. Wednesday’s attack killed three workers for CARE, the American aid group, and at least six others, most of them civilians. Aid workers said the true death toll was 13. In either case, it was the single biggest loss of life among the country’s 2,000 nongovernmental organizations in more than a year…” (Nordland, 5/13).

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WHO Establishes Global Multidisciplinary Technical Group On Digital Health

Becker’s Hospital Review: WHO recruits digital health experts for new department
“The World Health Organization has established a new Digital Health Department to advise the United Nations agency on and steer the development of technology initiatives in health care, WHO announced on May 10…” (Park, 5/10).

Health Policy Watch: WHO is establishing technical advisory group and roster of experts on digital health
“…WHO’s newly established Digital Health Department will work to harness the power of digital health technologies and steer developments to contribute to the attainment of all people to the highest level of health through the General Programme of Work (GPW13) triple billion goals and Sustainable Development Goal 3 (Ensure healthy lives and promote well-being for all at all ages)…” (5/10).

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More News In Global Health

Al Jazeera: Deadly cholera outbreak hits African migrants in Yemen (Ndukwe, 5/13).

Health Policy Watch: WHA 2019 Top Issues: Budget, UHC, Access To Medicines, Emergencies, Environment (New, 5/9).

Health Policy Watch: Global Fund Panel Stresses Strengthening Health Systems, Community Engagement Vital To Delivering UHC (Schlesinger, 5/8).

VOA News: Officials Probe Alarming HIV Outbreak in Southern Pakistan (Gul, 5/11).

VOA News: Medical Teams in Rohingya Camps Adapt to Prolonged Crisis (Grunebaum, 5/10).

Xinhua News: New technology enables large-scale production of artemisinin for malaria (5/13).

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Editorials and Opinions

BARDA Ready To Help Build New, Sustainable Business Models For Antibiotics Market Vital To Global Health Security

Forbes: Building New Models To Support The Ailing Antibiotics Market
Rick Bright, director of BARDA, a component of the Office of the Assistant Secretary for Preparedness and Response at the U.S. Department of Health and Human Services

“…[C]hallenges sustaining a robust enterprise to address the growing threat of antibiotic resistance remain. … [L]arge pharmaceutical companies continue to withdraw from the antibiotic R&D space in favor of more profitable disease areas. … [T]he capital to acquire assets is available, but antibiotics are not a priority. … Now is the time to build new business models and novel partnerships that foster a robust end-to-end enterprise, making critically needed antimicrobials available to patients. … BARDA … will focus on bold ideas and new partnerships, utilizing its unique authorities to stimulate innovation, streamline R&D, and successfully commercialize critically needed antibiotics. Thereby, ensuring greater health security for our nation. In addition, the biotech and pharmaceutical industry must join in pursuing better, sustainable business models for antimicrobials. BARDA is ready to lead and join others. Now is the time for real change” (5/10).

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Taiwan Should Be Allowed To Participate In Upcoming WHA

The Hill: Taiwan’s ability to share health care advances stymied by exclusion from WHO
Stanley Kao, representative of the Taipei Economic and Cultural Representative Office in the United States

“…As Taiwan’s Minister of Health and Welfare Chen Shih-chung stated in a recent interview: ‘Taiwan’s expertise in disease control and universal health coverage can strengthen global medical development, and the nation is willing and able to share its experiences.’ What better place to achieve this goal than at the upcoming 72nd [World Health Assembly (WHA)] in Geneva from May 20 to 28? However, due to China’s political meddling in what should be a basic human right — access to affordable health care for all the world’s citizens — Taiwan and its input and expertise have been excluded from the annual WHA gathering since 2017. … Meaningful participation in the WHO will allow Taiwan to fully contribute its abundant medical experiences. … Taiwan has already clearly demonstrated its role as a responsible health care stakeholder in the global community, despite China’s efforts to exclude Taiwan from international participation. It is therefore time for Taiwan to be again accorded a seat at the table at the annual WHA…” (5/10).

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Violence, Rumors, Mistrust Pose Challenges To Eliminating Polio

Washington Post: The world is close to conquering polio. Humans are holding us back.
Editorial Board

“A simple fact: The main obstacle to a world free of polio is not science, biology, or virology. Rather, it is guns, fear, and fake news. … To defeat the polio virus, the world must also defeat human behavior of the worst sort. … The most recent and glaring example of this came in shootings and panic that rocked the polio vaccination campaign in Pakistan, one of only three countries where polio is endemic. … All the incidents have a knock-on effect, causing delays and suspensions in the vaccination campaign, which in turn leads to swathes of population not being inoculated, making them vulnerable to infection. The trouble is not only gunmen. Social media easily spreads alarmist and false rumors about vaccinations. … Nowadays, vaccinations are a critical firewall against illness caused by polio, measles, and Ebola. But vaccines only work if people are inoculated — and they won’t be if frightened by false information on social media or gunmen on a motorcycle” (5/10).

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Poor Governance, Violence, Breakdown Of Public Services Led Venezuela Into Public Health Crisis

The Conversation: Venezuela’s soaring murder rate has plunged the nation into a public health crisis
José Manuel Aburto, PhD candidate at the Interdisciplinary Center on Population Dynamics at the University of Southern Denmark, and Jenny Garcia, PhD candidate at the Institut National d’Études Démographiques (INED)

“Over the past three decades, Venezuela has shifted from being a peaceful country to one of the most violent nations in the world. Decades of poor governance have driven what was once one of Latin America’s most prosperous countries to economic and political ruin. The violent confrontations between anti-government demonstrators and forces loyal to president Nicolás Maduro in recent days, alongside the systemic breakdown of public services, have plunged Venezuela’s population into a public health crisis. … Venezuela’s future does not look promising. Outbreaks of political violence have intensified recently … What’s more, severe shortages of food and medical supplies, and the total collapse of the public health system, have left Venezuelans unable to feed their families or access … basic health care. Infant and maternal mortality has increased again, and infectious and parasitic diseases, such as malaria, measles, and diphtheria, have re-emerged. The acute impacts of political and socioeconomic disintegration on mortality rates since 2013 … have yet to be measured. Public institutions in Venezuela have been forced to follow a strict policy of secrecy, and mortality and health data sources have not been updated, nor made publicly available since 2013. The stagnation in life expectancy found up to that year is likely to turn to decline, as this humanitarian crisis worsens” (5/10).

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From the Global Health Policy Community

FT Health Discusses Global Trends In Alcohol Use, Features Interview With Netherlands' Foreign Trade, Development Cooperation Minister

FT Health: Alcohol use jumps as battle against booze falters
The latest issue of the Financial Times’ weekly global health newsletter discusses global trends in alcohol consumption and the health risks it poses, as well as features an interview with Sigrid Kaag, minister for foreign trade and development cooperation in the Netherlands, who discusses the country’s health priorities. The newsletter also provides a roundup of global health-related news stories (Dodd/Jack, 5/10).

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Number Of People Living In Internal Displacement Worldwide At Highest Ever, New IDMC Report Says

Internal Displacement Monitoring Centre: More People Displaced Inside Their Own Countries Than Ever Before
“A record 41.3 million people are displaced inside their own countries because of conflict and violence, according to a new report by the Internal Displacement Monitoring Centre (IDMC) of the Norwegian Refugee Council (NRC). The number of people living in internal displacement worldwide as of the end of 2018 is the highest it has ever been, according to the Global Report on Internal Displacement, launched [Friday] at the United Nations in Geneva. This is an increase of more than a million since the end of 2017 and two-thirds more than the global number of refugees…” (5/10).

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From the U.S. Government

USAID, Defense Department Release Statements On New U.S. Global Health Security Strategy

USAID: USAID Administrator Mark Green on the launch of the U.S. Global Health Security Strategy
In this statement, USAID Administrator Mark Green says, “The increase in the number of infectious diseases outbreaks (e.g., Ebola, Zika, and yellow fever) around the world and the risk posed by an accidental or deliberate release of dangerous pathogens highlight the need for a sustained, multi-sectoral, and coordinated United States response. U.S. Agency for International Development (USAID) is proud to be working with more than ten other Federal Departments and agencies in this critically important effort…” (5/9).

U.S. Department of Defense: DOD Joins National Global Health Security Effort
“…Together with the National Security Strategy, National Biodefense Strategy, and Executive Order on ‘Advancing the Global Health Agenda to Achieve a World Safe and Secure from Infectious Disease Threats,’ the Global Health Security Strategy guides the federal government in protecting the United States and its partners abroad from infectious disease threats by working with other nations, international organizations, and nongovernmental stakeholders. ‘The Department of Defense is pleased to be a part of the U.S. government’s strong commitment to global health security and the global health security agenda,’ said Lt. Col. Carla Gleason, defense spokeswoman…” (5/9).

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