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Kaiser Daily Global Health Policy Report

In The News

U.K. Prime Minister Aims 'To Save' Post-2015 Development Goals Document, Guardian Reports

“As he prepares to co-chair a session of the U.N. High-Level Panel on aid in New York on Tuesday,” U.K. Prime Minister David Cameron “is to launch an 11th-hour bid to save a major U.N. report on the future of international development amid fears among aid groups that it … [may] lose sight of its original goals,” The Guardian reports. “Speaking ahead of the meeting, Cameron said: ‘It is coming to the end of its work. I hope it is going to be a good piece of work. But I need to be there in order to nail down some simple clear commitments that everyone can get behind as we look to the successors to the Millennium Development Goals [MDGs],'” the newspaper writes, noting Cameron co-chairs the panel with the presidents of Liberia and Indonesia.

“Aid agencies have warned that a report being drawn up on behalf of Cameron and his two fellow co-chairs has been stripped of some of its main goals,” The Guardian writes. According to the newspaper, “a first draft of the report made no mention of Cameron’s aim of eradicating child death and hunger by 2030 and eradicating extreme poverty by the same year.” The Guardian continues, “The absence of a reference to ‘zero’ goals is important because aid agencies believe it is important not to lose momentum towards achieving some MDGs which will be missed in 2015 but where progress has been made. These are in the area of access to education, access to health and sanitation and child mortality” (Watt, 5/14).

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Sanitation MDG Will Not Be Met At Current Rate Of Progress, U.N. Report Says

“While international targets on clean drinking water were met nearly three years ago, a joint United Nations agency report [on Monday warned] that without a major funding push, some 2.4 billion people — one-third of the world’s population — will remain without access to improved sanitation in 2015,” the U.N. News Centre reports. Compiled by the WHO and UNICEF’s Joint Monitoring Program for Water Supply and Sanitation, the report (.pdf), titled “Progress on sanitation and drinking-water 2013 update,” “warns that, at the current rate of progress, the 2015 Millennium Development Goal (MDG) target of halving the proportion of the 1990 population without sanitation will be missed by eight percent — or half a billion people,” the news service writes (5/13).

“Bruce Gordon, the acting coordinator for water, sanitation and health at the [WHO], said Monday’s report was published as a wake-up call,” VOA News states, adding, “Gordon said the impact of poor sanitation has major impacts on global health, education, and economies.” Gordon said, “A big, huge benefit for us is health. We have 1.5 million people dying every year because of inadequate sanitation or lack of access to safe water or proper hygiene,” the news service reports, noting “Gordon cited the most problematic regions by far as being Asia and sub-Saharan Africa” (Hennessy, 5/13). “The report echoes the urgent call to action by United Nations Deputy Secretary-General Jan Eliasson for the world community to combine efforts and end open defecation by 2025,” a WHO press release states, adding, “With less than three years to go to reach the MDG deadline, WHO and UNICEF call for a final push to meet the sanitation target” (5/13).

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Four Intestinal Microbes Responsible For Nearly Half Of All Childhood Diarrhea Cases, Study Shows

“Four intestinal bugs are responsible for nearly half of all cases of childhood diarrhea, which kills about 800,000 children around the world each year,” according to the findings of “a three-year project designed to give researchers and public health officials a clearer picture of a condition responsible for about 10 percent of deaths of children under age five,” the Washington Post reports. “The leading cause — rotavirus, responsible for about 20 percent of cases — can be prevented by a vaccine that is only now starting to be used in developing countries,” the newspaper writes (Brown, 5/13). The Global Enteric Multicenter Study (GEMS), coordinated by the University of Maryland School of Medicine’s Center for Vaccine Development and published Monday in The Lancet, “is the largest study ever conducted on diarrheal diseases in developing countries, enrolling more than 20,000 children from seven sites across Asia and Africa,” a University of Maryland School of Medicine Center for Vaccine Development press release states (5/13).

“In addition to mapping the microbial causes, the study looked at the consequences of diarrhea in young children,” finding “[a]bout two percent of children with ‘moderate-to-severe’ cases died in the three months after they became ill,” the Washington Post adds (5/13). “[U]ntil now, there’s been very little reliable data on the microbes behind all this mortality, as well as their precise effects on children’s health around the world,” Science magazine’s “Science Shots” blog notes (Wade, 5/13). The Lancet provides an infographic (.pdf) depicting data from the report (5/13).

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Afghan Taliban Ends Ban On Polio Vaccination In Country

The Taliban leadership in Afghanistan “has ended its war on polio vaccination workers and admitted immunization is the only way to protect children from the disease, its leadership said in a statement” issued on Monday, The Telegraph reports (Babakarkhail, 5/13). “Taliban spokesman, Zabiullah Mujahid, released a statement extolling the virtues of polio vaccinations, urging Taliban commanders to support the efforts of international organizations working to eradicate the disease,” the New York Times writes, adding, “While that has been the Taliban leadership’s position for some time, aid groups welcomed the commitment, particularly given the Pakistani Taliban’s campaign against polio workers next door” (Ahmed, 5/13). “The statement released by the Islamic Emirate of Afghanistan warns aid groups against employing foreign workers in its strongholds, and underscored the importance of the campaign’s respect of ‘Islamic values and local cultural traditions,'” Devex notes (Ravelo, 5/14). “The announcement comes just weeks after the Afghan government launched a new campaign to immunize more than eight million children between six months and five years old throughout the country,” The Telegraph adds (5/13).

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Health Officials Continue To Monitor 2 New Respiratory Virus Outbreaks

“Two respiratory viruses in different parts of the world have captured the attention of global health officials — a novel coronavirus [NCoV] in the Middle East and a new bird flu spreading in China,” the Associated Press reports. The “WHO, which is closely monitoring the viruses, says both have the potential to cause a pandemic … if they evolve into a form easily spread between people,” the news agency writes. “Since it was first spotted last year, the new coronavirus has infected 34 people, killing 18 of them,” the AP adds, noting, “Nearly all had some connection to the Middle East” (Cheng, 5/13). In China, 130 people have been infected with the new H7N9 bird flu strain, and 35 of those have died of the disease, according to Chinese state media, Reuters reports.

“Chinese scientists say the [flu] virus has been transmitted to humans from chickens, though the [WHO] says 40 percent of people infected with H7N9 had no contact with poultry,” the news agency notes (Koh, 5/13). In France, where two cases of NCoV have been confirmed, researchers “suspect the virus might have jumped to humans from bats, since it is similar to a bat virus, but other animals are being looked at,” the New York Times writes. “Cases have been reported in Britain and Germany, but most of those with the virus had traveled to Saudi Arabia, other Persian Gulf nations, Jordan or Pakistan,” the newspaper notes, adding, “Saudi Arabia has said the country has had 24 confirmed cases since summer, with 15 deaths” (Erlanger, 5/13).

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U.N. Report Says Edible Insects May Help Combat Global Hunger, Malnutrition, Air Pollution

“The United Nations says eating insects may combat global hunger and boost health worldwide by reducing malnutrition and even air pollution,” the Associated Press/CBS News reports. In a 200-page report (.pdf) released Monday at a news conference in Rome, the U.N.’s Food and Agriculture Organization (FAO) said “that grasshoppers, ants and other members of the insect world are an underutilized food for people, livestock and pets,” the news service adds (5/13). “The authors of the study by the Forestry Department, part of the [FAO], said many insects contained the same amount of protein and minerals as meat and more healthy fats doctors recommend in balanced diets,” Reuters notes (Hornby, 5/13).

“The case for houseflies — or other insects like crickets, beetles, bees, wasps, caterpillars, grasshoppers, termites and ants — becoming a major industrial food source is being taken seriously by governments, says the report, because they grow exceptionally fast and thrive on the waste of many industrial processes,” The Guardian writes (Vidal, 5/13). According to the report, “[F]arming insects for human and animal consumption is particularly relevant at a time when population growth, urbanization, and the rising middle class have increased the demand for food while simultaneously harming the environment that enables its production,” the U.N. News Centre notes (5/13). The report “notes that over two billion people worldwide already supplement their diet with insects,” according to BBC News, which adds, “However it admits that ‘consumer disgust’ remains a large barrier in many Western countries” (5/13).

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Somalia Reports First Wild Poliovirus Case Since 2007

Somalia has recorded its first wild poliovirus case since 2007, the WHO announced on May 11, Nature’s “News Blog” reports. “Genetic testing to determine the virus’s origin is underway and should be complete this week, according to a WHO representative,” the blog writes. Polio immunization campaigns have not taken place in some parts of Somalia because of conflict, the blog notes, adding the country plans to vaccinate 350,000 children in one region beginning May 14 and a nationwide campaign is being discussed, according to the WHO (Callaway, 5/13).

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Editorials and Opinions

U.S. Must Make New Commitment To Help Eradicate Polio

“Last month the U.S. government stood on the sidelines as much of the world united for the final push to eradicate polio,” David Oshinsky, a Pulitzer Prize-winning author and director of the Division of Medical Humanities at the NYU-Langone Medical Center, writes in a Roll Call opinion piece. “At the Global Vaccine Summit on April 25 in Abu Dhabi, world leaders committed $4 billion to the global effort to end this devastating disease,” he writes, adding, “Together they are investing in a new plan to get us to the finish line and achieve a polio-free world by 2018.” But “one important piece of the puzzle is currently missing: the United States,” he continues, noting, “The absence of a new commitment from the U.S. government is troubling and surprising, given our tradition of leading the polio eradication effort.”

“Now, Congress has a chance to put us back on track,” Oshinsky continues, adding, “Despite new commitments from around the world, including major multi-year commitments from several countries, the present plan still faces a $1.5 billion funding gap that dramatically compromises its chances of success.” He writes, “The U.S. government must now step up, as it has so generously in the past, by making a multi-year commitment to polio eradication in the same way it has for other critical global health priorities, including the GAVI Alliance for children’s vaccines and the Global Fund to Fight AIDS, Tuberculosis and Malaria.” He states, “In these times of budget austerity, it is more important than ever for Congress to prioritize polio and go beyond the president’s proposal,” concluding, “Congress and the American people have always been on the front lines of this struggle. We must continue our commitment until the job is done” (5/14).

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Opinion Pieces Address Post-2015 Development Agenda

The U.N. High-Level Panel on Post-2015 Development is set to meet this week to advise on the global development framework beyond 2015, the target date for the Millennium Development Goals (MDGs). The following opinion pieces discuss issues surrounding global development.

  • Paul Polman, The Guardian: “I believe that the post-2015 agenda should be built on the big social targets like hunger, water, health and education, which were set out in the original [MDGs],” Polman, CEO of the multinational food and detergent company Unilever, writes, adding, “With some 1,000 days left to make a difference, we should of course do everything in our power to ensure that as many of these goals are met by the original deadline of 2015.” However, “the post-2015 agenda needs to be different from its predecessor” in four ways, he continues. “First, it should recognize the best way of bringing people out of poverty is through economic development”; “Second, the post-2015 agenda must ensure that the gains made on poverty eradication are irreversible”; “Third, the post-2015 development agenda should recognize that eradicating poverty is difficult to achieve in the absence of functioning institutions”; “Last, the post-2015 agenda should consciously tackle the question of inequality,” he writes, expanding on each point. He adds, “Never has there been so much energy for tackling these challenges from members of all sectors or so much clarity about what needs to be done” (5/13).
  • Naila Kabeer and Jessica Woodroffe, The Guardian: “The lack of focus on inequality was a key limitation of the MDGs and, rightly, this has become a major priority for the post-2015 agenda,” Kabeer, a professor of development studies at the School of Oriental and African Studies in London, and Woodroffe, director of the Gender and Development Network, write. “Any new framework that fails to include gender as a distinct goal would significantly backtrack on previous commitments, sending a clear and dangerous signal that the issue is no longer a political priority,” they write. “The goal should: reflect the priorities of marginalized women and girls; address the structural causes of gender inequality; be accepted and acted upon by national governments and the international community; and address issues that cannot, or should not, be placed under other goals,” they state, adding, “The MDGs taught us that, without addressing the underlying structural causes of gender inequality, progress is likely to be uneven and prone to reversals” (5/14).

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To Prevent Famines, International Community Must Recognize Role Of Markets

“One of the major lessons in agricultural development over the past decade is this: markets matter,” Roger Thurow, a senior fellow at the Chicago Council on Global Affairs, writes in the Huffington Post’s “Impact” blog as part of a series marking the occasion of the council’s annual Global Food Security Symposium in Washington, D.C. He recollects the Ethiopian famine of 2003, “when international food aid rushed in to feed 14 million people,” noting the “famine tragically, and incomprehensibly, followed two years of bumper harvests in Ethiopia. The surplus production overwhelmed the country’s weak and inefficient markets. … Then the drought hit, and feast turned to famine. The markets had failed before the weather did.” However, “[i]n the past decade, science and research geared toward improving the work of smallholder farmers (who produce the majority of the food grown in the developing world) have been reinvigorated; so too have trade and business efforts accelerated to provide greater market incentives and opportunities for the farmers.”

“Prior to 2003, boosting agricultural production — growing more food — was the primary focus and developing markets was considered to be a ‘second-generation problem.’ Now, markets share top billing with production, as it should; markets provide incentive to produce more,” Thurow continues. He highlights Sidama Elto, “one of 16 cooperative unions in Ethiopia that have signed forward contracts with the [World Food Programme (WFP)] for the purchase of more than 28,000 metric tons of maize grown by their smallholder farmer members,” noting the program, implemented with the help of the Agricultural Transformation Agency (ATA), is part of the Purchase for Progress (P4P) program, “which uses the WFP’s purchasing power to create markets for smallholder farmers.” He states, “These public-private ventures bring both maturity and modernization to markets that hadn’t changed much for centuries,” adding, “Above all, says Khalid Bomba, the chief executive officer of ATA, ‘Smallholder farmers need confidence that there will be buyers for what they grow'” (5/13).

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From the Global Health Policy Community

GAO Reports Recommend Better Data Collection Practices For PEPFAR

The U.S. Government Accountability Office (GAO) recently published two reports on PEPFAR. “As PEPFAR partner countries assume greater responsibility for managing their treatment programs, fully functioning monitoring and evaluation (M&E) systems are critical for tracking results and ensuring treatment program effectiveness,” one report notes, according to the summary. The report recommends “[t]he Secretary of State should direct [the Office of the Global AIDS Coordinator (OGAC)] to (1) develop a method that better accounts for PEPFAR’s contributions to partner-country treatment programs, (2) establish a common set of indicators to measure the results of treatment program quality improvement efforts, and (3) establish a set of minimum standards for data generated by partner countries’ M&E systems,” the summary states (4/12). A second report found that “[u]sing an OGAC-developed budgetary formula, PEPFAR has met the legislative requirement that more than half of its funds be spent each year to provide specific treatment and care services for people living with HIV,” and “recommends that State develop a plan for (1) expanding the use of in-depth cost studies to additional countries and sites, where appropriate, and (2) broadening expenditure analysis to include non-PEPFAR costs, as feasible. State generally agreed with the report’s recommendations,” according to the summary (3/15).

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Local Leaders Report Positive Changes In How U.S. Government Invests Its Aid

“Oxfam is hearing that local leaders are starting to give the U.S. government better marks for how the U.S. invests its aid,” Gregory Adams, director of aid effectiveness at Oxfam, writes in the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog, noting Oxfam “conducted extensive field interviews with citizens, civil society representatives, businesspeople and public officials in Bangladesh, Ghana, Malawi, Peru, the Philippines, Rwanda, and Senegal to find out” whether “changes in U.S. government development policies in Washington changed practice on the ground.” He continues, “For too long the aid that the U.S. government provided was not a useful tool for local leaders,” but “over the past few years, … a number of U.S. policymakers and political leaders have increasingly tried to reorient U.S. development policies and programs to make them more responsive to and useful to local partners.” He highlights “a range of policies designed to support and leverage the leadership of local partners,” and writes, “The fight now is not only to ensure that these reforms prevail politically in Washington, but also to help improve their implementation and accelerate their progress, in order to restore the United States’ historic role as a global development leader” (5/13).

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Examining The Need For Ambitious Yet Feasible Targets For Post-2015 Development Agenda

Noting “[t]here are about 1,000 days to go before the deadline to achieve the current Millennium Development Goals (MDGs) expires in December 2015,” Mark Suzman, managing director for international policy, programs and advocacy at the Bill & Melinda Gates Foundation, writes in the foundation’s “Impatient Optimists” blog, “I see two threads in the post-2015 discussions that could diffuse the power of the MDGs.” He continues, “One is the push to dramatically expand the MDG agenda, which threatens consensus and dilutes the focus on a limited set of joint priorities. The other is a call for visionary goals and targets like ‘ending all preventable deaths,’ which, while laudable, have no hope of achievement by 2030.” He notes, “At the recent high-level consultation on health and the post-2015 agenda in Botswana, I argued that we should set ambitious, but technically feasible targets for post-2015 health outcomes,” and he provides examples (5/13).

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